Objective To demonstrate the association between fluid intake and sodium intake during the first 10 days of life and the risk of chronic lung disease (CLD) in very low birth weight (VLBW) infants.Methods A retrospective analysis of data from VLBW infants enrolled in the Neonatal Department of our hospital; 130 infants with birth weight between 790 and 1 470 g were randomized, among which 12 infants was diagnosised CLD. The daily fluid intake and sodium intake during the first 10 days of life were compared between the infants without CLD and those who developed CLD. Demographic and clinical neonatal variables were also compared. Results 118 infants survived without CLD and 12 infants developed CLD. Analysis showed that the daily fluid intakes were higher (day 2～10) and weight loss less (day 6～9) in the group of infants who developed CLD. In addition, the daily sodium intakes were also higher (day 2～6) in infants who developed CLD. Conclusion In the VLBW infants treated during the post surfactant era, higher fluid or sodi-um intake during the first 10 days of life were associated with an increased risk of CLD. The finding suggests that careful attention to fluid balance might be an important means to reduce the incidence of CLD.

Objective To investigate the effects of splenectomy on peripheral immune cells including Th17 cells in patients with portal hy-pertension and to analyze the influence of splenectomy on their immune function.Methods Twenty-five portal hypertension patients trea-ted with splenectomy in No.180 Hospital of PLA from June 2012 to June 2014 were selected as observation group,and 25 healthy controls who underwent physical examination in the same period as control group.Flow cytometry was used to determine the percentages of CD3 , CD4,and CD8 T lymphocytes,CD4/CD8 ratio,and percentage of Th17 cells in the peripheral blood of portal hypertension patients (1 day before operation and at 7 days,1 month,and 3 months after operation)and healthy controls.ELISA was used to evaluate the changes in ser-um interleukin-6 (IL-6),interleukin-17 (IL-17),and interleukin-23 (IL-23).Comparison between groups was made by one-way ANOVA and LSD-t test.Results Before splenectomy,the portal hypertension patients had significantly lower percentages of CD3, CD4,and CD8 T lymphocytes and CD4/CD8 ratio (P<0.01 for all)and significantly higher percentage of Th17 cells and levels of their as-sociated inflammatory cytokines (IL-6,IL-17,and IL-23)(P<0.01 for all),as compared with the control group.At 7 days,1 month,and 3 months after operation,the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ratio in portal hypertension patients first decreased and then increased,and these values were significantly lower at 7 days after operation than before operation (P<0.01 for all);at 3 months after operation,the patients showed no significant differences in the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ra-tio compared with the control group (P>0.05 for all).At 7 days,1 month,and 3 months after operation,the percentage of Th17 cells and levels of their associated inflammatory cytokines (IL-6,IL-17,and IL-23)in portal hypertension patients decreased gradually (P<0.05 for all).Conclusion Th17 cells and their associated inflammatory cytokines (IL-6,IL-17,and IL-23)are reduced in portal hy-pertension patients treated with splenectomy,so their immune function can be improved.

Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.

Objective To investigate the diagnostic value of JAK2V617F mutation detection in the diagnosis of polycythemia vera,and screen a more simple method for clinic laboratory to detect the mutation of JAK2V617F.Method DNA was extracted by standard procedures after isolating total leukocytes from peripheral blood mononuclear cells by density gradient centrifugation over Histopaque 1077.DNA samples were amplified,and single-stranded biotinylated PCR products were prepared for sequencing.At the same time,in order to testify the reliability of the allele-specific PCR,two forward primer and one common reverse primers were applied for identifying the mutation.Result In 32 of 38 patients with polycythemia vera,JAK2V617F mutation was determined by conventional DNA sequencing.35 JAK2V617F mutations were detected by the allele-specific PCR.and these mutations were confirmed by DNA sequencing.None mutation was found in secondary polycythemia and normal control.Conclusion JAK2V617F function mutation occuis in nearly all patients with PV,and JAK2V617F mutation should be a molecular marker in the diagnosis of polycythemia vera.Allele-specific PCR is a very sensitive and specific method for detecting JAK2V617F mutation.

Objective To observe differences between repeat and written response in speech recognition tests of short Mandarin monosyllable lists. Methods 12 normal-hearing subjects were tested by 6 short monosyllabic lists. The subjects should repeat and write down.the contents of the tests at the same time, the tester monitors au-rally and records the subjects' reactions. The speech recognition scoring error under different responses at different presentation levels could be obtained by comparing the records of the subjects with the tester. Results The speech recognition scoring of repeat and written response were highly correlated with each other (P<0.01). However, 19(26.4%) out of 72 pairs of test records were inconsistent. The error range of them was from -5% to 10%. When the presentation level was 5 dB HL, the difference among the speech recognition scoring was significant statistically, but not significant when the presentation level at 20, 15, 10 and 0 dB HL. Conclusion The test results of speech audiometry are impacted by different respond methods. In the open-set test, it's supposed that the subjects should make notes while repeating the contents of the tests, then compare with the aural monitoring records of the tester to keep the reliability of the test.

objective To explore a new method of repairing skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers. Methods The reversed dorsal metacarpal island flap was designed to be pedicled on the digital proper artery-common digital artery-fingerweb artery-dorsal metacarpal artery-cutaneous branch of dorsal metacarpal artery.In repairing digital palmar skin defects,after the flap was dissected,the proximal incision was extended along the direction of dorsal metacarpal nerve to harvest an enough length of the nerve so that the dorsal metacrppal nerve can be anastomosed with the digital proper nerve to restore the sensation of finger pulp.From the June 2003 to March 2009,the flap was used to repair 26 fingers in 24 patients with middle and distal digital skin defects complicated with fracture and tendon rupture.They were 17 men and 7 women,aged from 16 to 63 years (average,37 years).There were 15 cases of palmar skin defect and 9 cases of dorsal skin defect.In the 2 cases of combined tendon defects,a section of the extensor tendon of index(or little) finger was dissected together with the flap to repair the tendon rupture. Results The areas of the flap ranged from 3.1 cm ×1.6 cm to 6.0 cm × 4.0 cm.The flaps survived in all 24 cases without any vascular crisis.Twenty-two patients obtained an average follow-up of 14 months (from 4 to 32 months) but 2 were lost to the follow-up.The flaps were fine in texture,colour and appearance.The finger pulps appeared full and recovered sensations of pain and temperature.The average two-point discrimination was 7.5 mm (from 5 to 9 mm).Sensory function evaluation revealed an outcome of S3 + ～ S4.Tendon adhesion occurred in 4 cases which recovered digital function following secondary lysis 3 to 6 months postoperation. Conclusion Application of the reversed dorsal metacarpal island flap pedicled on the digital proper artery is a good way to repair skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers.

Objective To investigate the influence of c-myc on the growth, proliferation, apoptosis,invasion and cell cycle of the gastric line HFE145. Methods The cDNA of c-myc was subcloned into a constitutive vector pcDNA3.1 followed by transfection in HFE145 by using liposome. Then stable expression clones (HFE-myc) were selected. The apoptosis and cell cycles were detected using flow cytometry. The growth and proliferation were analyzed by making cell growth curves and colony formation assay respectively. The ability of invasion were tested using cell migration assay. Results HFE-myc group grew faster than HFE145and HFE-pc. The cell counts of HFE-myc in five of seven days were more than those of others significantly (P＜0.05). There was no difference between the two control group. Cell cycle analysis showed that HFE-myc group proliferated faster, mean proportion of cells in G2-M was about 25 % and higher significantly (P ＜0.05)than those of the two control groups. Results of colony formation assay showed that the mean colony formation rate of HFE-myc was 0.27 and higher than those of the control groups(P ＜0.05). The results of cell migration assay suggested that the cell migration rate of HFE-myc was not higher significantly than those of the control groups (P ＞0.05). Conclusion c-myc can promote the growth, proliferation. It can increase the proportion of cells in division stage, so promote the division. But it have little influence on the invasion of cells.

Objective To compare and analyze gene expression patterns in rat model of nonalcoholic fatty liver disease (NAFLD).Methods Twelve male Sprague-Dawley rats were randomly given either general diet (control group) or a high-fat diet (model group) for 4 weeks.The histopathologic changes of the liver were observed and gene expression patterns were analyzed and compared by cDNA mieroarray.Results Hepatocellular steatosis and inflammatory infiltration were observed in model group after high-fat diet for 4 weeks.Fifty-one differential genes were found in model group,20 of which were up-regulated (sterol regulatory element binding factor 1,stearoyl-coenzyme A desaturase 1 and Bcl 2 modifying factor)and 31 were down-regulated (peroxisomal enoyl coenzyme A hydratase 1,heat shock 70 protein 1A and ATPase inhibitory factor 1). The up-regulating genes were involved in lipogenesis and cell apoptosis,while down-regulated genes were involved in fatty acid oxidation, protein modification and energy metabolism.Conclusions The differential expression of genes may involve in the pathogenesis of NAFLD.

OBJECTIVE:To study on the effect of iodine (I2) on the acid content titration in the preparations,and establish a method of eliminating I2 for accurate determination of total acid content. METHODS:Taking an example of Onychomycosis paint,I2 was reduced by sodium sulfide(Na2S)before titration analysis and compared with the standard method of traditional titration. Ac-cording to the two methods of consumption of different sodium hydrate(NaOH)volume,the effect of I2 on the determination of to-tal acid content in preparation was explored. RESULTS:Reduction method of Na2S can eliminate the effect of I2,the color of indica-tor changed acutely. The determined total acid and theoretical values were the same;the linear range of the concentration of total ac-id in onychomycosis paint was 3.926-7.290 mol/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were no more than 0.04%;average recovery was 99.91%-100.10%(RSD=0.036%,n=6). CONCLUSIONS:I2 has effect on the determina-tion of total acid content,the disproportion reaction of I2 can generate hydriodic acid that can interfere acid-base titration's results, and the generated hydriodic acid can oxidize indicator to make the end point is not sensitive or even invariant color. Using Na2S can eliminate the effect of iodine on the preparation of acid titration,which has improved precision and reproducibility with accurate and reliable determination results.

Objective To investigate the clinical effect and safety of paracetamol in premature infants with patent ductus arteriosus(PDA). Method A protrospective comparsion study was performed onthe data of premature infants with PDA. Seventy-two premature infants with echocardiographically comfirmed PDA were randomized into the oral paracetamol group(n1=18) and the ibuprofen group(n2=54), and the rate of ductal closure, side effects and complications were compared between the two groups. Results The ductus was 66.7% (12 infants) in the paracetamol group, which was similar to 70.4% (38 cases) in the ibuprofen group, with no significant difference(χ2=0.087,P=0.768).Except for the incidence of hyperbilirubinemia in the paracetamol group was higher than that in the ibuprofen group (P<0.05), no statistical differences were found in the other index (P>0.05), including oliguria,NEC,renal impairment,the incidence of IVH3-4 and gastrointestinal bleeding. Conclusions The clinical effect of paracetamol in premature infants with PDA is similar to that of ibuprofen , withlower incidence of hyperbilirubinemia, and paracetamol is worthy of amplication in clinical practice.