Evidence based medicine is medicine based on evidence and the application of evidence based medicine to laboratory medicine is evidence based laboratory medicine. The major enforcement strategies of evidence based laboratory medicine include: discovering problems and bringing them forward; seeking valuable evidence from the laboratory or relevant literature; making experimental or methodological assessments; application in the practice of clinical laboratory; and evaluating the results of the practice. Evidence based medicine and evidence based laboratory medicine are of great significance to the advancement of laboratory medicine and clinical work.

Aristolochic Acids ; adverse effects ; Humans ; Kidney Diseases ; chemically induced

Objective To observe the blood vessels distribution in iliac blood velles triangular area of the lumbosacral vertebrae and confirm the range of safety working area,so as to provide anatomic data for anterior lumbosacral interbody fusion.Methods CTA imaging da-ta of abdominal vessels were randomly collected from 32 adult patients.Observed the distribution and intersection features of lumbosacral ver-tebral ventral blood vessels.Measured the distance from the bifurcation or confluence to the L5 dise,level interval of iliaca vessels in the infe-rior boundary of L5 ,and width of L5 /S1 intervertebral space.And then computed the range of safety working area and conducted a preliminary classification.Results The lumbosacral vertebral ventral operation space is mainly (87.4%)composed of left iliac vein and right common iliac artery.In this study,patients of type A accounted for 87.4%,vascular clearance of the L5 dise was (3.8 ±1.1)cm,safety working area was (5.2 ±1.2)cm2 ,and the display ratio of L5 /S1 was 73.2%.Patients of type B accounted for 6.3%,vascular clearance of the L5 dise was (4.2 ±0.5)cm,safety working area was (7.1 ±0.2)cm2 ,and the display ratio of L5 /S1 was 81.0%.Patients of type C accounted for 6.3%,vascular clearance of the L5 dise was (1.0 ±0.7)cm,safety working area was (1.3 ±0.7)cm2 ,and the display ratio of L5 /S1 was 31.2%.The differences of anatomical parameters among the three types were statistically significant (P <0.05).Conclusion The study showed that most ordinary people have enough operation space in the lumbosacral vertebral ventral,which is suitable for anterior lumbosacral interbody fusion,but it is necessary to take preoperative imaging screening.

Objective To explore the effects of Shenmai injection combined with Xuebijing injection on the coagulation function of the early and inflammatory factor traumatic hemorrhagic shock.Method 86 cases of traumatic hemorrhagic shock patients select from December 2012 to December 2015 in our hospital were randomly divided into a control group(n=43)and experimental group(n=43).The control group was fluid resuscitation and Xuebijing injection treatment,the experimental group was increased Shenmai injection treatment in the control group basis.Compared with coagulation function and inflammatory factor levels before and after treatment in two groups of patients.Results 2 groups of patients was no difference in the index values before treatment,compared with before treatment,after treatment,the two groups of patients prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and platelet count(PLT)were elevated,fibrinogen(FIB)was decreased,and the two groups were significantly different (P<0.05 or P<0.01),but in the control group was no difference in the index values after 0.5 h treatment;The inflammatory factor in two groups were significantly increased after treatment(P<0.01),the control group was significantly higher than the experimental group,a significant difference between the groups(P<0.01);The hemorheology indexes after treatment 7 d of 2 groups were significantly decreased compared with after treatment 1 d,and the experimental group was significantly lower than the control group(P<0.01).Conclusion The combined therapy of Xuebijing injection combined with Shenmai injection can effectively improve trauma patients with hemorrhagic shock early coagulation function,reduce the levels of inflammatory factors, improve hemorheology indexes,there are good clinical results.

Objective To investigate the changes of serum inflammatory mediators in septic rats. Methods Thirty male SD rats were randomly divided into sham operation group(10 rats)and sepsis group (20 rats). The model of sepsis was made by cecal ligation and puncture. Carotid artery blood samples were taken from the sham operation group,and from sepsis group at 0,24,48,72 h after model establishment. Enzyme linked immunosorbent assay(ELISA)was applied to detect the content of serum tumor necrosis factor alpha(TNF α), interleukin 1(IL-1),interleukin element 6(IL-6). Results Serum TNF-α content in the sham operation group was(9. 27 ± 3. 12)ng/ L,and(9. 26 ± 8. 01),(32. 01 ± 4. 52),(55. 22 ± 7. 61),(83. 31 ± 8. 57)ng/ L respectively at 0,24,48,72 h after model establishment in sepsis group. There were significant difference between sham operation group and sepsis group at different time points(P < 0. 01). Serum IL-1in sham operation group was(8. 93 ± 1. 26)ng/ L,lower than that in sepsis group model at 0,24,48,72 h after model establishment ((20. 01 ± 3. 51),(25. 51 ± 2. 79),(59. 67 ± 3. 26),(87. 86 ± 11. 51)ng/ L respectively),and the differences were significant(P < 0. 01). The serum IL-6 level in sepsis group at 0,24,48,72 h after model establishment were(11. 52 ± 2. 32),(31. 59 ± 12. 12),(57. 27 ± 13. 53),(71. 59 ± 12. 67)ng/ L,respectively,different from that of sham operation group((12. 36 ± 3. 25)ng/ L,(P < 0. 01)). Conclusion The serum transmitter levels in septic rats significantly increase,which suggest that a lot of inflammatory mediators are released,and it may be one of the factors for the occurrence of sepsis.

OBJECTIVE:To investigate the effects of Shenfu injection on hemodynamecs in patients after the success of cardiopulmonary resuscitation(CPR),and explore the protective effects of which on myocardial injury. METHODS: A total of 178 patients with return of spontaneous circulation in central intensive care unit were randomly assigned to receive 50 mL Shenfu injection iv gtt(group SF) or Mg-contained polarized solution(control group). Hemodynamic indexes were monitored,and serum myocardium enzymes(CK) and cardiac troponin I(CTn I) were determined simultaneously before and after treatment. RESULTS: Patients in both group presented with low blood pressure BP,low cardiac output and myocardial injury after CPR. In the treatment group compared with control group,the hemodynamic indexes were markedly improved,the cardiac pumping function,cardiac output,cardiac index,stroke volume and mean arterial pressure were all significantly increased,while serum CK,CK-MB,LDH,AST and CTn I levels were all decreased obviously after treatment.CONCLUSION: Shenfu injection can markedly improve hemodynamic indexes,enhance the myocardial contractile force,effectively decrease serum myocardium enzymes and repair the damage of myocardial cells caused by the myocardial ischemia and anoxemia after cardiac arrest in patients with return of spontaneous circulation after cardiac arrest.

Objective To study the Ile796Val polymorphism in human SCAP gene in Hubei area, and analyze its correlation with coronary heart disease (CHP) and hypertension and the relationship between polymorphism and lipid metabolism. Methods Using PCR RFLP, we detected genotypes of Ile796Val polymorphism in human SCAP gene. Results The allele A frequencies of Ile796Val in human SCAP gene for controls, CHD patients and the hypertension patients were 0.32, 0.45 and 0.42 respectively. The allele G frequencies were 0 68, 0.55 and 0.58 respectively. There were significant differences in frequencies of genotype and alleles between controls and hypertension group. And there was significant difference in the level of TC, LDL C and ApoB. In CHD group, there was significant difference in the TC level between different genotypes. In hypertension patients, although a difference was noted in genotype, there was no significant difference in allele frequencies and lipid level exceps a significant difference in the levels of TC, LDL C and ApoB in hypertension patients. Conclusion Ile796Val polymorphism in human SCAP gene may be a great agent to cause disorder in the lipid level of blood and lipid metabolism of tissue. It is of great significance in disorder in lipid metabolism of inter cellular and genetic investigation of hyperlipidemia.

Objective To analyze the prevalence of human papilloma virus(HPV) and the relationship between HPV and vaginal environment in puerperium women.Methods One thousand and twenty-nine cases puerperium women were detected for HPV subtype by using nucleic acid flow-through hybridization.Patients with HPV positive had been considered as observe group and the rest as control.The prenatal infection of HPV of HPV-DNA positive and negative postpartum puerperium women, and the vaginal cleanliness of prenatal and postpartum were analyzed.Results In 1 029 cases puerperium women, the total HPV-DNA positive rate was 10.30％(106/1029) ,and high risk infection rate was 95.65％ (110/115).The rate of HPV positive before pregnant in HPV positive group (46.51％, 40/86) was higher than that in HPV negative group (9.09％, 10/110).There was significant difference of vaginal environment in the two groups (x2 =36.567, P＜0.05).In HPV-DNA positive and negative women during the puerperium vaginal cleaning degree of Ⅰ , Ⅱ ratio prenatal respectively were 56.98％ (49/86) and 76.36％ (84/110), and the difference was significant (x2 =8.317, P ＜0.05).Postpartum to 45.35％ (39/86) and 60.00 (66/110), and the difference was significant (x2 =3.941, P＜0.05).Conclusion The HPV infection of pregnant women are easy to getagain.There is relevance between HPV infection and vaginal environment.

Objective To study the effect of clopidogrel on different CYP2C19 genotypes and platelet reactivity in acute cerebral infarction patients with antiplatelet aggregation.Methods Four hundred and seventy-four cases of cerebral infarction patients in Beijing Tiantan Hospital Affiliated to Capital Medical University from April 2015 to April 2016 were collected.CYP2C19 genotype was determined,and the genotype was divided into the wild type group,the heterozygous type group and the mutant homozygous group.Platelet aggregation inhibition rate(ADP%) and platelet reactivity index induced by ADP were detected.Patients were divided into clopidogrel resistance group(group CR) and non resistant group according to whether ADP% was less than 30.SPSS 16.0 statistical software was used for statistical analysis,the comparison between groups using independent samples t test,chi square test and multivariate analysis using Logistic regression analysis,when P<0.05 difference was statistically significant.Results Among the 474 patients,204 cases(43.04%) were divided into wild-type group,and 204(43.04%) and 66(13.92%) were divided into the mutant heterozygous group and mutant homozygous group.In Chi square test analysis,clopidogrel resistance group and non resistance group CYP2C19 genotype distribution was significantly different(χ2=6.658,P=0.036).CR group angle(α) values((68.87±5.47)°) and MA((66.77±6.25) mm) were higher than that of CS group ((66.55±6.05)° and (63.30±5.66) mm,t=2.199,3.387,P=0.029,0.001).The multivariate logistic regression analysis showed that OR of angle level was 1.028,95%CI was 0.929-1.137 (P=0.595);OR of Ma level was 1.561,95%CI was 0.785-0.970 (P=0.012).Conclusion The effect of clopidogrel on platelet aggregation in patients with acute cerebral infarction is decreased by CYP2C19 gene mutation.CYP2C19 mutant allele is a risk factor for clopidogrel resistance.Angle (α) value and MA value are the risk factors for the diagnosis of CR in the patients with acute cerebral infarction,and the risk of clopidogrel resistance increased when the patients′ Angle (α) value and the value of MA increased.MA value as a predictor of CR and the screening tool has a certain value.

Objective To investigate the effect of two kinds of mucosal protective agents combined with smoking cessation on peptic ulcer. Methods In our hospital from January 2014 to December 2016, 244 cases with peptic ulcer with smoking as the research object, randomly divided into the control groupand the observation group, 122cases in each group. The control group were given omeprazole and smoking cessation and bismuth potassium citrate, the observation group were given omeprazole and smoking cessation and misoprostol. The therapeutic effect and adverse reaction were compared between the two groups. Results The total efficiency in the observation group 97.54% was significantly higher than the control group 87.70% (P<0.05). The incidence of adverse reactions in the observation group 2.46% was significantly lower than in the control group 7.38% (P<0.05). Conclusion For the treatment of refractory peptic ulcer with the habit of smoking, smoking cessation combined with Losec and misoprostol can effectively improve the effect, and reduce the occurrence of adverse reaction, which is worthy of promotion.