Post-resuscitation multiple organ dysfunction syndrome(PR-MODS) is a major cause of low survival rate in patients with cardiac arrest.To fully understand the concept of PR-MODS is beneficial for estimating the state of illness,adjusting the therapy and eventually increasing the survival rate.This article reviews the development of PR-MODS concept and compares it with MODS of other causes,including their pathogeny,pathology,mechanism,diagnosis and therapy.

Granulocyte colony-stimulating factor is a glycosylated polypeptide chain cell growth factor that can promote proliferation and differentiation of myeloid progenitors and induce maturation of these cells toward terminally differentiated neutrophils.Granulocyte colony-stimulating factor which functions and effects depend on the combination with specific receptor on the surface of effector cells.With the development of gene cloning technology,ganulocyte colony-stimulating factor recombinant products have been widely used in clinic to provide effective means for the treatment of leucopenia,In recent years,we find the therapy of chemotherapeutics combining with granulocyte colony-stimulating factor is effective in refractory/relapsed/elderly cases of acute leukaemia.Currently,granulocyte colony-stimulating factor is one of important and successful hematopoietic cytokines in clinic.

Objective To investigate the significance of three electrocardiographic indexes in predicting the myocardial infarct related artery (IRA) in inferior wall of acute myocardial infarction (IAMI) Methods One hundred and twenty patients with IAMI were studied Results (1) IRA was related to right coronary artery (RCA) in 98 (81 7%) case, left circumflex branch (LCX) in 22 (18 3%) cases (2) ST segment depression in lead Ⅰ identified RCA occlusion with a sensitivity of 77 6%, specificity of 90 9% in patient with IAMI, but isoelectric or elevated ST segment in lead Ⅰ identified LCX occlusion with a sensitivity of 90 9%, specificity of 77 6% (3) About QRS wave of lead aVL, S/R≥1/3 identified RCA occlusion with a higher sensitivity of 93 9% and a lower specificity of 63 6% (4) When IRA was RCA, ST segment elevated amplitude Ⅲ≥Ⅱ identified as a diagnostic index no matter the location of occlusion Conclusion Three electrocardiographic indexes have significant value in predicting the infarct related artery in inferior wall acute myocardial infarction

Objectives To analyze a rare autosomal recessive disease, aggrecan type spondylometaphyseal dysplasia (SEMD), which was caused by ACAN gene mutations. Methods A 7 years old girl was diagnosed with short stature after excluding growth hormone deficiency, idiopathic short stature, and hypothyroidism. Combining family history and clinical features, SEMD were suspected and genetic tests were performed. Results The patient was found with homozygous mutations of c.512C > T inACAN gene, and was diagnosed with aggrecan type SEMD. Her parents were found to be heterozygous mutation carrier. Conclusions In patients with high suspection of a special type of short stature, early genetic tests should be carried out for a clear diagnosis.

Objective To evaluate clinical significance of the CEA, CA19-9, CA242, AFP, CA724,SCC, TPA, TPS combined detection for the clinical diagnosis of gastrointestial cancer. Methods 373 cases of upper digestive tract malignant tumor patient and 50 cases of healthy serum sample were detected for eight markers, evaluating the relationship between the level of markers and illness. Results 8 marker diagnostic positive rates were: CEA 26.80 %, CA19-9 27.34 %, CA242 34.14 %, AFP 2.84 %, SCC 19.72 %, CA724 12.13 %, TPA 34.15 %, TPS 30.89 %. The total positive rate of joint detection of 8 markers was 89.05 %.Preoperative CEA, CA242, SCC-positive patients had a shorter survival time. CA242 and CA19-9 levels with upper gastrointestinal malignancies were positively correlated. Conclusion The combined detection of a number of markers in different pathological type and clinical staging is statistically significant, and the positive rate is much higher than any single marker test results. CA19-9 and CA242 may be the best combination of monitoring the disease. CA724, CA242 and SCC can be as adverse prognostic indicators for cardia, stomach,esophageal malignant tumors, respectively.

Objective To evaluate the diagnostic accuracy of Streptocuccus pneumoniae urinary antigen test (SpUAT) in patients with community acquired Streptocuccus pneumoniae pneumoniae (SPP). Methods The clinical studies relating SpUAT diagnostic accuracy for community acquired Streptocuccus pneumoniae infection were searched via computer and manual screening of Chinese databases including China National Knowledge Internet (CNKI), China Biology Medicine disc, China Technical Journal Full-text Database, and Wanfang Database as well as English databases such as PubMed, EBSCO, Elsevier Science, Ovid Technologies, and Springer. Data were extracted according to appropriate inclusion and exclusion criteria and analyzed with Meta-disc 1.4 and Stata 12.0 software. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio as well as diagnostic odds ratio (DOR) were calculated, and summary receiver operating characteristic curve (SROC) was plotted and area under SROC (AUC) was calculated to analyze the diagnostic accuracy of SpUAT for adult community acquired SPP. Results A total of 15 studies enrolling 6 866 patients were included, all of which with a quality assessment of diagnostic accuracy studies (QUADAS) score not lower than 10, indicating a high study quality. Random effect model was applied owing to non-threshold effect associated heterogeneity. It was shown by Meta analysis that compared with routine pathogen diagnosis (hemoculture, sputum smears, sputum culture and trachea and bronchus attractive culture), the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, and pooled negative likelihood ratio was 73% [95% confidence interval (95%CI) = 71%-76%,] 91% (95%CI = 90%-92%), 6.97 (95%CI = 4.13-11.77), and 0.30 (95%CI = 0.26-0.34), respectively, pooled DOR was 24.34 (95%CI = 13.14-45.11), and AUC of SROC was 0.8051±0.0362. It was indicated by heterogeneity test that experiment design (prospective or retrospective), sample sizes (lower than 200 or higher than or equal to 200), reference test (fewer than 3 or more than or equal to 3 test methods), or literature language (Hispanic or non-Hispanic) had no effect on study heterogeneity, indicating certain other unknown factors may be involved. Funnel plot suggested that 15 involved studies uniformly distributed along the two sides of regression line, indicating no publication bias. Conclusions The use of SpUAT for the diagnosis of adult community acquired SPP has a moderate sensitivity and high specificity. Although the overall accuracy of SpUAT diagnosis is relatively high, there is significant heterogeneity among the studies, so more high-quality studies are needed.

Objective To investigate whether the gamma-aminobutyric acid (GABAB) receptor genes,including gabbr1 gene and gabbr2 gene,are the susceptible genes for simple febrile seizures (sFS) by screening mutation of gabbr1 gene and gabbr2 gene and to study the possible association between sFS and the 2 genes.Methods All exons and flanking introns of gabbr1 gene and gabbr2 gene were amplified with polymerase chain reaction (PCR) and sequenced to screen the possible mutation on 60 children with sFS in the northern China in Han nationality population.One hundred and one healthy children from the same area were selected as controls,and the genotypes of single nucleotiole polymorphisms (SNPS) (rs29220,rs29230,rs29267 on gabbr1 gene and rs1000440,rs3205936,rs2304391 on gabbr2 gene) were typed by PCR-restriction fragment length polymorphism.EH1.20 software was used to estimate haplotype frequency to study the association with the haplotype as genetic marker between case group and control group.Results No mutation associated with sFS was found in the 60 sFS cases.In all sequenced regions,23 SNPs were identified in both genes:6 SNPs in gabbr1 gene and 17 SNPs in gabbr2 gene.The frequencies of the 6 SNPs were complied well with the Hardy-weinberg equilibrium in sFS group and normal group.Genotype proportions and allele frequencies of 6 SNPs were not significantly different between both groups.The haplotypes of 3 SNPs in gabbr1 gene and in gabbr2 gene distributions were not significantly different between 2 groups.Conclusions No mutations and associations were identified between sFS with both GABAB receptor genes(gabbr1 gene and gabbr2 gene).They may not be the susceptibility gene for simple febrile seizures in Han nationality population in northern China.

Aim To determine the effects of Qiliqian-gxin injected into lateral ventricle on Cardiac function, angiotensin Ⅱ( Ang Ⅱ) , angiotensin converting en-zyme(ACE), angiotensin type 1 receptor(AT1R) and the sympathetic nervous system in the hypothalamic pa-raventricular nucleus of rats with chronic heart failure. Methods Rat model of heart failure was prepared by acute myocardial infarction that was induced by ligation of the left anterior descending coronary artery. Four weeks after heart failure, Qiliqiangxin and Losartan were continuously administered via a syringe pump in-jector connected to lateral ventricle. After four weeks, echocardiogram was used to evaluate the cardiac func-tion and HE was used to observe myocardial tissue morphology, and enzyme linked immunosorbent assay was used to measure plasma norepinephrine( NE) , ser-um NT-proBNP and Ang Ⅱ in the paraventricular nu-cleus. The expression of ACE and AT1 R at mRNA and protein levels in the paraventricular nucleus was deter-mined by Real-time PCR and Western blot, and the RSNA was measured by PowerLab in anesthetized rats. Results Compared with the sham control, the cardiac function was significantly lower while the AngII, ACE, AT1 R expression in the paraventricular nucleus and RSNA were significantly increased in rats with heart failure. Compared with heart failure control, Qiliqian-gxin and Losartan decreased the RSNA and the AngII, ACE, AT1 R expression in the paraventricular nucleus. Conclusion Giving traditional Chinese medicine to the lateral ventricles can decrease the activation of the RAS system, reduce the renal sympathetic nerve activi-ty and improve cardiac function.

Objective To study the changes of neuron specific enolase(NSE) and S100? protein levels in serum after cardiopulmonary resuscitation(CPR) in rats,and and to evaluate their significance on early diagnosis of brain injury. Methods Caridiac arrest model was induced by asphyxiation with ice-cold 0.5 mol KCl in rats,and resuscitation 5 minutes after arrest.Fifty male Sprague Dawley rats were randomly divided into 5 groups : sham control group (n=10) and 4 routine treatment group (experimental group) (n=10,per group) . The blood samples were taken from rats at 6 , 12 , 24 , 48 hours after restoration of spontaneous circulation(ROSC).NSE and S100? measured by enzyme-linked immunosorbent assay were compared between each experimental group,serum from sham control animals was also analyzed. Results Both NSE and S100? were significantly increased in serum after ROSC when compared to sham controls(P

Objective To assess the role of Th 17/Treg cell imbalance in the pathogenesis of HenochSch(o)nlein purpura (HSP). Methods Peripheral blood was obtained from 59 children with HSP and 38 ageand sex-matched healthy subjects. Flow cytometric analysis (FCM) was performed to detect the percentage of CD4+IL17+ T (Th17) cells and CD4+CD25+ Foxp3+ T (Treg) cells, real-time RT-PCR to measure the mRNA expressions of RORγt and Foxp3, which are specific transcription factors of Th17 and Treg cells, respectively.Results Patients with HSP showed a significant increase in the percentage of Th17 cells and mRNA level of RORγt (1.87% ± 0.56% vs 0.39% ± 0.15%, 7.71 ± 1.95 vs 1.49 ± 0.57, both P＜ 0.01) and a statistical decrease in the percentage of Treg cells and mRNA level of Foxp3 ( 1.63% ± 0.44% vs 5.04% ± 1.44%, 0.34 ±0.11 vs 1.71 ± 0.69, both P ＜ 0.01 ) compared with the normal controls. No significant difference was observed in the percentage of Th17 or Treg cells or the mRNA levels of RORγt or Foxp3 among patients with different types of HSP. Conclusion In patients with HSP, there is a change in the pecentage of Th17/Treg cells and expression of their transcription factors, which may lead to immune imbalance and contribute to the development of HSP.