Objective To explore the clinical effect of Salvianolate for treatment of coagulant function abnormality in patients with septic shock.Methods One hundred and fifty-two septic shock patients admitted to Intensive Care Unit (ICU) of Department of Critical Care Medicine,Liuzhou Municipal Liutie Central Hospital from January 2007 to June 2016 were enrolled,and they were divided into a control group (67 cases) and a Salvianolate group (85 cases) by random number table.In the control group,conventional western medicine treatment was given,while in Salvianolate group,besides conventional treatment,additionally,Salvianolate 200 mg intravenous drip was applied daily for consecutive 10 days.The levels of D-dimer and platelet count (PLT) were examined on the 1st,3rd,7th,10th day after admission;disseminated intravascular coagulation (DIC) incidence and mortality were observed in 10 days after admission in the two groups.Results The levels of D-dimer were significantly lower in the Salvianolate group than those of the control group on 3,7,10 days after admission (mg/L:3 days was 9.14 ± 2.25 vs.18.42 ± 3.15,7 days was 6.71 ± 1.49 vs.14.57 ± 1.81,10 days was 1.01-± 0.20 vs.4.79-± 0.81,all P ＜ 0.01).In both groups,on the first day after admission the level of PLT began to decrease,on the 3th,7th day the levels were lowered significantly,and on the 10th day,the level of PLT was elevated;in the Salvianolate group,the levels of PLT were obviously higher on the 3rd,7th,10th day after admission than those of the control group [PLT (x 109/L) 3 days after admission:67.05-± 7.76 vs.40.97 ± 6.51,7 days:67.24 ± 6.35 vs.32.06 ± 5.13,10 days:90.18 ± 11.42 vs.59.04 ± 6.57,all P ＜0.01].The DIC incidence and mortality were significantly lower in the Salvianolate group than those of the control group [DIC incidence:12.94％ (11/85) vs.38.8％ (26/67),mortality:5.88％ (5/85) vs.29.85％ (20/67),both P ＜0.01].Conclusions Coagulant function abnormality was found in most patients with septic shock.The cause of PLT decreasing is mainly due to micro-vascular thrombosis that consumes a lot of PLT.Early intervention with Salvianolate in such patients can inhibit thrombosis,block the exhaustion of PLT and correct the coagulant function abnormality with certain efficacy in the patients.

Objective Through the application of recombinant human Ⅱ tumor necrosis factor-Fc function protein (rhTNFR:Fc) in the treatment of juvenile idiopathic arthritis (JIA) with randomized control study,clinical characteristic and clinical effect were summarized.Methods According to the randomized controlled principle,124 patients with JIA were divided into control group and treatment group.The basic treatment in two groups were one antirheumatic slow-acting drug,nonsteroidal drug,adrenal cortical hormone.There were no significant differences between clinical type and basic treatment in two groups (P ＞ 0.05).Sixty-two patients of JIA treated with rhTNFR:Fc by subcutaneous injection.The doses was 0.8mg /kg per week.There were 17 cases of oligoarthritis,15 cases of polyarthritis,30 cases of systemic arthritis in the treatment group and control group respectively.The basic antirheumatic drugs,nonsteroidal anti-inflamatory drugs ( NSAIDs),adrenal cortex hormone were allowed to continued.Clinical evaluation index included ACR Pedi 30,ACR Pedi 50 and ACR Pedi 70.The adverse drug reactions were recorded.Results The remission rate of ACR Pedi 30,50,70 in 2 weeks,one month,three monthes and six monthes were different in types of JIA patients in the treatment group ( P ＜ 0.05 ).The remission rate of systemic arthritis was lower than the other two groups of arthritis ( P ＜ 0.05 ).Only 44％ ACR Pedi 50 remission was achieved after three monthes medication in systemic arthritis and 41.7％ ACR Pedi 50,29.2％ ACR Pedi 70 were achieved after six monthes.The remission rate in the types of oligoarthritis and polyarthritis at different time points (2 weeks,one month,three monthes,six monthes) of ACR Pedi 30,50,70 were similar.After six monthes,more than 80％ reached ACR Pedi 50 remission,more than half of patients reached ACR Pedi 70 remission.Three cases of macrophage activation syndrome in systemic arthritis group was effective treated with rhTNFR:Fc.In the treatment group,2 cases of systemic arthritis appeared ache and discomfort after one week treatment,3 cases appeared repeated mild upper respiratory tract infection and diarrhea during treatment,including one varicella infection.The incidence of adverse reactions in the treatment group of systemic arthritis were 16.7％,Other 2 types of patients did not show adverse reaction during rhTNFR:Fc treatment.Conclusion rhTNFR:Fc has good effect on oligoarthritis and polyarthritis of JIA.The adverse reactions of six monthes were rare.The cases of systemic arthritis could reach some clinical remission,but need to guard against infection and the occurrence of adverse reactions.To whom did not respond to conventional therapy in systemic arthritis or systemic arthritis combined with macrophage activation syndrome,it could be considered with rhTNFR:Fc.

Objective To explore the methods for estimating premorbid intelligence of patients with cerebral infarction.Methods Ten regression equations were employed to estimate intelligence quotients (IQs) of 74 patients and 74 demographically matched,healthy adults.Those valid estimated IQs were transformed into standard scores and adopted to evaluate the difference with don' t hold' subtests.Results In the healthy group,there were trivial difference between the estimated IQs and obtained IQs with mean discrepancy less than one and the correlation coefficients between them ranged from 0.755 to 0.956.However in the patients group,the estimated IQs were significantly higher than obtained IQs with mean discrepancy of 3.20-10.67.Mean estimated IQs of the patient group were lower than those of healthy group to varing degrees with mean discrepancy of 0.83-8.28,in which the mean IQs estimated just with demographic variables showed small between group effect size of 0.26,and so did IQs estimated with combination of demographic variables and performance on the Information or Figural Matrix (effect size:0.24 and 0.38 respectively).The latter two kinds of estimated IQs were adopted and transformed into standard scores to estimate premorbid intelligence.The two kinds of estimated normal scores of intelligence were higher than normal scores of the Digit Symbol (0.70 and 0.63 respectively) and the Block Design(0.67 and 0.61 respectively)in the patients group.As regarding the healthy group,the counterparts of discrepancies between estimates of intelligence and obtained scores were 0.21,0.21,0.12 and 0.12 respectively,which were significantly smaller than those in the patients group.Conclusion IQ estimated with combination of demographic variables and performance on the Information or Figural Matrix are suggested to estimate premorbid intelligence of patients with cerebral infarction.

Rosiglitazone is one of thiazolidinediones (TZD),an antidiabetic agent which improves insulin sensitivity,but the cardiovascular safety of the drug remains controversial.The new re-evaluation of the RECORD trial has suggested that rosiglitazone-containing drugs do not show an increased risk of heart attack compared to the standard type 2 diabetes medicines,such as mefformin and sulfonylurea.The post hoc analysis of the BARI 2D also indicates that rosiglitazone may not relate with the increased risk of major ischemic cardiovascular events.According to these new results,there is no clear evidence that rosiglitazone may increase cardiovascular risk.The U.S.Food and Drug Administration announced in July 2013 that it is requiring the removal of some prescribing and dispensing restrictions for rosiglitazone-containing diabetes medicines.

Objective:To meet the multitier needs of medical students′ health and health career development through the establishment of relevant mechanisms for medical charity and strengthening the social responsibility theme education among medical students. Methods:The present study was conducted in a stratified sample using the method of investigation mainly. The questionnaire was self -conducted; in the end 967 valid questionnaires were collected and combined with 48 relevant interviews. The data was analyzed using SPSS l6. 0. Results: The current positive trends of social responsibility among medical students are gratifying. The students had correct atti-tude to study but the initiative needed to be improved. The professional cognition was optimistic but the morality emphasis needed to be strengthened. The capacity cognitive was clearly but the awareness of accountability needs to be improved. The social consciousness was intense but responsibility needed to be strengthened. The life value was positive but the physical and mental health needed concerns. And it was needed to further strengthen social respon-sibility education. Conclusion: We should make full use of the excellent resources of the Affiliated Hospital of Medical College. With the medical charity starting point, the social responsibility should be strengthened through the Five in One promotion mechanism that including the culture education leading, clinical practice inspiring, social practice annealing, campus culture edifying, and powers of role model effecting.

Objective To explore the application value of indocyanine green (ICG)in sentinel lymph node biopsy(SLNB)for breast cancer.Methods A total of 160 patients with breast cancer in our hospital from January 2013 to December 2015 were analyzed,who were randomly divided into methylene blue group(n =65)and methylene blue plus ICG group(n =95).The success rate of detection,accuracy and false negative rate between two groups were compared.Results The success rate of detection and accuracy in methylene blue plus ICG group was significantly higher than thoase in methylene blue group,with statistically significant difference(P <0.05).The false negative rate of methylene blue plus ICG group was significantly lower than that of methylene blue group,with statistically significant difference (P <0.05).The number of sentinel lymph node in methylene blue plus ICG group was (2.9 ±0.9)/case which was more than (1.9 ± 0.5)/case in methylene blue group ,with statistically significant difference(P <0.05).The length of opertion of methylene blue plus ICG group was obviously shorter than that of methylene blue group.Conclusion Indocyanine green used in the sentinel lymph node detection for breast cancer can provide a reliable basis and reduce the false negative rate,who improves the level of diagnosis of breast cancer.

Mitochondrial disease is an unusual genetic disease .The in vitro fertilization technology of “three-parent embryos” as a new assisted reproductive technology , may help women to prevent their mitochondrial diseases passing on to their children , but it′s still controversial in many aspects .The article presents some scientific and ethical analysis and reflection on this technology .In terms of its necessity , safety, efficacy, and ethical were dis-cussed , and the application of the technology may bring the risk of concern is put forward , based on the present sit-uation of and attitude toward the technology should be taken to keep .

BACKGROUND: Rheumatoid arthritis(RA) is a systemic disease mainly characterized by chronic and symmetric polyarthritis. Peripheral neuropathy due to RA, however, is uncommon.OBJECTIVE: To analyze the clinical manifestations and laboratory findings of RA complicated by peripheral neuropathy in 5 cases.DESIGN: A retrospective case analysis based on patients as subjects.SETTING: Department of Rheumatism and Immunity, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.PARTICIPANTS: Totally 567 RA patients were admitted to Peking Union Medical College Hospital from January 1983 to December 2002, including 5 cases of peripheral neuropathy. All the cases met the criteria for RA formulated by American Rheumatism Association(ARA), according to which 5 cases of peripheral neuropathy in the active phase were confirmed due to RA. The laboratory indexes in 5 cases accorded with the active core indexes of RA.METHODS: Clinical data of 5 cases of RA were analyzed, and symptoms of peripheral neuropathy, as well as the indexes recorded electrophysiologically and in laboratory were recorded and assessed MAIN OUTCOME MEASURES: Sex, age, course of disease, severity of muscle strength disorder and sensory disorder, electromyography(EMG),biopsy of muscle and nerve, and related laboratory indexes.RESULTS: Five cases were enrolled, including 2 males and 3 females, 42 to 60 years of age(meanly 52 years old), and the course of disease ranged 1 to 14 years, and 5.4 years on the average. Four cases were hospitalized for neurological manifestations, accounting for 80% (4/5), and the other one appeared to have decreased muscle strength and hypoalgesia. Asthenia and numbness of limbs and hypoalgesia of the distal of limbs occurred in 4 cases,paraesthesia in 3 cases, foot drop in 2 cases, carpoptosis in 1 case, myatrophy in 3 cases, decreased muscle strength in 5 cases, and tendon areflexia in 3 cases; joint swelling or pain during the appearance and aggravation of peripheral neuropathy in 4 cases, increased erythrocyte sedimentation, increased level of C-reactive protein, high-titer rheumatoid factor and X-ray changes of joints( i. e., narrowed joint space or erosion and destruction on surface of joint) in 5 cases There were 3 cases complicated by vasculitis, and 2 cases by rheumatoid nodules. EMG showed damages of peripheral nerves in 4 cases. Muscle biopsy and nerve biopsy exhibited neurogenic lesion and chronic moderate axonal neuropathy respectively in 1 case.CONCLUSION: In the present study, the incidence of peripheral polyneuropathy was 1% (5/569), which mainly occurred or was aggravated in the active phase of RA. Among the 5 cases of peripheral neuropathy, 100% (5/5 )developed decreased muscle strength, 60% (3/5) developed myatrophy and 80% (4/5) had symptoms of peripheral neuropathy. The findings are helpful in the early diagnosis of RA.

OBJECTIVE: One possible autoantigen-human cartilage glycoprotein 39(HC gp-39) becomes a hotspot in the researches on the morbidity and the therapy of rheumatoid arthritis(RA) by international rheumatologists in recent years. This exploration would investigate the source, structure, and biochemical significance of HC gp-39 and its effects in RA morbidity.DATA SOURCES: HC gp-39 related articles between January 1990 and January 2004 were searched by the computer on Medline with the searching word of "HC gp-39" and the language of the article was limited in English.STUDY SELECTION: Totally 100 English literatures related with HCgp-39 were selected.DATA EXTRACTION: Related literatures were extracted according to the latest progress of HC gp-39.DATA SYNTHESIS: Summery was summed up according to the source,structure and function of HC gp-39,and the relationship between HC gp-39and disease,especially the relationship between HC gp-39 and RA.CONCLUSION: HC gp-39 can be used as another measurable indicator except the traditional indicators for RA activity. The establishment of serological detection method has certain significance for RA early diagnosis,the judgment of the situation of RA,the improvement of prognosis and transformation. Antigen-specific immunotherapy can be considered.

BACKGROUND: Studies of umbilical cord blood stem cells transplantation for liver function failure have demonstrated that Astragalus membranaceus preparation can stimulate hemopoietic stem/progenitor cell proliferation.OBJECTIVE: To explore the effect of Astragalus membranaceus injection on the differentiation of umbilical cord blood stem cell into hepatocyte in vitro and in vivo for the treatment of liver failure. METHODS: The third and fourth passage of human umbilical cord blood stem cells (HUCBSCs) were collected. In drug screening test, there were 4 groups: cells were separately cultured with 0, 40, 200, and 400 mg/L Astragalus membranaceus injection to screen the appropriate for cell growth. In cell differentiation test, there were 2 groups: HUCBSCs were respectively cultured with hepatocyte growth factor (HGF, 10 μg/L), and HGF (10 μg/L) plus 200 mg/L Astragalus membranaceus injection. D-aminogalactose was intraperitoneally injected to establish a model of acute liver failure. Surviving model rats (48 hours) were randomly divided into six groups: model control, Astragalus membranaceus injection, rat peripheral blood mononuclear cells, combination, combination+Cytoxan, and combination+dexamethasone groups. The alpha fetoprotein mRNA and albumin mRNA expression was determined by RT-PCR, and liver function indexes were observed. RESULTS AND CONCLUSION: Different mass concentration of Astragalus membranaceus injection displayed varied influence on HUCBSC proliferation: 200 mg/L was the best for HUCBSC proliferation. Compared with HUCBSC cultured with HGF alone, the number of albumen-positive cells in HUCBSCs cultured with 200 mg/L Astragalus membranaceus injection and HGF was greater (P < 0.05). Moreover, the expression of albumen mRNA in combination, combination+Cytoxan, and combination+dexamethasone groups was greater than rat peripheral blood mononuclear cells group, while alpha fetoprotein mRNA expression was only greater than rat peripheral blood mononuclear cells group in early stage. At 7 days of treatment, the values of alanine aminotransferase, aspartate amino transferase and total bilirubin were significantly greater in combination, combination+Cytoxan, and combination+dexamethasone groups compared with model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P < 0.05), but no differences were observed among model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P > 0.05). Results indicate that Astragalus membranaceus injection at 200 mg/L can promote the proliferation and differentiation of HUCBSCs into hepatocyte in vitro and in vivo, ameliorate liver function and improve treatment effect of HUCBSC transplantation for liver failure.