Natriuretic factors,include cardionatrin(CN)and digoxin-like immunoreac-tive substances(DLIS),were important humoral factors relating to ascites formation inliver cirrhosis.An observation was made on the levels of plasma CN,DLIS,angiotensinⅡ, aldosterone and serum and urine sodium contents berore and after ascites extinction in40 cirrhotic patients.The results showed that the plasma levels of CN and DLIS had dis-tinct changes before and after ascites extinction and their changes were parallel with theactivity of renin-angiotensin-aldosterone system.These facts suggested that CN and DLIShad certain relation with ascites formation in liver cirrhosis.

To evaluate the risk of sequela after serious vaccine reaction.The rare serious vaccine reactions might result in sequela,the incidence of rare serious vaccine reactions,the estimated incidence of sequela and cases reported were reviewed.Further research should be developed to provide the scientific basis for sequela control and prevention.

Objective The study is to analyze the occurrence features of Adverse Event Following Immunization (AEFI) in China,and to evaluate the implementation of AEFI surveillance system,the safety of National Immunization Program (NIP) Vaccines and the quality of the immunization services.Methods The AEFI data of 2007-2008 were collected through the China Information System and the Children Immunization Information System,which reported before march 25,2009.The descriptive methodology was used in the study.Results 32120 AEFI cases of 2007-2008 were reported,95.02% were reported from 10 pilot provinces.The ratio of male and female was 1.41:1.77.53% cases were ≤1 years old and the cases were occurred more often between april to october.The first three vaccines are DPT,MPV and JREV.65.85% happened after the 1st and 2nd dose and 75.05% within ld after vaccination.The estimat reported incidence of NIP vaccines were 7.99～322.77 per million doses.In the classification of AEFI cases,79.93% cases were common,minor reactions,14.65% were rare,serious reactions and others were

Objective To analyze the detection results of 75 suspected type A influenza cases and to understand the distribution situation of influenza patients to provide the guidance for its early prevention and control .Methods The nasopharyngeal swabs specimens from 75 patients with suspected type A influenza were detected for understanding the viral infection situation by real‐time fluorescent quantitative PCR .Results In the specimens of 75 suspected patients ,13 cases with type A influenza virus were detected out ,in which 9 cases were the H1N1 subtype ,mean age > 50 years old .The temporal distribution was 3 cases in March 2013 ,1 case in April ,7 cases in January 2014 and 2 cases in February .No H7N9 subtype was detected out .Conclusion Real‐time fluores‐cent quantitative PCR has the characteristics of rapidness and high accuracy .The winter is the high onset season of flu ,elderly pa‐tients are susceptible to influenza virus .The monitoring and early treatment should be strengthened .

Objective To detect the levels of high mobility group box 1 protein HMGB1),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),C-reactive protein (CRP) in order to explore the clinical significance of HMGB1 in patients with severely traumatic brain injury.Methods A total of 75 patients composed of 40 male and 35 female with severely traumatic brain injury were hospitalized from March 2011 through March 2012.The scores of Glasgow Coma Scale (GCS) were 5-8 within 12 hours after brain injury.Casualties with history of hypertension,diabetes,severe diseases of heart,liver and kidney,and with concurrent trauma of other parts of body were excluded.Another 50 healthy subjects were enrolled as controls.Serum samples were taken from both patients and controls at admission.The levels of HMGB1,TNF-α and IL-6 were measured by using enzyme-linked immunosorbent assay (ELISA).The level of CRP was measured by using automatic biochemistry analyzer.Comparisons of the levels of HMGB1,TNF-α,IL-6and CRP between casuahies and healthy controls were carried out.The correlations of HMGB1 with TNF-α,IL-6,CRP in patients with severe traumatic brain injury were analyzed.Thereafter,75 patients were divided into two groups post hoc:the death group and the survival group.On the 1st day,the 3rd day and the 7th day after trauma,serum HMGB1 was detected.The comparison of HMGB1 was made between death group and survival group by using t-test.Results Serum HMGB1 level in the traumatic patients was higher than that of healthy controls (P ＜ 0.01).Correlative analysis showed that there was a positive correlation between HMGB1 and TNF-α (r =0.365,P＜0.05),IL-6 (r=0.530,P＜0.05),CRP (r=0.661,P＜0.05) in patients with severe traumatic brain injury.Serum HMGB1 level in the death group was higher than the survival group (P ＜ 0.01).Conclusions Increased serum HMGB1 level was found after severe traumatic brain injury.There were positive correlations between HMGB1 and three inflammatory factors,TNF-α,IL-6and CRP.Serum HMGB1 should be used as reliable hiomarker to judge the prognosis of patients with severe traumatic brain injury.

Objective To investigate the causes of a suspected outbreak of lower respiratory tract infection (LR-TI)caused by carbapenem-resistant Acinetobacter baumannii (CRAB)in the general intensive care unit(ICU)of a hospital,and provide scientific evidence for effective control of healthcare-associated infection(HAI).Methods Epi-demiological investigation on patients infected with CRAB and on-site monitoring on ICU environmental hygiene from March 4 to 23,2014 were performed,active prevention and control measures were taken.Results A total of 7 patients developed CRAB infection,the total length of stay during epidemic period were 160 days,the infection density of LRTI was 43.75‰(7/160),4 of 5 patients at No.02 bed had CRAB LRTI.Univariate analysis revealed that adopting conventional sputum suction procedure was a risk factor;the qualified rate of bacterial count on the object surfaces was 31 .75% (20/63).CRAB was also isolated from outer frame of suction device of No.02 bed, which had the same antimicrobial pattern as CRAB from 7 patients’sputum.After taking a series of controlling measures,there was no CRAB infection case after March 24,2014,this outbreak was effectively controlled. Conclusion This suspected HAI outbreak may be caused by inadequate disinfection of outer frame of suction device contaminated by CRAB,and horizontally transmitted through manipulation of sputum suction by health care workers.Clean and disinfection of ICU environmental object surfaces is of great importance for preventing HAI.

BACKGROUND:With the medical development, prognostic outcomes of spinal cord injuries have not been improved significantly, and most patients also suffer from severe complications. Nowadays, lots of laboratories and clinical researches have suggested that celltherapy has a great potential, especial y the application of umbilical cord blood stem cells in nervous system diseases. OBJECTIVE:To explore the feasibility and clinical effect of umbilical cord blood neural stem cells transplantation for patients with obsolete spinal cord injury. METHODS:Umbilical cord blood was harvested from newborns under aseptic condition, and differentiated into neural stem cells in vitro that were prepared into cellsuspension at a concentration of 109/L. The cellsuspension (3 mL) was injected via the L 3-4 or L 4-5 into the subarachnoid space. American Spinal Injury Association (ASIA) scores and the residual urine were assessed before and 3 months after transplantation. RESULTS AND CONCLUSION:After transplantation, al the patients showed a stable life indication. Three months later, ASIA scores were increased and the residual urine decreased, which significantly differed from those before transplantation (P<0.05). These findings indicate that umbilical cord blood neural stem cells transplantation is a new treatment that can improve the limb function and life quality of patients with obsolete spinal cord injury.

Radiological evaluation is a key step for donor's preoperative evaluation in living donor liver transplantation(LDLT).There are many powerful functions in multi-slice computed tomography (MSCT)which can suit all-in-one radiological evaluation before donor's operation.By referring to the articles from home and abroad in recent years,from viewpoint of surgeon,this artical reviews the application status of multi-slice CT for preoperative assessment in LDLT,which can help to provide theory support for choice of radiological examination in LDLT donor.

Objective: To explore the effects of Cordyceps extract in regulating the imbalance of Th1/Th2 ratio and inhibiting the inflammatory reaction, and to find the theoretical basis of Cordyceps extract for treating asthma in remission stage. Methods: A total of 20 peripheral venous blood samples (3 mL) were collected from 20 asthmatic children during remission stage, and peripheral blood mononuclear cells (PBMCs) were separated by Ficoll method. PBMCs were separated into three groups (blank group, low-dose group and high-dose group). The PBMCs were incubated in vitro for 48 hours in the absence (blank group) or presence (low-dose group and high-dose group) of Cordyceps extract at different concentrations (10, 20 mug/mL). The expressions of interferon-gamma (IFN-gamma), interleukin-4 (IL-4), IL-10, T-box expressed in T cells (T-bet), GATA-binding protein-3 (GATA-3) and forkhead/winged-helix transcription factor-3 (Foxp3) mRNAs in PBMCs were measured by real-time fluorescent quantitative polymerase chain reaction, and the contents of IFN-gamma, IL-4 and IL-10 in supernatants were measured by enzyme-linked immunosorbent assay. Results: The expressions of IFN-gamma mRNA showed no significant differences among the three groups. The expressions of the IL-4 mRNA in the high-dose group and the low-dose group were lower than that in the blank group (P=0.014, P=0.011). The expression of IL-10 mRNA in the high-dose group was higher than that in the blank group (P=0.034). And the differences of the IFN-gamma mRNA/IL-4 mRNA ratio presented no statistic significance among the three groups. The level of IL-4 content in the high-dose group was lower than that in the blank group (P=0.018), but the level of IL-10 content, and ratio of IFN-gamma/IL-4 in the high-dose group were higher than those in the blank group (P=0.011, P=0.045). The differences of the IFN-gamma presented no statistic significance among the three groups. The T-bet/GATA-3 ratio and Foxp3 mRNA expression in the high-dose group were higher than those in the blank group (P=0.001, P=0.015). There was significant difference in expression of GATA-3 mRNA between the high-dose group and the blank group (P=0.028), and between the low-dose group and the blank group (P=0.019). The expression differences of T-bet mRNA were insignificant between any two groups. Conclusion: Cordyceps extract can inhibit the proliferation and differentiation of Th2 cells and reduce the expression of related cytokines by down-regulating the expression of GATA-3 mRNA and up-regulating the expression of Foxp3 mRNA in PBMCs. Meanwhile, it can alleviate the chronic allergic inflammation by increasing the content of IL-10.

Objective To evaluate the safety and effect of one-way barbs line (absorbable sutures v - locTM180) in primary suturing of laparoscopic choledocholithotomy. Methods From July 2014 to June 2015, clinical data of 86 cases performed primary suturing in laparoscopic choledocholithotomy by the same performer were retrospectively analyzed. The patients were divided into three groups, One-way barbs line continuous full-thickness suture group (A group), ordinary absorption line continuous full-thickness suture group (B group) and ordinary absorption line discontinuous full-thickness suture group (C group). The bile duct suture needed time, intraoperative blood loss, postoperative eating time, postoperative hospital stay and postoperative bile fistula were compared. Results All the 86 cases underwent successful operation without T tube, and none of them received alternative open operation. Compared with group B and C, time needed for bile duct suturing in A group have statistical significance. There was no significant difference in the intraoperative blood loss, postoperative eating time, postoperative hospital stay between the three groups (P > 0.05). The incidence of postoperative bile fistula in A group were none. The incidence of postoperative bile fistula in B group was 1 case, the incidence of postoperative bile fistula in C group was 2 cases.Conclusions The method of one-way barbs line continuous full-thickness suture were simple and secure in primary suturing of laparoscopic choledocholithotomy.