Objective To explore the changes of blood gas, plasma fibrinogen and D-dimmer levels in neonates with severe hyaline membrane disease (HMD). Methods Forty - three neonates with severe HMD(treated by mechanical ventilation) ,26 neonates with mild HMD( without treated by mechanical venti-lation) and 31 controls were studied. The blood gas,plasma fibrinogen and D-dimmer levels were measured. Results Compared with other two groups, the levels of blood pH, PaO2 and FBG decreased significantly in neonates with severe HMD (P<0.01). The levels of PaCO2 and D-dimmer increased significantly (P<0.01). The blood pH was negatively correlated with plasma D-dimmer level,but it was positively correlated with plasma FBG level in neonates with severe HMD. Conclusion There are coagulation abnormalities in neonates with severe HMD. Hypoxemia and acidosis have close relationship with the coagulation abnormali-ties.

OBJECTIVE:To uncover the potentiality of brand management in pharmaceutical industry and to explore its importance in pharmaceutical industry.METHODS:The developmental opportunity of brand management was analyzed be?ginning from the current circumstances of pharmaceutical industry.RESULTS&CONCLUSION:The pharmaceutical in?dustries are confronted with unprecedented development for brand management.With the ending of the products era,brand management has become an important resource for the pharmaceutical industry to obtain competitive advantages.

Objective To study the effect of mild hypothermia combined with edaravone on the expressions of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in cerebrospinal fluid(CSF)of patients with severe traumatic brain injury(sTBI)and on their prognoses. Methods A prospective randomizd controled trial was conducted. Seventy-seven patients in the Center for Neurology and Neurosurgery of Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces were randomly assigned into control group(38 cases)and treatment group(39 cases)according to random number table. All the patients were treated with routine treatments such as dehydration of intracranial pressure(ICP),neural nutrition,anti-infection,mechanical ventilation and maintenance of water and electrolyte balance in control group,while in treatment group,the patients received mild hypothermia combined with edaravone on the basis of routine treatment within 24 hours after injury. The contents of TNF-αand IL-6 in CSF were measured by radio-immunoassay(RIA)at different time points in both groups. In the meantime,the ICP was also measured. The prognosis was evaluated after 6 months of injury according to Glasgow outcome scale(GOS). Results Compared to control group,in the treatment group,the expression levels of TNF-αand IL-6 in CSF had no significant difference(both P>0.05)on the 1st day after injury,but they were significantly increased on the 3rd day after injury,began to decline on the 7th day,and reached to the valley value on the 14th day after injury,the degree of descent in treatment group being more significant than that in control group〔TNF-α(μg/L):2.43±0.39 vs. 3.12±0.47,IL-6(ng/L):83.53±11.48 vs. 101.69±13.64,both P<0.01〕. Before the treatment,the level of ICP in treatment group had no significant difference from that of control group(P>0.05),but it was gradually increased on the 1st day after injury in both groups,it reached the peak value on the 3rd day after injury,and began to decline on the 7th day after injury,the degree of descent being more significant in treatment group〔mmHg(1 mmHg=0.133 kPa):14.88±3.73 vs. 21.76±4.78,P<0.01〕. The favorable prognosis rate was significantly higher〔35.9%(14/39)vs. 21.1%(8/38),P<0.05〕,and the mortality was obviously lower in treatment group than those of control group〔28.2%(11)vs. 42.1%(16),P<0.05〕. Conclusion In patients with sTBI,mild hypothermia combined with edaravone can protect brain tissue through alleviating high ICP and decreasing the expression levels of TNF-αand IL-6 in CSF, resulting in promoting the recovery of nerve functions and improving prognosis.

Objective To investigate and analyze the prevalence rate as well as antibiotics use in this hospital and to improve the awareness of the hospital infection administration for the medical staff .Methods The hospital infection prevalence rate in hospital and the risk factors were analyzed by prevalence survey and bed-side and case records investigation .Results In all 320 patients sur-veyed ,25 patients were diagnosed with hospital infection and the rate was 7 .81% ;27 cases of hospital infection was reported and the cases prevalence rate was 8 .44% .The main infection site was respiratory tract and it accounted for 48 .14% ,moreover ,the in-tensive care unit ,urology ,and neurology were the high incidence departments .The day of usage rate of antimicrobial drug was 62 .50% ,prevention of drug use was 46 .50% ,a kind drug use was 74 .00% ,and the two kind drug uses was 22 .00% .The positive rate of hospital infection pathogenic detection was 46 .87% .Hospital infection rate was related to the age ,urinary tract intubation , and ventilator factors .Conclusion Hospital infection administration should be strengthened to reduce invasive procedures for key depart-ments and focus groups ,meanwhile ,the rational application of antibiotics should be regulated to reduce hospital infection rates .

Objective To systematically assess the efficiency of colonoscopy screening for the asymptomatic elderly.Methods A search was performed to identify studies related to colonoscopy screening for the aged in Pubmed and Embase.The key words used for the search included colorectal neoplasm, adenoma, screening, elderly, and colonoscopy.The detection rate of colorectal adenomas, advanced adenomas,colorectal cancer in the elderly and non-elderly were extracted.The studies were evaluated and analyzed by software RevMan 5.3.Results Twelve studies involving 312 111 cases were included(25 107 elderly and 287 004 non-elderly).The total AADR of the elderly was 9.97％ ,ADR was 11.33％ ,while CRC detection rate Was 1.79％.The meta-analysis showed that there were significant differences in the AADR(RR =1.57,95％ CI: 1.51-1.64), ADR(RR =1.22, 95％ CI: 1.19-1.25) and CRC detection rate(RR =2.6,95％ CI:2.34-2.90) between the elderly and the younger patients (P ＜ 0.000 01).The detection rate of AADR,ADR, CRC in the elderly were significantly higher than the non-elderly.Conclusion The elderly have higher AADR and CRC detection rate than the younger.But further studies are needed because life expectancy and complications are factors that need to be considered for screening.

Hepatitis B virus (HBV)-specific cytotoxic T lymphocytes (CTLs) are believed to play a major role in viral clearance and disease pathogenesis during HBV infection. To clarify the differences in host immune responses between self-limited and chronic HBV infections, we constructed three HLA-A*0201/HBV tetramers with immunodominant epitopes of core18-27, polymerase 575-583 and envelope 335-343, and analyzed the HBV-specific CTLs in peripheral blood mononuclear cells (PBMCs) from patients infected with HBV. The frequencies and expansion ability of HBV-specific CD8(+) T cells in most self-limited HBV infected individuals were higher than those in chronic HBV-infected patients. HBV-specific CD8(+) T cells could be induced by in vitro peptide stimulation from chronic patients with a low level of serum HBV-DNA but not from those with a high level of serum HBV-DNA. In chronic infection, no significant correlation was found either between the frequencies of HBV-specific CD8(+) T cells and the viral load, or between the frequencies and the levels of alanine transaminase. Our results suggested that the frequencies of HBV-specific CTLs are not the main determinant of immune-mediated protection in chronic HBV infection and immunotherapeutic approaches should be aimed at not only boosting a HBV-specific CD8(+) T response but also improving its function.

Objective To determine the effect of moderate hypothermia on coagulation in patients with severe traumatic brain injury (sTBI) and investigate the clinical significance of thrombelastogram (TEG) monitoring.Methods Seventy-five patients with sTBI were randomly assigned to hypothermia group (conventional treatment + moderate hypothermia within 24 hours posttrauma,n =38) and control group (conventional treatment alone,n =38).TEG aided in monitoring coagulation function by measuring clot reaction time (R),clot formation time (K),clotting rate (α),maximal amplitude (MA),and percent fibrinolysis at 30 minutes after MA (LY30).Meantime,the intracranial pressure,vital signs,blood gas values,and blood electrolytes were also measured.Outcome was evaluated by using Glasgow outcome scale (GOS).Results The two groups were similar on admission with respect to R,K,α,MA,and LY30 (P ＞ 0.05),but the coagulation index in hypothermia group was significantly different from that in control group at days 1,2,3 and 7 posttreatment (P ＜ 0.05).Moreover,moderate hypothermia therapy demonstrated decrease of intraeranial pressure (P ＜ 0.01),with no severe complications,low mortality and improved outcome in comparison with control group.Conclusion Moderate hypothermia improves the hypercoagulability in patients with sTBI without increasing the risk of hyperfibrinolysis and protects brain tissue by decreasing intracranial pressure.

BACKGROUND:Gastric cancer mesenchyal stem cel s from clinical stomach cancer specimens and tumorigenic tissues in nude mice are similar to the bone marrow mesenchymal stem cel s in biological characteristics, which have been proved to be an important component of tumor microenvironment to promote tumor growth. It is speculated that biological characteristic of bone marrow mesenchymal stem cel s may change in stomach cancer microenvironment. OBJECTIVE:To observe the effect of stomach cancer microenvironment on morphology and proliferation of bone marrow mesenchymal stem cel s and expressions of CD34 and CD44. METHODS:Rat bone marrow mesenchymal stem cel s were cultured alone as control group. In the test group, rat bone marrow mesenchymal stem cel s were co-cultured with human stomach cancer BGC-823 cel s using Transwel chamber assay to establish the stomach cancer microenvironment. Then, cel morphology, proliferation, cel cycle and CD34, CD44 expressions were observed and detected using inverted phase contrast microscope, MTT assay, and flow cytometry, respectively. RESULTS AND CONCLUSION:In the test group, bone marrow mesenchymal stem cel s were similar to human stomach cancer cel s BGC-823 that arranged disorderly and irregularly, were interconnected loosely, became thinner and longer, and grew in clusters with smal er nuclei. The cel proportion in G 1 phase significantly decreased, but that in S and G 2/M phases significantly increased (P<0.01, P<0.05). The positive rate of CD44 significantly declined, and the CD34 expression significantly raised (P<0.01). In conclusion, stomach cancer microenvironment by non-contact co-culture with BCG-823 cel s has an obvious effect on the morphology, proliferation and surface antigens expressions of bone marrow mesenchymal stem cel s that wil tend to be malignant gastric cancer cel s.

Objective To observe the protective effects of autologous bone marrow mesenchymal stem cells transplantation alone with bone marrow stem cells mobilization on liver cells in rats with severe acute paucreatitis in order to explore their mechanism. Method After the establishment of severe acute pancreatitis in rats made by intraperitoneal injection of L-arginine, 240 SD rats were randomly divided into sham-operated group (n = 48), model control group (n = 48), bone marrow mesenchymal stem cell transplanted (MSC) group (n = 48), granu-lacyte-colony stimulating factor treated (G-CSF) group (n = 48) and MSC + G-CSF (n = 48). The rats of MSC group were prepared by injection of 1.2 mL MSC into femoral vein 6 hours after SAP. The rats of G-CSF group were prepared by subcutaneous injection of G-CSF 40 μg/kg for 3 days before SAP. The rats of MSC + G-CSF group received MSC and G-CSF together. The rats of sham-operated group were injected with equal volume of nor-real saline. The rats in each group were sabdivided into 12 h, 24 h, 48 h and 72 h sub-groups (n = 12) according to the examinations in different intervals after operation. Of different subgroups, the morality rate, pathological changes, expression levels of Bax, Bcl-2 proteins and apoptosis indexes of livers were observed respectively. The contents of serum TNF-α,IL-6,ALT,AST,LDH and CRP were simultaneously determined to compare the difference among subgroups by variance analysis. Results Compared to the respective model group, the mortality rates of all treated 72 h subgroups showed no difference (P > 0.05), and no rats died before 48 h. The pathological injuries of liver cells were rather attenuated in rats of treated group than in rats of control group. The liver cell apoptosis in-dexes of 48 h and 72 h MSC + G-CSF subgroups were 107.1 ± 7.0, 110.3 ± 8.6, respectively; the expression of Bax in livers of 24 h,48 h and 72 h subgroups was 5.60±0.Z5, 5.69±0.22, 5.73±0.27, respectively;Bcl-2 protein of 48 h,72 h subgroups was 4.61±0.28, 4.43±0.28, respectively; compared with MSC and G-CSF subgroups the differences were significant (P < 0.05). The serum TNF-α, IL-6, ALT, AST, LDH and CRP de-creased obviously in 24 h/48 h treated subgroups in comparison with control group (P < 0.05). The MSC + G-CSF group showed more significant effects on those biomarkers than MSC or G-CSF alone after 48 hours (P < 0.05). Conclusions Autologous bone marrow mesenchymal stem cells transplantation alonewith bone marrow stem cells mobilization can significantly protect livers from severe damage during the course of severe acute panere-atitis, and the probable mechanisms are likely associated with the pathological regeneration, anti-inflammatory ef-fect and apoptosis inhibition of MSC.

Objective To study the effects of different concentrations of hypertonic saline (HS) and 20%mannitol on decreasing intracranial pressure (ICP) in patients with moderate-sever traumatic brain injury (TBI). Methods A total of 60 patients were randomly assigned into 7.5%HS group, 3%HS group and 20%mannitol group, 20 patients in each group. All of patients were treated with conventional treatment according to the diagnostic and treatment practices of TBI. When ICP was above 20 mmHg for more than 5 minutes, patients were administered corresponding hypertonic dehydrator. The levels of ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), urine volume per hour and serum sodium were monitored continuously within 6 hours after the initiation of therapy. Results All agents could significantly decrease the ICP (P<0.05), but the onset time in 7.5%HS group was less than that of the other two groups (P<0.05), and the decreased magnitude of ICP and the effective time of decreasing ICP in 7.5%HS group were more than those of the other two groups (P < 0.05). Both 7.5%HS and 3%HS could increase MAP and CPP. There was no statistical difference in serum sodium between both groups , but the diuretic effect in both groups was worse than that of 20%mannitol group. Conclusion The rapidly infusion of 7.5%HS could significantly decrease the ICP, increase the MAP and CPP without obvious side-effect in patients with moderate-sever TBI, and which is a safe and effective therapy for intracranial hypertension after traumatic brain injury .