Objective To assess the efficacy of percutaneous transhepatie variceal embolization (PTVE) in treating esophageal and gastric variceal bleeding after esophageal-gastric devascularization with splenectomy in patients with liver cirrhosis. Methods Twenty-two patients, who had history of esophageal-gastric devascularization with splenectomy, were either underwent PTVE with TH glue (n=10) or endoscopic injection of sclerosis (EIS, n = 12) for treatment of esophageal or gastric variceal rebleeding between Nov. 2006 and Sep. 2008. The patients were followed-up for recurrent bleeding, mortality, grade of esophageal and gastric varices and liver function. Portal vein pressure was measured before and after collateral embolization in PTVE group. Results ① The patients were followed-up for 12.5 months in PTVE group and 13.4 months in EIS group. There was significant difference (P<0.05) between PTVE and EIS groups in rebleeding rate (1/10 vs 7/12) and mortality (0 vs 3/12). ② The degree of esophageal and gastric varices after embolization or EIS was improved significantly. ③ For patients with portal vein thrombosis, combination of PTVE with portal vein balloon plasty could markedly improve portal vein blood supply. ④ Neither PTVE nor EIS aggravated the liver cirrhosis. Conclusion Compared with EIS, PTVE with TH glue may be a more effiective method in the treatment of rebleeding of patients with liver cirrhosis who had accepted esophagealgastric devascularization with splenectomy.

Objective To discuss the influence of microRNA(miR)-155/miR-21 on toll-like receptor 4 (TLR4) in children with sepsis.Methods Fifty children with sepsis who were hospita-lized in Pediatric Intensive Care Unit,Shenzhen Children's Hospital,were enrolled in the study,and 15 healthy children at the same age were selected as healthy control group.Expression levels of TLR4 protein and human leukocyte antigen(HLA)-DR in CD14 + monocytes (MC) were detected by using flow cytometry,and sepsis patients were divided into 2 groups according to whether they exceeded the value of HLA-DR by 30％ or not.Expression level of programmed cell death factor 4 (PDCDM) and inositol phosphatases 1 containing SH2 (SHIP1) were detected at the same time.MC were separated by CD14 + immune magnetic bead,and expression level of miR-155,miR-21 and tumor necrosis factor-α (TNF-α),interleukin-10 (IL-10) mRNA in CD14 + MC were detected by using real-time fluorescent quantitative PCR.Results Sepsis group consisted of 27 male and 23 female,and their ages were (2.34 ± 0.79) years old,among whom 9 patients died.There were 36 patients in the HLA-DR increase group and 14 patients in the HLA-DR decrease group.Expressions ofTLR4(2.33±0.90),miR-155[(7.19±3.75) ×10 3] and TNF-α[(21.98±14.15) ×10-2 pg/L] in CD14 + MC were higher in the HLA-DR increase group than those in the HLA-DR decrease group [1.24±0.60,(4.83 ±1.17) × 10-3,(14.18±5.45) ×10-2 μg/L] and healthy control group[1.57±0.55,(3.99 ± 1.29) × 10-3,(1.61 ± 0.84) × 10 2 pg/L],and the differences were statistically significant(F =11.943,7.583,18.538,all P ＜0.05),while the expressions of miR-21 (12.10 ±5.66),IL-10[(29.74 ± 12.55) × 10-4 μg/L] in CD14 + MC were lower in the HLA-DR increase group than those in the HLA-DR decrease group[4.68 ± 2.07,(12.50 ± 5.73) × 10-4 μg/L] and healthy control group [2.39 ± 0.86,(2.04 ± 0.92) × 10-4 μg/L],and the differences were statistically significant(F =41.673,54.991,all P ＜ 0.05).The levels of SH1P1 and PDCD4 decreased in sepsis compared with healthy control group[0.70 ±0.36)vs.(1.59 ±0.48);(1.55 ±0.56) vs.(3.01 ±0.70)],and the differences were statistically significant (t =7.682,8.339,all P ＜ 0.05),but SHIP1 decreased more significantly in the HLA-DR increase group than that in the HLA-DR decrease group [(0.60 ± 0.34) vs.(0.97 ± 0.26)],and the difference was statistically significant (F =39.214,P ＜ 0.05).PDCD4 decreased more significantly in the HLA-DR decrease group than that in the HLA-DR increase group (0.94 ±0.19 vs.1.79 ±0.47),the difference was statistically significant(F =65.367,P ＜ 0.05).Conclusions Regulation imbalance of miR-155/miR-21 may be one of the reasons for abnormal expression of TLR4 in children with sepsis,and it plays a role in enlarged or inhibited expression of TLR4 in the sepsis process which results in different immune status in sepsis patients.

Objective: To investigate and analyze the clinical data of tetramine poisoning in a family and prevent similar incidents from happening again. Methods: The study was conducted in July 2016 in a fami-ly with thiamine poisoning in shandong province, and the clinical data were analyzed. Results: In this case, there are six cases of poisoning caused by the tetramine poisoning, and the convulsions are the main clinical manifestations, and the blood perfusion can have a good effect on the severe patients. After positive treatment, all 6 patients were cured. Conclusions The tetramine poisoning can cause severe convulsion, although the country has banned the production and use of it, the tetramine poisoning case still exist and cannot be ignored.

Objective: To investigate an incident of mushroom poisoning and related clinical data. Methods: A descriptive analysis was performed to investigate an incident of poisonous mushroom poisoning in Jinan, Shandong Province, China in July 2016. The clinical data of four patients were analyzed and summarized, and the causes of this incident and prevention and control measures were summarized. Results: This incident of acute poisonous mushroom poisoning was caused by Lepiota brunneoincarnata. The patients mainly had digestive system symptoms, including nausea, vomiting, and severe abdominal pain, and later developed liver damage. After comprehensive rescue treatment, one patient died and three survived. The main clinical manifestation of the patient who died was multiple organ failure, especially liver failure. Conclusion This incident of poisoning was caused by Lepiota brunneoincarnata the residents ate by mistake.

Objective: To investigation to an accident of occupational trichloroethylene explosion and analyze the clinical datas. Methods: An investigation was carried out on the explosion of trichloroethylene in a place in shandong province in June 2016, and the clinical data of 4 patients with trichloroethylene poisoning were analyzed. Results: The incident is caused by irregularities in workers, 4 patients were characterized by different levels of the respiratory system, nervous system, liver, and skin lesions. Among them, respiratory system damage was more prominent, mainly manifested as chemical bronchitis and pneumonia, after positive rescue and treatment all recovered and discharged. Conclusions Trichloroethylene leak can cause severe ex-plosion accidents, can cause workers of the respiratory system, nervous system, liver and skin lesions, mainly glucocorticoids comprehensive therapy has good curative effect.

Objective: To explore the acute toxicity of Diquat in mice and to calculate the median lethal dose (LD₅₀) of Diquat to rats and observe the pathological changes of tissues and organs in rats with different concentrations of Diquat. Methods: Diquat solution of 50 mg/kg was prepared freshly with 1 000 mg of Diquat and dilute the solution with water to a total of 20 ml. A total of 99 healthy adult male Wistar rats were randomly divided into part one, part two and control groups. In the first part, 36 rats were randomly divided into 4 groups: 100 mg/kg group, 200 mg/kg group, 300 mg/kg group and 400 mg/kg group, which were treated with 100 mg/kg, 200 mg/kg, 300 mg/kg and 400 mg/kg of Diquat solution by gavage, respectively. The death and symptoms of poisoning after intragastric administration were recorded, and the maximum tolerated dose and absolute lethal dose were measured. In the second part, 54 rats were randomly divided into 6 groups: 200 mg/kg group, 220 mg/kg group, 240 mg/kg group, 260 mg/kg、280 mg/kg group and 300 mg/kg group, whichwere treated with 200 mg/kg, 220 mg/kg, 240 mg/kg, 260 mg/kg, 280 mg/kg and 300 mg/kg of Diquat solution by gavage, respectively. The survival of rats in different concentration of Diquat was observed and the LD₅₀ was calculated by Excel processing the formula of Koch's method. The control group were given equal volume water under the same experimental conditions. And moreover, the lungs, kidneys, hearts, livers, and brain tissues were collected and fixed by formaldehyde, embedded by paraffin, and sectioned for histopathological light microscopy. Results: The maximum tolerated dose was 240 mg/kg and the absolute lethal dose was 300 mg/kg. The LD₅₀ of Diquat for Rats was 280.58 mg/kg. The high-dose group had significantly more organ damage than the low-dose group after diquat poisoning. Conclusion The determination of the half-lethal dose of diquat, at the same time observed multiple organs damaged in rats after the diquat quickly poisoned. Kidneys, lungs and heart might be the main organ which was heavily damaged. With the extension of observation time, the organ damage of rats exposed to small doses gradually stabilized.

Objective: To investigate a mass of occupational acute methyl bromide poisoning incident and analyzed their clinical data. Methods: To investigate an incident a mass of occupational acute methyl bromide poisoning in occurred in Shandong province in November 2016, and the clinical datas of 3 cases of severe patients with methyl bromide poisoning were analysed. Results: This event was a sudden occupational poisoning incident. Lack of vocational training and irregularities is the main reason for the accident 3 patients with nervous system, respiratory system, circulatory system, urinary system damage is given priority to, after comprehensive rescue treatment, 2 cases died and 1 case survived. Conclusions Methyl bromide can cause severe poisoning, has high mortality in patients with acute severe poisoning.

Objective:To investigation and analysis of ammonia gas leakage in a meat factory.Methods:In April 2013, Enterprise managers and workers were investigated, and clinical data of 24 patients were analyzed.Results:The company caused a leak in the ammonia pipeline maintenance operation, Among the patients, 20 had stimulus response and 4 had mild poisoning.Conclusion:To prevent group occupational ammonia poisoning, it is necessary to strengthen the awareness of occupational disease prevention of enterprise owners and the awareness of self-protection of workers.

Objective To investigate the expression of miR-146a in CD14+ monocytes (MC) of children with sepsis.Methods Forty children with sepsis in PICU were enrolled in the study.Fifteen children with systemic inflammatory response syndrome (SIRS) afteRsurgical treatment and fifteen healthy children were selected as control group.Expressions of miR-146a and TNF-α,IL-10 of CD14+ MC were detected by real-time quantitative PCR(qRT-PCR).HLA-DRlevels of CD14+ MC were detected by flow cytometry.Levels of high-sensitivity C-reactive protein (CRP) and procalcitonin (PCT) were detected.Results The HLA-DRlevels of CD14+ MC in all the children with sepsis were oveR30%.The miR-146a level of CD14+ MC were significantly higheRin sepsis group than SIRS group and healthy controls (P<0.05),and the level decreased when sepsis children were recovered (P<0.05).The TNF-α,IL-10 level of CD14+ MC in children with sepsis was significantly higheRthan healthy controls (P<0.05).Conclusion The expressions of CD14+ MC miR-146a in children with sepsis are significantly up-regulated.

Objective:To investigation and analysis of ammonia gas leakage in a meat factory.Methods:In April 2013, Enterprise managers and workers were investigated, and clinical data of 24 patients were analyzed.Results:The company caused a leak in the ammonia pipeline maintenance operation, Among the patients, 20 had stimulus response and 4 had mild poisoning.Conclusion:To prevent group occupational ammonia poisoning, it is necessary to strengthen the awareness of occupational disease prevention of enterprise owners and the awareness of self-protection of workers.