Objective To study the value of plasma D-dimer ＜ 500 μg/L level in diagnosis of pulmonary thromboembolism occurred in patients.Methods The clinical data of the patients with pulmonary embolism confirmed by imaging examination with plasma D-dimer levels ＜ 500 μg/L admitted from January 1st 2008 to June 30th 2011 were analyzed retrospectively.Results Totally,there were ten pulmonary embolism patients with plasma D-dimer levels ＜ 500 μg/L.The 10 eligible patients were assessed for the possibility of pulmonary embolism by using the Wells score (i.e.Wells clinical pretest probability prediction model).Of them,0 cases was evaluated as low clinical pretest probability (grade ＜2),7 cases as moderate clinical pretest probability (grade 2 ～6) and 3 cases as high clinical pretest probability (grade ＞ 6).Conclusions Pulmonary thromboembolism was easily misdiagnosed for lacking specific clinical manifestations and the missed diagnosis in patients caused high mortality,so it was difficult to exclude acute pulmonary embolism simply depending on the D-dimer levels ＜ 500 μg/L.Therefore,in case of plasma D-dimer levels less than 500 μ g/L,the possibility of pulmonary embolism cannot be ruled out in patients with moderate or high Wells clinical pretest probability.

Objective:To develop a simple culture and purifying method for rat dental follicle cells.Methods:The upper and lower first and second intact molar germs of SD rat were separated. Then, dental follicle and enamel organ were stripped together, minced into little pieces, digested with collagenase and cultured. Dental follicular cells were purified by differential passage and indentified by immunohistochemical staining of vimentin and cytokeratin. Results:The primary cells were mixed, consisting of dental follicle cells and enamel organ cells. After differential passage, the cells of fourth passage became purified dental follicle cells. Purified dental follicle cells were elongated spindle or triangle in shape, positive for vimentin and negative for cytokeratin.Conclusion:Dental follicle cells can be purified by several differential passages from the mixed primarily cultured cells.

Objective To evaluate the efficacy of servo controlled sevoflurane closed-circuit anesthesia and the feasibility of the predictive and intelligent control.Methods One hundred and forty-three ASA Ⅰ-Ⅲ patients (90 males, 53 females) aged between 3-77 yrs undergoing elective surgery were studied. Anesthesia was induced with intravenous fentanyl 2-3 ?g ?kg-1 , midazolam 0.12 mg?kg-1 and vecuronium 0.1 mg?kg-1 . After tracheal intubation the tracheal tube was connected to the servo-controlled closed-circuit system composed of IBM computer, O2 mass flow controller and electrically controlled sevoflurane injection pump and multifunctional monitor. The fresh gas flow of O2 = [body weight (kg)3/4 ? 10 + 20] ml?min-1 . The end-expired sevoflurane concentration was maintained at 1.3 MAC by predictive and intelligent control.Results The average wash-in time to reach the target concentration was (5.2 ?2.4) min. The O2 flow rate was(0.22?0.04) L?min-1 . The cumulative uptake of sevoflurane was 5.16 ml, 7.74ml, 9.17ml, 11.08ml, 12.57ml, 13.00ml, 14.18ml, 15.60ml, 18.56ml and 24.6 ml at 30, 60, 90, 120, 150, 180, 210, 240, 300 and 420 min respectively. The uptake rate of fluid sevoflurane was equivalent to (0.2673e-0.0598t + 0.2269e-0.0597t + 0.1150e-0.002t) ml?min-1 . Conclusion The servo controlled sevoflurane closed-circuit system can effectively control the pre-set end-tidal sevoflurane concentration in spite of the influence of multiple factors and is safe and effective.

Animals ; Animals, Newborn ; Cells, Cultured ; Fibroblasts ; cytology ; metabolism ; Matrix Metalloproteinase 1 ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Myocardium ; cytology ; metabolism ; Oligopeptides ; physiology ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; pharmacology

Objective To investigate the expressions and significance of transforming growth factor-beta 1(TGF?1) and its typeⅡ receptor(TGF?RⅡ) in experimental rat ascending aortic aneurysm of rat model.Methods The rat ascending aortic aneurysm models were made by banding ascending aorta of young Wistar rats.The ascending aortas were taken 4 months after operation.Immunohistochemistry staining and Western blotting were used to investigate the expressions of TGF?1 and TGF?RⅡ.Result Immunohistochemistry staining results showed that TGF?1 expressed in all layers of the aortic aneurysm and the control.TGF?RⅡ was extensively located in the hyperplastic intima and tunica media smooth muscle cells in the aortic aneurysm,while there was only a little positive staining in the control group.Western blotting results indicated that the expression levels of TGF?1 and TGF?RⅡ in the aortic aneurysm were stronger than the control,P

BACKGROUND: Sleep deprivation cannot only cause learning and memory impairment of animal and human, but also lead to increased content of nitric oxide in brain tissue of rats. Melatonin has the effects of antifreeradical and antioxidation. It has been reported that melatonin can improve aluminum chloride and morphine abstinence induced learning and memory impairment of animal, however, whether it has influence on sleep deprivation induced learning and memory impairment is not very clear. OBJECTIVE: To observe the effect of melatonin on memory of rats after sleep deprivation and analyze its possible mechanism. DESIGN: Randomized controlled trial.SETTING: Teaching and Experiment Center of Basic Medicine and Department of Nursing, the Fourth Military Medical University.MATERIALS: The experiment was performed in Teaching and Experiment Center of Basic Medicine of the Fourth Military Medical University in January 2005. A total of 24 adult male Sprague Dawley rats were selected and randomly divided into 3 groups, namely, control group, small dosage of melatonin group and large dosage of melatonin group, with 8 in each group on the basis of random digits table.METHODS: To rats in small dosage of melatonin group and large dosage of melatonin group, the dosage of melatonin was 5 mg/kg and 15 mg/kg respectively, which was made into 2 mL solution and intraperitoneally injected into the rats at 17:00 o'clock every day, while rats in control group were injected with 2 mL physiological sodium at the same time, once a day for continuous 7 days. Then a 3-day sleep deprivation was given to the rats; melatonin or physiological sodium were also given according to different groups during these days. Rat model of sleep deprivation was established by "Flower Ppot" technique; water maze was used for detecting the memory of rats after 48-hour and 72-hour sleep deprivation; took escape latency (s) as indicator of changes of learning and memory of rats; the shorter the escape latency, the better the spacial memory of rats. When sleep deprivation was finished, all the rats were put to death and hippocampus and cerebral cortex were taken out in ice bath. The content of nitric oxide in cerebral cortex and hippocampus was detected with the method of nitrate reduction, and malondialdehyde (MDA) with the method of thiobarbital acid.MAIN OUTCOME MEASURES: Results of escape latency after 48hour and 72-hour sleep deprivation. Contents of nitric oxide and MDA in cerebral cortex and hippocampus of rats.There was significant difference in escape latency in water maze after 48-hour and 72-hour sleep deprivation among each group (F=11.886, P=0.000)and (F=5.440, P=0.012); the escape latency after 48-hour and 72-hour sleep deprivation remarkably decreased both in small and large dosage of melatonin groups as compared with control group, and the latency after 48-hour sleep deprivation was shorter in large dosage group than that in small ide and MDA in brain of rats among each group, namely, nitric oxide in cerebral cortex (F=14.038, P=0.000), MDA in cerebral cortex (F=27.414,P=0.000), nitric oxide in hippocampus (F=22.692, P=0.000), MDA in hippocampus (F=14.316, P=0.000). Compared with control group, the contents of nitric oxide and MDA in cerebral cortex and hippocampus in the two experimental groups decreased significantly, and there was obvious difference in the content of nitric oxide in hippocampus between large and small dosage groups, which showed a dose-effect relationship.CONCLUSION: Melatonin can improve memory impairment of rats after sleep deprivation, which may be closely related to the effect of inhibiting the increase of nitric oxide and MDA in their cerebral cortex and hippocampus.

Adolescent ; Adult ; Drug Industry ; Hematologic Tests ; Humans ; Middle Aged ; Occupational Exposure ; Platinum Compounds ; blood ; Workplace ; Young Adult

Command of the JCI standard is conducive to promoting the "Patient-centered" quality management concept awareness and realizing the patient safety objective. To this end, a campaign to stage the hospital quality management system and bottom-up quality activities has been launched. These efforts may help improve the hospital quality management system, covering such aspects as standardized document management, human resource management, normalized diagnosis and therapy management centering on clinical path, clinical nursing service quality, safety management, equipment and facility management, as well as data analysis and quality improvement system. These have been subject to and certified by JCI with a gold medal.

Objective To retrospectively analyze the diagnostic value of a noninvasive score system based on transient elastography (TE),serological test and imaging examination on esophageal variceal bleeding (EVB) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between April 2011 and December 2012,172 patients with HBV-related cirrhosis including 120 males and 52 females who visited clinic or hospitalized at the Department of Hepatology,Tianjin Third Central Hospital,were retrospectively enrolled.The mean age was (52.9 ± 10.6) years.Patients underwent upper gastrointestinal endoscopy to evaluate esophageal varices (EV) and were further categorized into three stages of mild,moderate and severe according to the morphology of EV and the risk of bleeding.Liver stiffness and spleen stiffness measurement were performed using Fibroscan.Portal vein width,splenic width and spleen thickness were measured using color Doppler ultrasound.All the patients were tested for white blood cell counts and platelet counts.With endoscopy as the gold standard,receiver operating characteristic (ROC) curves and the areas under curves (AUC) were used to assess the performance of the noninvasive score system in predicting EV by liver stiffness,spleen stiffness,portal vein width,spleen thickness and platelet counts.Student's t-test was performed to determine differences between continuous variables.Pearson's correlation was used to evaluate the association between EVB and these parameters.Results All these 172 patients underwent endoscopy.Among them,41 were EVB patients and 131 with no bleeding of EV.Among 172 EV patients,39 without EV,30 were mild EV,47 were moderate EV and 56 were severe EV.EVB was all positively correlated with liver and spleen stiffness,portal vein width,spleen thickness,splenic vein width (r=0.224,0.771,0.214,0.425 and 0.364,respectively; all P＜0.05).EVB was negatively correlated with platelet counts (r=-0.408,P=0.000).Liver stiffness,spleen stiffness,portal vein width,spleen thickness and splenic vein width in EVB patients were significantly higher than those in EV patients (P＜0.05).In contrast,platelet counts level was lower in EVB patients with difference of statistical significance (P＜0.05).AUC of non-invasive score system for EV and EVB were 0.953 and 0.882,respectively (P＜0.05).The optimal cut-off level of noninvasive score system for prediction of EV and EBV were 7 (sensitivity:96 ％,specificity:85 ％) in EV patients and 10 (sensitivity:78％,specificity:89 ％) in EVB patients.Conclusion Non-invasive score system based on liver stiffness,spleen stiffness,spleen thickness,width of splenic and portal vein and platelet counts is of clinical importance in assessing the presence of EV in patients with HBV-related cirrhosis,which is higher clinically valuable in the diagnosis for EV.