Objective To further study the pathogenesis for congenital heart disease (CHD) and connective tissue growth factor(CTGF) for the early diagnosis of CHD and pulmonary hypertension (PH).Methods Sixty-six cases of children with CHD were selected from the thoracic surgery who were performed in the Children's Hospital of Shanxi Province during the period between Sep.2012 and Jan.2013.Based on the cardiac color Doppler estimation of the pulmonary artery systolic pressure,they were classified into several groups:unincorporated PH group with 16 cases,mild PH group with 18 cases,moderate PH group with 17 cases,and severe PH group with 15 cases.Based on types,the 66 cases could be classified as ventricular septal defect (VSD) group with 23 cases,atrial septal defect (ASD) group with 17 cases,patent ductus arteriosus(PDA) group with 14 cases,and composite(including 2 or more of the congenital cardiovascular anomalies) group with 12 cases.Twenty healthy children who had medical examination over the same period in the Children's Hospital of Shanxi Province were randomly chosen as the healthy control group.The serum concentration of CTGF in the research objects were determined with the aid of double antibody sandwich enzyme-linked immunosorbent assay method.According to the different pulmonary artery systolic pressure and different types of CHD,the serum concentration of CTGF were compared among groups.The correlation of between the CTGF concentration in the serum and pulmonary artery systolic pressure were also analyzed among the groups of children with CHD.Results Quantitative measurement revealed that the serum CTGF concentration measured in the groups of children with CHD were significantly higher than that in the healthy control group(P ＜ 0.05) ; the serum CTGF concentration of the children with CHD and PH was higher than that in the group of children with CHD alone(P ＜ 0.05).With the increase in pulmonary artery pressure,CHD patients serum levels of CTGF also increased(P ＜ 0.05).By the correlation analysis,the results showed that the serum level of CTGF in the CHD groups were positively correlated with the pulmonary artery pressure (r =0.670,P =0.005 ; r =0.514.P =0.029 ; r =0.517,P =0.034 ; r =0.707,P =0.003).The difference in terms of serum CTGF concentration in different types of CHD patients was not significant (F =0.270,P =0.847).Conclusions There exists certain damage in CHD early myocardial fibrosis(unincorporated PH),when combined with PH,myocardial fibrosis increases with the gradual increase of pulmonary artery pressure.However,the degree of myocardial fibrosis shows no correlation with the type of CHD.

10.3969/j.issn.1000-3606.2013.06.006

Objective To assess the serum level of stromal-cell-derived factor 1 (SDF-1) in patients with congenital heart disease (CHD) and pulmonary arterial hypertension. Methods The heart color Doppler ultrasound was conducted to measure the tricuspid regurgitation velocity, in order to estimate pulmonary artery systolic pressure. According to the existing standards, a total of 86 patients were divided into CHD without pulmonary hypertension group (n=16), mild pulmonary hypertension group (n=18), moderate pulmonary hypertension group (n=17), severe pulmonary hypertension group (n=15). Another 20 healthy chil-dren were recruited as control group (n=20), The serum level of SDF-1 was detected by the ELISA method. Results The serum SDF-1 levels were signiifcantly lower in CHD groups than in control group (F=27.793, P<0.001). In CHD groups, CHD with se-vere pulmonary hypertension group had the lowest SDF-1 level, and CHD without pulmonary hypertension group had the highest SDF-1 level. There were signiifcant differences between CHD groups (P<0.05). The pulmonary artery systolic pressure was cor-related with serum SDF-1 levels (r=-0.737, P<0.001). Conclusions The serum level of SDF-1 is decreased in patients with CHD, and is negatively correlated with the severity of pulmonary arterial hypertension.

Objective To explore the mechanisms of coronary artery lesions in patients with Kawasaki disease by detecting thrombomodulin level in both acute and convalescence stages. Methods Fifty-eight patients were recruited in which 34 were male and 24 were female. This group was further divided into coronary artery lesion group(25 cases) and non-coronary artery lesion group(33 cases). Normal control group was consisted of 30 healthy children in which 17 were male and 13 were female. Thrombomodulin was measured by enzyme linked immunosorbent assay. Results Compared with the control group, TM level was increased in the Kawasaki disease group. TM level in the acute stage group and convalescence group was higher than that of the control group, TM level in acute stage group was higher than that of the convalescence group (P<0.05). Compared with non-coronary artery lesion group, TM level of the coronary artery lesion group was increased and the difference was significant (P<0.01). Correlation analysis showed that the TM level was positively related with coronary complications of the Kawasaki disease (r=0.855, P<0.01 ). Conclusion TM increases significantly in Kawasaki disease. It is correlated with the development of coronary artery lesions. In addition, it is also associated with apparent hypereoagulation and thrombocytophilia. TM can predict the development of coronary artery lesions.

Objective To investigate the changes and diagnostic significance in plasma undercarboxylated osteocalcin in children with Kawasaki disease (KD),especially with coronary artery lesions (CALs).Methods The data of 36 KD children were collected,who were inpatients at Department of Cardiovascular and Rheumatology,Shanxi Province Children's Hospital from January 2015 to December 2015,including 20 boys and 16 girls,aged (2.3 ± 1.1)years old.According to the course of the disease,KD children were divided into an acute stage group and a subacute stage group.Based on the echocardiography findings,KD children were subdivided into CALs group and no coronary artery lesions (NCALs) group.Twenty-five healthy children from the physical examination during the same period were selected as the healthy control group,13 boys and 12 girls,aged (2.6-± 1.0) years old.Plasma undercarboxylated osteocalcin level was measured by double antibody sandwich enzyme-linked immunosorbent method.Sigrnaplot 12.5software was used to analyze the data statistically,and the receiver-operating characteristic (ROC) curve was used to evaluate the diagnostic effect of plasma undercarboxylated osteocalcin in KD with CALs.Results The levels of plasma undercarboxylated osteocalcin in the healthy control group,the acute stage group and the subacute stage group were (16.4 ± 1.6) μg/L,(14.2 ± 1.6) μg/L,(14.3-± 1.7) μg/L,respectively.Compared with the healthy control group,the plasma undercarboxylated osteocalcin level in the acute stage and the subacute stage were significantly lower,the differences were statistically significant (q =6.088,5.687,all P ＜ 0.01).But there was no difference of plasma undercarboxylated osteocalcin level between the acute stage group and the subacute stage group (q =0.466,P ＞ 0.05).The levels of plasma undercarboxylated osteocalcin in acute stage group with CALs and acute stage group with NCALs were (12.9 ± 1.2) μg/L,(15.0 ± 1.4) μg/L.Compared with healthy control group,the plasma undercarboxylated osteocalcin levels of children with CALs and with NCALs were obviously decreased,the differences were statistically significant (q =8.711,3.891,all P ＜ 0.01).There was a statistical difference in plasma undercarboxylated osteocalcin level between the acute stage with CALs and the acute stage with NCALs (q =5.171,P ＜ 0.01).The plasma undercarboxylated osteocalcin levels of KD children with CALs in the subacute stage was (13.0-± 1.3) μg/L.Compared with acute stage,there was no statistical difference (t =0.257,P ＞ 0.05).There was a sensitivity of 79％,specificity of 82％,positive predictive value of 88％ and negative predictive value of 70％ for the 15.7 μg/L undercarboxylated osteocalcin for diagnosing KD.There was a sensitivity of 83％,specificity of 88％,positive predictive value of 83％ and negative predictive value of 88％ for the 13.7 μg/L undercarboxylated osteocalcin for diagnosing KD with CALs.Conclusions Osteocalcin is related to the pathogenesis and development of KD.Plasma undercarboxylated osteocalcin contributes to the diagnosis of KD with CALs.

Objective: To investigate the significance of doctor -patient communication courses to medical staff.Methods:Using self-made questionnaire and self -evaluation of anxiety scale (SAS), selection in our u-niversity study of 200 cases of medical personnel , in accordance with the doctor -patient communication before and after the course is divided into classes before and after teaching group , respectively on two groups before and after learning the medical staff on the SAS scores and questionnaire survey .Results:Compared with group before teach-ing, teaching group after medical staff thought through the study of doctor -patient communication course , is con-ducive to cultivating communication consciousness , improve doctor -patient communication skills as well as pre-venting the doctor-patient contradiction (P<0.05).After teaching group SAS score (34.50 ±6.88), signifi-cantly lower than the teaching group SAS score (45.51 ±6.97), difference was statistically significant (t =15 .622 ,P<0 .01 ) .Conclusion:Doctor-patient communication courses are effective way to improve the ability to communicate , to alleviate the anxiety of the medical staff at the same time also has a certain value .

The trypsin inhibitor is a kind of substance that can inhibit trypsin activity.It shares extensive physiological roles.The trypsin inhibitor not only inhibits the activities of many enzymes,but also has significant anti-cancer effects by suppressing cell invasion and promoting cell apoptosis.Wnt signaling pathway involves in the regulation of cell growth,proliferation and apoptosis.It also plays an important role in tumor development.This review focuses on the impacts of trypsin inhibitors on Wnt signaling pathway and tumor cell apoptosis.

Objective To assess the effect of PRISMA statement on intervention-related systematic reviews and meta-analyses published in Evidence-based medicine .Methods Intervention-related systematic reviews and meta-analyses published in Evidence-based medicine from 2001 to 2011 were assessed according to the PRISMA scale and analyzed by Meta Analysist software.Results Seventy intervention-related systematic reviews and meta-analyses involving 14-disease spectra were included in this study.PRISMA statement and systematic reviews and meta-analysespublished by au-thors in colleges and universities could improve their academic level (P<0.05), fund support and the number of authors showed no significant effect on their academic level.Conclusion Literature retrieval methods,literature screening methods,bias assessment methods, and other analyzing methods used systematic reviews and meta-analyses published in Evidence-based medicine and their academic level can be improved by PRISMA statement.

Objective By exploring the alteration of tissue plasminogen activator (t-PA) and tissue plasminogen activator inhibitor-1 (PAI-l) in plasma in Kawasaki disease (KD) patients to identify the pathophysiological mechanism of vascular damage and to detect the relationship between fibrinolytic system function and coronary artery lesion complications in Kawasaki disease patients. Method Plasma levels of t-PA, PAI-1 antigen were measured by enzyme-linked immunosorbent assay. Patients with KD were grouped into acute phase group, recovery phase group patients with coronary artery lesion group and non-coronary artery lesion group. Results Plasma t-PA and PAI-1 in acute phase and recovery phase groups were significantly higher than those in the healthy group (P

Homocestkink is a mktabolitk of mkthionink,which has bkkn provkd to bk associatkd with multiplk sestkmic diskasks. In pkdiatric diskasks,homocestkinkmia has bkkn paid mork and mork attkntion in rkcknt ekars. Hepkr-homocestkinkmia is associatkd with somk diskasks of cardiovascular sestkm,rhkumatoid immunk sestkm,urinare sestkm, nkrvous sestkm,blood sestkm,digkstivk sestkm in childrkn. Lnd karle mkasurkmknt of homocestkinkmia plaes an impor-tant rolk in thk diagnosis,trkatmknt and prkvkntion of somk diskasks in childrkn. Through sunmmarizing thk mktacha-nism of homocestkink and its rklationship with multiplk sestkmic diskasks in childrkn,wk invkstigatk thk clinical valuk of homocestkink in childrkn.