Objective To explore the clinical value of using heparin in DIC caused by Tsutsugamushi.Methods 27 cases of Tsutsugamushi with DIC were divided into two groups. The heparin treatment group(n = 15) and non-heparin treatment group(n = 12). The two groups were compared and analyzed. All the cases were diagnosed definitely depended on the "Tsutsugamushi-Disease-Diagnosis Standard".Results The group which use heparin improved in rectifying shock,terminating heorrhage,restoring the time of lab index of DIC,rating of MOF and death. Compared with the control group, the difference had statistical significance(P

Desmoid tumor of abdominal wall was also known as fibronmatosis of abdominal wall.It is a rare benign fibroblastic tumor, which is characterized by non-enveloped,strong local infiltration, with high recurrence rate after surgery.In December 2011, one patient with huge desmoid tumor of abdominal wall with intestinal tube received surgical resection with single-stage patch repair for the large defect in abdominal wall at the 210th Hospital of PLA, and the result was satisfactory.

Objective To identify the influencing factors for pediatric nursese' reporting of adverse events at 3A hospitals in Beijing. Methods Adopting the random sampling of ten 3A hospitals with pediatric wards in Beijing and conducting an questionnaire survey of some nurses in those hospitals. Results The possibility of adverse events reporting increased with the awareness of adverse events which was related with their severity. Except for title, educational background, length of service, position and past experiences were not associated with the barriers. The major perceived barrier was fear of colleague relationship brokenup and some other undesirable consequence. Conclusions Better training of awareness of adverse events and changes of the punitive culture by the roots as well as some regulation or policy were the major solutions to improve incident reporting.

BACKGROUND: The expression of Fas antigen and P53 protein in colorectal cancer could reflect the biological character and the prognosis of the tumor.OBJECTIVE: To investigate the relationship between the expression of Fas antigen and P53 protein in coloreetal cancer and the tumor-related biological characters.DESIGN: A controlled experiment by introducing pathological specimens as subjects.SETTING: The study was conducted in the Department of Pathology of Xijing Hospital Affiliated with the Fourth Military Medical University of Chinese PLA.PARTICIPANT S: Totally 32 pathological specimens of colorectal cancer were randomly selected from the Department of Surgery of Xijing Hospital between January 1995 and October 1998. Sixteen normal large intestine tissues were selected form the cadaver of pathology department.METHODS: The expression of Fas antigen and P53 protein in 32 colorectal cancer tissue and 16 normal intestine tissue were tested and compared with immunohistochemical method.MAIN OUTCOME MEASURES: Fas antigen and P53 protein expression in coloreetal cancer and normal intestine, and the clinical indicators of patients with colorectal cancer.RESULTS: The expression of Fas antigen was positive in normal large intestine tissue while the expression of P53 protein was negative. The positive rate of Fas antigen expression in colorectal cancer was 41% (13/32), while the positive rate of P53 expression in colorectal caner was 53% (17/32). Fas antigen significantly decreased in colorectal cancer tissues. The expression of Fas antigen was correlated with the histological type of colorectal cancer and its liver metastasis( P ＜ 0.05) . And the expression of P53 protein was correlated with the liver metastasis of colorectal cancer( P ＜ 0. 05).CONCLUSION: The expression of Fas antigen significantly decreases in colorectal cancer. The higher the malignance is, the more significant less the expression is. Fas antigen does not express in liver metastasis patients. P53protein had positive expression in colorectal cancer tissues, especially in patients with liver metastasis. The reduction and deletion of Fas antigen expression and the excessive expression of P53 protein indicate poor prognosis.

Objective To investigate the infection status of A ngiostrongylus cantonensis in winkle from 9 cities in Guizhou Province.Methods The winkles were collected randomly from aquatic products wholesale market,agricultural market or restaurants in 9 cities (Guiyang,Zunyi,Tongren,Kaili,Anshun,Duyun,Xingyi,Bijie and Shuicheng) and classified in Guizhou Province,and the third-stage larvas of Angiostrongylus cantonensis were separated and detected with microscopy by tissue homogenization (Pomacea canaliculata was first checked with lung screening method,and then rechecked by tissue homogenization),and infection rate was calculated.Results Totally 2 177 winkles were tested,the overall infection rate of Angiostrongylus cantonensis was 1.5％ (32/2 177),among them,Pomacea canaliculata was 1 287,five was positive,and the infection rate was 0.4％; Achatinafulica was 240,positive 27,the infection rate was 11.3％; Bellamya lithophaga was 372 and all 278 Cipangopaludina chinensis was not positive.Conclusions There is a higher risk of infection with Angiostrongylus cantonensis if eating winkles.The third-stage larva in Pomacea canaliculata and Achatina fulica has been found in Guizhou Province.Market management,food-safety inspection of the winkles on sale,and public health education should be strengthened.

Purpose:To investigate the effects of bcl 2 antisense phosphorothioate oligodeoxynucleotides (ASODN) combined with arsenic trioxide on the malignant lymphoma cell lines.Methods:Apoptosis, cellular DNA contents and bcl 2 expression were determined by cell stain, TdT mediated dUTP Nick end Labeling (TUNEL) and flow cytometry. Results:10～40?mol/L bcl 2 ASODN and 0.5～2.0 ?mol/L As 2 O 3 could inhibit Raji cell growth and induce apoptosis significantly. Number of Sub G 1 cells significantly increased and Bcl 2 protein expression in Raji cells significantly was downregulated by flow cytometry assay. The relationship between level of bcl 2 protein and concentrations of As 2 O 3 and bcl 2 ASODN showed a dose and time dependent effect; so did the number of Sub G 1 cells. There is much more effective inhibition of growth and induction of apoptosis by their combination than alone. Conclusions:It is found that bcl 2 ASODN could significantly inhibit the growth of B lymphoma cell lines and induce their apoptosis when combined with arsenic trioxide.

Objective:To analyze the report accuracy and risk factors of congenital syphilis (CS), and to provide references of accurate diagnosis for clinicians.Methods:CS notification data, including suspected cases and confirmed cases, were obtained from national notifiable disease reporting system (NNDRS) reported from 2016 to 2019 in Guangzhou City. Information of syphilis infected pregnant women and their children who were diagnosed or excluded with CS during 2012-2019 were extracted from Guangzhou City'the integrated prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus surveillance system’. Their demographic characteristics, serological test results of syphilis, reporting doctors and treatment regimens were analyzed.Chi-square test was used for univariate analysis and multivariate logistic regression analysis was used to identify the influencing factors associated with CS.Results:A total of 95 CS cases were reported in NNDRS, and the reporting accuracy rate was 36.8%(35 cases). The proportion of children younger than 30 days who were reported incorrectly (73.3%(44/60)) was higher than the proportion of those were reported correctly (51.4%(18/35)), and the difference was statistically significant ( χ2=4.679, P=0.031). However, the reporting accuracy was not associated with hospital grade, doctor profession and doctor title of reporting ( χ2=0.283, 0.483 and 3.681, respectively, all P>0.05). Maternal age≤24 years (adjusted odds ratio ( aOR)=4.62), titers of non- Treponema pallidum antigen serologic test before treatment≥1∶8 ( aOR=7.56), initiation of antisyphilitic treatment during delivery ( aOR=25.43), no antisyphilitic treatment during pregnancy ( aOR=14.12), and premature delivery ( aOR=8.97) increased the risks of CS (all P<0.01). Conclusions:The reporting accuracy rate of CS is low. Young mothers, high serological titers of non- Treponema pallidum antigen before treatment, initiation of antisyphilitic treatment during delivery or no antisyphilitic treatment during pregnancy, and premature delivery are risk factors for CS. Doctors may focus on collecting this information to assist clinical diagnosis.

Objective Investigate the effect of recombinant human growth hormone on large area burn with severely inhalation injury. Methods Forty cases of large area burn with severely inhalation injury were divided randomly into two groups, 20 in control group and 20 in rhGH group. The indexes of nutritional status (including MAMC,Hb,total protein,albumin and so far),healing time of burn wound,and the time of mechanical ventilation were recorded and compared between two groups. Results The nutritional status showed no difference between two groups before treatment,and was significantly better in rhGH group after treatment.The healing time of autologous skin pulp grafting and donor site,the time of mechanical ventilation and the length of hospital stay were significantly shorter in rhGH group patients than control group.Conclusion rhGH can enhance the wound healing rate,improve the nutritional status of patients with mechanical ventilation,shorten the time of mechanical ventilation,and decrease the complications of burn.

Objective:To study the effect of continuous blood purification on inflammatory state and immune response in patients with multiple injury and sepsis.Methods:88 patients with multiple injury and sepsis who were treated in our hospital from January 2015 to May 2016 were selected as the research object,they were divided into the control group (n=44) and observation group (n=44) according to random number table method.The control group was given conventional treatment,and the observation group was given continuous blood purification treatment.The acute physiology and chronic health conditions Ⅱ (APACHE Ⅱ)score was observed in two groups Ⅱ at 3 d after treatment.The serum content of Interleukin-2(IL-2),Interleukin-4(IL-4),Interleukin-10(IL-10) and interferon-γ (IFN-γ) were detected by ELISA method.The levels of CD3 +,CD4 +,CD8 + and NK cell were analyzed by flow cytometry.The urea nitrogen (BUN),serum creatinine (Scr),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time (APTT) were tested by automatic biochemical analyzer.Results:The APACHE Ⅱ score,BUN and Scr levels in observation group were lower than the control group (P＜0.05).The content ofIL-2,IL-4,IL-10 and IFN-γ in observation group were lower than the control group (P＜0.05).The levels of CD3+,CD4+,CD8+ and NK in observation group were higher than the control group (P＜0.05).The levels ofPT,TT and APTT in observation group were lower than the control group (P＜0.05).Conclusion:Continuous blood purification in patients with multiple injury and sepsis had better clinical curative effect,can reduce inflammation,improve immune function and the function of blood coagulation.

In this study,with the mechanism for teaching supervision in military colleges and universities construction as the starting point,the author makes an in-depth analysis of the problems existing in the current teaching supervision system of military academies,such as the imperfect mechanism,the limitation of the function,the lack of full-time staff,the lag of information technology and so on,and investigates and surveys the status quo of teaching supervision at home and abroad.It also puts forward some countermeasures,such as constructing the comprehensive supervision system,realizing the function transformation,promoting the innovation of the mode,expanding the connotation of the supervision,optimizing the structure of the team,developing the professional training,and strengthening the information construction and so on.