Objective To investigate the value of the E-selectin,IL-6 and TNF-α for the diagnosis of myocardial damage in children.Methods The E-selectin,IL-6 and TNF-α levels were detected in 62 patients with myocardial damage and 62 children without myocardial damage.The values of the E-selectin,IL-6 and TNF-α for the diagnosis of myocardial damage were analyzed by the receiver operating characteristic (ROC) curve.Results E-selectin levels were (45.16 ± 5.34) and (15.37 ± 4.65) μg/L,respectively in the patients with myocardial damage and the control group,and the difference between the two groups was significant(P ＜ 0.001).IL-6 levels were (21.31 ± 5.28) ng/L and (17.09 ± 4.62) ng/L,TNF-α levels were (27.22 ± 8.56) ng/L and(21.46 ± 8.08) ng/L,showing no significant difference (P ＞ 0.05).ROC curve analysis showed that AOC of E-selectin in the diagnosis of myocardial damage was 0.945 with 95％ CI 0.899 ～0.991 (sensitivity:0.801,specificity:0.999,Youden Index:0.800),and the cutoff value was 29.93 μg/L.Conclusion E-selectin can be used as one of the diagnostic indices for myocardial damage in children,which has great diagnostic value.IL-6 and TNF-α are of limited value in the diagnosis of myocardial damage.

Objective To study the effects of phycocyanin on the expressions of matrix metalloproteinase 2 and 9(MMP-2 and MMP-9) after focal cerebral ischemic reperfusion in rats.Methods A rat middle cerebral artery occlusion/reperfusion(MCAO/R) model was built up using the intraluminal filament method and treated by phycocyanin.The brain water content(BWC) was calculated with dry-wet method and the Evans blue(EB) of the brain was measured with the method of colorimetry.The expressions of MMP-2 and MMP-9 were determined by immunohistochemical assay.Results The BWC and EB of the brain increased after cerebral ischemic reperfusion and peaked at reperfusion 2d,and decreased after applying phycocyanin.In control group,the upregulation of MMP-2 began at ischemic reperfusion 24h,reached a maximum at 3～7d,then subsided gradually,but was still in high level at 14d.In phycocyanin group,the expressing time-phase pattern of MMP-2 was similar to and significantly lower than that in control group at same time.In control group,the upregulation of MMP-9 began at ischemic reperfusion 6h,increased at 12h and reached a maximum at 2d,then subsided gradually at 3d to sham group level at 14d.In the phycocyanin group,the expression of MMP-9 was significantly lower than that in control group,and the time-phase pattern of MMP-9 was similar to that in control group.Conclusions Phycocyanin might play an neuroprotective effect by down regulating the expressions of MMP-2 and MMP-9 to reduce brain edema after cerebral ischemic reperfusion.

Objective To discuss and establish a method for screening of the metallo ? lactamase in the clinical microbiology laboratory in order to help choosing antibiotics. Methods The enzyme inhibitor was EDTA.K 2, and the substrate were ceftazidime, cefotaxime. and imipenem. The microbiology sensitivity synergic tests, were processed by KB method in the M H agar. and compared with the PCR results of metallo beta lactamase gene detection. Results The metallo ? lactamase producing bacteria, synergize with EDTA K2 disc at least in one of the three kinds of substrate In 132 of imipenem resistance strains, the metallo ? lactamase positive strains were detected by this method was 88 and that by PCR was 63, respectively. 61 strains were positive detected by the two methods synchronously, as well as 44 strains were negative, 2 strains were positive detected by PCR assay but negative by this method, and, 27 strains were contrary. Conclusion This method was simple, credible and cheap. It was suitable for screening detection of the metallo ? lactamase routinely in the clinical microbiology laboratory.

Objective To investigate the method and efficiency of supracondylar dome osteotomy of femur combined with arthroscopy for the treatment of the adult valgus deformity of knees. Methods From September 2008 to May 2012, 32 patients (35 knees) with valgus deformity of knees were treated with supracondylar dome osteotomy of femur combined with arthroscopy. The study group included 7 male and 25 female (average age: 43 years). The pre-operative HSS knee score was an average of 60.46. The weight-bearing knee joint AP & LAT and the full-length AP view of the lower extremity were examined before and after operation. At the same time , the femoral angle and femoral-tibial angle were measured and evaluated. The internal fixation was taken out in an average in 12 months. All the patients were followed-up and the change of the correction angles , the function of the knee and the condition of bone healing was recorded. Result The follow-up time was an average of 24 months. All the patients got a satisfied correction of the deformity, good bone union and obvious improvement of joint function. The postoperative HSS knee score was an average of 85.40. Conclusion The supracondylar dome osteotomy of femur combined with arthroscopy is a safe, reliable and effective strategy for the treatment of the adult valgus deformity of knees.

Objective: To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharmacists for chemotherapy-induced Ⅳ degree myelosuppression.Methods: One advanced lung adenocarcinoma patient suffering from chemotherapy-induced Ⅳ degree myolosuppression was selected as the example, clinical pharmacists provided suggestions on the chemotherapy regimen, assisted physicians in making reasonable treatment plan and implemented comprehensive pharmaceutical care for the patient.Results: Clinical pharmacists played a positive role in the clinical treatment through the comprehensive pharmaceutical care in oncology department.Conclusion: With the professional knowledge of pharmacy, clinical pharmacists can improve the level of clinical rational drug use.

Objective To investegate the effect of ginsenoside Rg1 on the apoptosis related protein FLICE-inhibitory protein(FLIP),Fas-associated death domain protein (FADD)and Caspase-3 in the subatania nigra(SN)of 1-methyl-4-phenyl-1,2,3,6-tetrahyd-ropyridine (MPTP)-induced mouse models of Parkinson’s disease(PD), and to investigate the role of FADD and FLIP in the pathogenesis of PD and the protective effect of ginsenosides Rg1 on dopaminergic neurons.Methods 45 C57BL/6N mice were randomly divided into control group,model group and ginsenoside Rg1 group (n=15).The mice in model group were injected with MPTP by intraperitoneal,the mice in Rg1 group were injected with ginsenoside Rg1 before injecting MPTP,and the mice in control group were injected with normal saline by intraperitoneal. The behavioral changes of the mice in various groups were observed, and immunohistochemistry and Western blotting methods were used to observe the expressions of tyrosine hydroxylase (TH),FADD,FLIP and Caspase-3 in substantia nigra of the mice.Results Compared with control group,the mice in model group presented with typical symptoms of PD, the TH-positive neurons in the subatania nigra was significantly reduced (P<0.01 ), the number of FADD, FLIP and Caspase-3 positive cells was significantly increased(P<0.01),and the cytoplasm was deeply stained;the protein expression levels of FADD,FLIP and Caspase-3 were significantly increased (P<0.01).Compared with model group,the PD symptoms of the mice in ginsenoside Rg1 group reduced, the number of TH-positive neurons was significantly increased, the number of positive cells of FLIP,FADD and Caspase-3 were significantly reduced(P<0.01),and the cytoplasm was lightly stained;the protein expression levels of FADD, FLIP and Caspase-3 were significantly reduced (P<0.01 ). Nonlinear correlation analysis found that there was a positive relationship between the number of FADD and Caspase-3 positive cells (r=0.791,P<0.05).Conclusion Ginsenoside Rg1 may play a neural protective effect dopaminergic on neurons by modulating the FADD and FLIP expressions in SN of PD model mice.

Object:To explore the clinical effect of periacetabular osteotomy (PAO) in the treatment of developmental dysplasia of hip (DDH).Methods:The clinical data of 305 patients with DDH admitted to Tangshan Second Hospital from January 2012 to June 2018 were analyzed retrospectively. All patients were treated with PAO alone. There were 123 cases of left hip dysplasia, 131 cases of right hip dysplasia and 51 cases of double hip dysplasia (356 hips in total). The patients underwent X-ray examination before and on the second day after operation to compare the acetabular index and the lateral center edge angle (LCEA) and the anterior center edge angle (ACEA) of the acetabulum before and after operation. The ability of daily living and hip joint function were evaluated before and 6 months after operation, and Barthel index and Harris score of hip joint were compared before and after treatment. The measurement data with normal distribution are expressed in xˉ± s, and the paired t test was used for comparison before and after operation. The measurement data of non-normal distribution is expressed by M( Q1, Q3), and the comparison before and after surgery is performed by the rank sum test. Results:On the second day after operation, the LCEA and ACEA of 356 hip joints in 305 patients were greater than those before operation (32.5(20.0,47.5)° vs 8.5(-18.5 23.0)°, 29.0(18.5,52.3)° vs 2.5(-20.8, 24.5)°), while the acetabulum index was lower than that before operation (6.7(-8.4,12.5)° vs 26.8(10.0, 62.3)°), and the differences were statistically significant ( Z values were 51.50, 45.37, 32.22, all P<0.001). After 6 months of follow-up, the Barthel score and Harris score of the hip joint were higher than those before the operation (92.5±1.3) scores vs (65.6±1.5) scores, (96.4±2.5) scores vs (85.1±1.3) scores, and the difference was statistically significant ( t values were 335.56 and 89.70, both P<0.001). Conclusions:PAO can make the acetabulum cover the femoral head well through acetabular transposition, improve the ability of daily living and hip joint function of DDH patients, reduce pain, increase joint range of motion, and correct limb deformities. It is an effective means to treat DDH.

Objective To evaluate the predictive values of interleukin (IL)-2 and soluble interleukin 2 receptor (sIL-2R) in the serum and cerebrospinal fluid in early intracranial infection,and provide the reference for choosing diagnostic markers of early intracranial infection after craniotomy.Methods From January 2014 to January 2016,36 patients with intracranial infection after craniotomy in our hospital were chosen as infection group,and 45 patients without intracranial infection were as non-infection group.The body temperature and levels ofcerebrospinaI fluid glucose,blood white blood cell (WBC),cerebrospinal fluid WBC,serum IL-2,cerebrospinal fluid IL-2,serum sIL-2R and cerebrospinal fluid sIL-2R were compared between the two groups.The diagnosis values of IL-2 and sIL-2R in serum and cerebrospinal fluid in intracranial infection were analyzed by receiver operating characteristic curve (ROC) curve.The sensitivity and specificity of IL-2 and sIL-2R in the serum and cerebrospinal fluid in intracranial infection were compared between the two groups.Results The body temperature of the two groups showed no statistical difference (P＞0.05).As compared with those in the non-infection group,the glucose of cerebrospinal fluid in the infection group significantly decreased (P＜0.05),the blood WBC,cerebrospinal fluid WBC,serum IL-2,cerebrospinal fluid IL-2,serum sIL-2R and cerebrospinal fluid sIL-2R in the infection group significantly increased (P＜0.05).The areas under of curve for body temperature,glucose of cerebrospinal fluid,blood WBC,cerebrospinal fluid WBC,serum IL-2,cerebrospinal fluid IL-2,serum sIL-2R and cerebrospinal fluid sIL-2R,respectively,were 0.671,0.718,0.698,0.741,0.714,0.927,0.722 and 0.968;the sensitivity of those indexes,respectively,was 61.1％,63.9％,69.4％,91.7％,88.9％,91.7％,86.1％and94.4％;the specificityofthoseindexes,respectively,was 48.9％,82.2％,60.0％,55.6％,62.2％,88.9％,66.7％ and 91.1％.Conclusion The IL-2 and sIL-2R levels in serum and cerebrospinal fluid have decided values in diagnosis of intracranial infection after craniotomy,but the sensitivity and specificity of IL-2 and sIL-2R in cerebrospinal fluid are higher than others.

Boao Lecheng International Medical Tourism Pilot Area is the only administrative area in China where the pilot application of real-world data is performed. Based on the special healthcare policy in Boao Lecheng, conducting real-world data study to provide real-world evidence for the clinical evaluations and approvals of innovated medical products has become an important field that supports the reform of China's evaluation and approval system of medical products. Trustworthy real-world evidence needs to rely on both high-quality real-world data and reasonable and rigorous study designs. Based on the real-world data research guidelines and specifications issued by relevant academic research and regulatory authorities both at home and abroad, combined with the special policy environment of Boao Lecheng and previous practice experience, this paper summarizes the study designs of real world data in Boao Lecheng and discusses the key considerations of different study design in the context of special healthcare policies in Boao Lecheng in order to provide reference for the further study of real-world data.

Randomized controlled trials (RCT) have long been considered the gold standard for assessing clinical efficacy. However, RCT are inappropriate for some diseases due to related ethical issues and costs, such as rare diseases that are seriously life-threatening but without adequate treatment. Using real world data (RWD) as external control for RCT could make recruitment less complicated and reduce time and cost. This paper introduces common application scenarios, data sources, study design, basic principles, and statistical methods of RWD as an external control based on the latest guidelines related to RWD and combined with our team's previous research experience. This study could provide references for scholars and sponsors who want to conduct RWD research.