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BACKGROUND Organophosphorus poisoning (OP) is one of the common critical conditions in emergency departments in China, which is usually caused by suicide by taking oral drugs. Patients with severe OP have disturbance of consciousness, respiratory failure, toxic shock, gastrointestinal dysfunction, and so on. As far as we know, the perforation of the duodenum caused by OP has not been reported yet. CASE SUMMARY A 33-year-old male patient suffered from acute severe OP, associated with abdominal pain. Multiple computed tomography scans of the upper abdomen showed no evidence of intestinal perforation. However, retrograde digital subtraction angiography, performed via an abdominal drainage tube, revealed duodenal perforation. After conservative treatment, the symptoms eased and the patient was discharged from hospital. CONCLUSION Clinicians should pay close attention to gastrointestinal dysfunction and abdominal signs in patients with severe OP. If clinical manifestation and vital signs cannot be explained by common complications, stress duodenal ulcer or perforation should be highly suspected.

To investigate the correlation of the Netrin-1 expression level with the clinical characteristics in children with acute lymphoblastic leukemia (ALL) and to explore its possible regulatory mechanism.ELISA was used to detect the expression level of Netrin-1 in peripheral blood serum from 48 child ALL patients (newly diagnosed, recurrent), and its relevance with clinical indicators was statistically analyzed. The blood serum samples from 27 children with non malignant hematological diseases were choosen as controls. Leukemia cell lines of Jurkat,Molt-4,SUP-B15 and Raji were cultivated in vitro, after treated with different concentrations of recombinant human Netrin-1 protein， the invasive ability of the cells was detected by Transwell method； the effect of Netrin-1 to the proli feration of cells was detected by CCK-8 method； The expression and phosphorylation level of key molecules, such as FAK,Erk1/2,PI3K and Akt signaling pathway were detected by Western blot.The expression of Netrin-1 in child patients was significantly higher than that of the control group (P0.05). With the increasing of Netrin-1 level, the level of Plt (r=0.483, P0.05) increased, while the level of WBC (r=-0.290, P0.05) decreased, and there were no significant correlation with age, Hb level and the proportion of immature cells in bone marrow. When the concentration of Netrin-1 was 25-50 ng/ml, the level of Netrin-1 positively correlated with WBC (r=0.886, P0.05) ; the level of Netrin-1 significantly decreased when the patient's WBC was ＞50×10There is abnormal expression of Netrin-1 in serum of children with ALL. Netrin-1 may affect the occurrence and development of ALL by increasing the proliferation and invasiveness of leukemia cells, and may become a risk factor of ALL or a potential target in biotherapy.Netrin-1在急性淋巴细胞白血病患者中的表达及意义.研究Netrin-1蛋白在儿童急性淋巴细胞白血病（ALL）患者中的表达及其与临床指标的相关性，并探讨其可能的调控机制.采用ELISA法检测48例ALL患儿（初诊、复发）外周血血清中Netrin-1的表达水平，并分析其与27例非恶性血液病患儿对照样本表达水平的差异，进而分析ALL外周血Netrin-1水平与临床指标的相关性。体外培养ALL细胞Jurkat、Molt-4、SUP-B15和Raji，经不同浓度重组人Netrin-1蛋白处理后，用Transwell法检测细胞的侵袭能力；CCK-8法测定Netrin-1对细胞增殖的作用；采用Western blot 检测FAK、Erk1/2、PI3K、Akt等信号通路关键蛋白的表达及其磷酸化水平.ALL患儿外周血中Netrin-1的表达量显著高于对照组（P＜0.05）。随着Netrin-1表达水平的上调，WBC水平（r=-0.290，P＜0.05）呈下降趋势，Plt水平（r=0.483，P＜0.05）呈上升趋势，且与年龄、Hb水平、骨髓幼稚细胞比例无显著相关性；Netrin-1浓度在25-50 ng/ml水平时，Netrin-1水平与WBC（r=0.886，P＜0.05）呈正相关； WBC50×10ALL患儿血清中存在Netrin-1的异常表达，Netrin-1可能通过增加白血病细胞的增殖、侵袭能力来影响ALL的发生发展，可能成为ALL的危险因素或生物治疗中的潜在靶点.

Autosomal dominant hyper IgE syndrome (AD-HIES) caused by STAT3 gene mutation is a rare primary immunodeficiency disease. To better understand the disease, we described the clinical characteristics of 20 AD-HIES patients in Chongqing, China and explored the effect of mutations in different domains of STAT3 gene on the function of STAT3 protein by Western blot and confocal microscopy. The mean age at onset was 0.12 years. The mean age at diagnosis was 5.31 years. The most common presentation was eczema, pneumonia, skin abscesses and chronic mucocutaneous candidiasis. Seven patients suffered from BCG complications. R382W/Q were identified in 12 patients, V637M mutation in three patients. Three patients have died. The phosphorylated STAT3 was expressed more in wild-type(WT) and R382W mutant STAT3 in the cytoplasm of COS7 cells with epidermal growth factor(EGF) stimulation, less in the V637M mutation and T620S mutation. Dynamic observation showed that STAT3 cytoplasmic accumulation and nuclear translocation occurred rapidly after EGF stimulation in WT-STAT3-GFP, the time of accumulation and nuclear translocation was later and the expression was less in R382W-STAT3-GFP compared with WT-STAT3-GFP, followed by V637M and T620S mutation. These results suggested that our patients had earlier onset, diagnostic age and higher rate of BCG complications. However, our patients had higher incidence of mortality though the earlier diagnostic age. We did not find a significant genotype/phenotype correlation, but Src homology 2 domain mutations (V637M and T620S) had a greater effect on STAT3 phosphorylation and nuclear translocation than DNA-binding domain mutation (R382W) in vitro.

Chronic granulomatous disease (CGD) is an inherited disorder, with phagocytes failing to produce antimicrobial superoxide due to deficient NADPH oxidase activity. Mutations in the gene encoding CYBB are responsible for the majority of the CGD cases. To date, there have been no reports on large samples of children with CGD in China. Therefore, in this study, we described the clinical and molecular features of 38 suspected CGD patients from 36 unrelated Chinese families. Clinical diagnosis was performed using dihydrorhodamine assays detected by flow cytometry. Molecular analysis was used to identify underlying CGD-causative genes. The mean age of onset in our 38 patients was 3.4 months, while the mean age at diagnosis was 31.7 months. Apart from recurrent pneumonia and abscesses, tuberculosis (TB) and Bacille Calmette-Guerin (BCG) infections were notable features in our cohort. Overall, 17 cases died and patient 1 did not participate in the follow-up period . In total, we identified 29 different CYBB gene mutations in 31 patients. We found NCF1 and CYBA mutations in 3 and 2 patients, respectively. In addition, we identified 31 carriers and prenatally diagnosed 4 CGD and 4 healthy fetuses. The results of our study demonstrate that children with BCG infections or recurrent TB infections should have immune function screening tests performed. Moreover, newborns with family histories of primary immunodeficiency diseases should avoid of BCG vaccination. Molecular analysis is an important tool for identifying patients, carriers, and high-risk CGD fetuses.

Hyper-IgE syndrome (HIES) is a rare primary immunodeficiency disease characterized by eczema, recurrent staphylococcal aureus skin abscesses, pneumonia with pneumatocele formation, remarkably high serum IgE levels, eosinophilia and involvement of skeleton and connective tissues. Heterozygous signal transducer and activator of transcription 3 (STAT3) mutations were shown to be the cause of autosomal dominant HIES (AD-HIES). In this study, we diagnosed nine patients with HIES from 9 unrelated families on the basis of a National Institutes of Health (NIH) score of ≥40 points, sequenced the STAT3 gene of all nine patients, and quantified Th17 cells in peripheral blood of seven patients by flow cytometry in mainland China. All nine patients had characteristic manifestation of HIES with the range of NIH scores 45-77 points. STAT3 hot mutations V637M or R382W/Q were identified in five patients. We identified two novel heterozygous missense mutations (T620S and R609G) located in Src homology 2 (SH2) domain in two patients, respectively. In two other patients, no STAT3 mutations were found. Quantified Th17 cell numbers were markedly decreased or absent (0-0.28% of CD4(+) T cells) in six patients with STAT3 mutations and almost normal (0.53% of CD4(+) T cells) in one wild-type STAT3 patient compared with healthy controls (0.40-2.25% of CD4(+) T cells). These results suggest that not all patients with HIES who had NIH scores over 40 points carry STAT3 mutations, those whose Th17 cell numbers strikingly decreased probably had AD-HIES with STAT3 mutations.

Summary Objectives To confirm the effect of occupational safety training and education programs (OSTEP) on needlestick injuries (NSIs) among nursing students in China. Methods Compare the rates and the nature of NSIs before and after OSTEP among the nursing students in China. Firstly, questionnaires were delivered to 248 randomly selected nursing students from seven training hospitals to obtain basic information concerning relevant occupational NSIs. Then regular intervention measures through OSTEP on 246 nursing students had been introduced for four years. And the resultant information concerning relevant occupational NSIs was obtained afterwards. Finally, the data analysis was performed using SPSS software, version 11.5. Results The rate of NSIs among these nursing students was relatively high before the OSTEP in China (average, 4.65 events/nurse). However, it decreased rapidly to 0.16 events/nurse average after the OSTEP. Occupational safety awareness and behavior in handling NSIs was improved in China. There was a significant difference in the results of Chi-square value (P Conclusions NSIs are common in nursing students in China. The OSTEP can reduce NSIs and change practical behavior markedly among nursing students in China. We should perform OSTEP on nurse students before and during the clinical practice. We must also provide effective preventive measures to reduce this kind of problem in future.

Aim at the actual operating condition of Su Cuo buried oil pipeline, the simulation model of this pipeline operation was built by the simulation software of TLNET to simulate the running states of pipeline in different operating conditions. With the target of saving energy and reducing consumption, the operating parameters of this pipeline with different throughput and different seasons were optimized, and the optimization results can be used to guide the pipeline operation.

On the basis of analyzing process and structure characteristics of branch shape water-injection pipe network, this paper established a hydraulic calculation method of branch shape water-injection pipe network based on binary tree. This method has many advantages, such as calculation speed is fast, occupying less memory, having high calculation accuracy, and so on. According to it, this paper compiled a computer program and presented an actual example.

The interaction between tosufloxacin (TELX) and bovine lactoferrin (BLF) in aqueous solution was analyzed by fluorescence spectroscopy and absorbance spectra. The binding parameters and energy-transfer efficiency parameters were determined and the mechanism of interaction was discussed. The effect of tosufloxacin acting on the BLF’s conformation was detected and the unfolding procedure of BLF induced by tosufloxacin was explored by “fluorescence phase diagram”. Following experimental data of fluorescence polarization values P and r, the saturation characteristic of such kind of binding reaction was observed for the first time. The interaction between tosufloxacin and BLF influenced by Ni2+ and Co2+ were also preliminarily explored in this work.