0.05) Conclusion Subtotal colectomy and intraoperative colonic irrigation are effective methods for management of obstructing carcinoma in the left colon To select an effective technique depends on the analysis of the practical situations and evaluation of the idiographic complexions.

Objective To explore the current status of healthcare-associated infection (HAI)and antimicrobial use in a children’s hospital.Methods Prevalence rates of HAI and antimicrobial use among hospitalized patients at 0∶00—24∶00 of May 1 ,2014 were investigated by combination of bedside visiting and medical record reviewing. Results A total of 1 027 patients were investigated,8 patients developed 10 times of infection,prevalence rate of HAI was 0.78%,prevalence case rate was 0.97%.HAI mainly occurred in patients in blood center (n =4),the main infection site was respiratory tract(upper respiratory tract,n=2;lower respiratory tract,n=2),antimicrobial usage rate was 62.12%.Antimicrobial usage rate,purpose of antimicrobial use,and combination use of antimicro-bial agents among different departments were all significantly different(all P <0.05).The departments with top 3 antimicrobial usage rates were neonatal center(89.69%),emergency center(76.00%),and comprehensive depart-ment(73.91 %);except department of ophthalmology-otorhinolaryngology-stomatology (preventive antimicrobial use accounted for 57.89%)and department of surgery(therapeutic antimicrobial use accounted for 26.32%),the other departments mainly used therapeutic antimicrobial agents;department of ophthalmology-otorhinolaryngology-stoma-tology,heart center,and neurological rehabilitation center mainly adopted single medication treatment (all >95%), two-drug combination rate in neonatal center accounted for 48.28%,three-drug combination rate in blood center ac-counted for 30.30%.Conclusion Routine surveillance on departments and sites of high HAI incidence should be in-tensified in children’s hospitals,training on knowledge of HAI among health care workers should be strengthened, and antimicrobial should be used rationally.

ObjectiveTo observe the effect of donor liver pretreated by breviscapine on liver transplantation ischemia/reperfusion injury in rats. Methods SD rats served as liver donors and recipients (n =48 each).The recipients were divided into four groups by random number table.The donors in groups A and C were not pretreated with breviscapine,but those in groups B and D were pretreated with 20 mg/L Breviscapine.The cold ischemia time in donor livers of groups A and B was 30-40 min,and that in groups C and D was 12 h. Clotting function, liver function, serum thrombomodulin,caspase3,and relative activity of NF-kB after liver transplantation were assessed,and the pathological changes and TUNEL apoptosis staining were observed.ResultsThe mortality in groups C and D was 40.0％ (8/20) and 29.4％ (5/17),respectively (P＞0.05).There were no significant changes in coagulation function in all groups after operation. The liver function was improved,pathological lesions were alleviated,and apoptosis rate,serum TM,caspase3 expression and activity of NF-kB in the liver tissues of group D were significantly decreased as compared with group C at 3rd day after operation (P＜0.01),but all these parameters in group B had no significant change compared to group A.ConclusionPretreatment of donor livers with breviscapine can reduce the ischemia/reperfusion injury and apoptosis after liver transplantation in rats probably by inhibiting the apoptosis-related pathway and alleviating the damage to the endothelial cells of the liver microcirculation.

Aim To observe the effects of rapamycin (Rapa) and starvation-induced autophagy on the morphology of neuronal cells, tau protein aggregation and expression of phosphorylated tau protein, to explore the possible mechanism of cytoprotective effect of these two classical autophagy inducers on phosphorylated tau expressing cells.Methods N2a cells were transfected with GFP-tau plasmid, and equal amount of empty vector was used as control.Then cells were incubated with or without okadaic acid(OA) for 12 h, followed by treatment with autophagy inducers rapamycin(Rapa) and EBSS, autophagy inhibitor Bafilomycin A1(Baf A1) for 6 h.DAB was used to observe tau expression and cell morphology.Confocal microscopy was used to observe the intracellular tau aggregation.TUNEL assay and cleaved caspase-3 level were used to detect cell apoptosis.Immunoblot was used to detect the expression of phosphorylated tau and autophagy-related proteins.Results Our study showed that the N2a cells treated with OA exhibited small cell body, retracted processes and increased tau aggregation, compared with only tau-expressing cells.Rapa and EBSS treatment significantly improved cell morphology, decreased tau aggregation and reduced cell apoptosis.On the contrary, Baf A1 treatment induced aberrant cell shape and increased tau aggregation and cell apoptosis.In addition, Rapa significantly decreased the high molecular weight, phosphorylated tau whereas EBSS especially decreased the low molecular weight phosphorylated tau.Conclusions Rapa and EBSS is alleviate hyperphosphorylated tau-induced cytotoxicity through different mechanism.Rapamycin mainly decreases phosphorylated tau oligomers, while EBSS liable to decrease the soluble phosphorylated tau.

Objective Membranous nephropathy ( MN) is rarely complicated by crescents.This study was to observe the clinicopathologic characteristics of MN with crescents. Methods This retrospective study included 53 cases of biopsy-proven idiopathic MN with crescents in the absence of immunologic and clinical etiologic factors and another 100 MN patients without histological crescents as controls.The clinicopathologic features, treatment response, and out-comes were analyzed and compared between the two groups of pa-tients. Results Significantly higher percentages of hypertension and decreased eGFR were observed in the MN +crescents group than in the control (47.2%vs 19.0%, P<0.05;28.3%vs 40.%, P<0.05).Circulating autoantibodies against the M-type phospholipase A2 receptor (PLA2R) were found in 66.7%(30/45) of the patients.The glomeruli exhibited a median of 4.6%(1.8%-35.3%) involvement of crescents.Compared with the controls, the MN +crescents group showed remarkably higher rates of segmental glomer-ulosclerosis lesions (16.0%vs 49.1%, P<0.05), capillary loops necrosis (0.0%vs 11.3%, P<0.05), interstitial fibrosis/tubu-lar atrophy (IFTA) (54.0%vs 86.8%, P<0.05) and afferent arterial lesions (65.0%vs 92.5%, P<0.05).No significant differ-ences were found in the outcomes of the two groups of patients. Conclusion MN with crescents is rare, and secondary MN and cres-centic glomerulonephritis should be considered.Crescentic MN usually presents with hypertension and renal dysfunction clinically and high rates of severe segmental and global glomerulosclerosis, capillary loops necrosis, and IFTA histologically.The condition has a fa-vorable short-term prognosis.

Five field strains of infectious bronchitis virus (IBV) were isolated from suspected flocks from different time and different regions of Shanxi province,respectively,and characterized by a series of systematic identification assays,such as morphological observation by electron-microscope,interfering with the propagation of NDV,virus pathological role to chicken embryo,virus pathological role to SPF chickens,hemagglutination activity,physiscochemical,and reverse transcription polymerase chain reaction(RT-PCR).The results showed:The typical coronavirus which the spherical virions 60-120 nm in diameter and surface covered with spike like corona were observed under electron-microscope)The propagation of NDV strain was seriously interfered by the 5 isolates respectively;The embryonated chicken egg passages of the 5 isolates could dwarf with chicken embryos;The five isolates had no hemagglutination activity,but after treatment with 1% trypsin,it can agglutinate chicken red blood cell.The strains are sensitive to chloroform and ethyl ether.The SPF chickens which inoculated with the 5 isolates showed clinical sign and result in respiratory and kidney diseases,flower-steak,and swollen with severe urate deposition.The specific fragments of N gene of the 5 isolates were amplified by RT-PCR,respectiveiy.On the basis of all above mentioned results,the 5 isolates were classified as IBV.The study got a good preparedness for further study on molecular epidemioogy of the 5 IBV isolates.

ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.

Hematoma enlargement occurs in about 20％ ～ 30％ of patients with intraeerebral hemorrhage,leading to worsening of the medical conditions and severe economic and social burden.It is pivotal to explore its mechanism and predictors,establish reliable prediction model,to understand the occurrence,development and treatment of the disease.In this paper,the physiopathologic mechanisms,imaging predictors,biochemical predictors,prediction models of hematoma enlargement are summarized as follows.

Objective To evaluate the efficacy of Scrophularia ningpoensis granules combined with fosinopril in treatment of congestive heart failure.Methods 60 congestive heart failure patients were randomly divided into 2 groups, 30 patients in the treatment group and 30 patients in the control group.Besides the conventional therapy, the control group was treated with fosinopril and the treatment group received Scrophularia ningpoensis granules plus fosinopril for 90 days.Left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and serum B-type brain natriuretic peptide (BNP) were measured before and after treatment.Results The total effective rate in the treatment group and the control group were 90%, but significantly effective number in the treatment group was higher than the control group.The levels of BNP, LVEDD and LVESD in both groups were decreased, while LVEF was increased after the treatment.The difference was statistically significant (P<0.01).The degree of improvement of heart function in the treatment group was better than that in the control group (P<0.05).Conclusion The combination therapy of Scrophularia ningpoensis granules and fosinopril is efficacious in treating CHF.

Objective To establish a high-throughput in-vitro screening cell model for anti-atherosclerosis leading compounds.Methods Hypoxia response element (HRE) was cloned into a luciferase reporter vector, pGL3-Enhancer, to construct pGL3-HIF-1α-HRE.The THP-1human monocyte cell line was infected with the pGL3-HIF-1α-HRE and a stable cell line, THP-1-HIF-1α-HRE, was screened.Results Real-time PCR assay showed that HIF-1αexpression and luciferase activity in THP-1-HIF-1α-HRE cells was effectively upregulated by hypoxia.The increase of HIF-1αexpression and luciferase activity induced by hypoxia was significantly inhibited by lovastatin or curcumin.Conclusion THP1-HIF-1α-HRE, an in-vitro cell model for high-throughput screening lead compounds for anti-atherosclerosis (AS) was successfully established.