Objective To assess the indications,effect and complications of plasma exchange(PE) application in children.Methods A total of 93 patients treated with PE were enrolled,and the clinical mani-festations before and after treatment were analyzed retrospectively.Results Ninety-three cases of children received PE treatment 2 to 1 1 times,an average of 5.5 times,53 cases with combination blood purification treatment.In 93 patients,there were 36 cases with hemolytic uremic syndrome,among them,22 cases (61.1 %)were healed,14 cases(38.9%)remained hematuria,and proteinuria and 5 of them(13.9%)with injured renal function.There were 9 cases with Guillain-Barre'syndrome and 8 of them got improved.Six in 8 cases with anti-N-methyl-D-aspartate receptorencephalitis got better after treatment.All of the 3 cases with myasthenia gravis got recovery.There were 4 cases with acute disseminated encephalomyelitis and 4 cases with chronic inflammatory demyelinating polyneuropathy respectively.The treatment effect rate was all 3 /4. Four in 9 patients with poisonous mushroom poisoning also got improved.The adverse reactions were ob-served in 12 cases(12.9%),including allergic in 9 cases and hypotension in 3 patients.No serious adverse reactions were found during treatment.Conclusion PE is an safe and effective blood purification method, with less adverse reaction,for treatment of the atypical hemolytic uremic syndrome and some serious nervous system diseases,such as myasthenia gravis,Guillain-Barre syndrome,etc.

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

Objective To explore the effect of health education improvement on promotion of timely vaccination among migrant children in community and to provide references for community health service center.Methods A total of 155 migrant children's parents were recruited from July 2015 to February 2016,and improved health education intervention was carried out on the basis of routine health education to promote parents' health belief on timely vaccination.The compliance of parents' participation in health education activities,the health belief of parents themselves on timely vaccination at different stages of intervention and parents' satisfaction,and the rate of timely vaccination of migrant children before and after intervention were evaluated.Results Regarding the compliance of health education activities for parents in 12 weeks,the first 3 weeks was 85％ ～ 91％,the last 4 weeks were 95％ and above.Six months after intervention,the score of parents' health belief on timely vaccination was higher than that after 3 months of intervention and before intervention,and the difference was statistically significant (P＜0.05).The timely vaccination rates in the study group for migrant children was higher than that in the historical groups (P＜0.05).After intervention,the satisfaction rate for parents was 95.484％.Conclusion Health education improvement could effectively promote parents' health belief on timely vaccination,satisfaction rate and rate of timely vaccination among migrant children.

Objective: To investigate the effects of Pantoprazole on the expression of TFF1 in stress-induced gastric mucosal lesions in rats, and the mechanism thereof. Methods: Fifty-six rats were randomly divided into seven groups, normal group, model groups (3 groups) and model therapy groups (3 groups). The rat model of water immersion- restraint stress (WRS) was established in model groups, model group1(the immediately after establishing models), model group 2 (4 h after establishing models) and model group 3(8 h after establishing models). The model therapy groups were divided into model therapy group 1 (immediately after establishing models), model therapy group 2 (4 h after establishing models), and model therapy group 3 (8 h after establishing models). The ulcer index (UI) and histological changes were observed after WRS in rats. The expression of TFF1 was detected by immunohistochemistry. Results: After WRS, the gastric mucosa was widely damaged in rats. UI were increased and the expression of TFF1 was decreased in model groups. After intervention with Pantoprazole, UI was lower in model therapy group than those in model groups (model group 1 vs model therapy group 1,69.13±1.97 vs 23.38±1.30, P ＜ 0.01; model group 2 vs model therapy group 2, 57.50±8.81 vs 10.38±3.02, P ＜ 0.01; model group 3 vs model therapy group 3, 43.50±6.76 vs 5.88±1.25, P ＜ 0.01). The staining scores of TFF1 were increased (model group 1 vs model therapy group 1, 0.55±0.11 vs 0.92±O.15, P＜ 0.01; model group 2 vs model therapy group 2, 0.76±0.24 vs 1.36±0.21, P＜ 0.01; model group 3 vs model therapy group 3, 1.12±0.16 vs 1.65±0.11, P ＜ 0.01). Conclusion: TFF1 may participate in the protection of gastric mucosa and promote ulcer recovery. Pantoprazole may participate in the defense of gastric mucosa through mediating the up-regulation of TFFI expression.

ObjectiveTo investigate the effect of tramadol on perioperative insulin resistance in patients un dergoing pulmonary lobectomy.MethodsThirty patients undergoing pulmonary lobectomy,were randomly divided in to two groups :group T(tramadol group)and group C (control group), five minutes before skin incison, group T re ceived tramadol 1.5 mg/kg intravenously (IV), followed immediately by a continuous infusin of 0.5mg/kg per hour until the end of surgery, and the control group received normal saline instead of tramadol.Blood samples were takenfrom vein for determination of plasma blood sugar,insulin, IL-6 and TNF-α concentrations before induction of anesthe sia(T0) ,at the end of the operation(T1) ,four hours after operation(T2)and seven oclock on the next morning(T3),and the value of ISI was calculated.ResultsThe concentrations of blood sugar, insulin,TNF-α and IL-6 at T1 andT2 ,T3 increased significantly compared to baseline(T0) in both groups(P ＜ 0.05).The concentrations of blood sugar,insulin,IL-6 and TNF-o at T1 ,T2 and T3 were significantly lower in group T than that in group C (P ＜0.05).Thevalue of ISI was significantly higher in group T than that in group C (P ＜ 0.05).ConclusionTramadol could allevi ate perioperative insulin resistance in patients undergoing pulmonary lobectomy by inhibiting plasma blood sugar,insu lin,IL-6 and TNF-α.

Human embryonic stem cell (hES cells) lines can be derived from the inner cell mass (ICM) of preimplantation blastocysts.hES cells are commonly defined as undifferentiated pluripotent cells that can proliferate and have the capacity of both self-renewal and differentiation into one or more types of specialized cells.hES cells remain undifferentiated when culture on feeder layers,such as murine embryonic fibroblasts (MEFs).It is believed that various factors secreted from feeder layers are necessary to prevent hES cell from differentiation.In this review,we will summarize the advantages and disadvantages of various types of feeder cells by which a reference for future research will be provided.

Objective: To investigate the protection roll of rosuvastatin on chronic heart failure (CHF) in rats with its effect on asymmetric dimethylarginine (ADMA) metabolic pathway.
Methods: A total of 36 male SD rats were randomly divided into 3 groups, n=12 in each group. Isoproterenol (ISO) group, the rats received ISO subcutaneous injection (5mg·kg·d) for 7 days to establish CHF model, and then received normal saline gavage administration for 7 days. Rosuvastatin (ROS) treatment group, the rats received ISO with ROS for 7 days, then continuously receiving ROS until 14 days. Normal control group, the rats received saline gavage administration for 7 days. The related serum index and haemodynamic parameters were examined, myocardial pathological changes were observed and the relevant protein expression was measured by Western blot analysis.
Results: Compared with Normal control group, ISO group had obviously increased troponin (cTn I), serum ADMA,-LVdP/dtmin, all P<0.01, and decreased left ventricular systolic pressure (LVSP), heart rate, arterial SP, mean arterial pressure, +LVdP/dtmax, all P<0.01. Compared with ISO group, ROS treatment group showed signiifcantly decreased BNP, cTn I, ADMA , -LVdP/dtmin, all P<0.01, and increased LVSP, heart rate, arterial SP, mean arterial pressure,+LVdP/dtmax, all P<0.01. Compared with Normal control group, ISO group had increased expression of protein arginine methyltransferases 1 (PRMT1), decreased expression of dimethyl- arginine dimethylaminohydrolase 2 (DDHA2), both P<0.01. Compared with ISO group, ROS treatment group showed decreased expression of PRMT1, P<0.01 and similar expression DDHA2, P>0.05.
Conclusion: Rosuvastatin has the protective roll on ISO induced CHF in rats, which might be related to decreased serum levels of cTn I, BNP and ADMA metabolic pathway regulation.

Objective To investigate the status of nutritional risk and nutritional support in general surgery patients, and to explore their association with postoperative complications and length of hospital stay.Methods From January 2014 to February 2015, 853 inpatients in general surgical wards in the Second Hospital of Hebei Medical University were enrolled.Nutritional Risk Screening 2002 (NRS 2002) was used to estimate nutritional status of patients.The patients were divided into 2 groups based on whether they received nutritional support.The length of hospital stay in days and postoperative complications were recorded.The association of nutritional risk and nutritional support with complications and length of hospital stay were analyzed.Results In the 853 surgery patients, the prevalence of nutritional risk was 31.1％ (265/853) and that of malnutrition was 5.4％ (46/853).The incidence of postoperative complications was 14.2％ (121/853).The patients with nutritional risk had a significantly higher incidence of postoperative complications compared to those without nutritional risk [29.8％ (79/265) vs.7.1％ (42/588) , P ＜ 0.000] , and a longer hospital stay [(12.5 ±6.4) days vs.(4.2 ±3.9) days, P ＜0.001].In the 853 patients, 27.3％ (233/853) received nutrition support.In the patients with nutritional risk, those on nutritional support had a significantly lower incidence of complications compared with those not on nutritional support [16.7％ (32/192) vs.64.4％ (47/73), P＜0.05] and shorter hospital stay [(7.5±4.6) days vs.(16.3±8.5)days, P ＜ 0.05].Conclusions According to NRS 2002 result, a fairly high percentage of general surgery patients may have nutritional risk.Patients with decreased body mass, less dietary intake, and at higher age may be more likely to have nutritional risk.Nutritional risk may be associated with a higher incidence of postoperative complications and longer hospital stay.Patients at nutritional risk appear to be more likely to benefit from nutritional support.

Objective To establish a fluorescent polymerase chain reaction (PCR) method for rapid, sensitive and specific determination of -88/-123 polymorphisms in Myxovirus resistance protein A (MxA) gene promoter so as to provide molecular biology tool for optimized interferon-a treatment in chronic hepatitis B patients. Methods Hepatitis B virus (HBV) genotyping,serum HBV DNA level,and- 88/- 123 polymorphisms in MxA gene promoter of patients who had been treated with interferon-α were detected. The statistical analysis was done by using SPSS software to understand the relationship between MxA gene polymorphisms and interferon-α treatment. Afterwards, an optimal fluorescent PCR system was established to determine -88/-123 polymorphisms in MxA gene promoter. The sensitivity and the specificity of this system were confirmed by DNA sequencing. P-value of chi square test, odds ratios of regression analysis and 95% confidence intervals were employed. Results Patients with- 88 G/T and - 123 C/A in the interferon-stimulated response element in MxA gene promoter were interferon-α sensitive, while patients with - 88 GIG and - 123 C/C were not interferon-α sensitive. The coincidence rate of this system was 99.65% in comparison with DNA sequencing.Conclusion MxA gene polymorphisms could be rapidly and sensitively determined by this fluorescent PCR system.

BACKGROUND: The establishment of amniotic fluid derived stem cells (AFS) can provide an individual reserve for cell therapy in nerve degenerative diseases.OBJECTIVE: To observe the effects of Noggin and basic fibroblast growth factor (bFGF) on AFS differentiation into neural cells.METHODS: Samples of amniotic fluid were obtained through amniocentesis by ultrasound from gestational age of 16-22 weeks for routine prenatal diagnosis. AFS were obtained from the 2~(nd) trimester amniotic fluid samples by immunomagnetic beads selection using CD117 antibody, and identified the surface antigen expression by flow cytometry after amplification. The 3~(rd) generation of AFS with good growth state were induced to differentiate into nerve cells, which were divided into the blank control,based-induced, Noggin-induced and bFGF-induced groups. The induced cell morphology was observed under inverted phase contrast microscopy, and the expression of nestin, β-Ⅲ tubulin and neurofilament in the induced cells was measured by using cell immunofluorescence detection.RESULTS AND CONCLUSION: Flow cytometry analysis indicated that most of AFS cells expressed CD44 and HLA-ABC, but negative for CD45 and HLA-DR. At 2 weeks after induction, the cell morphology exhibited significant changes with increased Nestin,β-Ⅲ tubulin and NF-positive rates in the bFGF-induced group. However, it had no significant difference in the Noggin-induced group and the based-induced group. It revealed that bFGF plays a vital role in the AFS differentiated into nerve cells.