Objective To investigate the detection of central venous oxygen saturation ( ScvO2 ) whether can be alternative mixed venous oxygen saturation ( SvO2 ) in elderly patients with acute left ventricular failure.Methods 42 elderly patients with acute heart failure were detected by central venous oxygen saturation and mixed venous oxy-gen saturation before the treatment and 1h,2h,4h after treatment.Then the parameters index changes were analyzed according to the prognosis.Results Whatever the prognosis of the patients were,the trend of ScvO2 and SvO2 was the same.Before the treatment,the blood oxygen saturation detected by the ScvO2 with patients was no statistical differ-ence with the ScvO2(t=0.867,P>0.05),and after treatment of 4h the change trend detected of both has also the consistency,no statistical difference (t=0.681,P>0.05) The correlation coefficient r=0.998,and the relationship between ScvO2 and SvO2 confirmed the same clinical significance.Conclusion Considering the factors of trauma, complications,costs and so on,ScvO2 can be used to replace SvO2 in elderly patients with acute left heart failure.

Objective To investigate the relationship of polymorphisms at codons 333 and 637 of TAP-1 allele gene to recurrent condyloma acuminatum (CA) in a Chinese population. Methods Amplificatory refraction mutation system-PCR (ARMS-PCR) was performed to detect TAP1 polymorphic residues at codon 333 in 88 patients with recurrent CA and 81 age- and sampling date-matched controls and at codon 637 in 60 patients with recurrent CA and 60 age- and sampling date-matched controls. Results The frequencies of AA,GG and AG genotypes at codon 333 of TAP-1 gene were 86.36%, 0, 13.64%, respectively, in patients with recurrent CA, 79.01%, 0 and 20.99%, respectively, in the controls, and no significant difference was observed between the two groups (χ2 = 1.604, P ＞ 0.05). However, a significant difference was observed in the frequencies of AA, GG and AG genotypes at codon 637 of TAP-1 gene between the patients and controls (3.33% vs 10.0%, 95.00% vs 60.00%, 1.67% vs 30.00%, χ2 = 21.551, P ＜ 0.01 ). Conclusions The recurrence of CA may be associated with the polymorphism at codon 637, but not with that at codon 333, of TAP-1 gene.

BACKGROUND:Al ogeneic penetrating keratoplasty is the most effective method for treating corneal blindness. However, the incidence of rejections is high after keratoplasty, so it is urgent to develop an immunosuppressive drug with high efficacy and low toxicity. OBJECTIVE:To establish al ogeneic penetrating keratoplasty models and monitor the expression of tumor necrosis factor-αin blank control group and after transforming growth factor-β1 eyedrop during acute rejection period of corneal grafts. METHODS:Al ogeneic penetrating keratoplasty models were established and were randomly divided into blank control group, ciclosporin A group (1%ciclosporin A), and transforming growth factor-β1 group (1μg/ml transforming growth factor-β1 eyedrop). The medications from each group commenced at 1 day after surgery, one eyedrop once, three eyedrops per day. Al the operated eyes were given 0.3%ofloxacin ophthalmic solutions and 0.5%tropicaide ophthalmic solution, three times per day, for 12 days. The corneal grafts were harvested for hematoxylin-eosin staining and immunihistochemical staining (SABC method), to detect tumor necrosis factor-αexpression in corneal grafts. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that, corneal grafts were significantly thickened, a large number of histoleucocytes and lymphocytes infiltrated in the blank control group;corneal grafts showed normal thickness and no inflammatory cel s infiltrated in the transforming growth factor-β1 group. Immunohistochemical staining showed that, there were less cel s positive for tumor necrosis factor-αin the transforming growth factor-β1 group compared with the blank control group (P<0.05). Transforming growth factor-β1 eyedrops can reduce the expression of tumor necrosis factor-αin the corneal grafts during acute rejection period, and reduce the inflammatory cel s infiltration in the corneal grafts, which is probably the mechanism of transforming growth factor-β1 to prevent and treat corneal al ograft rejection.

Objective To compare the differences of blood glucose detected by four methods with different instruments and specimen types at early stage in severely burned rats.Methods 24 Sprague-Dawley (SD) rats were randomly divided into two groups:control group 1 (Sham scald group,n=8) and scald injury group 1 (n=16).Blood samples of scald injury group 1 were collected at 12,and 24 hours after scald (n=8,each time).Another 20 SD rats were randomly divided into two groups:control group 2 (Sham scald group,n=10) and scald injury group 2 (n=10).Blood samples of scald injury group 2 were collected at 12 hours after scald.The rats in scald injury group 1 and 2 were placed into scalding water (95.0±0.5)℃ for 15 seconds to model third-degree burn with 30％ total burn surface area (TBSA).The rats in scald injury group 1 were given intraperitoneal injection with normal saline(40 ml/kg) immediately,while those in scald injury group 2 were given intraperitoneal injection with normal saline (40 ml/kg) 6 hours after scald.The rats in Sham scald group 1 and 2 were placed into warm water 37℃ for 15 seconds,and did not received injection.Portable glucometer/caudal artery (vein) blood,portable glucometer/abdominal aorta blood,spectrophotometer/femoral venous plasma,and spectrophotometer/abdominal aorta plasma were used to detect blood glucose.Results ①Compared with Sham scald group 1,the levels of blood glucose detected by portable glucometer/caudal artery (vein) blood and spectrophotometer/femoral venous plasma in scald injury group1 at 12,24 hours after scald were significantly increased(P＜0.05).Compared with Sham scald group 2,the levels of blood glucose detected by portable glucometer/abdominal aorta blood and spectrophotometer/abdominal aorta plasma in scald injury group 2 at 12 hours after scald were significantly increased(P＜0.05).②The comparison of portable glucometer/caudal artery (vein) blood and spectrophotometer/femoral venous plasma in Sham scald group 1,portable glucometer/abdominal aorta blood and spectrophotometer/abdominal aorta plasma in Sham scald group 2 had no statistical significance (P＞0.05).The levels of blood glucose detected by portable glucometer/caudal artery (vein) blood were significantly lower than those detected by spectrophotometer/femoral venous plasma (P＜0.05) in scald injury group 1.The comparison of blood glucose detected by portable glucometer/abdominal aorta blood and spectrophotometer/abdominal aorta plasma had no statistical significance in scald injury group 2 (P＞0.05).Conclusion Four kinds of methods used in this study shows that the levels of blood glucose were significantly increased at early stage in severely burned rats,and the portable glucometer/abdominal aorta blood is a relatively simple and fast method to detect blood glucose.

Objective To investigate the CT and MRI features of the autoimmune pancreatitis (ALP).Methods CT and MRI data of fourteen patients with AIP who were confirmed by histology and/or steroid therapy were retrospectively analyzed.Ten patients underwent CT examination, and seven patients underwent MRI, while three patients underwent both CT and MRI examinations.Results It was showed that diffuse (n =11 ) or local ( n = 3 ) enlargement of pancreas.CT features showed that the hypoattenuation pancreatic lesions on unenhanced CT (n = 10);segmental pancreatic duct could be seen in five patients;stenosis of common bile duct in the head of pancreas was observed in 5 patients;the capsule-like structure around lesions was seen in seven patients.Delayed homogeneous enhancement was showed on enhanced CT.MRI features included homogeneous ( n = 3) and heterogeneous ( n = 4) hyperintense on T1 WI with fat-suppression images and homogeneous ( n = 3 )and heterogeneous (n =4) hyperintense on T2WI with fat-suppression images.Pancreatic duct could be seen in four patients.MRCP showed pancreatic duct stenosis in the head of pancreas ( n = 1 ) and segmental pancreatic duct (n = 2).Stenosis of common bile duct in the head of pancreas was showed in 5 cases.The capsule-like structure around lesions was showed in seven patients.No pancreatic calcification was revealed, and no significant pancreatic duct dilation was detected ( ＞3 mm) in all 14 patients.Conclusions The CT and MRI manifestations of AIP had characteristic features such as sausage-like changes of the pancreas, capsule-like structure around the lesions, diffuse or local pancreatic duct stricture, and stenosis of common bile duct in the bead of pancreas.

Normotensive primary hyperaldosteronism is rare. One case of this syndrome treated with alcohol injection was reported, and the clinical manifestation and laboratory data were analysed and discussed.

OBJECTIVE To clarify the features of nosocomial infections for patients with multiple myeloma(MM).METHODS One hundred and seventy eight cases of MM treated in our hospital from Oct 1982 to Dec 2006 were analyzed retrospectively.RESULTS Eighty five patients(47.8%) suffered from nosocomial infections.The nosocomial infection took place more frequently on respiratory tract.Elder,granulocytopenia,hypoproteinemia,severe anemia,and diabetes were the risk factors.Totally 91 pathogens were isolated.Gram-negative bacilli accounted for 45.1%,and were the major pathogens.Fungi accounted for 37.4% and Gram-positives accounted for 17.6%.The ESBLs producing strains accounted for 31.6% in Klebsiella pneumoniae and Escherichia coli.Vancomycin resistant strains were found.The top one of fungi presented organism was the Candida albicans.CONCLUSIONS Nosocomial infections for patients with multiple myeloma has a high incidence.There are many risk factors.The resistance of commonly encountered bacteria to antimicrobial agents is a serious problem.Immunity protection and the rational use of antimicrobial agents should be emphasized.

AIM: To evaluate the effects of compound salivia miltorrhiza injection on an experimental model of kidney thrombus induced by lipopolysaccharide(LPS).METHODS: The model of microvascular thrombosis in the rabbits' kidney was performed by the method of Hermida,which was induced by infusing LPS.Treatments were begun simultaneously with LPS infusion,through the contralateral marginal ear vein.Six different groups were established: NS 10(ml?h~(-1)) was infused as the negative control group,compound salivia miltorrhiza injection was infused with the dosage of(0.1)(Low-dose),(0.2)(medium-dose),and 0.4(high-dose)(ml?kg~(-1)?h~(-1)),heparin 600,000(IU?kg~(-1)?h~(-1)) as positive control group.The further rabbits, which were given neither LPS nor compound salivia miltorrhiza injection,were infused with saline solution through both marginal ear veins.The measurement of fibrinogen concentrations and platelet counts were used to assess the degradation of microvascular thrombosis.Kinney sections were examined for the presence of fibrin microthrombi.RESULTS: Compound salivia miltorrhiza injection was infused with the dosage of(0.1)(Low-dose),(0.2)(medium-dose),and(0.4)(high-dose)(ml?kg~(-1)?h~(-1)),and the fibrinogen concentrations and blood platelet counts were improved,and the fibrin deposition was degraded.CONCLUSION: Compound salivia miltorrhiza injection can inhibit effectively LPS-induced renal microvascular thrombosis.

Objective To observe the efficacy and adverse reaction of raltitrexed combined with irino-tecan as first-line chemotherapy for recurrent or metastatic gastric cancer.Methods From January 201 4 to March 201 5,39 patients of recurrent or metastatic gastric cancer who received treatment in the First People′s Hospital of Zhangjiagang of Jiangsu Province were collected.All patients received raltitrexed (3.0 mg/m2 , 1 5 min intravenous drip)on the first day and irinotecan (1 80.0 mg/m2 ,90 min intravenous drip)on the first day.One cycle lasted 21 days.The efficacies were evaluated every 2-cycle.Adverse reactions were evaluated every cycle.Results The efficacies and adverse reactions could be evaluated in 39 patients.The study received 0 complete remission,1 6 partial remission,1 1 stable disease,1 2 progression disease.The objective response rate was 41 .03% (1 6 /39).The disease control rate was 69.23% (27 /39).The median overall sur-vival time was 9.3 months (95%CI:8.8-1 1 .1 months).The median progression-free survival time was 6.0 months (95%CI:5.1 -6.8 months).The adverse reactions were mainly neutropenia,anemia,liver dysfunc-tion,the incidence of them were 35.90%,33.33% and 28.21 % respectively.Conlusion Raltitrexed com-bined with irinotecan as first-line chemotherapy for recurrent or metastatic gastric cancer acquires an definite efficacy,and the adverse reactions can be tolerated,which is worthy of further clinical research.

Owing to medical students'joining in, the correlation between doctors and patients have expanded into the relationship between doctors and medical students and patients in clinical teaching of sexually transmitted disease ( STD). It is easy to disobey ethical principle and lead to medical dispute happened if not be cautious to deal with the relationship. So we present that ① strictly to following medical ethical principle; ② establishing a harmonious doctor - patient relationship; ③improveing teaching ways to a rational extent in medical treatment of medical students were concerned with patients, and disposing the relationship between " Teaching" and " Learning" ; ④enhancing the professional morality culture of doctors( clinical teachers) and medical students, and providing the high quality service for patients. Thus ethical problems can be avoided effectively in clinical teaching of STD, and clinical teaching can be ensured go on wheels effectively too.