The clinical medical work is accompanied with high risk .The medical treatment risk exists everywhere at anytime, but the graduate students of the Medical colleges lack the understanding of the hygiene laws. Therefore it is necessary for them to accept the education of hygiene law.

AIM To evaluate the value of arsenic trioxide (ATO) in the treatment of systemic lupus erythematosus and to investigate its mechanism. METHODS① Thirty four BXSB lupus mice were averagely and randomly divided into ATO treated group and control group. The mice of ATO treated group were given (ip) ATO 0.4 mg·kg-1 every other day until d 105 and the observation was ended on d 210. The survival rate of mice was recorded, and the levels of serum IgG and anti-dsDNA antibody were measured with enzyme-linked immunosorbent assay. ② Other 20 BXSB lupus mice were also divided into 2 groups and treated as above and sacrificed on d 90. The spleen and kidneys of each mouse were removed and total RNA was extracted. The levels of interferon-γ (IFN-γ) mRNA in renal and spleen tissues were measured by using reverse transcription polymerase chain reaction. RESULTSUp to d 210, 8 mice died in ATO treated group and 13 died in control group. On d 90 and d 105, the average levels of serum anti-dsDNA antibody (A450 nm) were (0.335±0.011) and (0.223±0.017) in ATO treated group, and (0.688±0.016) and (0.683 ±0.014) in control group. On d 90, the expressions of IFN-γ mRNA in spleen and renal tissues of ATO treated group were significantly lower than that of control group. On d 105, the serum level of IgG was much lower in ATO treated group than that in control group, which were (4.9±1.3) and (6.9±1.0)g·L-1, respectively. CONCLUSION ATO elevates the survival rate, lowers the serum levels of IgG and anti-dsDNA antibody, and depresses the expression of IFN-γ mRNA in spleen and kidney tissues of BXSB mice.

Objective To observe the effects of serum containing the medicine of Tujian Mixture on phospho-Akt and phospho-PTEN of glomerular mesangial cell (MC) cultured in high concentrations of glucose. Method The glomerular mesangial cells from SD rat were divided into six groups:the normal control group, the group of MC cultured in high concentrations of glucose, and four other groups cultured in high concentrations of glucose + different concentrations of rat’s serum containing Tujian Mixture. After 72 hours, the content level of phospho-Akt (Thr308) and phospho-PTEN (Ser380) in MC was detected by using sandwich ELISA. Results The level of phospho-Akt (Thr308) in the group of MC cultured in high concentrations of glucose was significant higher than that in the normal control group (P

Schwann cells play an important role in diabetic peripheral neuropathy.Recently,to investigate the effect of high glucose on Schwann cell in vitro has become a new research hotpoint with the development of cell culture technology.This review concentrates on the biological effect of high glucose on Schwann cell.

Objective To systemically review the efficacy and safety of heparin for treatment of sepsis.Methods Database search of IM/MEDLINE,Cochrane Library,SCIE,CBM,CNKI,VIP Data,WanFang Data (from January 2000 to June 2012) was conducted.The quality of included randomized controlled trials (RCTs) about heparin for treatment of sepsis was assessed,and relevant data were extracted according to the inclusion and exclusion criteria.Then meta analysis was performed using RevMan 5.1.Results 17 trials with 1 167 participants were included.The results of meta-analysis showed:compared with the control group,heparin significantly decreased 28-day mortality in patients with sepsis [odds ratio (OR) =0.59,95％ confidence interval (95％CI) 0.45-0.77,P=0.0001] ; heparin did not deteriorate coagulation disorders,but corrected sepsis-induced platelet (PLT) count reduction [mean difference (MD) =13.94,95％ CI 10.15 to 17.72,P＜0.000 01],while it had no significant effect on the activated partial thromboplastin time (APTT) and prothrombin time (PT,APTT:MD=-3.18,95％CI-6.88 to 0.53,P=0.09; PT:MD=-0.68,95％ CI-1.48 to 0.12,P=0.09).There was no significant difference between the two groups in the incidence of bleeding either.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of heparin group was significantly lower than that of the control group (MD=-2.58,95％CI-3.29 to-1.87,P＜0.000 01),and the incidence of multiple organ dysfunction syndrome (MODS) was significantly lower than that of the control group (OR=0.32,95％CI 0.17 to 0.61,P=0.000 6).In addition,heparin could shorten intensive care unit (ICU) stay (MD=-4.43,95％CI-6.79 to-2.07,P=0.000 2),whereas it showed no significant effect on the total length of hospital stay.Conclusions Heparin can ameliorate sepsis,and has high degree of safety and lower hospital expense.Due to limitation of the quality of included studies,larger sample and well-designed RCTs are needed to further support this conclusion.

Liver Imaging Reporting and Data System was released online in 2011 by America College of Radiology (ACR) for standardizing the performance,interpretation and reporting of CT and MR imaging examinations of the liver in patients at risk for hepatocellular carcinoma.This article overviewed the profile of this system,its updated version and recent progress on its clinical application.

ObjectiveTo investigate the effect of arsenic trioxide (ATO) on anti-dsDNA antibody and the expression of DNA methyltransferase 1-mRNA and CD11a-mRNA in lupus MRL/lpr mice.Methods MRL/lpr mice were divided into three groups:the ATO group,the sodium chloride(NS) group,and the cyclophosphamide(CTX) group.The control group consisted of 20 syngeneic normal C57/BL mice,which were subdivided into the ATO group and the NS group.After two-month treatment,all mice were sacrificed.Blood routine test was conducted by SYSMEX KX21.The anti-dsDNA antibody in the serum were detected by ELISA.The expression of DNMT1 and CD11a was determined by RT-PCR.ANOVA and paired t test were used for statistical analysis.Results① The serum level of anti-dsDNA antibody(0.89±0.07) and the gray scale value of CD11a-mRNA(0.43±0.25) in the ATO group were much lower than those in the NS group of MRL/lpr mice(1.77±0.28,P＜0.01; 0.99±0.31,P＜0.05),while the gray scale value of DNMTI-mRNA (0.32±0.30) was significantly higher than that in the NS group(0.16±0.26,P＜0.05 ).② The serum levels of anti-dsDNA antibody was low in both the ATO group and the CTX group (0.90±0.07,0.66±0.22),and it was higher in the ATO group than that in the CTX group (P＜0.05).The gray scale value of DNMT1 mRNA in the ATO group (0.32±0.30) was higher than that in the CTX group (0.16±0.18,P＜0.05) in MRL/lpr mice,and the gray scale value of CD11a mRNA in the ATO group(0.43±0.25) was lower than that in the CTX group (0.86±0.31,P＜0.05) in MRL/lpr mice.③ There was no difference in above parameters between the ATO-group and NS group in C57/BL mice(P＞0.05).ConclusionArsenic trioxide can reduce the serum level of auto-antibody and reverse low methylation.But it has no effect on normal mice.

Objective To investigate the risk factors of postoperative delirium in elderly patients with intertrochanteric facture.Methods This retrospective analysis was conducted on 256 patients aged over 65 years treated with internal fixation of intertrochanteric facture between January 2012 and December 2013.Incidence and risk factors of postoperative delirium were documented.Results Incidence of postoperative delirium was 14.8％ (38/256).Risk factors of postoperative delirium included body mass index (BMI) less than 20 kg/m2 (P ＜ 0.05),preoperative hemoglobin (Hb) less than 100 g/L (P ＜ 0.05),atrial fibrillation (P ＜ 0.05),low sodium (P ＜ 0.05),preoperative total protein less than 60 g/L (P ＜ 0.05),preoperative waiting time more than 4 days (P ＜ 0.05),preoperative cognitive impairment (P ＜ 0.05),operation time more than 2.5 hours (P ＜ 0.05),perioperation blood loss more than 1,000 ml (P ＜ 0.05),and more than two kinds of medical conditions (P ＜ 0.05).Logistic regression identified three independent factors for postoperative delirium:preoperative waiting time more than 4 days (P ＜ 0.05,OR =2.74),BMI less than 20 kg/m2 (P ＜ 0.05,OR =13.27),preoperative cognitive impairment (P ＜ 0.05,OR =4.47),and operation time more than 2.5 hours (P ＜ 0.05,OR =4.56).Conclusions Risk factors of postoperative delirium in elder patients with femoral intertrochanteric fracture are complicated.Therefore,overall situation should be taken into consideration and comprehensive and effective treatment should be formulated to prevent the occurrence of postoperative delirium.

Case teaching method was used to undergraduates’specialized courses of clinical laboratory medicine such as the clinical laboratory hemotology and basic clinical laboratory medicine. This teaching method achieved satisfactory effect in clinical ability culture and obtained the positive opinion of students.

Objective To observe the therapeutic effect of segmental scleral buckling and vitrectomy with/without lensectomy on the retinopathy of prematurity (ROP) stage 4a,4b and 5.Methods One hundred and thirty-four ROP infants (181 eyes) diagnosed as stage 4a,4b and 5,and performed with segmental scleral buckling or vitreous with/without lensectomy were retrospectively analyzed.The operated 4a-,4b-and 5-stage eyes were 40,51 and 90 eyes.The operational method depended on the location and severity of fibrovascular membrane.Of 181 eyes,segmental scleral buckling was referred for 37 eyes which include 23 eyes with 4a stage and 14 eyes with 4b stage;vitrectomy was referred for 50 eyes which include 14 eyes with 4a stage,29 eyes with 4b stage and 7 eyes with 5 stage;vitrectomy with lensectomy was referred for 94 eyes which include 3 eyes with 4a stage,8 eyes with 4b stage and 83 eyes with 5 stage.The effect was classified as success,improved and failure.Failure includes lost eye.Follow-up for 4a,4b and 5 stage patients are 34,31 and 29 months respectively.Results Segmental scleral buckling was referred for 37 eyes,success in 23 eyes (62.16％),improved in 11 eyes (29.73 ％),failure in 3 eyes (8.11 ％).Vitrectomy was referred for 50 eyes,and success in 20 eyes (40.00％),improved in 22 eyes (44.00％),and failure in 8 eyes (16.00％).In the total of 94 eyes underwent vitrectomy with lensectomy,20 eyes was success (21.28％),improved in 17 eyes (18.08％),failure in 57 eyes (60.64％).In 40 stage 4a eyes,33 successes (82.50％),6 improved (15.00％) and 1 failure (2.50％).In 51 stage4b eyes,11 successes (21.57％),30 improved (58.82％) and 10 failures (19.61％).For 90 stage 5 eyes,14 successes (17.50％),19 improved (23.75％) and 57 failures (71.25％).The therapeutic effect of segmental scleral buckling for stage 4a was better than that for stage 5 (x2 =6.707,P=0.035).The difference of therapeutic effect of vitrectomy for different stage was significant (x2=21.010,P =0.000);stage 4a was the best;stage 4b was the second,stage 5 was the worst.The therapeutic effect of vitrectomy with lensectomy for stage 5 was worse than that for stage 4a and 4b (x2=16.066,P=0.003).Conclusion The surgery patterns of ROP was determined based on the disease severity,the surgery effects of stage 4a and 4b were better than stage 5,which had nothing to do with the surgical procedures.