Objective To investigate the role of autonomic nerve system(ANS)in the pathogenesis of acute mountain sickness(AMS).Methods A hypobaric chamber was used to simulate 4500m altitude for 1 day.The function of ANS of 43 healthy young males was measured individually before the experiment,and then at a “height” of 4500m for 5min.GJB1098-91 clinical questionnaires were conducted to evaluate the AMS symptomatic scores.HRV was measured respectively before the test and 2h,10h,20h at 4500m;cold pressure test(CPT)and plasma concentration of NA were determined before the test and at 4500m,AMS scores were evaluated at the end of exposure.25 subjects with AMS scores of 10 or less were identified as mild AMS group(group A),and another 18 subjects with scores of over 10 were gathered as moderately severe AMS group(group B).Results Compared with group A,the systolic pressure(SP)during CPT increased markedly in group B(P

Objective To evaluate the clinical features of and appropriate surgical modality for congenital choledochal cyst(CCC). Methods Retrospective study on the clinical data of 85 surgically treated CCC cases was made. Results Among the 85 cases 12 were found malignant in character(14%). Out of the 29 cases in which the junction of pancreaticobiliary ductal system was showed by image, junction anomaly was identified in 26 cases. Surgical correction was applied to 83 cases with cyst excision and Roux-en-Y hepaticojejunostomy as the main procedure. External drainage of the CCC was adopted first in 4 cases to tide the patients over serious infection, before second stage definite radical resection was carried out. Excellent and good result were achieved on follow-up in 47 out of 60 CCC cases undergoing CCC resection and Roux-en-Y reconstruction, while only one out of 6 undergoing CCC internal drainage enjoyed fair result. Conclusions External drainage is mandatory for CCC patients with severe infection. The total choledochal cyst excision, with Roux-en-Y hepaticojejunstomy is effective in the treatment of CCC.

Objective To investigate the environmental quality and water quality of bathing beach in Haikou,Hainan province and the effects on human health.Methods The investigation of the bathing beach environment and the water quality were conducted according to Bathing Beach Monitoring Regulations(2002).The water samples were collected at PM 3:00-5.00 on May 28th to June 3th in 2007 from three sampling sites,No.1(easily be polluted),No.2(crowded),No.3(less pollution).The questionnaire survey was conducted on the present day and 7 days later,the items included the respiratory,digestive systems infection and eye,ear,nose and skin inflammation,the survey was completed in two days.Results The environment survey of bathing beach suggested that non-point source pollution caused by domestic wastewater emerged on raining days,the salinity was 31‰-33‰,clarity exceeded 30 centimeter and no heat pollution was found.The pH value,chroma,dissolved oxygen,nitrate nitrogen,chemical oxygen demand,inorganic nitrogen,fecal coli group was 8.01-8.10,11.42-15.00 NTU,5.60-6.71 mg/L,0.16- 0.17mg/L,2.70-3.40mg/L,0.19-0.21 mg/L and 35.0-36.0/L respectively.Four hundred and eight questionnaires were eligible, the response rate was over 90%.The results demonstrated that the swimmers were facing to the increased illness risk from the water quality,such as skin pruritus,gastrointestinal allergies,throat sore,eye and ear and nose infections.There was distinct higher proportion in the participants with water contact and complained one or more symptoms than those without water contact(P

Objective To investigate the association of red cell distribution width (RDW) with prognosis in patients with sepsis. Methods Patients with sepsis admitted to intensive care unit (ICU) of the First Hospital of Soochow University from January 2011 to December 2016 were enrolled. All clinical data were collected for participants, which mainly included basic data, main underlying disease, site of infection, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, blood routine test, biochemical test, blood gas analysis, coagulation index, procalcitonin (PCT), hospitalization days, and 28-day and 90-day mortality. Patients were divided into two groups according to whether the RDW levels were higher than the time of admission or not. Kaplan-Meier survival curve was performed to analyze 28-day and 90-day cumulative survival rates in two groups. Multivariate Cox regression analysis was done to find the independent risk factors of death in patients with sepsis. Results 196 septic patients were eligible to participate into this study. 150 patients (53.57%) had higher RDW levels than those at the time of admission. Compared to negative or static change of RDW group, positive change of RDW group had higher APACHE Ⅱ score (20.42±6.29 vs. 16.17±6.37), more percentage of chronic kidney insufficiency (35.24% vs. 19.78%), bloodstream infection (32.38% vs. 15.38%), continuous renal replacement therapy (CRRT: 32.38% vs. 16.48%), higher level of C-reactive protein [CRP (mg/L): 14.71±3.52 vs. 11.15±7.94], and higher serum creatinine [SCr (μmol/L): 128.0 (74.0, 263.5) vs. 90.0 (57.0, 145.5)], PCT [μg/L: 3.45 (2.39, 6.64) vs. 2.35 (0.56, 3.54)], and lactic acid [Lac (mmol/L): 3.40±1.72 vs. 2.70±1.61]; and had lower levels of hematocrit (Hct: 0.357±0.128 vs. 0.437±0.143), hemoglobin [Hb (g/L):103.60±22.63 vs. 115.67±28.49], platelets [PLT (×109/L): 133.37±87.29 vs. 191.43±87.65], albumin [Alb (g/L):28.15±5.72 vs. 35.51±5.91], total cholesterol [TC (mmol/L): 2.43±1.12 vs. 3.05±1.55], estimated glomerular filtration rate [eGFR (mL·min-1·1.73 m-2): 82.02±63.90 vs. 125.46±83.47], and oxygenation index [PaO2/FiO2 (mmHg, 1 mmHg = 0.133 kPa): 229.69±60.61 vs. 264.21±74.78]; and longer time of hospitalization [days: 17.0 (12.0, 21.7) vs. 11.0 (7.0, 18.0)], higher 28-day and 90-day mortality (57.14% vs. 36.26%, 62.86% vs. 47.25%) with statistically significant differences (all P < 0.05). It was shown by Kaplan-Meier survival curve that the 28-day and 90-day cumulative survival rate in positive change of RDW group was significantly lower than that of negative or static change of RDW group (χ 12 = 8.462, χ22 = 6.411, both P < 0.05). It was shown by multivariate Cox regression that high APACHE Ⅱ score [odds ratio (OR) = 1.049, 95% confidence interval (95%CI) = 1.010-1.090, P = 0.013] and positive change of RDW (OR = 0.517, 95%CI = 0.280-0.953, P = 0.034) were the risk factors of death in patients with sepsis. Conclusions The change of RDW values during hospitalization was related to the poor outcomes in patients with sepsis. The increase of RDW predicts the progress of sepsis and bad prognosis. Serial surveillance of RDW values could provide useful information for long-term prognosis in sepsis.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Hep G2 Cells ; Humans ; Interleukin-6 ; metabolism ; Liver Neoplasms ; metabolism ; pathology

Objective To analyze the frequency of NPM1 mutation in de novo acute myeloid leukemia (AML) patients and the relationship between NPM1 mutation and chromosome alterations,as well as FAB subgroups,and to analyze the mutation type.MethodsA total of 99 de novo AML patients from 2004 to 2010 in China-Japan Friendship Hospital were studied.Genomic DNA was amplified by polymerase chain reaction (PCR),denaturing polyacrylamide gel electrophoresis (PAGE) and capillary electrophoresis were used to detect the mutation of NPM1 gene in 99 AML patients,and karyotyping was performed in 72 AML patients by G banding techniques.DNA sequences analysis of NPM1 mutation was performed on 10 patients.Chi-square test was used to compare the frequencies of NPM1 mutation among the different subgroups,and McNemar's test was used to compare the different rates between denaturing PAGE and capillary electrophoresis.ResultsThe frequencies of NPM1 mutations were detected in 15％ (15/99) of AML patients with capillary electrophoresis and 11％ (11/99 ) with denaturing PAGE(x2 =2.25,P ＞0.05 ).The NPM1 was at different rates in M2(27％,8/30),M5(32％,6/19),M6( 13％,1/8),respectively (x2 =1.06,P ＞ 0.05 ),and not detected in the other subgroups.NPM1 mutation in patients with normal karyotype(26％ ) was more prevalent than patients with abnormal karyotype (4％) (x2 =5.61,P ＜ 0.05)All of the 10 patients were of A type ( c.860_863dupTCTG).The C-terminal portion of the NPM protein by replacing the last seven amino acids(WQWRKSL) with 11 residues (CLAVEEVSLRK).Two intronic deletions were novel,one case was IVS10-18_-15delCTTT,the other was IVS10-17_-15delTTT.Conclusions NPM1 mutations represents a common genetic abnormality in AML patients,and NPM1 mutation in patients with normal karyotype is higher than patients with abnormal karyotype.Two new intronic deletion mutations are identified.

Objective To investigate MRI manifestations of lumbar and proximal femoral bone marrow changes before and after recombinant human granulocyte colony stimulating factor (rhG-CSF) was subcutaneous injected for healthy adults.Methods Twenty healthy blood stem cell donors without hematologic disease were enrolled in this study. All of them underwent lumbar sagittal and proximal femur coronal MRI examination with spin echo T1 WI and fat-suppressed T2WI.The first examination were performed before subcutaneous injection of rhG-CSF for comparison. In 4-7 days and 30-60 days after injection, the other two examinations were performed. The signal changes of lumbar and proximal femoral bone marrow were investigated by reading pictures and calculating the contrasted noise ratio (CNR).ResultsBefore rhG-CSF injection, all patients presented normal signal intensity of hone marrow. In 4-7 days after injection, all the 20 cases presented homogeneous signal decrease in lumbar vertebral bodys on T1 WI, accompanied by reduced fatty signal. In proximal femur, patchy or stripped hypointensity areas were found in intertrochanteric and subtrochanteric areas on T1 WI. On fat-suppressed T2 WI images, the signal of lumbar and proximal femoral bone marrow changed to equal or slightly-high signal intensity. In all cases,abnormal signal areas presented in lumbar and proximal femoral bone marrow occurred simultaneously in the same case.In the 10 cases received the third MRI during 30-60 days after rhG-CSF injection, signal intensity of lumbar bone marrow turned to normal in all sequence, but abnormal signal intensity areas were still existed and extended to distal part in femoral bone marrow, which appeared as symmetric stripped or patchy equal or slightly-low signal intensity on T1 WI and equal or slightly-high signal intensity on T2 WI. The CNR of lumbar bone marrow to subcutaneous fat before rhG-CSF injection, in 4-7 days and 30-60 days after rhG-CSF injection were 114. 11 ± 15. 11,71.04 ± 12. 25 and 91.64 ± 1 I. 68, respectively. Significant difference was found between before rhG-CSF injection and 4-7 days after injection ( P ＜ 0. 05 ) , but no significant difference between the others( P ＞ 0. 05 ). Conclusion After injection of rhG-CSF, the short-term changes of hematopoietic cells and fat content in bone marrow can be displayed on MRI, which provided non-invasive information for bone marrow transplantation.

Objective To study the diagnosis and treatment of Currarino triad Methods A retrospective study was made on clinical features, diagnosis; treatment and prognosis of 7 cases with Currarino triad Results In 6 patients definite diagnosis was made only intraoperatively including reoperation in 3 cases All the 7 cases were cured Postoperative urinary retention and infection developed in one each Conclusion Correct preoperative diagnosis of Currarino triad has great influence on the treatment Total excision of presacral mass should be emphasized

Objective:To observe the efficacy of cytokine-induced killer (CIK) cells on patients with advanced lung cancer. Methods:A total of 90 patients with advanced lung cancer were identified from January 2011 to December 2013. CIK therapy was given to 41 pa-tients in the observation group, whereas the other 49 patients in the control group received the best support treatments without che-motherapy or radiotherapy within one month of inclusion. Following up was conducted for the patients in the two groups, and KPS scores, median survival, and adverse reactions compared. Results:The KPS score in the observation group was higher than that of the control group after treatment (P=0.034). The median survival period of the observation group was eight months, which was one month longer than that of the control group (P=0.044). Major adverse reactions included fever, joint pain, and insomnia, which were recorded 51.22%, 36.58%, and 29.27%of occurrence, respectively. Conclusion:CIK cell therapy improved the quality of life and pro-longed the survival of advanced lung cancer patients with tolerable adverse reactions.

Objective To explore the dynamic changes and significance of heart rate variability(HRV)during the initial phase after acute exposure to Tibet plateau by combining time,frequency domain and non-linear analysis.Methods Eighty-six healthy young men of Han nationality underwent short-term(5 min)heart rate variability(HRV)monitoring at 560 meter above sea level(plain),then were transported to Tibet plateau(3675-meter above sea level)by airplane.There,all subjects were divided into 3 groups,and A gorup(n=12)underwent HRV monitoring on the 2nd day after arrival,B group(n=48)on the 3rd day,C group(n=26)on the 4th day.Results Compared with the data obtained at plain,the standard deviation of normal to normal intervals(SDNN),high frequency(HF)and total power(TP)decreased significantly(P50 ms(PNN50)and normalized high frequency(HFnu)also decreased obviously(P