Objective To study the application value of T lymphocyte subsets and inflammatory factors in evaluating severity andprognosisofaplasticanemia.Methods 40patientswithaplasticanemiainthehospitalwereenrolledinthestudyasAAgroup, which was further divided into acute aplastic anemia(AAA) subgroup and chronic aplastic anemia(CAA) subgroup .In addition to that ,40 healthy people who received physical examination in the hospital during the same period were enrolled in the study as con‐trol group .Then blood routine tests were performed ,T lymphocyte subsets content in peripheral blood and serum inflammatory fac‐tor content were detected and the results were compared .Results Th1 ,Th17 contents and Th1/Th2 ,Th17/Treg ratio in AA group were higher than those in control group(P<0 .05) ,while Th2 ,Treg contents were lower(P<0 .05);Th1 ,Th17 contents and Th1/Th2 ,Th17/Treg ratio in AAA group were higher than those in CAA group(P<0 .05) ,while Th2 ,Treg cells contents were lower . Serum IL‐2 ,IFN‐γ ,IL‐17 contents in AA group were higher than those in control group(P<0 .05) ,while IL‐4 ,IL‐6 ,IL‐10 contents were lower(P<0 .05);serum IL‐2 ,IFN‐γ,IL‐17 contents in AAA group were higher than those of CAA group ,while IL‐4 ,IL‐6 , IL‐10 contents were lower .Hb ,PTL contents were negatively correlated with Th1 ,Th17 contents and serum IL‐2 ,IFN‐γ ,IL‐17 contents ,while positively correlated with Th2 ,Treg cells contents and serum IL‐4 ,IL‐6 ,IL‐10 contents .Conclusion Peripheral blood T lymphocyte subsets and serum inflammatory factors contents in aplastic anemia are abnormal and are correlated with the severity and prognosis related indicators .

Objective To evaluate the effect of sevoflurane anesthesia on left ventricular synchroni?zation in patients undergoing coronary artery bypass grafting ( CABG ) . Methods Twenty?six patients of both sexes, aged 45-75 yr, with body mass index of 19-30 kg∕m2 and body surface area 1.4-2.0 m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and New York Heart Association class ⅡorⅢ, undergoing elective CABG with cardiopulmonary bypass, were divided into 2 groups using a random number table: control group ( group C, n=11) and sevoflurane group ( group S, n=15) . After induction of general anesthesia, the patients were endotracheally intubated and mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 4-6 mg·kg-1 ·h-1 , remifentanil 0. 2-0. 3 μg·kg-1 ·min-1 and cisatracurium 0.10-0.15 mg·kg-1·h-1, and intermittent iv boluses of fentanyl 0.5 μg∕kg, and bis?pectral index value was maintained at 40-60. In group S, sevoflurane ( end?tidal concentration: 2.05% for 45-49 yr, 1.80% for 50-59 yr, 1.60% for 60-75 yr) was inhaled for 30 min starting from 15 min after termination of cardiopulmonary bypass, followed by 30 min washout. The parameters of cardiac function
were monitored using transesophageal echocardiography. After induction and before sternotomy, immediate?ly before sevoflurane inhalation, at 30 min of sevoflurane inhalation, and at 30 min of washout, heart rate, mean arterial pressure, central venous pressure, pulmonary artery occlusion pressure, cardiac output, left ventricular ejection fraction, standardized standard deviation of time to peak systolic longitudinal strain of R?R interval ( Tssl?SD) of 17 left ventricular segment, and standardized standard deviation of time to peak systolic circumferential strain of R?R interval ( Tssc?SD) of 16 left ventricular segment were recorded. Re?sults Cardiac output and left ventricular ejection fraction were within in the normal ranges in the two groups. Compared with group C, heart rate was significantly decreased at 30 min of sevoflurane inhalation and 30 min of washout, and mean arterial pressure, cardiac output and left ventricular ejection fraction were significantly decreased at 30 min of sevoflurane inhalation in group S (P<0.05 or 0.01). There were no significant differences in standardized Tssl?SD and standardized Tssc?SD between group S and group C ( P>0.05) . Conclusion Sevoflurane anesthesia has no marked effect on the left ventricular synchronization in patients undergoing CABG.

Objective To describe X-ray and CT findings of lung in paraquat poisoning.Methods CT and X-ray data of chest in 21 patients with paraquat poisoning were retrospectively analyzed.Results X-ray and CT findings of lung were varied with different time.≤7 d,there were mainly increase of lung marking in 17 cases,ground-grass attenuation in 14 cases and consolidation in 2 cases.7~14 d,increase of lung marking,consolidation and pulmonary fibrosis each could be seen in 4 cases,and 3 cases with ground-grass attenuation.≥14 d,there were pulmonary fibrosis in 4 cases,bronchiectasis in 3 cases,increase of lung marking in 2 cases.Conclusion Chest plain X-ray film and CT are of important value in observing the evolution,evaluating the prognosis and guiding the treatment project for the patients with paraquat poisoning.

Objective To investigate the autophagy capacity in clear cell renal cell carcinoma tissue compared with adjacent normal tissue.Methods Sixty-nine pairs of samples from human clear cell renal cell carcinoma tissues and relatively healthy renal tissues adjacent to the tumor were collected during surgical resection.The expressions of proteins that were participating in the regulation and execution of autophagy were detected by immunohistochemisty.Electron-microscopy was also carried out for the morphometrical analysis.Results The protein expression of p-mTOR (P =0.004),P62 (P =0.000) and ULK1 (P =0.000) were up-regulated in the carcinoma tissue,while the expression of Beclin1 (P=0.000),LC3 (P =0.000) and ATG7 (P =0.000) were down-regulated,and the expression of ATG5 (P =0.349) had no signif-icant difference compared with adjacent normal tissue.Morphometrical analysis showed that the basal autophagic activity (measured by the presence of autophagy vacuole compartment) was remarkably down-regulated in carcinoma tissue,compared with adjacent normal tissue.The expression level of mTOR was correlated with P62,LC3 and ATG7,but results showed no correlation between mTOR and Beclin 1.Conclusion Our studies show a relatively reduced autophagy capacity in clear cell renal cell carcinoma,which is regulated by multiple autophagy-related proteins such as mTOR,Beclin 1 and LC3.

ISO 15189:2012Medical laboratories-Requirements for quality and competence was issued on November 1,2012,which replaced the second edition (ISO 15189:2007 Medical laboratoriesParticular requirements for quality and competence).A study on changes in new edition standard will facilitate medical laboratories,regulatory authorities,accreditation bodies to have a good understanding of requirements of this new edition.An implementation of new edition will assist medical laboratory to improve their management to continually meet requirements of international standards.To enable stakeholders mentioned above have a good understanding and application of this new edition,changes in new edition were discussed in depth in this article.

ObjectivesTo study the effect of community interventions and management on asthma in children and its impact on knowledge, attitude, and practice (KAP)of parents and the home environment.MethodsAn asthma health management profile of 0 to 14-year-old asthmatic children (n =93 ) in Sanlitun and Liulitun communities in Chaoyang District in Beijing was established.The children were randomly divided into a management group ( n =49) and control group ( n =44 ) based on community.Community-integrated management,such as regular follow-up,condition monitoring and health education,was implemented in the asthmatic children in the management group but not in the control group.The parents' KAP and the household environment in the two groups were compared after 1 year based on the changes shown in the health management profile.ResultsThe asthma relapse rate decreased to 27.9％ (12/43) in the management group.Compared with the control group,the rates of hospitalization (x2 =8.174,P =0.004) and school absences ( x2 =4.962,P =0.026) significantly decreased.The KAP level of parents increased to 67.4％ ( 29/43 ) in the management group and 20.4％ (9/44) in the control group,and the difference was statistically significant (x2 =19.517,P ＜0.01 ).Knowledge improved the most and showed a significant difference from the control group ( x2 =19.517,P ＜0.01 ).Home environment in the management group improved to 76.7％ (33/43).The number of indoor pets ( x2 =3.906,P =0.048) and indoor cockroaches ( x2 =4.962,P =0.026 ) reduced and showed significant differences between the two groups.In addition,children's allergy-related symptoms decreased to 30.2％ ( 13/43 ) in the management group compared with 9.1％ (4/44) in the control group,which was a significant difference ( x2 =6.183,P =0.013).ConclusionsParents' knowledge of asthma,compliance behaviors,and home environmentwere effectively improved through community-integrated management.This management technique can reduce the allergy-related symptoms of asthmatic children,improve asthma severity,and reduce the influence of asthma on children's daily lives.

A benzyl functionalized ionic liquid, 1-benzyl-3-methylimidazolium bis [( trifluoromethyl ) sulfonyl]imide ([BeMIM][Tf2 N]), was synthesized and characterized as an extraction solvent of dispersive liquid-liquid microextraction ( DLLME) for enrichment and determination of 5 organophosphorus pesticides (phoxim, fenitrothion, chlorpyrifos, phorate and parathion) and 2 aromatic compounds (chloronaphthalene and anthracene) from environmental water samples by high-performance liquid chromatography ( HPLC). [BeMIM] [ Tf2 N] had higher extraction efficiency than 1-octyl-3-methylimidazolium bis [( trifluoromethyl) sulfonyl]imide and common organic solvents such as CCl4 and C2 Cl4 . The extraction was performed using 40 μL of [BeMIM][Tf2N] and 1 mL of methanol as extraction solvent and dispersive solvent respectively with centrifugal time of 5 min. Under the optimal conditions, the method proposed here provided a good linearity for all analytes with correlation coefficients between 0. 9994 and 0. 9998. The repeatability values, described as intra-day and inter-day relative standard deviations (RSDs) of five replicate experiments at three different concentrations of 10, 40 and 100 μg / L, were 1. 1% -4. 3% and 0. 8% -4. 8% , respectively. The limits of detection (LOD) were 0. 01 μg / L-1. 0 μg / L at a signal-to-noise ratio (S / N) of 3. This developed method was convenient and speedy, and could be employed to detect the analytes in three real environmental water samples with satisfactory relative recovery of 82. 7% -118. 3% and RSD of 0. 7% -5. 6% . Introduction of benzyl group into the imidazolium could obviously enhance the extraction efficiecny for analytes due to the π-πinteraction between [BeMIM] [ Tf2 N] and analytes. [ BeMIM] [ Tf2 N] was a satisfactory extraction solvent with a high enrichment factor of 339 and extraction efficiency of 81. 4% . Partition coefficients of all analytes in [BeMIM][Tf2 N]-DLLME system were determined and the extraction mechanism was discussed.

Objective:To explore the effect of CDIO (conceive, design, implement, operate) model workshop training on the training of new nurses in the operating room.Methods:Forty-two nurses with standardized training were selected as the research objects, and they were randomly divided into two groups: observation group ( n=21) and control group ( n=21). The control group used the traditional training method in the operating room, and the observation group used the workshop training based on the CDIO model. SPSS 17.0 was used to statistically analyze the operation skill scores and case scores after training. The measurement data is expressed by (mean±standard deviation), the independent sample t test is used for comparison between the two groups, and the chi-square test is used for the comparison of counting data. Results:After the training, the scores of operating room knowledge assessment of the two groups were (72.31±2.16) points and (73.61±2.18) points respectively, with statistical significance ( P<0.05); the operation skill scores of observation group were (7.42±0.13) points, which were higher than those of the control group (6.62±0.11) points, and the disposal scores of observation group after operation were (7.12±0.20) points, which were higher than those of the control group (6.27±0.16) points, with statistical significance ( P<0.05); the professional quality scores of observation group were (7.41±0.25) points, which were higher than those of the control group (6.55±0.22) points; the adaptability scores of observation group were (7.06±0.22), which were higher than those of control group (6.35±0.21) points, with statistical significance ( P<0.05). Conclusion:The workshop training based on the CDIO model is effective for the training of nurses in the operating room, and the combined application effect is better than the effect of the traditional teaching model, especially for the improvement of practical skills.

Objective:To investigate the effects of exenatide on podocyte in diabetic nephropathy mice.Methods:Diabetic nephropathy mice models were induced by using streptozocin-treated C57BL/6J mice on high fat diets, which were randomized by random number table to diabetic nephropathy control group (DN group, n=8) and exenatide treatment diabetic nephropathy group (DN+ Ex group, n=8). The C57BL/6J mice on normal chow diet were used as normal control group (NC group, n=8). After the intervention, blood glucose, renal function, and urine albumin/creatinine ratio were measured. Pathological glomerular changes were observed by pexiodic acid-Schiff stain (PAS) staining. The mRNA expression of profibrotic molecules Collagen Ⅳ, transforming growth factor-β (TGF-β), and Fibronectin in glomerular lysates were measured by realtime quantitative PCR (RT-PCR). Podocyte injury and apoptosis were evaluated by immunofluorescent staining and transmission electron microscopy. The expression of Nephrin, Cleaved caspase-3, protein kinase B (Akt), and phosphorylated Akt (p-Akt) in glomerular lysates were examined by western blotting. Results:Compared with the DN group, urine albumin/creatinine ratio was significantly decreased in the DN+ Ex group ( P<0.01). PAS staining and analysis found that exenatide administration ameliorated mesangial matrix expansion and glomerular hypertrophyin in DN group ( P<0.05). RT-PCR analyses showed that the glomerular expression for Fibronectin, TGF-β, and Collagen Ⅳ were significantly decreased in the DN+ Ex group compared with the DN group ( P<0.01). Immunofluorescent staining and transmission electron microscopy revealed that exenatide treatment improved podocyte injury and apoptosis in DN group. Western blotting analyses showed that exenatide increased the Nephrin expression, decreased the Cleaved caspase-3 expression, increased the p-Akt expression in glomerular lysatesin diabetic nephropathy mice ( P<0.01). Conclusion:Exenatide attenuates podocyte injury and apoptosis and proteinuria, and prevents the progression of diabetic nephropathy mice. Phosphatidylinositol 3-kinase (PI3K)/Akt pathway in glomerular lysates may be related to the protective effects of exenatide.

Objective To investigate the efficacy and adverse reactions of risperidone orally disintegrating tablets joint oxazepam in the treatment of schizophrenia.Methods 63 patients with schizophrenia were selected and divided into two groups according to the order of admission Divided into the control group ( 31 cases ) and observation group ( 32 cases ) , were treated with chlorpromazine +alprazolam and risperidone orally disintegrating tablets+oxazepam.The two groups after treatment PANSS score, quality of life SF-36 health questionnaire score and ADL score before and after treatment, curative effect and adverse reactions were recorded and compared.Results The different PANSS score after treatment and compared, the observation group with different symptoms score and general psychopathology scores are significantly lower than the control group , the difference was statistically significant (P<0.05), the two groups after treatment ADL score compared with those before treatment were significantly increased, and the score of the observation group after treatment was significantly higher than the control group, the difference was statistically significant (P<0.05), the curative effect of observation group was 93.75%, significantly higher than the control group 77.42%, the difference was statistically significant ( P<0.05), quality of life questionnaire SF-36 score and one months after treatment, observation group scores were significantly higher than those in control group, the difference was statistically significant ( P <0.05), there were some adverse reactions in the two groups, the adverse reaction rate of observation group was 9.38%, significantly lower than 45.15%of the control group, the difference was statistically significant ( P <0.05 ) . Conclusion The implementation of schizophrenia risperidone orally disintegrating tablets oxazepam effect significantly , can better improve the clinical symptoms of patients, improve the patient's ability of daily life and quality of life.It can effectively reduce the occurrence of adverse reactions, and is a safe and effective treatment.