ObjectiveTo explore the weaning method of mechanical ventilation in the treatment of acute severe respiratory failure caused by organophosphate poisoning.MethodsThe clinical features and weaning situation of 51 patients with acute severe respiratory failure caused by organophosphate poisoning by the treatment of mechanical ventilation were retrospectively analyzed.ResultsIn 51 cases,45 cases were cured,the survival rate was 88.2％ and 6 cases died,the fatality rate 11.8％.Conclusion Early ventilator to rescue and choose opportunity for weaning could directly impact on the qualitv of life of patients,and improve outcomes,and reduce mortality.

Objective:To explore the application value of clopidogrel in patients with non ST segment elevation myo‐cardial infarction (NSTEMI) during emergency percutaneous coronary intervention (PCI) .Methods :A total of 168 NSTEMI patients treated in our hospital from Jan 2012 to Feb 2013 were randomly divided into clopidogrel group (n=84) and ticlopidine group (n=84) ,both groups received PCI .Therapeutic effect were observed and compared be‐tween two groups .Results:Compared with ticlopidine group , there were significant rise in percentage of TIMI blood flow grade 3 (88.1% vs .91.7% ) ,white blood cell counting [ (4.0 ± 2.9) 109/L vs .(7.2 ± 2.3) 109/L] and platelet counting [ (101 ± 35) 109/L vs .(141 ± 39) 109/L] ,and significant reduction in percentage of mild bleeding (40.5% vs .19.0% ) in clopidogrel group after operation 28d , P< 0.05 or < 0.01 ;compared with ticlopidine group , there were significant reductions in incidence rates of cardiovascular events (60.7% vs . 27.4% ) and adverse reactions (14.3% vs .10.8% ) in clopidogrel group after six‐month follow‐up ( P<0.05 both) .Conclusion:Clopi‐dogrel possesses satisfying therapeutic effect and high safety in patients with non ST segment elevation myocardial in ‐ farction during emergency percutaneous coronary intervention ,which is worth extension .

AIM:To establish a quality standard for Anshen Wendan Pill(Rhizoma Pinelliae Praeparata,Pericarpium Citri reticulatae,Poria,Radix et Rhizoma Ginseng,etc.). METHODS:Pericarpium Citri Reticulatae,Fructus Schisandrae Chinensis,Radix et Rhizoma Ginseng,and Radix et Rhizoma Glycyrrhizae were identified by TLC,and the contents of schisandrin and hesperidin were determined by HPLC. The content of cinnabaris was determined by titration. RESULTS:Pericarpium Citri reticulatae,Fructus Schisandrae Chinensis,Radix et Rhizoma Ginseng,and Radix et Rhizoma Glycyrrhizae could be identified by TLC. The calibration curve of schisandrin was linear in the range of 0.017-0.52 ?g with the correlation coefficient of 1.000 0(n=5).The average recovery of schisandrin was 99.83%(RSD=0.86%,n=6). The calibration curve of hesperidin was linear in the range 0.506 -2.53 ?g,with the correlation coefficient of 1.000 0(n=5).The average recovery hesperidin was 100.43%(RSD=1.39%,n=6). The average recovery of cinnabaris was 98.30%(RSD=1.06%,n=6). CONCLUSION :The methods are simple,accurate and reproducible. They are suitable for the quality control of Anshen Wendan Pill.

Objective To study the method, advantage and shortcoming of mini-laparoscopic treatment for indirect inguinal hemia in children. Methods 136 cases with indirect inguinal hernia(right:75cases,left:44 cases,bilateral:17 cases) had been treated by high ligation with mini-laparoscopy. Results The mean operation time was 10 mmin for unilateral hernia and 23 mmin for bilateral hernia. Among 119 cases with unilateral hernia,38 cases had been found with contralateral latent hernia. The mean of postoperative inhospital stay were about 1 ～ 2 day(s). All patients had been followed-up for 3 ～ 12 months,there were only 2 cases recurrence found but no complications was detected.Conclusion Mini-laparoscopic high ligation for indirect inguinal hernia in children is a single, safe, satisfactory, effective,and minimally invasive surgical method.

Objective:To study the effect of recombined TNF ? combined with induction of apoptosis and its relation with expression of bcl 2 in SW480 human colon cancer cells.Methods:The inhibitive effect of 5 Fu and TNF ? was measured by MTT.Apoptosis of colon cancer cells was studied by TUNEL.The expression of bcl 2 gene was determined by immunohistochemical analysis.Results:After SW480 colon cancer cells were treated with combination in various concentration of 5 Fu and 3 000 U/mL of TNF ? for 48 h,MTT assay revealed a significant decrease of relative viability in compasrison to the control.When SW480 colon cancer cells were treated with 3 000 U/mL of TNF ? and 125 ug/mL of 5 Fu in combination for 48 h,TUNEL method showed the number of nick end positive cells was significantly increased in comparison to the control.The expression level of bcl 2 gene lowered significantly than that of the control group.Conclusion:These results confirmed that combined TNF ? and 5 Fu could synergistically induce apoptosis in SW480 cells and decrease the expression level of bcl 2 gene.

Objective: To construct an angiopoietin-like protein 2(ANGPTL2) expression vector and obtain ANGPTL2 over-expression endothelial cell strains.Methods: Plasmid phrGFP-C was used to amplify hrGFP protein coding sequence by polymerase chain reaction.The amplified sequence was cloned into the A multiple cloning sites of pIRES to construct plasmid pIRES-hrGFP.Complementary oligonucleotides containing the recognition sequence of BamH I,Sal I,Xba I and SSe8387 I were synthesized,annealed and cloned into a BamH I site on the backbone of plasmid pIRES-hrGFP to obtain vector pIRES-hrGFP-MS.ANGPTL2 cDNA was cloned by RT-PCR while human renal RNA was used as the templet and then inserted into the B multiple cloning sites of the vector pIRES-hrGFP-MS.The newly constructed ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 was linearized by Xba I and introduced into human umbilical vein endothelial cells.ANGPTL2 over-expressed endothelial clones were screened out by G418 selection and identified by the expression levels of both hrGFP and ANGPTL2 genes in these cell clones.Results: The ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 was constructed successfully and two ANGPTL2 over-expression endothelial strains were obtained.The cells displayed a significantly extended appearance quite different from that of the control cells.Conclusion: The successful construction of the ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 and the obtainment of two ANGPTL2 over-expression HUVEC strains have paved the way for further investigation into the function of ANGPTL2 and its possible role in diabetic nephropathy.

Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children.Methods 38 cases of impalpabal testes(46 testicular) had been operated by mini-laparoscopy in children with cryptorchidism.Results 38 children with nonpalpable undescended testis (46 testicular) had been operated by mini-laparoscope.Results After laparoscopic exploration,inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location,10 testicular were located in intraperitoneal cavity.In addition to the absent testicular,the rest had been performed with mini-laparoscope:one period descent fixation 41 testes,Fowler-Stephens (F-S) installment orchiopexy three testes.Follow-up with side testicular atrophy 2,including one period orchiopexy a testis,F-S installment fixation a testicular; Testicular rebound 1,who had been operated with one phase of testicular descent fixtion.Conclusion For inguinal failed to find the testicular,children with cryptorchidism should be done by laparoscopy because of its positioning accuracy,and most children can do a period drop fixed,but for those really intraperitoneal more exalted person,stage surgery should be needed.Its overall treatment effect is satisfactory and is worth popularizing.

Objective To study medial umbilical ligament in the prevention of recurrence of indirect inguinal hernia with large sac by laparoscopic treatment in children.Methods The clinical data of 178 cases of indirect inguihal hernia with large sacs in children were retrospectively analyzed.After high suture ligation of the internal ring with pediatric laparoscopy,all of the internal tings were covered with the same side of medial umbilical ligament to further strengthen.Results All cases were discharged from hospital 1～2 days after surgery.No recurrence and no any other complications could be found after following up 3～18 months.Conclusion Pediatric laparoscopic application of medial umbilical ligament to further cover the internal ring could significantly reduce the rate of recurrence for indirect inguinal hernia with large sac.This method of operation waft safe and feasible.It Was worth promoting.

Objective To investigate the factors correlated to coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients.Methods This study included 132 patients(54 females,78 males),aged 26-94 years,who were on hemodialysis for 10-204 months(median dialysis duration 51.00 months).The parameters including calcium,phosphorus,parathyroid hormone,total cholesterol,low density lipoprotein,triglycerides,C-reactive protein (CRP),klotho,and so on were assessed.Quantification of CAC was determined by multi-slice spiral computed tomography (MSCT),known as the coronary artery calcification score (CACs).Results Ninety-two patients (69.70％) had CAC,with CACs ranging from 0 to 13 450.20.More than 30％ patients experienced one even a variety of cardiovascular and cerebrovascular diseases.A positive correlation was observed between the degree of CAC and the incidence of cardiovascular and cerebrovascular diseases.Whereas a positive correlation existed between CACs and age (r=0.347,P=0.000),duration of hemodialysis (r=0.245,P=0.005),systolic blood pressure (r=0.184,P=0.034),diabetes history (r=0.211,P=0.015),phosphorus (r=0.262,P=0.002),calcium-phosphorus product (r=0.247,P=0.004);and a negative correlation between CACs and klotho level (r=-0.294,P=0.001).Multivariate logistic regression analysis showed that the main factor influencing the degree of CAC in MHD patients was age.Conclusions CAC is common and widespread in hemodialysis patients,who are often accompanied by cardiovascular and cerebrovascular diseases.The prevalence rate of cardiovascular and cerebrovascular diseases increases with the aggravation of CAC degree.Age,duration of hemodialysis,systolic blood pressure,diabetes history,disturbance of calcium and phosphorus metabolism and klotho are correlated with the severity of CAC.Age is an independent risk factor of CAC degree.

This study was aimed to observe four kinds of kidney-tonification medicine, which were Epimedium, pso-ralen, Ligustrum lucidum, Polygonum with the active ingredient of icariin, psoralen, oleanolic acid, stilbene glucoside and their orthogonal compatibility. There were two kinds of non-kidney tonification medicine, which were Chuanx-iong and astragalus with the active ingredient of TMP and astragaloside. The observation was made on the regulatory role of rat bone marrow stem cells (BMSCs). A total of 65 SD rats were randomly divided into the normal control group, positive transformed control group, kidney-tonification compatibility group (including Group 1, Group 2, Group 3, Group 4, Group 5, Group 6, Group 7, Group 8, and Group 9), non-kidney tonification medicine control group (in-cluding TMP group and astragaloside group). Intragastric administration of medication was given to the kidney-tonifi-cation compatibility group and the non-kidney tonification medicine control group, once a day for 3 consecutive days. Intragastric administration of equal amount of normal saline was given to the normal control group and the posi-tive transformed control group. On the third day of intragastric administration, rats in each group were sacrificed. Serum containing medication was used in the culture of BMSCs for 6, 12, or 18 days. ELISA method was used to quantitatively detect the expression activity and content of BMP2 on the 6th, 12th, or 18th day, in order to evaluate the degree of bone cell differentiation degree. Real-time quantitative PCR method was used for detection of expression of Bmp2, Smad1, Smad4 mRNA in serum containing medication in the culture of BMSCs on the 18th day. The results showed that the kidney-tonification compatibility can improve the expression activity and content of BMP2 culture in vitro, with the peak on the 12th day. The kidney-tonification compatibility groups can upregulate expressions of Bmp2, Smad1, Smad4 mRNA. It was concluded that the active ingredient compatibility of kidney-tonification medicine can promote BMSCs. Its mechanism may be related to the upregulation of expression of Bmp2, Smad1, Smad4 mRNA, and the activity and content of Bmp2.