0.05),whereas DC number in T-NHL was fewer than that in normal control(P

ObjectiveTo investigate the efficacy of bundle treatment on patients with moderate or severe acute respiratory distress syndrome (ARDS).Methods A multicenter prospective observational study comparing the result of historical treatment strategy and bundle treatment was conducted. According to the new Berlin standard of definition, 73 patients with moderate or severe ARDS due to pulmonary factors, age from 18 to 65 years, admitted to Department of Critical Care Medicine of Taian Central Hospital and Handan Central Hospital were enrolled. Thirty-three patients admitted during September 2012 to May 2014 (prospective observation period) were enrolled as the bundle treatment group. Forty patients with matched disease history admitted from January 2010 to August 2012 were enrolled as the control group. The patients in bundle treatment group received bundle treatment based on the treatment strategy of primary diseases. Bundle treatment included restrictive fluid management, respiratory support, high-dose ambroxol combined with Xuebijing injection, prevention of ventilation associated pneumonia (VAP), individualized sedation plan, installation of continuous blood purification treatment for critical patients. A special team was organized to ensure the successful implementation of all bundle measures. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, oxygenation index, duration of mechanical ventilation, the length of intensive care unit (ICU) stay, incidence of VAP, and 28-day mortality 5 days after treatment were compared between two groups.Results There were no significant differences in basic characteristics of patients between the two groups, including gender, age, etiology, severity, etc. (allP> 0.05) with comparability. Compared with the control group, there was no significant difference in APACHEⅡ score 5 days after treatment in bundle treatment group (15.1±2.8 vs. 16.2±3.0,t = 1.618,P = 0.110). Compared with control group, oxygenation index in bundle treatment group was significantly improved [mmHg (1 mmHg = 0.133 kPa): 135.4±34.5 vs. 117.1±34.2,t = -2.273,P = 0.026), the duration of mechanical ventilation was obviously reduced (days: 8.70±2.50 vs. 10.10±2.67,t = 2.308,P = 0.024), incidence of VAP was significantly lower [18.2% (6/33) vs. 32.5% (13/40),χ2 = 5.027,P = 0.025], and 28-day mortality rate was obviously lowered [24.2% (8/33) vs. 37.5% (15/40),χ2 = 4.372,P = 0.037], the length of ICU stay shown no statistical difference (days:10.40±1.94 vs. 11.30±2.34,t = 1.620,P = 0.110).Conclusion Implementation of bundle treatment can significantly shorten the duration of mechanical ventilation, reduce the incidence of VAP, and improve the prognosis of patients.

Objective To analyze the fetus chromosome abnormalities in women with advanced maternal age under the universal two-child policy. Methods A total of 10607 women underwent prenatal diagnosis proce-dures from the year of 2015 to 2016,among which 3569 cases were with advanced maternal age. Cytogenetic karyotyping was conducted with chromosomal microarray analysis(CMA)in 854 cases. The ration of chromosome abnormalities in the two population groups(aged from 35~39 and over 40)were counted. The type of abnormali-ties were also analyzed. Results The ration of women with advanced maternal age in 10607 cases underwent pre-natal diagnosis between 2015 and 2016 was 33.6%. The respective rations were 27.2%and 37.9%. The detection rates of chromosome abnormalities were 7.9% and 10.8%,with significantly difference. The significant differences were also found in the detection rate of chromosome aneuploidies ,but no differences in other chromosome abnor- malities. CMA was benefit to detect the micro chromosome abnormalities. Conclusions In 2016,the number of prenatal diagnosis procedures increased under the two-child policy. The detection rate of chromosome abnormalities also significantly increased. The incidence of chromosome abnormalities was higher with the growing age of preg-nant women. Genetic counseling must be presented and prenatal diagnosis should be promoted in women with ad-vanced age.

Here we reported a research project based on Black-board to integrate medical curriculum .The key points of this research is application of clinical cases as teaching data and facilitate learning of knowledge following the principle of learning by doing and , input the concept of precision medicine and informatics in learning process with an individually designed framework of learning .The learning outcome is evaluated with big data tech-nology and thus creates a student-centered pathway of medical education .

In order to meet the needs of national clinical medical education strategy, to train medical students’ability of analyzing and solving problems, it is imminent to carry out the reform on comprehensive experiment in basic medi-cal teaching.During the practice, the basic medical college of Hebei North University tried to integrate functional ex-periment and morphological experiment, and had some experience to share with medical education colleagues.

Objective To investigate the status of invasive fungal infection(IFI)associated with hematopathy,and evaluate drug resistance and risk factors of fungal infection.Methods 1 246 cases of infection occurred in patients in a hospital from 2006 to 2010 were analyzed retrospectively,pathogenic features and risk factors of IFI were ana-lyzed.Results There were 281 cases of fungal infection,and 162 fungal isolates were isolated,the main infection site was respiratory tract(134 isolates,82.72%).Four major Candida were Candida albicans ,Candida tropicalis , Candida glabrata ,and Candida krusei ;in 2006-2009,the main fungi were Candida albicans ,while in 2010,the majority were non-Candida albicans .The resistant rates of four isolated Candida to fluconazole and itraconazole were 5.15% and 4.41 % respectively,6 isolated Candida krusei strains were all resistant to both fluconazole and itraconazole,voriconazole-resistant strain was not found.The independent risk factors for fungal infection were dia-betes and duration time of agranulocytosis>14 days.Conclusion The proportion of infection caused by non-Candi-da albicans increased obviously,fluconazole-and itraconazole-resistant non-Candida albicans strains have emerged, comprehensive measures should be adopted to prevent IFI actively and treat patients early.

BACKGROUND: Vitamin A deficiency disorders (VADD) is a healthy problem of children in the world, especially in the west of China and remote areas, and the nutritional intervention is needed.OBJECTIVE: To compare the improved effects of biscuits fortified with three different doses of vitamin A on the vitamin A status in children aged 3-6 years and explore ap ideal dose of vitamin A supplement for preventing VADD.DESIGN: Randomized controlled observation.SETTING: Health Surveillance Institute, Chongqing Municipal Health Bureau; Staff Room of Nutrition and Food Hygiene, College of Public Health, Chongqing University of Medical Sciences; Center for Children Nutrition, Children's Hospital, Chongqing University of Medical Sciences.PARTICIPANTS: The investigation was done between March and December 2002. 753 children aged 3-6 years from 8 kindergartens in Banan district of Chongqing city were enrolled with the agreement of their guardians. They were divided randomly into 4 groups: 30% recommended intake group, 100% recommended intake group, 20 000 international unit (IU) and 200 000 IU groups.METHODS: ① The biscuits fortified with 30% recommended intake of vitamin A (500 IU) were once given to people of the 30% recommended intake group (177 cases) every day. ②The biscuits fortified with 100% recommended intake of vitamin A (1666 IU) were once given to people of the 100% recommended intake group (173 cases) every day. ③The biscuits fortified with 20 000 IU of vitamin A were once given to people of the 20 000 IU group (209 cases) every week. ④The soft gelatin capsule with 200 000 IU of vitamin A were once given to people of the 200 000 IU group (194 cases).Height, body mass, serum retinal, prealbumin, haematoglobin and retinal binding protein of all children were measured before intervention and after intervention for 3 months. Above indexes were rechecked after supplement for 9 months in 87 children of 30% recommended intake groupMAIN OUTCOME MEASURES: ①Prevalence rate of VADD before in-tervention and after intervention for 3 months in children of every group.② Serum retinal, serum prealbumin, serum retinal binding protein,haematoglobin, height and body mass of children before intervention and after interventional for 3 months in every group.RESULTS: Because of lose of samples and detective technology, only 580 children' examination results were got by rechecking. ①Comparison of the prevalence rate of VADD of children in every group: Three months supplementation later, the prevalence of VADD in every group all decreased sig nificantly [1.48%,1.42%,1.21%, 2.16% ;6.78%,6.54%,8.61%,8.25%(χ2=3.86-8.57, P ＜ 0.05-0.01 )]. ②Comparison of serum retinal, serum prealbumin, serum retinal binding protein, haematoglobin, height and body mass of children of every group: After supplement for 3 months, except prealbumin and haematoglobin in the 30% recommended intake group ,other indexes in each group all increased significantly (t=2.52-37.44, P＜ 0.05-0.01 ). The increase of serum vitamin A in the 20 000 IU group was larger than that in the other groups (F=4.62,P＜ 0.01 ). The increases of haematoglobin, prealbumin and height in the 30% recommended intake group were less than those in the other groups (F=5.04-7.78 ,P ＜ 0.01 ).After supplement for 9 months, the increases of haematoglobin and prealbumin in the 30% recommended intake group were larger than those in the other groups (F= 11.62,10.21 ,P ＜ 0.01). The increase of serum retinal was still lower than that in the 20 000 IU group (F=4.21 ,P ＜ 0.01 ).CONCLUSION: Supplement with biscuits fortified with 3 different doses of vitamin A and capsule with 200 000 IU of vitamin A can improve obviously the nourished status of vitamin A and the level of ferrohemoglobin, in which 30% recommended intake and 100% recommended intake have small risk, and everyday supplement can maintain stably the level of vitamin A. That may be suitable for the long-term supplement for children, and the effect of 30% recommended intake was better than that of 100% recommended intake.

Vertebrobasilar dolichoectasia (VBD) as a distinct arterial disease is not rare.Posterior circulation cerebral infarction was one of the most frequent events and the primary cause of death in patients with VBD.The clinicoradiologic features and the pathophysiological mechanism of ischemic stroke in VBD remained unclear and required further investigation.We aimed to provide a review of advanced studies.

OBJECTIVETo study the relationship between the expression of soluble drug resistance-related calcium-binding protein (sorcin) gene and the clinical multidrug resistance in acute leukemia (AL).

METHODSA semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to investigate the transcription levels of the human sorcin gene in 95 AL patients and 27 controls.

RESULTSSorcin gene expression was significantly higher in AL patients than in normal contrls (P < 0.001), and higher in relapsed/refractory acute myeloid leukemia (AML) patients than in those newly diagnosed or in complete remission. Sorcin gene overexpression was significantly lower in non-resistant patients than in resistant ones (P < 0.001). CR rates of these two groups were 20.0% and 80.0%, respectively. Sorcin gene expression was higher in AML-M(5) patients than M(2), M(3), M(4) patients.

CONCLUSIONSorcin gene overexpression is significantly associated with clinical multidrug resistance and prognosis, it is one of the indicators for predicting prognosis of AL patients.

Acute Disease ; Calcium-Binding Proteins ; genetics ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Gene Expression ; Humans ; K562 Cells ; Leukemia, Myeloid ; genetics ; Neoplasm Proteins ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Solubility

OBJECTIVETo study the relationship between soluble resistance-related calcium-binding protein (sorcin) gene and multidrug resistance gene (mdr1), and their significance in clinical drug resistance and prognosis of acute myeloid leukemia (AML).

METHODSAmplification of sorcin gene and mdr1 gene in K562/A02 cell detected by Northern blot, were monitored by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) in 65 AML patients and 27 normal controls, with their relationship and clinical outcame analyzed.

RESULTSThe amplification of sorcin gene and mdr1 gene in AML patients were significantly higher than that in the normal control, which were related to clinical drug resistance and prognosis. The amplification of sorcin gene was related to the amplification of mdr1 gene in the two groups. The clinical drug resistance incidence rate and complete remission rate were 92.9% and 7.1% in sorcin(+)/mdr1(+) group. They were 8.6% and 91.4% in the sorcin(-)/mdr1(-) group (P < 0.001).

CONCLUSIONThe co-amplification of sorcin and mdr1 gene can be taken as a good indicator of clinical drug resistance and prognosis of AML.

ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; Acute Disease ; Blotting, Northern ; methods ; Calcium-Binding Proteins ; genetics ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Gene Expression ; Humans ; K562 Cells ; Leukemia, Myeloid ; genetics ; physiopathology ; Neoplasm Proteins ; genetics ; Prognosis