Objective To investigate the effects of splenectomy on peripheral immune cells including Th17 cells in patients with portal hy-pertension and to analyze the influence of splenectomy on their immune function.Methods Twenty-five portal hypertension patients trea-ted with splenectomy in No.180 Hospital of PLA from June 2012 to June 2014 were selected as observation group,and 25 healthy controls who underwent physical examination in the same period as control group.Flow cytometry was used to determine the percentages of CD3 , CD4,and CD8 T lymphocytes,CD4/CD8 ratio,and percentage of Th17 cells in the peripheral blood of portal hypertension patients (1 day before operation and at 7 days,1 month,and 3 months after operation)and healthy controls.ELISA was used to evaluate the changes in ser-um interleukin-6 (IL-6),interleukin-17 (IL-17),and interleukin-23 (IL-23).Comparison between groups was made by one-way ANOVA and LSD-t test.Results Before splenectomy,the portal hypertension patients had significantly lower percentages of CD3, CD4,and CD8 T lymphocytes and CD4/CD8 ratio (P<0.01 for all)and significantly higher percentage of Th17 cells and levels of their as-sociated inflammatory cytokines (IL-6,IL-17,and IL-23)(P<0.01 for all),as compared with the control group.At 7 days,1 month,and 3 months after operation,the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ratio in portal hypertension patients first decreased and then increased,and these values were significantly lower at 7 days after operation than before operation (P<0.01 for all);at 3 months after operation,the patients showed no significant differences in the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ra-tio compared with the control group (P>0.05 for all).At 7 days,1 month,and 3 months after operation,the percentage of Th17 cells and levels of their associated inflammatory cytokines (IL-6,IL-17,and IL-23)in portal hypertension patients decreased gradually (P<0.05 for all).Conclusion Th17 cells and their associated inflammatory cytokines (IL-6,IL-17,and IL-23)are reduced in portal hy-pertension patients treated with splenectomy,so their immune function can be improved.

Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.

Objective To demonstrate the association between fluid intake and sodium intake during the first 10 days of life and the risk of chronic lung disease (CLD) in very low birth weight (VLBW) infants.Methods A retrospective analysis of data from VLBW infants enrolled in the Neonatal Department of our hospital; 130 infants with birth weight between 790 and 1 470 g were randomized, among which 12 infants was diagnosised CLD. The daily fluid intake and sodium intake during the first 10 days of life were compared between the infants without CLD and those who developed CLD. Demographic and clinical neonatal variables were also compared. Results 118 infants survived without CLD and 12 infants developed CLD. Analysis showed that the daily fluid intakes were higher (day 2～10) and weight loss less (day 6～9) in the group of infants who developed CLD. In addition, the daily sodium intakes were also higher (day 2～6) in infants who developed CLD. Conclusion In the VLBW infants treated during the post surfactant era, higher fluid or sodi-um intake during the first 10 days of life were associated with an increased risk of CLD. The finding suggests that careful attention to fluid balance might be an important means to reduce the incidence of CLD.

Objective To investigate the diagnostic value of JAK2V617F mutation detection in the diagnosis of polycythemia vera,and screen a more simple method for clinic laboratory to detect the mutation of JAK2V617F.Method DNA was extracted by standard procedures after isolating total leukocytes from peripheral blood mononuclear cells by density gradient centrifugation over Histopaque 1077.DNA samples were amplified,and single-stranded biotinylated PCR products were prepared for sequencing.At the same time,in order to testify the reliability of the allele-specific PCR,two forward primer and one common reverse primers were applied for identifying the mutation.Result In 32 of 38 patients with polycythemia vera,JAK2V617F mutation was determined by conventional DNA sequencing.35 JAK2V617F mutations were detected by the allele-specific PCR.and these mutations were confirmed by DNA sequencing.None mutation was found in secondary polycythemia and normal control.Conclusion JAK2V617F function mutation occuis in nearly all patients with PV,and JAK2V617F mutation should be a molecular marker in the diagnosis of polycythemia vera.Allele-specific PCR is a very sensitive and specific method for detecting JAK2V617F mutation.

Objective To observe differences between repeat and written response in speech recognition tests of short Mandarin monosyllable lists. Methods 12 normal-hearing subjects were tested by 6 short monosyllabic lists. The subjects should repeat and write down.the contents of the tests at the same time, the tester monitors au-rally and records the subjects' reactions. The speech recognition scoring error under different responses at different presentation levels could be obtained by comparing the records of the subjects with the tester. Results The speech recognition scoring of repeat and written response were highly correlated with each other (P<0.01). However, 19(26.4%) out of 72 pairs of test records were inconsistent. The error range of them was from -5% to 10%. When the presentation level was 5 dB HL, the difference among the speech recognition scoring was significant statistically, but not significant when the presentation level at 20, 15, 10 and 0 dB HL. Conclusion The test results of speech audiometry are impacted by different respond methods. In the open-set test, it's supposed that the subjects should make notes while repeating the contents of the tests, then compare with the aural monitoring records of the tester to keep the reliability of the test.

Objective To compare the results of stroke risk assessment system in patients with non-valvular atrial fibrillation u-sing CHADS2 and CHA2 DS2-VASc .Methods A total of 420 patients with non-valvular atrial fibrillation were evaluated using CHADS2 and CHA2DS2-VASc ,they were divided into three groups according scores :low risk group(scores 0) ,intermediate risk group(scores 1) ,high risk group(scores≥2) .Compare the average scores and the proportions of three groups of two stroke risk as-sessment system .Results The average score of CHA2DS2-VASc was significantly higher than that′s of CHADS2 (2 .41 ± 1 .93 vs . 1 .39 ± 1 .39 ,P<0 .05) .According to scores of CHADS2 ,the proportions of low risk groups were 34 .5% (145/420) ,intermediate risk group were 28 .8% (121/420) ,high risk group were 36 .7% (154/420) .According to scores of CHA2DS2-VASc ,the propor-tions of low risk group were 16 .2% (68/420) ,intermediate risk group were 23 .3% (98/420) ,high risk group were 60 .5% (254/420) .CHA2 DS2-VASc compared with CHADS2 ,the proportion of low-risk group significantly lower than the latter ,the proportion of high-risk groups significantly higher than the latter(P<0 .05) .Conclusion The scores of CHA2DS2-VASc is significantly high-er than that′s of CHADS2 in patients with non-valvular atrial fibrillation ,there are more patients needs anticoagulation using stroke risk assessment system CHA2 DS2-VASc .

Objective To evaluate the application effect of evidence-based care model in hemostasis by compression in patients after renal biopsy.Methods 80 patients undergoing renal biopey from December 2006 to December 2009 in our hospital were chosen as the research object.They were randomly divided into the control group and the observation group with 40 patients in each group.The control group was given routine nursing,and the observation group was treated with evidence-based care model for nusing.The re-bleeding rates,satisfaction degree and the SAS,SDS score,mastering degree of related knowledge,treatment compliance for the two groups before and after nursing were compared.Results The ineidence rate of bleeding in the observation group was higher than the control group,satisfaction degree was higher,and the SAS,SDS score,related knowledge,treatment compliance were all better than the control group,there were significant differences.Conclusions The effect of evidence-based care model in hemostasis by compression after renal biopsy is better.It can significantly reduce the incidence of adverse circumstances and improve the negative emotional state of patients.

Dengue is the most wide-spread arthropod-borne viral disease of humans in the tropic and sub-tropic regions.In this study,genomic sequences of more than 3 000 dengue viruses available in the GenBank were aligned and analyzed by sero type.According to phylogenetic trees generated by the minimum evolution method of MEGA5.0,dengue viruses were divided into 4-6 genotypes within the four serotypes,respectively.Meanwhile,it was indicated that the distribution of most genotypes was associated with geographic origins of dengue viruses.Probable origins for most of the 39 strains from China with genomic sequences were deduced from relevant ancestral strains in the context of ME trees.These results revealed that the genotype distribution of dengue viruses was geographic origin-specific at genomic level,and that diverse introduction sources were attributed to dengue outbreaks in China.

OBJECTIVE:To study on the effect of iodine (I2) on the acid content titration in the preparations,and establish a method of eliminating I2 for accurate determination of total acid content. METHODS:Taking an example of Onychomycosis paint,I2 was reduced by sodium sulfide(Na2S)before titration analysis and compared with the standard method of traditional titration. Ac-cording to the two methods of consumption of different sodium hydrate(NaOH)volume,the effect of I2 on the determination of to-tal acid content in preparation was explored. RESULTS:Reduction method of Na2S can eliminate the effect of I2,the color of indica-tor changed acutely. The determined total acid and theoretical values were the same;the linear range of the concentration of total ac-id in onychomycosis paint was 3.926-7.290 mol/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were no more than 0.04%;average recovery was 99.91%-100.10%(RSD=0.036%,n=6). CONCLUSIONS:I2 has effect on the determina-tion of total acid content,the disproportion reaction of I2 can generate hydriodic acid that can interfere acid-base titration's results, and the generated hydriodic acid can oxidize indicator to make the end point is not sensitive or even invariant color. Using Na2S can eliminate the effect of iodine on the preparation of acid titration,which has improved precision and reproducibility with accurate and reliable determination results.

Objective To compare and analyze gene expression patterns in rat model of nonalcoholic fatty liver disease (NAFLD).Methods Twelve male Sprague-Dawley rats were randomly given either general diet (control group) or a high-fat diet (model group) for 4 weeks.The histopathologic changes of the liver were observed and gene expression patterns were analyzed and compared by cDNA mieroarray.Results Hepatocellular steatosis and inflammatory infiltration were observed in model group after high-fat diet for 4 weeks.Fifty-one differential genes were found in model group,20 of which were up-regulated (sterol regulatory element binding factor 1,stearoyl-coenzyme A desaturase 1 and Bcl 2 modifying factor)and 31 were down-regulated (peroxisomal enoyl coenzyme A hydratase 1,heat shock 70 protein 1A and ATPase inhibitory factor 1). The up-regulating genes were involved in lipogenesis and cell apoptosis,while down-regulated genes were involved in fatty acid oxidation, protein modification and energy metabolism.Conclusions The differential expression of genes may involve in the pathogenesis of NAFLD.