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.

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.

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.

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 study the feasibility and curative effect of laparoscopic radical resection of rectal carcinoma. Methods Twenty-eight cases undergoing laparoscopic radical resection (laparoscopic group) and 26 cases undergoing open radical resection (open group) were enrolled from January 2004 to December 2007. The following parameters: operation-related situations, postoperative recovery,result of radical resection, and postoperative outcome were compared between the two groups. Results The blood loss during operation in laparoscopic group was less than that in open group [(148.0±26.5) ml vs (396.0±79.6) ml, P<0.01]. The gastrointestinal tract and urination function in laparoseopic group recovered faster than those in open group[the time of diet in taking was (2.8±0.1) d vs (3.9±0.3) d,the time of detaining urethral catheter was(4.2±0.2) d vs (6.0±0.8) d] (P<0.05). The hospital stay was shorter in laparoscopic group than that in open group [(9.8±1.1) d vs(13.2±2.8) d, P<0.01]. The operation time, the number of cleared lymph nodes and complications of laparoscopic between the two groups were no significant difference (P>0.05). There was no significant difference in local recurrent and beyond metastases rates between the two groups. Conclusion Laparoscopic radical resection of rectal carcinoma parallels with open surgery is in safety and effectiveness, it has less traumatic and blood loss and faster in patients recovery.

Objective To compare and discuss the changes of cardiac structure and function between young and middle-aged obese and normal healthy subjects.Methods 67 obese objects were divided by the body mass index(BMI)into 3 groups and 23 normal objects were included.Echocardiography was performed using a HDI 3000 and a 2.0～3.0 MHZ transducer.The LV end-diastolic and end-systolic dimension were measured.LV diastolic function was determined by peak E wave velocity,A wave velocity and E/A ratio,IVRT.Results LVEDD,LVESD,IVS,LVMI of obese group were significantly greater,larger than those in control group (P0.05).BMI had significant positive correlation with the LVEDD(r=0.37,P

Objective To develop a portable, easily-used and effective fracture fixation material during emergency treatment of battle wound. Methods Based on vacuum plasticity, macromolecule particles were filled into prefabricated bag, in which the air was deflated. The bag became stiff. When it was bound with belt, it acted as fracture fixation. Results Experiments showed that this kind of splint attached closely with body without any accessorial material. The effect was good without any restriction from region or environment. Conclusion This kind of fracture fixation splint has advantages in operation time, applicable parts and fixation effects compared with other fixation material.