Objective To analysis the levels of serum homocysteine (Hcy)and erythropoietin (EPO)levels in patients with ischemic stroke and their relationship with carotid atherosclerosis.Methods The patients with ischemic stroke admitted be-tween January 1,2013 and July 31,2016 were selected as the subjects.Sera test of Hcy,EPO level,and then through the Doppler probe carotid artery method to check the degree of carotid atherosclerosis in all patients,and the use of quantitative records,according to set diagnostic criteria for classification,the use of grading results with the same type of Hcy,EPO lev-els of data analysis to determine the relationship between the two.Results Doppler exploration in 142 patients showed nor-mal carotid intima-media thickness in 34 patients,carotid intima-media thickening in 56 patients,and carotid plaques in 52 pa-tients.After analysis of variance (F=59.64,78.29,P<0.05),and the difference between the two groups was statistically significant (P<0.05),and the difference between the two groups was statistically significant.The data between any two groups were also statistically significant differences.108 patients with different levels of carotid atherosclerosis were graded into 47 of grade 1,34 of grade 2,and 27 of grade 3,with the same type in the plasma of different grades (F=78.39,48.61, P<0.05).After the qtest,there were no significant differences in the levels of Hcy and EPO.Data were also statistically dif-ferent between groups.Conclusion Serum homocysteine (Hcy)and erythropoietin (EPO)were associated with ischemic stroke and were associated with carotid atherosclerosis.

Objective To study the relationship between serum MMP-9,Gal-3,TGF-β1 and lung function in children with bronchial asthma.Methods The serum levels of matrix metalloproteinase-9 (MMP-9),serum galectin-3 (MMP-9),serum metalloproteinase-3 (MMP 9) and serum albumin were measured in 218 pediatric children between March 1,2012 and August 31,2016 in Shenzhen Longhua New District People's Hospital pediatric outpatient clinic.FEV1％,FEV1/FVC and FEF50 were measured and compared respectively with the index data of the control group.The lung function of the children was significantly higher than that of the control group (P＜0.05).Mild group and severe group children above.Results Serum levels measured in 218 children (F=35.34,46.51,56.73,all P＜0.05).The data of any two groups also showed statistical difference after q test,and the difference was statistically significant (FEV1 ％),1-second forced expiratory volume/forced vital capacity percentage (FEV1/FVC),forced expiratory 50％ (FEF50) of the first-second forced expiratory volume/forced expiratory volume of 1 second (F=78.13,52.69,26.24,all P＜0.05).After the q test,the data of any two groups were analyzed by ANOVA.Between the data were also statistically significant differences.Conclusion MM-9,Gal-3 and TGFβ1 in bronchoalveolar lavage and the degree of pulmonary function decline have close ties.

Objective To understand the birth conditions of newborns in four cities of China and its trend. Methods The physical development data of single live newborns in 4 cities of Beijing, Harbin, Changsha and Guangzhou were investi-gated by random cluster sampling method, and was compared with the national neonatal growth standard developed from the investigation in 15 cities from 1986 to 1987. Results The study investigated a total of 5 539 newborns:1 412 in Beijing, 1 410 in Harbin, 1 274 in Changsha and 1 443 in Guangzhou. Except for the head circumference of male newborns, the weight, height and head circumference of full-term newborns in four cities in 2012 were all more than the national neonatal growth standard of 1986-1987 (P<0.05). Compared with the data obtained from 1986-1987, the sex ratio and the prevalence of macrosomia and premature were higher, but the rates of post-term delivery and low birth weight were lower (P<0.01). Conclusions The new-borns in four cities of China are in good condition during recent 25 years. More attention should be paid to improve the birth sex ratio and to decrease rates of macrosomia and premature.

Objectives To investigate factors affecting neonate birth weight. Methods Random cluster sampling method was adopted to investigate the physical development of 5539 single live newborns in Beijing, Harbin, Changsha, and Guang-zhou. Single factor analysis and logistic regression analysis were used to find the factors influencing neonate birth weight. Re-sults Single factor analysis showed that neonatal sex, gestational age, maternal age, maternal pre-pregnancy BMI, gestational weight gain, mother's education and occupation have effects on neonatal birth weight. Risk factors for macrosomia, including male fetus, maternal age≥25 years before pregnancy, maternal pre-pregnancy BMI≥24 kg/m2, gestational weight gain greater than 12.5 kg, and preterm delivery and maternal pre-pregnant BMI<18.5 kg/m2 are the risk factors of low birth weight. Conclu-sions Premature, excessive weight gain during pregnancy, high or low maternal pre-pregnancy BMI are main factors that caused abnormal body mass in neonates.

Objective To compare the RIFLE and AKIN diagnosis criteria for acute kidney injury ( AKI) in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery from January 2004 to June 2007 were retrospectively evaluated. RIFLE and AKIN criteria were employed for the diagnosis and staging of AKI which occurred 7 d after cardiac surgery. The diagnosis sensitivity and precision for prediction of hospital mortality were compared between these two criteria. Results One thousand and fifty-six patients were included in this study. There was no significant difference between the prevalence of AKI after cardiac surgery diagnosed by RIFLE criteria and that diagnosed by AKIN criteria (29.55% vs 31.06%, P>0.05). There was no significant difference between the total hospital mortality and the hospital mortality of each stage of AKI diagnosed by RIFLE criteria and those diagnosed by AKIN criteria ( P > 0. 05). Logistic regression analysis suggested that the relative risk of hospital mortality for AKI was similar between patients diagnosed by AKIN criteria and those diagnosed by RIFLE criteria. The area under the ROC curve for hospital mortality was 0. 856 for RIFLE and 0.865 for AKIN in all patients (P<0.001). Conclusion Compared to RIFLE criteria, AKIN criteria do not improve the sensitivity of diagnosis and predictive ability of hospital mortality of AKI after cardiac surgery.

Objective: To analyze the relevant literature regarding the effect of tuina on postpartum milk secretion and thus summarize the clinical rules on tuina for lactation disorder. Method: Investigate the relationship between tuina and postpartum milk secretion for four aspects, including the initial time of lactation, level of serum prolactin, volume of lactation, and Chinese medicine's understanding of tuina on milk secretion. Result and Conclusion: Tuina on breasts after childbirth can speed and promote lactation. This has been proved by clinical practice over the past hundreds of years, along with modern laboratory and scientific research. This method, therefore, is of great significance in obstetrical nursing.

Objective: To observe the impact of high thoracic epidural blockade (HTEB) on atrial autonomic nerve remodeling in dogs with atrial ifbrillation (AF) induced by long-term rapid right atrial appendage pacing and to explore the effect of nerve growth factor (NGF) on atrial autonomic nerve remodeling.
Methods: AF model was established by consistent rapid atrial pacing for 6 weeks. 18 experimental dogs were randomly divided into 3 groups: Sham group, the dogs had no pacing while received normal saline injection; Control group, the dogs had pacing and normal saline injection; HTEB group, the dogs had pacing and 0.5% lidocaine injection for HTEB.n=6 in each group. Atrial myocardium collagen volume fraction (CVF) was examined by Masson staining; sprouting of NGF related protein 43 (GAP43) and tyrosine hydroxylase (TH) were assessed by immunohistochemistry; protein expressions of NGF, GAP43 and TH were measured by Western blot analysis.
Results: Compared with Sham group, HTEB group showed decreased CVF and sprouting of GAP43, TH,P<0.05;reduced protein expressions of NGF, GAP43 and TH,P<0.05-0.01. Compared with Sham group, HTEB group presented increased CVF and sprouting of GAP43, TH,P<0.05-0.01; elevated protein expressions of NGF, GAP43 and TH,P<0.05.
Conclusion: Long-term rapid atrial pacing induced AF dog had inhomogeneous sprouting of atrial myocardial nerve which may cause autonomic nerve remodeling; NGF played the important role in such process. HTEB could effectively inhibit NGF up-regulation and suppress the autonomic nerve remodeling in experimental dogs.

Objective To investigate the incidence of acute kidney injury (AKI) post-orthotopic liver transplant (OLT) and its association with prognosis. Methods Data of 28 patients received single OLT in our hospital from 2004 to 2006 were retrospectively analyzed. The incidence of AKI was investigated by new acute kidney injury network (AKIN) criteria. The follow-up was over one year. The prognosis of AKI patients at day 28 and 1 year was evaluated by Kaplan-Meier survival analysis. The association between AKI and prognosis was examined. Results A total of 193 patients were enrolled. The average age was (48.07±10.02) years old. The ratio of male to female was 4:1. One hundred and sixteen (60.1%) patients of post-OLT AKI were found, whose AKI stage 1, 2 and 3 were 50.0%, 21.6% and 28.4% respectively. Ten (8.6%) patients required renal replacement therapy (RRT) after OLT. In AKI post-OLT patients, day 28 and 1 year mortality were significantly higher than those in non-AKI patients (15.5% vs 0, 25.9% vs 3.9%, respectively, both P<0.05). Kaplan-Meier survival analysis showed the 1-year survival rates of AKI stage 1, 2, 3 post-OLT and non-AKl were 84.0%, 81.0%, 42.4% and 90.9%, respectively. The 1-year survival rate of non-AKI was significantly higher than that of AKI stage 1, 2, 3. The 1-year survival rate of AKI stage 3 was significantly lower than that of stage 1 and 2. There was no significant difference between AKI stage 1 and 2. Sct at 1 year post-OLT was significantly higher than that of baseline [(88.35±37.15) vs (73.70±33.88) μmol/L, P<0.05). The change of Scr value at 1 year compared to baseline in AKI patients was similar to non-AKI patients. However such change in AKI stage 2 and 3 was higher than that in stage 1. Conclusions The incidence of AKI post-OLT is quite high and associated to the poor prognosis in short and long periods. Renal function may decrease gradually which is associated to the AKI stage pest-OLTI.

Objective To explore the effects of acupuncture and individualized occupational therapy on the rehabilitation of patients with unilateral spatial neglect ( USN ) after stroke.Methods Stroke patients with hemiplegia were evaluated by neuropsychological tests,including line bisection,a cancellation test,clock drawing,and figure and shape copying.Sixty-nine right hemispheric stroke patients identified with USN were randomly assigned to 3 groups:20 patients as a control group received conventional rehabilitation therapy ; another 22 patients as an occupational group received type-specific individualized occupational therapy combined with conventional rehabilitation therapy; the remaining 23 patients as an acupuncture combined with occupational therapy group received acupuncture in addition to both conventional rehabilitation therapy and occupational therapy.These three groups were evaluated with neuropsychological tests and the modified Barthel index (MBI) before and after treatment.Results ①MBI scores in the occupational therapy group and the combined group were significantly higher after treatment,but no significant difference was observed in the control group.②The increased MBI scores in the combined and occupational groups were higher than those in the control group.At the same time the increase in MBI scores in the combined group was significantly greater than in the occupational therapy group.③The assessment results with both line bisection and cancellation tests in all three groups were significantly different after treatment.The line bisection results in the occupational therapy group and the combined group were significantly better than in the control group.The cancellation test results in the combined group were significantly better than in the control group.Conclusion These findings show that acupuncture combined with occupational therapy can have a positive effect on neglect recovery and greatly improve the daily life of USN patients.

Objective To investigate the incidence, risk factors and outcome of acute kidney injury (AKI) following cardiac surgeries. Methods Clinical data of 1056 patients undergoing open heart surgery in Renji Hospital from January 2004 to June 2007 were retrospectively analyzed. Univariate and multivariate analyses were used to evaluate possible pre-,intra-, and post-operative parameters associated with AKI according to AKI Network (AKIN). Results Of the 1056 patients, 328 (31.06%) developed AKI. In-hospital mortality was 4.07% in all discharges while 11.59% in AKI patients (P<0.01). Multivariate logistic regression analysis revealed that increased age (OR=1.40), pre-operative hyperurieemia (OR=1.97), pre-operative left ventricular insufficiency (OR=2.53), combined surgery (OR=2.79), prolonged operation time (OR=1.43), post-operative circulation volume insufficiency (OR=11.08) were risk factors of AKI. Conclusions AKI is a common complication and associated with increased mortality following cardiac surgery. Increased age, pre-operative hyperuricemia, pre-operative left ventricular insufficiency, combined surgery, prolonged operation time, post-operative circulation volume insufficiency are useful in stratifying risk factors for the development of AKI.