Objective To determine the clinical indicators of early death (within 72 hours) in patients with acute paraquat poisoning.Methods The data of 93 acute paraquat poisoning patients admitted to emergency intensive care unit (EICU) of the First Hospital of China Medical University were retrospectively analyzed.The patients were divided into two groups according to whether they died within 72 hours or not.The gender,age,poison dose,paraquat concentration in urine,reduction of paraquat amount in urine after each hemoperfusion,and the worst value of white blood cell (WBC) count,lymphocytes count,arterial blood gas analysis,blood K +,Na+,Cl-,and serum amylase,serum lipase,serum total bilirubin,troponin Ⅰ,creatine kinase (CK),blood urea nitrogen,serum creatinine within 24 hours after poisoning were compared.Spearman correlation analysis was used to analyze the correlation between paraquat concentration in urine and the dose of paraquat.The predictive value of each indicator at death in early stage of poisoning was analyzed with receiver operating characteristic curve (ROC curve).Results Nineteen patients in the group of those died in early stage of poisoning (within 72 hours) resulted in a mortality rate of 20.4％.Compared with non-early death group,in early death group,the value of poison dose (mL:133.4 ± 108.8 vs.58.6 ± 40.0,t=3.145,P=0.002),paraquat concentration in urine [mg/L:16.34 (11.87,96.76) vs.4.46 (1.21,12.78),Z=-3.422,P=0.001],WBC (× 109/L:22.63 ±9.72 vs.14.95 ±8.39,t=3.446,P=0.001),blood lactate [Lac (mmol/L):6.7 (2.2,12.1) vs.1.9 (1.1,3.4),Z=-3.294,P=0.001] were significantly higher,and the reduction rate of paraquat concentration in urine after first perfusion [(38.4 ± 15.63)％ vs.(67.59 ± 27.87)％,t=2.945,P=0.004] and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg=0.133 kPa):28.7 ± 9.3 vs.34.8 ± 6.7,t=-3.245,P=0.002] were significantly lowered.There was no significant difference between two groups in other indexes.Poison dose and paraquat concentration in urine showed significantly positive correlation (r=0.450,P＜0.001).ROC curve showed that the predictive value of paraquat concentration in urine,WBC,and Lac in early death were significant [area under the ROC curve (AUC) of paraquat concentrations in urine was 0.806,95％ confidence interval (95％CI) 0.699-0.913,the cut-off value was 11.64 mg/L,with sensitivity 84.6％,specificity 71.4％; AUC of WBC was 0.734,95％CI 0.569-0.899,the cut-off value was 15.94 × 109/L with sensitivity 69.2％,specificity 76.8％ ; AUC of Lac was 0.729,95％CI 0.568-0.891,the cut-off value was 1.95 mmol/L with sensitivity 84.6％,specificity 42.9％].Conclusions Paraquat concentrations in urine,WBC,Lac,poison dose and PaCO2 were the risk factors of the early death of the acute paraquat poisoning.The research suggests that paraquat concentration in urine,WBC and Lac are valuable in predicting early death of the patients.

@@

Aim To study the changes of the biological behavior of dermal fibroblasts in Ⅲ skin burns wound in rats using chitosan.Methods Wistar rats were randomly divided into 5 groups as follows:1% chitosan(W/V)group,2% chitosan(W/V)group,4% chitosan(W/V)group,bFGF(basic fibroblast growth factor) group and the control group.Rats were made for Ⅲ skin burns.The wound healing time was recorded,and the wound healing rate was calculated.Then the cell cycle and apoptotic dermal fibroblasts were determined and the amount of Hydroxyproline(HOP) in the skin tissue was analyzed.Results The wound healing rate of 4% chitosan(W/V) group was higher and the wound healing time of 4% chitosan(W/V) group was shorter than that of the control group.On the 7th,14th day post-injury,the content of protein of 4% chitosan(W/V) group was higher than that of the control group.The content of HOP of 2% and 4% chitosan(W/V) group was highest on the 7th day post-injury. Compared with that in control group,the percentage of cells of S stage in 4% chitosan(W/V) group was aboundant,and was reduced in apoptotic dermal fibroblasts.Conclusion The changes of cellular biological behaviors might be one of the mechanisms of that Chitosan could promote the wound healing of Ⅲ skin burns in rats significantly.

AlM:To investigate the effect of teaching mode of problem- based learning ( PBL ) in the teaching of medical students' clinical ophthalmology.
METHODS: Five classes ( total 148 students ) were randomly selected as experimental group, using PBL method, at the same time another 5 classes ( total 151 students) were also randomly selected as control group, using lecture-based learning ( LBL) mode in 2010 grade. The scores of the experimental group were compared with control at the end of term. ln addition, students and teachers were respectively interviewed using self -administered questionnaire to obtain their evaluation for PBL practice.
RESULTS:The mean scores of PBL group (78. 35±7. 63) were significantly higher than control group (71. 68±6. 37) (P<0. 001). Most of students thought that their ability of referring, synthesizing and analyzing information was enhanced by PBL, and their skills both in written and oral were also improved. PBL made it easier to understand the contexts of course. lt was the best way to improve the effect of teaching in ophthalmology based on the increase of quality in novitiate that gives more chance to students of contacting with practice, developing the ability of clinical thinking and verifying the theory in clinical novitiate. Lots of teachers considered that the classroom atmosphere was more active, students were becoming more and more proactive on their classes and the relationship between students and teachers were more harmonious when PBL was used.
CONCLUSlON:Using PBL teaching mode can highly improve the teaching effectiveness of clinical epidemiology, which is worth popularizing.

Objective To study the effects of salt sensitivity on evolution of blood pressure and develope- ment to hypertension from adolescents to youth.Methods A baseline survey was carried out in 4623 adolescents aged 6-15 years old in Hanzhong rural area in 1987,310 of them were recruited for determination of salt sensitiv- ity using the tests of oral saline load and furosemide sodium-volume depletion.Salt sensitivity (SS) were diag- nosed in 101 while 209 subjects as no-sah sensitivity (NSS).This cohort of adolescents were followed up for av- erage 18 years.Results The response rate for this cohort of adolescents was 71.9%.At the end of follow up period,BP in subjects with baseline SS was higher in youth than that in NSS (SBP:122.9?13.1 vs 117.3?12.4, P

BACKGROUND:Accumulative evidence supports that vitreous cryopreservation can improve the cel survival rate. OBJECTIVE:To investigate the effect of vitreous cryopreservation on the tenocytes co-cultured with the porous polydimethylsiloxane (PDMS) scaffold. METHODS:Tenocytes were co-cultured with the porous PDMS scaffold for 9-14 days, and then preserved and resuscitated in the 10%dimethyl sulfoxide (DMSO), 21%DMSO and VS55, respectively. One hour later, the survival rate of post-resuscitated tenocytes versus pre-resusciated tenocytes was analyzed by live/dead double color fluorescent staining and flow cytometry. RESULTS AND CONCLUSION:Live/dead double color fluorescent staining revealed that tenocytes in the 10%DMSO group appeared to be irregular and double stained, and a large number of cel s shedding from the scaffold. The VS55 and 21%DMSO groups showed some spindle and hemispherical cel s single stained for green fluorescence and few double stained irregular cel s. Additional y, the cel density in the two groups was significantly lower than that in the control group. Flow cytometry results found that there were homogenous cel s in the control group;the number of cel s in the 10%DMSO group was too low to undergo flow cytometry;smal cel particles were visible in the VS55 group;in the 21%DMSO group, the cel volume was similar with the control group, and smal particles also existed. The survival rate in the VS55 group (64.9%) was significantly lower than that in the 21%DMSO group (76.2%;P<0.05). Conversely, the survived cel s were rare in the 10%DMSO group. To conclude, 21%DMSO vitreous cryopreservation improves the cel survival rate and is beneficial for tenocyte adherence to the scaffold.

Objective To study the significance of Titin-ab and Ryanodine receptor-ab (RyR-ab) in the myasthenia gravis (MG) patients and the expression of Titin and RyR epitopes in thymoma of myasthenia gravis.Methods Using ELISA methods,the titer of the Titin-ab,RyR-ab in the sera of 62 patients with MG,as well as 45 cases non-MG with other neurologic disorders and 50 case of normal controls were determined,and Titin and RyR were studied with immunohistochemistry stain in the 19 samples of thymic tissues from 9 cases of MG with thymoma (MGT),6 cases of MG with thymic hyperplasia (MGH), 2 cases of MG with thymic atrophy (MGA),and 2 cases of non-MG with thymic carcinoma (NMGTC). Results The positive rate of Titin-ab in MG was 35.5% (22/62),with the highest being 82.3% (14/17) in MGT group.The positive rate of RyR-ab was 24.2% (15/62),the highest being 76.5% (13/17) in MGT group.Titin receptor epitopes were expressed in the transmembrane and cytoplasm region of thymoma epithelial cells of 7 cases of MGT patients,and RyR epitopes in the transmembrane region of thymoma epithelial cells of 6 cases of MGT;but no Titin nor RyR epitopes was identified in controls and such thymic pathological patterns,as MGH,MGA,NMGTC.Conclusions Titin-ab and RyR-ab are mostly found in MGT patients;Titin and RyR epitopes are expressed in neoplasm epithelial cells of thymoma with myasthenia gravis;it's a result of autoimmunization of Titin and RyR epitopes irritated by Titin and RyR specific T cells activated by the change of pathogenic microenvionment inside the thymoma.

Objective:To purify HLA-DR molecules. Methods: Anti-HLA-DR antibody L243 was purified and coupled with CNBr activated Sepharose 4B gel. Immunoaffinity column was used to purify HLA-DR molecules. Results:Twenty micrograms of HLA-DR molecules were isolated from about 5 g Epstein-Barr virus-transformed human B lymphoblastoid cell line RAJI lysates by affinity chromatography. The purified HLA-DR molecules existed in α/β heterodimers form and could bind to conformation-dependent antibody L243. These HLA-DR molecules were separated into two strands,α and β,by boiling denaturation. These results are the basis for studying MHC Ⅱ binding peptide motif and CD4＋ T cell epitopes of antigens in future.

This study was purposed to establish new method for detecting CBFB-MYH11 fusion gene in acute myeloid leukemia (AML) and to evaluate its value in clinical use. All fusion types of reported CBFB-MYH11 fusion gene were defined by search of references and databank, then the primers and probes were designed on this basis, and 3 positive plasmids and negative cell line as control were established. GUSB gene was also amplified as an internal reference. The primer/probe sets were tested with 3 positive plasmids and HL-60 cDNA using quantitative real-time PCR (qPCR) assays, which were then combined as a multiplex qPCR for simultaneous detection of CBFB-MYH11 and GUSB. After optimization, the multiplex qPCR assay demonstrated both high sensitivity (10 copies for all the 3 plasmids) and high specificity. Finally, the multiplex qPCR assay was clinically evaluated with 58 AML patients, and 4 CBFB-MYH11-positive cases (6.9%) were detected, involving A type (3 cases) and J type (1 case). By comparison, the multiplex qPCR assay showed results concordant with sequencing results, and detected one case that was missed by cytogenetic analysis. It is concluded that a novel qPCR method for screening of CBFB-MYH11 fusion gene in AML is established. This method is fast, comprehensive, sensitive, specific, reliable, and should consider to be a robust tool for identification and management of AML patients with CBFB-MYH11 fusion gene.
Case-Control Studies ; Core Binding Factor beta Subunit ; analysis ; genetics ; HL-60 Cells ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Myosin Heavy Chains ; analysis ; genetics ; Oncogene Proteins, Fusion ; analysis ; genetics ; Real-Time Polymerase Chain Reaction

OBJECTIVETo evaluate and compare the efficiency and safety of laparoscopic surgery (LS) and open surgery (OS) in the treatment of colorectal carcinoma.

METHODSRandomized controlled trials on laparoscopic surgery and open surgery for colorectal carcinoma from January 2000 to October 2010 were searched in the databases of EMbase, PubMed, Cochrane Library, Sciencedirect, Springer, VIP, CNKI, CBMdisc. The methodological quality was assessed according to the standard of Cochrane systematic review. For homogeneous studies, RevMan5.0 software was used for meta-analysis.

RESULTSA total of 13 RCTs involving 4603 patients were included in this study, and among those 6 were multi-center randomized controlled trials. The meta-analysis showed that: the operation time of the LS group was longer than that of the OS group (WMD = 38.91, 95%CI: 33.89 - 43.93, P < 0.001), the blood loss (WMD = -138.14, 95%CI: -195.79 - -80.50, P < 0.001) and the length of hospital stay (WMD = 2.91, 95%CI: -4.65 - -1.17, P = 0.001) of the LS group was less than those in OS group. There was no significant differences between the two groups in the number of dissected lymph nodes (WMD = -0.62, 95%CI: -1.47 - 0.23, P = 0.150). There was no significant differences between the two groups in terms of the postoperative complications (30 days) (RR = 0.78, 95%CI: 0.59 - 1.01, P = 0.06). There was no significant differences between the two groups in 3-year overall survival (RR = 1.00, 95%CI: 0.96 - 1.04, P = 0.970). There was no significant differences between the two groups in 5-year overall survival (RR = 1.03, 95%CI: 0.99 - 1.08, P = 0.140). There was no significant differences between the two groups in 5-year overall recurrence (RR = 0.89, 95%CI: 0.74 - 1.07, P = 0.200).

CONCLUSIONSLaparoscopic surgery for colorectal carcinoma is a safe and effective therapy as open surgery in the short term or long term outcomes. It could be an acceptable alternative to open surgery for colorectal carcinoma.