Persistent pulmonary hypertension of newborn (PPHN) is a clinical syndrome,characterized by pulmonary arterial pressure elevated relative to systemic blood pressure,leading to extrapulmonary right-to-left shunting of blood across the ductus arteriosus and foramen ovale,causing severe hypoxemia.Pulmonary vascular remodeling is pathognomonic of hypoxia-induced PPHN.The regulatory mechanism and cell composition of vascular wall were dysfunction,which led to vascular wall thickened.The review focus on three aspects,such as endothelial cells,smooth muscle cells,and adventitial cells,described the relation and the possible mechanisms between hypoxia-induced PPHN and pulmonary vascular remodeling.

Objective·To analyze changes in the type distribution and drug resistance of pathogenic bacteria isolated from burn wards and to provide evidence for rational use of antibiotics, reduction of drug-resistant isolates, and hospital infection control. Methods·Isolates from burn patients were collected from January 2011 to December 2014. Statistical analysis of infection sources, type distribution, and changes in resistance rates of main pathogens during the four year period was performed. Results·A total of 2399 isolates were collected, including 1286 (53.61%) gram-negative bacilli (G-b), 1088 (45.35%) gram-positive cocci (G+c), and 25 (1.04%) fungi. The most common G-b pathogens were Pseudomonas aeruginosa (447, 34.76%) and Acinetobacter baumannii (369, 28.69%). The most common G+c pathogen and fungus were Staphylococcus aureus (489, 44.94%) and Candida albicans (8, 33.33%), respectively. In the last two years, the detection rates of S.aureus and A.baumannii were significantly lower and the detection rate of P.aeruginosa was significantly higher than those in the first two years (P<0.05). P.aeruginosa and A.baumannii showed high resistance (>80%) to the third and fourth generation cephalosporins, carbapenems, aminoglycosides and quinolones, but the changes were not statistically significant (P>0.05). S.aureus was only highly resistant to penicillin (97.58%) and was 100% susceptible to vancomycin. Its resistance rates toward cefazolin, ampicillin/sulbactam, gentamicin, levofloxacin, and rifampin decreased significantly (P<0.05). The detection rate of methicillin-resistant S. aureus (MRSA) dropped from 72.28% to 63.00%. Conclusion·Many types of drug resistant bacteria were detected in burn wards. The drug resistance problem was serious. Improving management and rational use of antibiotics can reduce the occurrence of drug-resistant bacteria and increase the efficacy of clinical anti-infective treatment and nosocomial infection control.

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.

Objective:To investigate the effect of live lactobacillus preparation in the treatment of postpartum vagina microenviro-ment dysbiosis. Methods:Totally 300 cases of postpartum women were selected in our hospital from February 2013 to November 2013, including those with normal delivery, cesarean section and vaginal delivery after lochia, and each was with 100 cases. The vaginal se-cretion was withdrawn from vagina and the microenvironment was assessed. The patients with dysbiosis were randomly divided into two groups, the observation group was treated with living lactobacillus preparation and the treatment group was without treatment. The effi-cacy and incidence of bacterial vaginosis(BV) were observed. Results:Totally 88 cases (29. 3%) occurred vaginal dysbiosis. There were significant differences in the dysbiosis incidence rate, pH, H2 O2 results, microscopic examination results and the distribution of flora between the two groups (P <0. 05). The effective rate of the observation group was 95. 5%, which was significantly higher than that of the control group (29. 5%). The incidence rate of BV was 4. 5% in the observation group, which was significantly lower than that in the control group [75%] (P<0. 05). Conclusion: The effect of the lactobacillus preparation in the treatment of postpartum vagina microenviroment dysbiosis is promising and safe.

Objective To compare the efficacy of laryngeal tube suction Ⅱ (LTS Ⅱ ) and ProSeal laryngeal mask airway (PLMA) for airway management during general anesthesia. Methods One hundred and twenty adult ASA Ⅰ or Ⅱ female patients, aged 30-50, with body mass index ＜ 30 kg/m2, undergoing general anesthesia for elective surgery were randomly divided into 2 groups ( n = 60 each) : PLMA group and LTS Ⅱ group. Each group was further divided into 2 subgroups: PLMA controlled ventilation group (group PC), PLMA spontaneous breathing group (group PS), LTS Ⅱ controlled ventilation group (group LC) and LTS Ⅱ spontaneous breathing group (group LS) . The rate of successful insertion was recorded. PetCO2 , peak airway pressure, lung compliance and incidence of gas leakage during controlled ventilation were recorded before operation, 10 min after the start of operation and at the end of operation. The tidal volume and PetCO2 were recorded in patients breathing spontaneously when the breathing was stable. The bucking and body movement were observed during removal of LTS Ⅱ or PLMA. The side effects in 24 h after surgery were recorded.Results Insertion was successful in all the patients. During either spontaneous breathing or controlled ventilation, the peak airway pressure was significantly higher in the patients with LTS Ⅱ than in the patients with PLMA ( P ＜ 0.05), and there wag no significant difference in the other ventilatory parameters between the two devices. There was no significant difference in the incidences of postoperative complications among the groups ( P ＞ 0.05) . Conclusion The efficacy of PLMA for airway manage ment is better than that of LTSⅡ during general anesthesia.

Objective:To investigate the correlation between intratumor microvessel density (IMVD) and lymph node micrometastases. Method: IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively. Result:IMVD marked with CD105 antibody corre-lated with T stage and lymph node micrometastases(P<0.01). Conclusion: The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prog-nosis of patients with pN_0 supraglottic laryngeal squamous cell carcinoma.

Objective To evaluate the capability of three tests used alone or in combination for identification of Staphylococcus aureus.Methods Identification of Staphylococcus aureus by the detection of spa gene with PCR and the Vitek-2 system were selected as the reference methods.Comparison of three phenotypic tests including DNase,mannitol fermentation and tube coagulase test was carried out to analyze the sensitivity,specificity,positive/negative predictive value,positive/negative likelihood ratio and Youden index.The consistency,cost and related indexes of the assays were analyzed between the combined phenotypic tests and the reference methods.Results In the present study,324 isolates of Staphylococci,including 293 Staphylococcus aureus and 31 non-Staphylococcus aureus,were collected.Single biochemical test could not identify Staphylococcus aureus efficiently.Comparison between the reference methods and the combined three biochemical tests by Kappa statistic analysis indicated that an overall Kappa value was 0.9441,and the algorithm of combined test was less costly.The sensitivity and specificity of this algorithm were 100％ and 90.3％,respectively.Conclusion The cost-effective algorithm of combined DNase,mannitol fermentation and tube coagulase test could efficiently distinguish Staphylococcus aureus from other Staphylococcus species.

Objective This study aims to evaluate the initial results of a hybrid procedure for treating descending thoracic aortic disease that involves distal aortic arch.It also intends to report our initial experience in performing this procedure.Methods A total of 45 patients(35 males and 10 females) with descending thoracic aortic disease underwent a hybrid procedure,namely,thoracic endovascular aortic repair(TEVAR) combined with supra-arch branch vessel bypass,in our center from April 2009 to August 2014.Right axillary artery to left axillary artery bypass(n =20) or right axillary artery to left common carotid artery and left axillary artery bypass(n =25) were performed.The conditions of all patients were followed up from the 14th month to the 77th month postoperative[mean(38.0 ± 17.1) months].Mortality within 30 days,complications such as endoleak after the hybrid procedure,and stenosis or blockage of the bypass graft during the follow-up period were assessed.Results One case of death and one case of cerebral infarction were reported within 30 days.Two patients underwent open surgery beacuse of endoleak.And a newly formed intimal tear was observed in one patient and the patient underwent a second TEVAR during the follow-up period.Condusion Initial results suggest that the one-stage hybrid procedure is a suitable therapeutic option for thoracic aortic pathologies that involve distal aortic arch.However,this procedure is not recommended for type-B aortic dissection,in which a tear is located in the greater curvature or near the left subclavian artery,because of the high possibility of endoleak occurrence.

Objective To determine the dose?response relationship of bupivacaine coadministered with sufentanil for subarachnoid block in severely preeclamptic patients undergoing cesarean delivery. Methods Two hundred patients with severe preeclampsia, of American Society of Anesthesiologists physi?cal statusⅠ?Ⅲ, scheduled for elective cesarean delivery, were divided into 4 groups ( n=50 each) using a random number table: bupivacaine 4 mg group ( group B4 ) , bupivacaine 6 mg group ( group B6 ) , bupivacaine 8 mg group ( group B8 ) , and bupivacaine 10 mg group ( group B10 ) . In B4 , B6 , B8 and B10 groups, bupivacaine 4, 6, 8 and 10 mg plus 2.5μg sufentanil in 2.5 ml of normal saline were injected into the subarachnoid space, respectively. Effective anesthesia was defined as bilateral sensory block of T6 achieved at 10 min after intrathecal administration when measured by pin?prick test, and with no need for epidural supplementation ( lidocaine ) . A probit analysis was used to estimate the 50% effective dose ( ED50 ) and 95% effective dose ( ED95 ) with 95% confidence intervals for bupivacaine, coadministered with sufentanil, when used for subarachnoid block in severely preeclamptic patients underwent cesarean de?livery. Results When coadministered with sufentanil, the ED50 and ED95 ( 95% confidence interval) of bupivacaine were 5.67 ( 5. 20-6. 10) mg and 8. 82 ( 8. 14-9.87) mg, respectively, for subarachnoid block in severely preeclamptic patients underwent cesarean delivery. Conclusion The ED50 and ED95 of bupivacaine for subarachnoid block, when coadministered with sufentanil 2.5 μg, are 5.67 and 8.82 mg, respectively, in severely preeclamptic patients undergoing cesarean delivery.

Objective :To develop an agent that is more active against receptor-bearing target cells without increasing the toxic effect on non-target cells. Methods :By the use of molecular biology techniques,we designed and constructed a fusion protein 5＇IL6-TNF△ by connecting the human interleukin-6 (hIL-6) gene and a human tumor necrosis factor α derivative (TNF△) gene througha synthetic linker sequence followed by subsequent expression in E. Coli. Results: In cytotoxicity assay with myeloma cell line U266, the normal type of 5＇ IL6-TNF△ showed an antitumor activity 3 times higher than that of TNF△;and the antitumor activity of 5＇IL6-TNF△ blocked by IL-6Rwas only 1/30 of that of normal type of 5＇ IL6-TNF△. Meanwhile,the 5＇IL6-TNF△ blocked by an ti-TNF antibody did not show any cytotoxicity to U266 cells. In activity assay with L929 cells ,the toxic effect of the fusion protein was found 1/22 of that of TNF△. Conclusion: The 5＇IL6-TNF△fusion protein might be a useful cytotoxic agent in cancer treatment.