Objective To observe the change of serum anti-brain antibodies after cardiopulmonary resuscitation,and investigate the clinical significance.Methods A total of 27 cases of cardiopulmonary resuscitation after cardiac arrest patients with success and survival more than 12 weeks were divided into two groups according to Glasgow Coma Scale (GCS) score:mild and moderate group with GCS score ≥ 8 scores (12 cases) and severe group with GCS score≤7 scores (15 cases).The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after recovered in the spontaneous circulation (ROSC) was compared between two groups,and compared with control group (15 cases of healthy persons).Results The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after ROSC were significantly higher than those in control group [(1.34 ± 0.23),(1.30 ± 0.27) kU/L vs.(0.28 ± 0.05) kU/L,(1.38 ± 0.33),(1.44 ± 0.30) kU/L vs.(0.28 ±0.05) kU/L,(1.44 ±0.31),(1.51 ±0.33) kU/L vs.(0.28 ±0.05) kU/L,(1.53 ±0.27),(1.67 ±0.36) kU/L vs.(0.28 ±0.05) kU/L,(1.72 ±0.25),(1.93 ±0.44) kU/L vs.(0.28 ±0.05) kU/L,(1.98 ±0.45),(2.15 ±0.52) kU/L vs.(0.28 ±0.05) kU/L],and there were significant differences (P＜ 0.01).The serum anti-brain antibody levels in severe group were significantly higher than those in mild and moderate group,and there were significnat differences (P ＜ 0.05).Conclusions The serum anti-brain antibody levels after cardiopulmonary resuscitation rise significantly.Anti-brain antibody may be used as a biochemistry marker to judge degree and prognosis of brain injury with patients after cardiopulmonary resuscitation.

Objective To investigate the laboratory ifndings, clinical manifestations and treatment in hemolytic disease caused by red cell immune antibodies in neonates. Methods The laboratory and clinical data from 4 cases of hemolytic disease of neonates caused by red cell immune antibodies were retrospectively analyzed. Results IgG antibody were detected in all mothers of 4 cases during pregnancy and they were anti-E, anti-D, anti-Jkb and the autoantibody with the titer being 16, 2048, 1 and 16 respectively. The four neonates were all full-term. The jaundice appeared 6 h to 3 d after birth with varying degrees of skin stained yellow, with or without anemia. Serology and elution test found the existence of antibody same as the one on their maternal red cells and the titer was 4, 512, 0, and 2, respectively. All neonates were treated by phototherapy. Two servere cases were also treated by whole blood exchange and red blood cells transfusion. The prognosis were good in all neonates. Conclusions Prenatal immune hematological tests facilitated early detection of irregular erythrocyte antibodies and thus assessment of the risk of hemolytic dis-ease of the fetus and neonates.

Objective To discuss the diagnostic value of regular ultrasonic combined with ultrasonography micro-vessel enhanced presentation for breast malignant disease.Methods 152 patients with single breast tumour were collected,they were examined by regular ultrasonic,ultrasonography micro-vessel enhanced presentation before operation and received regular pathology after operation.The diagnostic sensitivity,specificity,negative predictor,positive predictor,accuracy,area under ROC curve,95 ％ reliable interval of regular ultrasonic,ultrasonography micro-vessel enhanced presentation and the combination for breast malignant disease were analyzed.Results Ultrasonography micro-vessel enhanced presentation is better than regular ultrasonic in the diagnostic sensitivity,specificity,negative predictor,positive predictor,accuracy (P =0.002).The combination of regular ultrasonic and ultrasonography microvessel enhanced presentation could improve the detection rate of breast malignant disease(regular ultrasonic compared with combination,P =0.002 ; ultrasonography micro-vessel enhanced presentation compared with combination,P =0.000) and increase area under ROC curve (P =0.000).Conclusion Regular ultrasonic combined with ultrasonography micro-vessel enhanced presentation has complementary advantages and can increase early detection rate for breast malignant disease.

Objective To observe changes in hippocampal network electrical activities in electroacupuncture regulation of abnormal cardiovascular activities and explore the central mechanism of the regulation. Method Experimental rats were randomized into three groups: normal urethane anesthesia without electroacupuncture (n=15), urethane enhanced deep anesthesia (n=9) and normal anesthesia plus anal canal pressurization (n=15). Femoral arterial pressure, cardiac electricity, hippocampal field potentials and cellular discharge were recorded in the three groups. The normal anesthesia group did not receive intervention measures. The other two groups received acupuncture intervention after successful induction of abnormal blood pressure. Result In rats with normal urethane anesthesia, sleep-like periodic hippocampal electrical activity occurred with periodic cardiovascular activities and theta oscillations was corresponding to increased heart rates. In rats with deep anesthesia and hypotension, theta oscillations appeared in hippocampal network with increased blood pressure and heart rates after electroacupuncture (P<0.001). Anal canal pressurization induced increases in blood pressure and heart rates and caused theta oscillations in hippocampal network. During that time, electroacupuncture could still activate theta-related cells, reduce blood pressure and decrease heart rates (P<0.001). Conclusion Theta oscillations in hippocampal network are involved in the bidirectional regulating effect of electroacupuncture on abnormal cardiovascular activities.

Hepatic veins as the only hepatic drainage veins are the important functional part of liver anatomy in the field of surgery.With the development of imaging technology,especially the application of three-dimensional visualization technology,it can provide precise and comprehensive information in the study of hepatic veins.And thus this paper comprehensively reviewed the recent researches on the three dimensional visualization technology for observign the hepatic veins.

The training of clinical skill is closely linked with medical personnel education.However,traditional paper-type training materials were unable to meet the training needs.As a new type of training materials,trial-and-error video-type clinical skill training materials (abbreviated as TEVT clinical skill training materials) have gradually attracted attention with its characteristics of lively and interesting,potentially informative,high acceptance among students,the advantages' of stimulating students' initiative exploration and consideration,fostering students' critical spirit and humanities.On the basis of analyzing the advantages' of TEVT training materials,we discussed the developing specialties of TEVT clinical skill training materials from four aspects as the material orientation and the application object,material sources,constructing the developing team and editing the teaching materials.Furthermore,we reflected the application prospect of TEVT clinical skill training materials in the future,in order to explore an available implementation path for the development of TEVT clinical skill training materials.

Despite the gradual improvement in surgical treatment techniques and surgical instruments, the complications and mortality of gastric cancer patients after gastrectomy remain high because of an increased proportion of advanced age and incidence of preoperative morbidity in these patients. Therefore, reducing the peri-operative adverse outcomes in gastrectomy is highly significant. According to published literature, the risk factors of morbidity and mortality may include age, TNM stage, ASA score, POSSUM score, complication, surgeon workload, hospital operation volume, lymphadenectomy scope, combined multiple organ resection, and gastrecto-my type. This review summarizes the recent progress in the risk factors for the mortality and morbidity of gastrectomy.

The hardcore of clinical medicine program education is to insist on improving the students'practical capability.The efficient methodology is the key to it.In this paper,the authors investigate the practice of Suzhou University and try to find out the ways to assess the graduates in this program.Also,the authors point out the deficiency in the assessment and put forward mending measures in order to improve the quality of clinical medicine graduate program education.

Objective To investigate the clinical characteristics of patients with polyarteritis nodosa (PAN),and to improve the understanding of the disease.Methods The data of 65 consecutive PAN patients admitted to Peking Union Medical College Hospital from October 2001 to March 2013 were analyzed.Patients were divided into two groups based on hapatitis B surface antigen (HBsAg) status.Chi-square test,Fisher exact probability,t test and Mann-Whitney test were used for statistical analysis.Results The male/female ratio of patients with PAN was 1.3/1,and the average age was (37.6±1.6) years old.Fever (in 40 cases,62％) was the most frequent manifestation.Skin was involved in 51 cases (79％),urologic involvement in 44 cases (68％),peripheral nervous system involvement in 22 cases (34％) and gastrointestinal involvement in 21 cases (32％).Forty-six (71％) patients had high-sensitivity C reactive protein (hs-CRP) elevation and 11 (17％) patients had eosinophil count elevation.The most common vascular involvements were limb arteries in 22 cases (34％),renal artery in 19 cases (29％),and gastrointestinal artery in 17 cases (26％).Patients with negative HBsAg had more frequent arthralgia or arthritis(41％ vs 9％,x2=4.00,P＜0.05),more indicators of poor prognosis (30％ vs 0,P＜0.05) and more glucocorticoid pulse therapy (30％ vs 0,P＜0.05) when compared with patients with positive HBsAg.Conclusion Clinical manifestations of PAN are complex.Young patients with fever of unknown origin,rash,weight loss,myalgias,accompanied by symptoms of multi-organ damage including urologic,peripheral nervous system,gastrointestinal involvement and negative autoantibodies should be highly suspected for the diagnosis of PAN.For the treatment of patients with positive HBsAg,special attention should be paid to maintain the delicate balance between controlling the organ damage caused by PAN and prevention of hepatitis B virus (HBV) infection reactivation.

Objective To observethe effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury.Methods Thirtysix patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients).The control group accepted conventional treatment,the CVVH group accepted CVVH treatment additionally for 7 d.ELISA was used to measure serum level of ABAb at 1,3,5,7,14 d after treatment.The change of ABAb in serum of each group was observed.The scores of Glasgow coma scale (GCS) was assessed everyday.Results The level of ABAb in CVVH group was significantly lower than that in control group from the third day after treatment[the third day:(1.28 ± 0.25) kU/L vs.(1.33 ± 0.30) kU/L;the fifth day:(1.37 ±0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day:(1.45 ±0.37) kU/L vs.(1.52 ± 0.35) kU/L;the fourteenth day:(1.49 ± 0.41) kU/L vs.(1.67 ± 0.39) kU/L,P ＜ 0.05 or ＜ 0.01].The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day:(6.95 ± 1.24) scores vs.(5.74 ± 1.51) scores;the fourteenth day:(9.29 ± 1.76) scores vs.(7.22 ± 1.24) scores] (P ＜ 0.01).Conclusion CVVH can decrease the level of ABAb and improve the prognosis.