Spesis/severe sepsis remains a serious problem in pediatric intensive care unit.The mortality of sepsis/severe sepsis is still very high.The waterfall cascade reaction of cell factors is the main reason leading to the continued deterioration of the condition.Continuous blood purification technology can not only remove inflammatory mediators by adsorption and filtration function,but also improve the immune function,even reduce the mortality rate.But there is a controversial topic on the selection of the appropriate dose.This review not only introduces the effects of high-volume hemofiltration and low-volume hemofiltration from different aspects,but also analyses the influencing factors of different effects.

Reform of the property right system in medical institutions is an important part of Chinas health reform. It is closely related to the reform of the health investment system, the operating mechanism of medical institutions, regional health planning, the structural readjustment of health services, and the health management system. For this reason, the paper offers an account of the motive, objective, major forms, place and functions of the reform of the property right system in medical institutions as well as some other issues worthy of attention.

Phase Ⅱ metabolic enzymes play pivotal role in the biotransform and metabolism of exogenous substances, which might influence its ability of metabolism and detoxification to exogenous carcinogens.Polymorphism have been demonstrated in various phase Ⅱ metabolic enzymes and etiology studies showed that individuals exposed to the same environment could develop different susceptibility to tumorigenesis due to different metabolic enzyme polymorphism. Here, we summarized the effects of phase Ⅱ metabolic enzyme polymorphism on the risk of cancer.

Good standardized training of resident physicians is indispensable for high quality medical personnel building.This paper gives a brief introduction to the experiences of endocrinology fellowship trainings in three top hospitals in USA.On the basis of current simation in China,a new and improve the quality'is proposed,and a new approach is explored,which is a valuable reference for the endocrine resident trainings in China.

OBJECTIVE To study the 16 genotypes of ?-lactamase in multidrug-resistant Acinetobacter baumannii isolated from inpatients,to know the state of multidrug resistance of A.baumannii in Urumqi.METHODS Bacterial strains were identified by system of API,and antibiotic susceptibility test was detected by K-B and microdilution according CLSI.PCR was used to determine the genotypes of ?-lactamase and compare with that in GenBank.RESULTS The antibiotic resistance rates to cefataxime and tetracycline of the isolates were the highest,(100%).Resistance rate to cefoperazone/sulbactam was the lowest(5 TEM(25%)strains and 10 OXA-23 strains(50%)from 20 strains multidrug resistant A.baumannii).CONCLUSIONS There is a high percentage of multidrug resistance production of A.baumannii in Urumqi.The ?-lactamase is focused on TEM and OXA-23;it is deserved to make further augmentation of epidemiology surveillance on ?-lactamase.

Background The effectiveness of medical tissue adhesive for the reparation of operative incision has been recognized,but its influence to ocular surface microenvironment is not quite clear.Objective This study was to appraise the safety and efficacy of α-cyanoacrylate,a medical issue adhesive,for the reparation of the conjunctival and skin laceration.Methods Twenty healthy New Zealand rabbits were randomly divided into suturing group and medical glue group.Routine ophthalmic examination,the level of tear secretion and breakup time of tear film (BUT) were tested before operation.The upper bulbar conjunctiva of each right eye was cut apart about 1.0 cm after surface anesthesia and the skin of back was incised about 2.5 cm length after local anesthesia.The conjunctival and skin lacerations were adhered with compound medical adhesive in the medical glue group,and continuous suture was done to repair the conjunctival laceration and interrupted suture to the skin laceration with 5-0 chorda serica chirurgicalis in the suture group.The routine ophthalmic examination,level of tear secretion,BUT and the states of wound healing were examined 1 day,2 days and 7 days postoperatively.Pathologic examination of the corresponding tissues was also carried out 1 week after the animals were sacrificed.The data were analyzed by SPSS 13.0 statistical software.This experiment followed the Administration of the Care and Use of Experimental Animals of Shanghai City.Results The conjunctival and skin lacerations healed well both in the suture group and the medical glue group.The levels of tear secretion 1 day and 2 days postoperatively in the medical glue group were (12.70±2.21)mm and (12.70±2.00)mm respectively,showing a significant lowness in comparison with (14.90±2.38)mm and (14.90±2.33)mm of the suture group (q =-4.02,P =0.03;q =-4.02,P =0.03).Compared with the baseline,the difference of the levels of tear secretion in the medical glue group was not statistically significant in various time points after operation (P=1.00,1.00,0.51).The BUT values at 2 days and 7 days postoperatively in the medical glue group were (4.50 ± 1.18) seconds and (4.10±0.88) seconds respectively,being significantly longer than (3.30 ± 1.06) seconds and (3.00±1.25) seconds in the suture group (q=4.37,P=0.02;q=4.19,P=0.03).Compared with the baseline,there was not statistically significant difference at each time point postoperatively in the medical glue group (P =0.28,0.59,0.21).However,BUT at each time point after operation in the suture group was significantly shorter than that of the baseline (P=0.01,0.01,0.00).Pathological examination showed that all the conjunctival and skin lacerations healed well.Trivial collagen hyperplasy was seen in the eyes of the suture group and infiltration of a few of inflammatory cells was found in the medical glue group.In the pathological result of the skin test,there was conspicuous scar and severe collagen hyperplasy in the suture group,but in the medical glue group,the skin structure was almost normal.Conclusions α-Cyanoacrylate is safe and effective for the repair of the conjunctival incision with little affection to ocular surface microenvironment.

66 patients with sick sinus syndrome were enrolled in this study. All patients meeting the indications for dual chamber pacing were randomly divided into two groups: right atrial appendage(RAA) pacing group was made up of 36 patients and low atrial septal(LAS) pacing group was made up of 30 patients. Follow-up was 12 months. The incidence of atrial fibrillation(AF) was lower in LAS group(3. 3% ) compared with the RAA group(19. 4% );P wave dispersion in RAA group was significantly higher than that in the LAS group (P < 0. 01). After 3 months of the operation, left atrial volume index(LAVI) in RAA group was significantly larger than that in the LAS group. In LAS group compared with the RAA group P wave dispersion and LAVI were significantly lower after operation in sick sinus syndrome. LAS pacing was superior to RAA pacing in preventing new atrial fibrillation.

Objective To investigate the role of single nucleotide polymorphisms(SNPs)of ALOXSAP promoter gene in ischemic stroke susceptibility in north Chinese Han population.Methods A total of 220 ischemic stroke patients of north Chinese Han population and 191 healthy controls that had been matched for age and sex were enrolled in this study.Polymerase chain reaction(PCR)and direct sequencing were used for target gene genotyping and SNPs analysis.Association study was performed to analyze the relationship between genotype and phenotype and logistic regression was adopted to adjust the bias of conventional stroke risk factors.Results Three novel SNPs located in the promoter of ALOXSAP gene were found and frequencies of G/A genotype of-499 site, G/T genotype of-290 site and G/G genotype of -190 site were significantly higher in ischemic stroke patients than controls.Meanwhile, three haplotypes consisted of these SNPs were identified to be correlated with ischemic stroke, including a protective haplotype, Hap I(OR O.54, 95% CI 0.408 to 0.715), and two risk ones, Hap Ⅱ(OR 2.91, 95% CI 1.351 to 6.239)and Hap Ⅲ(OR 18.82, 95% CI 2.562 to 138.38).Meanwhile, the frequencies of G/A genotype of-499 site, G/T genotype of-290 site, Hap Ⅱ and Hap Ⅲ were significantly higher in ischemic stroke patients with more severe cerebral atherosclerosis indicated by digital subtract angiography. Conclusion Three novel SNPs in promoter of ALOX5AP gene are closely associated with ischemic stroke susceptibility in north Chinese Han population.

Background Nowadays,glaucoma is the major cause of irreversible blindness worldwide and the second cause of global visual loss.To accurately obtain the anterior chamber depth (ACD)is of helpful for screening primary angle-closure glaucoma (PACG).ObjectiveThe aim of this study is to explore the difference and agreement in the measurement of ACD between Scheimplug Imaging System (Pentacam)and ultra-sonographic biomicroscope (UBM).MethodsSeventy-seven eyes of 77 PACG patients aged (69.96±7.87)were divided into two groups.Thirty-seven eyes with acute primary angle-closure glaucoma (APACG)were assigned to group 1,and forty eyes with chronic primary angle-closure glaucoma (CPACG)were assigned to group 2.Central ACD was measured with Pentacam and UBM,respectively.The Bland-Altman method was used to evaluate the agreement of the two methods.ResultsThe ACD values measured by Pentacam and UBM were (1.6467±0.2687)mm and (1.5601±0.2677)mm respectively in APACG,indicating a significant difference (t=-7.259,P<0.01)and a positive linear correlation between the results of these two methods (r=0.939,P<0.01).The ACD values measured by Pentacam and UBM were (2.0622±0.2317)mm and (1.9648±0.2176)mm respectively in CPACG eyes with a significant difference between them(t=-10.433,P<0.01)and a significant linear correlation between these two outcomes (r=0.967,P<0.01).The Bland-Altman method showed that the two modalities had comparable results for ACD.ConclusionPentacam,as a new 3-dimensional mathematical model of the anterior segment,presents some different results from UBM in the measurement of ACD,but it is not clinically significant.Combination of Pentacam and UBM may be available for the clinical measurement of ACD.

Objective　To find out the infection of brucella among local people.Methods　To implement requirement of brucella surveillance program according to the prevention and cure of brucella document.From 1996-1998,continous surveillance of the group people aged 7～60 years was done.Results　Three years surveillance showed that in Yuli county the brucella average infection rate is 13.11%,the rate of contracting disease is 2.62%.Such disease happened among different profession and different kinds of people.It shows that the brucela infection has transferred and diffused from pasturing area to rural section and town.Conclusions　The ways is to adopt the available prevention and cure ways,to avoid the source of brucella infection,to strengthen the prevention and cure of the brucella infection among the animals,to improve people's protection consciousness,to reduce the harm that disease done to people.