Objective To investigate the effects of different flow volume of continuous 1:1 blood crystalloid cardioplegia on open heart surgery.Methods Retrospective randomized study was performed on 80 patients undergoing valve replacement and congenital heart disease with 1:1 blood crystalloid cardioplegia by minimum-flow continuous perfusion[0.5ml/(kg·min),group A,40 cases],high-flow continuous perfusion[(2.0 ml/(kg·min),group B,40 cases).The changes of creatine kinase(CK),isoenzyme of creatine kinase(CK-MB),lactate dehydrogenase(LDH),lactic dehydrogenase isoenzyme(LDH_1)were detected before operation and at 6,12,24,48,72 h after operation.Results The cardioplegia liquid was (41.72±7.98)ml/kg in group A,(142.09±9.65)ml/kg in group B,there was significant difference between two groups(P<0.05).During the first 72 h postoperative the value of CK,CK-MB,LDH and LDH1 in two groups were increased to different degree,serum enzymes levd increased significantly between 12,24 h after operation(P<0.05)and return to normal at 72h after operation in two groups.Butbetween two groups there was no significant difference(P＞0.05).ConclusionMinimum-flow continuous perfusion of 1:1 blood crystalloid cardioplegia appears to be superior in safety,decrease of myocardial enzymes integrity.

Diffuse large B-cell lymphoma (DLBCL) is the aggressive non-Hodgkin's lymphoma.Rituximab in combination with chemotherapy had improved the outcomes,however,a substantial proportion of these patients transfer into refractory or eventually relapsed lymphoma after using R-CHOP as a front-line treatment regimen with poor prognosis.With the research development on DLBCL and its related gene,it is confirmed that gene biological targeted therapy can improve the prognosis of patients with refractory /relapsed DLBCL (RR-DLBCL).Recently,some new targeted therapies become research hotspots.This review will focus on recent development and future direction of biological targeted treatment in RR-DLBCL.

Acute kidney injury (AKI) is the most common and serious complication in the intensive care unit.The mortality of AKI is still as high as 60％ in critically ill children because of lack sensitive and special early predictive biomarker.Neutrophil gelatinase-associated lipocalin is one of the most promising early diagnose and predict biomarkers for AKI,produced and secreted by kidney tubule cells at low levels,but increasing dramatically in the urine and serum after ischemic, sepsis, or nephrotoxic injury of the kidneys.This review is to summarize the role of neutrophil gelatinase-associated lipocalin as an early biomarker of AKI with different clinical settings in children.

Objective To explore the effect of cognitive therapy on patients with traumatic paraplegia.Methods Toally 100 traumatic paraplegia patients were randomly divided into observation group and control group with 50 cases in each.The control group received routine nursing intervention and the observation group cognitive therapy on the basis of intervention for the control group.The two groups were compared in terms of anxiety,depression,mental health,suicidal ideation and quality of life by the instruments of self-rating anxiety scale (SAS),self-rating depression scale (SDS) and suicide attitude questionnaire (SQA) before and after intervention.Results Before the intervention,the scores by SDS,SAS scores and SQA were insignificant different between the groups (P＞0.05).Mter the intervention,the scores on suicidal ideation in the observation group were significantly higher and the quality of life were significantly higher and the depresion and anxiety and the mental health status were lower than those of the control group (P ＜0.05).Conclusion The cognitive therapy for the patients with traumatic paraplegia can significantly alleviate their depression and anxiety,reduce their suicidal ideation and improve the quality of life.

In this paper a series of gait quantitative assessment indexes:phase symmetry index,verti-cal force symmetry index,equilibrium function index,and brake and drive function indexes are obtainedwith VICON 3-dimensinal movement analysis system according to the results that 40 amputees,50 cerebralpalsy patients, 31 hemiplegia patients and 19 paraplegia are evaluated and the differences between the nor-mal and the abnormal(p<0.001)found with these indexes. The quantitative assessment methed of walk-ing function not only provides rehabilitation level of patients and for checking therapeutical effects,but alsolaies the foundation of gait analysis to standardization and practicalization further.

Objective:To investigate the relationship between the location of anterior cruciate ligament rupture (ACL) and the areas of bone bruises in patients with an acute ACL injury.Methods:A retrospective study was conducted on MRI of patients with ACL injuries from January to June 2019. According to the location of the ACL rupture on the distal to proximal length, the patients were divided into 5 groups, namely Type I, >90%; Type II, 75%-90%; Type III, 25%-75%; Type IV, 10%-25%, Type V, <10%. Gender, weight, body mass index, depth of lateral femoral condyle notch, and medial meniscus injury were compared among the five groups. The sagittal plane images of ePDWSPIRCLEAR sequence were selected to define the layer with the largest contusion areas of femur and tibia respectively. The maximum bone contusion areas of these two layers was measured using Image J 1.52t software.Results:Among the 63 cases of acute ACL injury, three cases (4.8%) were with type I tear, 14 cases (22.2%) with type II tear, 40 cases (63.5%) with type III tear, 2 cases (3.2%) with type IV tear, and 4 cases (6.3%) with Type V tear. There was no contusion of lateral femoral condyle or lateral tibial plateau bone in type I and type IV. The lateral femoral condyle bone contusion areas was 0 (0, 64.12) mm 2 in type II, 182.34 (86.58, 334.38) mm 2 in Type III, 38.64(0, 193.36) mm 2 in Type V with statistically significant difference ( H=21.665, P=0.000). The largest areas of bone contusion in the lateral tibial plateau was 76.78(28.25, 205.57) mm 2 in type II, 120.93(51.78, 239.37) mm 2 in Type III, 190.51(80.86, 238.75) mm 2 in Type V with statistically significant difference ( H=11.939, P=0.018). The maximum bone contused areas of the lateral tibial plateau in the medial meniscus injury group was 48.0(0, 105.97) mm 2, which was smaller than that in the non-injury group 185.67(54.36, 257.41) mm 2 ( H=8.848, P=0.003). The maximum bone contusion areas of the lateral femoral condyle in the injured group was 162.19(63.03, 301.33) mm 2, which was greater than 0(0, 103.37) mm 2 in the uninjured group ( H=11.554, P=0.001). Conclusion:ACL rupture often occurs in the middle segment. The middle segment ACL fracture combined with lateral meniscus injury had with the highest probability and with the largest area of bone contusion of lateral femoral condyle. The fracture of the ACL at the farthest terminal has the largest bone contusion areas of the lateral tibial plateau and with the lowest probability of combined injury of the medial meniscus.

Objective To investigate the influence of inspired oxygen fraction (FiO2) on the ratio of PaO2/FiO2(P/F) during the implementation of lung protective ventilation strategy in patients with acute respiratory distress syndrome(ARDS) in order to unravel its clinical significance. Method This was a prospective study of 16 selected patients with ARDS treated with mechanical ventilation ( MV ) to get ratio of P/F in range of 100 to 200 by PEEP≥5 cmH2O and high inspired oxygen. After lung recruitment maneuvers by BiPAP with high pressure (PH) of 40 cmH2O for40 s, the MV was maintained the basic requirement for stabilizing the patients for 30 minutes. A series of FiO2 were set at fractions of 0.5,0.6,0.7,0.8,0.9 and 1in random sequence, and the changes of respiratory mechanics, blood gas and hemodynamics under the different concentrations of FiO2 were analyzed by using SPSS version 13.0 software. Results ( 1 ) The ratio of P/F increased as FiO2 increased, and it's significant as FiO2 increased to 0.7 or above. As the fractions of FiO2 were set at 0.5 and 1. O, the ratios of P/F changed in 24.70% ± 23.36% respectively. ( 2 ) Of them,6 patients ( 37.5% ) treated with FiO2 set at 0.5 had the ratio of P/F ＜ 200, and the fraction of FiO2 was increased to 1.0, the P/F ＞ 200. (3) FiO2 and Qs/Qt were negatively correlated ( r = - 0.390, P = O. 027 ),the higher inspired oxygen fraction, the lower shunt. When the fractions of FiO2 were set at 0.5 and 1.0 ,there was a positive correlation between △Qs/Qt and △P/F( r = 0.82, P = 0.005 ). Conclusions The inspired oxygen fraction affects the ratio of P/F, which may be resulted from shunt and it may influence the diagnosis of ARDS.

Imatinib is an effective tyrosine kinase inhibitor, used in the treatment of advanced or inoperable gastrointestinal stromal tumors. Despite its efficacy, resistance is often developed among a portion of patients. Resistance to imatinib can be divided into primary and secondary resistance, with the latter becoming the focus of many recent researches. Research on the mechanisms of secondary resistance may lead to the identification of novel therapeutic strategies.

Objective To observe the short-term fusion rate of using osteophyte filled cage in ante-rior cervical disectomy and fusion. Methods From May 2007 to May 2009, 103 patients receiving anterior cervical disectomy, spine fusion by different surgeons were performed with cages containing exclusively au-tologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space. There are 69 males, 34 females, from 25 to 77 years of age, average 53.6 years. 60 patients received one level fusion. 33 and 10 patients received two-level and three-level fusion respectively. Patients were re-viewed 3 months after operation and fusion was evaluated by X-ray film, reconstructive CT and MR. Results 1. Only 1.9% (2/103) of patients' X-ray films indicate non-fusion (internal fixation failure) while 31.7% (32/ 103) of patients' CT and 30.1% (31/103) of patients' MR indicate non-fusion or being confusing to make a diagnosis. 2. The diagnostic coherence between CT and MR as to evaluate fusion is good (kappa=0.686, P= 0.00). 3. The total fusion rate was 77.7%(80/103) while the highest fusion rate achieved by single surgeon was 90%(18/20). The total one level fusion rate was 80%(48/60) while the highest rate by single surgeon was 88.2%(15/17). The total two-level fusion rate was 78.6%(26/33) while the highest rate by single sur-geon was 90%(9/10). The total three-level fusion rate was 60%(60/100) while the highest rate by single surgeon was 100%(3/3). No statistic significant difference in fusion rate was found between any two of the three groups. Conclusion The method of using osteophyte filled cage can acquire ideal short-term fusion rate in one and two-level anterior cervical disectomy, fusion and plate fixation.