As the most common disease for children with congenital heart disease ( CHD),congenital cardiovascular malformations have been closely associated with prenatal viral infectiotn.It is important to clarify the etiology of these diseases because the levels of physical and mental health for children with CHD are seriously damaged,and it also improves the levels of preventing and treating these diseases.This review focuses on the way of infection,pathogenesis and prevention measures for intrauterine viral infections leading to CHD.

With the development of modem technology,more and more plastic products are widely used in various fields,while bringing significant convenience to the society,it also leads to more and more environmental estrogen.The influence of plasticizer is increasing,especially on the development of children.Extensive contacting with plasticizer is considered to be closely related with gonadal digenesis,obesity and other problems in children.This review focuses on the latest research results about the basic and clinical experiments of Di (2-ethylhexyl) phthalate (DEHP),which illuminate the effects of DEHP on children's growth and metabolism,and lay foundations for rational clinical intervention and scientific plasticizer's application.

Objective To investigate factors influencing the quality of life (QOL) of cancer patients with bone metastases. Methods Eighty-two cancer patients with hone metastasis were investigated.A questionnaire designed according to European Organization for Treatment of Cancer quality of life questionnaire ( EORTC QLQ-C30),Monroe Dunaway Anderson symptom inventory-Chinese edition (MADSI-C) and hospital anxiety and depression scale (HADS) standards was used to collect the information. Results The average total standardized QOL score of these cancer patients was 53.28±19.20.Among the function subscales,social function got the lowest average score (47.54),while among the symptom subscales fatigue got the highest average score (56.65).According to the MDASI-C,the most serious symptom burdens were fatigue,distress and pain; working and walking experienced the most interference.The symptom burdens correlated significantly with the QOL results.Twenty-four of the patients (29.3％) had been diagnosed with anxiety,and 17 (20.7％) were diagnosed with depression.Anxiety and depression continued to be significantly associated with overall QOL and its various dimensions. Conclusions The results　show that the burden of fatigue and pain,as well as of anxiety and depression are significantly associated with impaired QOL among cancer patients with bone metastasis.Work (housework) and walking were the most severely affected activities.Psychological rehabilitation should be focused on the comprehensive treatment of patients with bone　metastasis along with other appropriate rehabilitation strategies to enhance their overall functioning,relieve their　symptoms and improve their QOL.

Objective To compare the effects of different modes of delivery on arterial oxygen saturation in the fetus.Methods One hundred and twenty ASA Ⅰ or Ⅱ parturients aged 22-32 yr with a single fetus at full term lying in normal headdown position were divided into 3 groups according to the modes of delivery (n =40 each):group cesarean section (group CS) ; group labor analgesia (group LA) and group spontaneous labor (group SL).In group CS cesarean section was performed under epidural anesthesia with 0.5％ ropivacaine.Epidural catheter was placed at L2,3 interspace in groups CS and LA.In group LA labor analgesia was started from the first stage and maintained until complete cervical dilatation.The patients received epidural PCA (PCEA) with O.125 ％ropivacaine plus fentanyl 2 μg/ml.PCEA setting was as follows:a loading dose of 8-10 ml; demand bolus 5 ml;20 min lockout; background infusion 6-10 ml/h.Blood samples were taken from umbilical artery at delivery for blood gas analysis and determination of serum concentrations of lactate,β-endorphin (β-EP) and neuropeptide Y (NP-Y).Apgar score and neurological and adaptive capacity score (NACS) were recorded.Results There was no significant difference in Apgar score,NACS and NP-Y and β-EP concentrations in umbilical arterial blood among the 3 groups.The lactate concentration and the absolute value of BE were significantly higher while pH was lower in group SL than in groups CS and LA.PO2 was significantly higher while PCO2 was lower in group LA than in groups SL and CS,and the lactate concentration and absolute value of BE were significantly lower while pH was higher in group LA than in group SL.Conclusion The 3 modes of delivery have significant effects on arterial oxygenation in fetus but have no clinical significance.

Objective To detect the expression of Bmi-1 and p16 gene in transitional cell carcinoma of bladder(TCC) tissue and explore its clinical significance.Methods The expression of Bmi-1 and p16 gene were detected by real-time quantitative polymerase chain reaction in 61 cases of TCC tissue and 12 cases of normal bladder tissue.Results The expression of Bmi-1 gene in TCC tissue was significantly higher than that in normal bladder tissue (0.242 ± 0.129 vs.0.031 ± 0.011),and the expression of p16 gene was significantly lower than that in normal bladder tissue (0.059 ± 0.021 vs.0.165 ± 0.029),there was significant difference (P ＜ 0.05).The expression of Bmi-1 and p16 gene were highly correlated with pathological grades,clinical stages and tumor recurrence (P ＜ 0.05 or ＜ 0.01).But there were not correlated with age and gender (P ＞ 0.05).There was a negative correlation between the expression of Bmi-1 gene and p16 gene in TCC tissue(rs =-0.714,P＜ 0.05).Conclusions Bmi-1 gene high expression and p16 gene low expression may be involved in the occurrence and development process of TCC.Bmi-1 may decrease the expression of p 16 gene in some ways,and then lead to the occurrence and development of TCC.

Objective:To study influence of intravenous injection urapidil and nitroglycerin micro pump on blood pressure and heart rate (HR) of hypertension patients undergoing tooth extraction.Methods:116 hypertension patients underwent electrocardiographic monitoring tooth extraction in our hospital from January 2015 to October 2016 were enrolled in this study.According to the random number table method,the patients were divided into observation group and control group with 58 cases,the control group was given nitroglycerin plus pump static point to maintain,the observation group was given intravenous urapidil and pump maintenance,compared the changes of systolic blood pressure (SBP),diastolic blood pressure (DBP) and HR in two groups before operation,at anesthesia,10min after anesthesia,in operation,10 min after operation,and compared the adverse reactions condition of the two groups.Results:The levels of SBP and DBP in two groups in operation and 10 min after operation were significantly lower than that before operation,and the SBP and DBP levels in the observation group in operation were significantly lower than control group,the differences were statistically significant (all P＜0.05).The HR in control group in operation,10 min after operation were significantly higher than before operation,while the observation group were significantly lower control group,the differences were statistically significant (P＜0.05).The total incidence of adverse reactions in the observation group was 6.90％(4/58),which has no significant difference than 10.34％ (6/58) in control group (P＞0.05).Conclusion:Intravenous injection urapidil has little effect on blood pressure and HR in hypertension patients undergoing tooth extraction,and with good safety,which is worthy of promotion.

Objective To verify the performance of the ABI ViiA 7 Taqman HBV-DNA detecting system for confirming its sta-bility,accuracy and reliability.Methods According to the evaluation protocols of Clinical and Laboratory Standards Institute (CLSI),the performance of ABI ViiA 7 Taqman HBV-DNA detecting system was assessed in the aspects of precision,accuracy,lin-earity and comparability;the quantitative detection limit validation experiments was performed by diluting specimen until quantita-tive detection limit is lower than the lower limit of detection,and the detection results were compared with the quality target re-quirements and the analysis capability declared by manufacturers.Results The CV in within-run precision of this detection system was 1.485%,1.990% and 0.932% respectively;the total CV was 1.876%,3.361% and 1.891%,respectively;the maximum devia-tion of accuracy was -6.8%;the linear correlation coefficient was 0.998 3;the regression equation was Y =0.974 8X +0.050 7. The linear range was 1.00E2 - 2.00E8;the quantitative detection limit was 100 IU/mL;the comparability of ABIViiA7 and ABI7500:P =0.115,r2 =0.994,the linear regression equation was Y =0.987 2X +0.051 7.Conclusion The ABI ViiA 7 Taqman HBV-DNA detection system has excellent precision,accuracy,sensitivity and linearity and has a good correlation with ABI7500, which can be used for the detection of clinical specimens.

Objective To investigate the value of lung adenocarcinoma classification developed by International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society ( IASLC/ATS/ERS) in predicting the effect of three-dimensional radiotherapy ( 3DRT) after surgery for locally advanced lung adenocarcinoma.Methods The clinical data of 150 patients with invasive lung adenocarcinoma who underwent radical resection and systematic lymph node dissection in Tianjin Medical University from 2010 to 2013 were analyzed, and according to the IASLC/ATS/ERS classification, they were divided into lepidic predominant group (LEP group), acinar predominant group (ACN group), papillary predominant group (PAP group), micropapillary predominant group (MIP group), and solid predominant group (SOL group), and further divided into LEP group, CAN/PAP group, and MIP/SOL group.The overall survival ( OS) and disease-free survival ( DFS) rates were compared between groups.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for survival difference analysis and univariate prognostic analysis, and the Cox proportional hazards model was used for multivariate prognostic analysis.Results Among all the patients, the median OS and DFS rates were 30.8 and 25.8 months, respectively.For the patients in the LEP group, ACN/PAP group, and MIP/SOL group, the median OS rates were 40.0, 32.2, and 28.4 months, respectively ( P=0.005) , and the median DFS rates were 29.2, 25.8, and 24.2 months, respectively ( P=0.011) .For the ACN/PAP group, the patients who received or did not receive radiotherapy had a median OS rate of 37.4 or 25.3 months ( P=0.000) and a DFS rate of 31.1 or 25.2 months (P=0.000).For the MIP/SOL group, the patients who received or did
not receive radiotherapy had a median OS rate of 28.3 or 27.4 months ( P=0.783) and a DFS rate of 25.3 or 24.0 months ( P=0.732 ) .Conclusions The IASLC/ATS/ERS classification helps to predict the prognosis of patients with locally advanced invasive lung adenocarcinoma who receive postoperative radiotherapy.Postoperative radiotherapy can be performed for ACN and PAP patients, while there is no need to perform radiotherapy for MIP and SOL patients .

Objective To investigate the effects of different metastatic sites on the prognosis of extensive?stage small cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed among 322 patients pathologically or cytologically diagnosed with extensive?stage SCLC ( stage ⅠV defined by the seventh edition of the American Joint Committee on Cancer) who were admitted to our hospital from 2011 to 2015. In those patients, 246 had primary lesions with distant metastasis and 76 primary lesions with non?regional lymph node metastasis;261 had single?organ metastasis and 61 multi?organ metastases. Survival rates were calculated using the Kaplan?Meier method. Between?group comparison of the survival was made by the log?rank test. A multivariate prognostic analysis was made by the Cox proportional hazard model. Results In all the patients, the median survival time ( MST) was 11. 7 months;1?and 2?year overall survival ( OS) rates were 47. 9% and 19. 5%, respectively. The patients with single?organ metastasis had significantly longer MST and significantly higher 1?and 2?year OS rates than the patients with multi?organ metastases ( 12. 4 vs. 8. 9 months;52. 5% vs. 30. 5%;21. 9% vs. 11. 2%;P=0. 014) . In the patients with single?organ metastasis, those with liver metastasis had the worst prognosis with a MST of 8. 5 months, while those with non?regional lymph node metastasis had the best prognosis with a MST of 14. 5 months ( P= 0. 001 );there was no significant difference in the prognosis between patients with metastasis to different organs other than the liver ( P=0. 139) . In the patients with multi?organ metastases, those with liver metastasis and bone metastasis had the worst prognosis ( P=0. 016,0. 006);there was no significant relationship between brain metastasis and the prognosis of extensive?stage SCLC with multi?organ metastases ( P=0. 995) . There was no significantdifference in the prognosis between those with liver metastasis only and multi?organ metastases ( P=0. 862) . Conclusions Liver metastasis predicts the worst prognosis in patients initially diagnosed with extensive?stage SCLC and single?organ metastasis. Liver metastasis and bone metastasis predict the worst prognosis in patients with multi?organ metastases. Brain metastasis has no significant effect on the prognosis. There is no significant difference in the prognosis of extensive?stage SCLC between patients with single?and multi?organ metastases once liver metastasis occurs.

Objective To investigate the effects of different chemoradiotherapy ( CRT) schemes on the prognosis of extensive?stage small?cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed in 322 patients with extensive?stage SCLC who were admitted to our hospital from 2011 to 2015.All patients received standard EP/CE ( etoposide+cisplatin/carboplatin) chemotherapy. According to RECIST criteria, the efficacy of chemotherapy was divided into complete response, partial response, stable disease, and progressive disease ( PD). A total of 232 patients without PD after chemotherapy were enrolled as subjects and divided into radiotherapy group (n=187) and non?radiotherapy group (n=45).The patients undergoing radiotherapy were further divided into early radiotherapy group ( before 3 cycles of chemotherapy, n=65) and late radiotherapy group (after 3 cycles of chemotherapy, n=122),or concurrent CRT group ( n=45 ) and sequential CRT group ( n=142 ) . The survival rates were analyzed using the Kaplan?Meier method. Between?group comparison was made by log?rank test. The Cox regression model was used for multivariate prognostic analysis. Results In all the patients, the median overall survival ( OS ) , progression?free survival (PFS),and local recurrence?free survival (LRFS) time was 13?2,8?7,and 14?6 months, respectively. The non?radiotherapy group had significantly shorter median OS, PFS, and LRFS time than the radiotherapy group ( 8?7 vs. 15?0 months, P=0?00;5?6 vs. 9?8 months, P=0?00;5?9 vs. 19?2 months, P=0?00).There were no significant differences in median OS, PFS, or LRFS time between the early radiotherapy group and the late radiotherapy group ( 15?4 vs. 14?6 months, P=0?720;8?0 vs. 10?8 months, P=0?426;19?2 vs. 18?1 months, P=0?981) . The concurrent CRT group had significantly longer median OS time than the sequential CRT group (19?4 vs. 13?8 months, P=0?036),while there were no significant differences in median PFS or LRFS time between the two groups ( 10?8 vs. 9?8 months, P=0?656;19?8 vs. 17?8 months, P= 0?768 ) . Generally, patients undergoing radiotherapy had increased incidence rates of adverse reactions than those without radiotherapy (P=0?038).However, the incidence rates of grade ≥3 adverse reactions were similar between the two groups ( P=0?126) . Conclusions In the treatment of extensive?stage SCLC, thoracic radiotherapy improves the treatment outcomes without increasing the incidence rates of severe adverse reactions. When to receive radiotherapy has nothing to do with the prognosis. Concurrent CRT may further improve the treatment outcomes, which still needs further studies.