Objective　To explore the significance of dynamic determination of arterial blood gas for early diagnosis, treatment and prognosis of patients with acute respiratory stress syndrome(ARDS). Methods　The results of 655 times arterial blood gas assayed in 113 patients with ARDS were analysed retrospectively.Results　(1)Types of acid-basic disturbance:The simple acid-base disturbances were 44 cases,in which respiratory alkalosis were 20 cases, respiratory acidosis 11 cases, metabolic acidosis 10 cases, metabolic alkalosis 3 cases. Complex acid-base disturbances were 53 cases,in which respiratory alkalosis with metabolic acidosis were12 cases, respiratory alkalosis with metabolic alkalosis 14 cases, respiratory acidosis with metabolic acidosis 21 cases, respiratory alkalosis with metabolic alkalosis 6 cases. Triple acid-base disturbances (TABD) were 16 cases, in which the type of respiratory alkalosis were 11 cases, the type of respiratory acidosis 5 cases. the types of acid-base disturbances in cured patients mainly were respiratory alkalosis (17 cases) and respiratory alkalosis with metabolic alkalosis (12 cases). The types of acid-base disturbances in dead patients were mainly respiratory acidosis with metabolic acidosis (19 cases),TABD (14 cases) and respiratory acidosis (9 cases).(2)The oxygenation indexes(PaO2/FiO2) of all 113 patients were less than 26.7kPa.(3)The cured rate in 113cases was 53/113(46.0%)and the mortality was 61/113(54.0%).Conclusion　Dynamic determination of arterial blood gas and calculation of index of oxygenation were of important clinical value in diagnosis and treatment of ARDS.

Objective To investigate the effect of multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in complex renal calculi operation. Methods Eighty six complex renal calculi patients were divided into two groups, study group (46 cases) was treated with multi-channel minimally invasive percutaneous nephrolithotomy combined with Yag laser, control group was treated with single-channel minimally invasive percutaneous nephrolithotomy combinated with extracorporeal shock wave treatment. Comparison of gravel removed time, stone clearance rate,postoperative hemoglobin decreasing rate, blood transfusion rate of surgery,length of stay time and operative complications were done between the two groups, the results were analysed statistically. Result The gravel removed time was (102±23) min in study group, and ( 121 ± 28) min in control group, there was no significant difference between the two groups(P ＞ 0.05 ). In study group, postoperative hemoglobin decreasing rate was 6.5%(3/46), blood transfusion rate of surgery was 17.4% (8/46), stone clearance rate was 82.6%( 38/46 ), length of stay time was (5.6 ± 1.7) d,while those in control group was 12.5%(5/40),22.5%(9/40),72.5%(29/40), (7.4 ± 1.8) d,respectively. There was statistical significance between the two groups(P＜ 0.05 ). Conclusion Multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in the treatment of complex renal calculi has the shorter operation time, less blood loss,less complications and higher stone clearance rate, and is worthy of promotion.

Objective To study the expression and distribution of TIMP 1 and TIMP 2 in liver tissue of cirrhosis patient and to investigate the roles and pathogenesis of TIMP 1 and TIMP 2 in liver cirrhosis. Methods TIMP 1 and TIMP 2 proteins and mRNA were detected with immunohistochemistry and in situ hybridization methods using monoclonal antibodies and cDNA probes. Results mRNA and proteins of TIMP 1 and TIMP 2 were detected in all the liver tissues from 40 liver cirrhosis patients, all in cytoplasm but not nucleus. TIMP 1 and TIMP 2 were found co exist in all samples, while TIMP 1 concentration was higher. Conclusions mRNA and protein of TIMP 1 and TIMP 2 are found in all the cirrhosis patient samples. Liver TIMP 1 and TIMP 2 concentrations increase with the progression of liver cirrhosis, decrease the degradation of extracellular matrix proteins, resulting in the initiation and the development of liver fibrosis and liver cirrhosis.

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

Objective To investigate the influence of participation of healthcare-associated infection (HAI)man-agement department in ward round presided over by hospital director on hand hygiene compliance of health care workers (HCWs)in a basic-level hospital.Methods Implementation of hand hygiene in January-June 2012 (control group :HAI management department didn’t participate ward round)and January-June 2013 (trial group :HAI management department participated ward round)were investigated,the compliance of hand hygiene of two groups of HCWs and consumption of hand hygiene products of each department were compared.Results HAI case rate in trail group was significantly lower than control group (1.49% vs 2.01% )(χ2= 4.31,P<0.05);HCWs’hand hy-giene compliance rate was significantly higher than control group (71 . 56% [3 249/4 540 ]vs 44. 00% [1 914/4 350]),hand hygiene compliance rates in nurses were higher than doctors of both groups(χ2= 151.30,179.92, respectively,bothP<0.001),hand hygiene compliance rate in trial group from high to low was department of pedi-atrics,obstetrics and gynecology,surgery,and internal medicine. The consumption of rapid hand disinfectant of trail group and control group was 5.38mL/bed-day and 1.88 mL/bed-day respectively,the consumption of hand sanitizer was 11.51 mL/bed-day and 7.03 mL/bed-day respectively.Conclusion Hand hygiene checked during the ward round presided over by hospital director can improve HCWs’hand hygiene compliance,reduce the incidence of HAI,and ensure medical safety.

The Union Youth Science & Research Fund was set up by the Peking Union Medical College (PUMC) using the Fundamental Research Funds for the central universities.Education Ministry's National College Special Fund for Basic Science& and Research drafted and implemented its own management rules.The rules standardize the fund's various aspects including its system construction,project classification,implementation terms,outlay management,and project management.In consequence,the rules promoted the young teachers' research on funded-subjects and improved the management level on scientific research projects.

Objective To observe the inhibition of asON phosphorothioate to the TIMP-1 gene and protein expression in the liver tissue of immune- induced hepatic fibrosis rats. Methods According to the analysis of modulator, structure protein, encoding sequence of TIMP-1 genome, we designed four different groups of asONs. These asONs were injected into the hepatic fibrosis rat models through coccygeal vein. The results were observed by RT-PCR, immunohistochemistry and in situ hybridization with collagen Ⅰ、Ⅲ, special staining of collagen fiber, electron microscope. Results The asON phosphorothioate of TIMP-1 could be expressed in vivo, and could block the TIMP-1 gene and protein expression in the liver of immune- induced hepatic fibrosis rats on the level of mRNA, which could promote the degradation of collagen Ⅰ、Ⅲ(P

Objective:To evaluate the effectiveness and safety of most common used regimens against brucellosis.Methods: Search PubMed and CENTRAL database of Cochrane library for all literatures written in English about treatment of brucellosis and CBM database for all RCTs for Brucellosis in Chinese from the year 1985 till now.Assess the quality of the included literatures using Cochrane Collaboration Risk of Bias form.Combine data of relapse,total therapeutic failure,and adverse reaction of regimens for treating human brucellosis.Results: 17 literatures were included.Combined antibiotic therapeutic regimens such as DR,DS,QR and DG were compared.Rate of total therapeutic failure(RRcb:2.53,95%CI:1.51-4.23) and relapse(RRcb:2.69,95%CI:1.46-4.98) of DS regimen was lower than those of DR regimen,while adverse reaction did not show any significant differences between them(RRcb:1.40,95%CI:0.97-2.01).No significant differences were seen in rate of relapse(RRcb:1.24,95%CI:0.67-2.30) and total therapeutic failure(RRcb:1.41,95%CI:0.86-2.32) between QR and DR regimen.QR regimen had lower rate of adverse reaction than DR regimen(RRcb:1.79,95%CI:1.17-2.74).Conclusion: DS regimen priors to DR regimen.QR equals DR in treatment outcome,has fewer adverse reactions meanwhile.Triple antimicrobial based on double regimens seemed to provide better outcomes without a significant increase in adverse reaction,but more clinical evidences are still needed.

Objective: To investigate the childrens congenital and acquired nutritional status and the physical development among the different nationalities in Guizhou province; to find out the factors that greatly influence the childrens physical development. Methods: Investigations were carried out on the diet, height and the weight of the mothers during the early and late stage of their pregnancy and after the delivery of the babies. Results: The living conditions in the groups of Miao and Buyi were very poor. For the pregnant women among Han, Miao and Buyi groups, during their middle and late stage of the pregnancy, the intakes of protein, calcium and VB 2 did not reach 80% RDA. For the 2-4 years old children, the intake of protein was below 80% RDA. For those in Miao and Buyi groups, the chief source of protein was from cereals. There was a great insufficient intake of calcium and VB 2 in different age groups of the children mentioned above. With the increase of age, the infants of Buyi and Miao groups were gradually diverting from the standard criterion from 3rd or 4th month. The greatest difference was in Miao group, i.e. at the age of 6, the difference in height was 9.8 cm(male), 8.3 cm(female); the difference in weight was 1.64 kg(male), 1.92 kg(female). Conclusion: The physical development of the infants in Buyi and Miao groups is inferior to those in Han group. Besides the environmental influence, the quality and quantity of the protein in diet play an important role in physical development.

BACKGROUND: Effects of Pericarpium aurantiin water extract on sleeping and spontaneous activity in Kunming mice has been investigated in three experiments, that is, the experiments of sleeping time due to supraliminal and subliminal dosage of sodium pentobarbital, and shaking cage for energy transducer, respectively.OBJECTIVE: To observe the influence of Pericarpium aurantiin water extract on sleeping and spontaneous activity of Kunming mice.DESIGN:Randomized controlled trial.SETTING: The Staff Rooms of Pathology, Physiology and Pharmacology in Gannan Medical College.MATERIALS: The experiment was conducted in the Central Laboratory of Science Research, Gannan Medical College from January through February 2005. Ninety adult Kunming mice, grade of clearness, were enrolled and randomly divided into three groups with 30 mice for each experiment:10 in control group, 10 in large-dosage group and 10 in small-dosage group.METHODS: ① In energy transforming trial, spontaneous activity of mice was recorded, small wave with wave amplitude ＜ 5 mm was considered as the waveform of gentle activity in mice, such as fur licking and tickling; middle wave with wave amplitude of 5-10 mm as the waveform of moderate activity, such as walking, standing, climbing up and down;large wave with wave amplitude ＞ 10 mm as the waveform of intensive activity, such as running, jumping up and down. Mice in the small-dosage group, large-dosage group and control group were respectively given intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline, and placed into the cage after 15 minutes. Then, 3 minutes later, waveforms of mice within 15 s was recorded. ② In the experiments on duration of sleep in mice due to supraliminal or subliminal dosage sodium pentobarbital, 0.02 mL/g or 0.01 mL/g sodium pentobarbital (2.5 g/L) were administrated intraperitoneally into mice in the small-dosage, large-dosage and control group 15 minutes after intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline were given to the three groups, respectively. Subsequently, comparisons of the number of sleeping mice, time to falling asleep, and sleeping time were carried out among the three groups.MAIN OUTCOME MEASURFS: ① Times of spontaneous activity, ②Sleeping time due to supraliminal dosage of sodium pentobarbital, ③ Duration of sleep due to subliminal dosage of sodium pentobarbital.RESULTS: All the mice were involved in the result analysis without loss.① There were fewer middle and large waves in the small-dosage and largedosage groups as compared with that in the control group (90.5±14.7,58.3±12.5, 45.6±10.1, t=2.341-3.215; P ＜0.05 or P ＜0.01), indicating that Pericarpium aurantiin water extract can evidently inhibit spontaneous activities in mice. ② In comparison with the control group, the time to falling asleep and the duration of sleep due to supraliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively,in the small-dosage and large-dosage groups. ③ In comparison with the control group, the time to falling asleep and duration of sleep due to subliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively, in the small-dosage and large-dosage groups.CONCLUSION: Pericarpium aurantiin water extract can prolong the duration of sleep and inhibit the spontaneous activities of Kunming mice,which is in cooperation with sodium pentobarbital in central inhibition.