Objective To investigate the value of fluid resuscitation strategy in septic shock patients by pulse indicator continuous cardiac out ( PiCCO ) .Methods 42 septic shock patients were divided into the PiCCO group(n=26) and the control group(n=16).All patients measured heart rate(HR),mean artery pressure(MAP), central venous pressure(CVP);CI,GEDVI,SVRI,EVLWI,CVP as indicator of fluid resuscitation after 0h,6h,24h of the diagnosis were measured respectively in PiCCO group;CVP as guiding volume resuscitation was measured in the control group .The effect of fluid resuscitation was compared between two groups .To analyse the relationship between CVP,GEDVI and CI in PiCCO group .according to CVP increase 2mmHg ,GEDVI whether elevated 10%.Results After 6h EGDT treatment bundle HR ,MAP,APACHEII score and clearance rate of lactic in PiCCO group improved more than those in control group [(101.3 ±7.8) and (119.4 ±7.2),t=-7.520,P<0.05;(71.8 ±7.6) and (51.5 ±8.9),t=7.873,P<0.05;(17.0 ±3.4) and (22.7 ±4.1),t=-4.978,P>0.05;(53.6 ±11.5) and (-16.5 ±5.2),t =9.283,P <0.05].There were no differences in 28-Day mortality between two groups (t =-2.162,P>0.05),but ICU hospitalization time decreased in PiCCO group [(13.8 ±2.6) and (23.3 ±2.2),t=-5.075,P<0.05].Changes in GEDVI was positively correlated with Changes in CI (r=0.799,P<0.05),while changes in CVP was poorly correlated with CI (r=-0.446,P>0.05).Conclusion Hemodynamic monitoring by PiCCO directed fluid resuscitation strategy can elevate reversal rate .Compared with pressure index CVP ,GEDVI is a sensitive indicator of cardiac preload .Correlation between CVP and GEDVI can reflect cardiac function ,Especially for septic shock patients with cardiac depression .

ObjectiveTo compare the prognosis of patiens with acute(within 72 hours) subarachnoid hemorrhage (SAH) within or without the clinical standardized pathway(CSP).Methods123 acute SAH cases were collected before CSP established meanwhile another 146 cases after CSP established from 2005 to 2009 in neurological intensive care unit of our hospital. Information such as age, gender, Hunt-Hess and CT-Fisher grade, timing and result of digital subtraction arteriography, treating time of aneurysm, and Modified Rankin Scale(MRS) at different time were recorded. Rehaemorrhagia, complications, mortality, prognosis and average stay were compared between two groups.ResultsThere was a significant difference between two groups in rehaemorrhagia, vasospasm，hydrocephaly, mortality, prognosis and average stay.ConclusionCSP is helpful to improve the prognosis of aneurysm subarachnoid hemorrhage.

Objective To study the effect of RNA interference on the expression of CTGF in skin fibroblasts of systemic sclerosis(SS). Methods Four CTGF specific siRNAs and a negative control siRNA were designed and then synthesized by in vitro transcription. siRNAs labeled with carboxyfluorescein-6-succimidyl ester (FAM) were transiently transfected into SS skin fibroblasts. Forty-eight hours after the fibroblasts were treated with siRNAs, the mRNA and protein expression of CTGF was detected by semiquantitative RT-PCR and Western blot analysis, respectively. Results The mRNA and protein expression of CTGF in fibroblasts was significantly down-regulated by 4 and 3 CTGF specific siRNAs (both P

OBJECTIVETo reprogram the 1q21.1 microdeletion pluripotent stem cells in order to establish an ideal model for further studying its pathogenesis.

METHODSHuman amniotic fluid-derived cells induced pluripotent stem cells (hAF-iPSCs) were induced from amniotic fluid cells harboring the 1q21.1 microdeletion by retroviral vectors encoding Oct4, Sox2, c-Myc and Klf4. Characteristics of the 1q21.1 microdeletion hAF-iPSCs were determined, which included in vitro pluripotency, karyotype, microarray analysis, the capacity of differentiation in vivo and in vitro, etc.

RESULTShAF-iPSCs derived from amniotic fluid cells harboring the 1q21.1 microdeletion have maintained self renewal, with expression of pluripotency marker genes detectable at mRNA level. Stem cell surface antigens were tested by immunocytochemistry. The 1q21.1 microdeletion hAF-iPSCs showed a normal karyotype after long-term culturing in vitro, and harbored the same microdeletion as confirmed by microarray analysis. The cells have maintained their differentiation capacity both in vivo and in vitro.

CONCLUSIONThe hAF-iPSCs harboring the 1q21.1 microdeletion have all the characteristics of normal pluripotent stem cells, and can be used for directed differentiation into specific cells, which may provide an ideal model for studying the pathogenesis of 1q21.1 microdeletion in vitro.

Abnormalities, Multiple ; embryology ; genetics ; physiopathology ; Adult ; Amniotic Fluid ; cytology ; Animals ; Cell Differentiation ; Chromosome Deletion ; Chromosomes, Human ; genetics ; Chromosomes, Human, Pair 1 ; genetics ; Female ; Fetal Diseases ; genetics ; physiopathology ; Gene Deletion ; Humans ; Induced Pluripotent Stem Cells ; cytology ; Male ; Megalencephaly ; embryology ; genetics ; physiopathology ; Mice ; Mice, SCID ; Models, Biological ; Pregnancy ; Young Adult

Objective To explore the influence of the iodine disinfection on nasal bacterial colonization through the transsphenoidal approach. Methods Totally 133 pituitary adenoma patients who underwent transsphenoidal surgery in our department from January to August 2017 were enrolled in this study. Before disinfection,pharyngeal swabs of inferior turbinate root secretions were taken for bacterial culture. After iodine disinfection,pharyngeal swabs were taken again at the same site. Changes in the nasal bacterial spectrum before and after disinfection were compared. Patients were followed up for three months after the surgery,during which any intracranial infection/bacteraemia was recorded,and its correlation with nasal bacteria colonization was analyzed. Results Nasal bacterial colonization was detected in 45 (33.8%) of 133 patients before iodine disinfection and in only 6 cases (4.5%) after iodine disinfection (χ=34.5,P=0.000). Thus,iodine disinfection eliminated 86.7%(39/45) of the colonized bacteria. The most common nasal bacterium was Staphylococcus aureus (24.4%,11/45),followed by Klebsiella pneumoniae (24.4%,11/45),and Staphylococcus epidermidis (13.3%,6/45). One patient had high fever and chills 2 days after surgery,but blood culture and cerebrospinal fluid culture showed negative Results . After the administration of third-generation cephalosporins,the symptoms disappeared after two days. Conclusion sThere are colonized bacteria in nasal cavity. Iodine disinfection of nasal cavity can effectively clear most of the nasal bacteria. The possibility of intracranial infection/bacteremia after transsphenoidal approach is low.