Objective To investigate the application of blood purification for critical disease with non-renal indications in PICU. Methods We retrospectively analyzed the clinical data of 10 critical disease cases with non-renal indications in PICU admitted from Jan to Dec 2009. Five cases were with acute liver failure,2 with autoimmune disease (1 with Guillaln-Barre syndrome, 1 with systemic juvenile rheumatoid arthritis with macrophage activation syndrome) ,2 with severe sepsis,one with metabolic diseases. Results Four cases were treated with plasma exchange combined with continuous veno-venous hemmofiltration. Three cases were treated with continuous veno-venous hemmofiltration. Three cases were treated with plasma exchange.Conclusion CBP is an effective and safe method in the treatment of critical diseases with non-renal indications in PICU.

Objective To investigate the application of continuous blood purification in the children with critical diseases. Methods Eighteen critical patients aged 1 ～ 15 years in PICU underwent continuous blood purification(CBP). Fourteen with acute renal failure (ARF) were treated with continuous veno-venous hemmofiltration(CVVH) ,2 with Guillain-Barre syndrome and 2 with Raye's syndrome were treated with plasma exchange(PE). The changes of clinical symptoms, blood biochemistry , blood gas, and oxygenation were analyzed before and after CBP. Results After CVVH treatment, the BUN and creatinine of 14 patients with ARF were decreased from (48.6 ± 14. 8) mmol/L to(28. 9 ±5.4) mmol/L and (634. 3 ±258. 2) μ mol/L to (318.4 ± 143.5) μmol/L,K+ and pH of serum were maintained in the normal range,oxygenation was significantly improved. Breathing difficulties and muscle strength in 2 patients with GBS were ameliorated and successfully weaned from ventilator after PE. Serum ALT,AST and ammonia of 2 cases with Raye's syndrome decreased significantly and they discharged after comprehensive treatment including PE. Bleeding in puncture region were found in 3 patients, hypothermia in 2 patients. During the treatment, vital signs of patients were stable,blood pressure and pulse were not fluctuated. Conclusion CBP is an effective and safe method in the treatment of critical diseases in children.

Occupational Health Services ; methods ; organization & administration

Background The hyperplasia of human Tenon capsule fibroblasts (HTFs) is a common cause of filtering surgery failure in glaucomous eye.Researches demonstrated that hydroxycamptothecin is a cell cycle arresting drug and induce apoptosis of cancer and fibroblasts.However,its mechanism is currently less understood.Objective This study was to investigate whether hydroxycamptothecin induce the apoptosis of HTFs and explore the possible mechanism.Methods Human Tenon capsule tissue was obtained from EyeBank of Jiangsu Province Hospital.HTFs were cultured using explant method in vivo and passaged in DMEM containing 10％ FBS.The cells were identified using vimentin and keratin by immunochemistry,and the cells of generation 3-6 in the logarithmic growth phase were used in the experiment.The cells were incubated with 0.01,0.05 or 0.10 g/L hydroxycamptothecin for 5 minutes respectively,and the cells without any hydroxycamptothecin were served as the control group.Cell viability then was assessed by cell counting kit-8 (CCK8) for the optimal inhibition concentration.The cells were treated by 0.10 g/L hydroxycamptothecin for 24 hours,and the apoptotic rate of the cells were assayed with annexin V/PI double-staining.Mitochondrial membrane potential of HTFs was assessed using JC-1 staining.The expressions of caspase-3,caspase-9 and cytochrome C (cyt C) in mitochondria and cytoplasm of HTFs were detected by Western blot.Results The proliferative value (A450) of the HTFs 0,0.01,0.05,0.10 g/L was 0.9716±0.0608,0.8035 ± 0.0346,0.7048 ±0.0446,0.6265 ±0.0286,with a significant difference (F =26.372,P =0.002).A450 of HTFs in the 0.01,0.05,0.10 g/L groups was significantly lower than the control group (P＜0.05),with the lowest A450 value in the 0.10 g/L group.The apoptotic percentage of HTFs was (18.72±1.41)％,in the 0.10 g/L hydroxycamptothecin group and that of the control group was (3.67 ±0.36)％,showing a significant difference between them (t =-10.374,P=0.001).The expression intensity of caspase-3 and caspase-9 protein in HTFs was higher in the 0.10 g/L hydroxycamptothecin group than that in the control group.JC-1 staining showed that the green fluorescence of the monomer JC-1 in cytoplasm was stronger in the 0.10 g/L hydroxycamptothecin group than that in the control group,but the red fluorescence of the polymer JC-1 in the 0.10 g/L hydroxycamptothecin group was weaker than that in the control group.The grey scale of cyt C protein in HTFs in mitochondrion was 0.0605±0.0022 in the 0.10 g/L hydroxycamptothecin group,showing a significant increase in comparison with 0.0301 ±0.0016 of the control group (t=4.865,P=0.014).However,the grey scale of cyt C protein in cytoplasm was declined in the 0.10 g/L hydroxycamptothecin group than that in the control group (0.0605 ±0.0022 vs.0.0301 ±0.0016) (t =-11.177,P =0.001).Conclusions Hydroxycamptothecin can induce the apoptosis of HTFs through activating the mitochondrial apoptosis pathway.

Objective:To investigate the expression of Foxp3 and CD25 on CD4+ T cells from patients with new-onset systemic lupus erythematosus(SLE)and assess their clinical significance.Methods:Twenty-one new-onset and untreated SLE patients including ten with active(SLEDAI≥10)and eleven with inactive disease(SLEDAI≤5)were enrolled in this study.Eleven age-and sex-matched healthy volunteers were also included as controls.Peripheral blood samples were collected and mononuclear cells isolated.The expression of CD25,Foxp3 and CD127 by CD4+ T cells was analyzed by flow cytometry(FACS).Proliferation assays were performed with the isolated CD4+CD25+ and/or CD4+CD25-T cells.Results:There was no significant difference in number of CD4+CD25+Foxp3+T cells in subjects with either active(1.91%-6.75%)or inactive(2.74%-7.01%)SLE compared to normal controls(2.11%-9.90%)(P=0.524 and P=0.794 respectively),Moreover,suppressive capacity of CD4+CD25+T cells in new-onset lupus patients was not impaired as measured by the capacity to inhibit proliferation of CD4+CD25-effector T cells(P=0.174,P=0.689).While CD4+CD25-Foxp3+T cells in both active(3.71%-10.94%)and inactive(2.97%-7.69%)patients with new-onset SLE were significantly more frequent than in normal controls(1.01%-3.62%)(P

Objective To investigate the expression of FOXP3 and CD25 in CD4+ T cells of peripheral blood from patients with early new-onset systemic lupus erythematosus(SLE) before and after treatment.Methods Forty-four early new-onset SLE patients including twenty-four with active disease (SLEDAI≥10), twenty with low active disease (SLEDAI

In this communication, the values of serum CA-50 in a series of patients with benign and malignant GI diseases are reported. It was found that CA-50 was positive in 86.7% of 30 pancreatic cancer patients with an average level of 427.53U/ml, which was statistically different from that found in non-malignant control group. In this series serum CA-50 determination helped to confirm the diagnosis of pancreatic cancer in 6 cases, in which B-mode ultrasono-graphy failed to make a definite diagnosis, and in another 3 cases CT scanning was unable to disclose the tumor. The combination of CA-50, B-mode ultrasonography, and CT made definite diagnosis in 100% of all 30 pancreatic cancer patients. The author discussed the significance of CA-50 determination in the diagnosis and differential diagnosis of pancreatic cancer.

The necessity to apply medical devices properly was introduced, and the present situation of the application of hospital medical devices were discussed from the aspects of overuse, abuse, operation and supervision. Some countermeasures were put forward to solve the problems in the application of hospital medical devices. It's pointed out that the application of hospital medical devices tends to be standardized with the progress of medical reformation, the attention on medical devices management, the supervision and etc.

Objective To study the therapeutic effects of extracorporeal shock wave therapy (ESWT) on temporomandibular joint disorders (TMDs).Methods Sixty patients with a temporomandibular joint disorder were randomly divided into an ESWT group and a control group,each of 30.Both groups were given routine rehabilitation training,but the treatment group additionally received ESWT for 2 weeks.Fricton's index was used to evaluate temporomandibular joint function.The subjects used a visual analogue scale (VAS) to evaluate their pain levels.The SF-36 scale was applied to assess their life quality.Results After two weeks of treatment,the average assessment score and VAS score had decreased significantly in both groups.After treatment the average scores for mandibular movement,muscle palpation,joint noise and joint palpation,and the palpation,dysfunction and craniomandibular indexes were all significantly lower in the ESWT group than in the control group.Significant differences were also found in the average VAS scores and on the social functioning domain of the SF-36 between the ESWT group and the control group.Conclusion ESWT combined with rehabilitation training can significantly relieve the symptoms and pain of TMDs.

Objective: To analyze the CYP2C19 gene polymorphism in patients with upper digestive system diseases in Anhui Province, so as to provide evidence for individual treatment. Methods: The 307 patients with upper digestive system diseases in the Department of Gastroenterology, The 901st Hospital of Combined Service Force of People＇s Liberation Army were selected. The CYP2C19 genotypes were detected by DNA microarray microarray. The CYP2C19 genotypes and metabolic types in different genders, ages and diseases were analyzed. Results: There were 197 males ( 64.17% ) and 110 females ( 35.83% ) , with the age of ( 58.00±16.13 ) years old. The gene frequency of CYP2C19*1, CYP2C19*2 and CYP2C19*3 was 62.70%, 32.25% and 5.05%, respectively. There were 119 cases (38.76%) of *1/*1 ( 636GG, 681GG ), 129 cases ( 42.02% ) of *1/*2 ( 636GG, 681GA ) , 18 cases (5.86%) of *1/*3 ( 636GA, 681GG ) , 29 cases ( 9.45% ) of *2/*2 ( 636GG, 681AA ) , 11 cases ( 3.58% ) of *2/*3 ( 636GA, 681GA ) , and 1 cases ( 0.33% ) of *3/*3 ( 636AA, 681GG ). In terms of metabolisms, there were 119 cases ( 38.76% ) of fast metabolism type, 147 cases (47.88%) of intermediate metabolism type and 41 cases (13.35%) of slow metabolism type. There were no significant differences in CYP2C19 genotypes and metabolic types among the patients with different gender, age and digestive system diseases ( P＞0.05 ). Conclusion The CYP2C19 genotypes of patients with upper digestive system diseases were polymorphic, mainly the fast metabolism type and the intermediate metabolism type, which could provide reference for the clinical medication of individualized treatment of proton pump inhibitors.