Objective To analyze the clinical feature,pathogenesis and treatment of autoimmune hemolytic anemia (AIHA) in patients after orthotopic liver transplantation.Method A retrospective analysis was conducted on 7 patients who developed AHA after orthotopic liver transplantation.The clinical feature,pathogenesis and treatment of AIHA were reviewed.Result The incidence of AIHA was 0.98％ (7/713).AIHA occurred (7.9-± 4.0) (3-14) days after transplantation.All patients were characterized by progressive anemia and jaundice.Laboratory examination showed lower hemoglobin and platelet count,higher lactate dehydrogenase,higher indirect bilirubin and higher reticuloeyte count.The causes of AIHA included ABO-incompatible liver transplantation,infection and repeated transfusion.Conclusion AIHA is a rare and serious complication after liver transplantation.The most cause is ABO-incompatible liver transplantation.The patients can be successfully cured if the diagnosis is clarified and the treatment is definitive.

Objective To observe and analyze the reasons of intra-abdominal hypertension,and to discuss the influence of intra-abdominal hypertension (IAH) on recipients' respiratory function and its changes after disposition.Method During January to June in 2012,50 patients who had performed orthotopic liver transplantation were involved in this study.Intra-abdominal pressure was measured by AbViser Intra-Abdominal Pressure Monitoring Kit.According to the value of intra-abdominal pressure,the patients were divided into two groups (IAH group and control group).The reasons of IAH were observed and analyzed.Respiratory rate,oxygenation index,and the arterial partial pressure of carbon dioxide between IAH and control groups were compared.IAH was dealt with restricting oral input,inserting nasogastric tube,administering enema,inserting ilues tube or placing percutaneous catheter drainage according to reasons.Intra-abdominal pressure,respiratory rate,oxygenation index,and arterial partial pressure of carbon dioxide were also observed after disposition.Result The incidence of IAH was 44％ (22/50).The respiratory rate of patients in IAH group was quicker than that in control group.The oxygenation index in IAH group was lower than that in control group.The arterial partial pressure of carbon dioxide in IAH grade I group was not higher than in control group.However,the arterial partial pressure of carbon dioxide in IAH grade Ⅱ and Ⅲ groups was higher than in control group.After disposition,the intra-abdominal pressure,respiratory rate and arterial partial pressure of carbon dioxide in IAH groups were decreased from 16.4 ± 3.1 mmHg,33.0 ± 5.2 L/min and 47.6 ± 9.4 mmHg to 10.5 ± 1.8 mrnHg,19.7 ± 4.1 L/min and 39.9 ± 2.9 mmHg respectively,while the oxygenation index was increased from 202.7 ± 72.9 mmHg to 350.5 ± 98.5 mmHg.Conclusion The incidence of IAH after orthotopic liver transplantation was high.The influence of IAH on patients' respiratory function was serious.After timely and proper disposition,the respiratory function of patients with IAH could be improved.

To cultivate medical postgraduates with scientific research quality is an important task of medical education. It is of significance for excellent medical postgraduates. Cultivation of scientific research quality in scientific research thinking training,scientific research items selection and implementation was expounded in the paper to provide suggestions for better medical postgraduate education.

BACKGROUND:As an important industrial solvent,benzene can cause DNA damage,chromosome aberrence,formation of DNA adducts and gene mutation. OBJECTIVE:To explore the effects of benzene on DNA and the mechanism,as well as the changes of antioxidase system it caused. DESIGN:Randomized case control study. SETTING:The Department of Clinical Laboratory of First Affiliated Hospital and Public Health College of Harbin Medical University. PARTICIPANTS:The experiment was completed in the Animal Centre in Public Health College,Harbin Medical University.Twenty-four healthy male mice of Kunming species weighed between 18 g to 22 g were chosen.The mice were provided by Experimental Animal Centre of Second Affiliated Hospital,Harbin Medical University. INTERVENTIONS:The mice were divided into control group,low dose benzene group and high dose benzene group.Inhaling benzene smoke method was used 4 hours per day to cause benzene poisoning to mice except those of the control group.The mice were executed two months later to separate marrow cells and peripheral lymphocytes and remove liver,spleen and brain to make homogenate. MAIN OUTCOME MEASURES:Single cell gel electrophoresis (SCGE) was used to assay the DNA damages of marrow cells and peripheral lymphocytes.Meanwhile,the contents of superoxide dismulase(SOD),glutathione peroxidase(GSH-Px) and malondialdehyde(MDA) in liver,spleen and brain tissues were also detected. RESULTS:The comet percentage of marrow cells and peripheral lymphocytes in two benzene poisoning groups were(83.56± 10.28),(92.54± 15.93)% ,and(41.27± 6.03)% ,(65.79± 11.62)% respectively which were much higher than those in control group[(4.13± 0.52)% ,(2.21± 0.31)% ](P< 0.01) and represented dose-response relationship.The SOD activity of liver homogenate and GSH-Px activity of high dose and low dose groups were (11 573.31± 1 938.72),(12 574.68± 1 938.72) nkat/g and (309.40± 82.85),(375.41± 55.18) nkat/g respectively which were much lower than those in control group [(16 668.67± 3 137.96),(588.62± 110.52) nkat/g] (P< 0.05).However, there was no significant difference between different dose groups. The GSH-Px activity in spleen homogenate in two experimental groups was(421.75± 124.02) and(523.10± 45.18) nkat/g respectively which was much lower than that of control group [(618.42± 57.01) nkat/g](P< 0.05) and there was significant difference between two groups (P< 0.05).In the brain homogenate of both benzene groups,the GSH-Px activity was(87.35± 19.84) and(95.02± 14.00) nkat/g respectively which was much lower than that of control group[(118.36± 7.67) nkat/g] (P< 0.05) and without difference between two groups.The MDA content in brain homogenate of high dose group was(3.99± 1.15) μ mol/mg which was much higher than that of control group [(2.58± 0.53) μ mol/g] (P< 0.05). CONCLUSION:Chronic benzene poisoning can cause DNA impairment of marrow cells and peripheral lymphocytes and reduce the activity of antioxidase.

The teaching reform in college is calling for changes in students' learning styles and teachers' teaching methods.It is very important to change teacher' s educational concept and transform teacher' s role in the teaching process in order to completely change the form and content of nutrition and food hygiene course.It means we should only change traditional teaching approaches into problem based learning or inquiry teaching but also summarize the teaching content and integrate the theory with practice.

Objective To detect the effect of Danhong injection on cerebral vascular hemodynamic parameters, Cys-c and Hcy in patients with transient cerebral ischemia(TIA), and analyze its clinical effect. Methods 80 TIA patients were selected. The patients were divided into a control group and a Danhong injection observation group with 40 cases each group. The control group was given conventional treatment, and the observation group was given conventional treatment and Danhong injection. The treatment course was 14 d. The hemodynamic parameters, Cys-c and Hcy expresssion were observed. Clinical effect was analyzed. Results After treatment, average blood flow speed (20.07 ± 4.28 cm/s vs. 16.17 ± 2.46 cm/s, t=5.230), average blood flow (11.14 ± 2.24 ml/s vs. 9.54 ± 1.65 ml/s, t=3.637), and cerebral vascular resistance (1 602.4 ± 98.3 kPa/s·m-1 vs. 1 738.5 ± 104.3 kPa/s·m-1, t=6.024) was significantly improved in the observation group than those in the control group (P<0.05). Cys-c (0.48 ± 0.11 mg/L vs. 0.71 ± 0.14 mg/L, t=8.170) and Hcy (17.45 ± 3.26 μmol/L vs. 23.62 ± 4.12 μmol/L, t=7.428) were significantly decreased in the observation group than those in the control group (P<0.05). The recurrence rate of TIA and cerebral infarction were 7.5% and 5% in observation group, which were significantly lower than that of 22.5% and 15% in control group (χ2=2.451, P<0.05;χ2=2.630, P<0.05).Conclusion Danhong injection can reduce the expression of Cys-c and Hcy and recurrence rate of TIA and cerebral infarction.

Objective To evaluate the effect of heparin and argatroban on the coagulating function and the vascular thrombosis in the early period after pediatric living related liver transplantation (LRLT).Method Eighty-four congenital biliary atresia pediatric patients who had performed LRLT were involved in this study.According to the method of anticoagulation,the patients were divided into two groups (heparin group and argatroban group).Antithrombin Ⅲ (AT-Ⅲ) activity,activated partial thromboplastin time (APTT) and international normalized ratio (INR) of two groups were measured in the first 5 days after LRLT.In order to determine whether vascular thrombosis existed,Doppler ultrasound was performed daily.Result There were no significant differences in gender,age,body weight,graft-recipient weight ratio and whether to accept Kassi procedure between two groups.The AT-Ⅲ activity of two groups was low and increased gradually after operation.There was no significant difference between two groups.There were no significant differences in APTT and INR between two groups immediate and at first day after operation.After anticoagulation,the differences in APTT and INR between two groups were significant.The incidence of vascular thrombosis was 4.76％ (3/63) and 0(0/21) respectively in heparin and argatroban groups.There was no significant difference between two groups.During treatment,there were no severe complications in two groups,such as active hemorrhage and allergy.Conclusion Argatroban is a direct anticoagulant.It is independent on the level of AT-Ⅲ activity.It may play an important role for preventing vascular thrombosis after pediatric LRLT.

Objective To study the variation of serum thyroid hormones in each trimester of pregnancy and their relationship with thyroid peroxidase antibody(TPOAb).Methods Three-hundred and seventy-seven pregnant women in different trimesters were enrolled,the serum TSH,FT3,FT4,TT3,TT4,and TPOAb were determined by ICMA assay.Results Serun TSH in normal pregnant group was gradually increased as the pregnant trimester grew up ( all P＜0.05 ).The median of TSH in positive TPOAb group was higher than that of negative TPOAb group( P＜0.05 ).The prevalences of both clinical and subclinical hypothyroidism in positive TPOAb group were also higher than those in negative TPOAb group( all P＜0.05 ).The prevalences of subclinical hypothyroidism were 23.61％ and 18.04％,while those of clinical hypothyroidism were 0.27％ and 5.84％ by using TT4 and FT4 determination,respectively( P＜0.05 ).Conclusions More attention should be paid to the difference between FT4 and TT4 in hypothyroidism diagnosis during both second and third trimesters of pregnancy.Establishment of normal thyroid hormoues cut-off points in each trimester of pregnancy and screening for TPOAb is necessary.