Acute Disease ; Cardiomyopathies ; chemically induced ; Chemical and Drug Induced Liver Injury ; Critical Illness ; Ethylene Oxide ; poisoning ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; chemically induced ; Occupational Diseases ; chemically induced ; Respiratory Tract Diseases ; chemically induced

The construction of art mass organization in medical colleges can consummate quality education system,make up insufficiency of the classroom teaching,promote medical students' comprehensive development and innovative ability and mold fine mind and lofty medical ethics.Therefore,it has important theoretical and practical significance to study existing problems and find out the ways to improve art mass organization construction of medical schools.

Objective To summarize the diagnosis and treatment in neonatal cow’s milk protein allergy (CMPA) with sepsis like initial symptom. Methods CMPA patients with the sepsis like initial symptom (n=10) were selected in our hospital from July 2009 to December 2013. History data, clinical manifestation, laboratory results and the treatment outcome of them were retrospectively analyzed. Results Among these 10 cases, 6 have family history of allergy. Main clinical mani-festations include skin, gastrointestinal symptoms and 1 case of anaphylactic shock. IgE mediated 6 cases with acidophilic cells count of (1.40±0.17)×109/L (5%); The rest 4 cases were not mediated by IgE, with acidophilic cells count of (0.71± 0.08)×109/L (0.02-0.03). Blood cultures were all negative;Blood leukocyte count is (24.5±3.3)×109/L;Rod nucleus granulo-cyte/neutrophils count is (0.161±0.035) ×109/L;The platelet count is (655±39)×109/L;Blood interleukin (IL)-6 is 0.31-0.93μg/L;C reactive protein (CRP) is 85-144 mg/L. All 10 cases were with extensively hydrolyzed formular or amino acid formu-lar feeding. Then their clinical symptoms improved or disappeared significantly and the inflammatory indexes returned to nor-mal. Conclusion It is necessary to make the differential diagnosis between sepsis and neonatal CMPA,which is accompa-nied by increased platelet and acidophil. The most effective treatment of neonatal CMPA is hypoallergenic formular replace-ment therapy.

Objective To investigate the infection state and genotype of Babesia from tick at Alataw port,the China-Kazakhstan border.Methods Drag-flag method and animal body surface method were used to collect ticks at Ebinur Lake wetland,Alataw port.18s rRNA gene of Babesia was tested by polymerase chain reaction (PCR),the sequence analysis was conducted with Blast and phylogenetic analysis was conducted with Mega 6.0.Results The positive rate of Babesia gene in ticks was 12.65％ (32/253) at Alataw port.By sequencing,32 sequences were divided in ALSK174,ALSK191,ALSK019 three groups.Analysis of Blast showed that ALSK174 had the highest homology with Babesia caballi (EU888904,South Africa),it was 99.72％ (356/357);ALSK191 had the highest homology with Babesia occultans (KP745626,Turkey),it was 99.72％ (350/351);ALSK019 had 95.76％ (339/354) homology with Babesia odocoilei (KC460321,Canada).Conclusion In this study,we have first reported that the Babesia is infected from ticks at Alataw port,the China-Kazakhstan border.

We conducted the detection the Francisella spp.nucle acid from Hyalomma asiaticum asiaticum that main distribution is on railway line area from China-Kazakhstan border.The free-living ticks were collected and then identified by morphological and molecular methods.After species identification,they were detected by PCR targeting 16S rRNA and sdhA of Francisella spp.The amplified products were sequenced and the sequences was analyzed by using the Blast.A phylogenetic tree was constructed using MEGA 6 software.A total of 243 fleas were identified as H.asiaticum asiaticum.Only 35 samples were detected for Francisella spp.positive and the positive rate was 14.4％.Sequence analysis showed that two different sequences (seql and seq2) and all belong to Francisella-like endosymbionts (FLEs).Phylogenetic analyses showed that two FLEs were belong to the same cladd.This is first detection of FLEs nucleic acid from H.asiaticum Railway line area of China-Kazakhstan border.

Thirty cases of pituitary stalk interruption syndrome were divided into normal height (group 1) and short stature (group 2).There was no significant difference in growth hormone or insulin-like growth factor-Ⅰ levels between two groups(P＞0.05).Expected height and body mass index in group 1 were higher than those in group 2,while testosterone,cortisol,and FT4 were lower.Height were positively correlated with age,expected height,birth weight,and body mass index.The height of patients with pituitary stalk interruption syndrome depended on both genetic factors and the hormones from pituitary-target gland.

OBJECTIVETo explore the high-risk factors and analyze the clinical characteristics of massive pulmonary hemorrhage (MPH) in infants with extremely low birth weight (ELBW).

METHODSTwo hundred and eleven ELBW infants were included in this study. Thirty-five ELBW infants who were diagnosed with MPH were labelled as the MPH group, and 176 ELBW infants without pulmonary hemorrhage were labelled as the control group. The differences in clinical characteristics, mortality rate, and incidence of complications between the two groups were analysed. The high-risk factors for MPH were identified by multiple logistic regression analysis.

RESULTSThe MPH group had significantly lower gestational age, birth weight, and 5-minute Apgar score than the control group (P<0.05). The MPH group had significantly higher rates of neonatal respiratory distress syndrome, patent ductus arteriosus (PDA), early-onset sepsis (EOS), intracranial hemorrhage, pulmonary surfactant utilization, and death compared with the control group (P<0.01). The multiple logistic regression analysis showed that 5-minute Apgar score was a protective factor for MPH (OR=0.666, P<0.05), and that PDA and EOS were risk factors for MPH (OR=3.717, 3.276 respectively; P<0.01). In the infants who were discharged normally, the MPH group had a longer duration of auxiliary ventilation and a higher incidence rate of ventilator-associated pneumonia (VAP) compared with the control group (P<0.05).

CONCLUSIONSA higher 5-minute Apgar score is associated a decreased risk for MPH, and the prensence of PDA or EOS is associated an increased risk for MPH in ELBW infants. ELBW infants with MPH have a prolonged mechanical ventilation, a higher mortality, and higher incidence rates of VAP and intracranial hemorrhage compared with those without pulmonary hemorrhage.

Female ; Hemorrhage ; etiology ; Humans ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Logistic Models ; Lung Diseases ; etiology ; Male ; Pneumonia, Ventilator-Associated ; epidemiology ; Respiratory Distress Syndrome, Newborn ; epidemiology ; Risk Factors

BACKGROUNDp53 is a tumor suppressor and plays a key role in regulating cell hyperplasia, repairing DNA and inducing apoptosis. This study was to investigate p53 expression in fibroblast-like synoviocytes (FLS) and its effect on CD4(+) T lymphocytes from patients with active rheumatoid arthritis (RA).

METHODSHuman FLS were transfected with p53 siRNA and cocultured with CD4(+) T lymphocytes from patients with active RA. The expressions of osteoprotegerin and interleukin (IL)-6 were detected in p53 siRNA and scramble siRNA-transfected FLS. In addition, protein levels of interferon (IFN)-γ, IL-17, IL-4 and CD25 as well as mRNAs of IFN-γ, retinoic acid-related orphan receptor (ROR)-γt, IL-17 and Foxp3 in cocultured CD4(+) T lymphocytes were also measured.

RESULTSIL-6 decreased in p53-knockdown FLS while osteoprotegerin expression was not altered. FLS with p53 deletion significantly increased the production of IL-17 and IFN-γ by CD4(+) T cells and upregulated Foxp3 mRNA expression without effects on the proportion of CD4(+)CD25(high) T lymphocytes.

CONCLUSIONp53 in FLS might regulate Th1 and Th17 functions in patients with RA and participate in the pathogenesis of RA.

Arthritis, Rheumatoid ; genetics ; immunology ; metabolism ; CD4-Positive T-Lymphocytes ; metabolism ; Cells, Cultured ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Forkhead Transcription Factors ; genetics ; metabolism ; Humans ; Interleukin-6 ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Synovial Membrane ; cytology ; Tumor Suppressor Protein p53 ; genetics ; metabolism

Objective To fulfill standardized and precision management of medical consumables purchasing. Methods Medical consumables purchasing was executed based on the e-commerce platform in the drug exchange facility, the access process was standardized for medical consumables, and the monitoring and supervision were implemented for price inquiry, purchasing ways, introduction flow of new products, qualification inspecting of suppliers and etc. Results The improved medical consumables purchasing flow based on drug exchange mode contributed to decreasing purchasing cost, avoiding bidding risks as well as precision management. Conclusion The purchasing based on drug exchange is of great value for hospital medical consumables purchasing management.

Objective Throush identify biochemical characteristics and virulence factors of 2 strains suspected Yersinia pestis(Y.pestis)isolated from the dead Marmota himalayana(M.himalayana)to confirm the nature epidemic focus in Dege County,Sichuan Province.Methods Y.pestis was analyzed by specific staining and shape,culturing characteristics,splitting-test by bacteriophage,test of biochemical characteristics and glycolysis ability,virulence factors,virulence,nutritional requirement,plasmid,genetic test and genetic type. Results The tested strains were Gram staining bacilus.The main biochemical characteristics were Arabinose(+)、 Rhamnose(-),Maltose(+),Melibiose(-),Glycerol(+),Denitrification(+).The virulence factors with FI+.VW+, Pgm+,Pst I+;and with the common 6.0×106,45.0×106,65.0×106 plasmids,also with the virulence-relative plasmid gene.Both their absolutely lethal dose(LD100)in mice were 50 bacteria.The nutritional requirement appeared which were depended on Phenylalanine and Methionine.With the Genomovar 5 genotype characteristics of M.himalayana plague foci of Qinghai-Tibet plateau.The difference between tested strains and Yersinia pseudotubercuosis on the 3 different culture medium was obvious.The tested strains had a Y.pestis' specific 3a fragment,Pst I and FI-Ag,at 22 ℃,the strains could be split by bacteriophage completely.Conclusions According to the diagnostic criteria of plague in China,the 2 suspected strains isolated from Dege County,Sichuan Province ale confirmed as Y.pestis.both with powerful virulenceand with the characteristics of the Y.pestis of M.himahtyana in Qinghai-Tibet plateau plague natural focus.