Objective To evaluate the influence of laboratory critical value reporting on the efficacy of pediatric critical care.Methods A comparative analysis was conducted to evaluate the changes after the establishment of laboratory critical value reporting system.The parameters chosen for assessment included laboratory test turnaround time,medical intervention start time,survival rate,etc.Results Before the establishment of laboratory critical value reporting system,laboratory test turnaround time was (44.5±14.6)min,medical intervention start time was (40.7±5.3)min,and the success rate of the emergency treatment in ICU was (80.36±6.32)%[the rate in normal ward was(82.64±9.21)%].But after the establishment of laboratory critical value reporting system,laboratory test turnaround time,medical intervention start time,the success rate of the emergency treatment in ICU (normal ward) were (18.7±8.8)min,(23.9±6.7)min and (89.49±4.58)% [(90.04±6.45)%].Laboratory critical value reporting system shortened laboratory test turnaround time and medical intervention start time (P<0.05),and the successful rate of the emergency treatment improved evidently.Conclusion Laboratory critical value reporting system can improve successful rate of the emergency treatment significantly.

Cytokeratin 1 4 (CK1 4)has a different degree of expression in NSCLC,breast cancer,cer-vical cancer,esophageal cancer and other tumors,except in the normal basal cells.CK1 4 is mainly expressed in the peripheral part of the tumor,which is rarely expressed in the non-aggressive part.Usually the higher malignant of the tumor has the more expression of CK1 4.Given all that,CK1 4 gene plays an important role in the tumor progression and metastasis in a variety of tumors,which can be considered as an biomarker being used in the diagnosis,treatment and prognosis evaluation.

BACKGROUND:The mechanisms of mesenchymal stem cells directional y homing to infarcted myocardium post myocardial infarction are stil unclear.
OBJECTIVE:To investigate the role of stromal cellderived factor-1 (SDF-1)/C-X-C chemokine receptor 4 (CXCR4) axis on mesenchymal stem cellmigration promoted by mononuclear cells after myocardial infarction.
METHODS:Cardiomyocytes and mesenchymal stem cells were respectively isolated from suckling and adult Sprague-Dawley rats. Twelve healthy Sprague-Dawley rats were selected (six rats for myocardial infarction models and six for sham models), then circulating mononuclear cells were isolated. 4,6-Diamino-2-phenyl indole-labeled mesenchymal stem cells, cardiomyocytes and mononuclear cells were cultured into the upper, middle and lower layers of the tri-chamber coculture system, respectively. In this experiment, there were four groups:myocardial infarction group, AMD3100 (CXCR4 inhibitor) group, sham group and blank control group. After 48 hours, the number of migrating mesenchymal stem cells with blue-lighting nucleus was calculated under fluoroscope. Immunocytochemistry and immunofluorescent staining was used to detect SDF-1 expression in cardiomyocytes and CXCR4 expression in mesenchymal stem cells, respectively.
RESULTS AND CONCLUSION:Migrating mesenchymal stem cells with positive expression of CXCR4 were observed in each group other than the blank control group. The number of migrating mesenchymal stem cells was higher in the myocardial infarction group than in the other groups. Tumor necrosis factor-αneutralizing antibody and CXCR4 inhibitor AMD3100 could obviously reduce the number of migrating mesenchymal stem cells (P<0.05). Cardiomyocytes in each group expressed SDF-1 positively. The gray values of SDF-1 expression in the myocardial infarction and AMD3100 groups were significantly higher than those in the sham and blank control groups (P<0.05). SDF-1/CXCR4 axis plays a certain role in mesenchymal stem cells migration promoted by mononuclear cells after myocardial infarction.

BACKGROUND:At present, electrical stimulation technology has become a hot topic, but its effect on body’s electrical activity remains unclear. Moreover, previous studies on this aspect mainly focused on smal-sized animals. OBJECTIVE:Under the premise without prejudice to cardiac electrical activity, to find the maximum pulse voltage and frequency of electrostimulation that is taken on the liver area of pigs. METHODS:Three healthy male Rong-Chang pigs were obtained. Pulse electrical stimulator electrodes were fixed on right lobe of the surface projection of corresponding liver area. Fixed electrical stimulation parameters were set, including pulse width 10 ms, square wave, stimulation time 1 hour. They received voltage tolerance experiment between 5 V and 100 V and a frequency tolerance experiment between 1 Hz and 5 Hz. A detail record of pigs’ electrocardiogram, discomfort reaction and changes in life behavior of the pigs were obtained. RESULTS AND CONCLUSION:During voltage tolerance experiment, high- and low-voltage electrical stimulation pulse was positively associated with heart rate increment. When the voltage was greater than 35 V, mild arrhythmia such as sinus arrhythmia and ventricular premature beats appeared, without malignant arrhythmia or death. When the voltage was greater than 60 V, qRs formation induced by electrical stimulation wave occurred. In frequency tolerance experiment, when frequency was greater than 2 Hz, arrhythmia appeared, no malignant arrhythmia was found. Pulsed electrical stimulation can induce the formation of qRs wave. Above findings suggest that the appropriate frequency and voltage of pulse electrical stimulation are 2 Hz and 35 V. At > 35 V voltage or > 2 Hz frequency, pulsed electrical stimulation on the liver area can cause arrhythmia, mostly benign arrhythmia.

Objective To understand the rpoB gene mutation in M.tuberculosis isolates,and to evaluate their clinical value.Method 335 clinical isolates of mycobacterium tuberculosis(109 isolates drug susceptible,246 isolates rifampin-resistance or multidrug resistance including rifampin) were detected using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP).Results SSCP pattern of reference mycobacterium tuberculosis H37Rv as control,no mutation was found in rifampin-suscepitible 109 strains.SSCP patterns of 225/246 rifampin resistant clinical isolates were different from the normal control.The sensitivity was 91 5%.31 resistant isolates,included 25 abnormal isolates and 6 normal isolates of SCCP were identified.Sequencing showed 29 isolates had rpoB gene mutations and 3 isolates were not found rpoB gene mutations.The 3 most frequent rpoB gene mutation situs were Leu-531(19 isolates.TCGTTG) and His-526(7 isolates,CACTAC) and Asp-516(3 isolates,GACGTC).Conclusions The results confirm that rpoB gene mutation is the most important mechanism in rifampin resistant tuberculosis mutation situs are 531 tryptophan and 526 histidine;respectively.It is feasible that using PCR-SSCP to detect drug resistance in mycobacterium tuberculosis.

10.3969/j.issn.2095-4344.2013.23.014

BACKGROUND:In recent years, embryonic hepatic stem cel s have attracted more attention, but there are few reports on the potential of embryonic hepatic stem cel s to differentiate into cardiomyocyte-like cel s as wel as the related differentiation conditions. OBJECTIVE:To investigate the moderate condition to induce mice embryonic hepatic stem cel s to differentiate into cardiomyocyte-like cel s in vitro with chemical reagents. METHODS:Dimethylsulfoxide in combination with 5-azacytidine with different concentrations and time were used to induce the embryonic hepatic stem cel s of 13.5 days mice and to observe the differentiation effect. RESULTS AND CONCLUSION:Under in vitro conditions, 0.8%dimethylsulfoxide+5μmol/L 5-azacytidine could induce the mouse embryonic hepatic stem cel s to express the specific markers of myocardial cel s, while increasing the concentration of the inducer and extending the induction time could not improve the induction efficacy.

Objective:To understand the prevalence of caries in the children aged 12 years in Fujian Province and to compare the influence of two kinds of dental probes examinations on caries detect rate.Methods:Based on oral health investigation of WHO and national oral health survey standards,multi-stage stratified sampling was used to randomly select 792 children in Fujian province to accept examination separately by two dental probes.Results:The prevalence of dental caries of youth aged 12 years in Fujian province has no statistical significance in different gender or between city and countryside.But the caries prevalence of female was higher than that of male when used by sharp dental probe.About 23.23% was found in different detection rates when using two dental probes.Compared to the sampling investigation of Fujian province in 2000 year,the caries prevalence has no obvious increase.Conclusion:The sharp probe has higher detection rate than CPI probe.

[Objective]To evaluate the operative technique and the short-term clinical results of total hip arthroplasty(THA) for developmental dysplasia of the hip(DDH) in adults. [Method]Sixty-one patients(77 hips) with DDH who received THR without cement between December 1997 and October 2006 were followed up.In this group,53 cases were female,and 8 cases were male.The average age was 31.4 years(range,17~56 years).According to the classification of Hartofilakidis,fifteen cases were type I(eighteen hips);twenty-three cases,type Il(thirty hips);and twenty-three cases,type III(twenty-nine hips).The average Harris Hip Score was 40 points(range,16~61).All of patients were exposed through the.posterolateral approach.The threaded cup with coating were put in or near the level of the true acetabulum in all of cases.Full coating stems were used in femoral side,shortening osteotomy below lesser trochanter of femur were performed in twelve cases. [Result]The mean duration of follow-up was 49 months(range,12~118 months),the average Harris Hip Score increased from 40(range,16~61) preoperatively to 91(range,82~95) at the time of the latest follow-up.All the hips acquired union of osteotomy and bone ingrowth.None of the patients had radiographic evidence of aseptic loosening of prosthesis. [Conclusion]Uncemented total hip arthroplasty for the developmental dislocation of the hip in adults can get better results significantly,although it presents greater technical difficulty.

Objective To alleviate or prevent the complication of propoful sedation and anesthesia during gastroscopy. Methods One thousand three hundred and fifty eight patients were undergone gastrosco-py under propoful sedation and anesthesia. Results Although some patients with intravenous use of propofol their blood pressure, heart and respiratory rate decreased in different extents, but others remained in normal range. During the operation, two cases(0. 15% )had hypotension which could be corrected after intravenous use of ephetonin; three cases (0. 22% ) had bradycardia that was restored after intravenous use of atropine; three hundred and eighteen cases (23. 42% )had cough which could be prevented by increasing the first dose of propofol and avoiding the pharyngeal simulation derived from operation; sixteen cases( 1. 18% )had serious chock accompanied with decreasing of blood oxygen saturation which could be alleviated by aspirating the guttural secretion, driving up the patients mandible and increasing oxygen inhalation, keeping the gastroscope dry and avoiding pumping water or air as passing through epiglottis are the effective methods in preventing chock. Forty six cases (3. 39% ) complained of pain in the injection site which could be alleviated by choosing a major vein and injecting drug slowly; forty three cases(3. 17% ) had nausea and two cases(0. 15% ) had phreno muscular spasm which could be alleviated or prevented by skilled manipulation; thirty nine cases (2. 87% )had vertigo after regaining consciousness, keeping in bed or deferring to wake the patient up are very effective in preventing and alleviating this symptom. Conclusion Although gastroscopy under propoful' s sedation and anesthesia is safe and effective, logical precautions are the keys to attain success and lessen complications.