Objective To investigate clinical efficacy and safety of carboprost tromethamine injection combined with low B -Lynch suture for intractable postpartum hemorrhage placenta previa.Methods 125 cases of intractable postpartum hemorrhage placenta previa were divided into two groups according to treatment(n =62)with the observation group(n =63),the control group was administered oxytocin,and the line in the placental separation surface 8 interrupted suture;the observation group was used carboprost tromethamine injection combined with low B -Lynch suture.Clinical efficacy,blood loss,bleeding,postoperative bleeding 2h,24h after blood loss,transfusion rate and index sex hormone levels were compared before and after treatment.Results (1)After treatment,total effec-tive rate of the control group and observation group was 77.42%(48 /62)and 95.24%(60 /63)respectively.There was a statistically significant difference between the two groups(P <0.05);(2)Blood loss,bleeding time,2h after blood loss,blood loss and transfusion rate after 24h in the observation group were (1 608.37 ±43.01)mL,(8.89 ± 1.09)min,(101.18 ±8.73)mL,(221.17 ±20.58)mL and 4.76%,respectively,which were significantly lower than those of the control group [(1 992.28 ±55.62)mL,(12.83 ±1.77)min,(145.49 ±12.19)mL,(255.54 ± 23.30)mL and 16.13%](t =4.559,5.128,3.928,3.382,χ2 =5.559,all P <0.05);(3)before and after treatment indicator hormone(E2 ,FSH and LH)levels were not significantly different(P >0.05),and after treatment,the index level differences were not statistically significant(P >0.05);(4)the two groups during treatment,liver and kidney functions were normal,three cases of the control group and two cases of the observation group occured nausea and vomiting.Conclusion Carboprost tromethamine injection combined with low B -Lynch suture has significant effect, a small amount of bleeding,high security for intractable postpartum hemorrhage placenta previa,which should be promoted.

Objective This present study explores and evaluates the effect of preliminary implementation in the clinical therapy programs for patients with chronic Keshan disease (CKD) in the disease seriously-affected endemic areas.Methods In 2010,seventy-six CKD patients with heart failure were chosen from Huangling and Xunyi Counties in Shaanxi Province,where incidences of CKD were high.Besides taking sodium selenite,all patients were given treatment with fixed prescription,which included angiotensin-converting enzyme inhibitor (captopril),β-blocker (propranolol),diuretics (hydrochlorothiazide,spironolactone) and cardiac (digoxin) for 4 months.The changes before and after treatment were analyzed,which included the changes of heart function by the United States of America New York Heart Association(NYHA) fractionation,cardiothoracic ratio,electrocardiogram,left ventricular ejection fraction(EF) and fractional shortening(FS).The therapeutic effect was subsequently evaluated.Results Seventy-four cases of the seventy-six CKD patients completed the treatment observation.The improvement rate of heart function was 81.1％ (60/74) after treatment.The elimination rates of ectopic rhythm,conduction block and ST-T changes were 37.5％ (9/24),2.7％ (1/36) and 26.9％ (7/26),respectively.The cardiothoracic ratios of heart function NYHA Ⅱ,Ⅲ and Ⅳ were 0.504 ± 0.051,0.572 ± 0.054 and 0.632 ± 0.063 before treatment.After treatment,the cardiothoracic ratios were 0.486 ± 0.048,0.538 ± 0.046 and 0.607 ± 0.048,which were reduced in all groups (t =2.643,6.641,3.005,all P ＜ 0.05),while the D-value of cardiothoracic ratio changes before and after treatment was not significantly different(F =3.005,P ＞ 0.05).Both the mild reduction group(35％≤EF ＜ 50％) and the moderate-severe group(EF ＜ 35％) EF were (43.62 ± 4.58)％,(27.57 ± 3.69)％ before treatment and were (48.21 ± 10.01)％,(36.57 ± 6.60)％ after treatment,EF were increased in the two groups,while the changes before and after treatment were significantly different(t =-2.911,-3.334,all P＜ 0.05).The EF D-value of the two groups was (4.59 ± 8.48)％ before treatment and was (9.00 ± 7.14)％ after treatment,which were not significantly different(P ＞ 0.05).FS was higher compared with pre-treatment in FS reduction group(FS ＜ 25％) and the changes before and after treatment[(19.75 ± 2.88)％,(21.92 ± 5.67)％] were significantly different(t =-2.297,P ＜ 0.05).Conclusions This study shows that the feasibility of clinical treatment of patients with CKD is very promising.The treatment of fixed prescription is effective.

Objective To prepare a novel annexin V and conjugate it with fluorescein isothiocyanate and test their binding ability to phosphatidylserine(PS)exposed erythrocytes.Methods The annexin V fused with an metal chelating binding site was obtained from pichia pastoris culturing and methanol induction expression.The annexin V was purified from the culture supernatant crude product by ion-exchange chromatography and ammonium sulfate precipitation.The annexin V was conjugated with fluorescein isothiocyanate in boric buffer and the conjugate annexin V-FITC was purified by ion-exchange chromatography.Sheep red blood cells were treated with Glutaraldehyde to expose membrane PS.The annexin V-FITC binding to PS exposed erythrocytes was investigated by fluorescent microscopy.Results The novel annexin V was purified and concentrated from pichia pastoris culture by ion-exchange chromatography and ammonium sulfate precipitation.After conjugating with FITC,the annexin V was found to bind PS exposed erythrocytes by fluorescent microscopy.Conclusion The annexin V expressed recombinantly in pichia pastoris retains the binding ability to PS exposed erythrocytes and is applicable to apoptosis detection in vitro.

Objective Establishing the scientific research competitiveness evaluation index system of Shanghai hospitals.Methods Delphi method and Analytic Hierarchy Process were applied.Results Thirty-four experts were invited to provide evaluation index and weighted scores.The positive coefficient from two rounds of expert's consultation were 88.24％ and 94％.The expert's opinion of authority coefficient of each indicator's was greater than 0.7.The degrees of coordinative consistency was high.Kendall concordance coefficient was increasing with the increasing of consulting times.After two rounds of Delphi expert consultation,2 level-one indictors,10 level-two indictors and 47 level-three indictors were confirmed.Conclusions After two rounds of Delphi expert consultation,using all objective indicators,an Index System for research competitiveness evaluation in the hospitals in Shanghai has been created and could be used with scientific,objectivity and feasibility.

Objective To explore the clinical.significance of serum anti-lysosomal associated membrane protein-2 (LAMP-2) antibody in the pathogenesis of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AASV) by investigating the relationship of its levels and AASV.Methods Sera from twenty patients with AASV and twenty healthy controls were collected.Serum anti-LAMP-2 antibody was detected using commercial enzyme linked immunosorbent assay (ELISA) kits.Anti-LAMP-2 antibody levels between the two groups were assessed using the t test,the correlation between anti-LAMP-2 antibody levels and erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) was assessed by Spearman's rank correlation test,the correlation between anti-LAMP-2 antibody levels and the Birmingham vasculitis activity score(BVAS),hemoglobin (Hb),albumin (Alb) was assessed by Pearson's rank correlation test.Results ① The serum level of anti-LAMP-2 antibody in patients with AASV [(3714±1446) pg/ml] was higher than that in the healthy controls [(174±43) pg/ml] (t=10.94,P＜0.05).The serum level of Hb [(99±30) g/L] and Alb [(27±5) g/L]in patients with AASV was lower than that in healthy controls [(138±14) g/L,(44±3) g/L] (t=5.27,t=13.04,P＞0.05).② The level of anti-LAMP-2 antibody in AASV was positively correlated with BVAS (r=0.669 9,P＜0.05),and was not found elevated compared with ESR,CRP,Hb and Alb (P＞0.05).Conclusion ① AntiLAMP-2 antibody is involved in the pathogenesis of AASV.② Anti-LAMP-2 antibody is correlated with the activity of AASV,it may be an indicator of AASV disease activity.

Objective To investigate the antimicrobial resistance of Haemophilus influenzae in Peking Union Medical College Hospital for rational clinical treatment.Methods A total of 223 strains of H .influenzae were collected from patients from Jan-uary 2008 to December 2011.The antimicrobial susceptibility was tested by Kirby-Bauer method.Production of beta-lactamase was detected using nitrocefin disks.WHONET 5.6 software was used to analyze the data of susceptibility testing.Results Tri-methoprim-sulfamethoxazole and tetracycline were the two antimicrobial agents to which the H .influenzae strains were most resistant.Theβ-lactamase positive ampicillin resistant strains accounted for 15.9 %,andβ-lactamase negative ampicillin resist-ant strains accounted for 8.9%.Conclusions H .influenzae is mainly isolated from respiratory specimens.Majority of the anti-microbial agents still show good antibacterial activity against H .influenzae strains.However,H .influenzae isolates are highly resistant to trimethoprim-sulfamethoxazole and tetracycline.

Objective To derermine the affinity of site-specific labeled annexin V with ~(99m)Tc to phosphatidylserine (PS)exposed erythrocytes.Methods The annexin V fused with a metal chelating binding site was obtained from Pichia Pastoris culture and methanol induction expression.The annexin V was purified from the culture supernatant crude product by uhrafihration.The annexin V was conjugated with ~(99m)Tc site-specifically through sodium glucoheptonic acid and SnCl_2.The radioactive annexin V was added to determine its affinity to PS exposed erythrocytes.Results The calcium concentration at which half of the protein is bound to cells(EC50)is changed with varying ratio of protein to cells.The affinity was determined at a low protein/cell ratio as 33.4.Conclusion The annexin V recombinantly expressed in Pichia Pastoris shows high affinity to PS exposed erythrocytes.

The purpose of this study was to reveal the current situation of health technology transfer in Shanghai hospitals,and to analyze the problems and needs.Questionnaire and interview were adopted for the study.We found that in the past 3 years,the transformation rate of patent technologies at Shanghai Tertiary Hospitals was 5.88％.The transfer routes mainly involves proactive enlist of enterprises by project leader,technology brokerage,exhibitions of patents achievements,friends' recommendation,etc..The main factors impacted the transfer included poorer quality of patent,lacking efficient management,and lacking channels for transfer.In order to improve the transfer of patents,hospitals need to provide information service,technology assessment,project packaging,patents application,consultant,and relevant trainings etc.Other things that could promote health technology transfer are to improve scientific research system,to enhance the quality of scientific achievements,and to develop technology brokerage.

Objective To explore the impact of silencing PLCε1 gene on proliferation and cell cycle of esophageal carci-noma Eca109 cells.Methods Three plasmid expression vectors (PLCε11, PLCε12 and PLCε13) were constructed to si-lence PLCε1 gene.A negative control plasmid expression vector (HK) was constructed at the same time to serve as a control .The plasmid expression vectors were transfected into esophageal carcinoma Eca 109 cells by cations liposome . The plasmid expression vector with the best interference effect ( PLCε12 ) was chosen .The study included Eca 109 group , HK group and PLCε12 group .Cell viability of Eca 109 cells was evaluated by MTT assay .The cell cycles were detected by FCM .The mRNA expression of P16 and CyclinD1 gene was measured by RT-PCR.Results The cell vi-abilitys of Eca109 cells in PLCε12 group were 80.73%and 75.88%at 48 and 72 h after transfection , which were significantly lower than that of Eca 109 cells in HK group (P<0.001).The percentage of S phase Eca109 cells in PLCε12 group was lower than that of Eca 109 cells in HK group ( P <0.01 ) , the cell cycle of PLCε12 group Eca109 cells was arrested in G0/G1 phase.The P16 gene mRNA expression of PLCε12 group Eca109 cells was higher than that of HK group Eca 109 cells ( P<0.01 ) .Conclusions Silencing PLCε1 gene may up-regulate P16 gene mRNA expression and then arrest the cell cycle at G 0/G1 phase and so inhibit proliferation of Eca 109 cells.

Objective To detect the molecular characteristics of the serum samples of rats suffered from sudden unexpected death of acute myocardial ischemia (experimental group) and death caused by air embolism (control group) applied by ATR-FTIR, and to discuss the forensic signiifcance of identiifcation of causes of death by sudden unexpected death of acute myocardial ischemia by two-dimension infrared spectroscopy. Methods Adult male SD rats were randomly divided into SCD group and DCAE group. The serum samples were analyzed by ATR-FTIR. The similarity coefifcient of spectra between two groups was analyzed by OMNIC software. The spectra with higher signal-noise ratio were obtained and used to build two-dimension spectra model by Matlab 2010a software. Results The peak shapes, positions and intensities of the spectra were extremely similar between two groups, and the similarity coefifcient reached 99.78%. Meanwhile, the similarity coefifcient of second derivative spectra decreased to 98.62% between two groups. Moreover, on the two-dimension spectra model, the component differences were present at about 1 625cm-1, 1 550cm-1, 1 080cm-1 and 860cm-1, and the number of auto-peaks was different, which suggested that the evident differences were related to the molecular contents of protein, glycogen, nuclear acid, and so on. Conclusion It is hard to differentiate the molecular differences of serum samples of rats between SCD and DACE based on one-dimension spectra. However, two-dimension infrared spectra could intuitively and effectively relfect the molecular differences, and it would apply to determining the cause of death in forensic science.