Objective To explore the etiological spectrum of pancytopenia ,in order to improve the diagnostic accuracy . Methods Retrospectively analysed myelogram and clinical data of 196 cases of patients with pancytopenia syndrom .Results The dominant cause of pancytopenia syndrom in 196 cases of patients was hematological diseases (accounted for 68 .9% ) ,including acute leukemia (14 .8% ) ,myelodysplastic syndrome (12 .2% ) ,aplastic anemia(11 .2% ) and immune‐related pancytopenia(10 .2% );while non‐hematologic diseases accounted for 31 .1% ,including connective tissue diseases (10 .7% ) ,chronic liver disease(7 .2% ) and in‐fection(6 .2% ) .Conclusion Etiology of pancytopenia syndrom is complex ,which should be comprehensively analysed with closely contacting clinics ,in order to clarify the cause ,reduce misdiagnosis and missed diagnosis and improve the diagnostic accuracy .

Objective To detect peripheral blood neutrophil CD64 and procalcitonin(PCT)in children with diarrhea ,and to ex‐plore significance for differential diagnosis of diarrhea in children .Methods A total of 180 cases of children with diarrhea treated in this hospital from July 2012 to May 2014 were selected as subjects ,and were classified into three groups :bacterial diarrhea group (n=60) ,viral diarrhea group(n=60)and non infectious diarrhea group(n=60) .The levels of peripheral blood neutrophil CD64 and PCT were determined in all three groups ,and the diagnostic values of CD64 index and PCT were evaluated .Results The peripheral blood neutrophil CD64 index and level of PCT in the bacterial diarrhea group were significantly higher than those in the viral diar‐rhea group and non infectious diarrhea group ,and the positive rates of CD64 index and PCT in the bacterial diarrhea group were sig‐nificantly higher than those in the viral diarrhea group and non infectious diarrhea group ,all had statistically significant differences (P<0 .05) .The specificity and positive predictive value of CD 64 index in diagnosing bacterial diarrhea were significantly higher than those of PCT ,both had statistically significant differences (P<0 .05) .The relative analysis showed that the CD64 index was positively correlated with level of PCT (r=0 .865 ,P<0 .05) .Conclusion The CD64 index and PCT level of children with bacterial diarrhea increase significantly ,which indicates that the detection of CD64 index and PCT have significant clinical value in early diag‐nosis of bacterial diarrhea .

Objective To summarize the experiences of treatment of calculus obstructive pyonephrosis with transureteroscopic holium laser lithotripsy. Methods There were 13 patients with flank pain and fever, all patients received antibacterial therapy and nutritional support before operation ,the patients of calculus obstructive pyonephrosis were treated using transureteroscopic holium laser lithotripsy. Results The ureteral calculus were cleared off in 10 cases, and in three cases, the stone moved to pelvis during operation that they needed additional procedure of ESWL, no severe complications were observed. Conclusion Transureteroscopic holium laser lithotripsy is safe,minimal in-vasive and effective method for treatment of calculus obstructive pyonephrosis and the therapeutic scheme can be the first choice.

OBJECTIVE To investigate the distribution and resistance of commonly encountered pathogens in a General Hospital,and provide reference for antimicrobial agents usage.METHODS All pathogenic bacteria were isolated from the clinical specimens during the last four years and samples were identified.K-B method was performed to test the antibiotic resistance.RESULTS Among 1643 isolates,The Gram-negative bacteria Pseudomonas aeruginosaand Escherichia coli,and the Gram-positive bacteria Staphyococcus epidermidisand S.aureus were the main pathogens.The P.aeruginosa was highly resistant to broad-spectrum penicillins,third-generation cephalosprins,aminoglycosides and quinolones.But impenem showed activity against Gram-negative bacilli,with resistant rates less than

ObjectiveTo investigate the effect of dexmedetomidine on postoperative intracranial pressure (ICP) in patients with severe brain injury.MethodsNinety ASA Ⅱ or Ⅲ patients with severe brain injury,aged 19-64 yr,with Glasgow coma scale 3-7,undergoing emergency craniotomy,were randomly divided into 3 groups (n =30 each):control group (group C) and 2 different doses of dexmedetomidine groups (groups D1,D2 ).Anesthesia was induced with propofol 1.5-2.0 mg/kg,fentanyl 4 μg/kg and vecuronium 0.1 mg/kg and maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of vecuronium.The patients were mechanically ventilated after tracheal intubation.Dexmedetomidine 0.3 and 0.7 μg· kg- 1· h- 1 were infused after tracheal intubation in groups D1 and D2 respectively and the infusion was maintained for 48 h.ICP was monitored after operation and maintained ＜ 30 mm Hg by iv injection of hexadecadrol,mannitol and glycerol fructose within 2 d after operation.Venous blood samples were obtained from peripheral vein after anesthesia induction and at 6,12 and 24 h after operation (T0-3) for determination of sertum IL-1β and TNF-α concentrations by ELISA.The clinical results were evaluated using Glasgow prognosis score at 3 months after operation.The amount of hexadecadrol,mannitol and glycerol fructose consumed during 2 d after operation was recorded.ResultsCompared with T0,serum IL-1βand TNF-α concentrations were significantly higher at T1-3 in the three groups ( P ＜ 0.05).The serum IL-1β and TNF-α concentrations at T1-3 and the amount of hexadecadrol,mannitol and glycerol fructose consumed were significantly lower,and the clinical results were significant better in groups D1 and D2 than in group C,and in group D2 than in group D1 ( P ＜ 0.05).ConclusionDexmedetomidine can reduce postoperative ICP in patients with severe brain injury in a dose-dependent manner which is helpful for improving prognosis.The decrease in IL-1β and TNF-α levels and inhibition of inflammatory response may be involved in the mechanism.

Objective To evaluate the effect of dexmedetomidine on the postoperative pulmonary function in patients undergoing laparoscopic operation.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-70 kg,undergoing laparoscopic radical resection of rectal cancer,were divided into 2 groups (n =40 each) using a random number table:control group (group C) and dexmedetomidine group (group Dex).General anesthesia combined with epidural anesthesia was used.In group Dex,dexmedetonidine was intravenously infused as a bolus of 0.3 μg/kg over 10 min after epidural catheterization and before induction of general anesthesia,followed by an infusion of O.4 μg · kg-1 · h-1 starting from the end of tracheal intubation until 30 min before the end of operation.The equal volume of normal saline was given instead in group C.After epidural catheterization and before infusion of dexmedetomidine (T0),immediately before termination of pneumoperitoneum (T1) and at 1,6 and 24 h after operation (T2-4),blood samples were taken from the peripheral vein for determination of concentrations of serum interleukin-6 (IL-6),IL-10,tumor necrosis factor-alpha and malondialdehyde,and arterial blood gas analysis was performed simultaneously.Respiratory index and oxygenation index (OI) were calculated,and the occurrence of OI ≤ 300 mmHg was recorded.Results Compared with group C,the serum IL-6 and tumor necrosis factor-alpha concentrations and respiratory index were significantly decreased,and IL-1O concentrations and OI were increased at T1-4,and malondialdehyde concentrations were decreased at T1-3,and the incidence of OI ≤ 300 mmHg was decreased in group Dex (P＜0.05).Conclusion Dexmedetomidine can inhibit inflammatory responses and improve the postoperative pulmonary function in patients undergoing laparoscopic operation.

OBJECTIVE:To prepare anti-microbicide contraceptive gel and establish its quality control method. METHODS: The gel was prepared with octoxynol and policresulen as main ingredients and HPMC as matrix. The content of octoxynol in the gel was determined by HPLC,and the content of policresulen in the gel was determined by titration method. RESULTS:Prepared gel was well-proportioned and of good viscidity and its identification and test were up to the standard. The linear rang of octoxynol was 250～1 500 mg?L-1(r=0.999 6)with an average recovery of 100.84%(RSD=0.74%,n=9). The average labeled amount of policresulen was 106.64%(n=3). CONCLUSION:This preparation is feasible and stable in quality,and the quality control method is simple and accurate.

Objective To study the effects of Forkhead box protein M1 (FoxM1) down regulation by small interfering RNA(siRNA) on chemosensitivity and mechanism of human pancreatic cancer cell and its mechanism.Methods Three FoxM1 siRNAs were designed and constructed.All cancer cells were divided into different groups,after transfected with FoxM1 siRNA for different time,the cultured cells were harvested to carry on the next tests.Expression of FoxM1 were determined by red-time PCR and Western blot,and prolifearion and chemosensitivity were evaluated by MTT assay,and the phosphorylation of Akt protein was examined by Western blot.Results FoxM1 siRNA could down-regulate the FoxM1 expression in a dose-and time-dependent manner.The MTF results showed that the inhibit rates was 17.78％,17.56％,35.39％,52.81％,70.98％ indifferentgroups [Con-A + Gemcitabine,Con-B + Gemcitabine,siRNA (3.125nM) + Gemcitabine,siRNA (6.25nM) + Gemcitabine and siRNA(12.5nM) + Gemcitabine,respectively.The phosphorylation of Akt protein was inhibited in a dose-dependent manner.Conclusions FoxM1 siRNA could sensitize human pancreaticr cancer cells chemotherapy sensitivity,it is the one of the important mechanisms through down-regulate Akt phosphorylated levels,but the molecular mechanism need to be explored further.

Objective To investigate the effect of early intervention with education combined with treatment on developing intelligence of preterm infants. Methods Ninety seven preterm infants were assigned into the intervention group(n=49)and control group(n=48):Those in the former group were managed with early intervention by education combined with medical treatment and those in the latter were given routine preventive health service.The two groups were compared in terms of body length and weight at months 6,9 and 12 as well as the developmental quotient(DQ)with developmental screening test(DST). Result The scores on DQ in the intervention group were all significantly higher than those of the control at the three time points(all P<0.01).Conclusion The early intervention with education combined with treatment is effective for the early development of intelligence of preterm infants.

Objective To investigate the effect of preemptive analgesia with parecoxib sodium on postoperative cognitive junction in the elderly patients.Methods Sixty ASA ⅠorⅡ patients aged 69-83 yr weighing 47-73 kg undergoing elective operation on the femoral head or hip joint were randomly divided into 2 groups (n=30 each):control group (group C) and parecoxib group (group P).Their preoperative mini-mental state examination scores were more than 23.Parecoxib sodium 40 mg in 5 ml normal saline was injected iv before induction of anesthesia in group P. Patient-controlled intravenous analgesia with fentanyl and tramadol was used in all patients. VAS score was maintained ≤3. If VAS score was more than 3, a bolus of fentanyl 0.2 μg/kg was given iv.Venous blood samples were taken at 1 day before and 1, 4, 24 and 72 h after operation for determination of plasma concentrations of cortisol.Cognitive function was assessed by mini-mental state examination. The total amount of fentanyl and tramadol consumed was recorded. Results Plasma cortisol concentrations and incidence of postoperative cognitive dysfunction were significantly lower and the total amount of fentanyl and tramadol consumed was smaller in group P than in group C.Conclusion Preemptive analgesia with parecoxib sodium 40 mg can reduce the incidence of postoperative cognitive dysfunction in the elderly patients.