Objective To study the clinical characteristics,treatment and prognosis of neonatal intestinal muscle defect with perforation.Methods The clinical data of 8 cases of newborns who had intestinal muscle defect with perforation in Department of Surgical Intensive Care Unit,Nanjing Children's Hospital Affiliated to Nanjing Medical University,were analyzed retrospectively.Results These 8 cases included 1 premature infant,1 term low birth weight infant,6 cases of term infants with normal birth weight,and all had no history of perinatal asphyxia.The ages of onset of all cases were ＜ 7 d.Clinical manifestations were crying and sudden onset of obvious abdominal distention.Bile or fecal vomiting occurred in 5 cases.These patients included 5 cases with congenital anorectal malformations,of which 3 cases had low deformity,1 case with middle deformity and 1 case with high deformity,with no other complications of gastrointestinal malformation.Surgical treatment was used in 8 cases,in which 7 cases of rectal perforation and 1 case of ileal perforation were confirmed.All cases were isolated perforation with a diameter of about 0.8-2.0 cm.The perforated periphery of the intestine was membranous.Intestinal repair was performed after total removal of the diseased tissue,and the patients with rectal perforation were performed at the same time for the proximal colostomy.The histopathologic examinations showed that the periphery of perforation had intact mucosa,muscularis propria was absent,myenteric plexus was absent in the region of muscle loss.Two cases were discharged within 1 d after colostomy.Except for 1 case with high anorectal malformation in the control of poor defecation functions,there were no other postoperative gastrointestinal complications in these 6 cases.Conclusions Rectal perforation is the most common in neonatal intestinal muscle defects,and it is an isolated and large diameter perforation.Most cases are term infants with normal birth weight.These patients are often associated with congenital anorectal malformations.High,middle and low deformity can be accompanied by intestinal muscle defect.Surgical excision of diseased tissue should be complete,in principle,and intestinal stoma should be performed proximal to the perforation.In case of congenital anorectal malformations complicated with gastrointestinal perforation,the rectum should be explored as an important region.Neonatal intestinal muscle defect maybe a primary lesion according to clinical characteristics of early sudden onset after birth and pathological examinations.Except for complications caused by associated malformations,the prognosis is satisfactory.

Objective To investigate whether serum miRNA-720 and miRNA-484 can be used as non-invasive biomarkers of colon cancer.Methods Real time-polymerase chain reaction was used to detect the expressions of miRNA-720 and miRNA-484 in serum from 104 colon cancer patients(divided intoⅠ~Ⅱ-stage group andⅢ~Ⅳ-stage group)compared with 60 ad-ditional healthy controls.ROC curve was performed to analyse the diagnostic usefulness of both miRNAs distinguishing be-tween different stages of colon cancer patients.Results Compared with healthy controls,the miRNA-720 was upregulated close to 2 times inⅠ~Ⅱ-stage group (t=1.997,P<0.05),and was upregulated about 3 times inⅢ~Ⅳ-stage group (t=2.133,P<0.05).The miRNA-484 was downregulated almost 2 times inⅠ~Ⅱ-stage group (t=2.585,P<0.05),but was upregulated over 3 times in Ⅲ~Ⅳ-stage group (t=3.416,P<0.01).The area under the ROC curve (AUC)for the diag-nosis of colon cancer were 0.76 (95%CI:0.67~0.86)and 0.79 (95%CI:0.69~0.89)respectively.The combined use of both miRNAs could make the AUC up to 0.87 (95%CI:0.77~0.96).Conclusion Serum miRNA-720 and miRNA-484 can be used as non-invasive biomarkers to diagnose early colon cancer.They can also distinguish between different stages of co-lon cancer patients.

Objective To observe how the ACC transmits nociceptive information and how it regulates spinal noceciption.Methods A total of 32 male SD rats were randomly divided into four groups:Sham group,CCI group,ACC group,and AP-5 group.After light-dark transition test, forced swimming test (FST),paw withdrawal mechanical threshold (PWMT),paw withdrawal ther-mal latency (PWTL)had been measured,the rats were finally anesthetized,then ACC and the spinal cord was rapidly removed,the expression of cAMP-response element binding protein (pCREB)and extracellular regulated protein kinases (pERK)were measured by Western blot.Results Compared with the sham group,the PWMT of the CCI rats were significantly decreased,rats spent less time in the light compartment and number of transition were decreased (P <0.01 ).The immobility time in FST were also significantly prolonged (P <0.01).After AP-5 injected in bilateral ACC 13 days after CCI operation,the PWMT of the CCI rats were significantly increased,rats spent more time in the light compartment and number of transition were increased (P <0.01).The immobility time in FST were also significantly shortened (P <0.01).Compared with sham group,the expression of pCREB, pERK increased significantly in ACC in CCI group (P <0.01).The expression of pCREB,pERK in spinal cord was increased in CCI group and decreased in AP-5 group (P <0.01 ).Conclusion ACC facilitate the spinal nociception in a descending mode.

Objective: To explore the influence of Aiweixin on cardiocyte apoptosis of myocardial ischemia-reperfusion injury in rats. Methods: Thirty male Wistar rats, 200-250g weight, were divided into 3 groups randomly: sham-operation group, Ischemia-reperfusion injury group (I/R) and Aiweixin preconditioning group, each group had 10 rats. The model of myocardial ischemia-reperfusion injury was established. The protein expressions of Bcl-2, Bax and Caspase-3 were studied by Immunohistch emicalstaining. Results:The protein expressions of Bax and Caspase-3 increased and Bcl-2 decreased signifi cantly (P

Objective To establish the 3rd national standard for un-fractionated heparin for National Institutes for Food and Drug Control(NIFDC).MethodsFour candidate heparin samples(code ampoule 1,2,3,4)were assayed against the International Standard(07/328)and National Standard(150509-200912).Jiangsu Institute for Food and Drug Control(JSIFDC)determined the potency of anti-FXa and anti-FIIa by chromogenic substrate methods and the potency of anticoagulation by whole rabbit blood of Chinese Pharmacopoeia(2015).Results All of the data from our institute were adopted to calculate the 3rd national standard for un-fractionated Heparin.NIFDC analyzed the data from 13 laboratories.The geometric coefficient of variation of inter-laboratory and intra-laboratory were both below 10％.Conclusion Approved by the national drug standards material Committee,the candidate(140817-201501)was recommended to be the 3rd national standard for un-fractionated Heparin with an assigned value of 2011IU per ampoule.

Clinical practice is an important teaching stage for interns of anesthesiology in medical universities.We discuss advantages and disadvantages for different teaching modes in the course of clinical practice,aiming at choosing a better one to optimize practice quality and bringing up graduates with high diathesis.

The essence of training for clinical postgraduates is comprehensive capacity,including clinical and scientific research capacity,and the demand for the former is relatively higher than the latter. By means of discussion on the source and the educational system for postgraduates,we try to train clinical anesthesiology postgraduates with high diathesis and meet the needs of clinical anesthesia.

Objective Myocardial blush grade (MBG) as a new angiographic parameter was used to describe the effectiveness of myocardial reperfusion in patients treated with thrombolysis for acute myocardial infarction (AMI) Methods Eighty nine patients received a small dose alteplase 50mg within 12 hours of acute infarction Coronary angiography was performed at 90 min after the initiation of thrombolytic therapy to evaluate infarct related artery (IRA) patency and myocardial reperfusion Cardiac events during a 6 month period were recorded Results There were 87 6% and 12 4% patients with and without successful clinical recanalization after thrombolysis respectively Coronary angiography showed that 82 6% patients with TIMI flow 2 or 3, 88 8% patients with MBG 2 or 3, and 40 4% patients with TIMI flow 3 and MBG 3 Mortality at follow up was 10 1% Multivariate analysis showed that the MBG and Killip grade at admission were major significant predictors of 6 month mortality Conclusion The primary objective of reperfusion therapies is not only restoration of blood flow in the epicardial coronary artery, but also complete reperfusion of the infarcted myocardium

Objective To evaluate influence of patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) on expressions of serum inflammatory cytokines in elderly patients with hemi or whole hip replacement using cemented artificial joint. Methods Elderly patients undergoing hip replacement were selected and were divided into PCIA group and PCEA group. VAS scores were calculated at 12 h postoperatively. Patients whose VAS scores were not more than 2 at postoperative 12h were included. 30 cases in each group were finally included. Fifteen cases were randomly chosen in each group and underwent sample blood drawing for assays. Expressions of serum inflammatory cytokines were detected by ELISA , RT-PCR and Western-blot. Results Gene and protein expressions of TNF-a as well as IL-6 in group PCEA were lower and expression of IL-10 was higher than that in group PCIA. Serum level of TGb-β was higher in group PCEA detected by ELISA. There was no significant difference in expression of IL-8 between groups. Conclusions PCEA may better promote expressions of anti-inflammatory cytokines and inhibit expressions of proinflammatory cytokines. PCEA is superior in maintenance of inflammatory cytokine balance.

Objective To evaluate the sensitizations of Hydroxyethyl Starch 40 Sodium Chloride Injection . Methods Active systemic anaphylaxis ( ASA) test, internal sensitive index ' s determination and screening and Passive Cutaneous Anaphylaxis ( PCA) test are carried out .Observe the allergy safety of the samples .Results We use guinea pigs to carry on ASA test and PCA test with Hydroxyethyl Starch 40 Sodium Chloride Injection from 45 batches of 3 companies and no changes have occurred .Measuring and comparing the sensitive index of HIS ,IgG, IgM and IgE in plasma, IgM and IgE are not obvious variation;HIS and IgG positive group and negative group and sample groups are different .Conclusions It is suggestion that Hydroxyethyl Starch 40 Sodium Chloride Injection safety evaluation should include allergic reactions , HIS and IgG sensitive index monitoring in clinical application of hydroxyethyl starch .