Objective To explore the clinical curative effect of early enteral nutritional support for acute se-vere organophosphorus pesticide poisoning.Methods 56 cases with acute severe organophosphorus pesticide poison-ing were selected and divided into group A and group B in accordance with the random number table.Both groups were given conventional emergency treatment.Enteral nutrition support with nutrition pump was applied for 30 cases of group A in 48 -72hours,while group B in 72h -5d.The time of consciousness recovery,CHE increase to normal 60%,the incidence rate of intermediate syndrome,gastrointestinal complications of abdominal pain,abdominal disten-sion,vomiting,reflux,diarrhea,VAP,MODS of the two groups of patients were compared.Results The time of con-sciousness recovery (3.6 ±0.8)d in group A was lower than that of group B(4.1 ±0.6)d (t=2.612,P<0.01), the CHE increase to normal 60%(5.5 ±1.3)d in group A was lower than that of group B(6.3 ±1.1)d(t=2.464, P<0.05),the incidence rate of intermediate syndrome(3.3%)in group A was lower than that of group B(38.5%) (χ2 =4.691,P<0.05),the VAP of 13.3% in group A was lower than that of group B(46.2%)(χ2 =7.352,P<0.01),the MODS of 13.3% in group A was lower than 38.5% of group B(χ2 =4.691,P<0.05),the duration in ICU of (8.0 ±1.2)d in group A was lower than (12.0 ±2.4)d of group B(t=7.705,P<0.01).There was no sig-nificant difference of gastrointestinal complications between the two groups (P >0.05 ).There was no significant difference of gastrointestinal complications between the two groups (P>0.05).Conclusion Early enteral nutritional support is effective and safe for acute severe organophosphorus pesticide poisoning and worthy of promotion.

Objective To explore the role of tumor necrosis factor (TNF-?) and endotoxin(LPS) in upper gastrointestinal bleeding in cirrhosis patients and the preventive and treatment mechanism of rhubarb. Methods 45 liver cirrhosis patients with upper gastrointestinal bleeding were treated with rhubarb, and its efficacy was compared with cemetidine's efficacy. Liver function, and serum levels of TNF-? and LPS were measured before and after the therapy. Results Patients’symptoms and liver function were improved, and serum levels of TNF-? and LPS significantly decreased after treated with rhubarb. Conclusions TNF-? and endotoxin might play an important role in upper gastrointestinal bleeding in cirrhosis patients. Rhubarb has protective and treatment effect on upper gastrointestinal bleeding in cirrhosis patients by reducing TNF-? and LPS release.

Objective To explore the application of CARE kV technique in the adult chest CT and the value of reducing radiation dose.Methods Sixty-nine patients were divided into two groups by random number generators:group A(39 cases) and group B(30 cases).Group A was examined by using CARE kV technique and group B was examined at routine 120 kV.CT dose index(CTDIvol),dose length product (DLP) and effective dose (E) were compared between the two groups,and analyzed the correlation between tube voltage selection and patient body mass index (BMI) of group A was analyzed.Results The average CTDIvol [(11.00 ± 3.89) mGy],DLP[(294.05 ± 91.17) mGy·cm] and E[(4.12 ± 1.28) mSv] of group A were lower than those of group B (16.64 ± 1.20) mGy,[(475.99 ± 41.16) mGy · cm],[(6.66 ±0.58) mSv].With statistically significant difference (t =-7.653,-10.151,-10.150,P ＜ 0.05).Compared with routine 120 kV technique (group B),the CARE kV technique (group A) could reduce the total radiation dose about 38.14％.Compared obese patients(BMI≥28 kg/m2) with non-obese patients in group A and B,the mean E of non-obese patients was lower than that of obese patients in group A,which reduced the total E about 31.74％ (t =4.322,P ＜0.05),while E in group B was no significant different between non-obese patients and obese patients.Conclusions In adult chest CT,CARE kV technique can select optimum scanning voltage automatically according to the patients with different BMI and anatomical regions,which can reduce the overall radiation dose while maintaining image quality.

Objective To estimate the diagnostic value of interstitial infiltration pattern for early morphea.Methods Twenty-five cases of early morphea pathologically characterized by interstitial infiltration of inflammatory cells were collected from 2010 to 2012.The clinicopathological features of these cases were retrospectively analyzed.Results The average clinical course was 7.5 months.The primary manifestation was edematous dark erythematous plaques,and interstitial or mixed infiltrate of inflammatory cells was the characteristic histopathological presentation.After anti-inflammatory treatment,lesions markedly improved or disappeared in 70％ of these patients.Conclusions Interstitial infiltration of inflammatory cells is a rare histologic pattern in early morphea.To learn and recognize this pattern may be beneficial to the diagnosis and treatment of early morphea.

Objectives To synthesize human telomerase reverse transcriptase (hTERT)- and human tolemerase RNA (hTR)- small interfering RNA (siRNA) and investigate their effects on telomerase activity in the cutaneous T-cell lymphoma (CTCL) cell line Hut78. Methods Two types of hTERT- and hTR- siRNAs were synthesized with T7 RNA polymerase via in vitro transcription, then either mixed with Hut78 cell lysates directly or transfected into Hut78 cells by calcium phosphate co-precipitation. Telomerase activity was tested by telomeric repeat amplification and polyacrylamide gel electrophoresis. Results With T7 RNA polymerase, hTERT- and hTR- siRNAs were synthesized efficiently with a concentration of 22.4?g siRNA per 40?L siRNA reaction mix. Telomerase activity was suppressed significantly by either of the siRNAs. The inhibition rate was 87% in the cell lysate group treated with siRNA directly, and 75% in the cell group Iransfected with siRNA. Conclusions The in vitro transcription of siRNA with T7 RNA polymerase is technically simple, costeffective, and can produce siRNA in an efficient way. hTERT- and hTR-siRNA can down-regulate telomerase activity significantly in Hut78 cells.

Aim To investigate the effect of the specif-ic inhibitor BIX-01294 of G9a on the proliferation, ap-optosis,DNA methylation and histone modulation of a-cute leukemia cell line, Molt-4. Methods Cells were cultured with different concentrations of BIX-01294 . Cell growth was determined by MTT. Cell apoptosis was analyzed by flow cytometry. The expression of Caspase-3, Bcl-2, Bax, P15, acetylated H3, H3 K9 me1 , H3 K9 me2 , H3 K9 me3 and H3 K27 me1 , H3K27me2 methylation were detected by Western blot. Results BIX-01294 downregulated bcl-2 , and upreg-ulated Bax, Caspase-3 and induced apoptosis in (5. 54 ± 1. 35)%, (10. 24 ± 2. 26)%, (32. 28 ± 3. 26)%, (47. 52 ± 4. 37 )% after 24 hours exposure to BIX-01294 in 0 , 1 , 2 , 4 μmol · L-1 . The difference be-tween them was statistically significant ( P <0. 05 ) . BIX-01294 inhibited DMNT1 and promoted P15 , which resulted in cell proliferation inhibition. Further studies showed that BIX-01294 decreased H3 K9 me1 , H3 K9 me2 , and H3 K27 me1 , H3 K27 me2 , and didn′t change protein expression of acetylated H3 and H3 K9 me3. Conclusion BIX-01294 inhibits G9a, resulting in downregulation of methylation of H3 K9 me1 , H3 K9 me2 , H3 K27 me1 and H3 K27 me2 and DMNT1 and P15 denovo. It inhibits cell proliferation and in-duces cell apoptosis.

OBJECTIVE To enhance the positive rate of the blood culture in order to make pathogenic diagnosis actually and quickly and conducting usage of antimicrobial agents in clinic.To value the clinical applied circumstance of BacT/Alert 3D automated blood culture system.METHODS The 3728 blood cultures were detected by BacT/Alert 3D automated blood culture system,and bacterial susceptibility test was conducted on all isolates using Kirby-Bauer methods with CLSI standards.To statistically analyze the examined time,the positive rate and variety and drug resistance for all kinds of pathogens.RESULTS The blood culture positive rate was 6.0% in the 3728 blood cultures with 222 strains of bacteria.The false positive rate was 0.2% and the false negative rate was 0.4%.The positive rate of blood culture was 0.89% in 12 hours,2.01% in 18 hours,and 3.51% in 24 hours.Among all the 222 isolates,29.7% were Enterobacteriaceae,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 13.6%,36.3%,42.4%,and 3.0%,respectively;20.3% were Staphylococcus,the drug resistant rates to erythromycin,levofloxacin,cefoxitin,and vancomycin were 75.6%,33.3%,68.9%,and 0,respectively;11.7% were Enterococcus,the drug resistant rates to errythromycin,levofloxacin,fosfomycin,and vancomycin were 96.2%,80.8%,23.1%,and 0,respectively;11.3% were non-fermented bacilli,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 32.0%,52.0%,32.0%,and 32.0%,respectively;12.6% were fungi.CONCLUSIONS The pathogens in the blood specimens are more wider in distribution and more higher in drug resistance rates than before.BacT/Alert 3D automated blood culture system can be an important tool for the blood culture,it can provide the diagnostic help quickly for the clinic and increase the positive rates in blood culture.It can not only shorten the check-up time,but also be more quick and more exact.

OBJECTIVE To understand the distribution or change and drug resistance of the bacteria flora in nosocomial infection,in order to provide laboratory evidence for controlling nosocomial infection and to indicate clinical antimicrobial agents usage.METHODS All isolates were identified by routine procedure and VITEK microbe automatic system and API identified system.Drug susceptibility test was used K-B paper disk diffusion method in accordance with the CLSI/NCCLS standards.RESULTS There were 11 464 strains of bacteria which were obtained from 2002 to 2006.Sputum,secretion and middle urine were the major specimens.The major bacteria floras were Pseudomonas aeruginosa,Escherichia coli,Acinetobacter,Enterococcus,Staphylococcus and Candida albicans,whose isolating rates were 57.02% in 2002,64.46% in 2003,57.83% in 2004,57.49% in 2005,and 60.73% in 2006.E.coli and Klebsiella pneumoniae produced ESBLs rates were from 39.87% to 61.98% that drug resistance rates to cefoperazone/sulbactam and imipenem were 14.06% and 0.64%.The drug resistance rates of nonferment Gram-negtive bacteria to cefoperazone/sulbactam were below 33.22%,Gram-positive cocci to vancomycin was below 0.34%.CONCLUSIONS Now,the important bacteria flora is nonferment Gram-negative bacteria in nosocomial infection.The P.aeruginosa,E.coli,Acinetobacter baumannii,Enterococcus faecalis,C.albicans,and meticillin-resistant staphylococcus(MRS) were prevalent important bacteria in nosocomial infection.The situation of producing ESBLs in Enterobacteriaceae is very severe.Glycopeptides are the best choice to MRS.To zymogenic bacteria and the nonferment Gram-negtive bacteria that cause severe infection,combining-drug treatment can be chosen according to drug susceptibility test results.

Objective To explore and observe the clinical characteristics and laboratory testing results of children with infectious mononuclear cells syndrome (IM),in order to improve diagnostic level.Methods 152 children with IM were selected,and the clinical manifestations,laboratory testing were retrospectively analyzed.Results There were a variety of clinical symptoms,the main clinical manifestations included fever 138 cases(90.8％),swollen lymph nodes 145 cases(95.4％),angina 112 cases (73.7％),hepatosplenomegaly 28 cases(18.4％),double eyelid edema 25 cases(16.4％),rash 7 cases(4.6％).Laboratory-testing of white blood cell count ＞ 10 × 109/L in 125 cases (82.2 ％),atypicallymphocyte proportion were more than or equal to 10％ in 48 cases (31.5 ％),liver function damage in 58 cases (38.2％),myocardial damage in 38 cases (25％),abnormal urine analysis in 30 cases (19.7％),thrombocytopenia 2 cases (3.4％).Conclusion Clinical symptoms of IM children are diversity,in some cases the clinical sympotoms are not typical,to improve the understanding of this disease can reduce the rates of missed diagnosis and misdiagnosis.