Objective To explore the sedation and analgesia effect of dexmedetomidine (DEX) in patients with multiple trauma during mechanical ventilation.Methods Eighty cases of multiple trauma patients under mechanical ventilation treated from September 2016 to March 2017 were analyzed by retrospective case-control study.There were 58 males and 22 females with an age range of 18-60 years (mean,41.87 years).The injury severity score (ISS) was (18.45 ±4.53)points.The patients were treated with sedation and analgesia,and they were divided into two groups according to the sedative drugs.DEX composite tartaric acid butorphanol were used in 40 patients as DEX group.Midazolam composite tartaric acid butorphanol were used in 40 patients as Midazolam group.The degree of sedation score (Ramsay score) were compared between groups.The time from initial drug use to effective sedation achievement,daily wake-up time,mechanical ventilation duration,emergency intensive care unit (EICU) time,dosage of tartaric acid butorphanol,heart rate,blood pressure changes,and incidence of delirium were compared.Results (1) Two groups could both reach the target of sedation.DEX group had shorter daily wake-up time,shorter mechanical ventilation time and shorter length of EICU stay compared with Midazolam group (P ＜ 0.05).(2) The time to achieve satisfied sedation after initial usage in Midazolam group was shorter than that in DEX group (P ＜ 0.05).(3) DEX group had smaller tartaric dosage of acid butorphanol,and lower incidence of delirium compared those in Midazolam group (P ＜ 0.05).(4) The comparison of systolic blood pressure,diastolic blood pressure,heart rate within either group showed significant difference before and after sedation (P ＜ 0.05),but had no significant difference between two groups (P ＞ 0.05).Conclusions For multiple trauma patients with mechanical ventilation,DEX can attain sedation and analgesia and shorten daily wake-up time,mechanical ventilation time,and length of hospital stay.DEX can reduce the dosage of analgesic (butorphanol) and the incidence of delirium.Blood pressure and heart rate are associated with small variations before and after sedation.

Objective To retrospectively study the serum IgG and IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2 in various populations, and analyze the clinical values.Methods From 2008 to 2015, 2 661 pregnant women, 324 infertile women, 2 492 women with abnormal pregnancy history, 623 women with recent abnormal pregnancy, 261 infants with intrauterine growth retardation and other diseases, 170 women for preconceptual examination, and 702 women for physical examination in Beijing were included .Commercial EIA kits were used to detect serum IgG and IgM antibodies to toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2. Positive reactions of IgM antibodies to any pathogens were re-tested with another kind of commercial EIA kit. PEMS3.1 software was used for statistical analysis.Results The prevalence of serum IgG or IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1& 2 were found within 0.7%-1.6%(0-1.2%) , 85.3%-92.0% ( 0.4%-2.7%) , 89.1%-94.9% ( 0.7%-1.7%) , 74.8%-86.0% ( 0 -0.7%) , 8.1% -17.4% ( 0 -4.1%) respectively in the studied population groups.The prevalence of TORCH IgG and IgM antibodies were not found to be higher in both populations with past suspicious exposure ( infertile women and women with abnormal pregnancy history ) and recent suspicious exposure ( women with recent abnormal pregnancy and infants with intrauterine growth retardation and other diseases) than that in pregnant women and women for preconceptual and physical examination. Conclusion No associations between TORCH infections and the suspicious exposure were found in the populations above.

The infection rate of human cytomegalovirus (CMV) in the general population in our country is very high.The latent virus often becomes activated when patients' immune status turned to immunocompromised,which will cause serious clinical consequences.Because the manifestations of cytomegalovirus infection are nonspecific,the diagnosis of cytomegalovirus infection mainly depends on the laboratory tests.This article will review laboratory diagnostic methods and clinical significance of CMV infection in immunosuppression patients.

Objective To assess the efficacy of the two antiviral medications in preventing cytomegalovirus infection and cytomegalovirus disease in renal transplant recipients.Method We searched articles from Pubmed,EMbase,Cochrane Library,Wanfang Med Online,and China's biomedical journal citation database on line.Randomized controlled trials evaluating preemptive treatment and universal prophylaxis for cytomegalovirus infection and cytomegalovirus disease in renal transplant recipients were reviewed.Two reviewers screened studies and assessed study quality according to the study population,intervention measure and results.Finally data from included studies were subjected to meta-analysis.Result Six studies involving total 752 renal transplant recipients were included in this review.Compared with preemptive treatment,universal prophylaxis significantly reduced the risk of cytomegalovirus infection at 3 rd and 12 th month,and the risk of cytomegalovirus disease at 12 th month after transplantation (RR =12.13,95 ％ CI.6.59～22.36,P＜0.05; RR =2.21,95％CI:1.62～3.01,P＜0.05; RR=1.79,95％Chl.22～2.63,P＜0.05).There was no statistically significant difference in the incidence of other opportunistic infection and acute rejection.Conclusion Universal prophylaxis was more effective than preemptive treatment in preventing CMV infection and CMV disease in renal transplant recipients.

ObjectiveTo analyze the seroepidemiologic of Mycoplasma pneumoniae infection and evaluate antibiotics medication of some positive patients by follow-up. Methods Serodia-MycolⅡ particle agglutination assay was used to detect serum antibodies against Mycoplasma pneumoniae in 3 134 clinically suspected infections. Mycoplasma pneumoniae infection was determined and seroepidemiologic was analyzed by results of the test, including positive antibody rates in whole subjects, in male or female groups, in different seasons or age groups as well as in different sources. Evaluate antibiotics medication of some positive patients by follow-up. The average days of medication were counted, different antibiotics medication and medication effect were analyzed. Results In 3 134 serum samples from clinically suspected Mycoplasma pneumoniae infections, 350 ( 11.2％ ) were tested with positive antibodies. The positive antibody rate in female patients was 12. 3％ ( 198/1 604), which was higher than 9. 9％ ( 152/1 530) in males (X2 =4. 58,P ＜0. 05). The peak season was found in the fourth quarter (October-December) with 13.2％ of positive antibody and the highest positive rate (32. 8％, 45/137 ) was found in school aged (5 -9 years old )children. Samples from pediatrics clinic and ward were tested to have highest positive rates ( 27. 9％ and 26. 5％, respectively ), comparing that from other sources. Infection due to Mycoplasma pneumoniae was identified in 28％ (7/25) of community-acquired pneumonia (CAP) patients, which is higher than other diseases. Based on the follow-up of 91 antibody positive patients, between 5 to 120 days ( mean 24. 2 days )were counted from appearance of clinical symptoms to clinic visiting/testing. 71 of 91 (78. 0％ ) patients was medicated with macrolide antibiotics, 4 (4. 4％ ) with quinolones, 4 (4. 4％ ) with cephalosporin, and the rest 12 ( 13.2％ ) patients were medicated with other antibiotics or only symptomatic treatment. The average period of antibiotics medication was between 3 to 21 days (mean 8. 2 days). Medication effect results by follow-up were cure in 35 ( 38. 5％ ), improvement in 50 (54. 9％ ), and poor responses in 6 (6. 6％ ).ConclusionsMycoplasma pneumoniae positive rate in female patients was higher than in males, and peak rate was found in the fourth quarter and in school aged children. Samples from pediatrics clinic and ward were tested to have highest positive rates. Physicians could choose first line antibiotics according to laboratory test results of Mycoplasma pneumoniae, and gain good effect.

Objective To establish plaque reduction assay and evaluate the activities of oseltamivir (tamiflu),amantadine,ribavirin and herb radix isatidis against influenza virus in vitro.Methods Plaque reduction assay was used to determine IC_(50) values of four studied drugs above in this susceptibility testing in which 8 clinical isolates(three influenza A virus isolates and five influenza B virus isolateds)were inoculated and tested.Results By testing of 8 clinical isolates of influenza virus A and B isolated between the year 2001 to 2008,oseltamivir and amantadine were found to be sensitive to influenza A virus with IC_(50) of 0.064 -0.128 mg/L and 0.5 mg/L,respectively.However,ribavirin(IC_(50)>8 mg/L)was not found to be sensitive,and herb radix isatidis had totally no activities.Unfortunately.all four studied drugs were not found to have activities against influenza B virus in vitro.Conclusions It Was indicated that oseltamivir and amantadine.but not ribavirin and herb radix isatidis.are sensitive to influenza A virus.All four studied drugs were not found to have activities against influenza B virus in vitro.

ted by the ECI analyzer.

Objective To detect the expression of SALL4 in patients with acute myeloid leukemia (AML) and analyze its potential clinical significance. Methods Reverse transcription polymerase chain reaction and Real-time fluorescence quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) was used to examine SALLA expression in peripheral blood mononuclear cells (PBMCs) of 68 cases of AML including 36 cases in acute phase and 32 cases in remission phase, 30 healthy controls, Kasumi-1 cells and THP-1 cells. Then, flow cytometry, bone marrow smear and automated hematology analyzer were used to analyze the relationship between the SALL4 expression and blast cell counts in the bone marrow, peripheral white blood cell (WBC) counts, peripheral large unstained cell (LUC), CD34 in blast cells. Further, the change of SALL4 level during pre-chemotherapy, chemotherapy (2nd w to 3rd w) and remission were investigated in 5 AML cases. Results The level of SALL4 expression in patients with AML in acute phase [69.01 (17.20-120.28)] was 26-fold and 61-fold high compared with that in remission phase [2.64(1.35-5.41)] and in healthy control [1.14(0.50-1.62)] (Z=-6.48,-6.83,P<0.01). The level of SALL4 expression in remission phase was 2.3-fold high compared with that in healthy control (Z=-3.61 ,P<0.01). The expression level of SALL4 was decreased along with efficient chemotherapy in 5 AML cases in which SALL4 expression level was 79.74 (33.76-89.09), 7.19 (5.97-20.21) and 3.40 (1.44-15.53) during pre-chemotherapy, chemotherapy (2nd w to 3rd w) and remission, respectively. In groups of abnormal increased counts of blast cell, peripheral LUC% and CD34%, expression of SALL4 [33.82 (16.00-144.01), 30.70(23.75-72.50) and 56.25(23.79-153.81), respectively] were higher than that in groups of normal counts [2.74 (1.59-5.13), 5.71 (2.52-22.40) and 20.82 (14.03-55.12), respectively ] (Z=-4.64,-2.18,-3.66,P<0.01 or P<0.05). The expression of SALL4 in the group of increased WBC counts [89.26(23.75-154.34)] was higher than that in the group of normal WBC counts [3.86(2.03-6.01)] and the group of decreased WBC counts [6.66(2.51-17.06)] (Z=-4.91,-4.21,P<0.01). The level of SALL4 expression was positively correlated with blast cell counts in bone marrow and peripheral WBC counts (r=0.45,0.40,P<0.01). Conclusions FQ-RT-PCR method can be used successfully to detect the expression of SALL4,and the expression of SALLA may be useful to predict disease progression of AML.

Objective To evaluate the activities of four demestic macrolides against C. trachomatis and C. pneumoniae by antimicrobiai susceptibility testing. Methods Cell culture and immunoflourescence staining of chlamydial inclusions were used to determine MICs of four demestic macrolides against C. trachomatis and C. pneumoniae. Results MIC (0.5 μg/ml) was found for acylspriramycin,erythromycin and azithromycin against C. trachomatis serovar B while it was 4 μg/ml for acetylspiramycin. Agaisnt C. trachomatis serovar D, MIC was 0.25 μg/mi in both acylspriramycin and azithromycin, and MICs were 0.5 μg/ml and 2 μml in erythromycin and acetylspiramycin, separately. Agaisnt C. pneumoniae TWAR, erythromycin was the most active with MIC≤0. 016 μg/ml, acylspriramycin and azithromycin were the second with same M1C of 0.032 μg/ml. However, acetylspiramycin was less active with 0.5 μg/ml of MIC. Conclusion Except acetylspiramycin, acylspriramycin erythromycin and azithromycin had reliable activities against both C. trachomatis (serovar B and D) and C. pneumoniae.

Objective To clone human Sjogren's syndrome antigen A(SSA)for expressing of antigen SSA-52kD and establishing a new clinical detecting method.Methods According to the human SSA-52kD cDNA sequence reported in GenBank,primers of human SSA-52kD cDNA were designed and synthesized.Human SSA-52kD cDNA was amplified from RNA of cultured Hela cell by reverse transcriptase polymerase chain reaction(RT-PCR).The production of amplification was ligated to PET-30a vector and then transformed into the competent bacteria DH5?to construct the recombinant plasmid PET-30a-SSA-52kD.The recombinant plasmid was digested with Bgl Ⅱ and Hind Ⅲ,and positive clones were sequenced.Results The Human SSA-52kD cDNA fragment containing 1447bp was amplified by RT-PCR.Restriction endonuclease mapping using Bgl II and Hind III showed that the target gene was inserted into the recombinant plasmid.The complete coding sequence of Human SSA-52kD was consistent with that of GenBank through DNA sequencing.Conclusions The full length of human SSA-52kD cDNA was successfully cloned and the recombinant plasmid PET-30a-SSA-52kD was constructed.