Astragalus Plant ; Cell Differentiation ; drug effects ; Cell Division ; drug effects ; Codonopsis ; Drugs, Chinese Herbal ; pharmacology ; Hematopoietic Stem Cells ; cytology ; drug effects

Objective Assess the value of several biomarkers and disease severity scores for the prognostic assessment of sepsis.Methods The clinical data of adult patients, who met the diagnostic criteria for Sepsis-3 and admitted to the intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University from January 2015 to December 2016 were retrospectively analyzed. These patients were divided into survival group and death group. The levels of serum lactate (Lac), lactate clearance rate of 24 hours later (24 h LCR), procalcitonin (PCT), quick sequential organ failure assessment (qSOFA) score, SOFA score, simplified acute physiology score Ⅱ (SAPS Ⅱ), acute physiology and chronic health evaluation scoring system Ⅱ (APACHE Ⅱ) score were determined, and the receiver operating characteristic curve (ROC) were used to analyze the prognostic value of the indicators above.Results 110 of 152 sepsis patients survived, while the others died. Compared with survival group, serum Lac, PCT, SOFA score, qSOFA score, SAPS Ⅱ score, APACHE Ⅱ score of death group were increased, and 24 h LCR was decreased. SAPS Ⅱ[area under the ROC curve (AUC) = 0.877,P = 0.000, when threshold value was 41.50, sensitivity was 94.3%, specificity was 68.5%], 24 h LCR (AUC = 0.869,P = 0.000, when threshold value was 40.2%, sensitivity was 92.1%, specificity was 75.5%) and SOFA score (AUC = 0.815,P = 0.000, when threshold value was 7.60, sensitivity was 79.9%, specificity was 78.5%) showed better predictive value of sepsis. However, the predictive value of PCT (AUC = 0.759), Lac (AUC = 0.725), qSOFA (AUC = 0.701) and APACHE Ⅱ score (AUC = 0.680) were poorer (AUC = 0.6-0.8). For sepsis caused by abdominal cavity infection, the most accurate index was SOFA score (AUC = 0.889,P = 0.000, when threshold value was 9.50, sensitivity was 81.2%, specificity was 83.5%), and for sepsis caused by pneumonia, the most accurate index was PCT (AUC = 0.891,P = 0.001, when threshold value was 3.95 mg/L, sensitivity was 84.7%, specificity was 94.1%).Conclusion SOFA score and qSOFA score cannot take the place of traditional evaluation index for the evaluation of the prognosis of patients with sepsis.

Objective To discuss drug resistance of wound-isolated pseudomonas aeruginosa and its correlation with use of antibiotics in children,for guiding the clinical use of antibiotics.Methods One hundred and forty wounded children admitted from January 2009 and December 2013 were collected in the study.There were 97 males and 43 females,aged (5.4 ± 2.6) years.All were victims of road traffic accidents.Distribution of bacteria isolated from the wound and drug resistance of pseudomonas aeruginosa were detected.Twenty-seven children with pseudomonas aeruginosa infection were divided into imipenem-resistant group (n =7) and non-imipenem resistant group (n =20).Drug resistance and application intensity of antibiotics were compared between the two groups.Results A total of 64 pathogens were isolated from the wound culture.Top five bacteria detected were acinetobacter baumannii,pseudomonas aeruginosa,enterobacter cloacae,escherichia coli and staphylococcus epidermidis.Pseudomonas aeruginosa showed resistance to β-lactam antibiotics,tetracyclines,chloram-phenicol and sulfanilamide.Drug resistance of piperacillin tazobactam (64.7％),meropenem (100％),ceftazidime (64.7％) and piperacillin (76.5％) in imipenem-resistant group were all 40％ higher than that in nonimipenem resistant group (P ＜ 0.05).Imipenem-resistant group versus non-imipenem resistant group revealed no significant differences in drug resistant rate of azactan (76.5％,39.0％),cefepime (70.6％,29.3％) and gentamicin (35.3％,17.1％) (P ＞ 0.05).There was no significant difference in total application intensity of antibiotics between the groups (P ＞ 0.05).Conclusions Wound-isolated pseudomonas aeruginosa in children is multidrug resistant.Thus bacterial monitoring in children with traumatic wounds should be strengthened and antibiotics should be selected rationally to reduce the production of multidrug resistance of pseudomonas aeruginosa.

BACKGROUND:Ideal tissue-engineered urinary tract should have good mechanical properties to bear long-term attack of urine and excretion. Muscular conduit of urinary tract in static culture exerts poor strength. It is reported that mechanical stimuli promote cellular growth and secretion of extracellular matrix. OBJECTIVE:To investigate the feasibility of constructing tissue-engineered muscular conduit of urinary tract in bioreactor. METHODS:Adipose-derived stem cells were harvested by col agen enzyme method. After series culture and expansion in vitro, flow cytometric analysis was carried out to detect the immunophenotypes of adipose-derived stem cells. Then the cel-polyglycolic acid complex was constructed by seeding adipose-derived stem cells on polyglycolic acid fibers. After 1 week of in vitro culture, cel-polyglycolic acid complex was cultured in a bioreactor. The experimental group was subjected to pulsatile stimuli, while the control group was cultured in static state. After 3 weeks of in vitro culture in basic medium, the cel-polyglycolic acid complex was induced in the induced culture medium for 4 weeks, and then engineered tissue was examined both grossly and histological y. RESULTS AND CONCLUSION:Flow cytometry demonstrated that the adipose-derived stem cells expressed CD90 (99.42%), CD44 (98.12%) and CD105 (93.27%), but not CD34 (4.92%) or CD45 (0.38%). In the experimental group, tissue-engineered muscular conduit of urinary tract appeared bright color with a round lumen. Immunohistochemical staining showed that after cel-polyglycolic acid complex was induced for 4 weeks, the cells expressed desmin and α-smooth muscle actin. More col agen was found in the complex. In contrast, the control group appeared pale surface and its lumen col apsed slightly. Less col agen was in the complex. Tissue-engineered muscular conduit of urinary tract with good structure can be constructed in a bioreactor.

Visfatin is a recently discovered adipokine secreted by visceral adipose tissue,corresponds to pre-B cell colony-enhancing factor(PBEF), which is composed of 473 amino acid coding a 52kDa polypeptide and expressed in bone marrow,liver,muscle and so on.Visfatin binds and activates the insulin receptor,exerting insulin-mimetic effects;promotes adipose tissue to differentiate,synthesis and accumulate,which is correlated with obesity;promote vascular smooth muscle cell to mature,participating in the processes of inflammatory response and cell differentiation and apoptosis.The multi-function of visfatin increases new contents of correlated disease pathogenesis and new targets of disease management.

AIM: To report the use of modified four ports pars plana vitrectomy in managing a dislocated posterior chamber intraocular lens.METHODS: A young man with bilateral pseudophakia and dislocated PC-IOLs had undergone modified four ports pars plana vitrectomy in relocating a dislocated posterior chamber intraocular lens. This procedure was surgically less tedious and demanding compared with previous methods of IOL retrieval.RESULTS: No significant intra- or post-operative complication was noted. The visual recovery of the operated eye was rapid with the best corrected visual acuity at 14 months post-operation being 0.5. In contrast, the right eye without operation due to patient refusal developed total retinal detachment with hand movement visual acuity.CONCLUSION: Modified four ports pars plana vitrectomy may be a more ophthalmic surgeon friendly alternative in the retrieval of dislocated IOL.

The adjustment of Laboratory Medicine to the first class subject is both challenges and opportunities. In order to meet the requirements of the modern laboratory medicine on the improved knowl-edge and skill, Weifang Medical University sets a goal of cultivatinghigh-qualified and applicative profes-sional personnel of Laboratory Medicine Science. To realize that, we build a new curriculum system with features of Medical Laboratory Science, including the theoretical curriculum system and the practical teach-ing system. The theoretical curriculum system breaks the traditional framework of the old curriculum which designed according to the discipline category, builds a new curriculum system of platform and module, scientifically integrates the basic course group in clinical laboratory medicine, and adds the course of clinical examination skills with its own professional characteristics. In the practical teaching system, we focus on the cultivation of practice ability and innovation ability, encourage the students to go to the hospital and company earlier, and promote the integration of production, teaching and research in various approaches.

Objective To investigate the effects of platelet-rich fibrin (PRF) on BMP-6 expression during mandibular distraction osteogenesis. Methods Twenty-five mature rabbits were randomly divided into five groups. Mandibular osteoto?mies were performed corticectomy in bilateral mandibles of rabbits. PRF was implanted in the one side of mandibles, which was used as experimental group. Another side of madibular was used as control group. Rabbits were sacrificed and the dis?tracted calluses were harvested and processed for HE and BMP-6 immunohistochemistry staining at 1, 3, 7, 14 and 28 days after the end of distraction, respectively. The expressions of BMP-6 in the distracted calluses were analyzed by cell digital imaging software. Results The regenerated bone was found in the distraction gap after mandibular lengthening. Expres?sions of BMP-6 were co-localized in cytoplasm of osteoblasts and newly embedded osteocytes. Compared with control group, the positive cell rate and positive area percentage of BMP-6 were significantly higher on the 1st, 3th and 7th day after the distraction in experimental group (P<0.05). There were no significant differences in positive cell rate and positive area per?centage of BMP-6 at 14-day and 28-day after the distraction between experimental group and control group. Conclusion PRF can accelerate bone formation of mandibular distraction osteogenesis in rabbits. BMP-6 may play important role at the early stage of mandibular distraction.

This paper explores subjective and objective reasons for missed diagnosis and diagnostic errors in health examination,aiming to improve mutual communication between patients and health staff,enhance people's consciousness in ethics,promote the medical concept which stresses preclinical prevention and early treatment for diseases,decrease the rate of missed diagnosis and diagnostic errors,and makes health examination profitable for both medical institutes and recipients.

Objective To study features of clinical manifestation,pathology and treatment effects of idiopathic membranous nephropathy(IMN).Methods A retrospective study was performed in patients with membranous nephropathy through renal biopsy diagnosis in Beijing Children's Hospital Affiliated to Capital Medical University from November 2009 to February 2013.Patients were diagnosed according to renal biopsy apart from hepatitis B virus-associated glomerulonephritis,Henoch-Schonlein purpura nephritis,lupus nephritis,tumor and drug associated nephritis.The study summed the clinical and pathological features of IMN and evaluated the effect of treatment according the follow up.Results (1) There were 13 patients,with the ratio of male and female being 1.0 ∶ 1.6,among them 1 patient was younger than 6 years old,3 cases were between 6 and 12 years old,and 9 cases were elder than 12 years old.Nine patients were nephrotic syndrome,and 3 patients had renal insufficiency.(2)Ten patients had infection,among them 5 cases were upper respiratory infection with agent unfound,4 patients were mcoplasma infection,1 patient was influenza B virus infection,1 patient had positive result of Hepatitis B surface antibody(HBsAb) and Hepatitis B core antibody (HBcAb),and 2 patients had positive result of purified protein derivative (PPD).(3)Pathological feature of IMN was atypical membranous nephropathy.Atypical membranous nephropathy was characterized by an irregular,thickened glomerular basement membrane(GBM),mesangial cells,and a mesangial matrix with mild to moderate hyperplasia.Immune complexes were stained in the subepithelial region,GBM,and mesangial region under light microscopy.Electron microscopy showed various sizes,density,and shapes of electron-dense deposits in multiple regions.The cases of immunofluorescence were 13 for IgG,10 for C3,9 for IgM,9 for C1q,5 for IgA,2 for C4,and 0 for fibrinogen.Seven patients were strongly positive(3 + and above) for IgG and one patient was strongly positive for C3.(4)Seven patients had complete remission,three patients had partial remission,and three patients had non-remission.Conclusions (1) In this study,children with IMN were mainly girls,and the age distribution was beyond 12 years.Nephrotic syndrome was the most common clinical manifestation.(2)Atypical membranous nephropathy was the most common pathological feature in children with IMN,which should be distinguished from hepatitis B virus-associated glomerulonephritis by testing HBV antigen in renal biopsy.(3) Prednisone was effective for IMN children,but it was suggested to give enough and long course of application.Effect of prednisone combined with cyclophosphamide was still undefined.