Objective To study the incidence,risk factors and clinical features of patients with acute hepatic dysfunction induced by sepsis. Methods One hundred and sixty patients with sepsis were assigned to two groups according to liver function: sepsis group and acute hepatic dysfunction group. Logistic regression analysis was used to study the risk factors.The comparison of plasma endothelin-1 ( ET-1 ) and sepsis-related organ failure assessment (SOFA) score between two groups was carried out.Results Of 160sepsis patients,25 (15.6％) patients were subjected to acute hepatic dysfunction induced by sepsis.Logistic regression analysis showed that long-term indulgence in wine drunk (OR =4.102,95％ CI 1.288 -13.063 ),history of cardiac insufficiency ( OR =4.109,95％ CI 1.352 - 12.493) and hypotension ( OR =5.833,95％ CI:1.712 - 19.868 ) were the significant risk factors.Though oxygenation index ( PaO2/FiO2),platelet (PLA) and Glasgow coma scale (GCS) were not different between two groups,the total bilirubin (Tbil),direct bilirubin (Dbil),creatitine (Cre),range of blood glucose variation (Rglu),lactic acid (Lac),plasma ET-1and SOFA score in acute hepatic dysfunction group were higher than those in sepsis group. Mortality rate in acute hepatic dysfunction group was higher than that in sepsis group.Conclusions Long-term drunk,history of cardiac insufficiency and hypotension are the risk factors in acute hepatic dysfunction induced by sepsis.Elevated arterial Lac and plasma ET-1 levels,and higher SOFA score in acute hepatic dysfunction group suggest poor prognosis.

Objective To explore effective coping style of targeted psychodrama on teenager offenders.Methods Targeted psychodrama intervention procedures were designed.60 teenagers selected from juvenile detention jail were randomly divided into experimental group and control group.Psychodrama intervention was applied to the experimental group to test the changes of the two groups before and after the intervention using simplified coping style questionnaire.Results Before the intervention,the positive coping style level of the experimental group was 1.40 ± 0.42,the negative coping style level was 2.19 ± 0.32; after the intervention,the positive coping style level of the experimental group was 2.13 ± 0.36,the negative coping style level was 1.77 ±0.30.The difference of the experimental group's positive response and the negative response were significant before and after the intervention(t =-6.223,P＜ 0.01; t =9.749,P＜0.01).The difference of the control group's positive response and the negative response were not significant (P ＞ 0.05).Conclusion Psychodrama intervention has a positive effect on the criminal teenagers coping styles,and it can improve their social adaptability.

Objective To investigate the incidence, risk factors and drug-resistance of Pseudomonas aeruginosa infection in intensive care unit (ICU). Methods Totally 171 patients with sepsis admitted in ICU were enrolled. Pathogenic bacteria culture and antimicrobial susceptibility tests were performed. SPSS10. 0 software was used for Logistic regression analysis of the risk factors. Results Pseudomonas aeruginosa infection was confirmed in 37 patients, and 45 strains of Pseudomonas aeruginosa were isolated. Logistic regression revealed that recent antibiotics use ( OR = 4. 291 , 95% CI: 1. 727-10. 662) , length of ICU stay (OR = 1.117, 95% CI: 1.058-1. 181) , mechanical ventilation (OR = 3.400, 95% CI: 1.348-8.579) and central venous catheterization (OR =3. 339, 95% CI: 1.322-8.434) were independent risk factors of Pseudomonas aeruginosa infection. The resistance rate of cefotaxime was the highest (68.9%) and 18 strains (40%) were multidrug-resistant. Conclusions Pseudomonas aeruginosa infection is common in ICU and it is usually multidrug resistant. The rational use of antibiotics and aseptic technique of invasive catheterization are important for the prevention of Pseudomonas aeruginosa infection.

Objective To investigate the relationship between the serum levels of CEA,cAl25,CA19-9 and clinical pathological characteristics in gastric cancel patients.Method The serum levels of CEA,CA125 and CA19-9 in 107 gastric cancer patients before the surgery were detected by electrochemiluminescence immunoassay.Results The preoperative seurm levels of CEA,CA125 and CA19-9 were not correlated with sex,age and the location of the tumor.The serum level of CEA,CA125 and CA19-9 in patients with lymph node metastasis were higher than those in patients without lymph node metastasis.The serum levels of CEA,CA125 and CA19-9 were positively correlated with the depth of tumor invasion and the size of the tumor.The serum levels of CA125 were correlated with the degrees of differentiation.Thehigher the CA125 levels,the lower the degrees of differentiation.But the levels of CEA and CA19-9 were not correlated with differentiation.There were positive.correlations among the serum levels of CEA,CA125 and CA19-9.The correlation coefficient of CA125 and CA19-9 was 0.623(P<0.01),CA125 and CEA was 0.572(P<0.01),CA19-9 and CEA was 0.412(P<0.01).Conclusions The serum levels of CEA,CA125 and CA19-9 in gastric cancer patients are significantly related with the size of the tumor,the depta of tumor invasion and lymph node metastasis.The preoperative serum levels of CEA,CA125 and CA19-9 can provide some reference for formulating the treatment of the gastric cancer patients.

Objective To observe the changes of serum anti-mttllerian hormone (AMH) level in women with premature ovarian fail-ure (POF) and its clinical significance. Methods Fasting serum levels of AMH in 25 POF patients were measured with enzyme-linked im-mtmosorbent assay (ELISA). Twenty healthy women matched for age and body mass index (BMI) were chosen as controls. Results The serum AMH level in POF group was (1.1±0.1) pmol/L, which was significantly lower than that of control group(P < 0.01). The serum AMH levels in 20 patients of POF group were undetectable. The other 5 patients were treated with artificial cycle at first, and then ovulated with hMG/HCG.2 patients had ovulation and 1 patient was pregnant. Conclusion The serum AMH level in POF patients was significantly decreased, and the measure for serum AMH had some significance for POF diagnosis and treatment.

Objective To study effects of the intrathymic injection of allohepatic cells on intestinal allograft.Methods Adult male DA and PVG rats,7-9 week old,were used as donors and recipients,respectively.The ectopic small howel transplantations were performed one week after intrathymic injection of hepatic cells without use of any immunosuppressants.The surgical procedures were carried out in a such manner that portal vein was anastomosed with 1eft renal vein by the cuff,aorta was anastomosed with superior mesenteric artery with its aortic patch.Results The donor liver ceils could survive in the recipient thymus for 3 weeks.The small intestinal allograft showed severe rejection and donor died one week after intrathymic injection of hepatic cells,but the hepatic cells could survive within the thymus at this time.Conclusion The intrathymic injection of allohepatic cells could not induce immune tolerance of the recipient to the same donor small intestinal graft.

BACKGROUND:Biomaterial combined with stem cels is revealing a bright future in bone tissue regeneration in orthopedic surgery. Induced pluripotent stem cels have better cel sources and characteristic, which have become a hotspot of stem cel field. OBJECTIVE:To review the research history, preparation method, cel characteristics of induced pluripotent stem cels and the research developments in orthopeadic surgery so far. METHODS:A computer-based search of CNKI and PubMed was performed for articles about induced pluripotent stem cels and their applications in the field of orthopeadic surgery published from 1999 to 2014. Typical and creative research achievements were enroled in result analysis. RESULTS AND CONCLUSION: Studies have shown that induced pluripotent stem cels have a potential application prospect in bone tissue regeneration, and they also show a satisfying biocompatibility with various scaffold materials, in which, the induced pluripotent stem cels can maintain a good osteogenetic potential. Detection methods and smal-molecule compounds have been discovered gradualy for cartilage regeneration. But how to effectively induce the chondrogenic differentiation of induced pluripotent stem cels and to realize the clinical applications need further research.

With the development of laboratory medicine,more and more biomarkers have been discovered and applied in the diagnosis and treatment of acute myocardial infarction.For patients with suspected myocardial infarction,early diagnosis and timely treatment can save endangered myocardium and reduce fatality rate to a great extent.The proper use of biomarkers is of important value in preventing cardiovascular events and improving prognosis.This paper reviews the recent literature on new biomarkers in diagnosis of acute myocardial infarction,introduces the characteristics of these markers and their clinical diagnostic value.

The McAb 2H3 to different target cells was investigated by using an indirect ELISA meth-ods. The result showed that the 2H3 could bind to the ConA actiuated mouse T lymphoblastsand CTLL-2 cells (an IL-2 dependent T cell line)but not to the resting mouse splenocytes,lymph node cells and thymocytes. The binding of FITC-anti-IL-2R to the activated mouse spleencells and CTLL-2 cells was seen as tested by immunofluorescence analysis. This binding reactionwas blocked when the target cells were previously treated with 2H3, but the binding reaction ofFITC-anti-Ia McAb to these target cells couldn't be blocded by 2H3. Further analysis of the tar-get antigen by using Western-Blotting technigue showed the molecular weight of this antihenrecognized by 2H3 was of 50～60KD in reducing condition. According to these data, target anti-gen recognized by the McAb 2H3 may be the IL-2R molecule(P_(55) mole cule)on the cell surface.

OBJECTIVE:To discuss the importance of essential drug supply system for national drug policies and the role of public governance theory in the supply of essential drugs.METHODS:In view of the status of the construction of medical insurance system in China for residents in city and countryside,some strategies for the improvement of the health service system were put forward from aspect of public governance.RESULTS:Taking service as orientation,changing the government administration to service administration,introducing non-profit organization and bringing the function of non-public ownership into full play can help improve the national essential drug policy and drug supply ensuring system and guarantee the people's accessibility to essential drugs and medication safety.CONCLUSION:It is urgent to establish the supply and marke-ting system of essential drugs.