Objective To explore the role ofmirror image on arterial lesion severity of acute ST segment elevation myocardial infarction (STEMI) patients with electrocardiograrn(ECG) reciprocal lead ST segment,as well as its clinical prognosis.Methods Totally 167 STEMI patients with completed data were enrolled in present study.The patients were divided into four groups according to the amplitude of corresponding lead ST segment.Group Ⅰ consisted of 33 patients with non ST depression and group Ⅱ consisted of 97 patients whose amplitude of corresponding lead ST segment were less or equal to the amplitude of the ST segment elevation in myocardial infarction area.Group Ⅲ consisted of 25 patients whose amplitude of corresponding lead ST segment was larger than the amplitude of the ST segment elevation and group Ⅳconsisted of 12 patients whose corresponding ST segment and ST segment in myocardial infarction area were all elevated.The culprit artery lesion and clinical prognosis were compared between the four groups.Results There were significant differences in terms of the extent of lesion stenosis and the number of coronary artery stenosis among the four groups (x2 =13.49,P＜0.05;x2=78.34,P＜0.01).In Ⅳ group,the prognosis indices included pump failure,low blood pressure,malignant arrhythmia,ventricular wall incoordination,left ventricular ejection fraction ≤ 50％ and inhospital mortality significantly increased(P＜0.01).Conclusion Different corresponding ST segment depression in patients with acute ST segment elevation myocardial infarction can forecast the culprit artery lesion and clinical prognosis.

Objective To evaluate the role of using non-invasive ventilation with bi-level positive airway pressure (BiPAP) in order to reduce the need of re-intubation in pediatric patients with respiratory failure after cardiac surgery. Method From January 2007 to December 2007, 25 patients aged from three months to 11 years with median 2.3 years operated on for cardiac surgery with respiratory insufficiency after extubation and re-intubation indicated were enrolled in this study. They were put on non-invasive nasal (mask) BiPAP ventilation before re-intubation. The arterial blood gas, A-aDO2 and PaO2/FiO2 were measured. In addition, clinical data including heart rate, respiratory rate, and the product of heart rate and systolic pressure were recorded before and after BiPAP. The software SPSSD 13.0 was used to process by ANOVA test for statistical analysis. Meanwhile, the outcome of these patients was analyzed. Results Twenty-five patients with 30 episodes of respiratory insufficiency were treated with BiPAP ventilation with median duration of 1.96 days ranged from 0.03 to 12 days. Of these respiratory failure episodes, 25 ones (83.3%) could be controlled by BiPAP and the needs of re-intubation were avoided. Five episodes of respiratory failure in 4 patients could not be quelled and the endo-tracheal tubes were inserted in these patients. All patients were saved with a median of mechanical ventilation duration of 3.4 days and ICU stay of 10.6 days. No major complications were observed. The heart rate, respiratory rate and the rate-pressure product were decreased significantly one hour after BiPAP (P < 0.05 all). Meanwhile, patients showed rapid improvement of oxygenation. The pH, SpO>2 and PaO2/FiO2 were increased significantly and A-aDO2 was decreased significantly (P < 0.05 all). The PaCO2, was decreased significantly four hours after BiPAP (P < 0.05). Conclusions Non-invasive nasal mask BiPAP can be used safely and effectively in children after cardiac surgery to improve oxygenation/ventilation, decreasing the work of breathing. It may be particularly useful in patients with high risk of re-intubation.

AIM:To observe the neuritogenic actions of botulinum neurotoxin serotype A heavy chain ( BoNT/A HC) on cultured Neuro-2a cells and to investigate the related signaling mechanisms for the effect of BoNT /A HC. METHODS:Neuro-2a cells were treated with different doses of BoNT/A HC (0.01, 0.1, 1 and 10 nmol/L), and then the cells were harvested at 24 h, 48 h and 72 h of BoNT/A HC exposure for detecting the neurite length and the percen-tage of the cells with neuronal processes by immunofluorescence staining .The most efficient dose of BoNT/A HC was cho-sen for exposure to Neuro-2a cells as the above.Whole cell protein was harvested at different time points for detecting the protein levels of phosphorylated ERK 1/2 ( p-ERK1/2 ) and phosphorylated Akt ( p-Akt ) by Western blot .RESULTS:Low doses of BoNT/A HC stimulated the neurite outgrowth , and increased the percentage of the cells with neurites com-pared with the negative controls (P<0.05), especially in the group with 1 nmol/L of BoNT/A HC treatment.Meanwhile, the phosphorylation of ERK 1/2 and Akt was increased after treated with BoNT/A HC.There was an increasing tendency for the phosphorylation of ERK1/2 after the exposure of the cells to BoNT/A HC.The obvious increase in p-ERK1/2 was seen from 60 min to 5 h with 1 nmol/L of BoNT/A HC treatment ( P<0.05 ) , and the increased protein level of p-Akt was mainly observed at 15 min and 60 min ( P<0.05 ) .CONCLUSION: BoNT/A HC stimulates the neuritogenesis .The neuritogenic mechanism of BoNT/A HC on Neuro-2a cells might be realized by activation of the phosphorylation of ERK 1/2 and Akt.

Objective To investigate the micro vibration with the hand nursing methods for disuse syndrome patients constipation curative effect. Methods During the time of March 2016 to September, 76 patients who had long term disuse syndrome with the constipation in two Elderly Care Homes in Urumqi were randomly divided into intervention group (n=37) and control group (n=39), in the experimental group, was treated by manual micro vibration nursing method which included hand micro vibration therapy, exercise therapy, health education guidance once a day, 50 minutes each time, a total of 4 weeks of intervention, while the control group received routine rehabilitation nursing. Before the intervention, intervention after 4 weeks, follow-up period after the end of 8 weeks according to the symptoms of constipation and evaluate the stool frequency. Results Preliminary experimental group and control group patients have different degrees of constipation symptoms, with the hand micro vibration method of nursing intervention, the experimental group had not constipation of symptoms, 17(43.6%) had constipation symptoms in the control group. Compared with the incidence of two groups of constipation patients. Before the intervention, intervention after 4 weeks, follow-up period after the end of 8 weeks, the experimental group patients defecation frequency was (5.33 ± 1.47), (29.70 ± 6.49) , (43.41 ± 6.15)times, The control group patients was(5.77 ± 1.39), (13.10 ± 1.27), (21.15 ± 4.23) time, comparison of the two groups, t=-1.357, 15.275, 18.458, P=0.179, 0.000, 0.000. Conclusions Hand micro vibration nursing method has remarkable effect on relieving constipation, and the treatment effect can be maintained for a long time, no recurrence occurred and adverse reactions, however, this method also economic, convenient, less time consuming and efficient.

ObjectiveTo investigate the change of D-dimer in haemolytic disease of newborn and its clinical significance. MethodsSixty cases with haemolytic disease of newborn were divided into nonserious group(34 cases) and serious group(26 cases) by the level of bilirubin, 40 cases of normal neonatus (control group) were also selected. The levels of D-dimer and fibrinogen(FIB) were measured and compared.ResultsThe level of D-dimer in serious group and non-serious group[ (9.29 ± 11.34), (0.84 ± 0.77 ) mg/L]was higher than that in control group [ (0.45 ± 0.06) mg/L](P ＜ 0.01 or ＜ 0.05 ),the level of D-dimer in serious group was higher than that in non-serious group (P＜ 0.01 ). There was no significant difference in the level of FIB among the three groups (P ＞ 0.05). ConclusionsThere is hypercoagulability in the serious haemolytic disease of newborn. It is valuable to detect plasma D-dimer density for serious haemolytic disease of judgement and treatment.

Objective To investigate the clinical significance and coagulation function changes in newborn hemolytic disease. Method The newborn hemolytic disease ( 60 cases, hemolytic disease group ), non-hemolytic hyperbilirubinemia (60 cases, non-hemolytic hyperbilirubinemia group) and normal newborn (60 cases,control group) were selected as the study subjects, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured, and the blood platelet count at the same time was detected. Results PT and APTT in hemolytic disease group were higher than those in non-hemolytic hyperbilirubinemia group[(28.79 ?.21) s vs. (18.98?.41) s and (58.52?.13) s vs. (47.26?.81) s], and they were apparently higher than those in control group [(13.81 ?1.83) s and (38.10 ?3.00) s], the difference had statistic significance (P<0.05). There was no statistic significance to detect the blood platelet count (P> 0.05). Conclusions The newborn hemolytic disease has the bleeding tendency, and the bleeding tendency has no relationship with the quantity of the blood platelet, but relates to the extension of PT and APTT. The more serious the case is, the more obvious the PT and APTT rise. PT and APTT can be as the detection index and evaluating effect of the newborn hemolytic disease coagulation function.

Objective To investigate the whole genomic expression profiles of chronic atrophic gastritis with interleukin(IL)-1β-31CC/-511TT genotype as measured by oligonucleotide microarray technique.Methods Genomic RNA was extracted from gastric biopsies of 12 patients with chronic atrophic gastritis(6 with IL-1β-31CC/-511TT and 6 with IL-1β-31TT/-511CC).The genomic profiles of IL-1β gene polymorphisms 31CC/-511TT and 31TT/-511CC were compared and tested for differential expressed genes associated with 31CC/-511TT using Agilent human whole genomic oligonucleotide microarrays.The results were further analyzed in terms of gene ontology(GO).Results There were 200 differentially expressed genes associated with IL-1β-31CC/-511TT,159 of which were up-regulated and 41 were down-regulated.These genes mainly involved in macromolecule metabolic process,post-translational protein modification,ubiquitin cycle,and protein kinase cascade.Five genes had biological activities,one of which was down-regulated gene(PCSK5)and 4 were upregulated genes(PRKCA,NPLOC4,TRIB3 and MAPKAPK3).Conclusions The chronic atrophic gastritis with IL-1β-31CC/-511TT genotype has molecular phenotypes which is associated with malignance and inflammation.These individuals are needed more intensive preemptive treatment and dynamic surveillance.

OBJECTIVETo investigate the clinical effect of modified Koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias.

METHODS49 cases with severe hypospadias treated from Jan. 2009 to Sep. 2011 were retrospectively studied. 25 patients underwent Koyanagi technique with coverage by tunica vaginalis of testis. 24 cases underwent one-stage Duplay + Duckett technique in the same term. The patients were followed up for 7-24 months.

RESULTSAmong the 25 children treated with Koyanagi procedure, 20 cases were cured, 5 patients had postoperative complications, including urethral fistula in 3 cases,urethral stenosis in 2 cases. At the same time, in the Duplay + Duckett group, 17 cases were cured, 7 children had postoperative complications, including urethral fistula in 4 cases, and urethral stenosis in 3 cases. All the patients with urethral fistula were repaired successfully 6 months after the first surgery; The urethral stenosis were cured by dilatation within 1 to 3 months. The successful rate in the 2 groups had no significant difference(P >0.05).

CONCLUSIONSKoyanagi technique with coverage by tunica vaginalis of testis is relatively simple with similar effect as Duplay + Duckett technique for severe hypospadias.

Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Surgical Flaps ; transplantation ; Testis ; surgery ; Urethral Diseases ; etiology ; therapy ; Urethral Stricture ; etiology ; therapy ; Urinary Fistula ; etiology ; surgery

clinical applications, especially suitable for large-scale cervical screening and epidemiology investigation.

OBJECTIVE: To determine the carrier rate for common recessive genetic diseases in Chenzhou region in order to provide a reference for carrier screening in this region. METHODS: Targeted capture and high-throughput sequencing were carried out to detect potential variants of 79 genes associated with 88 recessive genetic diseases. Couples at risk were provided with prenatal diagnosis upon their subsequent pregnancies. RESULTS: A total of 1314 individuals were enrolled, among whom 355 (27.02%) were found to be carrier for at least one disease. The carrier rates for 8 diseases have exceeded 1%, with the most common two including thalassemia (11.72%, 154/1314) and autosomal recessive deafness (5.48%, 72/1314). Ten couples were found to be at risk for producing affected offspring. Among these, five females were carriers for X-linked recessive genetic diseases. Following genetic counseling, seven couples had accepted prenatal diagnosis, and 3 affected fetuses were diagnosed. CONCLUSION The disease types and pathogenic variants of Chenzhou region have differed from previously reported. Further research is required to validate the above finding with a larger populations.
Female ; Pregnancy ; Humans ; China ; Prenatal Diagnosis ; Fetus ; Genetic Counseling ; Genetic Diseases, X-Linked