0.05).Conclusions Transcatheter intervention of VSD with large sack both thin-waist-big-side occluder or symmetrical occluder showed satisfactory result.Attention should be paid in the indications of these 2 types of occluders.

There is a broad and urgent need for the clinical application of anticancer nanomedicine in tumor therapy, but the complex biological barrier in solid tumors has always been the main obstacle to infiltrating nanomedicine into the tumor. The traditional design of nanomedicine based on enhanced permeability and retention (EPR) effect still has some limitations in tumor permeability, it is urgent to find other design theories. Therefore, this review summarizes two novel strategies, active transcytosis and immune cell-mediated tumor penetration, for promoting tumor penetration of anticancer nanomedicine.

Objective To evaluate transthoracic echocardiographic guidance for closure of atrial septal defects with Amplatzer occlusion device in the adults Methods Thirty patients with atrial septal defects were occluded by use of Amplatzer septal occluder The mean age was (32 3?14 7) years (ranging from 13-65 years) Transthoracic echocardiography was undertaken for guidance for closure before and in the procedure of intervention Transthoracic echocardiography was done immediately, one month and three month respectively after intervention to evaluate the treatment efficiency Results Twenty four patients were treated successfully directly by guidance of transthoracic echocardiography during the period of closure, the total effectiveness was 80%. Five patients needed to have transesophageal echocardiography before closure to select indication and another one patient was treated successfully by adding transesophageal echocardiography for guidance in the procedure There was no significant complication that occurred during the procedures, and there was no emergency surgical case Trivial to small residual shunts were found in 2 cases (6 7%) immediately after the procedure No residual shunts were found in the one month follow up, and all patients had no displacement and recanalization in the one month follow up Conclusion Transthoracic echocardiography can guide most of atrial septal defect patients for closure of atrial septal defects with the Amplatzer occlusion device

Objective To analyze the clinical features of acute leukemia(AL) with positive mixed lineage leukemia(MLL)fusion gene in children,and explore their treatment protocols,prognosis factors,and so on.Methods Clinical features,treatment protocols,and prognosis factors were studied retrospectively among 51 AL patients with MLL fusion gene.MLL fusion gene was detected by morphology immunology,cytogenetics,molecul arbiology and reverse transcrption polymerase chain reaction(RT-PCR).Results Fifty-one AL patients with MLL fusion gene positive,included 37 cases of acute lymphoblastic leukemia(ALL) and 14 cases of acute myelocytic leukemia(AML).Forty-two patients exhibited abnormal clonal chromosome 11.MLL fusion gene rearrangements and MLL fusion gene partial tandem duplication were found among 36 cases and 15 cases,respectively.Thirty-two cases who received regular chemotherapy were followed up.Twenty-four cases including 19 cases of ALL and 5 cases of AML had achieved complete remission(CR).Six cases including 5 cases of ALL and 1 cases of AML had achieved more than 2 years CR.Sixteen cases were alive update including 12 cases of ALL and 4 cases of AML.Ten cases of positive MLL fusion gene were turning negative.Up to now,6 cases relapsed and 6 cases were dead.Conclusions The incidence of AL children with positive MLL fusion gene is low.It has some features,such as,high replapse rate and poor prognosis.A few patients sensitive to chemotherapies can achieve CR.They live with constant negative MLL fusion gene.

Child, Preschool ; Heart Diseases ; physiopathology ; Humans ; Iliac Vein ; physiopathology ; Leukemia, Lymphoid ; complications ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; Thrombosis ; etiology ; physiopathology

Child ; Cimetidine ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Nephritis ; prevention & control ; Purpura, Schoenlein-Henoch ; complications ; drug therapy ; Pyrazines ; therapeutic use

Objective:To observe the serum level of fibroblast growth factor-23(FGF-23) in patients with end stage renal disease (ESRD) and study its association with phosphorus and vitamin D metabolism.Methods: Serum FGF-23 level was determined by enzyme-linked immunosorbent assay (ELISA) in ESRD patients undergoing haemodialysis (HD, n=50) and peritoneal dialysis (PD, n=24) and in twenty healthy controls (control group,n=20).Serum level of 1,25-(OH) 2VitD was measured by enzyme immunoassay(EIA).Serum intact parathyroid hormone (PTH), creatinine, and calcium and phosphorus were also measured.Results: Serum FGF-23 was obviously higher in HD group([88.51?35.01] ng/L vs [11.76?3.63] ng/L)and PD group([87.85?33.65] ng/L vs [11.76?3.63] ng/L)than in control group. Moreover, the serum level of 1,25-(OH)2VitD was lower in HD and PD groups than in control group ([19.82?4.99] pmol/L vs [48.37?3.47] pmol/L; [24.31?7.11] pmol/L vs [48.37?3.47] pmol/L ), and the level of 1,25-(OH)2VitD was much lower in HD group than in PD group. Pearson relativity analysis showed that serum FGF-23 level was positively correlated with serum creatinine, phosphorus, intact PTH and duration of dialysis(P

Objective To observe the expressions of efflux pump gene cluster adeAB in acinetobacter baumannii isolated from the burn patients and the expression changes of its upstream regulatory genes adeR and adeS and determine the influence of those genes on drug resistance of acinetobacter baumannii.Methods Nine drug-resistant strains and nine sensitive strains of acinetobacter baumannii isolated from the burn patients treated between June 2012 and March 2013 were used.After strain identification using 16SrDNA sequencing,acinetobacter baumannii standard strain ATCC19606 was employed as the control.mRNA expressions of efllux pump genes adeA and adeB and their upstream regulatory genes adeR and adeS were detected by real-time quantitative PCR.Results (1) adeA and adeB genes presented higher expressions in drug-resistant strains (3.71 ±0.95,76.16 ± 8.75) than in sensitive strains (0.92 ± 0.94,0.72 ± 0.78) (F =38.71,663.65 respectively,both P ＜ 0.05).(2) adeS and adeR genes showed higher expressions in drug resistant strains (18.02 ± 6.71,3.02 ± 2.69) than in sensitive strains (1.64±1.51,0.76±0.61) (F =51.04,5.57 respectively,bothP＜0.05).Conclusions The over-expression of efflux pump gene cluster adeAB induced by the expression alteration of its upstream regulatory genes adeR and adeS is closely associated with the drug resistance of acinetobacter baumannii in the burn patient.Besides,the regulatory genes may depend on adeS to sense the nosocomial environment condition,activate or inactivate adeR and hence regulate efflux pump expression.

Objective To investigate the influence of abaI expression on acinetobacter baumannii biofilm formation.Methods Acinetobacter baumannii strain S isolated from bums patients was collected for the study,while the standard strain ATCC19606 was served as the control.At 6,24 and 48 hours,the gene expressions of abaI,pgaA,pgaB and pgaC were detected by real-time fluorescent quantitative PT-PCR,secretion of N-acyl-homoserine lactones (AHLs) by biological sensor and biofilm formation by MTT method.Results (1) Gene expressions of abaI,pgaA,pgaB and pgaC at 6 hours were 8.63 ±5.93,1.98 ± 1.93,1.01 ± 1.32 and 2.67 ± 3.46 respectively,which showed a quick increase at 24 hours (22.81 ± 17.60,5.13 ± 4.32,5.66 ± 3.97,11.97 ± 7.75 respectively),followed by a rapid decline in 48 hours (3.43 ± 0.88,1.30 ± 0.24,3.01 ± 3.00,3.02 ± 3.29 respectively).Gene expressions of pgaB and pgaC at 6 hours and that of pgaA and pgaC at 48 hours revealed statistically significant differences from those at 24 hours (P ＜ 0.05).(2) AHLs showed a level of 18.49 ± 11.03 at 6 hours,reached a peak of 52.23 ± 15.95 at 24 hours,then descended to 5.53 ± 0.94 at 48 hours.AHLs level at 24 hours showed statistically significant difference from that at 6 hours and 48 hours (P ＜ 0.05).(3)Biofilm formation at 24 hours and 48 hours was 2.83 ±0.44 and 2.71 ±0.15 respectively,far higher than that at 6 hours (0.49 ± 0.11,P ＜ 0.05).(4) In the correlation analysis among AHLs,biofilm formation and gene abaI,pgaA,pgaB and pgaC expressions,significant positive correlation was found between abaI and pgaA and between AHLs and pgaC expression (P ＜ 0.05).Conclusion Acinetobacter baumannii may regulate gene expressions of pgaA and pgaC responsible for biofilm formation to adjust to the external environment by means of changing abaI gene expression and AHLs secretion.

Objective To investigate the clinical efficacy of hydrocortisone sodium succinate for treatment of septic shock patients and their prognoses. Methods A prospective case control study was conducted. 49 patients with septic shock in the Department of Emergency of the First Affiliated Hospital of Xi'an Jiaotong University were enrolled from January 2010 to January 2012,and the patients were sequentially divided into two groups,the treatment group(24 cases)and the control group(25 cases),by the difference in odd or even number. All patients in the two groups accepted the conventional treatment. The treatment group additionally received hydrocortisone sodium succinate injection 200 mg,once a day for 5 days. The levels of serum procalcitonin(PCT),C-reactive protein(CRP)were measured in all the patients before treatment and 24 hours,72 hours and 7 days after treatment. The mortalities were compared in 14 days between the two groups. Results The levels of PCT,CRP before and 24 hours after treatment were not statistically significant different from those of pre-treatment in two groups(all P>0.05). PCT and CRP were decreased at 72 hours and 7 days after treatment in the two groups,and on the 7th day the decline was more significant, and compared with the control group,the levels of PCT and CRP in treatment group were reduced more markedly at 72 hours and on the 7th day〔PCT(μg/L):72 hours 9.73±2.10 vs. 12.36±2.56,7 days 5.33±2.05 vs. 8.76±1.78;CRP(μg/L):72 hours 69.12±13.61 vs. 109.68±16.16,7 days 20.16±9.64 vs. 42.32±13.16,all P<0.05〕. But the mortality in 14 days was not statistically significant different between control group and treatment group(52.0%vs. 45.8%,P>0.05). Conclusion The treatment with hydrocortisone sodium succinate can reduce the inflammation of patients with septic shock,thus it has clinical value in the improvement of the disease situation.