Objective To evaluate the influence of different hemoperfusion (HP) intensities on prognosis in patients with acute paraquat (PQ) poisoning. Methods The data of patients with acute PQ poisoning admitted to Department of Emergency of Shengjing Hospital Affiliated to China Medical University from January 2012 to February 2016 were retrospectively analyzed. Patients satisfied the following criteria were enrolled in the study: adult patients, ingestion PQ within 12 hours and receiving HP treatment within 24 hours. Depending on the intensity of HP, patients were divided into lower intensity HP group (LHP, defined as receiving HP for less than 2 hours, 1 column) and higher intensity HP group (HHP, defined as receiving HP longer than 6 hours, 3 columns). Patients were divided into three groups, i.e. small dose (< 20 mL), medium dose (20-40 mL), and high dose (> 40 mL) poisoning groups on the basis of PQ ingestion volume. The baseline data of patients after hospital admission and arterial partial pressure of oxygen (PaO2), white blood cell (WBC), proportion of neutrophils (NEUT), alanine aminotransferase (ALT), total bilirubin (TBil), MB isoenzyme of creatine kinase (CK-MB), blood urea nitrogen (BUN) and serum creatinine (SCr) on the 4th day after hospital admission were compared, and 28-day mortality was followed up. Multiple logistic regression model was used to evaluate the characteristics of the dead patients within 28 days. The predictive value of each indicator for death in early stage of poisoning was analyzed with receiver operating characteristic curve (ROC). Results ① LHP group consisted 67 patients of 144 patients included with 24 in small dose group, 27 in medium dose group and 16 in high dose group. HHP group consisted of 77 patients with 28 in small dose group, 29 in medium dose group and 20 in high dose group. There were no significant differences in age, ingestion dose, time from poisoning to gastric lavage, and the time from the admission to HP between different intensities groups. ② Compared with LHP group, 28-day mortality in HHP group was significantly lowered (46.8% vs. 70.1%, χ2 = 8.032, P = 0.005). The patients receiving HHP in medium and small doses groups had lower 28-day mortality compared with those receiving LHP (41.4% vs. 74.1%, χ2 = 4.841, P = 0.017; 21.4% vs. 50.0%, χ2 = 4.661, P = 0.043). But there was no significant difference in 28-day mortality in high dose group between HHP and LHP (90.0% vs. 93.8%, χ2 = 0.000, P = 1.000). ③ The survival time of 12 patients with high dose poisoning was less than 72 hours, which were excluded for statistical analysis. Compared with LHP, the indexes of medium and small dose groups were obviously improved after HHP for 4 days. ④ Compared with survival group, PQ ingestion dose in non-survival group was increased, time from poisoning to gastric lavage and the time from the admission to HP were prolonged, and lower patients receiving HHP. ⑤ It was indicated by multiple logistic regression model that PQ ingestion dose [medium dose: odds ratio (OR) = 0.018, 95% confidence interval (95%CI) = 0.004-0.085, P < 0.001; high dose: OR = 0.075, 95%CI = 0.018-0.322, P < 0.001], time from poisoning to gastric lavage over 120 minutes (OR = 0.146, 95%CI = 0.045-0.470, P = 0.001), time from admission to HP over 4 hours (OR = 0.108, 95%CI = 0.029-0.395, P = 0.001), and LHP selection (OR = 0.363, 95%CI = 0.142-0.930, P = 0.035) were risk factors for the death at 28 days in patients with acute PQ poisoning. ⑥ It was shown by ROC curve that area under ROC curve (AUC) of PQ ingestion dose was 0.804 (95%CI = 0.723-0.885); when the cut-off value was 5.50 mL, the sensitivity was 94.0%, and the specificity was 65.6%. The AUC of time from poisoning to gastric lavage was 0.702 (95%CI = 0.617-0.786); when the cut-off value was 85.00 minutes, the sensitivity was 48.2%, and the specificity was 83.6%. AUC of time from the admission to HP was 0.719 (95%CI = 0.636-0.801); when the cut-off value was 3.50 hours, the sensitivity was 59.0%, and the specificity was 78.7%. Conclusions PQ ingestion dose, time from poisoning to gastric lavage, and time from the admission to HP are valuable factors for prognosis of the patients. HHP can improve the prognosis of patients with ingestion PQ less than 40 mL as early as possible, but for high dose group patients there was no much effect.

Objective To study the significance of AP-PCR i n identification and subtyping of der-matophytes.Methods Using a pair of random primers,OPAA11(5' -ACCCGACCTG -3' ),and OPD18(5' -GAGAGCCAAC -3' )the DNAs of 64isolates of dermatophytes(9species of 3genera),Sporothrix schenckii and Candida albicans were amplified by AP-PCR and analyse d by electrophoresis.Results Distinct DNA band patterns were observed in diffe rent dermatophyte species.Common major DNA bands were observed in Trichophyton rubrum isolated from different areas with s train difference.Conclusion Using OPAA11and OPD18as primers,AP-PCR may be applied in the identification and subtypi ng of dermatophytes.

ObjectiveTo investigate the culture conditions of skin-derived precursors (SKPs) and to explore a new cell source for central nervous system cell transplantation.MethodCells from skins of juvenile and adult mice were isolated and cultured in serum -free medium, and mechanical methods were adapted to passage these cells and ce lls were identified by immunocytochemistry.ResultsA population of SKPs could be isolated from adult and neonatal skins. They co uld be maintained in vitro for extended periods with stable population doubling, and they were expanded as undifferentiated cells in culture for more than 8 pas sages, indicating their proliferative capacity. About 50?% of SKPs expressed n estin and the majorities of these cells expressed fibronectin when they were pla ted on polyornithine and laminin coated plates. About 5?% cells showed typical complicated neuronal states and expressed NF-M and NSE when SKPs were plated i n serum-containing medium. These cell could also differentiate into adipocytes and fibroblast-like cells.ConclusionsAdult skin contains stem cells capable of differentiating into neurons, adipocyt es and fibroblast-like cells. SKPs may represent an alternative autologous stem cell source for CNS cell transplantation.

AIM: To evaluate the cardiac contractility and relaxation by Doppler tissue imaging (DTI) combined with myocardial contrast echocardiography (MCE) via injection of contrast media, Albunex. METHODS： Nineteen healthy mongrel dogs were conducted 60 min ligation of left anterior descending coronary artery (LAD), followed by reperfusion of 60, 120 and 180 min to establish an acute myocardial ischemic-reperfused canine model. (1) MCE was performed by bolus injection of Albunex at pre-reperfusion and at post-reperfusion. The perfused defect area defined by MCE at pre-reperfusion was regarded as risk area (RAMCE), while perfused defect area at post-reperfusion was regarded as no-reflow area (NRAMCE). When the ratio of NRAMCE to RAMCE exceeded 25%, myocardial reperfusion was considered incomplete, I.e., no-reflow group; If the ratio was <25%, myocardial reperfusion was considered adequate, I.e., reflow group. (2) Left ventricular ejection fraction (LVEF) and wall thickness ratio (△T%) of LV anterior wall were determined. (3)S-wave, e-wave and a-wave velocities at the LV anterior wall were determined by DTI. The e/a ratio was measured. RESULTS: The results of MCE showed 7 dogs in reflow group and 10 dogs in no-reflow group. (1) LVEF in reflow group gradually increased with time course after myocardial reperfusion, and in no-reflow group, however, LVEF increasingly declined with ongoing myocardial reperfusion. At the same reperfusion time point, LVEF of no-reflow group was significantly lower than that of reflow group. (2) △T% in reflow group improved gradually, and however, it can not come back to that of baseline at 180-min reperfusion. △T% in no-reflow group had no signal of recovery with progressive reperfusion. (3) S-wave, e-wave velocities measured by DTI significantly declined after ligation of LAD, and a-wave velocity increased, leading to decline of e/a. After myocardial reperfusion, s-wave, e-wave velocities and e/a in reflow group gradually increased at post-reperfusion, and a-wave velocity somewhat declined. In no-reflow group, on the other hand, s-wave, e-wave velocities and e/a progressively declined and a significant difference was present between reflow group and no-reflow group (P<0.05). CONCLUSION: Cardiac contractility and relaxation can not be recovered during myocardial microvascular impairment. This change may be further deteriorated with size enlargement of no-reflow area. DTI may provide a sensitive, reliable method for quantifying cardiac contractility and relaxation.

Objective This study was designed to investigate the relationship of the coronary anatomy pattern in 56 arterial switch operation (ASO) with the early outcome.Methods From May 2010 to September 2013,a total of 56 patients with transposition of the great arteries complicated with other defomities(39 males and 17 females,with age of 5 days to 126 months),who were undertook ASO in Capital Medical University affiliated Beijing Anzhen Hospital.There were 19 patients with complete transposition of the great arteries and intact ventricular septum,35 patients with complete transposition of the great arteries and ventricular septal defect.and 1 patient with double outlet right ventricle with subpulmonary ventricular septal defect (Taussing-Bing).33 were complicated with atrial septal defect and 26 with patent ductus arteriosus,20 had severe pulmonary hypertension,2 had pumonic valve stenosis and 1 had coarctatioin of aorta.All patients undertook ASO,coronay distribution were detected during the procedure and coronary artery were grafed.Results Coronary artery:Yacoub type A were 46 cases:4 patients died during the 30 days after the operation,Yacoub type B were 5 cases:2 patients died.Yacoub type C were 2 cases:1 died of low cardiac output on the operating day.Yacoub type D were 1 case and Yacoub type E were 2 cases:none of them died.Conclusion Patients with common coronary variants have undergone ASO without added mortality rate.Those with intramural or single coronary arteries have significant added mortality rate.

Objective To investigate the CT and MRI manifestations of abdominal inflammatory myofibroblastic tumor (IMT). Methods Imaging and clinical data of 8 cases with IMT which proved by pathology were analyzed retrospectively.5 cases were scaned with contrast medium enhancement CT,and 3 cases with contrast medium enhancement MRI.Results Tumors were located in mesenteric region in 3 cases,in the transverse colon in 1 case,in retroperitoneal space in 1 case,in the small omentum in 1 case, in the omentum in 2 cases.8 cases were all single lesion,5 cases boundaries were demarcated,3 cases boundaries were fuzzy.The maximum diameter of tumors were from 4.6-12.5 cm.The density were uniformin 2 cases,and uneven in 3 cases.3 cases were significantly enhanced on enhanced scanning,2 cases were slight enhanced.1 case was solid soft tissue mass with homogeneous enhancement.2 cases were cystic tumor.The solid part was obvious homogeneous enhancement on enhanced scanning.The cystic areas were not enhancement. Conclusion CT and MRI can clearly demonstrate the location,size,number and the relationship with the surrounding structures of IMT.

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD decreased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P<0.05), and there was no significant difference between the two groups 4 and 8 weeks after treatment (P>0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.

Objective To detect the expression level of Taurine up?regulated gene 1( TUG1) in the re?nal cell carcinoma and paired paracancerous normal tissues,then explore the relationships between the expression level of TUG1 and clinical characteristics.Methods RNA was Extacted from the resected renal cell carcinoma tissues and paired paracancerous normal tissues of 46 patients respectively,by reverse transcription to get cDNA, the expression level of the TUG1 was detected by RT?qPCR, the relationship between the expression level of TUG1 and the clinicopathological characteristics was analyzed by statistically software. Results The expression of TUG1 in renal cell carcinoma was obviously lower than that in paired paracancerous normal tissues(0.533±0. 027 vs. 1.000±0.298,t=-3.350,P<0.01).The△CT value of Tug1 in 46 cases of renal cell carcinoma after log?arithmic transformation,the minimum value was -5.535,maximum was 3.085,average value was -0.908,with the average of -0.908 as a dividing line,46 cases of renal cell carcinoma with 25 cases (54.34%) were down regulated the expression.The expression level of TUG1 of patients with renal carcinoma have no significant corre?lation with age,sex,type of renal cell carcinoma,TNM staging and UICC/AJCC staging(P>0.05).Conclusion The expression of TUG1 in renal cell carcinoma tissues are down?regulated,which also suggest that it may be re?lated to the tumorigenesis and development of renal cell carcinoma.

Objective This article introduced the concrete methods and benefits of promoting and holding competition of acupuncture and moxibustion in TCM universities or colleges. A regular skill competition will not only stimulate students' passion for TCM study and expand teaching methods, but also serve as a effective way to enhance practical skills of students.