Objective To summarize and analyze the epidemiological and clinical characteristics of hemorrhagic fever patients with renal syndrome (HFRS),so as to provide a basis for prevention and treatment.Methods The epidemiological and clinical data of 104 HFRS patients,who were treated in the First Affiliated Hospital of Harbin Medical University in 2014,were collected.The HFRS patient's age,sex,urban and rural areas,occupation and time of onset distributions,summary onset clinical manifestations,laboratory findings,treatment and outcome were analyzed retrospectively.Results Average age of the 104 cases of HFRS patients was 43.46 years old,the youngest was 12 years old and the oldest was 80 years old.Most of the patients were 30-＜50 years old,which was accounted for 54.81％ (57/104),and most of the patients were male,which was accounted for 78.85％ (82/ 104).Most of the patients lived in rural areas,which was accounted for 81.73％ (85/104).Most patients were onset in November,accounted for 19.23％ (20/104),and the least was in August,accounted for 2.88％ (3/104),and was sporadic in the rest of the year.For the clinical classification,the light type and the moderate type were the largest part,98 cases,accounted for 94.23％,while the severe type and the critically severe type were 6 cases,accounted for 5.77％.The clinical manifestations were as follows:fever majority in 94 cases,accounted for 90.38％,fatigue,aches and pain in 89 cases,accounted for 85.57％;polyuria in 88 cases,accounted for 84.62％;chemosis in 86 cases,accounted for 82.69％;skin bleeding,petechiae in 84 cases,accounted for 80.77％;oliguria in 81 cases,accounted for 77.88％.Laboratory test results were as following:87 cases of blood platelet (PLT) reduced (83.65％),74 cases of serum creatinine (sCr) increased (71.15％),74 cases of alanine aminotransferase (ALT) increased (71.15％),85 cases of aspartate transaminase (AST) increased (81.73％),96 cases of lactate dehydrogenase (LDH) increased (92.31％),and 31 cases of creatine kinase (CK) increased (29.81％).All of the 104 patients were cured,with no death.Conclusions Majority of the HFRS patients are young adults.The peak of the incidence of HFRS lies in Autumn.The proportion of the moderate type is the highest.Early diagnosis and treatment is the key to improve the prognosis of patients with HFRS.

ObjectiveTo study the effect of recombinant human growth hormone (rhGH) on postoperative patients on mechanical ventilation.Methods Forty postoperative respiratory failure patients on mechanical ventilation were treated by rhGH 8?IU injection subcutaneously QD.ResultsThe time of mechanical ventilation of rhGH group was (30?12)?d, compared with that in 40 control patients (39?13)?d (t=2 538,P

Objective:To study effects of 5 recipes for tonifing and supplementing on apoptosis and splenocytes in mice treated with cyclophosphamide.Methods:Apoptosis and cellular cycles of splenocytes were detected by flowcytometric analysis.Results:Sijunzi Decoction,Liuwei Dihuang Pill,Shengmai Powder,Jingui Shenqi Pill could antagonize the decline of proliferation induced by cyclophosphamide,and Sijunzi Decoction and Liuwei Dihuang Pill could resist the apoptosis of splenocytes caused by cyclophosphamide;and the recipes all could inhibit atrophy of the spleen induced by cyclophosphamide Conclusion:The 5 recipes for tonifying and supplementing all can improve the injury of the spleen induced by cyclopbosphamide in varying degrees,Sijunzi Decoction and Liuwei Dihuang Pill being the best.

Objective To observe the change of early postoperative cognition in the elderly under low central venous pressure (LCVP) after lobe resection to investigate the safety and feasibility of LCVP in Geriatrics.Methods A total of 45 ASA class Ⅰ ～ Ⅱ old patients (60 ～ 75 y)with elective liver resection were divided into L group and C group.In the LCVP group (L group),CVP was maintained below 5 cmH2O during liver resection until the lobe was done.The patients in the control group (C group) received standard care (The CVP was controlled between 6 cmH2O to 12 cmH2O).To compare the anesthesia recovery after surgery,all patients were tested with a battery of neuropsychologic assessment of cognitive function preoperatively and on the 7th day postoperatively.Results During liver resection,the MAP [(75.8 ±7.9)mmHg] and CVP [(3.1 ±0.4)cmH2O] of experimental group were lower than the control group [MAP (92.3 ± 10.6)mmHg,CVP(9.3 ± 1.4)cmH2O].The difference was statistically significant (t' =20.08,P ＜0.05,t =5.89,P ＜0.01) ;There was no statistically significant difference in postoperative recovery of spontaneous breathing,respiratory,eye opening time,extubation time and leave the operating room time between two groups[(18.1 ±6.7)min,(25.4±8.3)min,(31.9±11.7)min,(42.8±17.8)minvs (15.3 ± 7.0)min,(22.6 ±9.4)min,(30.2 ± 10.8) min,(45.4 ± 13.6) min,P ＞ 0.05].The incidence of POCD was 30.0％ in the experimental group and 27.3％ in the control group.The difference was no statistical significance between two groups(P ＞0.05).Conclusious There was no significant influence of low central venous pressure on anesthesia recovery time and early postoperative cognition in the elderly under hepatic resections.

Medical genetics is the mutual penetrative and combined discipline of genetics and medicine.Medical genetics teaching should be improved to adapt to the discipline development.Teaching reform and practice of medical genetics was developed in basic medical college of Nanjing university of traditional Chinese medicine.Constructive exploration was made in teaching content,teaching techniques,teaching methods,scientific research and performance appraisal standards in order to improve the quality of medical genetics teaching and to train high-quality medical talents.

Objective To study somatic cell embryogenesis of Acanthopanax senticosus induced by different concentration of 2,4D and type of explants,which provides theoretic evidence in protection of A.senticosus resources and genetic engineering.Methods Using 3-week seedlings and zygotic embryos(cotyledon, hypocotyls,and roots) of stratificated seeds as explants researches the effect of different hormones on somatic cell embryogenesis of A.senticosus. Results Explants of zygotic embryos of stratificated seeds cultured on MS and 1/2MS media containing 0.5 mg/L 2,4-D generated the highest frequency(57.1%) and the most number(3.3) of somatic cell embryos,which can develop into maturation in the initial medium.But it is more beneficial to generate new somatic cell embryos and to develop primary somatic cell embryos into maturation when transferred into 2,4-D of decreased concentration.And the deve-(lopment) process of somatic cell embryos of A.senticosus is similar to that of zygotic embryos.Conclusion(Somatic) embryogenesis of A.senticosus is realized by culturing explants of zygotic embryos and the inductive rate of somatic cell embryos is related to the concentration of 2,4-D and developmental stage of explants.

Aim To study effects of loganin and morro-niside on aging astrocytes induced by D-galactose. Methods Cortex astrocytes of newly born rats were cultured in vivo and indentified by immunofluorescence method.Firstly,appropriate D-galactose concentration was selected and effects of loganin and morroniside on proliferation activity of aging astrocytes induced by D-galactose were determined by MTT test.Then SOD, MDA were taken as indicators to study the effects of loganin and morroniside on aging astrocytes induced by D-galactose.Thirdly,growth factors like gliar cell line-derived neurotrophic factor (GDNF),basic fibro-blast growth factor (bFGF)tested by ELISA method and expression of Bax,caspase-3,phospho-extracellu-lar signal-regulated kinese (p-ERK1 /2),phospho-mi-togen-actived protein kinase /extracellular signal-regu-lated kinase kinase (p-MEK1 /2)were taken as indi-cators to discuss the potential protection mechanism. Results Loganin and morroniside exerted certain effects on proliferation of aging astrocytes induced by D-galactose,improving SOD,GDNF,bFGF release and lowering MDA release significantly (P <0.05 ). The expressions of Bax and caspase-3 proteins had no difference between model group and loganin group, morroniside group.While the expressions of p-ERK1 /2,p-MEK1 /2 of loganin group,morroniside group were improved significantly compared with model group.Conclusion Loganin and morroniside have protective effects on aging astrocytes induced by D-ga-lactose,and increase the proliferation ability.Protec-ting their antioxidant systems and improving the expres-sion of p-ERK1 /2,p-MEK1 /2 proteins are possible mechanisms.

Objective To evaluate the efficacy of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in the treatment of idiopathic pulmonary fibrosis through the method of system evaluation. Methods A computer-based online search of Pubmed, Embase, Cochrane Library, CNKI, CBM and Wanfang were used for database retrieval. Revman 5.0 was used to assess the bias of the included studies. The Stata 14.0 was used to evaluate the extraction indexes of efficacy, p (O2), p (CO2), DLco, FEV1 and VC. GRADE score was used to evaluate the level of evidence. Results A total of 17 articles (related with 1381 patients) were included in this study, including 14 studies using ARB and 3 studies using ACEI. Compared with the control group ACEI and ARB drugs showed advantages in the treatment of pulmonary fibrosis (RR=1.34, 95%CI:1.24-1.44, Z=7.81, P<0.001). Auxiliary index analysis showed that the test groups were treated with enalapril (SMD=0.72, 95%CI:0.21-1.22, Z=2.77, P=0.006), telmisartan (SMD=3.86, 95%CI:2.44-5.27, Z=5.35, P<0.001), valsartan (SMD=1.94, 95%CI:1.33-2.55, Z=6.27, P<0.001) and captopril (SMD=0.60, 95%CI:0.11-1.09, Z=2.41, P=0.016), the p(O2) levels were significantly improved in patients ≥65 years old (SMD=0.76, 95%CI:0.52-1.00, Z=6.18, P<0.001) and patients < 65 years old (SMD=3.97, 95%CI:2.61-5.32, Z=5.73, P<0.001), and disease duration≥5 years (SMD=1.39, 95%CI:0.45-2.33, Z=2.89, P=0.004) and disease duration<5 years (SMD=3.26, 95%CI:2.06-4.46, Z=5.34, P<0.001) compared with those of control group (SMD=2.95, 95%CI:1.95-3.94, Z=5.82, P<0.001). The curative effect of telmisartan was better than that of other drug groups (P < 0.001), and which was much better for patients under 65 years old (P<0.001). There was no significant difference in the disease duration between two groups (P=0.307). The p (CO2) levels were significantly improved in patients treated with telmisartan [SMD=-12.94,95%CI:(-14.01)-(-11.86),Z=23.51,P<0.001), valsartan [SMD=-1.95,95%CI:(-2.56)-(-1.34),Z=6.29,P<0.001] compared with those of control group [SMD=-11.13,95%CI:(-17.03)-(-5.24),Z=3.70,P<0.001]. The effect of telmisartan was better than that of valsartan (P<0.001). In addition, values of DLco (SMD=0.64, 95%CI:0.45-0.83, Z=6.72, P<0.001), FEV1 (SMD=1.19, 95%CI:0.52-1.86, Z=3.47, P<0.001) and VC (SMD=0.51, 95%CI:0.16-0.85, Z=2.85, P=0.004) were improved in test group compare with those of control group. And the GRADE scores of relevant indexes were low quality to moderate quality. Conclusion ACEI and ARB can improve the efficacy, the p (O2) and p (CO2) in the treatment of pulmonary fibrosis. Patients with age<65 years old and treated with telmisartan have the best curative effect, and which is not related to the disease duration.

Aim To investigate the proliferative effect and the apoptosis of human hepatoma SMMC-7721 cells induced by gallic acid ( GA ) , and its underlying mechanism. Methods SMMC-7721 cells were cul-tured in vitro. MTT assay was used to observe the pro-liferation of SMMC-7721 cells induced on GA 24 , 48 , 72 h. The morphological and ultra structural changes of the SMMC-7721 cells were observed by inverted micro-scope and transmission electron microscope respective-ly. Annexin V-FITC/PI staining was used to quantify the percentages of apoptosis in the total cell popula-tion. The expression of p53 mRNA was investigated by RT-PCR. Western blot was used to determine the pro-tein expression of p53. Results GA(6. 25~50 μmol ·L-1 ) markedly inhibited the activity of proliferation and induced apoptosis of SMMC-7721 cells after 48 h in a dose-dependent manner. GA significantly induced cell nuclear condensation and fragmentation. RT-PCR and Western blot results showed that GA could improve the expression of p53 mRNA and protein. Conclusion GA can inhibit the proliferation of human hepatoma SMMC-7721 cells and induce cells apoptosis. The mechanism may be associated with improving tumor suppressor gene p53 expression.

Objective To explore the possible role of CD28 +/CD152 +:B7 eostimulators in immune pathophysiology of severe pneumonia.Methods 22 severe pneumonia peripheral blood sample were used to analyze the expression of CD3+ T cell CD28+,CD152+,CD14++ on mononuelear cell CD86+,and HLA - DR + by FACS expression.The relationship between CD28+,CTLA4,CD86+ and the HLA-DR +,and the relationship between APACHE Ⅱ Grading,CD28+,CD152+,CD86+ and HLA-DR + were analyzed.Results Compared with the control group,the expression of CD3 + T cell,CD86+ and HLA - DR + were remarkably reduced while the expression of CD28+ and CD152+ were markedly increased in patients with severe pneumonia who were hospitalized in 24 h(P＜0.05).However,T cells with positive CD8+ CD3+ and CD4+ CD3+ had no significant change between two groups(P＞0.05).For patients with severe pneumonia who survived,the APACHE Ⅱ scores were significantly reduced while the expression of CD28+,CD152+,CD86+,HLA-DR + and CD3+ + cells were significantly increased after 10 days from admission(P＜0.05).By contrast,T cells with positive CD8+ CD3+ and CD4+CD3+ had no significant change between two groups(P＞0.05).There were no relation between costimulators CD28+ and HLA - DR + (r=-0.12,P=0.54)and APACHE Ⅱ scores(r=-0.30,P=0.19) in control group.CD86+ and HLA - DR + showed positive correlation(r=0.65,P=0.00).CD86+ and APACHE Ⅱ scores had no correlation(r=-0.38,P=0.09).Conclusion The costimulators expressed abnormally in circumference blood of patients with severe pneumonia,CD86+ decreased,but CD28+,CD152+ increased.T cell of circumference blood was at the condition of "anergy".The increase of CD28+,CD86+,CD86+ and HLA - DR + during convalescence stages in patient with severe pneumonia showed that spocific immunity was advantageous for restoration in these patients.The relationship among CD86+,CTLA4 and HLA - DR + indicated that CD28+/CD152+:B7 play an role in the occurrence and development of severe pneumonia.