Objective To investigate the application of permissive hypercapnia in the thoraco-scopic surgery of neonates with congenital esophageal atresia.Methods Thirty newborns with con-genital esophageal atresia,seventeen males,thirteen females,aged 1-5 days,weighing 1.42-3.28 kg, ASA physical status Ⅱ or Ⅲ,undergoing the thoracoscopic surgery,were randomly divided into group P and group C,n =1 5 in each group.The newborns were intratracheally intubated and adopted intravenous anesthesia combining inhalational anesthesia.FiO 2 100%,fresh gas flow 2 L/min,then adjusted the respirator parameters according to the results of airway pressure and arterial blood gas a-nalysis.Group P maintained PaCO 2 ranging at 60-80 mm Hg,group C maintained PaCO 2 ranging at 35-45 mm Hg.Arterial blood gas analysis was conducted respectively before artificial pneumothorax (T0 ),1 5 min after foundation of artificial pneumothorax (T1 ),30 min after foundation of artificial pneumothorax (T2 ),60 min after foundation of artificial pneumothorax (T3 )and 1 5 min after artifi-cial pneumothorax (T4 ).Two hours after surgery,a chest X ray photograph was taken to observe pneumothorax.The time from the end of the surgery to the ventilator weaning was recorded. Results At T1-T3 ,the PET CO 2 [(73.93 ± 3.53 )mm Hg vs.(41.53 ± 1.59 )mm Hg,(73.46 ± 3.04)mm Hg vs.(41.30±1.29)mm Hg,(74.13±2.85)mm Hg vs.(41.67 ±1.35)mm Hg]in group P were greatly higher than those in group C (P <0.05);the arterial blood pH value of group P (7.25±0.02 vs.7.38 ± 0.03,7.24 ± 0.01 vs.7.37 ± 0.03,7.25 ± 0.01 vs.7.38 ± 0.02 )were greatly lower than those in group C (P <0.05);PaCO 2 [(74.80±2.45)mm Hg vs.(41.93±1.39) mm Hg,(75.33±2.1 9)mm Hg vs.(42.01±1.31)mm Hg,(75.20±2.08)mm Hg vs.(42.13± 1.1 9)mm Hg ] were greatly higher than those in group C (P < 0.05 ).The incidence of pneumothorax of group P was obviously lower than that of group C (6.7% vs.40.0%,P <0.05 ). There was no statistically significant difference of the time from the end of surgery to the ventilator weaning [(3.6±0.6)d vs.(3.5 ±0.6)d]between the two groups.Conclusion Permissive hyper-capnia significantly reduces the incidence of pneumothorax in the thoracoscopic surgery of neonates with congenital esophageal atresia.Permissive hypercapnia (PaCO 2 60-80 mm Hg)can be safely ap-plied to the thoracoscopic surgery of neonates with congenital esophageal atresia.

Objective To verify the correlation between rs17118 polymorphism of xyluloknase homolog (XYLB) gene and risk of ischemic stroke in a Chinese Han population.Methods A case-control study design was used.The case group was the patients with first-ever ischemic stroke and the control group was the healthy subjects from hospital physical examination.Taqman probe fluorescence quantitative polymerase chain reaction technique was used to detect the genotype distribution of rs17118 C/A polymorphisms.Results A total of 475 patients with ischemic stroke and 483 controls were enrolled in the study.The proportion of hypertension (67.9％ vs.22.2％;x2 =292.982,P ＜ 0.001) and diabetes (24.2％ vs.7.3％;x2 =25.864,P ＜ 0.001),as well as the levels of triacylglycerol (1.649 ± 1.126 mmol/L vs.1.157 ±1.480 mmol/L;t=3.592,P＜0.001),and low-density lipoprotein cholesterol (3.499 ± 1.163 mmol/L vs.3.105 ± 0.627 mmol/L;t =-6.227,P ＜ 0.001) in the case group were significantly higher than those in the control group,but the total cholesterol level was significantly lower than that in the control group (5.144 ± 1.296 mmol/L vs.5.491 ± 1.335 mmol/L;t =4.650,P ＜ 0.001).The AA genotyp e (11.4％ vs.7.5 ％;x2 =6.136,P =0.016) and A allele (32.3 ％ vs.26.4％;x2 =8.093,P =0.005) frequencies in the case group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that after adjusting for traditional risk factors,the risk of ischemic stroke in AA genotype carriers was 1.97 times of the CC genotype carriers (odds ratio 1.971,95％ confidence interval 1.040-3.736,P=0.038).Conclusions The rsl7118C/A polymorphism of XYLB gene may be associated with the risk of ischemic stroke in the Chinese Han population.

Pancreatic cancer is a one of the most malignant digestive cancer.Because the lack of effective methods for early diagnosis,most patients have been ineligible for surgical resection when diagnosed.Kallikrein family is a group of serine proteases,because of its ability to decompose the extracellular matrix proteins,it may be closely related to the invasion and metastasis of various cancers.And some members of kallikrein family may become cancer diagnostic biomarkers.This paper reviews all the recent articles about kallikrein family study in pancreatic cancer.

Objective To evaluate the endoscopic precut sphincterotomy for malignant biliary obstruction. Methods Endoscopic precut sphincterotomy was performed in different ways for 46 patients with malignant biliary obstruction and difficult biliary cannulation according to the anatomic structure of the papilla and cannulation. Ways of precut were summarized and complications were analyzed. Results Precut sphincterotomy was performed with bow-like knife in 4 patients, with needle-knife in 24, with trans-pancreatic sphincterotomy in 12 and with combined ways in 6. The procedure succeeded in 35 cases (76. 1%, 35/46). Post-procedure complications included bleeding in 3 patients, pancreatitis in 1, hyper-amylasemia in 2and cholangitis in 1. No perforation was found. Conclusion Endoscopic precut sphincterotomy is not only able to improve the therapeutic endoscopy achievement rate in patients with malignant biliary obstruction, but also to lower the incidence of complications if used adequately.

OBJECTIVETo analyze the literature on power frequency electric field testing data and to propose views and suggestions for current testing.

METHODSThe literature on power frequency electric field testing data published in the previous years was searched to identify 306 articles involving 193 valid testing data. Mann-Whitney test and Wilcoxon W test were used for analyzing the testing data.

RESULTSThe classification of data was carried out according to one quarter of occupational exposure limit (1.25 kV/m), one half of the exposure limit (2.5 kV/m), and the exposure limit (5 kV/m). The structure of testing data showed a significant difference between the non-power facility group and the power facility group (P<0.05).

CONCLUSIONAs occupational hazard factors, the radiation exposure from power frequency electric field is extensive. However, the power frequency electric field testing data in actual workplaces except high-voltage power facilities are far less than the occupational exposure limit with little harmfulness. There is a phenomenon of excessive testing at present.

Objective To study the effects of exercise on blood pressure (BP) and aorta gaseous molecules of spontaneously hypertensive rats (SHR),so as to explore the role of gaseous molecules in exercise-induced changes of hypertension.Methods Sixteen male SHR were randomly divided into the SHR control (SC) group and SHR training (ST) group.Eight healthy male Wistar rats were used as normal control (WC) group.All the rats were fed normal foodstuff.The ST group was subject to 90-minute moderate swimming exercise once daily,6 times a week,for a total of 8 weeks,while the SC and WC groups were give no special intervention.The blood pressure and the contents of aorta NO,CO and H2S were examined before and at the end of the 4th,5th and 8th weeks of the exercise.Results After 8-week,a within-group comparison showed that the systolic BP (SBP) and diastolic BP (DBP) was significantly elevated in SC group as compared with the baseline BP[(198.07 ± 7.27) vs (159.91 ±6.48) mmHgin SBP,(132.75 ±11.93) vs (103.75 ±3.69) mmHg in BBP](P＜0.05),while that the BP remained without significant changes in the ST group [(164.85 ± 3.73) mmHg for SBP and (103.20 ± 7.63)mmHg for DBP] after 8-week of exercise.A between-group comparison showed that BP values measured at the end of 4th,5th and 8th weeks post-exercise in the ST group were significantly lower than those in the SC group (P ＜ 0.05).It was also shown that,at the end of 8th week post-intervention,the levels of aorta NOS,NO,HO,CO,CSE and H2 S of SC group was significantly lower than those of the WC group (P ＜ 0.05),and the levels of NOS,HO,CSE in the ST group were significantly lower than those in the WC group (P ＜ 0.05).Conclusion Moderate exercise can help relieve hypertension in SHR,and the gaseous molecules might synergistically mediate the effect of exercise in lowering the BP.

OBJECTIVE To carry out "Occupation Exposition Risk Guard" curriculum practice in high rank nursing and discuss the value of built this curriculum in senior professional school.METHODS The skin damage and after-damage processing were investigated by questionaire before and after this curriculum.RESULTS People not accepted this curriculum had skin damage of 96.25%,after-damage processing rate of 36.25%,and reporting rate of 20.00%,vs 70.00%,100.00% and 87.5% in but people who accepted this curriculum.CONCLUSIONS In the process of training the education of occupation exposition protection knowledge has important value.

Objective To investigate clinical features and extent of gastric, liver and pancreatic damage of primary Sjgren syndrome(pSS). Method Clinical data of 152 pSS patients with gastric,liver and pancreatic damage were analyzed.Results The occurence of chronic atrophic gastritis(CAG),the most commonly seen gastic involvment in pSS,was 77.8%.The atrophic leisions differed with patient's age.Compared with the control group, the atrophy and intestinal metaplasia of the pSS patients with CAG were milder(P

Objective To intensify the diagnosis and treatment of primary osseous Hodgkin disease (HD) and reinforce the impression of its features of pathology and imaging. Methods The clinical manifestation, laboratory examination, treatment and outcome of a patient with primary Hodgkin disease of the supermaxilla were first reported and the pertinent literatures were reviewed. Results Pain of the right supermaxilla was the first clinicM symptom. Plain X-rays showed mixed osteolytic and partially osteosclerotie lesions in the right supermaxiUa. The tumor was removed and the pathohistology was HD lymphocyte-depletion. The clinical diagnosis was primary HD of the supermaxilla (Stage Ⅰ ). The case was treated with ABVD regimen and no obviously adverse reaction appeared. Conclusion Primary osseous HD rarely presents as a malignant bone lymphoma and is easily misdiagnoed. Pathological and immunohistologic studies can be useful to confirm the diagnosis of primary osseous HD. Early diagnosis and the differentiation from other disease should be performed and the prognosis of the present-day chemotherapy regimen appears good.

Objective To explore the effects of zinc finger E-box binding protein (ZEB)2 3′UTR gene transfection on proliferation, invasion and migration in human gastric epithelial cell line GES-1. Methods The synthetic ZEB2 3′UTR and miR-200b micmics were transfected into GES-1 cell line by lipofectamine 2000. We set up control grop, the mutation group and ZEB2 3′UTR group. Real-time quantitative PCR was performed to evaluate the expression levels of miR-200a/b/c and ZEB1/ZEB2 mRNAs after transfection.And then we set up control group, ZEB2 3′UTR group, ZEB2 3′UTR+negative control group and ZEB2 3′UTR+miR-200b micmics group. The protein expression levels of ZEB1, ZEB2, matrix metallopro-teinases (MMP) 2/9 and proliferating cell nuclear antigen (PCNA) were detected by Western blot assay. The invasion and mi-gration capability were analyzed by transwell assay and wound healing test. MTT assay was used to detect the proliferation ability. Results Compared with control group and mutation group, the expressions of miR-200a/b/c were significantly de-creased, especially for miR-200b. And the expressions of ZEB1/ZEB2 were significantly increased at both mRNA and pro-tein levels after transfected with the ZEB2 3′UTR, enhancing the capability of migration,invasion,and proliferation (P <0.05). Compared with ZEB2 3′UTR group, the capabilities of proliferation,invasion and migration were significantly lower in combined group. Conclusion ZEB2 3′UTR can increase the ability of cell proliferation, invasion and metastasis through regulating the levels of miR-200a/b/c, and then influence the regulation of transcription of the target gene, which could lead to malignant transformation of GES-1 cells.