10% at 24-hour later than the initial value.Conclusion In patients with refractory septic shock who achieved the goal of combiming CVP ≥ 8mmHg,MAP ≥ 65mmHg,SmVO2 ≥ 65% hyperlactemia was ameliorated.Lactate clearance rate can be used as a good marker to predict outcome of septic shock patients.

Objective To Observe both curative and side effects of rhIL-11(recombinant human interleukin 11)in preventing and curing thrombocytopenia caused by chemotherapy.Methods From May 2003 to May 2004,research was done in the Department of Oncology,General Hospital of Shenyang Military Region by adopting double-blind placebo contrast and self cross-over study methods on 42 non-small cell lung cancer patients who had received GC chemotherapy.The effects of rhIL-11 and placebo on the minimal number of thrombocytes and their toxins were compared.24 hours later after the medicine for chemotherapy was given,rhIL-11 was administered hypodermically to the patients at the amount of 25 ?g/kg for 7 to 14 days.When the thrombocyte number was higher than 300?10~9/L,the administration of rhIL-11 was stopped.Results RhIL-11 could obviously increase the minimal number of thrombocytes during chemotherapy and reduce the times for blood transfusion.The side of rhIL-11 were mild edema,weariness and symptoms of catching cold.Conclusion RhIL-11 plays an obvious role in preventing and curing thrombocytopenia caused by chemotherapy,and has safe and definite curative effects without serious effects.

Objective To investigate the relationship between brucellosis arthritis of the hip and femoral head necrosis.Methods In August 2007 to August 2013,16 diagnosed and hospitalized patients with brucellosis complicated with femoral head necrosis in Heilongjiang Land Reclamation Bureau General Hospital were chosen as the objects of observation,and the patients' hospitalization information was analyzed retrospectively.Patients' medical records were investigated and analyzed.Observations included general condition of the patient,clinical symptoms and signs,imaging,pathology,treatment and curative effect.Results All the 16 patients had definite clinical manifestations of hip arthritis and femoral head necrosis including hip pain,limited mobility,positive 4 test,limp or bedridden,and sick limb muscle atrophy.Imaging examination:X-ray computer tomography (CT) showed cystic change and deformation collapse of femoral head.Magnetic resonance imaging(MRI) showed low signal on weighted T1 images,high signal on weighted T2 and soft tissue granulation hyperplasia could be seen in the hip joint.Pathological examination:most femoral bone tissue necrosis,dissolved,bone cells disappeared,a few bone cells present,and some fibrous tissue hyperplasia.Patients were treated with antibiotics according to the treatment principles of brucellosis,and the effect was obvious.Conclusions There is a causal relationship between brucellosis arthritis of the hip and femoral head necrosis.Therefore,positive and effective treatment of brucellosis arthritis of the hip in the early stages is crucial to prevent the occurrence of femoral head necrosis.

Objective To investigate the relationship between end-tidal carbon dioxide with its related indicators and ventilation/perfusion of the acute respiratory distress syndrome (ARDS) lung,and to explore a feasible way to titrate positive end-expiratory pressure (PEEP) in clinical practice.Methods Five mixed-breed dogs with oleic acid lung injury model were mechanically ventilated at a serial PEEP trial including a recruitment maneuver (RM) before each PEEP level changed.The value of blood dynamics,end-tidal carbon dioxide partial pressure ( PetCO2 ) and arterial carbon dioxide pressure under different PEEP levels were recorded.Arterial end-tidal carbon dioxide gradient (Pa-etCO2) and dead space fraction (Vd/Vt％) were calculated.All dogs received CT scan.Lung volume under different pressure levels,and ratio and volume of alveolar closing pressure,collapsed alveoli,sufficiently and insufficiently ventilated alveoli were obtained.Alveolar opening and closing analysis were performed by non-liner regression equation.Results The mean pressure when Vd/Vt％ obtained lowest level were ( 11.2 ± 4.4 ) cm H2O(1 em H2 O =0.098 kPa),which had no significant difference when compared to alveolar closing pressure[ ( 11.5 ± 3.2 ) cm H2O ]( P ＞ 0.05 ).The fraction of insufficiently ventilated and collapsed alveoli showed a significant linear correlation with the Vd/Vt％ when PEEP was lower than Pmin ( r =0.632,P =0.004 ).There was a linear correlation between the Vd/Vt％ and the fraction of over-distended alveoli when PEEP was higher than Pmin ( r =0.770,P =0.001 ).Conclusions Closing pressure is in accordance with PEEP level after RM having reached the best ventilation/circulation ratio.The characteristics of lung collapse can be revealed by Vd/Vt％ changes after RM.To titrate PEEP for the lowest Vd/Vt％ after RM may be a feasible way to match the best ventilation and circulation effects of PEEP.

Objective To investigate the clinical efficacy of autologous dendritic cells and cytokine-induced killer cells (DC/CIK) combined with transcatheter arterial chemoembolization (TACE) in the treatment of moderate and advanced hepatocellular carcinoma (HCC). Methods Sixty patients with moderste and advanced HCC were randomly divided into two groups: the experimental group (n = 32), in which the treatment of DC/CIK combined with TACE was used, and the control group (n=28), in which TACE treatment was used only. The parameters of tumor size , serum alpha-fetoprotein , survival rate , the median survival time and quality of life , were detected in patients of the two groups before and after corresponding therapy . Results ( 1 ) After receiving corresponding treatments, the efficient rates of DC/CIK combined with TACE and TACE only were 87.50% and 64.29%, respectively, with significant difference;(2) The level of serum AFP decreased in the two groups after corresponding treatment, with no significant difference; (3) The 6-month survival rate was 96.88%and 92.85%, and the 1-year survival rate was 84.38%and 64.29%, the 2-year survival rate was 65.63%and 42.86%in the experimental group and in the control group, respectively. And the median survival time was 21 months and 17 months in the experimental group and the control group, respectively, with no significant difference; (4) The quality of life was improved significantly in the DC/CIK combined with TACE group after treatment. Conclusions Administration of DC and CIK combined with TACE can prolong the survival time, increase the survival rate and especially improve the life quality of HCC patients. It is a promising approach for the treatment of patients with moderate and advanced HCC.

Objective To analyze the distribution and clinical characteristics of gastrointestinal virus infection in infants with acute diarrhea.Methods Stool samples and clinical data were collected from 900 infants (≤5 years old) with acute diarrhea in outpatient department of Beilun District People' s Hospital during July 2012 and July 2013.Specimens were tested for 5 gastrointestinal virus including group A/B/C rotavirus (RV),adenovirus (AdV),astrovirus (AstV),sapovirus (SV) and norovirus (NV) by the multiplex PCR assay.Chi-square test was performed to compare the positive rates of virus infection among children with different genders and ages.Results Among 900 stool samples,369 were positive of gastrointestinal virus,of which 291 were positive for single virus and 78 for mixed virus.In single virus infection,NV was detected with the highest positive rate of 19.4％ (4.9％ for G Ⅰ and 14.6％ for G Ⅱ),followed by RV-A (8.2％),SV (2.9％),AstV (1.0％) and AdV (0.8％).RV-B and C type were not found.In 78 cases with mixed infections,RV-A plus NV infection was the most common one with a prevalent rate of 5.8％.The positive rate in age group ≤2 years old was 51.0％,which was significantly higher than that of age group ＞ 2-5 years old (22.1％,x2 =70.404,P ＜ 0.01).In 369 children with positive gastrointestinal virus,fever was present in 24.1％,and vomit in 35.2％ of children.Fever,vomit and fever plus vomit was more common symptoms in children with mixed infections (x2 =17.878,21.869 and 14.155,P ＜ 0.01).Conclusion NV and RV-A are the most common pathogens in infants with acute diarrhea in Beilun district,especially in children younger than 2 years old.

AIM:To investigate the protective effect of bactericidal/permeability-increasing protein (BPI) on sepsis induced by intra-abdominal infection in rats and its mechanism.METHODS:Intra-abdominal infection induced sepsis was reproduced by cecal ligation and puncture (CLP). BPI or equal volume of physiological saline was intra-abdominally given immediately after CLP and 12 hours after CLP respectively (2.5 mg/kg of BPI each time). Plasma endotoxin levels were determined with limulus amebocyte chromogenic assay.RESULTS:(1)The survival time in BPI group was significantly higher than in physiological saline (PS) group. (2)The values of MAP, LVSP, IP, d p /d t max and -d p /d t max in BPI group, although decreasing ,were markedly higher than those in PS group. (3) Plasma glutamate-pyruvate transaminase and urea nitrogen levels in BPI group, though increasing, were significantly lower than those in PS group.(4) There was no significant change of plasma endotoxin levels in BPI group, while plasma endotoxin levels were markedly increased in PS group. There was significantly different between two groups. CONCLUSIONS:BPI has an obvious protective effect on intra-abdominal infection induced sepsis, which might be related to its antagonism against endotoxin.

Objective To investigate the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on the generation of human myeloid derived suppressor cells (MDSCs) relied on peripheral blood monocytes,and to establish efficient induction system in vitro of MDSCs.Methods Kidney transplantation recipients between January and March 2017 were included in this study.Purified CD14 + cells isolated from peripheral blood were cultured in the presence of GM-CSF with different concentrations for 7 days.Phenotypes and immunosuppressive abilities of induced MDSCs (iMDSCs) were investigated with FACS analyses.Inducible nitric oxide synthase (iNOS) mRNA expression was detected by qRT-PCR to determine the influence of iNOS-pathway on the immunosuppressive abilities of iMDSCs.Results A total of 11 recipients were included in this study.HLA-DR expression decreased sharply after the culture with GM-CSF.iMDSCs showed the similar phenotype characteristics with monocytic-MDSCs (M-MDSCs) as well as significant ability to suppress T cells proliferation and cytokines production.iMDSCs expressed higher levels of iNOS than monocytes,and the inhibitor effects of iMDSCs were significantly reduced after treatment with L-NMMA (1 mmol/L).The variations of phenotype and suppressive ability were concentrationdependent,and more significant changes could be revealed in the group of 10 μg/L GM-CSF.Conclusion GM-CSF-treated peripheral blood monocytes can be efficiently transformed to M-MDSCs,and suppress T cells proliferation and cytokines secretion via iNOS-dependent pathway.These results may contribute to establish MDSCs induction system,which would provide a basis for the clinical application of MDSCs.

This paper reviews the etiology , pathogenesis ,prediction and evaluation and other related aspects of motion sickness in order to contribute to further research on motion sickness and to proride the theorotic basis for prevention .

Objective To evaluate the clinical feasibility of grading of ureteral stricture in renal allograft.Methods The clinical data of 9 case of ureteral stricture after renal transplantion from February 2015 to September 2015 were retrospectively analyzed and relative articles were reviewed to evaluate the significance of ureteral stricture grading.The diagnosis of ureteral stenosis was made by serum creatinine elevation,ultrasound of allograft kidneys and presence of stricture on a pyelogram.Grade 1 ureteral stenosis was defined as graft function deterioration with presence of hydronephrosis on ultrasound,but no obvious stricture identified on a pyelogranm.Grade 2 was defined as serum creatinine elevation,presence of hydronephrosis on ultrasound,and a focal (＜1 cm) distal ureteral stricture at the ureteral anastomotic site on a pyelogram.Grade 3 was defined as serum creatinine elevation,hydronephrosis on ultrasound,and a long segment (＞1 cm) distal ureteral stricture extending to proximal ureter or pelvis on pyelogram.Results One case,6 cases and 2 cases were classified to grade 1,2 (stricture length ＜1 cm) and 3 (＞1 cm),respectively.One case of grade 1,6 cases of grade 2 and 1 case of grade 3 were successfully dilated by balloon dilation catheter and endoureterotomy.One case of grade 3 was converted to open reconstructive surgery.Surgery success rate of grade 1 and 2 was 100％ (7/7) and 100％ (6/6) 6 and 9 months after surgery,respectively.Ureteral stenosis did not recur in one case of grade 1 and 6 cases of grade 2 during a follow-up period of 12 months after surgery.However,one case of grade 3 reoccurred 6 months after surgery,and reoperation was performed and there was no recurrence up to now (10 months).Conclusion Wuzhi tablet acted as an effective agent that makes rifampicin containing anti-tuberculosis chemotherapy possible and safe by stabilizing blood concentration of tacrolimus in post-renal transplant tuberculosis patients,which also reduced the dosage of tacrolimus as well as the risk of acute rejection greatly.