Objective To investigate the blood levels of amino acids in children aged 0-15 year, with an attempt to provide evidence for evaluating amino acid status and diagnosing metabolic diseases of amino acid.Methods The blood levels of eleven amino acids in 1900 children aged 0-15 years were determined by tandem mass spectrometry (MS/MS). Results The blood levels of leucine & isoleucine, valine, phenylalanine tyrosine,glycine, proline, ornithine, and alanine gradually decreased after birth, reaching the lowest levels at the ages of 4-6 months, and then gradually increased, reaching the normal range at the ages of 7 months-1 year. The blood levels of alanine and glycine reach the second peaks on the ages of 9 years in girls and on 11 years in boys. The blood levels of methionine and arginine were lowest in the first week of age, became highest in 1-3 months, decreased to the normal ranges after 4-6 months, and kept the level afterwards. The ratios between prosomatic amino acid and productive amino acid, between ornithine and arginine, between citrulline and arginine, and between ornithin and citrulline were highest in the first week of age and decreased to normal values after 3 to 12 months. The concentrations of amino acids in group of 7 months-15 years were significantly different from the group of 1 day-1 month and group of 2-6 months (P ＜0. 05 or P ＜0. 01 ). The concentrations of amino acids were significantly higher in females than in males in the group of 1 day-1 month and in all age groups (P ＜0. 05 or P ＜0. 01 ) . Conclusions The concentrations and profiles of amino acids change remarkably during the first year of age. Age should be carefully considered when evaluating the nutritional status of amino acid and diagnosing metabolic diseases of amino acids.

Objective To analyze the current situation of TB control in Hefeng County and probe into the role of medical institutions in TB control. Methods In-depth interviews were conducted with health workers of TB prevention, TB patients and their family members; data on registered TB patients were collected; the current situation of TB control was analyzed and countermeasures were put forward. Results The TB epidemic was pretty serious in Hefeng County, with a high morbidity rate and a low cure rate. According to an epidemiological survey in 1990, the TB morbidity rate in the county was 1000/100000. Conclusion Hefeng County failed to give full play to the role of hospitals in TB control and the treatment of TB patients was separated from their management. Hence the deplorable results of TB control. The following countermeasures were presented: ①giving full play to the role of general hospitals in TB control; and ②perfecting the three-level medical networks of prevention and healthcare.

Objective:To have a research and application on management system of cold chain facilities temperature control in the hospital and real-time monitor the temperature and humidity changes of cold-chain facilities.Methods: Based on RFID radio frequency, Internet of things and computer technology to realize the construction of the system hardware and software platform, through commissioning and case analysis for system improvement, the system was popularized and applied comprehensively.Results: After one year’s trial run, it showed that the system could accurately and effectively monitor the abnormal temperature and humidity of the hospital’s cold chain facilities and give the acousto-optic hint and remote alarm in time, effectively improving the management level of cold chain temperature control.Conclusion: The system could guarantee the fine management of the cold chain facilities temperature control, provide safe and traceable historical data, and put forward a new solution for building the quality and safety of cold chain facilities temperature control system.

Objective To provide methodological references for laboratories to carry out newborn screening for disorders of amino acid metabolism,we compared the difference and distribution of ten amino acids including alanine (Ala),arginine (Arg),citrulline (Cit),glycine (Gly),leucine (Leu),methionine (Met),ornithine (Orn),phenylalanine (Phe),tyrosine (Tyr),and valine (Val) from newborn dried blood spots specimen using derivatization or non-derivatization as sample preparation methods.Method It is a comparative research study.A total of 4135 newborn screening dried blood spot samples for inborn errors of metabolism were collected from January to June,2012.All specimens came from neonatal screening center of shanghai children's hospital.Samples were prepared by two different techniques,the corresponding kits and the procedures were used as follows:(1) Simultaneous detection of 100 dried blood spot specimens using two methods respectively to compare the paired difference of each amino acid.(2) 2000 cases of normal newborn specimens were detected respectively to obtain the normal distribution of ten neonatal amino acids.(3) 35 specimens from patients previously diagnosed positively as inborn errors of metabolism were simultaneously detected with 7 amino acids to verify the consistency of two techniques in clinical judgment.Results The amino acid levels of normal newborns analyzed by one-sample.kolmogorovSmirnov test (Z value ranged from 1.997 to 6.229) showed a skewed distribution (P ＜ 0.01).Except for Leu and Tyr,non-derivatization techniqueshowed a lower concentration than derivatization technique,and the CVs of nine amino acids were ＜ 10％ except for Met (the CV of Met was 47.8％),and the average CV is 7.8％.Except for Met,Phe and Tyr,the levels of other 7 amino acids measured by two techniques showed no significant difference (P ＞ 0.05).According to 0.5th to 99.5th percentiles,the normal reference range for derivatization method were greater than on-derivatization method,and the average value was 25.3％.After clinic judgment,the results of the abnormal indicators of children with true metabolism disorders showed no statistically significant between two methods (P ＞ 0.05),the detection rate was 100％.Conclusions There was a slight difference between derivatization and the non-derivatization techniques in detecting multiple amino acids.The results of the abnormal indicators of amino acid metabolism disordersshow no statically significant difference between the two methods,and no difference in clinical judgment.Both methods can be used in detecting amino acid metabolism disorders in newborn screening.

Objective To summarize the acylcarnitine profile in children with malnutrition,with an attempt to distinguish it from those of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency,multiple acylCoA dehydrogenase (MAD) deficiency,or glutaric aciduria type Ⅱ (GA Ⅱ).Methods Thirteen pediatric patients with malnutrition and 214 children of the same age but without malnutrition,which was set as the control group,were included in this study.The blood samples were collected at admission,and the concentration of carnitine and acylcarnitines were measured in bloodspots by tandem mass spectrometry using samples nnderivatized.Results The concentrations of acylcarnitines which were involved in fatty acid oxidation,including octadecanoyl (C18) to acetyl (C2) acylcarnitines and ketonic acylcarnitines,were higher in malnutrition group than in the control group.Particularly,the concentration of decanoyl acylcarnitine (C10) in the malnutrition group was (0.203 ±0.105) μmol/L,which was out of the normal rang (0-0.200 μmol/L),was significantly higher than that [(0.054 ±0.030) μmol/L] in the control group (P ＜0.001).There was no significant difference in the concentrations of acylcarnitines [e.g.propionyl (C3),isovaleryl (C5),3-hydroxy-isovaleryl (C5OH),and glutaryl (C5DC) acylcamitines] involved in amino acid decomposition between the malnutrition and control groups.Conclusions The concentrations of acylcarnitines related to fatty acid oxidation elevate in children with malnutrition.In particular,the medium-chain acylcarnitines C10 is out of the normal range,which can be used to differentiate malnutrition from MCAD and MAD.

Objective: To determine the relationship among perceived stigma, mental health and unsafe sexual behaviors of people living with HIV/AIDS. Methods: Cross-sectional research was used to interview people living with HIV/AIDS (PLWHA) from April 2012 to March 2013 in Changsha, China. The questionnaires included General Questionnaire, Sexual Behavior Questionnaire, Patient Health Questionnaire Depression Scale (PHQ-9), General Anxiety Disorder Scale (GAD-7) and Psychometric Assessment of the HIV Stigma Scale. hTe results were statistically analyzed with SPSS18.0. Results: hTe total score of perceived stigma and its 4 dimensions were positively correlated with anxiety and depression. The total score of perceived stigma and its dimensions were associated with disclosure, but no signiifcantly correlated with other sexual behaviors. Hierarchical regression showed perceived stigma had an effect on anxiety. Conclusion: hTe stigma perceived by PLWHA is above the average level. Perceived stigma has an effect on mental health, especially anxiety, but no effect on unsafe sexual behaviors.

Objective To evaluate the effect of dexmedetomidine administered locally on the median effective concentration ( EC50 ) of ropivacaine for paravertebral nerve block ( PVNB) . Methods Forty?eight ASA physical status Ⅰ or Ⅱ female patients, aged 20-64 yr, with body mass index<24 kg∕m2 , scheduled for elective unilateral segmental mastectomy under PVNB, were randomly divided into 2 groups ( n=24 each) using a random number table: ropivacaine group ( group R) and ropivacaine mixed with dexmedetomidine group ( group RD) . PVNB was performed at T4 on the operated side guided by ultrasound and nerve stimulator. Ropivacaine 20 ml and a mixture of ropivacaine and 20 μg dexmedetomidine 20 ml were injected locally in group R and group RD, respectively. The concentration of ropivacaine was determined by up?and?down sequential allocation. The initial ropivacaine concentration was set at 0. 35%, and the ratio between the two successive concentrations was 1. 2. The EC50 and 95%confidence interval of ropivacaine were calculated using Dixon?Massey method. Results The EC50 ( 95%confidence interval) of ropivacaine was 0.27% (0.23%-0.30%) and 0.22% (0.18%-0.25%) in group R and group RD, respectively. Compared with group R, the EC50 of ropivacaine was significantly decreased by 19% in group RD. Conclusion Small dose of dexmedetomidine administered locally can significantly enhance the efficacy of PVNB with ropivacaine.

ObjectiveTo observe the effects of psychological intervention on anxiety, depression, and postoperative cardiovascular complications in adult patients with lung cancer. Methods96 patients (aged ≤55 years) with lung cancer and undergoing thoracic operation were divided into intervention and control groups. The control group was only given routine care advice and health education, while the intervention groups was combined with various psychological intervention before and after operation. All the patients were assessed with self-rating of anxiety and depression scale (SAS, SDS) and the blood pressure were measured at admission, 1 d before operation, 5 d after operation, and the heart were monitored pre- and post-operation. ResultsThe SAS, SDS score, and blood pressure were not statistically significant between two groups at admission, but significant 1 d before operation and 5 d after operation. The incidence of cardiovascular complications was significantly different after operation (P<0.05). ConclusionThe individual psychological intervention can reduce the anxiety and depression, stabilize blood pressure, and decrease the incidence of cardiovascular complications in adult lung cancer patients undergoing thoracic operation.

ObjectiveTo investigate the role of phosphatidylinositol 3-kinase/protein-serine-threonine kinases (PI3K-Akt) signal pathway in the protection of myocardium against ischemia-reperfusion (I/R) injury by diasoxide postconditioning in rats.MethodsThirty-six male SD rats weighing 250-300 g were randomly divided into 4 groups using random number table (n =9 each):group I/R; group diazoxide (group D); group wortmannin (PI3K inhibitor) (group W) and group wortmannin + diazoxide (group WD).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 4 ml/kg,intubated and mechanically ventilated.Myocardial I/R was produced by 30 min occlusion of left anterior descending coronary artery followed by 120 min reperfusion.0.1％ dimethyl sulfoxide (the vehicle for diazoxide and wortmannin)/diazoxide at 0.47 mg· kg-1 · min-1/wortmannin at 1 μg·kg-1 ·min-1 was infused for 15 min starting from 25 min of ischemia in groups I/R,D and W respectively.In group DW wortmannin was infused at 5 min before diazoxide infusion.Blood samples were collected from left ventricle at the end of 120 min reperfusion for measurement of lactate dehydrogenase (LDH) activity.Myocardial infarct size was measured.Myocardial specimens were obtained for determination of apoptosis index (the number of apoptotic cells/the total number of cells examined) and expression of Bcl-2 and Bax.Bcl-2/Bax ratio was calculated.ResultsDiazoxide postconditioning significantly decreased plasma LDH activity,myocardial infarct size,apoptosis index and Bax expression in myocardium and increased myocardial Bcl-2 expression and Bcl-2/Bax ratio in group D compared with group I/R.Wortmannin partly counteracted the protective effects of diazoxide postconditioning against myocardial infarct.There was no significant difference in the above variables between groups I/R and W.ConclusionPI3K-Akt signal pathway is involved in the protective effects of diazoxide postconditioning on myocardium against I/R injury.

Objective To evaluate MRI diagnostic value for single lesion characteristics in the splenium of corpus callosum.Methods MRI features,clinical data,and parts of follow-up results of 9 cases with single lesion in the splenium of corpus callosum were analyzed retrospectively.Results (1)Clinical manifestations:headache and dizziness occurred in 4 cases,syncope in 3 cases,fever in 2 cases, physical activity barriers in 2 cases.(2)Clinical diagnosis:hypoglycemic encephalopathy were rescaned one month later in 3 cases, in which the previous lesion completely disappeared.Clinical experience of encephalitis were improved after treatment in 2 cases. Cerebral infarction,epilepsy,brain injury and degeneration were diagnosed respectively in each one case,in which lesion still existed after treatmented.(3)Image findings:despite the different clinical manifestations,image features of all cases were quite similar. Round or foliated like lesions of slightly long T1 and long T2 signals in the splenium of corpus callosum were presented in all cases. High signals on diffusion weighted imaging and low signals on the ADC were showed with same lesions,andno obvious enhancement after contract media injected was seen.Conclusion Single lesions in the splenium of corpus callosum are showed in many diseases. The image features of hypoglycemic encephalopathy or encephalitis have certain characteristics (single lesion is reversible).Accurate diagnosis need to combine with clinical data and medical history.