Kawasaki disease (KD) is an acute, self-limited vasculitis of children and the principal cause of acquired heart disease in children in developed countries. The recent follow-up studies of KD revealed that cardiac sequelae had been observed for many years in a minority of patients with KD. Cardiac sequelae especially the coronary artery aneurysm is the leading cause of ischemic heart disease or even the sudden death.The long-term management of KD was developed in many countries in order to prevent the cardiac events.This paper reviews the long-term prognosis and follow-up of KD.

Objective To clarify the relationship between the serum prolactin (PRL),immunity and prognosis of the critical patients.Methods The data of 80 patients with complete clinical data in the Intensive Care Unit of the Fujian Provincial Hospital during October 1,2010 to October 1,2011 were collected.The patients were divided into 2 groups according to the prognosis:death group and survival group.Fasting blood is extracted respectively on the morning of the 2nd day after they were admitted,the 4th day and the 8th day.Chemiluminescence immunoassay system was used to detect the serum PRL,flow cytometers to test peripheral blood T-lymphocyte subsets,and immunization rate nephelometry to check the 5 items for bumoral immunity in peripheral blood.The multi-factor repeated measure analysis of variance was used in the comparison of the two groups.Results Compared with those of the survival group,the serum PRL (P=0.037,0.036,0.030),the percentages of CD3+ (P=0.034,0.023,0.023),CD4+ (P =0.046,0.003,0.046) and CD8+ (P =0.040,0.039,0.045) cells of the death group were significantly lower.However,positive correlation exists between the value of serum PRL and the percentages ofCD3+,CD4+ and CD8+ cells (P=0.004,0.043,0.003):the higher the former,the higher the latter.Conclusions The change of cellular immunity is important for the prognosis of the patients.Downgradationof the cellular innunity indicates an undesirable prognosis.The serum PRL may work positively on cellular immunity.

In recent years, with the changes of human living environment, the morbidity of respiratory tiact allergic diseases such as allergic rhinitis, infant wheezing, allergic asthma, and other diseases increased rapidly, thereby affecting the quality of children′s life, and increasing heavy burdens to families and society.Microbial infection, including virus, bacteria, mycoplasma pneumoniae/chlamydia, fungi and parasites, can regulate the occurrence and development of respiratory tract allergic diseases through the immune mechanism.In order to deepen the understanding of the relationship between respiratory allergy and microbial infection and its related mechanism, the research progress on the relationship between respiratory allergy and microbial infection was reviewed in this paper.

At present, oncology medical student in our country has many communication problems, such as communication awareness is not strong,the lack of communication,communication is not enough self-confidence and other issues.To improve the communication ability between doctors and patients for the oncology professional medical students:it is the necessary premise for correct implementation of diagnosis and treatment, an effective way to reduce medical disputes, adapt to the demand of the development of higher medical education.And pointed out the effective ways to improve the ability of doctor-patient communication:to set up the doctor-patient communi-cation and tumor department before the internship training course;establishlisten with your heart and professional guidancemode;with teacher actively guiding; learn to empathymode; adhere to the concept of taking pa-tients as the center.

OBJECTIVE:To explore clinical efficacy of levoearnitine combined with trimetazidine in the treatment of ischemic cardiomyopathy(ICM) heart failure in elderly patients.METHODS:64 ICM elderly patients with heart failure were randomly divided into control group and observation group(n=32).Both group were given therapy of regulating blood lipid,antiplatelet,anti ischemia and conventional anti-heart failure therapy.Observation group were additionally intravenously injected with levoearnitine and given oral dose of trimetazidine for 2 weeks.Cardiac function classification,left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) of patients were determined before and after treatment.RESULTS:The cardiac function and the level of LVEDD,LVESD and LVEF in observation group were all significantly better than in control group.There were statistical significance in difference between two groups(P

Objective To detect the expression levels of serum alpha fetal protein (AFP),carbohydrate antigen 199(CA-199) and carcinoembryonic antigen(CEA) in a rat model of liver cancer and elderly liver cancer patients,and explore its clinical significance.Methods A rat model of liver cancer was successfully established by intraperitoneal injection of a low dose of diethylnitrosamine (DEN).The expression levels of serum AFP,CA-199 and CEA in rats were determined and compared during the development of liver cancer.Blood samples were collected from elderly subjects with normal liver and elderly liver cancer patients(n=80,each).The expressions of serum AFP,CA-199 and CEA were determined and compared between healthy elderly patients and elderly liver cancer patients.Results Serum levels of AFP,CA-199 and CEA were higher in liver cancer rats than in normal rats [(4.21±1.32) μg/Lvs.(1.05±0.33) μg/L,(3.78±1.04) kU/L vs.(1.00±0.28) kU/L,(3.54±0.92) μg/Lvs.(1.10±0.37) μg/L,t=9.493,8.609,7.675,respectively,all P=0.000].Serum AFP,CA-199 and CEA levels were higher in elderly patients with liver cancer than in elderly subjects with normal liver [(66.89±9.33) μg/L vs.(2.56±1.09) μg/L,(116.89±43.33) kU/L vs.(5.56±1.26) kU/L,(5.83 ± 1.56) μg/L vs.(1.17 ± 0.51) μg/L(t=14.379,17.470,10.677,respectively,all P=0.000).The positive rate of joint detection of AFP,CA-199 and CEA was higher in elderly patients with liver cancer than in elderly subjects with normal liver [77.50％ (62/80) vs.1.25％(1/80),x2 =17.260,P=0.000].Conclusions The joint detection of AFP,CA-199 and CEA can help increase the diagnostic rate of liver cancer in elderly patients.

Objective To evaluate the value of the short-segment nerve conduction studies (SSCSs, inching test) in the diagnosis and localization of cubital tunnel syndrome (CubTS).Methods The clinical and electrophysiologic data of 46 patients (92 limbs from 32 men and 14 women, aged from 19 to 59 years, with average age of 41.2 years) with CubTS were collected.The symptoms occurred in unilateral arm in 41 patients and bilateral arms in 5 patients, involving 35 left arms and 16 right arms.SSCSs were performed in both arms in all the 46 patients.Sixty ulnar nerves were studied in 30 healthy control subjects using SSCSs.Results The 51 symptomatic arms with CubTS were abnormal in long segment motor nerve conduction studies.There were 68 abnormal arms ( 51 symptomatic arms, 17 asymptomatic arms ) in SSCSs.The lesions were located 2 cm proximal to the elbow-the elbow segment ( AE2-E ) in 41 arms (44.6%),the elbow-2 cm distal to the elbow segment (E-BE2) in 23 arms (25%), 4 cm proximal to the elbow-2 cm proximal to the elbow segment (AE4-AE2) in 18 arms (19.6%), 6 cm proximal to the elbow-4 cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2 cm distal to the elbow-4 cm distal to the elbow segment (BE2-BE4) in 8 arms(8.6%) and 4 cm distal to the elbow-6 cm distal to the elbow segment (BE4-BE6) in 6 arms(6.5%),respectively.Conclusions SSCSs are more sensitive in detecting CubTS than the conventional long segment motor conduction studies.SSCSs could precisely localize the entrapment lesions in patients with CubTS ,might be a useful tool for the detection of ulnar mononeuropathy at the elbow, especially for diagnosing the patients with CubTS who have no clinical features or have a normal long segmental nerve conduction findings.

ObjectiveTo assess the differential diagnostic value of serum intestinal fatty acid binding protein (I-FABP)in distinguishing intestinal ischemia patients from acute abdomen patients.MethodsA total of 151 patients with acute abdomen and 17 healthy controls from the PLA General Hospital were enrolled from November,2009 to August,2011. Serum I-FABP levels were measured by ELISA.According to the ROC curve,the cut-off value,sensitivity,specificity,positive likelihood ratio (PLR),negative likelihood ratio ( NLR),positive predietive value (PPV) and negative predictive value (NPV) were calculated. ResultsOf the 151 acute abdomen patients,there were 24 intestinal ischemia patients and 127 without intestinal ischemia.Serum I-FABP level in intestinal ischemia group [( 109.67 ±48.82) μg/L]was significantly higher than those in patients without intestinal ischemia [(36.78 ± 11.25) μg/L]and healthy controls[(8.33 ±6.25) μg/L]( all P values ＜0.01 ).The serum I-FABP cut-off value for the diagnosis of intestinal ischemia was 87.52 μg/L.Serum I-FABP was efficient in terms of sensitivity (0.762),NPV(0.963),PLR(3.05) and NLR (0.24) in the diagnosis of intestinal ischemia.ConclusionI-FABP is potentially useful for discriminating intestinal ischemia from acute abdomen.

Objective To explore the feasibility and secure cold storage time of human arteries during sequentially cold-cryopreservation by observing the cellular metabolic activity and structure after cold storage and cryopreservation. Methods Human iliac and splenic arteries were stored for 72 h, 1 week, 2 weeks, 3 weeks and 4 weeks in UW solution at 4 ℃. After the cold storage procedure, half of the vascular allografts were examined by NBT dye method, electron and light microscope. The other vascular allografts continued to be stored by - 80 ℃ cryopreservation procedure for 4 weeks, and then the vascular allografts were examined by NBT dye method, electron and light microscope. Results There was no statistically significant difference in NBT dyeing time between the groups stored in UW solution within 2 weeks and fresh group at 4 ℃ (P ＞ 0. 05). After - 80 ℃ cryopreservation, there was also no statistically significant difference in NBT dyeing time between the groups stored by UW solution within 1 week and fresh group at 4 ℃ (P＞0. 05). Along with the extension of cold storage time, the destruction of ultrastructure was aggravated. When vascular allograft was stored over 2 weeks at 4 ℃, the destruction was more obvious. As the cold storage time prolonged, the ultrastructural destruction of vascular allografts was aggravated, especially those stored over 1 week. Conclusion The optimal time limit for arteries stored at 4 ℃ in UW solution was 2 weeks. Cryopreservation at - 80 ℃ kept the arteries satisfactory metabolic activity and organizational structure. The arteries stored within 1 week at 4 ℃ in UW solution, which restored at - 80 ℃ , could maintain satisfactory metabolic activity and organizational structure.

Objectives To investigate the correlation between HIF-1α expression level and clinical pathological characteristics of ovarian carcinoma in the elderly.Methods The expression levels of HIF-1α in normal ovary tissue,benign ovarian tumor tissue,borderline ovarian tumor tissue and ovarian cancer tissue were detected in the elderly by immunohistochemical method.And the correlations between HIF-1α expression level and clinical pathological characteristics of ovarian carcinoma were analyzed in the elderly.Results The HIF-1α expression was almost nothing in normal ovarian and benign ovarian tumor tissues,low in the borderline ovarian tissues,and high in the ovarian cancer tissue(Z=11.324,P =0.002).The IOD value of tissues was higher in borderline ovarian tumor tissue[(2.58 ± 0.65) × 105] and ovarian cancer tissue [(5.95 ± 1.02) × 105] than in normal ovary tissue[(1.90±0.35) × 105]and benign ovarian tumor tissue[1.95±0.41) × 105] (F=15.711,P=0.001).The expression of HIF-1α in the tissues was lower in ovarian cancer with stage Ⅰ-Ⅱ,high or moderate differentiation and non-metastatic lymph node than in ovarian cancer with stage Ⅲ-Ⅳ,low differentiation and metastatic lymph node (x2 =4.714,6.121,6.364;P =0.030,0.013,0.012).Conclusions The expression of HIF-1α is up-regulated in ovarian cancer in the elderly compared with normal ovarian tissues,which may be related to occurrence,development and clinical prognosis of ovarian cancer.