Post-resuscitation multiple organ dysfunction syndrome(PR-MODS) is a major cause of low survival rate in patients with cardiac arrest.To fully understand the concept of PR-MODS is beneficial for estimating the state of illness,adjusting the therapy and eventually increasing the survival rate.This article reviews the development of PR-MODS concept and compares it with MODS of other causes,including their pathogeny,pathology,mechanism,diagnosis and therapy.

Granulocyte colony-stimulating factor is a glycosylated polypeptide chain cell growth factor that can promote proliferation and differentiation of myeloid progenitors and induce maturation of these cells toward terminally differentiated neutrophils.Granulocyte colony-stimulating factor which functions and effects depend on the combination with specific receptor on the surface of effector cells.With the development of gene cloning technology,ganulocyte colony-stimulating factor recombinant products have been widely used in clinic to provide effective means for the treatment of leucopenia,In recent years,we find the therapy of chemotherapeutics combining with granulocyte colony-stimulating factor is effective in refractory/relapsed/elderly cases of acute leukaemia.Currently,granulocyte colony-stimulating factor is one of important and successful hematopoietic cytokines in clinic.

Objective To investigate the significance of three electrocardiographic indexes in predicting the myocardial infarct related artery (IRA) in inferior wall of acute myocardial infarction (IAMI) Methods One hundred and twenty patients with IAMI were studied Results (1) IRA was related to right coronary artery (RCA) in 98 (81 7%) case, left circumflex branch (LCX) in 22 (18 3%) cases (2) ST segment depression in lead Ⅰ identified RCA occlusion with a sensitivity of 77 6%, specificity of 90 9% in patient with IAMI, but isoelectric or elevated ST segment in lead Ⅰ identified LCX occlusion with a sensitivity of 90 9%, specificity of 77 6% (3) About QRS wave of lead aVL, S/R≥1/3 identified RCA occlusion with a higher sensitivity of 93 9% and a lower specificity of 63 6% (4) When IRA was RCA, ST segment elevated amplitude Ⅲ≥Ⅱ identified as a diagnostic index no matter the location of occlusion Conclusion Three electrocardiographic indexes have significant value in predicting the infarct related artery in inferior wall acute myocardial infarction

Objectives To analyze a rare autosomal recessive disease, aggrecan type spondylometaphyseal dysplasia (SEMD), which was caused by ACAN gene mutations. Methods A 7 years old girl was diagnosed with short stature after excluding growth hormone deficiency, idiopathic short stature, and hypothyroidism. Combining family history and clinical features, SEMD were suspected and genetic tests were performed. Results The patient was found with homozygous mutations of c.512C > T inACAN gene, and was diagnosed with aggrecan type SEMD. Her parents were found to be heterozygous mutation carrier. Conclusions In patients with high suspection of a special type of short stature, early genetic tests should be carried out for a clear diagnosis.

Objective To evaluate the diagnostic accuracy of Streptocuccus pneumoniae urinary antigen test (SpUAT) in patients with community acquired Streptocuccus pneumoniae pneumoniae (SPP). Methods The clinical studies relating SpUAT diagnostic accuracy for community acquired Streptocuccus pneumoniae infection were searched via computer and manual screening of Chinese databases including China National Knowledge Internet (CNKI), China Biology Medicine disc, China Technical Journal Full-text Database, and Wanfang Database as well as English databases such as PubMed, EBSCO, Elsevier Science, Ovid Technologies, and Springer. Data were extracted according to appropriate inclusion and exclusion criteria and analyzed with Meta-disc 1.4 and Stata 12.0 software. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio as well as diagnostic odds ratio (DOR) were calculated, and summary receiver operating characteristic curve (SROC) was plotted and area under SROC (AUC) was calculated to analyze the diagnostic accuracy of SpUAT for adult community acquired SPP. Results A total of 15 studies enrolling 6 866 patients were included, all of which with a quality assessment of diagnostic accuracy studies (QUADAS) score not lower than 10, indicating a high study quality. Random effect model was applied owing to non-threshold effect associated heterogeneity. It was shown by Meta analysis that compared with routine pathogen diagnosis (hemoculture, sputum smears, sputum culture and trachea and bronchus attractive culture), the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, and pooled negative likelihood ratio was 73% [95% confidence interval (95%CI) = 71%-76%,] 91% (95%CI = 90%-92%), 6.97 (95%CI = 4.13-11.77), and 0.30 (95%CI = 0.26-0.34), respectively, pooled DOR was 24.34 (95%CI = 13.14-45.11), and AUC of SROC was 0.8051±0.0362. It was indicated by heterogeneity test that experiment design (prospective or retrospective), sample sizes (lower than 200 or higher than or equal to 200), reference test (fewer than 3 or more than or equal to 3 test methods), or literature language (Hispanic or non-Hispanic) had no effect on study heterogeneity, indicating certain other unknown factors may be involved. Funnel plot suggested that 15 involved studies uniformly distributed along the two sides of regression line, indicating no publication bias. Conclusions The use of SpUAT for the diagnosis of adult community acquired SPP has a moderate sensitivity and high specificity. Although the overall accuracy of SpUAT diagnosis is relatively high, there is significant heterogeneity among the studies, so more high-quality studies are needed.

Objective To investigate the effect of polymorphism of plasminogen activator inhibitor-1(PAI-1) promotor region gene,plasma tissue plasminogen activator(t-PA)and PAI-1 on patients with acute pulmonary thromboembolism(APTE).Method Fifty-two patients with APTE were divided into two groups according to the presence or absence of traditional enviromnent risk facters,and there were26 patients in each gnup,and auother 57 healthy indiriduals as controls were analyzed.The genotypos of subjects were determined for the 4G/5G polymorphism of PAI-1 gene using polymerase chain reaction based restriction fragment length polymorphism analysis.Plasma PAI-1 and tPA were measured by ELISA.Results(1)The ratio of 4G/4G genotype in group without traditional environment risk factors was much higher than that of the other two groups.(2)Plasma t-PA decreased and plasma PAI-1 elevated significantly in group without traditional environment risk factors compared with that of the other two groups.(3)Except the 5G homozygous,plasma PAI-1 level in group without traditional environgment risk factors was significantly higher than the other two groups.There existed correlation between 4G allele and plasma PAI-1.Conclusions 4G/5G polymorphism of PAI-1 gene is associated with AFFE.4G/4G genotype increases the risk of APTE for individuals without traditional risk factors.There are hypercoagulation and hypofibrinolysis in APTE patients without traditional risk factors.

Objective To explore the expression, as well as the proportion of subsets of the natural killer (NK) T cells in peripheral blood of patients with esophageal carcinoma before and after surgery, and provide ideas and experimental basis for immune treatment through tests. Methods Using CD3, CD56, CD4 and CD8 antibody to study the NKT cells and its subsets. Peripheral NKT cell subsets in 59 patients with esophageal carcinoma were analysed by flow cytometer. Results With the ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 gradually increased, the proportion of phase Ⅲ- Ⅳ patients with esophageal carcinoma is gradually decreased between the groups. One-way ANOVA analysis showed that there were differences between the groups (P ＜0.05). The ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 was in Non-linear related to CD+3 CD+56 CD+4NKT cells; CD+3 CD+56 CD+8; NKT cells were positively correlated with CD-3 CD+56 NK cells and negatively correlated with CD+3 T cells.Conclusion The ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 may relate to tumor burden, and is helpful to determine the extent of disease in patients with esophageal carcinoma and prognosis.

Aim To observe the effect of Guishao-tongluo ( GSTL ) on the angiogenesis of vasa vasorum and oxidative stress in the early stage of atherosclero-sis. Methods The rabbits ( n =84 ) were randomly divided into 7 groups (n=12):control group,high-fat group, adventitial injury group, GSTL high(GH)and medium ( GM ) dose group, atorvastain group ( ATO ) , and Tongxinluo group ( TXL ) . The normal group was fed with common foodstuffs, and high-fat foodstuffs for the high-fat group to establish an early model of hyper-lipidemia, and all the other groups were fed with high-fat diet combined with carotid artery cannula to build early atherosclerosis carotid artery injury rabbit mod-els. The GSTL high and medium dose was given Guishaotongluo ultrafine powder 4. 16,2. 08 g·kg-1 · d-1 respectively. The atorvastain group and Tongxinluo group were given suspension of atorvastain solution 2. 5 mg·kg-1 ·d-1 , Tongxinluo supermicro powder 0. 6 g ·kg-1 ·d-1 . All groups were treated with gastric per-fusion for 4 weeks. Biochemical method was applied to detect blood lipid change. HE staining was used to ob-serve the pathological morphology of intima-media. Aactivity of serum superoxide dismutase( SOD) ,malon-dialdehyde ( MDA ) content and the total antioxidant capacity ( T-AOC ) in artery serum were detected. NADPH subunits p22phox mRNA, gp91phox mRNA in carotid arteries were located and semi-quantitated by fluorescence in situ hybridization. The expression of VEGF, VEGFR-2 in the carotid artery adventitia was detected by Western blot. Results Compared with normal group,the contents of TC,TG and LDL-C were significantly increased, and VEGF, VEGFR-2 protein levels were remarkly increased in high-fat and adventi-tial injury group. The carotid artery injuries,the degree of angiogenesis of vasa vasorum and NADPH subunits p22phox, gp91phox mRNA in adventitia tissue of the GH,GM, ATO and TXL group were milder in varying degrees compared with those of the vasa injury group. Also the activity of SOD,T-AOC increased,while MDA content,VEGF,VEGFR-2 protein levels were remarkly decreased ( P < 0. 5 or P < 0. 01 ) . Conclusions GSTL can inbibit adventitial neovascularization in the early stage of atherosclerosis, and its mechanism might be related to the increase of total antioxidant capacity of the vascular system and adventitia tissue.

Objective To evaluate clinical significance of the CEA, CA19-9, CA242, AFP, CA724,SCC, TPA, TPS combined detection for the clinical diagnosis of gastrointestial cancer. Methods 373 cases of upper digestive tract malignant tumor patient and 50 cases of healthy serum sample were detected for eight markers, evaluating the relationship between the level of markers and illness. Results 8 marker diagnostic positive rates were: CEA 26.80 %, CA19-9 27.34 %, CA242 34.14 %, AFP 2.84 %, SCC 19.72 %, CA724 12.13 %, TPA 34.15 %, TPS 30.89 %. The total positive rate of joint detection of 8 markers was 89.05 %.Preoperative CEA, CA242, SCC-positive patients had a shorter survival time. CA242 and CA19-9 levels with upper gastrointestinal malignancies were positively correlated. Conclusion The combined detection of a number of markers in different pathological type and clinical staging is statistically significant, and the positive rate is much higher than any single marker test results. CA19-9 and CA242 may be the best combination of monitoring the disease. CA724, CA242 and SCC can be as adverse prognostic indicators for cardia, stomach,esophageal malignant tumors, respectively.

Objective To assess the role of Th 17/Treg cell imbalance in the pathogenesis of HenochSch(o)nlein purpura (HSP). Methods Peripheral blood was obtained from 59 children with HSP and 38 ageand sex-matched healthy subjects. Flow cytometric analysis (FCM) was performed to detect the percentage of CD4+IL17+ T (Th17) cells and CD4+CD25+ Foxp3+ T (Treg) cells, real-time RT-PCR to measure the mRNA expressions of RORγt and Foxp3, which are specific transcription factors of Th17 and Treg cells, respectively.Results Patients with HSP showed a significant increase in the percentage of Th17 cells and mRNA level of RORγt (1.87% ± 0.56% vs 0.39% ± 0.15%, 7.71 ± 1.95 vs 1.49 ± 0.57, both P＜ 0.01) and a statistical decrease in the percentage of Treg cells and mRNA level of Foxp3 ( 1.63% ± 0.44% vs 5.04% ± 1.44%, 0.34 ±0.11 vs 1.71 ± 0.69, both P ＜ 0.01 ) compared with the normal controls. No significant difference was observed in the percentage of Th17 or Treg cells or the mRNA levels of RORγt or Foxp3 among patients with different types of HSP. Conclusion In patients with HSP, there is a change in the pecentage of Th17/Treg cells and expression of their transcription factors, which may lead to immune imbalance and contribute to the development of HSP.