Objective To investigate the factors in association with colorectal disorders in adult recipients of liver allograft. Methods A retrospective cohort study was carried out with clinical, microbiological and management data regarding diarrhea in 218 adult recipients of liver allograft from Jan. 2003 to Dec. 2006. Results Of the 218 patients, 68(31.2%) of them, who did not history of ulcerative colitis, were found to have diarrhea after orthotopic liver transplantation. Among these 68 patients, diarrhea was probably caused by administration of immunosuppressive agents in 35 cases (51.4%), in 12 cases (17.6%) diarrhea was antibiotics associated, and in 5 cases (7.4%) it was due to intraperitoneal infection. The other pathogenic factors included fungal infection in 3 cases (4.4%), cytomegalovirus infection in 3 cases (4.4%), Roux-en-Y choledochojejunostomy in 8 cases (11.8%) and some other unknown problem related in 2 cases (2.9%). Diarrhea occurred soon after transplantation in most cases. Of the 68 patients, the symptom of diarrhea occurred in the first 2 months in 45 cases (66.2%), and in the next 4 months in 23 cases (33.8%), i.e. the symptoms occurred 5-180 days after transplantation. Conclusion Immunosuppressive agents, antibiotics, fungal infection and cytomegalovirus infection are the top four common causes of diarrhea after orthotopic liver transplantation. The outcome is good with appropriate conservative management.

Objective To observe the effects of ulinastatin on the expressions of tumor necrosis factor-α (TNF-α) in the lung tissues of rats with acute lung injmy induced by phosgene, and to explore the mechanism of ulinastafin in treating acute lung injury. Method Sixty-four clean grade healthy male SD rots were randomly divided(random number) into eight groups with eight in each group. Group A1 in which rats were exposed to air. Group A2 in which rots wereexposed to air and treated with saline. Group A3 in which rats were exposed to air and treated with dexamethasone. Group A4 in which mrs were exposed to air and treated with ulinastatin. Group B1 in which rots were exposed to phosgene without treatment. Group B2 in which rats were exposed to phosgene and treated with saline. Group B3 in which rats were exposed to phosgene and treated with dexamethasone. Group B4 in which rats were exposed to phosgene and treated with ulinastatin. The expressions of TNF-α in the lung tissues were measured by using immunohistocheistry. Lung tissues were observed grossly and under 200-fold light microscope to identify the positive expressions in kytoplasm. Results In group B1 and group B2, the wet weight, dry weight and wet/dry weight ratio og right lower lobe of lung were higher thai those in group A1 and group A4( P <0.01 ), and those in group B4 and group B3 were significantly lower than those in group B1(P<0.01 ), but still higher than those in group A1 and A4(P<0.01). The gross observation suggested that the surfaces of lung tissues in group A1and group A2 were slick and rose pink without congestion, dropsy or infarction; the surfaces of lung tissue in groups B1 and B2 appeared with congestion, dropsy and many petechia. The surfaces of lung tissue in groups B3 and B4 were similar to those in groups B1 and B2. Under the light microscope, the structure, of lungs in groups A1 and A2 were clear without congestion, effusion or inflammatory cell infiltration. In groups B1 and B2, the engorgement of lung capillary vessels, congestion and tiny thrombosis were found and there abundant edematous fluid and inflammatory cell infiltration in lung stroma and alveolus with focal pulmonary atelectasis in some lung tissue section. The tissues in groups B3 and B4 showed congestion, dropsy, tiny thrombosis and inflammatory cell infiltration, but these changes were slighter than those in groups B1 and B2. The expressions of TNF-α in groups B1, B2, B3, and B4 were significantly higher thanthose in groups A1 and A2( P < 0.01 ), but the expressions of TNF-α IN group B4 was lower than that in groups B1 and B2(P<0.01). Conclusions Ulinastatin could lessen the lung injury by reducing the expressions of pro-inflammatory cytokines such as TNF-α.

Calcium/calmodulin-dependent protein kinase Ⅱ(CaMKⅡ),which is an important protein kinase involved in learning and memory,is found in most tissues,but it is present in especially high concentrations in neurons.The relatively high expression of CaMKⅡin nervous system suggests it plays an im-portant role in the function of nervous system.This paper re-views the research development of the molecular structure of CaMKⅡ and its autophosphorylation,subcellular localization and its role in synaptic plasticity.

Objective To investigate the change of serum alpha-L-fucosidase(AFU)and its correlation with the blood glucose and lipid level in small for gestational age(SGA)fetuses. Methods 125 SGA fetuses and 128 fetuses in appropriate for gestational age(AGA)with wet lung were treated in our hospital and were investigated as case control study. The serum of AFU ,blood glucose and lipid were measured and compared within 24 hours after birth in these 2 groups. Results Comparing with the AGA infants ,the SGA babies had lower level of serum AFU,high density lipoprotein,apolipoprotein A and apolipoprotein B(P<0.05). The correlation analysis showed that the serum AFU level has positive correlation with blood glucose,total cholesterol,high density lipoprotein, low density lipoproteinand apolipoprotein A(P < 0.05),while it has negative correlation with serum triglycerides in SGA(P<0.05). Conclusions The SGA infants have lower level of serum AFU and lipid metabolic disorders after birth,and its serum AFU level has correlation with its blood glucose and lipid level.

AIM: To observe the influence of the selective decontamination of the digestive tract (SDD) and caecosomy/colonic irrigation on gut endotoxin/bacteria translocation following acute severe pancreatitis (ASP). METHODS: Twenty three pigs weighing 16-22 kg were divided into four groups. Group I (n=5): sham-control; Group Ⅱ (n=6): ASP-control; Group Ⅲ (n=6): gntamicin [(8.55?10~5?5.70?10~4) units/time] and nystatin [(1.37?10~5?9.00?10~3) units/time] were fed orally every 8 h for 1 week before the induction of ASP; Group Ⅳ (n=6): caecostomy was performed before the induction of ASP. ASP was induced by infecting 1 mL/kg BW of combined solution of 5% sodium taurocholate and (8-10)?10~6 BAEE units/L of trypsin into pancreas via pancreatic duct. Systemic plasma endotoxin levels were quantified by the chromogenic limulus amebocyte lysate (LAL) technique. Specimens of tissue from mesenteriolum and mesocolon lymph nodes, lung, lymph nodes in hilus pulmonis, pancreas and the samples of both portal and systemic blood were collected before and at 72 h following ASP and cultured for aerobic as well as anaerobic bacteria growth. Positive specimens were subcultured and the bacteria identified by standard procedure. RESULTS: Preventive SDD not only effectively reduced the amount of bacteria in stool (P

Chronic microinflammatory state is common in the patients undergoing maintenance hemodialysis (MHD), which seriously affects the long-term survival rate of MHD patients. It is important to improve the microinflammatory state in MHD patients.

Objective To analyze the status of reference intervals (RIs) of complete blood cell count (CBC) in China and compare them with the published standards.Methods The RIs information of CBC (containing the items of WBC,RBC,Hb,HCT,MCV,MCH,MCHC and PLT) were collected by the External Quality Assessment (EQA)software from laboratories participated in the Second Complete Blood Cell Count EQA Program in 2013,which including the sources of RIs,the lower and upper limits of RIs and the validation information of RIs.The sources and validation information of RIs were analyzed by Microsoft Excel 2007 using all data except those from maternal and child care service center,children's hospital and corporations.The outliers of limits of RIs were excluded according to the International Federation of Clinical Chemistry(IFCC)guidelines,then data were analyzed by SPSS 13.0.The mean of the upper and lower limits of the RIs were compared with the published standards by the t-test.Results Totally 299 (57.72％) of 518 laboratories reported were using RIs according to National Clinical Laboratory Operation Rules,while 112(26.62％)labs were using RIs from instrument/reagent manufacturer instructions,411 (80.00％)labs did not validate the RIs they used,of which 258 (50.00％) did not know how to validate RIs.The deviation of the maximum and the minimum ranged from 16％ to 70％.More than one third laboratories did not separate RIs of RBC,Hb and HCT according to the gender.The upper and lower limits of WBC and MCV of most laboratories were higher,while those of RBC(male/female),PLT and Hb(male) were lower than that from the published standard.The RIs of MCH was narrower than that from the published standard.Meanwhile,HCT,MCHC (male/female) and Hb (female) were near the upper and lower limits of published standards.Conclusions At present,the RIs of CBC used in laboratories is chaotic,which is significantly different from the published standard.On the basis of standardization,the RIs of published standard result from a multi-center study in Chinese people should be preferred.

ObjectiveTo investigate the control rate and influence factors of glycolated hemoglobin A1C(HbA1c) of type 2 diabetes in Baoding city community.MethodsA cluster-randomized study was conducted and three communities were selected randomly.The study involved all of people aged 45 years old and above in the three communities.The type 2 diabetic patients diagnosed before,were recorded through the cross section study.Then the questionnaire was finished.All diabetic plasma HbA1c was determined by HPLC method.ResultsEighty-seven patients with HbA1c≤7％ were only 18.6％ in all diabetic patients.As the plasma level of HbA1c increased,occurrences of macroangiopathy and microangiopathy were both increased,by the trend test.Logistic regression analysis showed that therapeutic measures and knowledge about diabetes were main influence factors of achieving the hemoglobin Alc target of ＜7％ in type 2 diabetes.ConclusionThere were low HbA1c control in diabetic patients of Baoding community,and knowing diabetes well and receiving insulin treatment might decrease HbA1c level apparently.

OBJECTIVE To explore the treatment measure of pulmonary infection after liver transplantation.METHODS The clinical data of 78 cases of pulmonary infection after liver transplantation in our hospital were analyzed retrospectively.RESULTS The incidence of pulmonary infection in this group of patients was 48.8%.The mean onset time of the first pulmonary infection after operation was(9.56?5.53)days after surgery.Forty four patients were diagnosed as right pneumonia,14 as left pneumonia,and 20 bilateral pneumonia.Long operation time,mechanical ventilatory time,abdominal bleeding,intraoperative total fluid perfusion and renal dysfunction after liver transplantation were risk factors of pulmonary infection.87.2% Of these patients improved,and 12.8% died.CONCLUSIONS The mortality of pulmonary infection after liver transplantation is high.Bacteria and fungi are the major pathogens.The key of prevention and cure of pulmonary infection after liver transplantation wis included of cutting down operation time,lessening abdominal bleeding,controlling intraoperative fluid perfusion,extubating as soon as possible,protecting renal dysfunction and raising pathogeny to check.

ObjectiveTo explore the mechanism of clopidogrel in human gastric epithelial cell line (GES-1) injury.MethodsSet up GES-1 cells monolayer culture model.Then the GES-1 cells were divided into negative control group,U0126 intervented group,clopidogrel intervented group and combined intervented group (U0t26 treated firstly then clopidogrel intervented).The cell proliferation and apoptosis in each group was examined by methyl thiazolyl tetrazolium (MTT) assay and Flow cytometry.TheexpressionofphosphorylatedERK1/2ineachgroupwasdetectedby immunocytochemistry method,and the expression quantity of phosphorylated ERK1/2 in each group was measured by western blot.ResultsThe result of MTT assay showed that compared with negative control group,the proliferation of GES-1 cells was inhibited in U0126 group,clopidogrel group and combined intervented group,and the inhibition percentage was 21.8％ ±2.7％,46.3％ ± 3.4％ and 82.9 ％ ± 0.8 ％ respectively ( F=615.556,P =0.000 ).The result of immunocytochemistry indicated that the expression of p-ERK in U0126 group,Clopidogrel group and combined intervented group decreased compared with negative control group,which was 10.80±1.64,7.20± 1.64,4.40±0.89and 1.40±0.55 respecitively (F=49.426,P=0.000).The result of western blot and immunocytochemistry was of the same trend.Conclusion In GES-1 cell model,clopidogrel may injureGES-1 cells through MAPK/EPK signal transduction pathway.