Objective To evaluate the influence of laboratory critical value reporting on the efficacy of pediatric critical care.Methods A comparative analysis was conducted to evaluate the changes after the establishment of laboratory critical value reporting system.The parameters chosen for assessment included laboratory test turnaround time,medical intervention start time,survival rate,etc.Results Before the establishment of laboratory critical value reporting system,laboratory test turnaround time was (44.5±14.6)min,medical intervention start time was (40.7±5.3)min,and the success rate of the emergency treatment in ICU was (80.36±6.32)%[the rate in normal ward was(82.64±9.21)%].But after the establishment of laboratory critical value reporting system,laboratory test turnaround time,medical intervention start time,the success rate of the emergency treatment in ICU (normal ward) were (18.7±8.8)min,(23.9±6.7)min and (89.49±4.58)% [(90.04±6.45)%].Laboratory critical value reporting system shortened laboratory test turnaround time and medical intervention start time (P<0.05),and the successful rate of the emergency treatment improved evidently.Conclusion Laboratory critical value reporting system can improve successful rate of the emergency treatment significantly.

Cytokeratin 1 4 (CK1 4)has a different degree of expression in NSCLC,breast cancer,cer-vical cancer,esophageal cancer and other tumors,except in the normal basal cells.CK1 4 is mainly expressed in the peripheral part of the tumor,which is rarely expressed in the non-aggressive part.Usually the higher malignant of the tumor has the more expression of CK1 4.Given all that,CK1 4 gene plays an important role in the tumor progression and metastasis in a variety of tumors,which can be considered as an biomarker being used in the diagnosis,treatment and prognosis evaluation.

BACKGROUND:The mechanisms of mesenchymal stem cells directional y homing to infarcted myocardium post myocardial infarction are stil unclear.
OBJECTIVE:To investigate the role of stromal cellderived factor-1 (SDF-1)/C-X-C chemokine receptor 4 (CXCR4) axis on mesenchymal stem cellmigration promoted by mononuclear cells after myocardial infarction.
METHODS:Cardiomyocytes and mesenchymal stem cells were respectively isolated from suckling and adult Sprague-Dawley rats. Twelve healthy Sprague-Dawley rats were selected (six rats for myocardial infarction models and six for sham models), then circulating mononuclear cells were isolated. 4,6-Diamino-2-phenyl indole-labeled mesenchymal stem cells, cardiomyocytes and mononuclear cells were cultured into the upper, middle and lower layers of the tri-chamber coculture system, respectively. In this experiment, there were four groups:myocardial infarction group, AMD3100 (CXCR4 inhibitor) group, sham group and blank control group. After 48 hours, the number of migrating mesenchymal stem cells with blue-lighting nucleus was calculated under fluoroscope. Immunocytochemistry and immunofluorescent staining was used to detect SDF-1 expression in cardiomyocytes and CXCR4 expression in mesenchymal stem cells, respectively.
RESULTS AND CONCLUSION:Migrating mesenchymal stem cells with positive expression of CXCR4 were observed in each group other than the blank control group. The number of migrating mesenchymal stem cells was higher in the myocardial infarction group than in the other groups. Tumor necrosis factor-αneutralizing antibody and CXCR4 inhibitor AMD3100 could obviously reduce the number of migrating mesenchymal stem cells (P<0.05). Cardiomyocytes in each group expressed SDF-1 positively. The gray values of SDF-1 expression in the myocardial infarction and AMD3100 groups were significantly higher than those in the sham and blank control groups (P<0.05). SDF-1/CXCR4 axis plays a certain role in mesenchymal stem cells migration promoted by mononuclear cells after myocardial infarction.

BACKGROUND:At present, electrical stimulation technology has become a hot topic, but its effect on body’s electrical activity remains unclear. Moreover, previous studies on this aspect mainly focused on smal-sized animals. OBJECTIVE:Under the premise without prejudice to cardiac electrical activity, to find the maximum pulse voltage and frequency of electrostimulation that is taken on the liver area of pigs. METHODS:Three healthy male Rong-Chang pigs were obtained. Pulse electrical stimulator electrodes were fixed on right lobe of the surface projection of corresponding liver area. Fixed electrical stimulation parameters were set, including pulse width 10 ms, square wave, stimulation time 1 hour. They received voltage tolerance experiment between 5 V and 100 V and a frequency tolerance experiment between 1 Hz and 5 Hz. A detail record of pigs’ electrocardiogram, discomfort reaction and changes in life behavior of the pigs were obtained. RESULTS AND CONCLUSION:During voltage tolerance experiment, high- and low-voltage electrical stimulation pulse was positively associated with heart rate increment. When the voltage was greater than 35 V, mild arrhythmia such as sinus arrhythmia and ventricular premature beats appeared, without malignant arrhythmia or death. When the voltage was greater than 60 V, qRs formation induced by electrical stimulation wave occurred. In frequency tolerance experiment, when frequency was greater than 2 Hz, arrhythmia appeared, no malignant arrhythmia was found. Pulsed electrical stimulation can induce the formation of qRs wave. Above findings suggest that the appropriate frequency and voltage of pulse electrical stimulation are 2 Hz and 35 V. At > 35 V voltage or > 2 Hz frequency, pulsed electrical stimulation on the liver area can cause arrhythmia, mostly benign arrhythmia.

Objective To understand the rpoB gene mutation in M.tuberculosis isolates,and to evaluate their clinical value.Method 335 clinical isolates of mycobacterium tuberculosis(109 isolates drug susceptible,246 isolates rifampin-resistance or multidrug resistance including rifampin) were detected using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP).Results SSCP pattern of reference mycobacterium tuberculosis H37Rv as control,no mutation was found in rifampin-suscepitible 109 strains.SSCP patterns of 225/246 rifampin resistant clinical isolates were different from the normal control.The sensitivity was 91 5%.31 resistant isolates,included 25 abnormal isolates and 6 normal isolates of SCCP were identified.Sequencing showed 29 isolates had rpoB gene mutations and 3 isolates were not found rpoB gene mutations.The 3 most frequent rpoB gene mutation situs were Leu-531(19 isolates.TCGTTG) and His-526(7 isolates,CACTAC) and Asp-516(3 isolates,GACGTC).Conclusions The results confirm that rpoB gene mutation is the most important mechanism in rifampin resistant tuberculosis mutation situs are 531 tryptophan and 526 histidine;respectively.It is feasible that using PCR-SSCP to detect drug resistance in mycobacterium tuberculosis.

10.3969/j.issn.2095-4344.2013.23.014

Objective To study the feasibility and curative effect of laparoscopic radical resection of rectal carcinoma. Methods Twenty-eight cases undergoing laparoscopic radical resection (laparoscopic group) and 26 cases undergoing open radical resection (open group) were enrolled from January 2004 to December 2007. The following parameters: operation-related situations, postoperative recovery,result of radical resection, and postoperative outcome were compared between the two groups. Results The blood loss during operation in laparoscopic group was less than that in open group [(148.0±26.5) ml vs (396.0±79.6) ml, P<0.01]. The gastrointestinal tract and urination function in laparoseopic group recovered faster than those in open group[the time of diet in taking was (2.8±0.1) d vs (3.9±0.3) d,the time of detaining urethral catheter was(4.2±0.2) d vs (6.0±0.8) d] (P<0.05). The hospital stay was shorter in laparoscopic group than that in open group [(9.8±1.1) d vs(13.2±2.8) d, P<0.01]. The operation time, the number of cleared lymph nodes and complications of laparoscopic between the two groups were no significant difference (P>0.05). There was no significant difference in local recurrent and beyond metastases rates between the two groups. Conclusion Laparoscopic radical resection of rectal carcinoma parallels with open surgery is in safety and effectiveness, it has less traumatic and blood loss and faster in patients recovery.

Objective To develop a portable, easily-used and effective fracture fixation material during emergency treatment of battle wound. Methods Based on vacuum plasticity, macromolecule particles were filled into prefabricated bag, in which the air was deflated. The bag became stiff. When it was bound with belt, it acted as fracture fixation. Results Experiments showed that this kind of splint attached closely with body without any accessorial material. The effect was good without any restriction from region or environment. Conclusion This kind of fracture fixation splint has advantages in operation time, applicable parts and fixation effects compared with other fixation material.

Objective To investigate the clinical effect of using ambroxol hydrochloride and dexamethasone by nasal spray inhalation after endoscopic sinus surgery in treating chronic sinusitis.Methods One hundred and forty patients with chronic sinusitis receiving endoscopic sinus surgery in our hospital from January 2014 to December 2014 were selected as the research subjects.After surgery,the control group was given dexamethasone nasal spray inhalation,while the observation group was given ambroxol hydrochloride and dexamethasone by nasal spray inhalation.The curative efficacy,the score of visual analogue scale(VAS) was adopted to evaluate the subjective symptoms severity and the nasal endoscopy and CT examination results were evaluated by the Lund-Kennedy score.The serum levels of IL-5 and IL-12 were detected in the two groups.Results All cases were successful completed surgery and no severe adverse reactions appeared after surgery.The observation group had a total effective rate of 97.1 ％,which was signif icantly higher than 88.6 ％ in the control group,the difference was statistically significant(P＜0.05).In the aspects of sinusitis related symptoms after operation,compared with the control group,the VAS scores of nasal discharge,nasal obstruction,cheek pain,headache and hyposmia in the observation group were significantly decreased,the difference was statistically significant(P＜0.05).In the postoperative re-examination process,the score of assessment of nasal endoscopic score and paranasal sinuses CT score in the observation group were significantly decreased,the difference was statistically significant(P＜0.05).In the serological indicator determination,serum levels of IL-5 and IL-12 after treatment in the observation group were significantly lower than those in the control group,the difference was statistically significant(P＜0.05).Conclusion Using ambroxol hydrochloride combined with dexamethasone by nasal spray inhalation after endoscopic sinus surgery has good efficacy in treating chronic sinusitis,can decrease serum levels of IL-5 and IL-12.

BACKGROUND: Fetal liver cells can have stronger abilities to proliferation and differentiation and lower immunogenicity compared to bone marrow stem cells. However, there are few studies on direct isolation and culture of embryonic hepatic stem cells (EHSCs). OBJECTIVE: To isolate and cultivate EHSCs in vitro and to identify their biological features. DESIGN, TIME AND SETTING: The cytology in vitro controlled study was performed at the Chongqing Key Laboratory of Neurology from March to June 2008. MATERIALS: A total of 9 SPF Kunming fetal mice aged 13.5 days were obtained from Animal Experimental Center of Chongqing Medical University. METHODS: Collagenase + EDTA digestion and differential adherence method were used to isolate EHSCs, which were then incubated at 2?108 /L. Cells were digested and passaged when 80%-90% cells were confluent. Using streptavidin-biotin-peroxidase complex technique, adhered cells following 5 days of incubation were labeled with various EHSC surface marker. MAIN OUTCOME MEASURES: Morphology, passage, amplification and surface marker surface of EHSCs were measured. RESULTS: The isolated EHSCs adhered to the culture plastic and presented pykno-round cells and distinct borderline 24 hours after cultivation in vitro. Cells grew spindle-shaped 3 days. After 7 days they grew like epithelium. Cell amplified speed following passage did not have significant changes. Cells still presented epithelium-like shape at the passage 5. The adhered cells at day 5 following primary incubation were positively for human stem cell factor receptor and alpha fetoprotein, and negatively for albumin and cytokeratin 19. CONCLUSION: EHSCs were positively for human stem cell factor receptor and alpha fetoprotein, and negatively for albumin and cytokeratin 19 in early primary culture. This indicated that the cultivated cells are proved to be primordial progenitor cells and still in undifferentiated early phase.