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Objective To study the mechanism of brain death-induced heart damage by observing the change patterns of morphological damage to the heart and related inflammatory factors after brain death and provide the experimental basis for heart transplantation by brain-dead donor.Methods The 30 rabbits were equally divided into two groups by the random digital table method:sham-operation group and brain death group.The rabbit brain death model was established in the brain death group,and the sham-operation group was given slow intracranial pressure.The rest treatments in the two groups were the same.At 2nd,6th and 8th h after operation,blood pressure,heart rate and respiratory rate were recorded.The damage of heart tissues was observed by HE staining.The plasma concentrations of IL-1,IL-6 and IL-8 were tested by ELISA.The expression of some inflammatory factors in heart issues was detected by RT-PCR and immunohistochemistry.Results At 8 h after brain death,there was no signifiant difference in blood pressure and heart rate between two groups (P＞0.05).The damage of heart issues in the brain death group was more serious than in the shamoperation group.With the prolongation of brain death,the plasma concentrations of IL-6 and IL-8 increased significantly in the brain death group (P＜0.05),but the concentration of IL-1β showed no siginificant difference between the two groups at 2 h after brain death (P＜0.05).Besides,the expression of HSP27 and HSP70 mRNA as well as the protein expression of ICAM and NF-κB was significantly increased in the brain death group as compared with that in the sham-operation group (P＜0.05).Conclusion With the prolongation of brain death time,the inflammatory factors in the heart tissues and plasma interleukin were increased,suggesting the inflammatory reaction occurs in donor heart under the condition of brain death,which influences the quality of donor in the heart transplantation.
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Regulating phase Ⅰ and Ⅱ enzyme,drug transporters and constitutive androstane receptor (CAR) play an important role in dug metabolism and keeping balance on the levels of glucose,lipids and hormone in serum.As a hub of material metabolism within body,CAR can affect the efficacy of various drugs and be involved in many common metabolic diseases.Studying its polymorphism is referential for explaining the individual difference genetically and predicting the occurrence and development of diseases.This review focuses on the correlation between the CAR polymorphism and metabolic,which provides evidence for predicting the development of disease and choosing clinical drug dosage.
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Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.
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Objective To parse the concept of self-management in the context of coronary heart disease based on the content analysis,to clarify the connotation of the concept of self-management.Methods Thirty-four references were recruited through the databases of CNKI,VIP journals knowledge service platform,Wanfang Data Services Platform and Pubmed.We broke the concept of self-management in the context of coronary heart disease into such three aspects as implementing body,major behavior,and facilitators.Results The most common indicators were symptom management(which was mentioned by 78.57％ of domestic literature and 66.67％ of foreign literature),and protect and promote healthcame second,the person with the chronic diseasewas 42.85％,other indicators' frequency existed differences.The major body of coronary artery disease self-management was the patient itself,with the help of assist staff and using lifestyle management,symptom management,rehabilitation and exercise,environmental control,emotional awareness behavior management and medication to maintain patients' satisfactory functional status.Conclusions To parse the concept of self-management in the context of coronary heart disease can be applied as the basis for clinical nursing research and build an effective reference and guidance for future coronary heart disease self-management model building.
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As the development of the microsurgical technique,cataract surgery rapidly got good result and visual acuity,and patients had been demanded for higher visual quality.Because of popular surgical equipments,shorter surgical time and better efficiency,some unpractical advertisements appeared.So the medical dispute associated with cataract surgery has been increasing.The factors associated with medical dispute and how to prevent them will be discussed.
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Objective To compare the accuracy of intraocular lens(IOL)power calculations by using 6 formulas(SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ)in different axial lengths of the eye,in order to improve the accuracy of predicating IOL powers for patients after cataract surgery.Design Retrospective comparative clinical analysis.Participants 169 patients(169 eyes)with age-related cataract underwent regular phacoemulsification and posterior chamber IOL implantation.Methods 169 eyes with cataract were divided into five groups according to the axial lengths:AXL≤22mm,22mm28.4mm.The axial lengths and keratometry of the 169 eyes were measured with A-mode ultrasound before operation,and the actual postoperative refraction was measured with the methods of computer and retinoscopy optometry when patients could gain best corrected visual acuity one month after surgery or later.Inputting the axial lengths,keratometry and IOL powers into A-mode ultrasound,the predicted postoperative refraction was calculated with SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ formulas,and the differences of predicted and actual postoperative refractions in different axial lengths were compared.Main Outcome Measures The absolute value with the differences of the predicted and actual postoperative refractions,i.e.absolute predicted errors.Results(1)Comparing the difference of predicted and actual postoperative refraction,there was no statistical significance between the five formulas in the groups of axial length(AXL)≤22mm,22mm28.4mm,but the average absolute predicted error of Haigis and SRK-T formulas is significantly smaller than SRK-Ⅱand Binkhorst-Ⅱ formulas.Conclusions In existing sample size,there was no obvious influence on postoperative refraction when using other five formulas except Binkhorst-Ⅱ.But in the extremely long AXL group,Haigis and SRK-T formulas have some ascendancy over the other formulas.
ABSTRACT
Microphthalmos is a developmental disorder of the eye consisting of a smaller cornea,coloboma of iris and choroid and nystagmus.It can present as an isolated disease or associate with other systemic disor- ders.Cataract commonly occurs in these eyes.Ten eyes which received cataract extraction and intraocular lens implant were reviewed in this paper.If the diameters of the cornea are smaller than 8mm,the surgical results arc not good;otherwise it is safe and successful.