Objective To compare the clinical diagnoses with autopsy findings and evaluate the frequency of misdiagnosis.Methods The findings of 356 cases who were autopsied in our department due to medical treatment dispute during the period of 1988 to 2007 were retrospectively analyzed.The clinical diagnosis and autopsy findings,sex and age of the death,length of hospitalization,the hospital department,distribution of death disease and the rank of hospital were analyzed.The concordance between diagnosis before death and at autopsy was calculated.Results In 162 cases(45.5%),the autopsy findings confirmed the clinical diagnosis.In 101 cases(28.4%),the clinical diagnosis suggested by clinicians were discordant with the autopsy findings.In 63 cases(17.7%),some diagnoses made by clinicians were proved by autopsy,and in 30 cases(8.4%),the clinical and postmortem diagnosis were beyond comparison.The most frequently misdiagnosed diseases were from cardiovascular and respiratory diseases,and among them,cardiomyopathy,aortic atherosclerosis and pneumonia were most common.Conclusion Autopsy is not only helpful for the management of medical dispute,but also beneficial to reduce the misdiagnosis in clinical practice.

Objective To study the preventive effect of Omeprazole on post-endoscopic retrograde choledo-chopallcreatography(ERCP)-induced pancreatitis.Methods 126 patients were divided into two groups at random.One group received Omeprazole 20mg bid for two days.and the other group received placebo(Vitamine B).Blood was drawn in each group the day before,4 hours and 24 hours following ERCP for examination of amylase and hepa-torenal functions.Meanwhile Meanwhile the clinical manifestations of acute pancreatitis were also observed.Results Acute pancreatitis was clinically induced in 1.59% cases of placebo group,but none in the Omeprazole group.Hyperamy-lasemia occurred in 20.63%-7.93%in Omeprazole group at 4 hours and 24 hours after ERCP operation,while 30.16%.14.29%in placebo group;The incidence rate of acute pancreatitis following ERCP and hyperamylasemia 4 h after ERCP in omeprazole group were significantly lower than in placebo group(P<0.01,P<0.05).There were no significance differences in amylase 24 hours following ERCP between two groups(P>0.05).Concluslon Omeprazole can prevent the acute pancreatitis induced by ERCP to some extent.

Objective To explore the effect of telomerase reverse transcriptase(TERT) gene transfected bone marrow stem cell(BMSC)on the memory function and hippocampal CA1 region synaptic plasticity in vascular dementia rat.Methods A total of 60 rats were randomly divided into the negative control group(group A),model group(group B),conventional BMSC group(group C) and transfected BMSC group(group D).The related indicators in each group were detected by using the Morris maze test,RTPCR and Western blot respectively.Results The escape latency period in the group C and group D was significantly longer than that in the group B,which in the group D was significantly longer than that in the group C.Compared with the group A,the expressions of brain-derived neurotrophic factor(BDNF)mRNA,TERT mRNA,SYP mRNA and protein in the group B,group C and group D were significantly decreased.The synaptic cleft arrange in group A was clear with more SYN positive ceils.The synaptic cleft in the group D was clearer,and the number of SYN positive cells was close to that in group A.Conclusion TERT transfected BMSC has obvious therapeutic effect on vascular dementia rats and its mechanism may be related to the promotion of BDNF,TrkB expression and the improvement of synaptic plasticity.

ObjectiveTo study the influence of anti-tuberculosis drugs on mitochondrial function in mice hepatocytes and to explore the mechanism of the anti-tuberculosis drugs induced liver injury.Methods A total of 150 mice were randomized into five groups:control group (C group),rifampin (RFP) group,isoniazid (INH) group,pyrazinamide (PZA) group and three antituberculosis drug combination group (MIX).The mice were administered intragastrically with 0.9 ％ NaC1 solution or RFP 135 mg · kg-1 · d-1 or INH 90 mg · kg-1 · d-1 or PZA 315 mg · kg-1 · d-1 or RFP+INH+ PZA (135±90+315) mg · kg-1 · d-1 once a day.Ten mice in each group were sacrificed at day 3,7 and 15 of administration,respectively.The following parameters in each group were monitored.the concentration of malondialdehyde (MDA),the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) in mitochondrion of hepatocytes and the concentration of 8-hydroxydeoxyguanosine (8-OH-dG) in mitochondrial DNA (mtDNA).The data were analyzed by one-way ANOVA or rank sum test.Results Along with the prolonged medication duration,the concentrations of MDA all gradually increased in RFP group (Z=6.020,P=0.049),IN H group (Z=10.220,P=0.006) and MIX group (Z=7.460,P=0.024),whereas the activity of SOD significantly decreased in RFP group (F=6.751,P =0.011 ) and MIX groups (F=4.891,P =0.041 ) compared with control group and PZA group.Meanwhile,the activity of GSH-PX was significantly lower in RFP group compared to the other groups (F=32.445,P＜0.01).The changes of other parameters didn't show meaningful trend.The concentrations of 8-OH-dG in mtDNA also increased in all treated groups,and those were all significantly increased in RPF group (F=6.602,P＜0.01 ),PZA group (F=5.927,P＜0.01) and MIX groups (F=7.974,P＜0.01).Conclusions Antituberculosis drugs can induce higher MDA concentration in mitochondrion and higher 8-OH-dG concentration in mtDNA,while result in lower activities of SOD and GSH-PX.The liver damage tends to become more severe along with the prolonged medication duration.The combination of three antituberculosis drugs could aggravate the damage of mitochondrion in mice hepatocytes.

Objective To investigate the clinical efficacy of ilaprazole and bismuth combined ten-day standard quadruple therapy and sequential therapy in the treatment of patients with Helicobacter pylori (H .pylori)infected chronic gastritis.Methods A total of 200 patients with H .pylori-positive chronic gastritis diagnosed by gastroendoscopy examination and rapid urease test (RUT)were randomly divided into standard quadruple therapy group and sequential therapy group,100 cases in each group.One group received ilaprazole,bismuth,amoxicillin-clavulanatepotassium and ofloxacin 10-day standard quadruple therapy, and the other group received ilaprazole, amoxicillin-clavulanatepotassium, ofloxacin and furazolidone 10-day sequential therapy.In four to six weeks after the therapy,the condition of H .pylori eradication was detected by a 14 C-urea breath test.The improvement of clinical symptoms and adverse effects were also observed. Normal distributed and variance homogenized measurement data were compared by t test,while unordered categorical data were analyzed by chi-square test and the exact probability method,and categorical data were compared by two independent sample rank sum test.Results The per-protocol analysis values of H .pylori eradication rates of the standard quadruple therapy group and the sequential therapy group were 88.54%(85/96)and 87.23%(82/94),respectively,while the intention-to-treat analysis values were 85 .00%(85/100)and 82.00%(82/100 ),respectively.The effective rates of symptomatic relief of upper abdominal pain,acid regurgitation,heart burning in the standard quadruple therapy group and the sequential therapy group were 95 .83%(92/96)and 95 .74%(90/94),respectively. The incidence of adverse effects which weve very mild was 6.25 % (6/96 ) and 7.44% (7/94 ), respectively.There was no statistically significant difference in the above three factors between the two groups (all P >0.05).Conclusions Ilaprazole and bismuth combined 10-day standard quadruple therapy and sequential therapy in the treatment of patients with H .pylori positive chronic gastritis both achieves high rates of H .pylori eradication and symptom relief with mild adverse effects.

Objective To investigate the physical fitness status of stationed on an island and the influence factors of military operational ability in order to take effective intervention measures to cope with the problems encountered by the garrison force.Methods The outdoor environment heat intensity of the island was monitored and evaluated by thermal environment monitors.The physical fitness of thirty-eight soldiers randomly selected was evaluated by measuring VO 2max. Ninety soldiers stationed on this island were selected by random sampling , for whom questionnaires and interviews were designed, involving the influence factors of military operational ability .Results This island was a typical humid-hot environment, with high temperature , high humidity and high radiation .The physical fitness of soldiers declined obviously because of the typical humid-hot environment.The top five working environmental factors were high temperature , humidity, solar radiation, wind and seasonal drying .The top five personal factors were physical fatigue , overtraining, injury, mental fatigue and lack of sleep .Conclusion Considering the obviously decreased physical fitness of soldiers caused by the typical humid-hot environment , how to assess military combat effectiveness and how to determine whether the level of combat effectiveness can meet the actual needs of tropical combat , requires scientific indicators and criteria of evaluation .

OBJECTIVE:To investigate therapeutic efficacy and safety of leosimendan in the treatment of acute left heart failure (ALHF) and its effects on left ventricular function indexes and serum markers.METHODS:A total of 110 patients with acute left ventricular function selected as research objects from No.251 Hospital of PLA during Jan.2014-Dec.2015,and then were divided into control group (53 cases) and observation group (57 cases) according to random number table.Both groups received routine therapy.Control group was additionally given Dopamine hydrochloride injection or Dobutamine hydrochloride injection as cardiotonic on the basis of routine therapy.Observation group was additionally given Levosimendan injection with initial dose of 10 μg/kg+0.9％ Sodium chloride injection 50 mL,ivgtt (10 min),and then with micro pump infusion at the rate of 0.1 g/(kg· min) for continuous 24 h.Both groups were treated for continuous 7 d.Clinical efficacies of 2 groups were observed,and the levels of left ventricular function indexes (PER,PFR,LVEF,LVSF) level,serum marker (NT-proBNP) and galectin-3 (Gal-3) before and after treatment,the occurrence of ADR was recorded.RESULTS:Two cases were withdrawn from the study due to death (one case in each group).Finally,a total of 108 cases were included,involving 52 cases in control group and 56 cases in observation group.Clinical total response rate of observation group (94.64％) was higher than that of control group (86.54％),but without statistical significance (P＞0.05).Before treatment,there was no statistical significance in left ventricular function indexes or serum markers levels between 2 groups (P＞ 0.05).After treatment,the levels of left ventricular function indexes were improved significantly in 2 groups,and LVEF and LVSF of observation group were significantly higher than those of control group,with statistical significance (P＜0.05).NT-proBNP and Gal-3 of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).No obvious ADR was found in 2 groups during treatment.CONCLUSIONS:Leosimendan in the treatment of ALHF have the similor clinical efficacy with dopamine,but helps to strengthen the left heart pump function,reduce heart failure markers levels with good safety.

OBJECTIVETo construct a novel immunogene therapeutic plasmid that expresses human interleukin-12 (IL-12), granulocyte-macrophage colony stimulating factor (GM-CSF) and B7.1 and observe its expression in vivo and in vitro.

METHODSHuman IL-12 gene fragment was cloned into the upper stream of IRES gene in the previously constructed plasmid pVAX-IRES-GM-CSF-B7.1, and the positive recombinant plasmid pVAX-IL-12-GB was transfected into 293T cells via Lipofectamine 2000. The expressions of IL-12 and GM-CSF-B7.1 mRNA and proteins in the transfected cells were assayed by RT-PCR and ELISA, and B7.1 expression was tested by fluorescence-activated cell sorting and immunofluorescence assay. The plasmid pVAX-IL-12-GB was delivered into mouse muscle by electroporation, and the expression of IL-12 in the muscle tissue was identified by immunohistochemistry.

RESULTSEnzyme digestion, PCR and sequence analysis all confirmed successful construction of the recombinant plasmid pVAX-IL-12-GB. IL-12, GM-CSF and B7.1 expressions were all detected in transfected 293T cells, and the expression of IL-12 was also detected in the transfected mouse muscular tissues.

CONCLUSIONA novel anti-tumor immunogene vaccine constructed can be expressed both in vivo and in vitro, which facilitates further studies of tumor immunogene therapy.

Animals ; B7-1 Antigen ; genetics ; immunology ; Cancer Vaccines ; genetics ; immunology ; Electroporation ; Genetic Therapy ; Granulocyte-Macrophage Colony-Stimulating Factor ; genetics ; immunology ; Humans ; Interleukin-12 ; genetics ; immunology ; Mice ; Plasmids ; Transfection

Objective To investigate the morbidity of soldiers stationed on an island ,analyze the relationship betweendiseases and the environment,and to provide an effective method for disease prevention and treatment .Method Data ofoutpatients from troops stationed on an island between September 2012 and August 2013 were statistically investigatedaccording to the classification of diseases.The cause of disease was analyzed .In addition,90 soldiers stationed on an islandwere randomly selected to investigate their response to heat and humidity and parts susceptible to skin diseases viaquestionnaires and talks.Results A total of 789 cases of disease were identified,including 226 cases of upper respiratorytract infection,118 cases of orthopedic-related diseases,90 cases of traumatic diseases,88 cases of oral diseases,74 casesof digestive system diseases,62 cases of skin diseases,53 cases of ENT diseases,41 cases of urinary tract infection,and37 cases of anorectal diseases.The top five responses to heat and humidity were sweating,thirst,body fatigue,dizzinessand profuse sweating.The most susceptible part to skin diseases was the feet ,followed by the cheek,crotch,back andneck.Conclusion The epidemiological characteristics of diseases on this island are significant,and medical supportshould be focused on improving the overall level of hospital treatment.