Objective To determine the clinical characteristic, main treatment, and prognosis for the sake of more effective treatments for critically ill patients with H1N1 influenza. Methods Eight critically ill patients with H1N1 influenza in intensive care unit were retrospectively studied, including clinical characteristics, indexex of correlation, and prognosis. Results The acute physiology and chronic health evaluationⅡ score was 19.0±7.8. Five patients died, 4 of whom were caused by respiratory failure. The number of platelets in dead patient was lower than that in healing and improved ones(χ2=8.000,P＜0.05).All the 4 patients treated with glucocorticoid died, 5 out of the 6 patients received invasive mechanical ventilation rather than noninvasive mechanical ventilation, and 3 of them who complicated barotraumas in the lung died at last. Conclusion Critically ill patients with H1N1 influenza have high mortality. Respiratory failure is the main cause of death. Critically ill patients with H1N1 influenza should not be treated with glucocorticoid. Patients who need mechanical ventilation should be treated with invasive mechanical ventilation with low tidal volume and low positive end-expiratory pressure.

ObjectiveTo investigate the clinical characteristics of patients,risk factors and preventive measures of nosocomial infection in diabetic cerebral infarction(DCI).MethodsThe clinical data of 124 DCI cases with nosocomial infection and 116 DCI cases without nosocomial infection were analyzed retrospectively.ResultsThe clinical characteristics of nosocomial infection in DCI patients were that large cerebral infarction and severity neurological deficits were very common.The patients always had long hospitalization days and poor prognosis.Invasive operation,antibiotic prophylaxis,severity neurological deficits,fasting plasma glucose,urinary albumin,size of cerebral infarction,albumin/globulin and hospitalization days were the risk factors for nosocomial infection in DCI.Among the patients,nosocomial lower respiratory tract infection was the highest(41.5%),the second one was urinary tract infection(28.1%).The case that both sites of infected was common(8.9%).Klebsiella pneumoniae(16.7%),Pseudomonas aeruginosa(15.9%),Candida albicans(12.1%) and Escherichia coli(12.1%) were the most frequent pathogens.ConclusionThe patient's condition of nosocomial infection in DCI is serious and has poor prognosis.Taking preventive measures according to the risk factors can reduce the infection rate.

Objective To detect the expression levels of renal tissue M-type phospholipase A2 receptor 1(PLA2R1) antigen and its antibody in the patients with membranous nephropathy(MN).Methods Fifty-eight cases of biopsy-proved idiopathic membranous nephropathy(IMN),fifteen cases of hepatitis B-associated membranous nephropathy(HBV-MN) and seventeen cases of V type lupus nephritis(V-LN) were selected.Renal tissue PLA2R1 antigen was detected by indirect immunofluorescence and colocaliazed with IgG4.Serum anti-PLA2R1 antibody was simultaneously examined.The expression difference of PLA2R1 antigen and antiPLA2R1 antibody in MN was analyzed.And the differences of clinical data were analyzed between PLA2R1 positive and negative patients.Results The PLA2R1 antibody was not found in the renal tissue and serum of the patients with LN and HBV-MN;PLA2R1 antigen was found in 81.03％ of IMN patients,and its antibody was found in serum of 70.69％ of IMN patients.PLA2R1 antigen and IgG4 co-localization all deposited along glomerular capillary loop presenting as fine granules.The 24 h urine protein level in the patients with PLA2R1 antigen deposition in renal tissues was higher than that in the patients without PLA2R1 deposition (P＜0.05),moreover serum albumin level was lower than that in the patients without PLA2R1 deposition(P＜0.05).Conclusion The sensitivity and specificity of renal tissue PLA2R1 antigen in the diagnosis of IMN are higher.The expression of PLA2R1 antigen in renal tissue by biopsy is significantly correlated with the clinical severity.

Objective To explore the differences and similarities of clinical characteristics,pathological features, treatment and prognosis between primary gastric lymphoma(PGL)and primary intestinal lymphoma (PIL). Methods The clinical characteristics, pathological features, therapeutic results, the detection of Helicobacter pylori (Hp) and prognosis of 48 PGL cases and 15 PIL cases were retrospectively analyzed. Results There was no statistical significance in age, gender, abdominal pain, gastrointestinal bleeding, B symptoms, clinical stage, mortality between PGL and PIL groups (P>0. 05). However, there were significant differences in the pathological type, acute abdomen emergency surgery between these two groups (P<0. 05). There was 12 Hp positive cases in mucosalassociated lymphoid tissue (MALT) lymphoma of PGL group (12/19), and 5 Hp positive cases in diffuse large B-cell lymphoma (DLBCL) (5/20). There was significant difference in Hp detection rate of these two pathological types. Hp was not found in PIL group. The Cox multivariate analysis indicated that stage Ⅲ-Ⅳ was the independent adverse factors affecting PGL prognosis (P<0. 05).Conclusions Mainly histological types are DLBCL and MALT lymphoma in PGL, and DLBCL in PIL.PIL predispose to T-cell lymphoma compared with PGL. MALT lymphoma is rare in PIL group. The mainly clinical stage is Ⅲ-Ⅳ both in PGL group and PIL group. Emergency surgery is often needed in PIL because of intussusception or perforation. The prognosis of PGL is correlated with the stage and the prognosis of PIL are correlated with the stage, B symptoms and T cell phenotype.

OBJECTIVE:To establish a method for the simultaneous determination of(R,S)-goitrin,chlorogenic acid,luteolo-side and isochlorogenic acid A in Xiaoer ganmao granule. METHODS:HPLC was performed on the column of Hedera C18 with mo-bile phase of acetonitrile-0.1% formic acid aqueous at a flow rate of 1.0 ml/min,the detection wavelength was 254 nm,330 nm and 370 nm,column temperature was 40 ℃,and the injection volume was 5 μl,RESULTS:The linear range was 6.6-105 μg/ml for (R,S)-goitrin (r=0.999 9),9-140 μg/ml for chlorogenic acid (r=0.999 9),9-144 μg/ml for luteoloside (r=0.999 8) and 9-138 μg/ml for isochlorogenic acid A(r=0.999 6);the limits of quantitation were 330 ng,450 ng,450 ng and 450 ng,limits of detection were 66 ng,90 ng,90 ng and 90 ng,respectively;RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 95.01%-98.77%(RSD=1.48%,n=6),95.14%-98.91%(RSD=1.52%,n=6),95.11%-97.54%(RSD=0.93%,n=6) and 95.58%-99.63%(RSD=1.73%,n=6). CONCLUSIONS:The method is simple and accurate,and suitable for the simultaneous determination of(R,S)-goitrin,chlorogenic acid,luteoloside and isochlorogenic acid A in Xiaoer ganmao granule.

Objective To observe the efficacy and adverse effects of MRC UKALL Ⅻ/ECOG E2993 regimen in inducing remission of Chinese adults with acute iymphoblastic leukemia(ALL). Methods 11 cases of previously untreated ALL patients were treated with MRC UKALL Ⅻ/ECOG E2993 regimen, then observe the efficacy and adverse effects. Results All of the 11 patients achieved complete rcmission(CR), the CR rate was 100 %. Among the 11 patients,8 patients achieved CR after the first course of chemotherapy. In the 8 patients which could be followed up, 5 patients achieved durative CR, among that the longest survival time was 30 months, and 3 patients had relapses. This regimen has a severe myelosuppression. There was an effect on liver function, mostly in the increase of glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase.After the symptomatic treatment, liver function could return to normal. No treatment-related deaths occurred. Conclusion MRC UKALL Ⅻ/ECOG E2993 regimen can be used as inducing remission therapy for Chinese adults with acute lymphoblastic leukemia.

Esophageal submucosal hematoma is rarely seen in clinical practice and its clinical presentations are untypical.Gastroscopy might injure the esophageal mucosa and cause bleeding.Computed tomography had the advantages of quick examination and formation of imaging,as well as non-invasiveness,which is helpful for the diagnosis and differential diagnosis of the esophageal submucosal hematoma.The clinical data of 9 patients with esophageal submucosal hematoma who were admitted to the Yueqing People's Hospital,the First Affiliated Hospital of Wenzhou Medical University,the First Affiliated Hospital of the Zhengzhou University and the Third People's Hospital of Wenzhou from July 2005 to February 2014 were retrospectively analyzed.The features of computed tomography examination of esophageal submocosal hematoma include the range of the esophageal submucosal hematoma exceeds 2 parts of the esophagus,the rip of the esophageal mucosa begins and ends at the physiological narrowing of the esophagus,thickening of the esophageal wall,stricture of the esophagus,annular thickening and eccentric thickening of the esophageal wall,crescent,spot or gas shadows of the esophageal cavity,the density of the hematoma decreases as the time passed by.These features of computed tomography are of great importance for the diagnosis of esophageal submucosal hematoma.

Objective After hydrogen bonding between collagen ( COL) and silk fibroin ( SF ) at different concentrations, a composite scaffold with adjustable stiffness was prepared by combining with gel system, and its physical and chemical properties were characterized. Methods SF with different qualities was dissolved in sodium alginate (SA) solution, then COL solution at different concentration and calcium carbonate ( CaCO3 ) powder were added. The hydrogels of SC1, SC2, and SC3 groups were obtained by taking out the mixed solution and adding some gluconic acid lactone ( GDL) powder, and different SF scaffolds were obtained after freeze drying. Results The SF scaffolds with adjustable stiffness were successfully prepared. The compression moduli of SC1, SC2, and SC3 groups were (17. 31±2. 73), (24. 12±1. 81), (32. 54±1. 81) kPa, respectively. The innerstructure of the scaffolds was observed. From SC1 group to SC3 group, pores of the scaffolds were smaller and fewer, and hydrophilicity of the materials become better and better. Conclusions Three-dimensional ( 3D) porous scaffolds with different matrix stiffness can be prepared by changing the concentration of SF and COL solution. The concentration of SF and COL is proportional to the compression modulus, water absorption, water retention and swelling rate of SF scaffolds, while inversely proportional to porosity. The findings of this study are expected to provide theoretical guidance for construction of scaffolds with appropriate matrix stiffness for inducing osteogenic differentiation of mesenchymal stem cells

Objective: To explore the relationship between childhood abuse, adult attachment and borderline personality disorder (BPD) in college students, and to provide reference for promoting the physical and mental health of college students. Methods: We selected undergraduate students from four colleges in Hefei, a total of 4 034 college students were surveyed by the childhood trauma questionnaire short form(CTQ-SF), the state adult attachment measure (SAAM) and the Personality Diagnostic Questionnaire(PDQ). Results: BPD was found in 4.2% of subjects, 4.5% of males and 3.7% of females. The score of BPD in non-single-parent families was lower than that in single-parent families, in families with average family economic status was lower than that in families with poor and good family economic status, and in families with medium father education level was lower than that in fathers with low and high education level(Z=-2.30, 29.25, 9.63, P<0.05). Childhood abuse, avoidant attachment and anxious attachment positively predicted BPD(β=0.21, 0.10, 0.23, P<0.01), secure attachment negatively predicted BPD(β=-0.15, P<0.01). Adult attachment played a partial mediating role in the effects of childhood abuse on BPD, with the mediating effect accounting for 16.7% of the total effect. Conclusion Adult attachment plays a mediating role in the effects of childhood abuse on BPD.

Objective: To explore the effects of precollege peer bullying at different stages, on quality of life (QOL) among college students. Methods: A stratified cluster sampling method was used to select participants in October, 2018. Cluster sampling method was adopted to recruit a sample of 4 034 college students from four universities in Hefei city, Anhui province. Relations between peer bullying at different stages before entering college, and the quality of life, were investigated. t test and analysis of variance were used to compare the differences of QOL in different groups. Multiple linear regression models were used to assess the associations between various types of peer bullying at different stages and the QOL at precollege days. Results: Among all the 4 034 college students under study, mean scores of the 4 dimensions of QOL appeared as physical (12.61±2.02), psychological (14.09±2.62), social relationship (13.72±2.71) and environment (13.77±2.46), respectively. After adjusting the confounding factors, data from multiple linear regression showed that, factors as verbal bullying victimization during primary school (β=-0.21)/secondary school (β=-0.27)/or at both periods (β=-0.56), relational (β=-0.21) and physical (β=-0.38) bullying victimization in secondary school, and physical bullying victimization in both periods (β=-0.67) were negatively correlated with the physical dimension of QOL. Verbal bullying victimization in both periods (β=-0.41) and relational bullying victimization in secondary school (β=-0.42) were negatively correlated with psychological dimension of QOL. Factors as relational (β=-0.32) and physical (β=-0.51) bullying victimization in secondary school, physical/cyber bullying victimization in both periods (β=-0.57) were negatively correlated with the social dimension of QOL. Verbal bullying victimization during primary school (β=-0.20) and both periods (β=-0.46), relational bullying perpetration during primary school (β=-0.35) or at both periods (β=-0.90) were negatively correlated with the environmental dimension of QOL (All P<0.05). Index related to bullying victimization (β=-0.33, -0.36, -0.30, -0.33) and bullying perpetration β=-0.28, -0.31, -0.23, -0.28) were both negatively correlated to all the 4 dimensions (physical, psychological, social relationship and environment) of QOL (P<0.001). Conclusions Various forms of peer bullying experiences occurring before college, were associated with the decreased scores of QOL in different domains, among the university students. Programs on prevention and control of peer bullying in different stages before college days seemed important thus should be strengthened.