Myelodysplastic syndromes (MDS) comprises a heterogeneous group of malignant disorders. it has been purified clonal hematopoietic stem cell disorder from the initial initial dysplasia hematopoietic syndrome.The diagnosis of MDS has changed from completely morphological diagnosis to multi-parameter diagnosis. In this review, the laboratory examination and diagnosis technology of MDS are discussed.

ObjectiveTo study the effect of electromygraphic biofeedback on upper extremity function in patients with hemiplegia after stroke.Methods79 patients were randomly divided into experimental group(40 cases) and control group(39 cases).Patients in each group were given clinical treatment and regularly physical therapy, while those in experimental group were given electromygraphic biofeedback training. All patients were evaluated with electromyography amplitude and active range of motion(AROM) of wrist dorsiflexion and upper extremity Fugl-Meyer assessment pre-treatment and 3 months after stroke.ResultsAll the patients gained improvement after treating(P<0.05).Compared with the controls, patients in experimental group significantly improved their function in all measured item(P<0.01).ConclusionThe electromygraphic biofeedback can improve the arm function of hemiplegic patients.

Pancreatic cancer is one of common malignant tumors in the digestive system.There is still no effective means for the early diag-nosis of pancreatic cancer.As a mixture of oral gland secretion and oral mucosal transudate,saliva contains abundant biological information including microorganisms,proteins,and nucleic acids,which will change when the disease occurs.So saliva can be used for the early diag-nosis of pancreatic cancer.Through summarizing and analyzing the current studies and advantages of its application for early diagnosis,this article suggests that saliva bioinformatics holds promise for the application in the early diagnosis of pancreatic cancer.

Objective To investigate the effects of endaravane on hypoxia-ischemia (HI)-induced brain injury in neonatal piglets. Methods Male piglets 3-7 days old weighing 2.0-3.0 kg were used in this study. Group Ⅰ 10 piglets were randomly collected as sham operation without HI. Twenty piglets with HI were randomly divided into 2 groups (n = 10 each) : group Ⅱ HI and group Ⅲ HI + endaravone. The animals were anesthetized with intraperitoneal pentobarbital sodium 50 mg/kg, tracheostomized and mechanically ventilated with 30% O_2. Right femoral artery and vein were cannulated. MAP, HR, PET CO_2, blood gases and glucose and rectal temperature were monitored. After 15 min stabilization cardiac arrest was induced by inhalation of hypoxic air (O_2 10%) for 40 min followed by inhalation of 21% O_2 for 5 min. The tracheal tube was then occluded for 7 min. Cardio-pulmonary resuscitation (CPR) was then started until recovery of spontaneous circulation (ROSC). CPR > 3 min was considered a failure. A bolus of endaravone 3 mg/kg was given iv over an hour at 30 min after CPR,followed by continuous infusion at 1.5 mg·kg~(-1)·h~(-1) for 5.5 h in group Ⅲ , while in group Ⅱ vehicle was given instead of endaravone. The neurological function of the animals was evaluated at 48, 72 and 96 h after ROSC and scored (0-154, 0 = normal, 154 = severest dysfunction). The animals were killed at 96 h after ROSC. The brains were removed for microscopic examination of striatum and cortex and determination of 8-hydroxy-2'-deoxyguanine (8-OHdG/OHG) expression in putamen by immuno-histochemistry. Results The neurological function scores were significantly higher at 48 h after ROSC and the number of viable neurons in striatum and sensory cortex were significantly lower and the expression of 8-OHdG/OHG in putamen was significantly higher in group Ⅱ than in group Ⅲ . Conclusion The antioxidant endaravone given after CPR can attenuate Hl-induced brain injury by inhibiting oxidative damage to DNA and RNA.

Objective To investigate the effects of midazolam on hypoxic-ischemic (HI) brain injury in neonatal piglets.Methods Twenty-four newborn male piglets 3-7 days old weighing 1.8-3,0 kg were randomly divided into 3 groups ( n = 8 each): sham group (group S), HI + normal saline group (group HI-S) and HI + midasolam group (group HI-M). The animals of group HI-S and HI-M were subjected to 7 min of hypoxia, producing asphyxic cardiac arrest, followed by cardiopulmonary resuscitation. At 3 h after restoration of spontaneous circulation (ROSC), animals received i.v. infusion of fentanyl at a rate of 10-30 μg·kg-1·h-1 and pancuroniumat a rate of 0.1-0.2 mg·kg-1·h-1 from 3 h after ROSC to 24 h after ROSC to maintain the anesthesia. In addition, midazolam at a rate of 0.05 mg·kg-1·h-1 wee infused simultaneously until 24 h after ROSC in HI-M group, while the equal volume of normal saline was infused instead in group HI-S and S. Arterial blood samples were taken before hypoxia (baseline), and at 37 min of hypoxia, 5 min of air inspiration, 5 min of asphyxia and 6, 12, and 24 h after ROSC for blood gas analysis, and MAP was monitored at the each time point. Neurological behavior was assessed and scored (NBS) at 48, 72, 96 and 240 h after ROSC. Brains were removed at 10 h after ROSC, the remaining viable neurons in putamen and candate nucleus were counted and the density of viable neurons was determined using light microscopic examination. Results PaO2 was significantly decreased during hypoxia-eephyxia, and PaCO2 was significantly increased, while pH value and MAP were significantly decreased at 5 min of asphyxia in group HI-S and HI-M compared with group S and the baseline (P < 0.05).There were no significant differences in MAP and arterial blood gas analysis at the each time point between group HI-S and HI-M ( P > 0.05). The density of viable neurons in putamen and caudate nucleus was significantly lower, and NBS at 48-96 h after BOSC significantly higher in group HI-S and HI-M than in group S ( P < 0.05). The density of viable neurons in putamen and caudate nucleus was significantly higher and NBS at 72 and 96 h after ROSC significantly lower in group HI-M than in group HI-S ( P < 0.05). Conclusion Midazolam used at the early stage of cardiopulmonary resuscitation can attenuate HI brain injury in neonatal piglets.

?AlM: To investigate theprotective effect of melatonin against hydrogen peroxide ( H2 O2 )-induced oxidative damage to human lens epithelial cells.
?METHODS: Sub-culture human lens epithelial cells preprocessed with different concentrations of melatonin for 12h and then 100 μmol/L H2 O2 for 24h. The impact of melatonin on H2 O2-induced lens epithelial cell viability was detected by MTT assay, rate of apoptosis was detected by flow cytometry instrument and activity of apoptosis-related factors, Caspase-3 and Caspase-9, were detected by colorimetric method.
?RESULTS: MTT assay showed that melatonin had no effect on the activity of lens epithelial cells, and the drug can inhibit the decrease of H2 O2-induced cell activity, as well as flow cytometry showed that melatonin can inhibit H2 O2-induced apoptosis. ln addition, melatonin can also reduce H2 O2-induced Caspase-3 and Caspase-9 activity in lens epithelial cells, and their activity decreased with effect of melatonin along with extending time.
?CONCLUSlON: Melatonin can obviously inhibit H2 O2 -induced apoptosis of human lens epithelial cells, which provide reliable experimental basis for drug on treatment of cataract.

OBJECTIVE:To explore the effects of dobutamine on hemodynamics,tissue perfusion and respiratory function in patients with ARDS caused by septic shock. METHODS:Totally 26 patients with ARDS caused by septic shock were given Dobu-tamine hydrochloride injection 5 μg/(kg·min) by continuous pump for 20 min ,increasing by 5 μg/(kg·min) every 20 min to 15μg/(kg·min)for 6 h. Mean artery pressure(MAP)maintained at about 65 mmHg during continuous pump. Hemodynamic index-es [HR,MAP,cardiac output(CO),stroke volume(SV),total end diastolic volume(GEDV),intrathoracic blood volume index (ITBI),extravascular lung water index (ELWI),systemic vascular resistance index (SVRI)],tissue perfusion indexes (norepi-nephrine,urine volume,blood oxygen saturation,blood lactate)and ventilator parameter indexes(positive breathing pressure,min-ute ventilation volume,respiratory rate,peak inspiratory pressure and plateau pressure)of all patients were recorded before medica-tion,6,24,48 h after medication. RESULTS:There were no statistical significances in HR,MAP,GEDV,ITBI,blood oxygen saturation,blood lactate and respiratory rate before and after treatment (P>0.05). CO,SV,urine volume and minute ventilation volume of all patients 6,24,48 h after medication were significantly higher than before medication,and those indexes increased gradually as medication time. ELWI,SVRI,positive breathing pressure,peak inspiratory pressure and plateau pressure of all pa-tients after medication were significantly lower than before medication,and those indexes decreased gradually as medication time, with statistical significance(P<0.05). The levels of norepinephrine in all patients 24,48 h after medication were significantly low-er than before medication and 6 h after medication,with statistical significance(P<0.05);but there was no statistical significance between before medication and 6 h after medication(P>0.05). CONCLUSIONS:The early application of dobutamine ELWI,tis-sue perfusion and respiratory function in patients with ARDS caused by septic shock,and can keep hemodynamics stable.

Objective To establish an infection model using Caenorhabditis elegans (C.elegans)-extensively drug-resistant Klebsiella pneumoniae (XDRKP)system.Methods Clinically isolated XDRKP strains were used to infect C.elegans in the liquid killing assay,the nematode survival and the number of bacteria in C.elegans digestive tract was observed.Results C.elegans was significantly retarded after being infected by XDRKP,different concentra-tions of XDRKP led to different patterns of the worm death.Log-rank test showed that survival curves of C. elegans infected with 1 .5×106 CFU/mL of XDRKP and E.coli OP50 (control)were not significantly different (χ2 =0.08,P >0.05);survival curves of C.elegans infected with 1 .5 ×107 CFU/mL,1 .5 ×108 CFU/mL of XDRKP and E.coli OP50 were significantly different(χ2 =229.37,275.98,respectively,both P <0.001).The survival rates of 1 .5×108 and 1 .5 ×107 CFU/mL XDRKP groups were both lower than that of the control group.Supernatant suspension obtained from test was performed bacterial culture,identification and antimicrobial susceptibility testing, XDRKP was determined.After being infected with XDRKP 4,6,12,and 24 hours,the total number of bacteria in C.elegans were(0.28±0.02)×105 CFU/mL,(0.50 ±0.38)×105 CFU/mL,(1 .73 ±0.56)×105 CFU/mL,and (2.62±0.53)×105 CFU/mL,respectively,the number of bacteria in C.elegans digestive tract was significantly different at different time points (F =1 363.39,P <0.001).Conclusion The infection model of C.elegans-XDRKP is established successfully.

Objective Clinical parenteral nutrition( PN) support still lacks in standards on some degree .This paper was to analyze the clinical application of PN support in our hospital in order to provide the basis for clinical rational drug use . Methods Random weighting method was applied to collect 5% hospitalized patients′information from each patient unit each month from April 2012 to March 2013 in Nanjing Gerneral Hospital of Nanjing Military Region .NRS-2002 nutrition risk screening was applied to eval-uate whether the patient needed PN support .Statistical analysis were carried out on patients supported with parenteral nutrition from department distribution, PN detailed components and distribution intervals of aII in one admixture non-protein calorie and nitrogen ra-tio. Results According to the survey, 393 patients had received PN support, including 217 cases′NRS score <3 and 176 cases′NRS score ≥3.General surgery department ranked the first in the cases of usingall in oneadmixture support.Among 133 cases receiving all in one admixture support, the course of 37 cases(27.82%) <7 d.The aII in one admixture non-protein calorie and ni-trogen ratio(100~150∶1) only took up 28.57%. Conclusion Although PN has got wide application in clinical departments, the rationality of prescription should be strengthened .Pharmacists should help doctors set up appropriate prescription from the aspect of pharmacy.

The infection caused by pseudomonas aeruginosa biofilm has becoming one of the most urgent problems in hospital.Recent reports of possible mechanism of iron in biofilm formation were reviewed in this paper.The possible effects of iron on adsorption,microcolony formation,mature of colony and desorb were explained,and the prospect of clinical use of local iron or chelator spray was also reviewed here.