Objective To investigate the underlying causes, clinical characteristics, treatment and prognosis of non-traumatic pneumomediastinum (PM) in children. Methods A retrospective analysis of the clinical data of 64 children diagnosed with non-traumatic PM in Yuying Children’s Hospital Affiliated to Medical University from Jan 2003 to Dec 2013 was performed. Nineteen children with SPM and the other 45 with clear causes of non-traumatic PM were divided into two groups for comparison. According to age, 64 cases were divided into 0-6y group and 6-18y group for further comparison. Results A total of 64 patients with non-traumatic PM were collected. Nineteen of them aged 14.90±2.00 y had SPM with unknown etiology, and 84.2%were male. The other group of 45 patients aged 4.26±4.45y, and 55.6%of this group were male. The common causes were pneumonia or other lower respiratory tract infection, asthma and foreign body inspiration. The patients with SPM were always with chest pain. While the patients with clear causes of non-traumatic PM were more complained of dyspnea, coughing, subcutaneous emphysema. The treatment of patients with SPM was bed rest, oxygen uptaking, antitussive, anti-infection and other conservative therapy. All the patients with clear causes of non-traumatic PM had favorable prognosis with the treatment of actively curing primary disease and timely mediastinal air drainage, subcutaneous air drainage and thoracic close drainage. In 35 cases younger than 6 years old, the most common causes were pneumonia or other lower respiratory tract infection, none had SPM. In 29 cases older than 6 years, 19 of them had SPM. Conclusions Etiologies of pneumomediastinum varied with age in children,which should be vigilantly examined, especially for those younger than 6 years old. The key of the treatment to non-traumatic PM with clear etiologies was to treat its primary disease.

0.05) . Conclusion Air pollution can increase the risk of low birth weight and preterm birth in the exposed pregnant women.

Objective To investigate the safety and clinical effect of laparoscopic radical parametrectomy in the treatment of unexpected cervical cancer . Methods A retrospective analysis was made on clinical characteristics of 15 patients who were diagnosed as unexpected cervical cancer from January 2008 to December 2014.The age of the patients was between 29 and 67 years old, with an average of 43.9 years old.The indications for hysterectomy were cervical intraepithelial neoplasia (CIN) grade 2-3 in 7 cases, uterine myoma in 3 cases, dysfunctional uterine bleeding in 2 cases, uterine prolapse in 2 cases and adenomyosis in 1 case. Pathological results after the hysterectomy included 13 cases of cervical squamous carcinoma and 2 cases of adenocarcinoma .The lesions were all confined to the cervix , with 4 cases of stage ⅠA2 disease and 11 cases of stage ⅠB1 .The lymph-vascular space invasion was found in 4 cases.The operation interval between the two operations was 3-7 d (mean, 4.6 d).They were all given laparoscopic radical parametrectomy . Results The operation time was 212-285 min (mean, 249.6 min), and the blood loss was 250-500 ml ( mean, 376 ml) .Postoperative pathological findings showed no residual disease .Only one patient had left pelvic lymph node mestastasis .Two patients had intraoperative complications , including 1 bladder injury and 1 ureteral injury .There were 3 cases of postoperative complications , including 2 cases of uroschesis and 1 case of lymphocyst .The follow-up time was 6-84 months ( median, 48 months).No recurrence was seen.The 1-, 3-, 5-year survival rates were 100%, 93.3%, 86.7%, respectively. Conclusions Laparoscopic radical parametrectomy in the treatment of unexpected cervical cancer is difficult to perform and has more complications . This surgical method is applicable to those who refused postoperation radiotherapy or required retaining ovarian function .

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) with multiple differentiation potential can be induced into osteogenic or adipogenic differentiation under certain conditions. OBJECTIVE: To review the related factors regulating the adipo-osteogenic differentiation of BMSCs. METHODS: A computer-based search of CNKI and PubMed databases was performed for literature concerning the related factors regulating the adipo-osteogenic differentiation of BMSCs published from January 2006 to August 2016. The search terms were bone marrow mesenchymal stem cells, osteogenic differentiation, adipocyte differentiation in Chinese and English, respectively. RESULTS AND CONCLUSION: Signaling pathways, transcription factors, and smal molecule compounds that are interacted are key factors in the regulation of BMSCs differentiation, so the techniques to intervene BMSCs differentiation based on these key molecules may correct bone or fat abnormality and can be applied to tissue engineering and regenerative medicine in the future. Additionally, the biological clock is also one of the most important factors for adipo-osteogenic differentiation of BMSCs by regulating signaling pathways or transcription factors.

Objective To investigate the status of structural empowerment,job stress and burnout,and to explore the relationship aunong them.Methods The questionnaires of CWEQ-Ⅱ,job stressors and MBI were used to investigate 350 nurses working at tertiary-level hospitals.Results The average score of CWEQ-Ⅱ was (2.23±0.59),the score of EE of MBI was (29.75±13.94),PA was (27.40±11.21),both of them showed a high level of exhaustion,DP was (8.07±5.82),which showed a middle level of exhaustion.The findings showed that workload and time pressure were the most frequently encountered job stressor among staff nurses,the score was (3.23±0.95).There was a significant correlation among structural empowerment,job stressors and the level of burnout.Hierarchical regression analysis and structural equation modeling showed that structural empowerment had significant influence on every factor of job stressors and burnout,job stressors had significant influence on the every factors of burnout.Conciusins It is suggested to pay attention to the main job stressors,and take proper interventions to enhance nurses' structural empowerment to prevent burnout,and thereby to raise the quality of care.

Along with the development of the modernization of traditional Chinese medicine (TCM), the acupunc-ture related software has also been developed. This article was aimed to combine traditional acupuncture therapy with the modern information technology in order to design software which is practical for clinical guidance in the acupoint selection and treatment according to diseases. This software provides a convenient and effective self-acupuncture treatment program for the public. It makes TCM acupuncture popular in the public and further pro-motes the development of TCM .

Adipose stem cel s have been confirmed to promote the repair of soft tissue after damage, and the action mechanism is possibly related to the paracrine of adipose stem cel s, that is adipose stem cel s secrete a variety of cytokines, which may promote the restoration of damaged cel s. However, little report addressed the types of adipose stem cel s secreted factors, contents of each factor, and role in soft tissue repair after damage, especial y oral mucosa. To observe the influence of vascular endothelial growth factor, platelet-derived growth factor, and basic fibroblast growth factor in adipose stem cel-conditioned medium on the proliferation of oral mucosa fibroblasts. Protein microarray analysis was used to analyze the contents of vascular endothelial growth factor, platelet-derived growth factor, and basic fibroblast growth factor in adipose stem cel-conditioned medium. CCK8 analysis was used to analyze the effects of adipose stem cel-conditioned medium with different concentrations of vascular endothelial growth factor, platelet-derived growth factor, and basic fibroblast growth factor (0, 1, 10, 20, 50 and 100μg/L) or the neutralizing antibody of the three kinds of cytokines on the proliferation of oral mucosa fibroblast on 1, 2, 3, 4 and 5 days. High contents of vascular endothelial growth factor, platelet-derived growth factor, and basic fibroblast growth factor were contained in adipose stem cel-conditioned medium (signal value>300). Adipose stem cel-conditioned medium could promote the proliferation of oral mucosa fibroblasts, wherein, the promotion effects of platelet-derived growth factor and basic fibroblast growth factor were very significant, and the peak changes could be observed with variation of cytokines concentrations. The optimal concentrations of platelet-derived growth factor and basic fibroblast growth factor were 50μg/L and 1μg/L, respectively (P ≤ 0.05). The neutralizing antibody of platelet-derived growth factor and basic fibroblast growth factor inhibited the promotion effect of adipose stem cel-conditioned medium. On the other hand, vascular endothelial growth factor had no significant effect on the proliferation of oral mucosa fibroblasts. Adipose stem cel-conditioned medium can promote the proliferation of oral mucosa fibroblasts, platelet-derived growth factor and basic fibroblast growth factor in adipose stem cel-conditioned medium have obvious promotion effects, which are dependent on the cytokine concentrations. Therefore, we should pay attention to choose the optimal concentrations of cytokines, thereby effectively promoting the proliferation of fibroblasts.

To study the transport mechanisms of drugs for transplacental treatment of fetal tachyarrhythmia, MDCKII-BCRP and MDCKII cell models was used. MDCKII-BCRP and MDCKII cell monolayer model was used to investigate the bi-direction transport of sotalol, propranolol, propafenone, procainamide and flecainide. Drug concentrations were measured by HPLC-UV or chemiluminescence. The apparent permeability coefficient (P(app)), efflux rate (R(E)) and net efflux rate (R(net)) were calculated. Drugs with R(net) greater than 1.5 were further investigated using cellular accumulation experiments with or without a BCRP inhibitor. The R(net) of sotalol, propranolol, propafenone and procainamide were less than 1.5, while R(net) of flecainide with concentrations of 20 and 5 μmol x L(-1) were 1.6 and 1.9, respectively. The results showed that the transport of flecainide on MDCKII-BCRP cell monolayer could be mediated by BCRP; and the affinity increased when the concentration of flecainide decreased. Cellular accumulation experiments further suggested that accumulation of flecainide in MDCKII-BCRP cells was significantly lower than that in MDCKII cells in a concentration-dependent manner. BCRP inhibitor quercetin (50 μmol x L(-1)) significantly increased the accumulation of flecainide in MDCKII-BCRP cells (P < 0.05). Our preliminary data showed that flecainide but not sotalol, propranolol, propafenone or procainamide can be a substrate of BCRP. Thus the effect of flecainide may be affected by the BCRP in the maternal placental trophoblast membrane layer when treating fetal tachyarrhythmia.

Objective To investigate the effect of electro-acupuncture stimulation on the temperature over the body surface projection area of intestines in patients with functional constipation. Methods A total of 30 patients with functional constipation were randomly divided into a electro-acupuncture stimulation group and a false stimulation group, with 15 patients in each group. The patients in the electro-acupuncture stimulation recived electro-acupuncture at bilateral points of Tianshu, Fujie and upper Juxu for 8 weeks, a total of 28 times stimulation;the patients in the false stimulation group received false electro-acupuncture at fake bilateral points beside Tianshu, Fujie and upper Juxu for the same stimulation period. Medical infrared thermal imager was adopted to record the temperatures over the body surface projection area of ascending colon, transverse colon, descending colon, and small intestine. Results The temperature over the body surface projection area of of the ascending colon(33.35±0.96 ℃ vs. 34.62±1.15 ℃;t=2.977, P=0.010), transverse colon(33.32±0.97 ℃ vs. 34.60±1.23 ℃; t=2.839, P=0.013), descending colon(33.36±0.98 ℃ vs. 34.64±1.18 ℃; t=2.892, P=0.012), the small intestine(33.31±0.97 ℃ vs. 34.57±1.22 ℃; t=2.763, P=0.015)showed significant lower than those before the stimulation in the electro-acupuncture stimulation group. The temperature over the body surface projection area of of the ascending colon(33.74±1.25 ℃ vs. 34.52±1.64 ℃; t=1.701, P=0.111) transverse colon (33.71±1.27℃vs. 34.47±1.65℃;t=1.643, P=0.123), descending colon(33.72±1.25 ℃vs. 34.52±1.66 ℃; t=1.710, P=0.109), the small intestine(33.70±1.28 ℃ vs. 34.51±1.65 ℃; t=1.744, P=0.103)showed no significant different than those before the stimulation in the false stimulation group. Conclusion Electro-acupuncture stimulation can decrease the temperature over the body surface projection area of the ascending colon, transverse colon, descending colon, and small intestine.

Objective To investigate the correlation of plasma heme oxygenase-1 (HO-1) level and type 2 diabetes mellitus (T2DM). Methods The outpatient with type 2 diabetes mellitus (T2DM) undergoing oral glucose tolerance test and healthy individuals with physical examination were divided into T2DM group and healthy control group, the differences between the two groups in HO-1 and methane dicarboxylic aldehyde (MDA), mean fluorescence intensity (MFI), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting blood glucose (FBG) were comparatively analysed , and analyzed the correlations between HO-1 and reactive oxygen species (ROS) MFI, MDA, HOMA-IR and FBG. Results The type 2 diabetes group in MDA and MFI, the expression rate of HO-1 were higher than those of control group (P<0.05), correlation analysis of expression of HO-1 was positively correlated with MFI, MDA (r=0.489, 0.763, P<0.05) in the T2DM group, HO-1, HOMA-IR and FBG were significantly higher than the healthy control group, the difference was statistically significant(P<0.05). The expression of HO-1 and HOMA-IR and FPG levels were positively correlated in the T2DM group (r=0.271, 0.426, P <0.05). Conclusion T2DM patients with hyperglycemia and oxidative stress, plasma HO-1 expression is significantly increased, HO-1 is related to oxidative stress, insulin resistance and hyperglycaemia, which has certain value on clinical assessment of T2DM and therapeutic efficacy.