Objective To investigate the value of pathological examination in the diag-nosis of lethal cases due to acute poisoning.Methods The macroscopic and microscopic find-ings in 28 autopsy cases (10 cases of toxic gas,7 cases of pesticide,6 cases of drug,3 cases of alcohol and 2 cases of chinese herbal medicine) died of acute poisoning during the period from October,2001 to June,2012 were retrospectively reviewed.Results Gross Changes were found on gross examination in 22 of the 28 cases studied.Of them,7 cases died of acute carbon mono-xide poisoning had showed cherry red of Shiban,muscle,visceral organs and blood.In addition,11 and 8 cases had been found gastric mucosa hemorrhage and epicardium petechial hemorrhage respectively.Histologically,myocardial interstitial hemorrhage was observed in 9 cases,pulmonary hemorrhage in 18 cases,bronchospasm in 12 cases,cerebral hemorrhage in 4 cases,hepato-cyte necrosis in 11 cases,renal tubular necrosis in 7 cases and gastric mucosa hemorrhage in 11 cases.In 6 cases of oral pesticides poisoning,besides they had all gastric mucosa hemorrhage,the change of character of gastric contents was found in 3 cases and pesticide odor from stomach in 3 cases.In addition,acute inflammatory and necrosis of gastric wall in 6 cases of oral pesticides poisoning were observed under the light microscope.Drug addicts often suffered from chronic lesions in multiple organs,such as chronic liver disease,fatty infiltration of the myocardium with myocardial atrophy,interstitial lung disease and pulmonary foreign body granuloma.Conclusions Pathology examination is helpful in the diagnosis of some lethal cases due to acute ooisoning,and it can provide pathological basis to study on treatment of acute poisoning.

OBJECTIVE:To investigate the preparation technic of pantoprazole sodium freeze-dried injection.METHO_ DS:The kinds of auxiliary were screened based on the color and luster,external appearance,pH value,clarity and the compatible stability of pantoprazole sodium lyphilization injection with other infusion solutions;the content and other associated material of freeze-dried injection were determined by HPLC method.RESULTS:With Mannitol being freeze-dried powder supporting agent and disodium edetate being metal ion chelation agent and pH value at9.5～11.5adjusted by NaOH,the calibration curves of the prepared freeze-dried injection was linear within12.0～60.0?g/ml in concentration(r=0.9998),the average recovery rate of which at100.26%,RSD=1.14%(n=9),the labeled amount at98.6%.CONCLUSION:The preparation technics is appropriate and the quality control method is simple and feasible.And the prepared freeze-dried injection is able to meet both the pharmaceutical and clinical requirements.

Objective To investigate the influence of m4-1BBL on the anti-tumor effects induced by truncated human prostate specific membrane antigen (tPSMA) gene in mice. Methods A eukaryotic expression plasmid encoding tPSMA and m4-1BBL (pDC316-tPSMA-IRES-m4-1BBL), pDC316-tPSMA and pDC316 were constructed. C57BL/6 mice were vaccinated in the quadriceps femoris, respectively. The CTL activity of spleen cells from the immunized mice against prostate cancer RM-1-tPSMA was detected by CCK-8 kit in vitro. The tumor growth was then observed. Results The target cell specific cytotoxicity rate induced by pDC316-tPSMA-IRES-m4-1BBL was 42.6%, compared to 24.8% in the pDC316-tPSMA group and 10.8% in the pDC316 group. The difference was significant (P<0.05). The volume of tumor in the pDC316 group was 2657.4mm3 7 d after vaccination, compared to 1334.5 mm3 in the pDC316-tPSMA group, 9 d after vaccination. In the pDC316-tPSMA-IRES-m4-1BBL group, the tumor volume was 445.8 mm3, 12d after vaccination. The difference was significant (P<0.05). Conclusion Gene vaccines co-expressing tPSMA gene and m4-1BBL gene could significantly enhance anti-prostate cancer effects in mice.

Objective To study the application and significance of constructivism theory in pathological experiment teaching.Methods Six classes in total of 198 students majoring in clinical medicine were selected from grade 2009 of Guangdong medical college for research and were divided into experimental group (n=99) and control group (n=99) using random number table.Various teaching methods based on constructivism theory were used in experimental group while conventional teaching methods were applied in control group.The observing ability for specimen and slices,theoretical level and learning behavior of students were assessed with the same standard and anonymous homemade questionnaire survey was executed for students.SPSS 13.0 statistical software was used to analyze the results.The examination results of the two groups were compared using independent samples t-test.The questionnaire survey results of the two groups were compared using Wilcoxon rank-sum test.P＜0.05 represented the difference having statistical significance.Results The observing capability for specimen and slices,theoretical level and learning behavior of students in experimental group were significantly improved (P＜0.01)and the questionnaire survey results demonstrated that there were statistical difference in feedbacks between the two groups and the satisfaction rate was significantly improved in experiment group (P＜0.01).Conclusions Applying comprehensive teaching methods based on constructivism theory can stimulate students' interest and initiative in learning,improve students' learning behavior and learning strategies,and significantly improve the teaching quality.

Objective To investigate the effects of isehemic postconditioning (IPO) on the acute renal ischemia/reperfusion (I/R) injury in dogs. Methods Fifteen adult male mongrel dogs were randomly divided into three groups with 5 animals in each group. In sham operation group (S), after the dogs were anesthetized, the midline laparotomy was made and right nephrectomy was performed;In I/R group, animals were subjected to the similar surgical procedures, except that the left renal vessels were clamped; In IPO group, the IPO was induced by 6 cycles of reperfusion (30 s) and ischemia (30 s) after 60 min renal ischemia before reperfusion completely. Blood samples were obtained for determination of blood creatinine (Cr) and urea nitrogen (BUN) concentrations before operation and at 24, 48 and 72 h after operation. The dogs were killed at the thirdday after operation and left kidneys were removed for determination of SOD activity and MDA and MPO concentrations.The apoptosis in the nephridial tissue was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) and apoptotic index (AI) was calculated. The changes of renal tissue were examined by a microscope. Results Blood Cr and BUN concentrations in I/R group, IPO group and S group were decreased in turn after operation (P<0. 05). MDA and MPO concentrations were decreased significantly, SOD activity was significantly increased and AI was decreased significantly in IPO group as compared with I/R group at 72 h after operation (P<0. 05). Microscopic examination showed that there was no renal injury in S group and renal I/R resulted in tubular necrosis, medullary hemorrhage congestion and proteinaceous casts in I/R group. The renal I/R injury was significantly attenuated by IPO. In S group, IPO group and I/R group the renal AI was 2. 7 ±1.3, 28. 4 ± 6. 2 and 15.4±4. 1 respectively (P<0. 05). Conclusion IPO can attenuate renal damage induced by I/R by inhibiting oxidative stress and apoptosis and decreasing inflammation.

PURPOSE: The purpose of this study is to construct a recombinant adenovirus vector carrying mouse 4-1BBL and observe its effects in dendritic cells. MATERIALS AND METHODS: Mouse 4-1BBL cDNA was taken from the plasmid pcDNA3-m4-1BBL and subcloned into adenovirus shuttle plasmid pAdTrack-CMV, and then transformed into competent BJ5183 with plasmid pAdEasy-1. After recombination in E. coli, Ad-4-1BBL was packaged and amplified in HEK 293 cells. The expression of 4-1BBL in Ad-4-1BBL-transfected mouse prostate cancer cell line RM-1 was detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. After the co-culture of dendritic cells (DCs) with Ad-4-1BBL-transfected RM-1 cells, interleukin (IL)-6 and IL-12 production were assessed by enzyme-linked immunosorbent assay (ELISA) and co-stimulatary moleculs (CD80 and CD86) on DCs were analyzed by flow cytometry. RESULTS: The levels of IL-6 (3,960 pg/mL) and IL-12 (249 pg/mL) production in Ad-m4-1BBL-pulsed DCs were more than those in none-pulsed DCs. The differences were statistically significant (p < 0.05). The expression of co-stimulatary molecules (CD80 and CD86) was up-regulated in Ad-m4-1BBL-pulsed DCs. CONCLUSION: The results indicated the recombinant mouse 4-1BBL can effectively activate DCs.

Objective To explore the value of amplitude integrated electroencephalogram(aEEG)combined with electroencephalogram monitoring α percentage variation(PAV)in evaluating the short-term prognosis of patients with severe acute cerebral infarction(SACI).Methods A total of 212 SACI patients hospitalized in our ICU from January 2020 to December 2022 were recruited and then divided into poor prognosis group(93 cases)and good prognosis group(119 cases)ac-cording to the mRS score at 90 d.The differences in aEEG and PAV were observed between the two groups.Multivariate logistic regression analysis was used to observe the relationship of aEEG and PAV with poor prognosis.ROC curve was plotted to analyze the clinical value of aEEG and PAV in predicting the prognosis of SACI patients.Results The incidence of poor prognosis was 43.9％in 212 patients at the 90th day.The patients from the poor prognosis group had significantly higher aEEG score but lower PAV than those in the good prognosis group(P＜0.01).Multivari-ate logistic regression analysis showed that aEEG was a risk factor for poor prognosis(OR=1.403,95％CI:1.114-3.287,P=0.011),and PAV was a protective factor for poor prognosis(OR=0.714,95％CI:0.591-0.837,P=0.006).ROC curve results revealed that PAV had a high-er sensitivity,specificity and AUC value than aEEG in predicting poor prognosis of SACI pa-tients,and their combination obtained better sensitivity,specificity and AUC value than aEEG or PAV alone in the prediction(P＜0.01).Conclusion The combined use of aEEG and PAV has high clinical value in predicting the prognosis of SACI patients.

Objective To explore the correlation of nerve function and prognosis with serum uric acid(UA),homocysteine(Hcy)and low-density lipoprotein cholesterol(LDL-C)in patients with acute cerebral infarction(ACI)after alteplase intravenous thrombolysis.Methods A total of 220 ACI patients undergoing thrombolysis in Changsha First Hospital ICU between January 2020 and December 2022 were enrolled,and according to mRS score at 3 months after thrombolysis,they were divided into poor prognosis group(mRS score＞2,91 cases)and good prognosis group(mRS score ≤2,129 cases).The serum levels of UA,Hcy and LDL-C were compared between the two groups.The correlation between the three indexes and score of National Institutes of Health Stroke Scale(NIHSS),and their predictive value for poor prognosis were analyzed.Results At 1 and 3 d after thrombolysis,the serum levels of UA,Hcy and LDL-C and NIHSS score were sig-nificantly decreased in both groups,and the serum levels of UA and Hcy and NIHSS score at 3 d after thrombolysis were significantly lower than those at 1 d(P＜0.05).The poor prognosis group had obviously higher serum levels of UA,Hcy and LDL-C and NIHSS score at 1 and 3 d after thrombolysis than the good prognosis group(P＜0.05,P＜0.01).Pearson correlation analysis showed that the serum levels of UA,Hcy and LDL-C were positively correlated with NIHSS score at 1 and 3 d after thrombolysis(P＜0.01).ROC curve analysis indicated that the AUC values of UA,Hcy and LDL-C at 1 d after thrombolysis for predicting poor prognosis were 0.707(95％CI:0.639-0.776),0.800(95％CI:0.739-0.860)and 0.624(95％CI:0.550-0.698),respectively,while the values of them at 3 d after thrombolysis were 0.655(95％CI:0.583-0.726),0.730(95％CI:0.664-0.795)and 0.573(95％CI:0.497-0.649),respectively.Conclusion In ACI patients after thrombolysis,the serum levels of UA,Hcy and LDL-C are increased in those with poor prognosis,and are associated with the severity of nerve injury.The levels at 1 d after throm-bolysis have good predictive value for poor prognosis.

Objective To compare clinicopathological characteristics of coronary artery disease (CAD) patients with or without sudden coronary death(SCD).Methods A total of 145 autopsy cases with CAD were divided into SCD group(38 cases)and non-SCD group (107 cases).The difference on age,number of diseased coronary vessel,coronary athemsclerotic stage (fatty streak stage,fibrous plaque stage and atheromatous plaque stage),composite lesions of coronary artery,grade of stenosis severity,acute myocardial infarction,old myocardial infarction,hypertensive cardiomyopathy,myocardial fatty infiltration and arteriosclerosis of the arteries on the base of the brain were compared between SCD group and non-SCD group.Results (1) Patients were older in SCD group than in non-SCD group [(55.3 ± 14.5) years vs.(48.5 ± 13.3) years,P ＜ 0.01].(2) There was a significant positive correlation between coronary atherosclerotic stage and grade of coronary stenosis severity (rs =0.79,P ＜ 0.01).(3) The rate of multiple vessel disease,coronary atherosclerotic stage,composite lesions of coronary artery,grade Ⅲ-Ⅳ coronary artery stenosis,old myocardial infarction and arteriosclerosis of the arteries on the base of the brain were 60.5％ (23/38),84.2％ (32/38),63.2％ (24/38),86.8％ (33/38),36.8％ (14/38) and 34.2％ (13/ 38),respectively in SCD group,which were significantly higher than those in non-SCD group [25.2％ (27/ 107),29.0％ (31/107),18.7％ (20/107),19.6％ (21/107),3.7％ (4/107) and 6.5％ (7/107),respectively,all P ＜ 0.01].Conclusion Coronary artery atherosclerotic lesion is severer and patients are older in SCD patients than in non-SCD patients in this coronary artery disease patient cohort.

Objective:To retrieve and summarize the evidence of exercise guidance programs for patients with gynecological malignant tumors and lower extremity lymphedema, so as to provide a reference for medical and nursing staff to formulate and standardize the treatment and management of lower extremity lymphedema.Methods:This study used the population, intervention, professional, outcome, setting, type of evidence (PIPOST) tool to clarify evidence-based issues and set retrieval strategies, and include and exclude criteria. Guidelines, expert consensus, systematic reviews, original studies and other evidence related to gynecological malignant tumor-related lower extremity lymphedema exercises were systematically searched in common databases at home and abroad. The search time limit was from the establishment of the database to March 31, 2021. The quality evaluation of the articles was independently completed by two researchers systematically trained in evidence-based nursing.Results:A total of 16 articles were included, including 5 systematic reviews, 4 guidelines, 4 original studies, and 3 expert consensus. A total of 24 pieces of evidence were summarized from six aspects, namely, taboo population, exercise evaluation, exercise plan, exercise intensity, precautions and health education.Conclusions:The best evidence of exercise programs for patients with gynecological malignant tumor-related lower extremity lymphedema is collected and analyzed, and specific recommendations are put forward. Reliable evidence-based evidence and reference opinions are provided to standardize the use and practice of exercise programs for patients with gynecological malignant tumor-related lower limb lymphedema, so as to reduce the degree of lymphedema in patients and improve their quality of life.