Objective To analyze the m edical records of poisoned children to provide references for the forensic identification ofmelam ine-tainted milk pow der poisoning. Methods M edical records of six fatal cases of consum ing som e brandmelam ine-tainted milk pow der w ere studied, specifically the poisoning sym ptom s, m edical im aging, blood biochem ical tests, treatm ent and prognosis. Results The m ajor m edical problems of these eight-m onth sick infants w ere urinary tract obstruction caused by urinary tract calculi. The poisoned infants developed oliguria, anuria and other sym ptom s, eventually, acute renal failure or other com plications leaded to death. The serum BUN and Crabnorm ally increased. Conclusion B y con-sidering the toxicological effects of melam ine, it was concluded that the deaths of these sick infants w ere related to themelam ine poisoning.

Objective:To assess coronary stenosis using 256-slice spiral CT (CTA).Methods:The data of 126 pa-tients diagnosed as coronary heart disease (CHD)using CTA and coronary angiography (CAG)Were retrospectively analyzed.The CAG results for CHD Were regarded as “gold standard”diagnosing CHD.The CTA diagnostic value for CHD and consistency of CAG and CTA diagnosing coronary stenosis Were analyzed.Results:A total of 393 cor-onary segments Were assessed using CTA.According to CAG results for CHD ,the CTA diagnostic accuracy Was 89.3%,sensitivity Was 91.4%,specificity Was 84.8%,negative predictive value Was 82.2% and positive predictive value Was 92.8%;the consistency of CAG and CTA diagnosing coronary stenosis Was good (Kappa value =0.755, P<0.01).Conclusion:The 256-slice spiral CT can diagnosing coronary stenosis,it possesses high sensitivity in di-agnosing vascular stenosis;as a simple and noninvasive examination it can be used as a reliable method for early screening subhealthy population and reexamine of putients With coronary heart disease.

Objective To observe the safety of the compound Tiaoshi-plaster's use to skin,providing the scientific foundation for its use to the treatment for the younth's short sight.Methods Experiment 1,acute toxicity test for skin of rabbits:rabbits were randomly divided into two groups:a integrated skin group and a damaged skin group,in addition,every group further divide into high and low dosage group and vehicle control group,totally 5 groups.All above groups received the plaster or vehicle for 24 hours,then take away the drug,and after lh,24 h,48 h,72 h since the 7th day,observe each group's reaction separately everyday,to see whether there is a acute toxicity reaction or not.Experiment 2,self control group,use onerabbit's left and right sides' skin to observe stimulus toxicity via skin:divide the rabbits into a integrated skin group and a damaged skin group,in addition,every group further divide into high,low dosage group and vehicle control group,totally 6 groups.Observe the reaction after multiple doses,after 7 days' successive doses,take the drug-used tissues to do pathological examination.Experiment 3,cavy's skin irritation test:cavies were divide into vehicle group,plaster group,positive group,totally 3 groups,at the 6h,7th day,14th day,take off right side's skin of every group to do the provocative test respectively.On the 28th day,take off the left side's skin to do the provocative test.To see if the skin or the whole body is allergic to the plaster.Results In experiment 1,toxic response could not be found in any group; In experiment 2,rabbits in the integrated skin group didn't show redness or edema,rabbits in the damaged skin group all had redness and edema,but the differences were not statistically significant,compared with the corresponding time of vehicle group (P＞0.05).Such skin damage was not caused by plaster usage but inflammatory reaction of skin damage.In experiment 3,the vehicle group and the study group didn't show any abnormal anaphylactic reaction.Conclusion The compound Tiaoshiplaster is safe to skin.

Objective To study the value and significance of transcutaneous oxygen saturation monitoring from different parts in early diagnosis of neonatal critical congenital heart disease. Methods The transcutaneous oxygen saturation in right upper extremities and right lower extremities of neonates born in our hospital from July 2010 to July 2015 were detected at 2 hours to 24 hours after birth. If the transcutaneous oxygen saturation ≤ 0. 95 or difference between upper and lower extremities≥0. 03, color doppler ultrasound echocardiography were done. Results There were 24 385 cases of newborns in our study. 1 680 newborns with abnormal transcutaneous oxygen saturation ( ≤0. 95 or difference between upper and lower extremities ≥0. 03) were examined with color doppler ultrasound echocardiography. 204 cases of congenital heart disease (12. 1% ) contain 9 cases of critical congenital heart disease ( 0. 5% ) were detected. The critical congenital heart disease included complete transposition of great artery ( n = 3), tetralogy of Fallot ( n = 4), artery malformation ( n = 1), and pulmonary atresia with right ventricular dysplasia ( n = 1 ) . Conclusions Transcutaneous oxygen saturation monitoring from different parts has a high value for early detection of critical congenital heart disease in the newborn. It is recommended for clinical use in grass-roots hospitals.

10.3969/j.issn.1000-8179.2013.12.009

Objective To evaluate the effect of comprehensive experiments on multiple trauma emergency rescue in intensive training before nursing practice. Methods 772 students were divided into groups, 16 to 18 students in each group,each team distributed teaching notes, designed experiment scheme toget her, selected and played roles, undertook tasks, practiced independently before the class,then performed comprehensive training in class. Results 94.8% of the nursing students and 100.0% of the training teachers supported this method of comprehensive experiments in intensive training. Conclusions Nursing comprehensive experiments can shorten the gap between the clinical practice and class teaching, improve the students' professional ability and general quality. It is a popular education mode on intensive training before clinical practice.

Objective To explore the feasibility of carrying out the common imprecision range among different biochemical systems in different laboratories.Methods Biochemical professionals visited 18 third-grade class A hospitals in Hebei Province,investigated the internal quality control data of 21 biochemical tests and made classification according to certain parameter criterias.Data were collected from April to September,2010 and calculated for cumulative mean,standard deviation (s) and CV.Data were compared according to 1/3,1/4 of TEa established by CLIA'88 and allowable CVb％ derived from biological variants.Results Among 18 hospitals,5 (27.8％) set their target value by mean value of 6 months,5(27.8％) by continuous 20 days and 8(44.4％) by the given value of the supplier.CVs of 21biochemical tests were quite different among 18 biochemistry laboratories,in which LDH was 6.79 times and CK was 76.79 times different from one another.35.5％-94.1％ biochemical tests met the requirement of CV ＜ 1/3TEa and 0.0％-91.7％ met the requirement of CV ＜ 1/4TEa.0.0％-94.1％ of tests were below allowable CVb％ 16/21 (76.2％) tests could satisfy the requirement of CV ＜ 1/3TEa.The top five tests which didn't meet the requirements were Na,Urea,TBIL,ALT and Glu.Conclusions The internal quality control among biochemistry laboratories in Hebei Province has not been standardized yet.According to the survey data,biochemistry laboratories of third-grade class A hospitals may set 75％ point of imprecision as a reference.After a period of improvement,we will set common imprecision range among biochemistry laborotories in Hebei Province and even in China.

ObjectiveTo investigate the expression of ATA1 in the synovial tissue from patients with ankylosing spondylitis (AS) and to localize expression of ATA1 in AS synovial membranes.In addition,tag SNPs were genotyped to determine the possible association of this gene with AS risk.MethodsWestern blotting analysis was applied to determine the expression of ATA1 in the synovial tissues by comparing the expression profiles of AS(n=8),rheumatoid arthritis(RA,n=9) and osteoarthritis(OA,n=9) samples.Immuno-histochemistry was used to localize the expression of ATA1 in the synovial membrane.The levels of ATA1 in the synovial fluid of patients with AS were determined using ELISA with OA and RA as controls.Taqman method was used to genotype tag SNPs (rs2753934,rs2749531 and rs6575424) in 56 AS cases,260RA cases and 160 healthy controls.ANOVA,LSD test andx2 test were used for statistical analysis.Results Increased expression of ATA1 in synovial membranes of AS was found when compared with samples from RA and OA.ELISA results showed significantly elevated level of ATA1 in the synovial fluid of patients with AS (1.6+0.6),but not in samples of RA(1.4±0.5) and OA (1.2±0.5)(P＜0.05).Haplotype analysis did not reveal a haplotype association in AS or RA(P＞0.05).ConclusionThe current findings suggest that upregulation of ATA1 may play an important role in the pathogenesis of AS.

ObJective To locate the cysteine-rich domains(CRD) of murine 4-1BB binding to its natural ligand. Methods A serial soluble extracellular CRDs of routine 4-1BB and 4-1BBL fusion proteins was constructed and prepared. The binding of purified 4-1BB-Igs to 4-1BBL and 4-1BB monoclonal antibody were tested using ELISA assay and Western blot analysis. Blocking experiment with 4-1BBL and 4-1BB mon-oclonal antibody was performed by ELISA assay. Results All truncated overlapped proteins containing ex-tracellular CRD Ⅱ of murine 4-1BB were able to bind to 4-1BBL by ELISA assay, excepting the CRD Ⅰ do-main alone. A 4-1BB monoclonal antibody proved to block the interaction of 4-1BB and 4-1BBI, was also able to bind to CRD Ⅱ. Conclusion Murine 4-1BBL whose specificity was mapped to CRD Ⅱ of 4-1BB ex-tracellular region with a possible conformational structure.

Objective To investigate relationship between serum level of brain natriuretic peptide (BNP)and short-term prognosis in patients with acute myocardial infarction(AMI).Methods Ninetynine patients with AMl with elevated S-T segment in electrocardiogram admitted to the department of cardiology,the Fourth Hospital of Jilin University,Changchun during January to December 2008 were divided into two groups.one with percutaneous transluminal coronary angioplasty(PTCA)or pereutaneous coronary intervention(PCI)(61 eases)and the other without PTCA(38 cases)as controls.Their serum levels of BNP were measured at admission, and one day and seven days after admission,respectively,and their main adverse cardiac events(MACE)were followed-up and recorded for 30 days.Results No significant differenee in serum BNP level between the patients at admission and one day after admission was found(P＜0.01).Seven days after admission,serum BNP level in PCI group was significantly lower than that in controls(P＜0.01),and occurrence of MACE was significantly lower in PCI group than that in controls(P＜0.05).Logistic regression analysis indicated that serum BNP level in PCI group seven days after admission was the uppermost predictor for MACE in patients with AMI in one month after onset(OR=1.026,95%CI 1.014-1.038,P＜0.01).Serum BNP level was significantly higher in patients with MACE seven days after admission than that in those without it(P＜0.01)during 30-day followup.Conclusion Serum level of BNP seven days after admission is associated with their short-term prognosisfor patients with AMI.