Objective To access the relationship between the polymorphism of G protein-coupled receptor kinases 4(GRK4,including R65L,A486V and A142V) and essential hypertension.Methods All the literature on the subjects was searched by keywords such as essential hypertension,hypertension,G protein-coupled receptor kinases 4 gene,and polymorphism in the electronic databases,Medline of Year 1997 to 2006.RevMan 4.2 software was used for Meta analysis.Results A total of 857 cases and 913 controls from 4 studies were included.The ORs of genotypes of R65L,A142V and A486V were 0.97(0.75 to 1.25,P=0.81),0.81(0.30 to 2.08,P=0.65) and 1.48(1.16 to 1.8,P=0.001) respectively.Conclusion GRK4 gene polymorphism A486V is significantly associated with susceptibility of essential hypertension.People who carries A486V have a higher risk to be subject to essential hypertension.

Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4％),subpleural patchy opacities (n=24,68.6％),mass (＞3cm) (n=4,11.4％),halo sign (n=27,77.1％),cavities (n=8,22.9％),air crescent sign (n=4,11.4％),miliary nodules (n=2,5.7％),pleural effusion (n=14,40％).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.

Objective To compare the effect of thoracoscopy combined with laparoscopy Mckeown and tradi-tional three incision surgery in radical resection of esophageal carcinoma.Methods 300 patients with esophageal cancer who confirmed diagnosis by gastroscopy and pathology,were randomly divided into the observation group and the control group,150 patients in each group.The observation group was treated by thoracoscopy combined with lapa-roscopy Mckeown esophagectomy,and the control group was treated by traditional three incision surgery.The operation time,intraoperative blood loss,number of lymph node dissection,length of chest tube drainage,postoperative complica-tions,and length of postoperative hospital stay of the two groups were compared.Results There were no significant differences between the two groups in operating time[(282 ±62)min vs.(273 ±64)min,P >0.05],and number of lymph node dissection[(23.2 ±6.6)vs.(21.6 ±6.4),P >0.05],and there were significant differences in intraop-erative blood loss[(262.3 ±44.7)mL vs.(315.2 ±72.6)mL,P <0.05],length of chest tube drainage[(7.6 ± 1.6)d vs.(9.4 ±2.4)d,P <0.05],postoperative complications[16.7% vs.30.0%,P <0.05],and length of hos-pital stay[(10.5 ±2.5)d vs.(14.0 ±2.0)d,P <0.05].Conclusion Thoracoscopy combined with laparoscopy Mckeown esophagectomy can achieve the same efficacy compared with the traditional approach,and it is worth popu-larizing in clinic for reducing intraoperative blood loss,length of chest tube drainage,postoperative complications,and length of hospital stay.

Objective To evaluate the effect of awake tracheal intubation with intubating larynegeal mask airway (ILMA) on stress responses of hypertensive patients.Methods Sixty hypertensive patients,aged 45-64 yr,with body mass index of 20.3-27.5 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective abdominal surgery under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:direct laryngoscope group (group D) and ILMA group (group I).At 3 min after topical anesthesia (T1),while epiglottis and glottis were exposed with direct laryngoscope in group D or during ILMA insertion in group I (T2),immediately after completion of intubation (T3),when the maximum change in hemodynamics after intubation appeared (at about 15 s after tracheal tubes were placed,T4),and at 5 min after completion of intubation (T5),mean arterial pressure (MAP) and heart rate (HR) were recorded,and blood samples were collected for determination of plasma epinephrine concentrations by radio-immunity method.Successful intubation at first attempt was recorded.Results Compared with the parameters at T1,the MAP,HR and plasma epinephrine concentrations were significantly increased at T2-4 in group D (P＜0.01),and no significant change was found in the parameters mentioned above at the other time point in group I (P＞0.05).Compared with group D,the MAP,HR and plasma epinephrine concentrations were significantly decreased at T2-4 (P＜0.01),and no significant change was found in the success rate of intubation at first attempt in group I (P＞0.05).Conclusion Awake tracheal intubation with ILMA does not induce strong stress responses and is helpful in avoiding the occurrence of cerebrovascular accidents,thus increasing the safty of awake tracheal intubation in hypertensive patients.

AIM: To investigate the changes of intracellular calcium ion (Ca2+) concentration in mouse H9c2 (2-1) cells transfected with or without FK506 binding protein 12.6(FKBP12.6) gene by ultrasound mediated destruction of microbubbles. METHODS: The pcDNA3.1-FKBP12.6 plasmid, mingled with albumin-coated microbubbles agents, was transfected into H9c2 (2-1) cells by ultrasound-mediated destruction of microbubbles. The H9c2 (2-1) cell growth state was investigated by inverted microscope. The changes of intracellular Ca2+ concentration was determined by laser scanning confocal microscope. The FKBP12.6 protein expression was checked by immunohistochemistry. RESULTS: As compared with control cells, the H9c2 (2-1) cells, transfected with FKBP12.6 gene, grew better, had higher gross intracellular Ca2+ concentration. CONCLUSION: FKBP12.6 gene augments Ca2+ concentration in mouse H9c2 (2-1) cells, enhances the contractibility of the myocardial cell, which may be helpful to improve the myocardial dysfunction.

Objective To investigate the effect of cognitive behavioral therapy on psychological status and cellular immune function in patients with postoperative chemotherapy of breast cancer. Methods 70 breast cancer patients with postoperative chemotherapy from January 2014 to August 2017 were randomly divided into intervention group and control group. Both groups underwent CMFchemotherapy. The control group received routine intervention during the chemotherapy, and the intervention group received cognitive behavioral therapy on the basis of the treatment of the control group. Both groups were intervened for 3 months. The changes of psychological status and cellular immune function before and after treatment between two groups were observed and compared. Results The SDSand SASscores of both groups decreased to different degrees after 3 months of intervention(P＜0. 05 or P＜0. 01), and SDSand SASscores in the intervention group were lower than those of control group(P＜0. 05). The levels of CD4+ and the ratio of CD4+/ CD8+ in the intervention group increased at different degrees, and the levels of CD8+ in the intervention group decreased to different degrees (P＜0. 05 or P＜0. 01), while those in the control group did not change significantly (P＞0. 05). After treatment, the level of CD4+ and the ratio of CD4+/CD8+ in intervention group was higher than that in control group, and the level of CD8+ in the intervention group was lower than that in control group (P＜0. 05 or P＜0. 01). Conclusion Cognitive behavioral therapy is effective for patients with postoperative chemotherapy of breast cancer, which not only can significantly improve their psychological status and relieve their depression and anxiety states, but also regulate the disturbance of Tlymphocyte subsets and enhance the cellular immune function.

Objective To explore the influencing factors of pulmonary infection in patient with stroke, in order to provide the basis for clinical rehabilitation nursing. Methods A total of 237 patients with stroke who were treated in hospitalsfrom January 2015 to December 2015, were enrolled in the study. To analysis the effect of several influencing factors such as age, sex, consciousnessdisorders, pulmonary diseases, swallowing disorder and the activities of daily living(ADL). Results Of the 237 patients, 66 were complicated with pulmonary infection, and the incidence rate of pulmonary infection was 27.8％. Thepulmonary infection in patients with stroke was associated with swallowing disorder, hypertension, pulmonarydiseases, albumin,stomach pipe retaining, proton pump, swallowing disorder, long bedridden and ADL. These results had significantly deference (P<0.05). The logistic regression analysis showed that the independent risk factors for sex, consciousnessdisorders, pulmonarydiseases, swallowing disorder and ADL. Conclusions The influencing factors were existed in pulmonary infection in patients with stroke. The independent risk factors for pulmonary infection in patient with stroke included sex, consciousnessdisorders, pulmonarydiseases, swallowing disorder and ADL. In the above some factors, nurse should be providingrehabilitation nursing measure to reduce the incidence rate of pulmonary infection.