Objective To sum up the therapeutic experiences and to analyze the causes of multiple organ dysfunction syndrome (MODS) occurred in a patient who subjected to an accidental 60 Co exposure. Methods The patient was diagnosed as MODS by clinical manifestation, the auxiliary examinations and pathologic autopsy. In therapeutic aspects, intensive care, ventilator-assisted breathing, anti-infection, nutritional support treatment and protection management of important organs were given. Results After a successful transplantation of HLA-identical allogeneic peripheral blood stem cell, the complaints of MODS emerged repeatedly as fever, lung infection, respiratory failure, cardiac arrhythmia, circulatory failure, hepatic injury, decreased urine output and paralytic ileus. At last, the patient died of multi-organ failure 75 days after exposure to radiation. The results of auxiliary examinations showed enlargement of heart and cardiac arrhythmia. Biochemical examination also indicated the increased hyper-sensitive C-reactive protein. The results of pathologic autopsy indicated the existence of fungous infections in whole body, pulmonary fibrosis, myocardium degeneration and necrosis and radiation enteritis. In addition, congestive hepatopathy, renal hemorrhage and intracerebral hemorrhage were also found in the examination. Conclusion Some special clinical features were found in this case, and the cause of MODS is mainly related to radiation injury of important organs, low level of immunity and infection. So the measures of anti-infection and protective treatment of multiple organs should be taken. The key and difficulty for preventing such a kind of MODS might be to improve the patient's immunity and to help the tissue reparation after radiation injury.

12 cases of severe pulmonary infection were treated with ceftizoxime, one of cepha-losporins of the third generation. Clinical observation and pharmacokinetics were carried out. The result showed that intravenous infusion was the best route of drug administration. It had the advantages of high serum concentration and prolonged maintenance of serum level. 1 gram of ceftizoxi-me, two times a day, was enough for most pathogens except Pseudomonas aeruginosa.

AIM: To investigate the short-term efficacy and safety of sulfasalazine (SASP) 3 g per day in the treatment of patients with mild and moderate ulcerative colitis (UC). METHODS: 122 patients were treated with SASP ( 1 g, t.i.d.) for 6 weeks. The data of clinical manifestations, colonoscopic and histological involvements were compared before and after the treatment of UC. The short-period efficacy and adverse reactions were evaluated in 110 patients. RESULTS: The therapeutic project was carried out in the 110 out of 122 patients. After 110 patients were treated for 6 weeks, the clinical, colonoscopic and histological remission were 71.8%, 21.8% and 16.4%, respectively. Among the 79 patients with clinical remission, 58.2% and 67.1% of them remained grade 1 in colonoscopic and histological findings, respectively. The curative rates and the effective rates were 63.9% and 82.0%, respectively. Among the 122 patients treated with SASP, 21 of them ( 17.2%) had adverse reactions. Except 4 patients suffered urticaria and leukopenia, no patients quitted the treatment because of obvious adverse reaction. CONCLUSION: SASP ( 3 g per day) can be an effective and safe medicine in treatment of patients with mild and moderate UC, but more than half of the patients in clinical remission still have light inflammation in colonoscopy and histology.

To compare the effects of four different intensive insulin therapies on blood glucose control and vascular endothelial function in newly-diagnosed type 2 diabetes.Patients were randomly divided to accept pre-meal insulin aspart 30 or pre-meal insulin aspart and glargine at bedtime or pre-meal Novolin-R and NPH at bedtime or continuous subcutaneous insulin aspart infusion.Capillary blood glucose determination and continuous glucose monitoring system were carried out,therapeutic time and total insulin dosage were recorded.Ultrasound was used to evaluate the vascular endothelial function.Glucose level,incidence of low glucose,potency ratio of the four groups were similar( P＞0.05 ) ; FMD and NMD were not significantly improved ( P =0.718,P =0.065 ).The short-term efficacy and safety of the four groups are similar.The short-term intensive insulin therapy has no obvious effect on vascular endothelial function.

ObjectiveTo evaluate the effectiveness of treating tuberculous pleurisy with hydrogen peroxide solution washing and povidone iodine solution perfusing topically.MethodsAfter fixing position with B ultrasound or 64 rows spiral computed tomography,the thoracic cavity was firstly inspected with thoracoscope,the effusion was exhausted and the conglutionations was cut with thoracoscope or high frequency electrome,then the thoracic cavity was washed with 200 ml 3％ hydrogen peroxide solution,and lastly it was perfused continually with 0.5％ povidone iodine solution to control the intracavity infection quickly and to promote cicatrization.After routine antitubercular therapy for one year,the time of pleural effusion disappearing and the state of pleura hypertrophy was observed.ResultsThere were 86 cases in all.After antitubercular therapy and extracting pleural effusion at the same time in 48 cases.Twenty-two cases'effusion didn't increase basically after 4 weeks.They stopped extracting effusion and went on with antitubercular therapy (the first group).The rest 26 patients continued to accept the therapy of hydrogen peroxide solution washing and povidone iodine solution perfusing topically(the second group),and 23cases achieved remedial goal in a week with the effective rate of 88.46％ (23/26).The third group had 38 cases who didn't accept thoracocentesis but accepted the therapy of hydrogen peroxide solution washing and povidone iodine solution perfusing directly,and there were 36 cases that achieved remedial goal in a week with effective rate of 94.74％ (36/38).The time of pleural effusion disappearing in the third group was obviously shorter than that in the first group (1 week vs.4 weeks )(P ＜ 0.05 ),and there was no significant difference in the efftective rate between the second group and the third group (P ＞ 0.05 ).Half a year after therapy,the thickness of pleura was measured and it was found that in the first group was thickest and in the third group thinnest and even some without hypertrophy.It was the same effect after one year.Conclusions The effectiveness of the method treating tuberculous pleurisy with hydrogen peroxide solution washing and povidone iodine solution perfusing topically is defimite,and the method can shorten the time of pleural effusion disappearing and alleviate the pleural hypertrophy.

Objective To assess the value of magnetic resonance (MR) imaging (MRI) in depicting the depth of myometrial infiltration, cervical invasion and lymph nodes metastasis in patients with endometrial carcinoma compared with surgicopathologic findings. Methods Thirty-eight patients with endometrial carcinoma diagnosed by pathology were inspected by MRI in this prospective study. MR images were analyzed by two radiologists to report the depth of myometrial infiltration, infiltration of the uterine cervix and lymph nodes metastasis. MRI and surgicopathologic staging of endometrial carcinoma were based on FICO classification. MRI findings were compared with surgicopathologic findings. Results The overall accuracy rate of MRI in staging endometrial carcinoma was 77.1 %. The results of Kappa statistics showed that there was strong consistency between MRI and surgicopathology for staging of endometrial carcinoma (k= 0.677). Respective diagnostic accuracy, sensitivity, specificity, negative and positive predictive values in assessing myometrial infiltration(>l/2 depth) were 91.4 %, 83.3 %, 95.6 %, 91.7 % and 90.9 %; those in cervical infiltration were 94.2 %, 80.0 %, 96.7 %, 96.7 %, and 80.0 %; and those in lymph node assessment were 96.2 %, 66.7 %, 100 %, 95.8 % and 100 %. Conclusion MRI is highly accurate in depicting the depth of myometrial infiltration, cervical invasion, lymph nodes metastasis and local-regional staging of endometrial carcinoma.

The relationship of erectile dysfunction (ED) with serum levels of total testosterone (TT) and free testosterone (FT) was investigated in 53 men with type 2 diabetes under 50 years of age.The relevant clinical status was matched and no significant difference was noticed for TT [ ( 14.11 ±5.81 vs 14.97 ±4.93 ) nmol/L] and FT [ (9.31 ± 8.84 vs 8.72 ± 5.33 ) pg/ml ] levels in type 2 diabetic patients with and without ED.This study has demonstrated that testicular androgen may not contribute to ED in young and middle-aged men with type 2 diabetes.

Objective To investigate the value of cytokinesis-block micronuclei(CBMN)assay in estimation of the biological doses of the victims of radiation accident.Methods Samples of peripheral blood were collected from the 5 victims(Subjects 1-5)at 16 h after the radiation accident of Taiyuan,Shanxi Province.And the peripheral blood samples and bone marrow sample were collected from the victim No.1 at 23 and 24 h after the radiation.Eight days after the accident Subject 1 underwent allogeneic peripheral blood hematopoietic stem cell transplantation.At difierent time points in the period of 1 year after the accident.peripheral blood samples were collected from these 5 victims.CBMN assay was conducted on the peripheral blood lymphocytes on the samples,and the biological doses were estimated based on the micronuclei(MN)frequencies.The nuclear division index(NDI)obtained from in vitro irradiation experiment using high dose of 60Coγ-rays was used to estimate the exposed doses for Subject 1. Dynamic arialysis of the MN frequency for the 5 victims was performed in the period of 1 year after the accident.Results The MN frequency of Subject 1 surpassed the value corresponding to the upper limit of the MN dose.effective curve.The dose range estimated bv the combination of the CBMN and NDI (CBMN+NDl)assay was 10-20 Gy for Subject 1.The doses estimated by MN frequency for Subjects 2,3,4,and 5 were 3.6,2.9,2.3,and 2.9 Gy,respectively.The estimated doses were in accordance with those estimated by physicat method.chromosome aberration analysis.and clinical symptoms.Prominent decrease of the MN frequency was observed at 26 d after the accident(18 d after the transplantation)for Subject 1(u=3.295,P<0.05).Gradual decrease of MN frequency was observed after the accident for Subjects 2,3,4,and 5.The MN frequencies 1 month after the accident of Subjects 3,4,and 5 were all significantly lower than those 16 h later(u=6.874,4.526,and 7.811,P<0.05).Conclusions Quick and accurate.CBMN assay reinforces and verifies the result of chromosome aberration analysis.The new index CBMN+NDI assay is of reference valne for estimating higher dose of irradiation.

Objective To establish a dose-effect curve of premature condensation chromosome ring (PCC-R)in lymphocytes of human peripheral blood after exposed to high doses of Y-rays. Methods Peripheral blood samples was drawn from three healthy individuals, and exposed to 60Co γ-rays with doses between 0 and 30 Gy. The frequencies of PCC-R in premature condensation chromosome (PCC) cells obtained by Okadaic acid (OA) induction were calculated, and a dose-effect curve was fitted. Results PCC index tapered with dose. Frequencies of PCC-R per cell increased until 20 Gy, and then saturation was observed. The results were fitted to a lineal model up to 20 Gy: y = - 0.020 + 0.052D ,where y was the frequencies of PCC-R per cell, D was the radiation dose (Gy). Conclusins The highest dose could be estimated is 20 Gy by the dose-effect curve established with PCC-R method. Its utility and validity will be verified in the future application of radiation accident.

Objective To investigate the effect of the asthmatic mice's airway inflammation and bronchial hyperresponsiveness treated with curcumin.Methods The mice were divided into three teams randomly,the normal mice,the asthmatic mice and the curcumin mice.The mice of three teams were detected by lung function,Giemsa dying,HE and PAS dying,and ELISA.Results After the Mch concentration of 6.25 g/L,the value of Penh in asthmatic mice was higher than the control mice,which was sighifiantly different(P ＜ 0.01).However,the value of Penh in curcumin team was lower than asthmatic mice,which was sighifiantly different (P ＜0.01).The number of total white blood cells and eosinophils was higher in asthmatic mice than the contol,which was sighifiantly different(P ＜0.01).However,the number in curcumin team was lowered than asthmatic team(P ＜ 0.01).The IgE content of BALF in asthmatic mice was higher than the control,which was significantly different(P ＜ 0.01).However,the content in curcumin team was lowered than the asthmatic mice,which had a significant difference(P ＜0.01).Pathology of HE staining in asthmatic mice showed the thickening bronchial wall,narrow lumen,peribronchial and perivascular infiltration with a large number of eosinophil-based inflammatory cells,lumen with many inflammatory secretions.However,the curcumin team was alleviated than the asthmatic mice.There were more goblet cells and more mucus secretion in the asthmatic mice by PAS staining.However,the curcumin team was alleviated than the asthmatic mice.Conclusion Curcumin can alleviate the airway inflammation,mucus secretion,airway hyperresponsiveness and the IgE content of bronchoalveolar lavege fluid.