Natriuretic factors,include cardionatrin(CN)and digoxin-like immunoreac-tive substances(DLIS),were important humoral factors relating to ascites formation inliver cirrhosis.An observation was made on the levels of plasma CN,DLIS,angiotensinⅡ, aldosterone and serum and urine sodium contents berore and after ascites extinction in40 cirrhotic patients.The results showed that the plasma levels of CN and DLIS had dis-tinct changes before and after ascites extinction and their changes were parallel with theactivity of renin-angiotensin-aldosterone system.These facts suggested that CN and DLIShad certain relation with ascites formation in liver cirrhosis.

To evaluate the risk of sequela after serious vaccine reaction.The rare serious vaccine reactions might result in sequela,the incidence of rare serious vaccine reactions,the estimated incidence of sequela and cases reported were reviewed.Further research should be developed to provide the scientific basis for sequela control and prevention.

Objective The study is to analyze the occurrence features of Adverse Event Following Immunization (AEFI) in China,and to evaluate the implementation of AEFI surveillance system,the safety of National Immunization Program (NIP) Vaccines and the quality of the immunization services.Methods The AEFI data of 2007-2008 were collected through the China Information System and the Children Immunization Information System,which reported before march 25,2009.The descriptive methodology was used in the study.Results 32120 AEFI cases of 2007-2008 were reported,95.02% were reported from 10 pilot provinces.The ratio of male and female was 1.41:1.77.53% cases were ≤1 years old and the cases were occurred more often between april to october.The first three vaccines are DPT,MPV and JREV.65.85% happened after the 1st and 2nd dose and 75.05% within ld after vaccination.The estimat reported incidence of NIP vaccines were 7.99～322.77 per million doses.In the classification of AEFI cases,79.93% cases were common,minor reactions,14.65% were rare,serious reactions and others were

Objective To analyze the detection results of 75 suspected type A influenza cases and to understand the distribution situation of influenza patients to provide the guidance for its early prevention and control .Methods The nasopharyngeal swabs specimens from 75 patients with suspected type A influenza were detected for understanding the viral infection situation by real‐time fluorescent quantitative PCR .Results In the specimens of 75 suspected patients ,13 cases with type A influenza virus were detected out ,in which 9 cases were the H1N1 subtype ,mean age > 50 years old .The temporal distribution was 3 cases in March 2013 ,1 case in April ,7 cases in January 2014 and 2 cases in February .No H7N9 subtype was detected out .Conclusion Real‐time fluores‐cent quantitative PCR has the characteristics of rapidness and high accuracy .The winter is the high onset season of flu ,elderly pa‐tients are susceptible to influenza virus .The monitoring and early treatment should be strengthened .

Objective To investigate the causes of a suspected outbreak of lower respiratory tract infection (LR-TI)caused by carbapenem-resistant Acinetobacter baumannii (CRAB)in the general intensive care unit(ICU)of a hospital,and provide scientific evidence for effective control of healthcare-associated infection(HAI).Methods Epi-demiological investigation on patients infected with CRAB and on-site monitoring on ICU environmental hygiene from March 4 to 23,2014 were performed,active prevention and control measures were taken.Results A total of 7 patients developed CRAB infection,the total length of stay during epidemic period were 160 days,the infection density of LRTI was 43.75‰(7/160),4 of 5 patients at No.02 bed had CRAB LRTI.Univariate analysis revealed that adopting conventional sputum suction procedure was a risk factor;the qualified rate of bacterial count on the object surfaces was 31 .75% (20/63).CRAB was also isolated from outer frame of suction device of No.02 bed, which had the same antimicrobial pattern as CRAB from 7 patients’sputum.After taking a series of controlling measures,there was no CRAB infection case after March 24,2014,this outbreak was effectively controlled. Conclusion This suspected HAI outbreak may be caused by inadequate disinfection of outer frame of suction device contaminated by CRAB,and horizontally transmitted through manipulation of sputum suction by health care workers.Clean and disinfection of ICU environmental object surfaces is of great importance for preventing HAI.

Objective To detect the levels of high mobility group box 1 protein HMGB1),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),C-reactive protein (CRP) in order to explore the clinical significance of HMGB1 in patients with severely traumatic brain injury.Methods A total of 75 patients composed of 40 male and 35 female with severely traumatic brain injury were hospitalized from March 2011 through March 2012.The scores of Glasgow Coma Scale (GCS) were 5-8 within 12 hours after brain injury.Casualties with history of hypertension,diabetes,severe diseases of heart,liver and kidney,and with concurrent trauma of other parts of body were excluded.Another 50 healthy subjects were enrolled as controls.Serum samples were taken from both patients and controls at admission.The levels of HMGB1,TNF-α and IL-6 were measured by using enzyme-linked immunosorbent assay (ELISA).The level of CRP was measured by using automatic biochemistry analyzer.Comparisons of the levels of HMGB1,TNF-α,IL-6and CRP between casuahies and healthy controls were carried out.The correlations of HMGB1 with TNF-α,IL-6,CRP in patients with severe traumatic brain injury were analyzed.Thereafter,75 patients were divided into two groups post hoc:the death group and the survival group.On the 1st day,the 3rd day and the 7th day after trauma,serum HMGB1 was detected.The comparison of HMGB1 was made between death group and survival group by using t-test.Results Serum HMGB1 level in the traumatic patients was higher than that of healthy controls (P ＜ 0.01).Correlative analysis showed that there was a positive correlation between HMGB1 and TNF-α (r =0.365,P＜0.05),IL-6 (r=0.530,P＜0.05),CRP (r=0.661,P＜0.05) in patients with severe traumatic brain injury.Serum HMGB1 level in the death group was higher than the survival group (P ＜ 0.01).Conclusions Increased serum HMGB1 level was found after severe traumatic brain injury.There were positive correlations between HMGB1 and three inflammatory factors,TNF-α,IL-6and CRP.Serum HMGB1 should be used as reliable hiomarker to judge the prognosis of patients with severe traumatic brain injury.

Objective To investigate the clinical manifestations in patients with 22q11.2 deletion syndrome (22q11.2DS) to improve the understanding of the disease.Methods Twenty patients with 22q11.2 DS were enrolled from Children's Hospital of Fudan University between August 2008 and April 2014.Cytogenetic and molecular genetic methods included fluorescence in situ hybridization (10 cases),and multiplex ligation-dependent probe amplification (10 cases).Age at the time of the diagnosis,sex and clinical manifestations were analyzed.Results The subject group consisted of 20 patients.Among them,13 cases (65％) were male and 7 cases (35％) were female.The median diagnostic age was 3.9 months.The presence of congenital heart diseases was identified in 17 patients (85％) and surgical correction was performed in 9 cases of them.The most frequent of complex congenital heart diseases were tetralogy of Fallot (20％) and pulmonary atresia (20％).Ten patients had varying degrees of T-cell immune function defects.Decrease in total lymphocytes and only CD8 counts were present in 45％ and 5％,respectively.Hypogammaglobulinemia was not detected in any patient.Six eases with T-cell immune function defects were treated with thymosin,4 of which were followed up for months,and the prognosis was good.Hypocalcemia was detected in 6 patients (30％),3 of whom presented with hypocalcemic seizures and hypoparathyroidism.Craniofacial dysmorphisms were detected in 3 patients(15％),2 of them only presented with micrognathia.Otorhinolaryngologic abnormalities were found in 4 cases (20％),3 of whom had laryngeal abnormalities,one of whom had cleft palate.Psychomotor developmental delay was found in 9 cases.Conclusions Congenital heart defects,hypocalcemia and/or impaired immune function are diagnostic features for 22q1 1.2 deletion syndrome,and they should be considered for cytogenetic analysis.

Objective To investitate the efficacy of cannabinoid-2 receptor (CB2R) activation in preventing liver ischemia-reperfusion (I/R) injury in mice.Methods Forty-eight male C57BL/6J mice,weighing 20-30 g,were divided into 4 groups (n =12 each):sham operation group (group S),group I/R,CB2R agonist JWH133 group (group J),and CB2R agonist JWH133 + CB2R antagonist SR144528 group (group JS).Liver I/ R was produced by blocking the hepatic artery and portal vein for 30 min followed by 45 min of reperfusion in anesthetized mice.At 60 min before ischemia,JWH133 20 mg/kg was injected intraperitoneally in group J,and JWH133 20 mg/kg and SR144528 30 mg/kg were injected intraperitoneally in group JS.The liver was removed at 45 min of reperfusion for determination of tumor necrosis factor-α (TNF-α),macrophage inflammatory protein-1α (MIP-1α) and MIP-2 contents (using ELISA),and expression of TNF-α,MIP-1α,MIP-2 and intercellular adhesion molecule-1 (ICAM-1) mRNA (by RT-PCR) in the liver tissues and for microscopic examination of the pathological changes.Results Compared with group S,the contents of TNF-α,MIP-1α and MIP-2 were significantly increased,and the expression of TNF-α,MIP-1α,MIP-2 and ICAM-1 mRNA was up-regulated in J and JS groups.Compared with group I/R,the contents of TNF-α,MIP-1α and MIP-2 were significantly decreased,and the expression of TNF-α,MIP-1α,MIP-2 and ICAM-1 mRNA was down-regulated in J group,and no significant change was found in the parameters mentioned above in JS group.Compared with group J,the contents ofTNF-α,MIP-1α and MIP-2 were significantly increased,and the expression of TNF-α,MIP-1α,MIP-2 and ICAM-1 mRNA was up-regulated in JS group.The pathological changes of liver tissues were significantly attenuated in group J as compared with I/R and JS groups.Conclusion CB2R activation is effective in preventing liver I/R injury in mice and the mechanism is related to inhibitioni of inflammatory responses in liver tissues.

Objective To investigate the clinical and laboratory diagnosis in a rare case with dwarifsm and multisystem abnormalities. Methods Whole-exome sequencing was performed and data was processed using high-throughput data analysis pipeline. Genetic test result is veriifed by Sanger sequencing. Results This is a 14-year-old boy with short stature (the height is 132 cm) and autoimmune hemolytic anemia. He was treated with long-term oral prednisone. Head CT from other hospital found multiple calciifcations on both sides of the basal ganglia, two sides of the frontal lobe, and the left side of parietal lobe. Lateral spinal X-ray photography showed lfat in thoracolumbar vertebral body. Valgus was surgically corrected. He also has facial pigmentation spot and onychomycosis. Whole-exome sequencing combined with Sanger sequencing identiifed a known homozygous pathogenic mutation in ACP 5 genes (c. 643 G>A, p.G 215 R). Identiifcation of such a mutation results in the diagnosis of spondylo enchondrody splasia with immune dysregulation (SPENCDI). Conclusions Whole-exome sequencing is one of the effective methods for detection of rare disease, the SPENCDI case reported here is a good example of it.

0.05).After the EN,the level of blood total protein,albumin and prealbumin significantly increased(P