Objective To analyze the clinical and pathological characteristics and laboratory outcomes in henoch-schonlein purpura nephritis(HSPN) patients.Methods Twenty patients with HSPN were respectively studied. The clinical characteristics and laboratory outcomes were compared between patients with different glomerulus and renal tubule pathologic classification respectively. Results Patients with grade Ⅲ had a higher proteinuria rate than those with grade Ⅱ,and the glomerulus and renal tubule pathologic markedly changed in grade Ⅲ than that in grade Ⅱ.The HSPN patients had a higher concentration of IgA,C 3 in plasma and of minimal protein in urine than that in normal groups.Conclusions There are both glomerulus and renal tubule pathologic changes in HSPN patients. The basic pathologic changes are parallel and correlated with clinical manifestation.

This stued examined the effects of nutritional support in 56 patients suffer from COPD. The influence of nutritional support on lung function and arteny blood gases after infusion of an amino acid solution (7% Fan Ming) were observed. The results suggested theft PaO2, FEV1. FVC levels were increased significantry compared to the control group. PaOz decreased significantly in Fan Ming infusion group compared 100 control group.

Objective:to culture excellent bachelor majoring in anesthesiology.Methods:to make teaching plan for practice in anesthesiological department with emphasis on following aspects:culture of emotional intelligence;development of the sense of responsibility for work;training of clinical thought to combine theory and practice and training of basic techniques;formation of good relationship and communication with the others and culture of scientific research ability.Results:All faculties execute the plan carefully,and all the interns graduate with clinical and research ability as expected.Conclusion:It is very important for ability improvement of interns to make and execute available plan,keep strict and careful attitude,train their clinical thought and basic techniques,and emphasis the sense of responsibility for work.

BACKGROUND:A steady method that can isolate endothelial progenitor cells(EPCs) need to be explored.Studies show that the EPCs riches in bone marrow with strong reproductive activity,which can be easily obtained.OBJECTIVE:To evaluate the isolating culture and biological characterization of EPCs derived from rat marrow.DESIGN,TIME AND SETTING:The in vitro cytology experiment was performed at the central laboratory of the First Affiliated Hospital of Chongqing Medical University from August to December 2008.MATERIALS:Twenty SD rats,with two-week-old,were obtained from Experimental Animal Center of Chongqing Medical University.METHODS:femurs and tibias of rats were isolated under sterile conditions,and then the bone marrow cavity was washed by 4 ℃ 0.01 mol/L phosphate buffer(PBS).Mononuclear cells were collected from marrow suspension by density gradient centrifugation,followed by cultured with M199 culture medium containing 20% fetal bovine serum to obtained cell suspension.The cells were vaccinated into culture flask(coated with fibronectin) with the density of 1?109/L,and incubated at 37 ℃ in 5% CO2 atmosphere.MAIN OUTCOME MEASURES:Morphologic change of cells was observed by an invert microscope,the expression of CD133,CD34 as well as KDR was detected by immunocytochemistry,and the flow cytometry was used to analyze the growth curve.RESULTS:The adherent cells formed clusters that were found to be characterized by density packed round cells surrounded by spindle-likes cells.Adherent cells were identified positive for CD133,CD34 and KDR by immunocytochemistry on days 4,7,10 and 14.CD133-positive cells reduced after 10 days.Flow cytometry analysis indicated that the number of CD133/KDR double positive cells gradually increased to the maximum at day 10 and then declined.KDR-positive cells gradually increased up with the time.EPCs growth curve showed that cells proliferated fast on days 3-6.CONCLUSION:EPCs can be isolated and cultured by density gradient centrifugation from marrow suspension of SD rats.These cells exhibit the characterization of endothelial cells,and can differentiate into endothelial cells.

Objective: To investigate the possible mechanism of neuroprotection produced by taurine supplement on brain in young rats. Methods: In vitro, taurine treatment or co-treatment with sodium selenite that produced significant neuronal apoptosis was used in cultured cortical neurons to examine the neuroprotection effect using MTT assay and DNA fragmentation electrophoresis. In vivo, female weanling Sprague Dawley rats were divided into four groups, eight rats per group. The treated groups were fed on diets with different contents of taurine respectively, and the control group was fed on taurine unsupplemented diets. The experiment lasted five weeks. Results: Taurine significantly increased neuronal survival in dose-dependent manner. The typical DNA ladder pattern could be prevented by taurine. Taurine could elevate brain wet weight, and significantly increased the level of taurine, protein and AChE in brain. Conclusion: It is proposed that the neuroprotection effect of taurine could be achieved by modulating expression of related genes and blocking neuronal apoptosis.

BACKGROUND: This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS: Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn't meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method. RESULTS: Twenty patients were involved, but one patient wasn't analyzed because he didn't meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05). CONCLUSION: Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.

OBJECTIVE To investigate the hospital infection rate and sites of patients in emergency intensive care(unit)(EICU),and provide basis for prevention and treatment of hospital infection.METHODS Patients who were hospitalized in EICU were investigated by retrospective study.RESULTS Among the hospital infection sites,(respiratory) tract was the most frequent one(65.63%),the next was urinary tract(28.13%),and the deep vein was the third(6.25%).The most common hospital infection bacteria were Staphylococcus aureus,Pseudomonas aeruginosa and Acinetobacter baumannii.CONCLUSIONS The analysis of the subjective and objective factors of hospital infection,and the acknowledge of relationship between nursing and hospital infection sites are(important) basis for hospital infection prevention and treatment.

Objective To investigate the potential clinical factors associated with the prognosis and relapse of adult onset Still's disease(AOSD).Methods The factors possibly influencing the prognosis and relapse of AOSD were analyzed by logistic regression and COX regression in the cohort study.Ninety-six con- secutive inpatients of AOSD diagnosed based on Yamaguchi criteria in the hospital from March 1996 to September 2004 were included in the study.Results Nine cases(9.4%)were lost during the follow-up. Eleven patients(12.6%)were diagnosed as other diseases(5 with other rheumatic diseases,4 with tumor and 2 with infections)in the 87 follow-up cases.In 76 cases,3 patients(3.9%)died and 33 patients(43.4%) got remission over one year after treatment.Splenomegaly(OR=3.14,95%CI=1.01～9.74)and treated with methotrexate(OR=0.22,95%CI=0.07～0.67)were associated with the prognosis from the logistic regression analysis of the 76 cases.The serum ferritin(RR=I.05,95%CI=1.01～1.08)and treated with methotrexate (RR=0.13,95%CI=0.02～0.76)were associated with relapse from the COX regression analysis of the 61 remis- sion cases.Conclusion We need to be very cautious in the follow-up of AOSD patients because some of them may change to other diseases.Methotrexate may be an importent therapy of AOSD not only in improve- ment the prognosis but also in reduction of relapse.

Objective To study morphological changes of rabbit artery endothelial cell injury and atherosclerosis caused by high fluoride and the role of selenium. Methods Twenty healthy male New Zealand white rabbits, body weight (2.0 ± 0.5)kg, were randomly divided into control group(drinking deionized water, fed basic diet), fluoride group(drinking fluoride 100 mg/L deionized water, fed basic diet), selenium group(drinking selenium 1 mg/L deionized water, fed basic diet), fluoride plus selenium group(drinking fluoride 100 mg/L deionized water, selenium 1 mg/L of deionized water, fed basic diet). The experimental period was 6 months. At 0, 3, 6 months of the experiment, serum fluorine and selenium levels were determined. At the end of the experiment,thoracic aorta was collected to observe its pathology and ultrastructural changes. Results Serum fluoride was significantly higher at the 3rd and the 6th month of experiment(all P ＜ 0.01 ) in fluoride group[ (0.589 ± 0.146),(0.772 ± 0.175)mg/L] and fluoride plus selenium group[ (0.502 ± 0.094), (0.693 ± 0.158)mg/L] than in control group[ (0.174 ± 0.002), (0.208 ± 0.031 )mg/L] and serum fluoride was significantly higher at 6 months than at 3 months(P ＜ 0.05 ) in fluoride group. Serum selenium was significantly higher at the 3rd and the 6th month of experiment (all P ＜ 0.01 ) in selenium group[ (0.252 ± 0.022), (0.319 ± 0.052)mg/L] and fluoride plus selenium group[ (0.239 ±0.016), (0.294 ± 0.018)mg/L] than in control group[(0.135 ± 0.014), (0.167 ± 0.019)mg/L], and serum selenium was significantly higher at the 6th month than at 3rd month of experiment in selenium group(P ＜ 0.05). Endothelial cell apoptosis indices were (4.92 ± 1.32)%, (30.30 ± 6.80)%, (6.57 ± 2.14)% and (14.29 ± 2.99)%, respectively in control group, fluoride group, selenium group and fluoride plus selenium group. Their main effect of fluorine and selenium was statistically significant (F = 106.833,20.082, all P ＜ 0.01 ). There were antagonistic effect between fluoride and selenium(F = 30.402, P ＜ 0.01 ). Pathological changes of rabbit aortic endothelial cells in fluoride group included endothelial with attached fibrin and red blood cells, and structural of the cells changed, with serious vascular injury; in fluoride plus selenium group apoptosis of endothelial cells decreased, with reduced number of attached red blood cells and fibrin, endothelial cell structure normal, the extent and scope of vascular damage significantly reduced. Conclusions Appropriate amount of selenium inhibits the apoptosis of endothelial cells induced by high fluoride, reduces aortic structural damage caused by high fluoride, and maintains the integrity of endothelial cells, thereby antagonizes the vascular damage and atherosclerosis induced by high fluoride.

Background Acute bacterial conjunctivitis is a common ocular infectious disease.It can be cured by topical administration of antibiotics,but these antibiotic eye drops often was used several times per day at present.Azithromycin is thought to offer less using times and shorten the duration of treatment.Objective The purpose of this clinical trail was to evaluate the clinical efficacy and safety of topical administration of 1％azithromycin eye drops for the treatment of acute bacterial conjunctivitis.Methods This study was approved by Ethic Committee of Beijing Tongren Hospital and followed the Declaration of Helsinki.Written informed consent was obtained prior to entering into this trial.A randomized,double-blind and placebo-controlled study was designed.One hundred and eighty patients with acute bacterial conjunctivitis were enrolled in Affiliated Hospital of Qingdao Medical College and Qingdao Municipal Hospital from may,2011 to September,2011.Azithromycin eye drops at the concentration of 1％ was topically administered on 89 eyes of 89 patients twice per day initial and once per day later for 9 days in the trial group,and placebo eye drops was used on 91 eyes of 91 patients in the same way in the control group.The inflammation response of all eyes was examined and scored under the slit lamp microscope,and germiculture was carried out.All adverse responses were assessed during the follow-up.Clinical efficacy was evaluated with the clinical cure rate as the primary indicator and bacterial clearance rate as the secondary indicator.The safety of drug was determined,including the ocular irritation sign,lens transparency and intraocular pressure.The differences of the examining results mentioned-above were compared with Chi Square test.Results One hundred and eighty patients completed the clinical trials according to the program without lost and exclusion cases.The clinical cure rate in 89 subjects in the trial group and 91 control individuals was 76.40％ (68/89) and 43.96％ (40/91),respectively,with significant difference between them (x2=19.73,P＜0.01).The bacterial eradication rate was 85.71％ (24/28) in the trial group and 60.53％ (23/38) in the control group,showing a significant difference (x2 =4.99,P＜0.05).Both 1％ azithromycin eye drops and placebo were well-tolerated with a low incidence of adverse events.Conclusions One percent azithromycin eye drops is effective and safe for the treatment of acute bacterial conjunctivitis with less adverse reaction.