With the advances of medical management and surgical techniques during cardiopulmonary bypass,children with congenital heart disease are increasingly surviving to adulthood.Research into their neurodevelopmental outcomes in the past 20 years had revealed sobering realizations about the adverse impact on the quality of life of these surgical survivors.A multitude of factors contribute to the incidence and severity of neurodevelopmental abnormalities and can be separated into preoperative,intraoperative,and postoperative events,in addition to genetic contributions and socioeconomic factors.This article highlight some of current understanding of these protean factors.Understanding should lead to modification of current techniques and management strategies,all with the ultimate goal of improving patients' quality of life.

In general the valuation criterions of teaching quality in class are exactness,lifelikeness and profundity.The author's own understanding and some suggestions about the criterions will be put forward in this article.

Actinomyces ; growth & development ; Coinfection ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; diagnosis ; microbiology

Integrins such as αvβ3, α5β1 play a key role in angiogenesis regulation, invasion and metastasis, inflammation, wound healing, etc. The up-regulation of integrin αvβ3 after cerebral ischemic stroke can promote angiogenesis, which in turn improves functional recovery. In addition, the integrin αvβ3 inhibitor can block the blood-brain barrier (BBB) leakage induced by vascular endothelial growth factor (VEGF) and also can reduce inflammatory reaction, decrease the deposition of fibrinogen. Other studies showed that integrin αvβ3 is not essential in revascularization. Therefore, the effect of integrin αvβ3 in the whole process of brain function recovery merits further study.

Objective: To express and purify the inhibitor of differentiation(Id3) in E.coli.Methods: The DNA fragment in the coding region of the human Id3 gene was amplified by PCR and cloned into the pGEM-T Easy vector for sequencing.The Id3 cDNA fragment was then subcloned into the prokaryotic expression vector(pET-32a)(+) and transformed into E.coli BL 21(DE3).The expression of the histidine-tagged(His-Tag) fusion protein was induced with isopropy-?-D-thiogalactoside(IPTG),confirmed by Western blot and purified by the immobilized Ni2+ absorption chromatographic column.Results: The prokaryotic expression vector of Id3 was successfully constructed.Western blot confirmed the expression of the His-Tag fusion protein in E.coli BL 21(DE3) and that of the Id3 fusion protein with the relative molecular mass size of 33 000 after purified by the affinity chromatographic column. Conclusion: Recombinant Id3 can be expressed in E.coli BL 21(DE3) and the obtained fusion protein can be purified by the Ni-affinity chromatography column.

Adult ; Female ; Hearing Loss, Noise-Induced ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Occupational Diseases ; diagnosis ; etiology

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Vasculitis ; therapy

Altitude Sickness ; Chronic Disease ; Humans ; Male ; Middle Aged ; Occupational Diseases

Objectives: To investigate the role of Xpert MTB/RIF assay for rapid diagnosis of osteoarticular tuberculosis.Methods: From February 2014 to November 2014,pus specimens of 49 osteoarticular tuberculosis patients and 32 nontuberculosis patients were detected by Xpert MTB/RIF system,and the sensitivity,specificity,positive predictive value,negative predictive value,agreement rate of Xpert MTB/RIF system were calculated,and clinical diagnosis was used as the reference standard.All the pus specimens were detected by acid-fast stain and fast culturing(BACTECT MGIT 960),to find the difference of sensitivity and specificity among Xpert MTB/RIF,acid-fast stain,and fast culturing.The role of Xpert MTB/RIF assay for rapid diagnosis of osteoarticular tuberculosis was evaluated through the two factors above.Results: It took 2.3±0.2h to detect each pus specimen by Xpert MTB/RIF.Among the 49 osteoarticular disease patients,46 were positive,3 were negative by Xpert MTB/RIF test.Among the 32 nontuberculosis patients,1 was positive,31 were negative by Xpert MTB/RIF test.The sensitivity,specificity,positive predictive value,negative predictive value,agreement rate was 93.87%,96.87%,97.87%,91.17%,95.06% respectively for Xpert MTB/RIF assay.Among the 46 specimens which were positive by Xpert MTB/RIF test,10 had rifampicin resistance mutation,with the rate of rifampicin resistance mutation as 21.73%.Among the 49 osteoarticular disease patients,8 were positive,41 were negative by acid-fast stain test,the sensitivity was 17.39%,and based on fast culturing test,11 were positive,38 were negative,the sensitivity was 23.91%.All pus specimens of 32 nontuberculosis patients were negative by acid-fast stain test and fast culturing test.As for the sensitivity,Xpert MTB/RIF was superior to acid-fast stain and fast cultureing (P＜0.05).While as for the specificity,there was no statistical difference among Xpert MTB/RIF,acid-fast stain,or fast culturing (P＞0.05).Conclusions: The role of Xpert MTB/RIF assay for rapid diagnosis of osteoarticular tuberculosis is perfect.It is of time saving,high sensitivity and high specificity,which is superior to the traditional methods.

Objective:To discuss the experience accumulation and thinking tralning of clinical pharmacist in the pharmaceutical consultation with SOAP model. Methods:Clinical pharmacist performed the condition evaluation for one patient with Acinetobacter bau-rnannii infection after esophagus cancer surgery and was invited to the consultation for three times. Clinical pharmacist also provided the references for the drug treatment and monitored the whole process. Clinical pharmacist actively followed and pald return visits for the prognosis of the patient for one month. Results: After identifying the pathogen, the experiential therapy was given and the condi-tions of the patient were improved. According to the changes of the conditions, the treatment was adjusted in time with the most suitable drugs for the conditions and infection degree. Finally, the infection was controlled effectively, and the patient was discharged after the 35-day postoperative treatment. Conclusion:During the consultation, clinical pharmacist should correctly judge the conditions of pa-tients, summarize and evaluate the earlier therapy results, and then choose suitable drugs according to the property of PK/PD. Clinical pharmacist also should track the therapy results to assess the conditions of patients and individualize the treatment.