Objective To observethe effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury.Methods Thirtysix patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients).The control group accepted conventional treatment,the CVVH group accepted CVVH treatment additionally for 7 d.ELISA was used to measure serum level of ABAb at 1,3,5,7,14 d after treatment.The change of ABAb in serum of each group was observed.The scores of Glasgow coma scale (GCS) was assessed everyday.Results The level of ABAb in CVVH group was significantly lower than that in control group from the third day after treatment[the third day:(1.28 ± 0.25) kU/L vs.(1.33 ± 0.30) kU/L;the fifth day:(1.37 ±0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day:(1.45 ±0.37) kU/L vs.(1.52 ± 0.35) kU/L;the fourteenth day:(1.49 ± 0.41) kU/L vs.(1.67 ± 0.39) kU/L,P ＜ 0.05 or ＜ 0.01].The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day:(6.95 ± 1.24) scores vs.(5.74 ± 1.51) scores;the fourteenth day:(9.29 ± 1.76) scores vs.(7.22 ± 1.24) scores] (P ＜ 0.01).Conclusion CVVH can decrease the level of ABAb and improve the prognosis.

Objective To observe the change of serum anti-brain antibodies after cardiopulmonary resuscitation,and investigate the clinical significance.Methods A total of 27 cases of cardiopulmonary resuscitation after cardiac arrest patients with success and survival more than 12 weeks were divided into two groups according to Glasgow Coma Scale (GCS) score:mild and moderate group with GCS score ≥ 8 scores (12 cases) and severe group with GCS score≤7 scores (15 cases).The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after recovered in the spontaneous circulation (ROSC) was compared between two groups,and compared with control group (15 cases of healthy persons).Results The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after ROSC were significantly higher than those in control group [(1.34 ± 0.23),(1.30 ± 0.27) kU/L vs.(0.28 ± 0.05) kU/L,(1.38 ± 0.33),(1.44 ± 0.30) kU/L vs.(0.28 ±0.05) kU/L,(1.44 ±0.31),(1.51 ±0.33) kU/L vs.(0.28 ±0.05) kU/L,(1.53 ±0.27),(1.67 ±0.36) kU/L vs.(0.28 ±0.05) kU/L,(1.72 ±0.25),(1.93 ±0.44) kU/L vs.(0.28 ±0.05) kU/L,(1.98 ±0.45),(2.15 ±0.52) kU/L vs.(0.28 ±0.05) kU/L],and there were significant differences (P＜ 0.01).The serum anti-brain antibody levels in severe group were significantly higher than those in mild and moderate group,and there were significnat differences (P ＜ 0.05).Conclusions The serum anti-brain antibody levels after cardiopulmonary resuscitation rise significantly.Anti-brain antibody may be used as a biochemistry marker to judge degree and prognosis of brain injury with patients after cardiopulmonary resuscitation.

Objective To investigate the function of donor-derived dendritic cells (DCs) treated with NF-?B decoy in prolonging murine cardiac allograft survival time.Methods Donor bone marrow- derived DCs were treated with NF-?B decoy in vitro.Heterotopic abdominal heart transplantation was performed from BALB/c to C57BL/6 mice.Recipients were grouped according to different pretreat ments as follows:(1) Control group,infusion of PBS (0.2 ml) alone intravenously via the portal vein 7 days before heart transplantation;(2) CsA group,treated with sub-therapeutic CsA only for 7 days (10 mg?kg~(-1)?day~(-1)) through intraperitoneal injection after transplantation,and the same as control group before transplantation;(3) Control DCs group,infusion of only cultured 5th-day recipient DCs untreated with NF-?B ODN decoy;(4) Treated DCs group,infusion of recipient DCs pretreated with NF-~cB ODN decoy;(5) Combined treatment group,infusion of recipient DCs treated with NF-~cB ODN decoy before transplantation and intraperitoneal injection of sub-therapeutic CsA for 7 days (10 mg?kg~(-1)?day~(-1)) after transplantation;(6) Third party donor group,C3H/HeJ mice used as donor, and recipient (C57BL/6) was treated the same as combined treatment group.Every group had 8 mice and graft survival time was observed.Cytokines (IL-2,INF-?,IL-4 and IL-10) in recipient serums were analyzed by ELISA at 7th day after transplantation.Results The graft mean survival time (MST) in control group,CsA group,Control DCs group,treated DCs group,combined treatment group and third party donor group was 7 days,10.3 days,7.6 days,21.4 days,53.6 days and 9 days,respectively.There was significant difference in MST between treated DCs group and control group or control DCs group (P

Objective To assess the safety and efficiency of Angioseal device in patients undergoing coronary percutaneous procedure.Methods A prospective trial was carried out in 260 patients undergoing angiograph and angioplasty during october 2002 to July 2003.All patients were divided into two groups: Angioseal closure device and manual compression.Results In angiography,the time to hemostasis was (1.8?0.9)min by Angioseal and (25.3?13.4)min by manual compression(P

Objective:Toprepare poly-DL-lactide-poly (PELA) microspheres encapsulating recombinant tissue inhibitors of metalloproteinase-1 (TIMP-1) adenovirus, and to investigate their effects on the proliferation of hepatocellular carcinoma HepG2 cells. Methods: The microsphere was constructed by encapsulating recombinant adenovirus containing TIMP-1 in biodegradable PELA. The diameter of the microsphere, quantity of virus encapsulated, loading rate, and releasing kinetics were measured. HepG2 cells were infected with the microspheres; the infection efficiency was examined by fluorescent microscope; and the ultrastructure was observed by TEM. The expression of TIMP-1 mRNA in HepG2 cells was examined by semi-quantitative RT-PCR, and the proliferation of HepG2 cells was detected by MTT assay. Results: The microsphere encapsulating recombinant TIMP-1 adenovirus was successfully constructed, with its diameter, entrapment efficiency, and virus loading rate being 1.965, 60.0%, and 10.5×10~8/mg, respectively. About 60% of the viruses were released within 120 h, and the total releasing time was longer than 240 h. Infection with rAdTIMP-1 PELA microsphere efficiently induced TIMP-1 expression in HepG2 cells, and significantly inhibited the proliferation of HepG2 cells, with the inhibitory rate being 47%. Conclusion: PELA microsphere encapsulating recombinant TIMP-1 adenovirus can markedly inhibit the proliferation of HepG2 cells, which provides an experimental basis for the combining macromolecular chemistry and gene therapy for treatment of hepatocellular carcinoma.

Objective To study the kidney histological categories of isolated hematuria in children.Methods Twenty-three children with isolated hematuria were performed renal biopsy under real time ultrasound guidance utilizing menghini style negative pressure biopsy device after local anesthesia or general anesthesia.The renopuncture tissue was directly sent by the mail-boxes to the remote pathologic service.All of the biopsies were examined by light microscopy,electron microscopy and immunohistochemistry.Results Biopsies were classified as measangial proliferative glomerulonephritis(MsPGN)(8 cases),minimal change nephropathy(MCN)(5 cases),IgA nephropathy(IgAN)(4 cases),thin basement membrane nephropathy(TMN)(3 cases),Alport′s syndrome(AS)(1 case),focal segmental glomerulosclerosis(FSGS)(1 case)and IgM nephropathy(IgMN)(1 case).Conclusions In this series,MsPGN,MGA,IgAN are the most common biopsy diagnosis.TMN and Alport′s are account for some proportion.A few IgMN and FSGS may also present as isolated hematuria.

Objective To explore the dynamic changes of D-dimers during pregnancy and early puerperium (within 3 days postpartum). Methods A retrospective study was performed among 8 367 healthy women who had term singleton delivery in Women′s Hospital, School of Medicine, Zhejiang University from January 2007 to December 2014. D-dimers concentrations during pregnancy and early puerprium of all the cases were collected. Data of 21 065 D-dimers tests were assigned to 5 groups according to the time of sampling, including early pregnancy (≤12 gestation weeks), middle pregnancy (12-28 gestation weeks), late pregnancy (>28 gestation weeks), 1 postpartum (within 48 hours postpartum) and 2 postpartum (48-72 hours postpartum). The D-dimers concentrations in different groups were compared. The effect of delivery mode on D-dimers of early pureperium was analyzed. The correlation between D-dimers and the thromboembolic disease was also explored. In this study, Student′s t-test and Wilcoxon rank sum test were used for statistical analysis. D-dimers concentration≤0.5 mg/L was used as the normal range. Results (1) D-dimers concentrations during pregnancy were higher than the non-pregnant women (P<0.01), but there was no statistical difference between early pregnancy and late pregnancy (P=0.820). D-dimers concentration in the 1 postpartum group was higher than that of early pregnancy group or late pregnancy group (P<0.01). But in the 2 postpartum group, it was lower than early pregnancy, late pregnancy and 1 postpartum groups. (2)D-dimers in cesarean section cases was significantly higher than in vaginal delivery cases in each period of pregnancy and early pueprium.(3)The 95%CI of D-dimers in early pregnancy, late pregnancy, 48 hours after vaginal delivery, 48-72 hours after vaginal delivery, ≤48 hours after cesarean section, 48-72 hours after cesarean section were 0.58-8.28, 0.47-11.52, 1.04-9.59, 0.87-5.22, 1.07-11.58 and 1.00-6.23 mg/L, respectively.(4)In 6 cases with thromboembolic disease, D-dimers was 6.89-19.89 mg/L, with the mean value of 13.66 mg/L. It was significantly higher than normal range. In 3 cases, all after cesarean section, with lower extremity vein thrombosis within 48 hours postpartum, the D-dimers concentrations, 9.77, 8.65 and 6.89 mg/L respectively, were in the 95%CI of the study population after cesarean section. Conclusions D-dimers concentration of 0.5 mg/L is not suitable for venous thromboembolism screening during pregnancy. D-dimers concentration in pregnancy and early puerprium is higher than non-pregnancy. It increases in the very early period postpartum and decreases with time. D-dimers should not be a routine screening test to exclude thromboembolic disease in pregnant women without high risk factors and clinical manifestation of thromboembolic disease.

Objective To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods A retrospective analysis was conducted in 135584 women who delivered in Women′s Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups.(1) The diagnosis was consistent prenatally and postnatally in 715 cases(58.99%,715/1212) as the diagnosis group.(2)In 312 cases (25.74%,312/1212), the diagnosis was made after birth as the missed diagnosis group.(3)In 185 cases (15.26%,185/1212), the diagnosis was made prenatally but excluded after birth as the misdiagnosis group. The disease classification was made, and the risk factors, clinical manifestations, lab results, the time of termination and perinatal outcomes were recorded in the 3 groups. The reasons of missed diagnosis and misdiagnosis were analyzed. Results (1) In the 1212 cases, the diagnosis of placental abruption was confirmed in 1027 cases, with the incidence of 0.76%(1027/135584). The rate of missed diagnosis was 30.38%(312/1027), and the rate of misdiagnosis was 0.14%(185/134557). (2) There were significant differences in the degree of placental abruption among the 3 groups (P＜0.05). (3)Significant differences were found among the 3 groups regarding the ratio of hypertensive disorders, trauma, induced labor and advanced maternal age (all P＜0.05). (4) There were statistically significant differences among the 3 groups regarding the incidence of vaginal bleeding, persistent abdominal pain and uterine tenderness, bloody amniotic fluid, increased uterine tension and stillbirth (all P＜0.05). (5) There was no significant difference in the rate of abnormal fetal heart rate mornitoring among the 3 groups (P=0.22). The differences were statistically significant among the 3 groups when regarding the incidence of abnormal ultrasound finding and abnormal blood coagulation (P＜0.01), with the highest incidence of abnormal ultrasound in the diagnosis group (68.1%) and the highest incidence of abnormal coagulation in the misdiagnosis group (24.9%). (6)There was statistically significant difference among the 3 groups when comparing the ratio of termination of pregnancy within 24 hours (P=0.01). (7) There were statistically significant differences among the 3 groups when the ratios of postpartum hemorrhage, DIC, neonatal asphyxia and perinatal death were compared (all P＜0.05). The highest incidence of postpartum hemorrhage was in the diagnosis group (17.9%) and the lowest was in the misdiagnosis group (5.4%). The highest incidence of DIC was in the diagnosis group (3.9%) and the lowest was in the misdiagnosis group (0). The highest incidence of neonatal asphyxia was in the diagnosis group (30.6%) and the lowest was in the misdiagnosis group (7.6%). And for perinatal death, the highest incidence was in the diagnosis group (12.6%), the lowest was in the misdiagnosis group (2.2%). Conclusions Placental abruption could be misdiagnosed when depending on risk factors, such as trauma. And it could be missed diagnosis during the induction of labor. Uterine contraction, abnormal fetal heart rate mornitoring, abnormal ultrasound and abnormal coagulation function are important in the diagnosis of placental abruption.

BACKGROUND: Posttraumatic stress disorder(PTSD) arises as a delayed and /or protracted response to a stressful event or situation of an exceptionally threatening or catastrophic nature. There have been reports about natural disasters causing PTSD, but there have been few reports about PTSDcaused by technological disasters. Our study investigated the mental status of those survivors after a serious explosion.OBJECTIVE: To investigate the characteristics and the factors of impact of PTSD caused by technological disasters.DESIGN: A case controlled study of the survivors of a momentous explosion.SETTING: A provincial mental health center.PARTICIPANTS: A serious explosion happened in Urumqi on September 8, 2000. Twenty-eight survivors(as the study group) who were still hospitalized for treatment 3 -5 months after the accident were involved in this study. And in the control group were 30 normal persons whose general demographic data were the same as those patients.METHODS: A psychiatrist told the subjects the following: The objective and meaning of the test, and explained the self-making questionnaire about their general condition, symptom checklist (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale(SDS), cornell medical index(CMI), the questionnaire on dealing styles, the questionnaire on social support, and others-evaluating scale, incident effect scale(IES); a list of stress reaction symptoms.MAIN OUTCOME MEASURES:Main resulta:①Clinical feature of PTSD caused by the technological disaster.②the related factors to PTSD in the technologal disaster.Secondary results: Comparison of the results between the two groups in IES, CMI, SDS and SAS.RESULTS: A total of 22(79% ) survivors met the criteria as PTSD. There were significant differences in all the assessments(IES, CMI, SDS, SAS,SCL-90) between the study group and the control group (t =3.62-8.17, P ＜ 0.01 ) . The diagnosis of PTSD was positively correlated with the level of traumatic exposure( r = 0. 420, P ＜ 0. 05), and negatively correlated with the degree of satisfaction with the post-event solutions( r = 0. 420, P＜ 0.05), positively correlated with IES scoring and the level of heart pain ( r = 0. 389 - 0. 665, P ＜ 0. 01 ) . The total scores of IES were positively correlated with the level of exposure ( r = 0. 478, P ＜ 0.05 ).CONCLUSION: The incidence of PTSD after explosion was high, and its occurrence was related with the degree of exposure in the event and that of the satisfaction with the post-event solutions.

OBJECTIVE:To regulate the management of operation drug and promote medication security. METHODS:Based on the relevant principles in the standard of JCI,the practice about establishment of operation pharmacy in our hospital was intro-duced,and it were stated from two aspects which included working mode and effects. RESULTS:The working mode were format-ed by definiting the duties and working flow of pharmacist,anesthetist and liaison man. The establishment of operation pharmacy, which brought operation drugs into the unified management system of our hospital,saved manpower and improved work efficien-cy,refined the management of drugs in all aspects,improved the management of drug safety level,strengthened drug expiration date management,implemented the reporting of adverse drug reactions(event)and collecting of medication(potential)errors. The established mode conformed to the relative standard of JCI including preparation,grant,storage and collection of ADR of drug. CONCLUSIONS:The established drug management of operation pharmacy promotes standardized administration of surgery drug, which guarantees the drug use safety of patients.