Objective: To analyze the influencing factors of whole blood colloid osmotic pressure (COP) and predict reference range of plasma protein for safe COP to guide clinical infusion of protein in critically ill patients. Methods: Physical data and blood gas analysis of 405 patients were collected. hTe patients were divided into 2 groups by COP: group A (COP≤18 mmHg) and group B (COP>18 mmHg). The serum proteins including total protein (TP), albumin (Alb), globumin (Glb) and ifbrinogen (FIB) were detected. Results: APACHE II of group B was signiifcantly lower than that of group A (P<0.05). hTe survival rate, TP, Alb, Glb and FIB of group B were significantly higher than these of group A (P<0.05).Standardized regression coeffcient of Alb, Glb and FIB was 0.518,0.283 and 0.113 (P<0.05); the 95% reference range of 4 types of protein level in group B: Alb>23.3 g/L,Glb 12.6-37.6 g/L and FIB 1.3-8.7 g/L; 5 reformed equations were made. Conclusion: The main influencing factors of COP include Alb, Glb and FIB. We can use the reference range of 4 types of protein level to guide the clinical management of protein agents, and reformed equations can be used to preliminarily forecast COP in critically ill patients.

To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.
●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.
●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.
●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

OBJECTIVE: To evaluate the sustained efficacy of 2-year sublingual immunotherapy (SLIT) and 1 year after 2-year SLIT in children with allergic rhinitis (AR). METHOD: This study is a randomized, open and prospective trial. One hundred twenty children (between 4 and 11 years old) suffering from AR duo to mite were chosen from November, 2008 to June, 2009 in department of otolaryngology in our hospital divided into two groups: 60 underwent 2-year course of SLIT and one year follow-up combined with 3-year drug therapy as SLIT group; 60 received only drug therapy as control group. The patients were evaluated at three time points (baseline, end of SLIT and 1 year after SLIT discontinuation) regarding symptom scores including total nasal symptom score (TNSS), sneezing, rhinorrhoea, nasal obstruction, nasal itching and total medication scores (TMS) and adverse reaction. RESULT: (1) At the end of SLIT, the symptom scores excepting sneezing and total medication scores in SLIT group are obviously lower than those in control group (P < 0.01). At 1 year after SLIT discontinuation, all of the score including sneezing (P < 0.05) in SLIT group are lower than those of control group. (2) At the end of SLIT and 1 year after SLIT discontinuation, all of the scores are lower than those at baseline in SLIT group (P < 0.01); the scores were no different in SLIT group between the end of SLIT and 1 year after SLIT discontinuation (P > 0.05). But at the end of SLIT and 1 year after SLIT discontinuation, TMS was higher than it at baseline in control group (P < 0.01). At 1 year after SLIT discontinuation, nasal obstruction score was higher than it at baseline (P < 0.05). CONCLUSION SLIT can obviously improve the AR and the efficacy can sustain after 1-year SLIT discontinua tion. Drug increased in 3 years without SLIT.
Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Rhinitis, Allergic ; therapy ; Sublingual Immunotherapy ; Treatment Outcome

Objective To investigate the morphology and quantity of melanin and blood vessels in chloasma lesions by using reflectance confocal microscopy(RCM)and dermoscopy, and to explore the relationship of melanin and blood vessels with lesion color. Methods RCM was used to evaluate the quantity and distribution of melanin in lesions of 135 patients with chloasma, and to observe the morphology of melanin and dendritic melanocytes in 54 of the 135 patients, and dermoscopy was performed to assess the quantity and morphology of blood vessels in lesions of the 54 patients. Statistical analysis was carried out by Spearman correlation analysis to assess the relationship of melanin and blood vessels with lesion color. Results Increased quantity of melanin was observed in both the epidermal layer and dermo?epidermal junction in all the 135 patients, and in only the superficial dermis in 36(27%)patients. No patients showed increased quantity of melanin in only the dermis without epidermal involvement. Among the 54 patients, there was a positive correlation between the quantity score and morphology score of melanin(r=0.73, P<0.001), between the quantity score and morphology score of blood vessels(r=0.87, P<0.001), as well as between the total melanin score and total blood vessel score(r=0.554, P<0.001). Lesion color was positively correlated with the quantity and morphology of melanin(r = 0.51, 0.39, respectively, both P < 0.05)and blood vessels(r = 0.46, 0.44, respectively, both P<0.05). Conclusions RCM and dermoscopy can be used to evaluate melanin and blood vessels in chloasma lesions. There is a positive correlation between the quantity and morphology of melanin and between those of blood vessels in chloasma lesions, and lesion color is positively correlated with the quantity and morphology of melanin and blood vessels.

Objective To study the gastroscopic and pathohistologic mucosal changes in children′s chronic gastritis and to improve the diagnosis of the chronic gastritis in children.Methods Two thousand four hundred and forty children with upper-abdominal symptoms who were examined by gastroscopic observation were collected,and samples of gastric mucosa were examined by the same pathohistologist.And then the pathohistologic changes were analysed.Results All the 2440 children had different mucosal inflammation confirmed by gastroscope,and the pathologic results show that there were 2132 cases of chronic superficial gastritis(90.03%) and 76 cases of chronic atrophic gastritis(3.21%).Among 2440 cases,80 cases with intestinal metaplasia(3.37%),972 cases with lymphoid follicles(41.05%),409 cases with active inflammation(17.28%),902 cases with helicobacter pylori(Hp) infection(38.09%).Moderate and severe inflammatory were more predominant in patients with Hp infection,especially with lymphoid follicles or active gastritis,and the percentage of them were 50.79%,68.73%,73.53%,respectively.Conclusions Major chornic gastritis in children are chronic superficial gastritis,and the pathohistological changes are different from the adults.It also shows that there is a close relationship between gastric mucosal inflammation and Hp.

Objective:To analyze and compare pharmacology cognizing between five-year and three-year systems students in medicine to provide materials for teaching innovation.Method:To gather feedbacks from the students and to analyze and induce the cases by EXCEL software.Results:The effectiveness of medicament is the focus.But five-year and three-year systems students concern different problems.57.1% questions raised by three-year system students are about the effectiveness and the effective factors of medicament,while 53.2% by five-year system students are about the effectiveness and the mechanism of medicament.Conclusion: There have been certain differences of pharmacology cognizing between five-year and three-year systems students.

Child ; Female ; Hematemesis ; complications ; Humans ; Tracheoesophageal Fistula ; complications ; congenital

Objective To study the renal protective effects of superfine powder of Rhodiola rosea in diabetic nephropathy (DN)rats.Methods The DN rats model was established by one side nephrectomy and intraperitoneal injection of streptozotocin(STZ).Then rats were randomly divided into 6 groups:sham-operation group,model group,Rhodiola rosea common powder groups(3 g/kg·d-1),and superfine powder of low,medium and high dose groups (0.75、1.5、3.0 g/kg·d 1),10 rats in each group.Rats were given the relevant drugs respectively for 7 weeks.Finally the levels of fasting blood glucose (FBG),serum total cholesterol (STC),blood urea nitrogen (BUN),creatinine (Cr) and urinary protein (Upro) were detected.The kidney tissue was taken for histopathological observation.Results Compared with DN modelgroup [FBG,STC,BUN,Cr and Upro was (24.78±3.66)mmol/L,(4.07±1.32)mmol/L,(22.36±2.54)mmol/L,(86.78±7.47) μmol/L,(50.23±6.82)mg respectively],the rats in DN model group after treatment with common and superfine powder (medium and high dose groups) of Rhodiola rosea appeared different levels of improvement ofFBG [(18.67±2.74) mmol/L,(17.21 ±3.17)mmol/L,(15.48±2.46) mmol/L],STC [(3.33±0.87) mmol/L,(3.42 ± 0.74) mmol/L,(3.21 ±0.92)mmol/L],BUN [(15.43±2.04)mmol/L,(16.56±1.85)mmol/L,(12.44±1.36)mmol/L],Cr [(66.17 ± 4.43) μmol/L,(68.42 ± 5.06) μmol/L,(61.33±4.21)μmol/L] and Upro [(37.47±5.64) mg、(35.66 ± 4.72) mg,(27.37± 3.92) mg],P＜ 0.05.The pathologic changes of kidney tissue were improved,too.Conclusion Rhodiola rosea has a good renal protective effect in rats with DN.Furthermore,the superfine powder is more effective than the common powder in renal protective effects.

Objective To investigate the relationship between endothelial damage and p120-catenin (p120-ctn) in a model of paraquat intoxication,and the modulatory effect of mangiferin on p120-ctn.Methods Human umbilical vein endothelial cells (HUVECs) were cultured in two compartment spreading apparatus in vitro.The endothelial cells were divided into three groups:control group (cultured in DMEM with 10％ fetal bovine serum),paraquat group (paraquat was added to the medium with final concentration of 0.05 μmol/L) and mangiferin group (cultured in medium with addition of paraquat for 30 minutes,then mangiferin was added in a final concentration of 20 μmol/L).The cellular permeability at 6,12,24,48,72 hours after culture in the three groups was measured.The expressions of p120-ctn 1A,p120-ctn 3A mRNA and p120-ctn protein were measured by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot analysis.The distribution of p120-ctn protein was observed by immunofluorescence.Results Compared with control group,cellular permeability in paraquat and mangiferin groups were increased with prolongation of time,and peaked at 72 hours [(29.86 ± 3.98)％,(24.39 ± 2.79)％ vs.(11.71 ± 1.67)％,both P＜0.05].The cellular permeability was significantly lower in mangiferin group than that in paraquat group at different time points (all P＜0.05).At 6 hours after intoxication,the expressions of p120-ctn 1A,p 120-ctn 3A mRNA (gray value) and p 120-ctn protein (gray value) were significantly lower in paraquat group than those in control group (p120-ctn 1A mRNA:0.150 ± 0.024 vs.0.433 ± 0.024,p120-ctn 3A mRNA:0.316 ± 0.043 vs.0.701 ±0.020,p120-ctn protein:0.485 ±0.031 vs.0.763 ±0.038,all P＜0.01).The expressions of p120-ctn 1A,p120-ctn 3A mRNA and p120-ctn protein were significantly higher in mangiferin group than those in paraquat group from 6 hours on (p120-ctn 1A mRNA:0.281 ± 0.021 vs.0.150 ± 0.024,p120-ctn 3A mRNA:0.602 ± 0.042 vs.0.316 ± 0.043,p120-ctn protein:0.675 ± 0.031 vs.0.485 ± 0.031,all P＜0.01),and they were gradually increased with prolongation of time,and peaked at 72 hours (p120-ctn 1A mRNA:1.376 ±0.128 vs.0.150 ± 0.024,p120-ctn 3A mRNA:1.251 ± 0.059 vs.0.316 ± 0.043,p120-ctn protein:0.844 ± 0.050 vs.0.485 ± 0.031,all P＜ 0.01).Under upright fluorescence microscope,p120-ctn was mainly distributed in the cell membrane in control group,with a slight expression in cytoplasm,and no expression in the nuclei.With prolongation of time,p120-ctn expression in the cell membrane was gradually decreased in paraquat group,while it was increased in the cytoplasm and nuclei,with blurring of cell membrane and widening of cellular gap.p120-ctn expression was improved on the cell membrane in mangiferin group at corresponding time points,with decreased in expression in nuclei and cytoplasm.Conclusion The p120-ctn protein plays an important role in the enhancement of endothelial permeability in paraquat intoxication,and mangiferin may attenuate endothelial injury in paraquat intoxication possibly through modulation of p 120-ctn protein.

Objective The purpose of this study was to evaluate the effects of intensified training on muscular strength of soldiers' ankles and Achilles tendon, and to search for effective training methods through the kinetic study of the ankle joint and cross-sectional area (CSA) measurements of the Achilles tendon. Methods 30 recruits and 30 soldiers enlisted over one year were selected randomly. The recruits underwent an intensified training for eight weeks, and the enlisted soldiers underwent only routine training. The muscular strength of the ankle was tested by CYBEX-6000 isokinetic test system and the cross-sectional area (CSA) of the Achilles tendon was measured in the recruits and the enlisted soldiers before and after the intensified training. Results No difference of CSA of Achilles tendon was found among the recruits before and after the intensified training and the soldiers enlisted over one year (0.64?0.05cm~2、0.67?0.07cm~2、0.65?0.07cm~2) (P=0.698, F=0.361), while the CSA showed a positive correlation with body weight (r=0.446). The isokinetic test results indicated that the muscular strength of the ankle of the recruits was built up obviously after intensified training (P0.05). Conclusion The effects of 8-week intensified training were almost similar to one-year routine training. Enforced training seemed to be able to improve training outcomes in a shorter time. The results that no change in CSA of the Achilles tendon after intensified training indicated that the improvement in ankle muscular strength might be attributed to the moulding reconstruction of tendon function rather than by the enlargement of the tendon.