Objective To observe the effects of intensive insulin therapy on C-reactive protein (CRP) ,interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α ) in the patients of critical illness complicated with hyperglycemia and its incidence of side effect. Methods Two hundred and nine patients of critical illness complicated with hyperglycemia were randomly divided into intensive insulin therapy group (106 patients,blood glucose maintained at a level of 4.4-6.1 mmol/L) and conventional insulin therapy group ( 103 patients, blood glucose maintained at a level of 9.0-11.1 mmol/L). Serum levels of CRP,TNF- α and IL-6 were determined on 0,24,48,72 h respectively after ICU admission. Results The levels of blood glucose of both groups reached the target level. The incidence rates of the hypoglycemia had no significant difference between two groups [6.60 % (7/106) vs. 4.76% ( 3/63 ),P > 0.05]. After 72 h treatment, serum level of CRP in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 24,48 and 72 h treatment, serum level of IL-6 in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 48 and 72 h treatment, serum level of TNF-αin intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05). Conclusion Intensive insulin therapy can significantly decrease the levels of non-specific inflammatory factors in patients of critical illness complicated with hyperglycemia, which brings beneficial effect to the patients.

The premembrane and envelope proteins (prM-E),which contains the mainly protective antigen related with virulence and tropism,are the primary structural protein of flavivirus.However,prM-E in ZIKV is rarely understood.We have analyzed the structure and biological effects of prM-E in ZIKV by bionformatics methods.The prM-E proteins virus-like particles of dengue virus was introduced in the present.Then,the prM-E proteins virus like particles of ZIKV was prospected.

Objective To investigate the effect of the continuing quality improvement on PICC-related phlebitis in breast cancer patients undergoing chemotherapy. Methods Eighty breast cancer patients undergoing PICC for chemotherapy in our hospital from September to December 2014 were selected as control group, receiving routine nursing care. Another eighty patients undergoing PICC for chemotherapy from January to March in 2015 were selected as experiment group and the quality control cycle was used, the measures including investigating the present situation aiming to theme, goal setting and analyzing, working out and using countermeasures and effect comfirming. Result After applying continuing quality improvement in the experiment group the incidence rate of phlebitis in the continuing quality improvement group was significantly lower than those before continuing quality improvement and in the control group (P<0.05). Conclusion The implementation of continuing quality improvement activities can reduce the incidence of pzce-related phlebitis in patients with breast cancer during chemotherapy. It can improve the safety of PICC catheter and therefore, it is worthy of popularization.

Medical therapy,education and scientific research are three functions of a hospital,in which education is one of the core tasks.The author thinks that we should strengthen the cultivation of the teachers;raise the level of the managements;increase the teaching input and reinforce the reform of education and scientific research so as to drive and improve the development of the hospital.

Objective: To explore the value of dual energy CT lung perfusion imaging (DEPI) for diagnosing pulmonary embolism (PE) in comparison with CT pulmonary angiography (CTPA). Methods: There were 49 patients with suspected PE received DEPI scanning and 19 with CTPA conifrmed diagnosis were enrolled in this study. CTPA image was obtained by 80 kv data, and DEPI image was obtained by PBV software. The location, type of PE in CTPA image, and the location, shape of perfusion defect in DEPI were observed and compared by segment basis. The correlation and agreement of CTPA and DEPI for diagnosing PE were calculated and the un-agreement was analyzed. Results: A total of 380 segments were included for analysis. CTPA detected 162 segments of PE and DEPI detected 155 segments of perfusion defect or reduction, partial PE were mainly presented by perfusion defects as speckles, patches or without perfusion defect, and complete PE were mainly showed segmental or sub-segmental perfusion defects. CTPA and DEPI were correlated for PE diagnosis (χ2=305.5,P=0.000), the diagnostic agreement was 83.42% and KAPPA value was 0.659. Conclusion: The perfusion defect in DEPI is related to the degree and type of PE presented in CTPA, their combination is helpful for diagnosing PE.

Objective To investigate the reference interval of platelet‐related parameters including mean platelet volume (MPV) ,platelet distribution width (PDW) ,platelet hematocrit (PCT) .Methods Used Sysmex XN‐9000 assembly line and PEN‐TRA 120 hematology analyzer to analysis the venous blood cells for 3 415 cases of 16 to 90 years old physical examination personnel in Mianyang Central Hospital ,the platelet‐related parameters results of 2 718 standard healthy population by screening were statis‐tically analyzed .Results Platelet‐related parameters 95% reference interval (2 .5% -97 .5% ) of XN assembly line :M PV 9 .9-14 . 7 fL ,PDW 11 .2% -24 .3% ,PCT 0 .15% -0 .30% ;Platelet‐related parameters of 95% reference interval of PENTRA 120:MPV 8 .4-12 .7 fL ,PDW 13 .8% -24 .8% ,PCT 0 .12% -0 .26% ;comparison between the instruments :MPV ,PDW ,PCT results showed significant differences (P<0 .05);comparison between men and women :PCT test results of XN assembly line were differ‐ent (P<0 .05) ,MPV ,PDW ,PCT results of PENTRA 120 were different (P<0 .05);comparison between age groups :PCT result of all ages between men and women were different in XN assembly line (P<0 .05) ,in PENTRA 120 ,MPV ,PDW ,PCT results be‐tween ages were different in men (P<0 .05) ,PCT results between ages were different in women (P<0 .05) .Conclusion Each la‐boratory should establish the laboratory supporting biological reference interval of platelet‐related parameters based on different in‐struments ;in practical applications ,should set the reference interval for different gender or age .

Objective: To observe the effect of hypoxia on changes of proliferation ability of cultured human periodontal ligament fibroblasts (HPLFS) in vitro. Methods: HPLFS were randomly divided into two groups (experimental group and control group) by different oxygen concentrations. The oxygen concentration of control group was 21%. The oxygen concentrations of experiment group were 10%, 5% and 2%. The proliferation ability of HPLFS was detected by MTT colorimetric assay. The cell ultrastructure was observed by transmission electron microscope (TEM). Results: MTT assay results showed that compared with the control group, at the 12 h and 24 h, cell proliferation was enhanced with the hypoxia degree. At 24 h, cell proliferation showed significant differences. At 48 h and 72 h, proliferation of the cultured HPLFS in severe hypoxia group reduced significantly. Observed by TEM, at 24 h, not only the number of mitochondria, rough endoplasmic reticulum but also cell process increased in the cultured HPLFS in severe hypoxia group. At 72 h, the number of lysosome increased and the cell structure degenerated. Conclusion: Long-time severe hypoxia may lower the repair and remodeling abilities of periodontium, which might be one of the important etiological factors of periodontal disease under condition of high altitude.

Objective To discuss the clinical effect of restrict rehydration strategy on anastomotic healing of patients with colorectal cancer.Methods 483 cases of colorectal cancer ( from January 2008 to November 2009) were analyzed retrospectively,166 in fluid restriction group and 317 in tradition therapy group.Postoperative early rehabilitations and complications were studied and compared.Results The first time of passing flatus(3.9 d vs 4.4 d),first ambulation(2.9 d vs 3.3 d),oral intake(2.9 d vs 3.6 d),time with use of urinary catheter(4.6 d vs 5.5 d),and drains(2.2 d vs 3.1 d),and postoperative hospital stay ( 8.7 d vs 11.6 d) in fluid restriction group were significantly earlier or less than those in tradition therapy group ( P ＜ 0.01 ),while there were no significant differences in time with use of nasogastric tubes ( 1.1 d vs 1.2 d) between the 2 groups ( P ＞ 0.05 ).There was significant difference in the postoperative complications rate between the two groups ( P ＜ 0.05 ).Conclusions Restrictive fluid regimen could reduce the incidence of common complications for patients after colorectal surgery,and might have a certain promoter action to the anastomotic healing.

Objective To explore the values of potential clinical application ofsingle tube/ten colorsflow cytometry for leukocyte differential count in peripheral blood.Methods Utilizing multiple monoclonal antibody combinations and the vavious logical gating strategies,the single tube/12 antibodies with no-wash method for the leukocyte differential count in peripheral blood were determined by using 10 colors flow cytometry.Leukocyte differentials of 142 peripheral blood samples were determined by both Beckman-Coulter LH750 hematology analyzer and 10 colors flow cytometry.The results were then compared to standard microscopic examination as a reference method.The clinical diagnostic efficiency ofsingle tube/10 colorsflow cytometry was calculated.The correlations between standard microscopic cytology,single tube/10 colorsflow cytometry and the hematology analyzer were determined.In addition,the clinical diagnosis efficiency for blast counts ofsingle tube/10 colorswere compared to the results determined by BD FACS Calibur flow cytometer.Results The leukocyte differentials were correlated well between the single tube/10 colorsflow cytometry and standard microscopic cytology(r>0.700,P<0.01) except for basophils.The correlations with neutrophilic granulocytes,lymphocytes,immature granulocytes and blasts were superior(r=0.972,0.951,0.801,0.912,respectively,P<0.01).When 1% was selected as the cut-off point for immature granulocytes determined by standard microscopic cytology,the sensitivity and the specificity ofsingle tube/10 colorsflow cytometry were 92%(57/62) and 79% (63/80),respectively.When 0.5% was selected as the cut-off point for blasts detected by standard microscopic cytology,the sensitivity and the specificity were 99% (67/68) and 92% (68/74).Using the immunophenotyping results from BD FACS Calibur as a standard,the sensitivity for detecting blasts bysingle tube/10 colOrsflow cytometry was 100% (40/40),the specificity was 91% (10/11),the positive predictive value was 98% (40/41),the negative predictive value was 100% (10/10) and the accuracy was 98% (50/51).Conclusions Thesingle tube/10 colorsflow cytometry has a excellent correlation with the standard microscopic cytology when applied on leukocyte differential count in peripheral blood.It may potentially use as a subsequent method for verification of abnormal results of complete blood cell count in the future.

ObjectiveTo observe the effect of rhubarb as the main composition in the therapy for patients with acute paraquat poisoning (APP).MethodsA prospective randomized controlled trial was conducted. 128 patients with APP admitted to Harrison International Peace Hospital from March 2011 to December 2013 were randomly divided into western medicine control group (n = 64) and western medicine and traditional Chinese medicine (TCM) combination group (n = 64). All the patients were treated with repeated gastric lavage and oral kaolin. The patients in western medicine control group were given 20% mannitol and (or) magnesium sulfate for catharsis, early (within 8 hours of admission) hemoperfusion (HP), and also given the routine combined therapy. In TCM combination group, in addition to the above treatment patients were given oral paraquat poisoning detoxification prescription No.1 every 2 hours for catharsis, which was composed of rhubarb 10 g, glauber salt 12 g, agrimony 12 g, and licorice 6 g. When green stool disappeared, detoxification therapy was changed to No. 2 compound once a day for 14 days, which was consisted of rhubarb 10 g, ginseng 6 g, agrimony 15 g, rhizoma chuanxiong 10 g, licorice 6 g. The poison volume, first dose of oral drug, time for the first HP, time of the first defecation, the time of last green stool, decontamination time, white blood cell count (WBC), C-reactive protein (CRP), arterial blood gas analysis, blood lactic acid (Lac), liver and kidney functions, myocardial enzyme spectrum, chest CT, adverse reaction, days of hospitalization, and mortality rate were observed in both groups. The levels of paraquat in plasma and urine were determined before treatment and 12 hours after poisoning in both groups. Sixty days after discharge, chest CT was taken for observation of pulmonary fibrosis. ResultsThere were no significant differences in the poison volume, ingestion time and the time for the first HP between the two groups. Compared with western medicine control group, the first defecation time (hours: 3.94±1.14 vs. 6.17±1.52), the last time of green stool (hours: 36.90±4.10 vs. 51.63±4.91), and poison clean-up time from plasma (hours: 19.48±3.63 vs. 23.84±3.29) in combination with TCM group were significantly earlier (allP< 0.01). WBC, CRP, alanine aminotransferase (ALT), blood urea nitrogen (BUN), and serum creatinine (SCr) levels were gradually increased after admission in combination with TCM group, and they peaked on 5th day [WBC (×109/L): 15.35±2.17 vs. 17.47±2.09, CRP (mg/L): 32.62±2.76 vs. 39.51±2.45, ALT (U/L): 270.88±11.06 vs. 334.67±7.85, BUN (mmol/L): 13.29±1.90 vs. 17.63±1.42, SCr (μmol/L): 203.54±18.40 vs. 251.53±14.38, allP< 0.05], and then they declined; Lac after admission was gradually increased, and peaked at 7 days (mmol/L: 3.53±0.21 vs. 3.82±0.14, P< 0.05), and then it was decreased. Myocardial enzyme spectrum was increased after admission, and peaked on 3rd day [creatine kinase (CK, U/L): 192.09±16.26 vs. 216.20±11.96, creatine kinase isoenzyme enzyme (CK-MB, U/L):39.03±3.75 vs. 47.22±5.84, bothP< 0.05), and then they declined gradually. Arterial partial pressure of oxygen (PaO2) and base excess (BE) were gradually decreased after admission, down to trough on the 7th day after admission [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 87.04±2.37 vs. 84.93±2.44, BE (mmol/L): -7.31±2.31 vs. -9.18±2.49, bothP< 0.05], and then they were increased. At 12 hours after poisoning, paraquat contents in plasma and urine in combination with TCM group were significantly lower than those of the western medicine control group [plasma (ng/L):0.83±0.08 vs. 0.96±0.10, urine (ng/L): 0.88±0.09 vs. 0.97±011, bothP< 0.05]. The injury to lung tissue was significantly improved in combination with TCM group compared with that in the western medicine control group, and no serious adverse reactions was found, and the hospital stay time (days: 20.46±6.07 vs. 29.73±9.16) was significantly shortened (P< 0.01), and the mortality rate [35.9% (23/64) vs. 45.3% (29/64)] was significantly lowered compared with western medicine control group (P< 0.05). In the combination with TCM group pulmonary fibrosis was lighter than that in the western medicine control group during the 60-day follow-up. ConclusionThe sequential treatment of No. 1 and No. 2 detoxification of APP, using rhubarb as the main drug, can effectively eliminate paraquat, reduce absorption of the toxin, prevent the development of multiple organ dysfunction syndrome (MODS) induced by the toxin, shorten the hospital stay days, and improve the prognosis of APP.