Objective To systematically review the efficacy of dexmedetomidine or midazolam for sedation in critically ill patients. Methods We searched the PubMed, EMBaes, Cochrane Library, Wanfang Database,CNKI and VIP for all randomized controlled trials (RCTs) about the efficacy of dexmedetomidine versus midazolam for sedation in severe cases. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software. Results Six RCTs involving 613 patients were included in our Meta-analysis. The results of Meta-analysis showed that the length of ICU stay was significantly shorter in group dexmedetomidine than in group midazolam. There were no significant differences in the duration of mechanical ventilation, incidences of bradycardia, hypotension and delirium and mortality rate between the two groups. Conclusion Dexmedetomidin can shorten the length of ICU stay and is beneficial for the outcome in critically ill patients.

Objective:To prepare the monoclonal antibody(mAb) against human B7 1 and analyse its biological characteristics.Methods:The B lymphocytes hybridization technique was applied by using XG7 B7 cell,a multiple myeloma(MM) cell line transfected with human B7 1 gene,as immunogen;the specificity and the antigen binding activity of mAbs were identified by flow cytometry and Western blot analysis;its biological effects on human PBTC and human B lymphoma cell line were examined by 3H TdR incroporation and annexin V satining.Results:Four mouse anti human B7 1(B7 1) hybridoma(1F11,3H8,6H2,7B10) were obtained.They secrete continuosly and steadily specific anti human B7 1(B7 1) mAb and their subclasses belong to IgG1 and IgM respectively;three of four mAbs could inhibit the proliferation of response cells(the human peripheral blood T lymphocytes),stimulated by costimulatory molecule B7 1.Furthermore,it was found that these mAbs induced the apoptosis of human B lymphoma cell line,Raji,which express naturally human B7 1 molecule,by using annexin V staining analysis after 24 hours of mAb treatment.Conclusion:Sucessefully obtained four mouse anti human B7 1 functional monoclonal antibodies,which have a potential value in anti allogenetic graft rejection and in the therapeutic approach of B lymphoma.

Objective To evaluate the effects and safety of closed tracheal suction system(CTSS)versus open tracheal suction system (OTSS) for mechanically ventilated patients.Methods All randomized controlled trials (RCTs) comparing CTSS with OTSS for mechanically ventilated patients home and abroad were identified via manual and computer retrieval.All related data were extracted.Meta analysis was conducted using the statistical software RevMan 5.1 on the basis of strict quality evaluation with the methods recommended by the Cochrane Collaboration.Results Fifty-one related papers were found and 12 RCTs involving 1205 patients in CTSS group and 1179 patients in OTSS group were included.The results of meta analysis showed that CTSS was associated with a significant reduction in the duration of mechanical ventilation (WMD =-0.73,95％ CI-1.07--0.40,P＜0.0001),but the incidence of ventilator associated pneumonia and microbial colonization,mortality and length of ICU stay exhibited no difference between the two groups (P ＞ 0.05).However,compared with OTSS,CTSS reduced the incidence of arrhythmia (RR =0.23,95％ CI 0.07-0.74,P =0.01) and minimized the disturbance to heart rate (WMD =-1.97,95％ CI-3.03--0.91,P =0.0003),mean arterial pressure (WMD =-2.01,95％ CI-3.02--1.01,P ＜ 0.0001) and oxygen saturation (SpO2) (WMD =-1.00,95％ CI-1.14--0.86,P ＜ 0.000 01).Conclusions Compared with OTSS,CTSS could reduce disturbance to respiratory and circulatory system by sputum suction and shorten the duration of mechanical ventilation.However,CTSS has no advantage in prevention of ventilator associated pneumonia or microbial colonization,nor does it shorten the length of ICU stay or improve the outcome of mechanically ventilated patients.

Objective To investigate the clinical value of bile reinfusion combined with enteral nutrition before R0 resection of hilar cholangiocarcinoma.Methods The clinical data of 46 patients with hilar cholangiocarcinoma who underwent R0 resection at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2010 to January 2014 were analyzed retrospectively.The clinical data of 21 patients (the experimental group) who received bile reinfusion by preoperative percutaneous transhepatic cholangiography and drainage (PTCD) combined with enteral nutrition with nasojejunal tube were compared with 25 patients (the control group) who received neither PTCD nor enteral nutrition.The differences in the clinical indicators between the 2 groups were analyzed.Results In the experimental group,the levels of ALT,AKP,TBil and DBil decreased significantly after PTCD as compared with the original levels (t =4.433,4.547,5.648,4.681,P ＜ 0.05).The operation time and blood loss in the experimental group was reduced significantly when compared with the control group (t =-2.810,-2.047,P ＜ 0.05).The volume of postoperative albumin transfusion and the postoperative hospitalization in the experimental group was significantly reduced when compared with the control group (t =-3.083,t =-3.083,P ＜ 0.05).Conclusion Bile reinfusion combined with enteral nutrition facilitated the recovery of preoperative hepatic function in patients who underwent R0 resection of hilar cholangiocarcinoma,thus improving the safety of surgery and facilitated postoperative rehabilitation.

10.3969/j.issn.1000-3606.2013.06.020

Objective To investigate the feasibility of the simultaneous measurement of right ventricular pressure-volume loops by cardiac catheterization and 2D electrocardiogram. Methods Patients referred for pulmonary hypertension underwent right heart catheterization in our hospital between June 1st, 2015 and June 1st, 2017 are to be enrolled in this study. The right ventricular volume was measured simultaneously by catheter and electrocardiogram. The pressure-volume loops were constructed by the parameters of the pressure and volume in the same cardiac cycle. Results The study completed in four cases and their pressure-volume loops were drawn. The obtained images were irregular and there was no relationship among them. As a result, the construction was a failure. Conclusions The construction of the right ventricular pressure-volume loops of pulmonary hypertension patients by simultaneous catheterization and 2D electrocardiogram is difficult to overcome the technology defects.

Spinal biomechanics, especially the range of spine motion,has close connection with spinal surgery. The change of the range of motion (ROM) is an important indicator of diseases and injuries of spine, and the essential evaluating standards of effect of surgeries and therapies to spine. The analysis of ROM can be dated to the time of the invention of X-ray and even that before it. With the development of science and technology as well as the optimization of various types of calculation methods, diverse measuring methods have emerged, from imaging methods to non-imaging methods, from two-dimensional to three-dimensional, from measuring directly on the X-ray films to calculating automatically by computer. Analysis of ROM has made great progress, but there are some older methods cannot meet the needs of the times and disappear, some classical methods such as X-ray still have vitality. Combining different methods, three dimensions and more vivo spine research are the trend of analysis of ROM. And more and more researchers began to focus on vivo spine research. In this paper, the advantages and disadvantages of the methods utilized recently are presented through viewing recent literatures, providing reference and help for the movement analysis of spine.
Animals ; Humans ; Imaging, Three-Dimensional ; instrumentation ; methods ; trends ; Radiography ; Spine ; diagnostic imaging

To establish and manage of multicentral collection bio-sample banks of malignant tumors from digestive system, the paper designed a multicentral management system, established the standard operation procedures (SOPs) and leaded ten hospitals nationwide to collect tumor samples. The biobank has been established for half a year, and has collected 695 samples from patients with digestive system malignant tumor. The clinical data is full and complete, labeled in a unified way and classified to be managed. The clinical and molecular biology researches were based on the biobank, and obtained achievements. The biobank provides a research platform for malignant tumor of digestive system from different regions and of different types.
Biological Specimen Banks ; organization & administration ; Digestive System ; pathology ; Humans ; Neoplasms ; Specimen Handling

Baculovirus-mediated gene transfer into mammalian cells has been used to develop non-replicative vector vaccines against a number of diseases in several animal models.A baculovirus pseudotyped with the glycoprotein of vesicular stomatitis virus was used as vector to construct the recombinant baculovirus expressing classical swine fever virus(CSFV) E2 protein under the control of ie1 promoter from white spot syndrome virus.The E2 gene was shown to be efficiently expressed in both insect and mammalian cells.Intramuscular injection of mice with the recombinant baculovirus resulted in the production of high-level CSFV-specific antibodies.Specific lymphoproliferative responses to the CSFV stimulation were induced in the splenocytes of the immunized mice as demonstrated by CFSE staining assay and WST-8 assay.The results indicates that the pseudotyped baculovirus-delivered gene can be a potential non-replicative vaccine against CSFV infection.

Objective To investigate the effect of plasma erythropoietin ( EPO) concentration on left ventricular systolic function and its relationship with acute mountain sickness ( AMS ) .Methods A total of 289 healthy young men were recruited in this study and divided into five groups:plain control group (Ⅰ) with 55 subjects;acute high altitude exposure group(Ⅱ) with 74 subjects(3700 m exposure for 24 h); the group of acute exposure after acclimatization (Ⅲ) with 68 subjects(4400 m exposure for 24 h after 1 week acclimatization at 3700 m); high altitude migrate group (Ⅳ) with 19 subjects ( migration to 3700 m for more than 1 year ); and the group of exposure after migration (Ⅴ) with 73 subjects (4400 m exposure for 50 d after more than one year migration to 3700 m).Lake Louise Self-assessment Scoring System ( LLSS) was used to assess AMS .Plasma concentrations of EPO and echocardiography were also determined .Results EPO was significantly increased after acute high altitude exposure .There was no significant difference in EPO between groupⅡand Ⅲ(P>0.05), but significantly higher than in group Ⅰ (P<0.05).No significant difference was found between group Ⅳ,Ⅴ and Ⅰ (P>0.05).In group Ⅱ, positive correlation was found between EPO concentration and stroke volume (SV) as well as left ventricular diastolic diameter (LVDD) (R=0.278 and 0.236,respectively,P<0.05), while negative correlation was expressed between EPO concentration and the AMS score (R=-0.249,P<0.05).In other groups,there was no relationship between EPO concentration and the index of left ventricular function .Conclusion EPO may work on AMS through left ventricular systolic function enhancement after acute high altitude exposure .