Objective To investigate the histological injury as well as the risk factors for the course of HBeAg-negative chronic hep-atitis B virus( HBV)-infected patients with persistently normal alanine aminotransferase ( ALT) levels ( PNAL) . Methods Ninty four patients of HBeAg-negative chronic HBV-infected with PNAL were performed liver puncturing. The ALT, HBV markers, and liver histo-logical changes were detected. The gender, age, family history, HBV-DNA and HBsAg levels were compared between different patients with liver inflammation and fibrosis. And the Logistic model was used during the analysis of independent risk factor. Results Among 94 cases, patients with inflammatory necrosis classification≥G2 accounted for 74. 5%, fibrosis grading≥S2 accounted for 27. 7%. Patients in the group of inflammatory necrosis classification≥G2 was older than the group of < G2, and the ALT level of≥G2 group was higher, as well as a higher HBV-DNA. What is more,Patients in the group of inflammatory necrosis classification ≥G2 were mainly male, and were associated with a family history of hepatitis B. Patients in the group of fibrosis stage ≥S2 was older than < S2 group, and the ALT level of fibrosis stage ≥S2 group was higher. And those patients were often associated with a family history of hepatitis B, but there was no significant difference among the HBV-DNA level and gender constitution. HBV-DNA and family history were the independent risk fac-tors of liver inflammation necrosis≥G2, and family history was the only independent risk factor of fibrosis stage≥S2. Conclusion The patients of HBeAg-negative chronic HBV-infected with PNAL, regardless of the ALT and HBV-DNA, must have a liver biopsy. The pa-tients with high level of HBV-DNA and with a family history of hepatitis B should be performed liver puncturing accordingly.

Objective: To improve the micro-manipulation of mouse fertilized eggs,promoting its survival rate and productivity in pseudo-pregnant mice. Methods: DNA fragments of definite concentration and size were used for micro-manipulation with conventional and improved methods, then their survival rate of manupulated eggs and productivity of pseudo-pregnant mice were analyzed and compared. Results: With improved methods, the survival rate of eggs increased from 60.3% to 79.5%, the productivity of pseudo-pregnant mice and offspring increased from 35.7% to 56.8% and 10.1% to 14.1% respectively. Conclusion: The improved methods of micro-manipulation can be used in transgenic mouse production.

Objective To investigate the clinical significance of central venous oxygen saturation (ScvO2) monitoring in the patients after cardiac operation.Methods Fifty patients after cardiac operation were randomly selected into this study.After the patients entered ICU 2 h,ScvO2,mixed venous oxygen saturation (S(v)vO2),lactate (Lac) were detected at the same time and oxygen extraction rate (O2ER) was calculated.Fifty patients were divided into three groups according to the level of ScvO2,group A (ScvO2 ＜0.65,23 patients),group B (ScvO2 0.65-0.75,18 patients),group C (ScvO2 ＞ 0.75,9 patients).The correlation among ScvO2,S(v)vO2,O2ER were analyzed.The correlation between ScvO2 and Lac in each group were calculated.The level of Lac in three groups were compared.The incidence rate of complications,ventilator time and ICU stay time were compared.Results The level of ScvO2,S（v）O2,O2ER,Lac in 50patients were 0.656 ±0.086,0.639 ±0.081,0.356 ±0.084,(2.6 ± 1.3) mmol/L.The level of ScvO2 had significantly positive correlation with S(v)O2 (r =0.688,P ＜ 0.01),and had significantly negative correlation with O2ER (r =-0.640,P ＜0.01).In group A,the level of Lac had significantly negative correlation with ScvO2 (r =-0.772,P ＜ 0.01).In group C,the level of Lac had significantly positive correlation with ScvO2 (r =0.717,P ＜ 0.05).In group B,the level of Lac had no significant correlation with ScvO2 (r =-0.358,P ＞0.05).The level of Lac in group A and group C was significantly higher than that in group B [(2.0 ± 0.9),(4.8 ±2.1) mmol/L vs.(1.6 ±0.5) mmol/L] (P ＜0.05 or ＜0.01).The incidence rate of hyoxemia,low cardiac output syndrome and renal functional lesion in group A were significantly higher than those in group B (P ＜ 0.05).The incidence rate of liver functional lesion and renal functional lesion in group C were significantly higher than those in group B (P ＜ 0.05).The ventilator time and ICU stay time in group A andgroup C were significantly longer than those in group B (P ＜ 0.05).Conclusions ScvO2 is an ideal index to judge oxygen equilibrium in early period after cardiac operation.The lower and supranormal ScvO2 both suggest tissue hypoxia,resulting in increased postoperative complications and prolonged treatment.

The laboratory accreditation plan is an effective way to realize the standardization of medical laboratories.The test method validation is required by ISO 15189 guideline and CAP checklists.However,after CBC analyzers and coagulation analyzers are repaired,no solution for the validation is put forward.

Ojective To determine the risk factors and the clinical distribution of multiple drug resistant bacteria in stroke- associated pneumonia (SAP) patients with multiple drug-resistant bacterial infections from in-tensive care unit, providing guidance for clinical treatment of SAP. Methods A retrospective study was de-signed to analyze the clinical data of the SAP patients from January 2012 to December 2015. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections , and investigated the distribu-tion and drug resistance of MDR. Results There were 183 SAP patients, of which 131patients (71.6%) had MDR infection. There are 193 MDR strains in the 131 patients , the first 5 MDR strains were Acinetobacter bau-mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. MDR in-fection is highly associated with sever unconsciousness , time of stay in ICU longer than 7 days , ventilator time longer than 7 days and late-onset pneumonia and the difference was significant (P < 0.05). Conclusion SAP patients with MDR bacterial infections are in association with the following risk factors: sever unconsciousness , time of stay in ICU longer than 7 days, ventilator time longer than 7 days and late-onset pneumonia. The rate of MDR bacterial infections was high , and these MDR strains were widely different degrees of resistance to many antibiotics.

Objective To observe the effects of Ulinastatin on pulmonary vascular endothelium permeability and respiratory function in patients with extrapulmonary acute respiratory distress syndrome(ARDS exp). Methods The data of 39 patients with ARDS exp were retrospectively analyzed.According to whether treated with Ulinastatin or not, all patients were divided into Ulinastatin group(n = 21)and control group(n = 18); The level of extravascular lung water index (EVLWI), pulmonary vascular permeability index(PVPI) and respiratory function were measured before and after the treatment. Results The mortality rate of Ulinastatin group was lower than that of control group (28.6% vs 38.9%). The time of decreasing EVLWI, PVPI and improving PaO2/FiO and respiratory function in Ulinastatin group was shorter than that of control group, and the effect was superior. Conclusion Ulinastatin could reduce EVLWI and PVPI, improve pulmonary compliance and oxygenation, and reduce mortality rate in patients with extrapulmonary acute respiratory distress.

0.05). Conclusions HF could not only relax cerebral vessels, reduce the CVR and enhance the CBF, but also dilate the femoral vessels of CVS dogs. Nevertheless, the latter action was much weaker. Furthermore, there was no relationship between effects of HF on vascular relaxation and contraction activity and the blood vessel endothelium.

Risk management is derived from industry.In recent years,risk management is introduced by many medical laboratories their process management abroad.However,the concept of risk management is still very new for laboratories in China.Therefore,the establishment of the project for risk detection,classification,correction,prevention and supervision could help medical laboratories improve their service quality.

Objective To simulate the three-dimensional(3-D) growth pattern of stem cells in vivo by a 3-D culture system in vitro constructed by rat tail collagen scaffold.Methods Circular strands were prepared by mixing suspended murine embryonic stem cells(mESCs) with rat tail collagen.Growth profile of mESCs within the collagen strand was observed with phase contrast microscopy.Their metabolic activity was evaluated by glucose/lactic acid contents.To evaluate the effect of 3D culture system on ESCs differentiation,ES-derived cardiomyocytes were detected by immunohistochemistry,RT-PCR and transmission electron microscopy respectively.Results ESCs grew well in the 3-D culture system constructed by rat tail collagen.Cell connections can be found in those cell clusters formed within collagen stands,which indicated that tissue-like cultures should be produced during the process of 3-D culture in vitro.ESCs cultured by 3-D collagen strand differentiated into cardiomyocytes spontaneously.Conclusion Collagen provides an ideal growth matrix for ESCs proliferation in vitro and promotes ESCs differentiation towards tissue-like structures.Thus,the three dimensional culture system constructed by rat tail collagen can be applied to study ESCs differentiation in vivo.

Objective To observe the effects of statins on ATP-binding cassette transporter 1(ABCA1) gene expression in neurons and astrocytes.Methods Primary human astrocytes and neuron cell line HCN-2 were incubated with simvastatin and pravastatin at different concentrations and under different conditions.Using RNA isolated from the cultured cells,we performed quantitative PCR to measure the ABCA1 gene expression in astrocytes and neurons.The protein expression of ABCA1 was measured by Western blot.Results The two statins significantly decreased the ABCA1 gene and protein expressions.Compared with pravastatin,simvastatin significantly reduced the expression of ABCA1 in neurons and astrocytes by 95% and 75%,respectively(both P