Objective To discuss the value of emergency bedside ultrasound in diagnose of blunt abdominal injury. Methods Portable ultrasound was used in 184 patients with blunt abdominal trauma in emergency department. The abnormal changes of the sound and image of the abdomen were observed,paying equal attention to free intraperitoneal fluid and gas. Results The emergency bedside ultrasound identified 169 (91.8%) patients with blunt abdominal injury, of whom 149 patients (95.5%) with single-organ injury and 20 patients (71.4%) with multi-organ injury. There were 21 patients missed diagnosis and three misdiagnosed, with rate of missed diagnosis and misdiagnosis of 13%. Surgical treatment was performed in 119 patients and conservative treatment in 65, which were proved by CT/MRI examination or clinic conservative treatment. Conclusion Emergency bedside ultrasound can provide fast and credible diagnostic information for blunt abdominal trauma, with high diagnosis accordance rate.

Primary biliary cirrhosis (PBC)is characterized by injury of small intrahepatic bile ducts,but its mechanism,especially the role of B cell immunity in this disease,remains unclear.The possible role of B cell immunity in the pathogenesis of PBC is reviewed from the fol-lowing aspects:distribution of B cells and plasma cells in the liver tissues of PBC patients,clearance of B cells,mechanism of abnormal in-crease in serum IgM and its sources among PBC patients,mechanism of production of antimitochondrial antibodies and their possible func-tions in bile duct injury,and typical autoantibodies in PBC.B cell immunity is considered to play a significant role in the pathogenesis of PBC,but there are still many key problems to be clarified.

We investigated the clinical and photographic characteristics of uremic lung and review the associated literature,so as to improve the diagnostic and therapeutic abilities of uremic lung.The clinical symptoms and signs together with the photographic characteristics of the patient who was diagnosed as uremic lung complicated with pulmonary infection and congestive heart failure in our division were analysed and the associated literature was reviewed.The patient was admitted for the complaint of cough,expectoration and dyspnea.He was diagnosed as chronic renal failure with pulmonary infection and congestive heart failure.The symptoms alleviated after adequate hemodialysis and antibiotic therapy.However,mild dyspnea remained with photographic examination still showing consolidation in the lungs.The diagnosis of uremic lung was established after the exclusion of pulmonary infections of other pathogens and tumor.After 8-month maintenance hemodialysis,the pulmonary lesions were thoroughly absorbed.Uremic lung is a common complication of end-stage renal failure.The diagnosis is established after the exclusion of cardiac pulmonary edema,pulmonary infections and tumors.Sufficient hemodialysis is the most adequate treatment for uremic lung.Abstract:SUMM ARY W e investigated the clinical and photographic characteristics of urem ic lung and review the associated literature,so as to improve the d iagnostic and therapeutic abilities of urem ic lung.The clinical symptoms and signs togetherwith the photographic characteristics of the patientwho was d iagnosed as ure-m ic lung complicated with pulmonary infection and congestive heart failure in our d ivision were analysed and the associated literature was reviewed.The patientwas adm itted for the complaint of cough,expecto-ration and dyspnea.He was d iagnosed as chronic renal failure with pulmonary infection and congestive heart failure.The symptoms alleviated after adequate hemod ialysis and antibiotic therapy.However,m ild dyspnea remained with photographic exam ination still showing consolidation in the lungs.The d iagnosis of urem ic lung was established after the exclusion of pulmonary infections of other pathogens and tumor.Af-ter 8-month maintenance hemod ialysis,the pulmonary lesionswere thoroughly absorbed.Urem ic lung is a common complication of end-stage renal failure.The d iagnosis is established after the exclusion of card iac pulmonary edema,pulmonary infections and tumors.Sufficient hemod ialysis is the most adequate treat-ment for urem ic lung.

Objective To construct a subtractive cDNA library of genes transactivated by XTP3 protein with suppression subtractive hybridization technique in order to clone genes associated with transactivation. Methods mRNA was isolated from HepG2 cells transfected by pcDNA3.1(-)-XTP3 and pcDNA3.1(-) empty vector respectively, and then cDNA was synthesized. After restriction enzyme Rsa Ⅰ digestion, small sizes cDNAs were obtained. Then tester cDNA was divided into two groups and ligated to the specific adaptor 1 and adaptor 2 respectively. After being hybridized with driver cDNA twice and underwent two times of nested PCR, tester cDNA was subcloned into T/A plasmid vectors to set up the subtractive library. Amplification of the library was carried out with E.Coli strain JM109. The cDNA was sequenced and analyzed in GenBank with Blast search after PCR. Results The amplified library contained 30 positive clones. Colony PCR showed that 23 clones contained 200-1 000bp inserts. Sequence analysis was performed also. It was found that 20 kinds of known and 2 kinds of novel cDNA sequences may be target genes transactivated by XTP3 protein. Conclusion The subtractive library of genes transactivated by XTP3 protein was constructed successfully. It provides a foundation for the further research on pathogenesis of the viral proteins.

Objective To search for clinical appearance and fungal resistance of candidemia in ICU.Methods Thirty-four cases of candidemia in ICU during 2003and 2006 were analyzed retrospectively.Results Twelve of 34 cases of candidemia were C.albicans,and 22 of 34 cases were non-C.albicans,which were 64.71% in candida monilia.Fever and chill of candidemia were 100% and 70.59% differently.Conclusion If there is high risk factor of fungous infection in clinic,at the same time fever and chill appear,and antibiotics treat is inefficacy not effective,it is possible to consider candidemia.

Primary biliary cholangitis (PBC) is an autoimmune liver disease with unclear pathogenesis.The amino acid composition and sequence in the complementarity-determining region 3 of T cell receptor (TCR) and B cell receptor (BCR) are highly diverse, which forms a large antigen recognition receptor repertoire, i.e., immune repertoire.In recent years, second-generation sequencing techniques combined with multiplex PCR or amplicon rescue multiplex PCR have been used to study the features of immune repertoire in PBC patients, and it has been found that PBC patients have clonal expansion of specific CD4+ T lymphocytes, clonal diversity of B lymphocytes, somatic hypermutation, and reduction in class switch, as well as increase in clonal diversity after treatment with ursodeoxycholic acid.These findings need to be confirmed by large-scale in vivo and in vitro studies and different immune repertoire research strategies.

Objectives:To study the impact of nutritional support in non operative management of severe acute pancreatitis. Methods:Sixteen patients with severe acute pancreatitis were provided with stage nutritional support. Results:Fourteen cases fully recovered and 2 cases died. Stage of maintenance equilibration was (57.0?12.5)hours,TPN was (12.1?4.2)days and PN+EN was (12.2?3.5)days. Conclusions:Stage nutritional support might be favourable in improving prognosis and survival rate of severe acute pancreatitis.

Objective To report 1 case with renal immunoglobulin light and heavy chain deposited disease (IgG-κ light chain and γ1 heavy chain).Methods The clinical manifestations,serum immunofixation electrophoresis,light and heavy chain abnormalities of blood and urine,bone marrow biopsy and renal biopsy data laboratory data were recorded and analyzed.Results A 63-year-old woman presented with massive proteinuria,microscopic hematuria,hypertension,anemia and serum IgG-κ light chain.Bone marrow aspirate revealed 4％ plasma cells.Renal biopsy revealed nodular glomerulopathy with congo red staining-negative.Immunofluorescence showed that κ light chain and IgG1 (γ1 heavy chain) were deposited along the glomerular basement membranes (GBM) and tubular basement membranes (TBM).Electron-microscopy revealed electrondense deposits that delineate the outer aspect of TBM and endothelial aspect of GBM.Conclusion The diagnosis of renal immunoglobulin light and heavy chain deposited disease (IgG-κ light chain and γ1 heavy chain) should be addressed combine with clinical and is pathology,especially with immune pathological examination.

ly decreased,which will increase during HAART.It may indicate CD4+ cells restoration was delayed during HAART compared with peripheral blood.

OBJECTIVE To understand the mechanisms,adverse effect and notices in use of quinalones.METHODS The adverse effect of quinalones used sinylely or in combination was collected and analyzed.RESULTS Serious central nerve system side-effects,phototoxicity,hepatotoxicity hemolytic anemia,uremia and so on could be found in few cases.Some quinolones could result in Q-T interval elongation inducing the severe ventricular dysrythmia.The serum glucose also could be affected when quinolones were used together with the medications for diabetes.CONCLUSIONS The key points for quinolones usage are rational use and paying attention to their safety.