Objective To discuss the role of platelet-actived factors and hepatic and renal function in the development of pre-eclampsia and eclampsia by detecting the levels of the GP Ⅱb/Ⅲa in the blood, Pt and hepatic and renal function of the patients with pre-eclampsia and eclampsia. Method GP Ⅱb/Ⅲa, Pt and hepatic and renal function were measured in the normal non-pregnancy women, normal late-pregnancy women and pre-eclampsia and eclampsia women. Results The level of GP Ⅱb/Ⅲa in patients with severe pre-eclampsia and eclampsia was higher than that in non-pregnancy, normal late-pregnancy and mild pre-eclampsia (P<0.01). The count of Pt in patients with severe pre-eclampsia and eclampsia was lower than that in non-pregnancy, normal late-pregnancy and mild pre-eclampsia (P<0.01). Except ALB, the hepatic and renal function had significant difference among severe pre-eclampsia and eclampsia, normal late-pregnancy and mild pre-eclampsia. Conclusion Detecting the GP Ⅱb/Ⅲa, Pt and hepatic and renal function have clinical significance in severe pre-eclampsia and eclampsia.

Objective To observe and analyze the medium and long term follow-up data of arrhythmias after transcatheter closure of children with ventricular septal defect (VSD). Methods Retrospectively analyzed the clinical data of 1071 children with VSD, who successfully underwent transcatheter device closure, at l, 3, 6, 12 months and ev-ery year post procedure from March 2002 to December 2010. Results Of all 1071 children, 272 cases (25.4%) were ob-served of having arrhythmias within 1 month after intervention, mainly including atrioventricular block (AVB), branch block, junctional tachycardia, atrial and ventricular tachycardia, frequent contractions, etc. Among them, 22 cases (2.1%) had above II degree AVB, complete left bundle branch block (CLBBB) and other causes of serious arrhythmias. After treatment, all cases got better and no permanent pacemaker was necessary. After 1 to 107 months (2.8±1.7 years) fol-low-up, 161 cases (18.2%) were observed of having persistent abnormal ECG mainly caused by AVB and branch block, including 10 cases (1.1%) with serious arrhythmias. In 4 cases with late-onset AVB, 3 cases had already appeared AVB in early postoperative, 1 case had recurrence CLBBB, left ventricle enlarge, and died of heart failure during follow up. Four cases were implanted permanent pacemaker. Conclusion During follow-up, serious arrhythmias after VSD closure, such as AVB or CLBBB, have high risk of recurring. Conduction block arrhythmias may reappear or worsen, while arrhythmias like tachycardia and premature heart rhythm mostly return to normal.

Objective To investigate the neuroprotective effect and possible mechanism of Compound Porcine Cerebroside and Ganglio-side Injection (CPCGI) on cerebral ischemia-reperfusion injury in rats. Methods Healthy adult male Sprague-Dawley rats were divided into sham group (n=10), model group (n=10), CPCGI low dosage group (n=10) and high dosage group (n=10), and control group (Ginkgo biloba extract, n=10). All the rats was subjected to middle cerebral artery occlusion (MCAO) for two hours and reperfusion except sham group, and received treatment for fourteen days once reperfusion started. They were tested with modified Neurological Severity Score one, three, seven and fourteen days after MCAO, and adhesive-removal test and beam-walking test fourteen days after MCAO. The expression of Beclin1, PINK1 and Parkin were detected with Western blotting. Results Compared with the model group, the Neurological Severity Score reduced (P<0.05) and the time crossing the beam reduced (P<0.01) in all the medical groups fourteen days after MCAO, and the time removing the adhesive paper reduced in the CPCGI groups (P<0.01). The expression of Beclin1 and Parkin decreased and the PINK1 level increased in the model group (P<0.01), and it was reversed in all the CPCGI groups (P<0.05). Conclusion CPCGI could relieve the cerebral ischemia-re-perfusion injury in rats through the regulation in mitophagy.

Objective: To investigate the protective effect of glucose regulatory protein 78 (GRP78) on cardiomyocytes in atrial fibrillation and its mechanism. Methods: HL-1 cardiomyocyte cell line was cultured from June 2016 to March 2017 at Harbin Medical University Central Laboratory.The cells were randomly divided into 4 groups: control group, pacing group, pacing+ GRP78cDNA group, pacing+ GRP78siRNA group.The following indicators were detected: (1)oxidative stress: flow cytometry was used to detect the content of reactive oxygen species (ROS) in each group; (2)Ca²⁺ overload and cell electrophysiology: flow cytometry was used to detect Ca²⁺ content in each group; (3)cell structure reconstruction: cell apoptosis was detected by flow cytometry. Results: The ROS production in the pacing group was significantly higher than that in the control group [(28.8±0.5)% vs.(4.5±0.8)%, F=27.91, P<0.01]. The number of ROS in the GRP78siRNA group was significantly higher than that in the pacing group [(71.1±0.3%) vs.(28.8±0.5)%, F=34.12, P<0.01]. The ROS content of the GRP78cDNA group was lower than that of the pacing group [(26.1±2.7)% vs.(28.8±0.5)%, F=26.60, P<0.01]. Pacing significantly increased Ca²⁺ concentration in HL-1 cells; GRP concentration in HL-1 cells in the GRP78siRNA group was significantly higher than that in the pacing group [(72.53±2.5)AM vs.(39.23±1.9)AM, F=19.50, P<0.05]. The intracellular Ca²⁺ concentration in the GRP78cDNA group was significantly lower than that in the pacing group [(31.23±0.57)AM vs.(39.23±1.9)AM, F=28.17, P<0.01]. The survival rate of the GRP78cDNA group was significantly higher than that of the pacing group [(87.9±0.4)% vs.(80.1±0.5)%, F=19, P<0.05]. Conclusion GRP78 protein reduces intracellular calcium overload by reducing ROS production in myocardial cells during atrial fibrillation.It can alleviate the oxidative stress of cardiomyocytes and improve the survival rate of cardiomyocytes, and has protective effect on cardiomyocytes.

Objective To summarize nursing care of 6 critically ill patients with human infections of avian influenza A H7N9 virus. Methods Totally 6 cases of human infection with H7N9 avian influenza in our hospital during December 2016 to February 2017 were treated, with nursing care including:careful nursing of medication, nutrition management, oxygen therapy, analgesic sedative care, delirium prevention, humane care and protective isolation. Results About 5 cases were discharged from the hospital and 1 case died. Conclusion The key nursing points include observation of anti-avian influenza virus efficacy and side effects, nutrition management, oxygen therapy and mechanical ventilation care, analgesic sedative care, delirium prevention, humane care, and preventive isolation, which are key to the successful treatment of critically ill patients with human infections of avian influenza A H7N9 virus.

Objective To evaluate the prevalence and risk factors of arrhythmia after transcatheter closure of ventricular septal defect (VSD) in children.Methods A total 1 069 children (583 males,mean age (7.7 ± 3.6) years) underwent transcatheter closure of VSD from January 2002 to December 2010 in our hospital were enrolled and retrospectively analyzed.VSD diameters were (4.0 ± 1.8) mm,336 cases accompanied membranous aneurysm.Electrocardiogram were performed at 1,3 days after the procedure.Once arrhythmias recorded,electrocardiogram was performed daily till discharge.All cases were followed up by ECG at 1,3,6,12 months after the procedure in outpatient department and then in a year interval.The risk factors were identified by multivariable logistical analysis.Results All VSDs were closed successfully and the diameters of occluder was (7.2 ± 2.1) mm.The median follow-up time was 2.2 (1.0-4.2)years.Mortality was zero during follow up.Incidence of early (＜ 1 month) post-procedure arrhythmias was 24.6 ％ (263 cases),and severe arrhythmias were recorded in 50 cases (4.7％).There were 43 late (≥1month) post-procedure arrhythmias (4.0％) including 4 (0.4％) complete atrioventricular block.Multivariable logistic analysis revealed that VSD treated with thin-waist-big-side occluder (OR =2.426,95％ CI:1.835-3.208,P ＜ 0.001),male gender(OR =1.267,95％ CI:1.055-1.523,P =0.011) were the risk factors while higher body weight (OR =0.838,95％ CI:0.737-0.951,P =0.006) was protective factor for early onset arrhythmia.Placement of asymmetrical occluder (OR =4.777,95％ CI:2.079-10.978,P ＜ 0.001),longer procedure time (OR =1.011,95％ CI:1.002-1.020,P =0.012),occluder from foreign countries (OR =2.621,95％ CI:1.143-6.014,P =0.021) were the risks factors for early onset severe conduct block.Treatment with thin-waist-big-side occluder (OR =2.654,95％ CI:1.042-6.760,P =0.041) was the risk factor while higher body weight (OR =0.373,95％ CI:0.159-0.875,P=0.023)was a protective factor for late onset conduct block.Conclusions Arrhythmia after transcatheter closure of VSD is common in children,and late onset severe conduct block is rare.The weight of patients should not too light and symmetrical occluder should be chosen if possible in the transcatheter closure VSD procedure to minimize the risk of late onset conduct block.

Objective To evaluate the significance of AFP-IgM, this is one of new tumor markers, in the diagnosis of primary hepatocellular carcinoma (PHC). Methods The contents of AFP-IgM and AFP in serum of 103 healthy subjects, 74 patients suffered primary hepatic carcinoma, 27 patients affected by liver cirrhosis and 63 patients affected by chronic hepatitis were detected by means of enzyme linked immunosorbent assay and electrochemiluminescence. No-PHC is comprised of liver cirrhosis,chronic hepatitis and health subjects as control group. Results The area under ROC curve of AFP was larger than that of AFP-IgM (0.85 vs 0.72, Z=3.21) and the best cut-off value of AFP-IgM and AFP was 3×105-AU/L and 10 ug/L respectively, which was determined by ROC curve. Under the cut-off value, the sensitivity of AFP- lgM and AFP for PHC were 64.9% and 79.7%, and the specificity were 75.6% and 80.3%, yet their efficacies were similar. However, for early diagnosis of liver cancer (stage Ⅰ and Ⅱ), the area under ROC curve of AFP-IgM was larger than that of AFP (0.91 vs 0.82,Z=1.73). The sensitivity of AFP-IgM andAFP were 94.4% and 72. 2%, and the specificity were 81.9% and 79.9%. The differences of AFP-IgMand AFP for early diagnosis of liver cancer were statistically significant. When both of the test results combined AFP-IgM with AFP are positive, it can be diagnosed as liver cancer. The specificity of combineddetermination of the two forms was 89.1%, and the efficacy was 79. 0%. Conclusions Both of thesensitivity and specificity of the AFP-IgM test were higher than that of the AFP for early diagnosis of livercancer. We also found that combined determination of the two forms significantly increased the specificityand the positive predictive value for the diagnosis of PHC, thus AFP-IgM was of especially significance forearly diagnosis of liver cancer.

Objective To evaluate effects of 7 common hemoglobin variants on HbA 1c measurements using 4 ion exchange high performance liquid chromatography methods .Methods Ninety five samples with hemoglobin variants were collected from January 2017 to February 2018 during HbA1c measurements in laboratary medicine of peking university shenzhen hospital .Samples with 7 common hemoglobin variants were measured using Sebia Capillary 2 Flex Piercing, Bio-Rad D-10, Arkray HA8180V, Tosoh G8, and MQ6000 Plus, respectively.Effects of 7 common hemoglobin variants on HbA 1c measurements by the 4 methods were analyzed using Capillary 2 Flex Piercing as a comparative method .All statistical analyses were carried out using SPSS software version 19.0 .Mean bias were calculated for samples with hemoglobin variants , box plot was established to display bias distribution .Results Hb New York showed no interference on the 4 HPLC mechods although Hb New York could not be detected .D-10 could detect 6 Hb variants, and showed clinically significant interference for Hb J-Bangkok, Hb G-Coushatta, and Hb G-Taipei.HA-8180V fast mode yielded no HbA1c values for Hb J-Bangkok, Hb G-Coushatta, and Hb G-Taipei.Hb E, Hb Q-Thailand, and Hb G-Honolulu produced significant negative biases for HA-8180V.G8 standard mode could detect 1 Hb variant, and showed significant negative biases for six Hb variants .MQ6000 Plus could separate six Hb variants , only Hb G-Coushatta and Hb G-Taipei produced significant negative biases for the system . Conclusions Some common hemoglobin variants can interfere with HbA 1c determination by the most popular methods in South China , which may lead to erroneous HbA 1c values.

Objective: To explore the relationship between weight change and the changes in blood pressure, blood glucose and blood lipid profiles in middle-aged and elderly Chinese people. Methods: All participants were from the Dongfeng-Tongji cohort study. The study included 16 606 middle-aged and elderly Chinese people with complete information in the baseline survey in 2008 and the first follow-up survey in 2013. We collected the data on demographic characteristics, lifestyle, history of diseases and medication, and the results of medical health examinations, including height, weight, blood pressure, fasting blood glucose and lipid profiles. We divided the weight change into five groups, moderate or above weight loss (<-8.0%), slight weight loss (-8.0%, -3.1%), weight maintenance (-3.0%, 3.0%), slight weight increased (3.1%, 8.0%), and moderate or above weight increased (>8.0%). Generalized linear regression model was used to analyze the relationship between weight change and the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). Subgroup analyses were used to explore the influences of gender, age and baseline BMI level on the relationship between weight change and the above-mentioned metabolic indicators. Results: The average age of participants in baseline survey was (62.19±7.28) years with a range of 45 to 89 years. During the five-year period, there were 18.86% (2 633), 28.03% (4 655), 35.87% (5 956), 13.96% (2 319), 6.28% (1 043) people with moderate or above weight loss, slight weight loss, weight maintenance, slight weight increased, and moderate or above weight increased, respectively. Regression analyses showed that body weight change were positively correlated with changes in SBP, DBP, FBG, TC, LDL-C and TG, and negatively correlated with change in HDL-C (all linear trend P values were<0.05); As every 10% of weight changed, the β (95%CI) of changes in SBP (mmHg) (1 mmHg=0.133 kPa), DBP (mmHg), FBG (mmol/L), TC (mmol/L), LDL-C (mmol/L), HDL-C (mmol/L) and TG (mmol/L) were 4.94 (4.32, 5.55), 2.50 (2.11, 2.88), 0.05 (0.02, 0.08), 0.13 (0.11, 0.16), 0.14 (0.12, 0.16), -0.05 (-0.07, -0.04) and 0.16 (0.14, 0.18), respectively. Furthermore, subgroup analyses showed that weight change can lead to greater changes in blood pressure in older and overweight or obesity elderly people (all P for interaction<0.05). Conclusion Weight loss was beneficial for middle-aged and elderly people to improve the blood pressure, blood glucose and blood lipid profiles, regardless of the weight at the baseline, while weight gain was not.

Objective:This study aimed to reveal the distribution and course of the branches of the infraorbital nerve(IN),its communication relationship between the branches of the infraorbital nerve and facial nerve,so as to provide morphological basis for clinical implementation of accurate infraorbital nerve trunk in the infraorbital canal,regional facial anesthesia and facial surgery,so as to improve the success rate of maxillofacial surgery.Methods:25 adult cada-vers with formalin immobilized semi-face were selected.Exclude facial defect samples caused by tumor,trauma,deformity,surgery,etc.The length and diameter of the trunk of the infraorbital nerve and the length of the infraorbital canal were measured.The total number of infraorbital nerve and the number of branches were counted,and the course,distribution and communication relationship between infraorbital nerve and facial nerve were investigated.Results:The length of infraorbital nerve trunk ranged from 19.61 to 44.47 mm,with an average length of(23.33±4.95)mm.The length of infraorbital canal ranged from 9.49 to 31.21 mm,with an average length of(12.87±3.99)mm.The number of infraorbital nerve branches ranged from 5 to 12,and the average number was(7.29±2.29).The number of upper labial branches was the widest,ranging from 1 to 5,while the distribution area of eyelid branches was the narrowest.There are(were)a large number of intersections and anastomoses between the infraorbital nerve and the facial nerve,forming a complex multi-layer network structure.Conclusion:The infraorbital nerve trunk and the infraorbital canal va-ry in length.The number and distribution range of infraorbital nerve branches are not constant,and the communication relationship between infraorbital nerve and facial nerve is complicated.