Objective To investigate the early diagnosis of myocardial injury after neonatal asphyxia based on the clinical manifestations of myocardial injury, electrocardiogram (ECG), cardiac enzymes and tissue Doppler echocardiography. Methods From January 1, 2013 to June 30, 2014, 101 cases of neonatal asphyxia in the neonatal intensive care unit of the First Hospital of Tsinghua University, with gestational age> 37 weeks and birth weight > 2 500 g, were enrolled. Apgar scores were used to diagnose neonatal asphyxia. Myocardial damage after neonatal asphyxia was diagnosed according to the hypoxia history, clinical presentation, ECG and cardiac enzymes. According to the umbilical arterial blood gas analysis, severe asphyxia was divided into two groups:the severe asphyxia with severe acidosis group and the severe asphyxia without acidosis group. The incidence of myocardial damage, clinical manifestations associated with myocardial damage, ECG and myocardial enzymes [creatine kinase isoenzyme MB (CK-MB) and cardiac troponin T (TnT); control group involved 50 cases for the same period of admission with newborn jaundice] and echocardiography (control group involved 30 cases for the same period with normal term delivery) were compared among the three groups [mild asphyxia (n=72), severe asphyxia with severe acidosis (n=18) and severe asphyxia without severe acidosis (n=11)]. One-way ANOVA, the LSD test, Kruskal-Wallis test for independent samples, Chi–square test and Fisher's exact test were used for statistical analysis. Results (1) The incidence of myocardial damage after asphyxia was 34.6%(35/101). It was higher in the severe asphyxia group than in the mild asphyxia group [62.1%(18/29) vs 23.6% (17/72), χ2=7.549, P=0.006]; and it was higher in the severe asphyxia with severe acidosis group than in the severe asphyxia without severe acidosis group (14/18 vs 4/11, Fisher's exact test, P=0.048). (2) Clinical manifestations: The proportion of bradycardia was greater in the severe asphyxia with severe acidosis group (13/14) than in the severe asphyxia without severe acidosis group (1/4) and the mild asphyxia group (7/17);the differences were statistically significant (Fisher's exact test, P=0.019 and 0.007). (3) ECG: Eighteen cases (51.4%, 18/35) showed ECG abnormalities. (4) Cardiac enzymes:CK-MB 48 h after birth in the severe asphyxia with severe acidosis group, severe asphyxia without severe acidosis group, mild asphyxia group and the control group were 78.72 (34.63-122.01), 31.71 (21.33-37.12), 23.11 (14.61-36.02) and 11.82 (8.64-18.93) μg/L, respectively. CK-MB in the severe asphyxia with severe acidosis group was higher than in the severe asphyxia without severe acidosis group, mild asphyxia group and the control group (H=48.425, 90.040 and 96.045, respectively, all P<0.01). After treatment for 5-7 days, there was no statistically significant difference in these four groups (H=7.165, P=0.416). TnT 48 h after birth in the four groups was 0.19 (0.12-0.39), 0.11 (0.06-0.34), 0.07 (0.05-0.13) and 0.06 (0.04-0.08) μg/L, respectively. TnT in the severe asphyxia with severe acidosis group was higher than in the other three groups (H=45.753, 44.665 and 61.215, respectively, all P < 0.01). Despite the reduced TnT level after treatment for 5-7 days, TnT in the severe asphyxia with severe acidosis group was higher than that in the other three groups (H=17.520, 21.122 and 43.286, respectively, all P<0.01). (5) Echocardiography:Twenty cases (57.1%, 20/35) showed abnormalities. The values of mitral systolic peak velocity and late diastolic peak velocity in the severe asphyxia with severe acidosis group were lower than those in the control group found by tissue Doppler echocardiography [(3.4±0.3) vs (4.8±0.3) cm/s, (4.1±0.2) vs (6.0±1.1) cm/s, respectively, t=3.293 and 2.542, both P < 0.05]. Conclusions Myocardial damage can occur after neonatal asphyxia. Cord blood pH value should be combined to determine the severity of asphyxia. Myocardial damage is more serious in the severe asphyxia with severe acidosis group. Clinical manifestations should be taken seriously, and laboratory examinations should be improved for early diagnosis and treatment.

Objective To study the characteristics of satellite nodules of hepatocellular carcinoma (HCC) and the treatment methods by transcatheter hepatic arterial chemoembolization (TACE). Methods Forty one cases of massive HCC and single nodular HCC proved by pathology underwent the examination of spiral CT and angiography for observing the characteristics of satellite nodules. All the patients were treated by TACE and the results were analyzed. Results The satellite nodules were found in 17 out of 41 cases by CT and/or angiology of which 10 were hypervascular and 7 hypovascular. The satellite nodules located within 1 cm from the margin of the main HCC in 11 out of 17 cases. In the treatment of TACE, the tip of catheter was located on the proximal end of feeding artery of tumor so that the embolization area included the area of satellite nodules. After 6-19 months follow up, 5 patients were complete response (CR) and partial response (PR) in 17 cases but no progressive patients were found. Conclusion The satellite nodules extensively exist in HCC and can be effectively treated using reasonable methods.

Objective to investigate the current status of preoperative anxiety level and explore the influencing factors in elderly patients with pros-tatic hyperplasia. Methods A total of 124 patients with prostatic hyperplasia were selected for the study,and the State-trait Anxiety Inventory (StAI)was analyzed using the convenience sampling method. Results the score were 55.54±4.81 for SAI,34.60±2.09 for tAI,and 90.14±5.91 for StAI. the preoperative anxiety level of patients with prostatic hyperplasia varied in different demography(P < 0.05). According to multiple lin-ear stepwise regression equation,age,cultural level,place of residence,and the medical burden are the influence factors. Conclusion the preoper-ative anxiety level of elderly patients with prostatic hyperplasia is high,and more health education is needed. It is necessary to use different psycholog-ical persuasion according to their specific situation,so as to promote their physical and mental health,and to promote the effect of postoperative recov-ery.

Objective: To analyze the characteristics of imported coronavirus disease 2019 ( COVID-19 ) cases from abroad to Zhejiang Province,so as to provide basis for improving the prevention and control of COVID-19 imported epidemic. Methods: The imported COVID-19 cases reported by Zhejiang Province from September 1, 2020 to January 28, 2021 were extracted from the National Diseases Prevention and Control Information System.The case information were checked with the field epidemiological investigation reports. A descriptive analysis was adopted for the epidemiological characteristics of the imported COVID-19 cases,including time,spatial and population distribution,import source, etc. Results: Zhejiang Province reported 136 cases of COVID-19 from abroad from September 1, 2020 to January 28, 2021, with 38 confirmed cases ( 27.94% ) and 98 asymptomatic cases ( 72.06% ). No deaths and related local cases were reported. A total of 10 confirmed cases and 58 asymptomatic cases were positive for nucleic acid tests at the port of entry, 7 cases were positive after the medical observation period, and the other cases were positive during the medical observation period. Cases were reported in each month. The age of the cases was mainly 20 to 39 years old, accounting for 61.03% (83 cases). The occupations were mainly business services, accounting for 33.09% ( 45 cases ). The 136 imported cases came from 32 countries, among which 26 cases came from Philippines. Most of the imported cases enter China through Hangzhou, Ningbo and Shanghai. Conclusions The imported epidemic situation in Zhejiang Province is sporadic, with large proportion of asymptomatic infections. The imported cases are mainly business service providers and come from Philippines. Therefore, measures such as nucleic acid tests and isolation of entry personnel at ports should be strengthened to prevent the spread of the local epidemic caused by imported cases.

Objective:To explore the application of standardized treatment process for early enteral nutrition combined with gastric retention after operation in patients with esophageal cancer.Methods:Using convenience sampling, 84 patients with gastric retention complicated by early enteral nutrition support after esophagectomy in Department of Thoracic Surgery, Third People′s Hospital of Dalian from July 2015 to June 2020 were selected as the subjects. They were divided into control group and experimental group according to admission time with 42 cases in each group. The control group received routine nursing, while the experimental group received early enteral nutrition and gastric retention standardized treatment process nursing. The differences between the two groups in nutritional status and immune indexes before and 7 days after operation, the standard feeding rate within 7 days after operation, incidence of postoperative complications and enteral nutrition-related complications, length of hospitalization time and hospitalization expenses were compared.Results:In the control group, 2 cases were lost to follow-up. There was no statistically significant difference in preoperative nutritional status and immune indexes between the two groups ( P<0.05); 7 days after operation, the body mass index, serum total protein, prealbumin, nitrogen balance, IgM, CD3, CD4, and CD4/CD8 of the experimental group were all higher than those of the control group, and the differences between the two groups were statistically significant ( t values were 2.228-5.332, P<0.05 or 0.01).The standard feeding rate within 7 days was (68.93±8.12)% in the experimental group and (51.19±6.96)% in the control group, respectively, and the difference between the two groups was statistically significant ( t value was -4.38, P<0.01). The incidence of postoperative nausea and vomiting, Ⅱ B healing, anastomotic fistula and aspiration was 2.38% (1/42), 2.38% (1/42) and 0 (0/42), 2.38% (1/42) in the experimental group and 15.00%(6/40), 7.50% (3/40) and 5.00% (2/40) and 10.00% (4/40) in the control group, respectively, and the differences were statistically significant ( χ2 values were 5.99 - 9.88, P< 0.05 or 0.01). The length of hospitalization time in the experimental group was (10.18±1.69) d, and the hospitalization cost was (53 268.46 ±3 651.56) yuan, both lower than (13.66 ± 2.18) d and (64 972.39 ± 4 029.81) yuan in the control group, and the difference was statistically significant ( t values were 2.14, 2.89, P< 0.05). Conclusions:The standardized treatment process of enteral nutrition combined with gastric retention can improve the feeding rate, nutritional index and immune index within 7 days after operation, reduce postoperative complications and incidence of enteral nutrition related complications, reduce the hospitalization time and reduce hospitalization expenses.

Objective:To determine the content of cyclohexane, ethyl acetate, methanol, methylene chloride and trichloromethane in rupatadine fumarate by headspace gaschromatography. Methods:A DB-WAXETRR capillary column(30 m × 0. 32 mm,0. 25 μm)was used and the carrier gas was nitrogen. The detector was an FID and the inlet temperature was 200℃ . The column temperature program was with the initial temperature of 35℃,maintained 10 min,and then risen to 220℃ with the rate of 20℃·min -1 ,and maintained 5 min. Results:Cyclohexane,ethyl acetate,methanol,methylene chloride and trichloromethane showed a good linear relationship within the range of 77. 590 1- 698. 310 9 μg·ml -1(r = 0. 999 7),102. 166 6- 919. 499 4 μg· ml -1(r = 0. 999 8),62. 744 7- 564. 703 2μg·ml -1(r = 0. 999 9),12. 011 2- 108. 101 1 μg·ml-1(r = 0. 999 6)and 1. 262 8-11. 365 6 μg·ml -1(r = 0. 999 6). The average recovery was 103. 9% ,103. 5% ,104. 9% ,107. 1% and 103. 4% and RSD was 2. 3% ,2. 6% ,3. 1% ,2. 8% and 4. 5%(n = 9),respectively. The five residual solvents were not detected out in rupatadine fumarate. Conclusion:The method is stable,simple,sensitive and accurate,and can be used for the determination of residual solvents in rupatadine fumarate.

Objective To investigate methods and feasibility of percutaneous regional isolated hepatic perfusion combined with charcoal hemoperfusion(PRIHP-CHP).Methods Four out of 12 dogs underwent the procedure of routine transhepatic arterial infusion(TAI) as control group, 8 underwent PRIHP-CHP as experimental group. Adriamycin was used in our study, the concentration of plasma in hepatic vein and systemic vein was detected in both groups. Results All the procedures were successful in the PRIHP-CHP group eight, but 1 dog died because of air embolization. The average procedure duration for each was (132.3?15.3) minutes. The peak level of adriamycin concentration in hepatic vein and systemic in TAI were (3709.676?385.723) ng/ml and (1576.140?226.933) ng/ml respectively. In PRIHP-CHP, the peak level were (4653.420?430.204) ng/ml and (433.612?40.501) ng/ml. There were statistically significant differences between TAI and PRIHP-CHP (?

Objective: To study the pharmacokinetics of diclofenac sodium microemulsions in human. Methods: According to the crossover design, each volunteer was orally given diclofenac sodium microemulsion and diclofenac sodium tablet. The serum concentrations were determined by RP-HPLC with UV-detector. The concentration-time data were analyzed using 3P87 Pharmacokinetic Program and the pharmacokinetics parameters were compared by paired t-test. Results: It was found that diclofenac sodium in serum was linear within the range of 50-8 000 μg/L. The minimum detection concentration was 30 μg/L. The mean rate of recovery was (100.55±1.56)%. After a single oral dose, AUC0～∞ were 5.563，7.891 μg*h/ml, MRT 5.489， 5.387 h for dispersible diclofenac sodium microemulsion and tablet respectively. Conclusion: Absorption progress of diclofenac sodium microemulsion in human may be special.

Objective:To explore the role of tumor necrosis factor‐α(TNF‐α) and monocyte chemoattractant protein‐1 (MCP‐1) in pathogenesis of angina pectoris of coronary heart disease (CHD) .Methods :A total of 60 CHD pa‐tients diagnosed by coronary angiography (CAG) were selected and divided into stable angina pectoris (SAP) group (n=28) and unstable angina pectoris (UAP) group (n=32) ,and another 30 cases with normal CAG results were re‐garded as normal control group .Immune turbidity method and enzyme linked immunosorbent assay were used to measure plasma levels of TNF‐αand MCP‐1 respectively .Results:Compared with normal control group ,there were significant rise in plasma levels of TNF‐α[ (15.18 ± 4.12) ng/L vs .(18.56 ± 4.22) ng/L vs .(21.79 ± 4.43) ng/L] and MCP‐1 [(10.23 ± 3.21) pg/L vs .(14.67 ± 3.42) pg/L vs .(17.86 ± 3.51) pg/L] in SAP group and UAP group , P<0.01 all ,and those of UAP group were significantly higher than those of SAP group , P<0.01 both .Conclusion:Plasma tumor necrosis factor‐αand monocyte chemoattractant protein‐1 levels significantly rise ,it possesses impor‐tant clinical significance for predicting existence and development of coronary heart disease .

Objective To explore the effect of extracellular regulated protein kinases (ERK) signaling pathway on early brain injury and autophagy of nerve cell in hippocampus area in rats with subarachnoid hemorrhage (SAH). Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into sham group, SAH group, SAH+dimethyl sulfoxide (DMSO) group and SAH+U0126 group, with 12 rats in each group. The SAH model was established with puncture of internal carotid artery. The SAH+U0126 group was injected with U0126 0.05 mg/kg;the sham group and SAH group were injected with normal saline, and the SAH+DMSO group was injected with DMSO 30 min-utes before modeling. They were sacrificed 24 hours after modeling. The brain water content was measured with wet and dry method. The morphology changes of neural cells in hippocampus CA1 were observed by HE staining. The expression of phosphorylation ERK (p-ERK), Beclin-1 and LC3-Ⅱwere detected with immunohistochemical method and Western blotting. Results Compared with the sham group, the brain water content increased (P<0.05), the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱincreased in SAH group (P<0.05). Compared with SAH group, the brain water content increased, the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱ decreased in SAH+U0126 group (P<0.05); and no significant difference was found in SAH+DMSO group (P>0.05). Conclusion The activation of ERK signaling pathway may alleviate early brain injury after SAH by regulation of autophagy.