Objective To study the evolution and significance of cellular immune function in the children with nephrotic syndrome. Methods The level of peripheral blood T lymphocyte, netural killer in the children with nephrotic syndrome( n = 45) and normal controls group ( n = 30 ) were detected by flow cytometry. Results The percentage of CD3+ cells, CD4+ cells, CD(+16 + 56)+ cells and the ratio of CD4+/CD8+ were significantly lower at nephrotic syndrome active stage than thee in nephrotic syndrome catabasis stage and normal controls group( P < 0.05 ), the percentage of CD3+ cells were significantly lower at nephrotic syndrome catabasis stage than that in normal control group( P < 0.05 ). Conclusion The invasion of nephrotic syndrome was related to cellular immune function.

Objective To study the level of serum interleukin-8 and its clinical significance in the children with nephrotic syndrome. Methods The level of serum interleukin-8 in the children with nephrotic syndrome(n=45 ) and normal controls group(n=35) were detected by enzyme linked immunosorbent assay. Results The level of serum interleukin-8 in children with nephrotic syndrome at acute stage were significantly higher than those in nephrotie syndrome at catabasis stage and normal controls group(P＜0.05). The level of serum albumin in children with nephrotic syndrome at acute stage and catabasis stage were significantly lower than that in normal controls group(P＜0.05), the level of serum albumin in children with nephrotic syndrome at acute stage were significantly lower than that in catabasis stage(P＜0.05). There was a negative correlation between the level of interleukin 8 and the level of serum albumin in children with nephrotic syndrome at acute stage(r=-0. 607, P＜0.05 ). Conclusion The invasion of nephrotic syndrome maybe were related to interleukin-8.

The clinical data of 96 intubated inpatients with restricted cervical movement from June 2012 to June 2014 were retrospectively reviewed.They were divided into fiberoptic bronchoscope, Shikani optical stylet and McCoy laryngoscope groups (n =32 each).Identical anesthesia induction was applied.Compared with McCoy laryngoscope group, the total success rate and one-time success rate of tracheal intubation was higher in Shikani optical stylet group, tracheal intubation time was shorter and postoperative complications were fewer (P ＜ 0.05).Compared with group F, endotracheal intubation time was shorter (P ＜0.05).However, heart rate, mean arterial pressure (MAP), oxygen saturation (SpO2), total success rate of tracheal intubation, one-time success rate of tracheal intubation and complication rate showed no significant inter-group differences at all timepoints (P ＞ 0.05).Shikani optical stylet intubation has a less impact on hemodynamics and intubation time is short so that it is ideal for surgical patients with restricted cervical spine.

Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.

In this article a new principle of geometric design for blade's surface of an impeller is provided. This is an optimal control problem for the boundary geometric shape of flow and the control variable is the surface of the blade. We give a minimal functional depending on the geometry of the blade's surface and such that the flow's loss achieves minimum. The existence of the solution of the optimal control problem is proved and the Euler-Lagrange equations for the surface of the blade are derived. In addition, under a new curvilinear coordinate system, the flow domain between the two blades becomes a fixed hexahedron, and the surface as a mapping from a bounded domain in R2 into R3, is explicitly appearing in the objective functional. The Navier-Stokes equations, which include the mapping in their coefficients, can be computed by using operator splitting algorithm. Furthermore, derivatives of the solution of Navier-Stokes equations with respect to the mapping satisfy linearized Navier-Stokes equations which can be solved by using operator splitting algorithms too. Hence, a conjugate gradient method can be used to solve the optimal control problem.

Objective To investigate the effect of liraglutide and metformin hydrochioride on overweight diabetic patients because of poor glycemic control.Methods Forty-four overweight patients with poor glycemic control were randomly divided to the control group,the liraglutide group and the metformin hydrochioride group.Patients in control group were given diet and exercise control,in liraglutide group and the metformin hydrochioride group were given subcutaneous injection liraglutide,metformin hydrochioride oral treatment respectively for 12 weeks.Body mass index(BMI),fasting blood glucose (FBG),2-hour postprandial blood glucose (2 hPBG) and glycosylated hemoglobin (HbA1c) were measured.Results Compared with pretreatment,FBG,2 hPBG and HbA1c of patients in liraglutide group and metformin hydrochioride group were lower after treatment,and there was significant difference between the two group and the control group after treatment(P ＜ 0.05).BMI of patients in liraglutide group was (24.61 ± 3.47) kg/m2,lower than of the control group((25.37 ± 4.70) kg/m2,P ＜ 0.05).2 hPBG of patients in the liraglutide group was (7.13 ± 3.85)mtmol/L,lower than that of the metformin hydrochioride group ((8.03 ± 4.33) mtmol/L,P ＜ 0.05).FBG level in metformin hydrochioride group ((6.31 ± 3.45) mmol/L) was lower than that of the liraglutide group ((6.98±2.97) mmol/L),but the difference was not statistically significant(P ＞ 0.05).Conclusion Liraglutide and metformin hydrochioride treatment can effectively reduce weight and blood sugar of the overweight diabetics.The effect of liraglutide to reduce postprandial blood glucose and weight of the patient is more significant than of metformin hydrochioride.

Sixty patients with esophageal carcinoma undergoing thoracoscopic-laparoscopic resection were randomly divided into two groups with 30 cases in each group:endobronchial blocker was used during operation in group E and double-lumen tube( DLT) was used in group D.The results showed that compare to group D,intubation time was shorter and the incidence of postoperative hoarseness and sore throat was lower in group E [(27.4 ±8.6) vs.(37.2 ±10.3)s, 1 and 9 cases,5 and 14 cases, all P<0.05 ]; while the incidence of blockage shifting was higher in group E than group D (4 cases and 0, P<0.05).There were no significant differences in positioning time and effects of one lung ventilation between two groups[(115.6 ± 25.2) vs.(112.2 ±27.2) s, P>0.05].The study indicates that application of endobronchial blocker can reduce the incidence of postoperative hoarseness and sore throat and shorten the intubation time;especially, it is easy to operate and there is no need to replace the tube after surgery.

Objective To investigate β-lactamase gene and class 1 integron gene from 60 clinical Acinetobacter baumannii isolates.Methods The minimal inhibitory concentrations (MICs) for 16 antibiotics widely used were determined using the standard broth microdilution method.The β-lactamase gene,class 1 integron gene and adeB gene were determined by PCR and then sequenced.Results Fifty-three strains of the 60 A.baumanii isolates were multi-drug resistant.OXA-23 gene was detected positive in six A.baumanii isolates,which were all resistant to more than five antimicrobial agents including carbapenem and showed high resistance to many antibiotics.Thirtyeight strains earring PER-1 gene showed higher resistance to cephalosporins than those without this gene (P＜0.01).Class 1 integron gene was positive in 45 strains,which exhibited significantly higher multiple resistance than those without this gene (P＜0.01).Twenty-five strains carrying both class 1 integron and PER-1 genes had a markedly higher multiple resistance (P＜0.01),but not in resistant level,compared to the 7 strains without these two genes.Conclusion Class 1 integron and β-lactamase gene may be the causes of muhidrug-resistance of A.baumanii.The strains carrying OXA-23 gene always showed multiple and high resistance to several antibiotics,so effective measures must be taken to control the epidemic of these strains.

Objective To observe the safety and efficacy of rocuronium rapid sequence induction in patient undergoing laparoscopic cholecystectomy(LC).Methods 100 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups(n =50):control group(group C)and rocuronium rapid sequence induction group (group R).Conventional induction of anesthesia was used in group C,rocuronium rapid sequence induction was used in group R and assisted ventilation was not implemented in the induction process.Oxygen saturation(SpO2 ),partial pressure of oxygen(PaO2 ),carbon dioxide partial pressure(PaO2 ),pH were recored at the condition of breathing air (T0 ),breathing pure oxygen 5 minutes(T1 ),after intubation(T2 )and mechanical ventilation five minutes(T3 ).The grade of the exposure in operation field,the operative time,indwelling of gastric suction tube,the time of no ventilation in group R were recorded,too.Results Compared to T1 time point,PaO2 and pH in group R decreased,but PaCO2 was significantly higher at T2 time point(P <0.05);PaO2 and pH in group R were lower,but PaCO2 was significantly higher than group C at T2 time point(P <0.05).After 5 minutes mechanical ventilation,the PaCO2 and pH in two groups were restored to the preoperative level(P >0.05),but SpO2 and PaO2 were higher than preoperative at every time point(P <0.05).The incidence of Indwelling gastric suction tube is higher in group C than in group R,the grade of exposure in the operation field were better in group R than in group C(P <0.05).Conclusion Application of rocuronium rapid sequence induction technique in laparoscopic cholecystectomy can improve the operative conditions and field,it can be safely used in clinical anesthesia.

Objective To discuss the clinical and pathological features of urachal carcinoma.Methods The clinical and pathological data of 7 patients diagnosed as urachal carcinoma were retrospectively analyzed,and the cIinicopathologic features,diagnosis and treatment,surgical characteristics and surgical outcomes were reviewed.There were 6 males and 1 female.Patient's age ranged from 26-75 years,with average of 52 years.Examinations before surgery included ultrasound,cystoscopy,urine cytology,CT and IVU.Six patients underwent extensive partial cystectomy and 1 patient underwent conventional partial cystectomy. Results Pathological diagnosis were 5 cases of mucinous adenocarcinoma,1 case of not classified adenocarcinoma,1 case of small cell neuroendocrine carcinoma.Clinical stages according to Sheldon staging system were 6 cases of stage ⅢA and 1 case of ⅢC.One patient died of bone metastasis 3 months after operation,1 patient experienced recurrence in bladder neck and urethra in 15 months and 24 months after operation and received TUR-Bt,the other 5 patients were alive without recurrence and metastasis with follow-up of 2-30 months. Conclusion Urachal carcinoma is a rare malignancy,and patients with this disease haye a poor prognosis.