Objective To explore the role of tumor necrosis factor (TNF-?) and endotoxin(LPS) in upper gastrointestinal bleeding in cirrhosis patients and the preventive and treatment mechanism of rhubarb. Methods 45 liver cirrhosis patients with upper gastrointestinal bleeding were treated with rhubarb, and its efficacy was compared with cemetidine's efficacy. Liver function, and serum levels of TNF-? and LPS were measured before and after the therapy. Results Patients’symptoms and liver function were improved, and serum levels of TNF-? and LPS significantly decreased after treated with rhubarb. Conclusions TNF-? and endotoxin might play an important role in upper gastrointestinal bleeding in cirrhosis patients. Rhubarb has protective and treatment effect on upper gastrointestinal bleeding in cirrhosis patients by reducing TNF-? and LPS release.

Objective To explore the clinical curative effect of early enteral nutritional support for acute se-vere organophosphorus pesticide poisoning.Methods 56 cases with acute severe organophosphorus pesticide poison-ing were selected and divided into group A and group B in accordance with the random number table.Both groups were given conventional emergency treatment.Enteral nutrition support with nutrition pump was applied for 30 cases of group A in 48 -72hours,while group B in 72h -5d.The time of consciousness recovery,CHE increase to normal 60%,the incidence rate of intermediate syndrome,gastrointestinal complications of abdominal pain,abdominal disten-sion,vomiting,reflux,diarrhea,VAP,MODS of the two groups of patients were compared.Results The time of con-sciousness recovery (3.6 ±0.8)d in group A was lower than that of group B(4.1 ±0.6)d (t=2.612,P<0.01), the CHE increase to normal 60%(5.5 ±1.3)d in group A was lower than that of group B(6.3 ±1.1)d(t=2.464, P<0.05),the incidence rate of intermediate syndrome(3.3%)in group A was lower than that of group B(38.5%) (χ2 =4.691,P<0.05),the VAP of 13.3% in group A was lower than that of group B(46.2%)(χ2 =7.352,P<0.01),the MODS of 13.3% in group A was lower than 38.5% of group B(χ2 =4.691,P<0.05),the duration in ICU of (8.0 ±1.2)d in group A was lower than (12.0 ±2.4)d of group B(t=7.705,P<0.01).There was no sig-nificant difference of gastrointestinal complications between the two groups (P >0.05 ).There was no significant difference of gastrointestinal complications between the two groups (P>0.05).Conclusion Early enteral nutritional support is effective and safe for acute severe organophosphorus pesticide poisoning and worthy of promotion.

Objective:To explore the structure of maternal verbal scaffolding features and develop a questionnaire on Mother's language scaffolding characteristics, so as to provide a quantitative, convenient and economical self-assessment tool for describing maternal verbal scaffolding features.Methods:On the basis of qualitative research and literature research, a questionnaire survey was conducted among 704 mothers of preschool children. After item analysis and exploratory factor analysis, a formal questionnaire was formed. Two weeks later, 106 mothers were retested to collect test-retest reliability data. Preschool children's expressive vocabulary checklist was used as external criterion.Data were analyzed by SPSS 18.0 and Amos 21.0.Results:(1)The formal questionnaire includes 28 items with two factors-detailed support factor and control rejection factor, the internal consistency coefficients of the two factors were 0.849 and 0.811, the project load was from 0 .482 to 0 .701, and the variance contribution rate was 40.36%.(2) AMOS 21.0 was used for confirmatory factor analysis, indicating that the two-factor structure met the requirements of psychometrics.( χ 2/ df=1.96, RMSEA=0.05, NFI=0.86, CFI=0.90, IFI=0.89). (3)The results of two-factor text-retest reliability were 0.840 and 0.871 as well as the results of split-half reliability was 0.801.The internal consistency reliability was 0.740.The external validity analysis showed that the mother's education level was positively correlated with factor Ⅰ( r=0.288, P=0.000), but not with factor Ⅱ( r=-0.091, P=0.052). There was significant difference in factorⅠbetween mothers with expressive vocabulary development delay children (52.22±10.56) and non delayed children (57.71±7.51) ( t=-5.07, P=0.000). There also was a significant difference in factor Ⅱ between mothers with expressive vocabulary development delay children (37.12±10.09) and non delayed children (31.53±8.59) ( t=4.61, P=0.000). (4)There was no significant difference in the characteristics of language scaffolding between boys(factorⅠ(58.08±8.14), factorⅡ(32.86±9.51)) and girls' mothers(factorⅠ(56.93±8.20), factorⅡ(31.42±8.48)). Analysis of the sample groups showed that age did not affect the verbal scaffolding features of preschool children's mothers( F1=1.633, P1=0.181; F2=0.758, P2=0.518). Conclusion:There are two factors in the questionnaire of the verbal scaffolding features questionnaire, which meet the criteria of psychometrics.The questionnaire of the verbal scaffolding features questionnaire is suitable for evaluating the characteristics of language scaffolding of mothers of preschool children aged 3-6.

Objective To estimate the expression of ER and PR in the endometrium of both intrauterine adhesions (IUA) and non-IUA specimens. Methods The endometrium specimens from patients undergoing hysteroscopy for confirmed moderate IUA (n=20: 10 in proliferative phase, and 10 in secretory phase) were enrolled as the IUA group in Beijing Obstetrics and Gynecology Hospital from October 2014 to August 2015. The specimens scheduled for hysteroscopy due to infertility were recruited into the control group (n=26: 13 in proliferative phase, and 13 in secretory phase). Immunohistochemistry and quantificational real-time PCR (qRT-PCR) were used to detect the expression of ER-α, ER-β and PR in endometrium with different menstrual period in both groups. Results (1) Location: in both groups, the expression of ER-α, ER-β and PR appeared in the endometrial glandular epithelial cells and the stromal cells of the endometrium. The positive brown granules of ER-α, ER-β and PR appeared mainly in cell nucleus. (2) ER-α and ER-β in the endometrium:the protein expression of ER-α and ER-β in IUA group (proliferative phase: 0.657 ± 0.028, 0.493 ± 0.023; secretory phase: 0.537 ± 0.020, 0.365 ± 0.031) were significantly higher than those of control group (proliferative phase: 0.586 ± 0.025, 0.437 ± 0.022; secretory phase:0.459 ± 0.025, 0.323 ± 0.017;all P<0.01). And the ER-αand ER-βmRNA expressions in IUA group were 2.524 ± 0.296, 1.947 ± 0.339, higher than those of control group in the proliferative phase (all P<0.01), and in the secretory phase (1.977±0.333, 1.345±0.292) were also higher than those in the control group (all P<0.01). (3) PR in the endometrium: the protein expression of PR was not significantly different between IUA group (proliferative phase:0.248±0.025, secretory phase:0.194±0.024) and control group (proliferative phase: 0.234 ± 0.019, secretory phase: 0.186 ± 0.020; P=0.162, 0.359). Meanwhile, there were no statistical differences in the mRNA expression of PR in both groups with different menstrual period (proliferative phase: 1.144 ± 0.384 versus 0.981 ± 0.306, secretory phase: 0.763 ± 0.237 versus 0.631 ± 0.203; P=0.270, 0.166). (4) ER and PR expression in menstrual cycles: the expression of ER-α, ER-β and PR in the IUA group changed with the menstrual cycles, and their expression in the proliferative phase were higher than those in the secretory phase (all P<0.05). Conclusions The expression of ER-α and ER-β in the endometrium of IUA patients changes with menstrual cycle, and are higher compared with those in normal endometrium. No difference is found in the PR expression between the two groups.

Objective To investigate effects of different sedation methods on the mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 101 patients with mechanical ventilation in our hospital was randomly divided into observation (58 cases) and control (43 cases) groups.The observation group was given to strengthen psychological care during the day, and the night was given to the patients with AECOPD.The control group was treated with continuous analgesia and sedation, and the daily morning was executed to wake up the plan 1 ～ 2 hours.A set of indexes were observed, including white cell count, C-reactive protein, oxygen index, B-type natriuretic peptide, delirium occurred rate, unexpectedly drawn tube rate, and duration of mechanical ventilation.Results White blood cell number, C reactive protein, and oxygen index group in the observation group were significantly better than the control group [(10.1 ± 2.4) × 109/L vs (11.2 ± 2.8) × 109/L,(40.6 ± 11.6) mg/L vs (45.8 ± 12.2) mg/L, and (285.6 ±45.1) vs (268.2 ±42.6)] (P ＜0.05).The incidence of delirium rate in the observation group was significantly lower than the control group [30/58(51.7％) vs 31/43(72.1％)] (P ＜0.05).The mechanical ventilation time in the observation group was significantly shorter than the control group [(8.41 ± 3.96) d vs (10.35 ± 5.57) d] (P ＜ 0.05).There was no significant difference between B type natriuretic peptide and accidental extubation rate (P ＞ 0.05).Conclusions The night program sedation program can significantly improve AECOPD mechanical ventilation in patients with inflammatory index and oxygen index, reduces the incidence of delirium in patients with acute exacerbation of chronic obstructive pulmonary disease, does not increase the accidental extubation rate, and significantly shortens the AECOPD patients with mechanical ventilation duration of mechanical ventilation, as a mechanical ventilation in AECOPD patients who killed one of the options.

Objective To investigate the effect of phenylhexyle isothiocyanate (PHI) on demethylation and activation of transcription gene p15 in acute leukemia cell line Molt-4. Methods DNA sequencing and modified methylation specific PCR (MSP) were used to screen p15-M and p15-U mRNA after Moh-4 cells were treated with PHI. P15 mRNA was measured by RT-PCR. Pl5 protein was detected by Western blotting. Results Hypermethylation of gene pl5 was apparently attenuated and activation of transcription p15 gene was de novo after 5 days exposure to PHI. PHI enhanced both the expression of p15 mRNA and p15 protein in a concentration-dependent manner. The ratio of the gray scale of p15 mRNA strap was 0.17±0.12 in control, 0.29±0.14 in PHI 10 μmol/L, 0.55±0.07 in PHI 20 μmol/L, 0.93±0.13 in PHI 40 μmol/L. Conclusion PHI could active demethylation and transcription of gene p15.

Objective To observe the CT features of ovary Brenner tumor. Methods CT manifestations of 5 patients with ovary Brenner tumor confirmed with pathology and clinical follow-up were retrospectively analyzed, and the masses were described for location, size, configuration, enhancement pattern, presence of calcification and metastatic spread. Results There were 7 tumors in 5 patients, 3 patients had unilateral tumors and 2 had bilateral Brenner tumors (left side 3 and right side 4), with tumor size ranging from 1.52 to 16.25 cm (mean 7.36 cm). Five masses in 4 patients were benign, 2 (bilateral tumors in 1 patient) were malignant. All tumors had well-defined margin. One patient with bilateral benign tumors had large pleural effusion and seroperitoneum. Five tumors in 4 patients (5/7, 71.43%) were solid and had calcification, 2 tumors in 1 patients (2/7, 28.57%) were mainly cystic, with septa in the tumors. The solid part of all tumors were inhomogeneous and had mild enhancement. Conclusion CT findings of ovary Brenner tumor have some characteristics. Combining with clinical manifestations, CT is helpful for the diagnosis of ovary Brenner tumor.

Objective To estimate the diagnostic value of interstitial infiltration pattern for early morphea.Methods Twenty-five cases of early morphea pathologically characterized by interstitial infiltration of inflammatory cells were collected from 2010 to 2012.The clinicopathological features of these cases were retrospectively analyzed.Results The average clinical course was 7.5 months.The primary manifestation was edematous dark erythematous plaques,and interstitial or mixed infiltrate of inflammatory cells was the characteristic histopathological presentation.After anti-inflammatory treatment,lesions markedly improved or disappeared in 70％ of these patients.Conclusions Interstitial infiltration of inflammatory cells is a rare histologic pattern in early morphea.To learn and recognize this pattern may be beneficial to the diagnosis and treatment of early morphea.

Objective To explore the application of CARE kV technique in the adult chest CT and the value of reducing radiation dose.Methods Sixty-nine patients were divided into two groups by random number generators:group A(39 cases) and group B(30 cases).Group A was examined by using CARE kV technique and group B was examined at routine 120 kV.CT dose index(CTDIvol),dose length product (DLP) and effective dose (E) were compared between the two groups,and analyzed the correlation between tube voltage selection and patient body mass index (BMI) of group A was analyzed.Results The average CTDIvol [(11.00 ± 3.89) mGy],DLP[(294.05 ± 91.17) mGy·cm] and E[(4.12 ± 1.28) mSv] of group A were lower than those of group B (16.64 ± 1.20) mGy,[(475.99 ± 41.16) mGy · cm],[(6.66 ±0.58) mSv].With statistically significant difference (t =-7.653,-10.151,-10.150,P ＜ 0.05).Compared with routine 120 kV technique (group B),the CARE kV technique (group A) could reduce the total radiation dose about 38.14％.Compared obese patients(BMI≥28 kg/m2) with non-obese patients in group A and B,the mean E of non-obese patients was lower than that of obese patients in group A,which reduced the total E about 31.74％ (t =4.322,P ＜0.05),while E in group B was no significant different between non-obese patients and obese patients.Conclusions In adult chest CT,CARE kV technique can select optimum scanning voltage automatically according to the patients with different BMI and anatomical regions,which can reduce the overall radiation dose while maintaining image quality.