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 characteristics and ecological risk assessment of heavy metals pollution in the fluvial sediment in Hengyang section of Xiang river.Methods The fluvial sediments in 18 sites in 10 sections of Hengyang section of Xiang river were collected for determination of heavy metals(Cu,Zn,As,Hg,Cd,Cr,Pb) in 2007.The accumulation levels of heavy metals in the fluvial sediment and their potential ecological risks were assessed by the Hankanson potential ecological risk(PER) factors method.Results The average potential ecological risk index of Cd in sediment of Xiang river was 352.1 with the highest ecological risk,the index of Hg was 272.1 with higher ecological risk,the index of Pb and As was 150.1 and 104.7 with high ecological risk,the index of Cr,Zn and Cu were all lower than 40 with low ecological risk.On the whole,the integrated pollution index of seven kinds of heavy metal was 913.4.Conclusion The fluvial sediment of Hengyang section of Xiang rive has been polluted by heavy metals in a certain degree and is characterized as a complex pollution situation with a higher ecological risk.

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 .

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.

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.

Objective To observe the therapeutic effect of suspending-needle therapy combined with modified Zhengan Xifeng Decoction for the treatment of primary facial spasm,and to explore an effective traditional Chinese medicine therapy for primary facial spasm.Methods A total of 65 qualified patients were randomly divided into trial group (33 cases) and control group(32 cases),which was treated with suspending-needle therapy combined with modified Zhengan Xifeng Decoction,Carbamazepine tablets respectively.Twenty-eight days constituted one course of treatment.After treatment for one course,therapeutic efficacy of the two groups was evaluated,and the degree of facial spasm was assessed.Results (1) After one course of treatment,the markedly-effective rate of the trial group was 84.8％,and that of the control group was 62.5％,the difference being significant(P ＜ 0.05).(2) After treatment,the degree of facial spasm in the two groups was much improved as compared with that of the control group (P ＜ 0.05 or P ＜ 0.01),and the improvement in the trial group was superior to that in the control group (P ＜ 0.01).Conclusion Suspending-needle therapy combined with modified Zhengan Xifeng Decoction has better effect on relieving facial spasm of the primary facial spasm patients than Carbamazepine tablets.

Objective To examine the chemo-preventive effect of cyclooxygenase-2(COX-2) inhibitor (celecoxib) in an animal model of stomach carcinogenesis. Methods Eighty-six male Wistar rats were divided into six groups. The rats were given water alone (group A, n=5), N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) (group B, n=16), 3 mg/kg of indomethacin daily (group C, n=16), 5 mg/kg of celecoxib daily (group D, n=17), 10 mg/kg of celecoxib daily (group E, n=16) or 20 mg/kg of celecoxib daily (group F, n=16). The animals in group B to F were given 10% sodium chloride (in the initial 6 weeks) and drinking water containing MNNG (100 ?g/ml) to induce gastric adenocacinoma. All animals received treatment for 40 weeks, and were sacrificed after death or at week 48. Gastric tumor was evaluated histologically. Results Among 86 rats, 26 rats died, and 60 rats completed the experiment. The incidences of gastric cancer were found 0 (0%) in group A, 12 (75.0%) in group B, 11 (68.8%) in group C, 12 (70.6%) in group D, 3(18.8%) in group E, and 5(31.3%) in group F. There were significant differences in tumor incidence (P=0.002), multiplicity (P=0.001) and volume (P=0.009) among different groups. When compared with group B, the group E had the greatest reduction in tumor incidence (P=0.004), tumor multiplicity ( P=0.006) and mean tumor volume (P=0.02). Treatment with indomethacin had no significant effect on tumor development. Conclusion While treatment with indomethacin had no significant effect on tumor development, treatment with celecoxib reduced gastric cancer incidence and growth in rats.

Objective To further understand the etiology,definition,clinical manifestation,prognosis and treatment of cutaneous leukocytoclastic vasculitis.Method Retrospective study of23patients with leuko-cytoclastic vasculitis followed up at Peking Union Medical College Hospital from1990to2001.Results Twenty patients were classified as hypersensitive vasculitis,one of whom was diagnosed as Wegeners granulo-matosis2.5years later,two were diagnosed as urticarial vasculitis,and one was systemic lupus erythematosus.Conclusion Cutaneous leukocytoclastic vasculitis,which is usually a benign syndrome,may be caused by in-fection or drugs.Its main clinical manifestaions are skin symptoms.