Objective To investigate the nosocomial infections among patients undergoing abdominal operation . Method Data in three hundred patients underwent abdominal operation in our department from January 2012 to December 2014 were reviewed. Results Seventeen cases developed nosocomial infection after operation, including 6 cases of respiratory system infection, accounting for 35.29%, 4 cases of urinary infection, accounting for 23.53%. The probability of nosocomial infection from the type Ⅲ operations was higher than that from the typeⅡ operations and that by emergency surgery was higher than that by non-emergency operations(P<0.05). Conclusions Respiratory and urinary infections are the major two types of the nosocomial infections in the abdominal operation. Sufficient preoperative preparation and postoperative nursing can reduce the incidence of nosocomial infections in abdominal surgery.

Objective To explore the effects of physiological deep-sea water(PDSW) on hyperthermal tolerance of Kunming (KM ) mice in the 45 .0 ℃ environment .Methods Deep-sea water from the south Chinese sea was processed ,and the metallic ele-ments dissolved in the DSW were analysed .The mice were randomly divided into 2 groups :the control group received tap water ;the experimental group treated with PDSW for 15 d .And then the mice were fed in the 45 .0 ℃ conditions .The survival time and histo-morphometric analyses of the brain ,lung ,heart ,liver and kidney were investigated .Results The survival time in PDSW-fed group was significantly longer than that of the control group (P< 0 .05) .Moreover ,histomorphometric analyses showed that PDSW could protect the brain ,lung ,heart ,liver and kidney of KM mice from the 45 .0 ℃ conditions .The results of western blot revealed that ex-pression of HSP72 of liver tissues for PDSW-fed group substantially increased ,when compared with the control mice(P< 0 .05) . Conclusion PDSW could improve hyperthermal tolerance of KM mice ,which maybe in the relation with expression of HSP72 pro-moted by PDSW .

Objective:To prospectively investigate the prevalence of heparin-induced thrombocytopenia (HIT) in critically ill children during extracorporeal membrane oxygenation(ECMO) and explore the clinical characteristics and prognosis of HIT during ECMO.Methods:A total of 22 critically ill children, who had received ECMO support for more than 96 hours in the Intensive Care Unit at the Children′s Hospital of Fudan University from March 2019 to December 2020, were enrolled.According to the 4T score and the heparin/platelet factor 4(PF4) antibody, children whose 4T scores were not less than 6 and heparin/ PF4 antibodies were positive, were classified into HIT group ( n=6), and non-HIT group ( n=16). The clinical outcomes and the incidence of thrombotic events were compared between two groups. Results:The incidence of HIT during ECMO in critically ill children was 27% in this study.The incidence of thrombosis in the ECMO circuit in the HIT group was higher (100% vs.63%, P=0.133), and the average time to the first thrombosis in ECMO circuit in the HIT group was shorter than that in the non-HIT group (3.70 d vs.5.44 d, P=0.06). During the first 14 days of ECMO, the proportion of children with thrombotic events no less than twice was higher in the HIT group (67% vs.19%, P=0.054). There was no significant difference regarding the survival rate at 28 days after ECMO withdrawal between two groups (33% vs.50%, P=0.664). Conclusion:The prevalence of HIT during ECMO in critically ill children is high.Thrombosis events tend to occur earlier and more extensively in children with HIT during ECMO.No significant effect of HIT on the survival rate of children during ECMO is found.Whether HIT has effect on the survival rate of children with ECMO requires a prospective and large clinical study.

Objective:To investigate the correlation and consistency between the parameters of the thromboelastography(TEG) and of routine coagulation tests and platelet count(PLT) in critically ill children in the pediatric intensive care unit.Methods:We conducted a retrospective analysis on the results of the simultaneous TEGs, coagulation tests and PLT of 231 children in pediatric intensive care unit at Children′s Hospital Affiliated to Fudan University from March 2019 to July 2019, including the correlation analysis, the chi-square test and Kappa consistency analysis.Results:The reaction time(R) was linearly dependent on activated partial thromboplastin time(APTT), prothrombin time(PT) and thrombin time(TT), respectively.The maximal amplitude(MA), clot time formation(K) and alpha-angle(α) were linearly dependent on fibrinogen.The MA, K and α were linearly dependent on PLT, too.And the correlation between MA and PLT was the best( R=0.656). There were significant differences( P<0.001) and poor consistency(Kappa value: 0.112, 0.047, 0.124) between R and APTT, PT, TT.There was no significant difference( P>0.05) and there was moderate consistency(Kappa value: 0528, 0.518, 0.408) between Ma, K, α and PLT.There were significant differences( P<0.001) and the consistency was poor or fair(Kappa value: 0.324, 0.188, 0.170) between Ma, K, α and fibrinogen. Conclusion:TEG is significantly correlated with PLT in evaluating platelet function and the consistency is good.The TEG parameters are linearly correlated with the relevant results of routine coagulation tests in evaluating the coagulation factor and fibrinogen function, but consistency is weak.Therefore, it is concluded that these two methods are irreplaceable.

Objective To investigate the effect and mechanism of tetrahydrobiopterin ( BH4) on the angiogenesis in hepatocellular carcinoma ( HCC) .Methods BALBc/-nu mice were subcutaneously injected with HepG-2 cells and randomly divided into control and BH 4 groups.The BH4 group and control group received 20 mg/kg BH4 or saline by intraperitoneal injection daily for two weeks , respectively .The level of BH4was measured by high performance liquid chromatography (HPLC), the level of nitric oxide (NO) was measured by Griess test array , the transcriptional level of K-ras was measured by quantitative RT-PCR, and the protein expressions of guanosine triphosphate cyclohydrolase Ⅰ( GTPCH ) , endothelial nitric oxide synthase ( eNOS) , phospho-Akt and Akt were determined by Western blot .Results BH4 level in the tumor tissues of BH4 group was (0.24±0.02) μg/ml, significantly higher than the (0.17±0.01) μg/ml in the control group (P<0.01).The level of NO in the tumor tissues of BH4group was (51.44±2.90) mmol/L, significantly higher than the (24.77±0.54) mmol/L in the control group( P<00.1 ).The tumor volume of BH4 group was (191.05±8.70) mm3, significantly higher than the (103.10±5.03) mm3 in the control group (P<0.01).The expressions of CD34 , K-ras, phospho-eNOS, phospho-Akt and GTPCH were significantly up-regulated in the tumor tissues of BH4 group when compared with those of the control group (P<0.01). Conclusions BH4 recognized as an essential cofactor of eNOS can increase tumor-produced NO by activating the wild-type Ras-PI3K/Akt pathway, thus induces angiogenesis .This might provide a novel and promising way to control the progression of hepatocellular carcinoma through targeting BH 4 synthesis pathway and inhibiting angiogenesis .

Objective To investigate the effect and mechanism of tetrahydrobiopterin ( BH4) on the angiogenesis in hepatocellular carcinoma ( HCC) .Methods BALBc/-nu mice were subcutaneously injected with HepG-2 cells and randomly divided into control and BH 4 groups.The BH4 group and control group received 20 mg/kg BH4 or saline by intraperitoneal injection daily for two weeks , respectively .The level of BH4was measured by high performance liquid chromatography (HPLC), the level of nitric oxide (NO) was measured by Griess test array , the transcriptional level of K-ras was measured by quantitative RT-PCR, and the protein expressions of guanosine triphosphate cyclohydrolase Ⅰ( GTPCH ) , endothelial nitric oxide synthase ( eNOS) , phospho-Akt and Akt were determined by Western blot .Results BH4 level in the tumor tissues of BH4 group was (0.24±0.02) μg/ml, significantly higher than the (0.17±0.01) μg/ml in the control group (P<0.01).The level of NO in the tumor tissues of BH4group was (51.44±2.90) mmol/L, significantly higher than the (24.77±0.54) mmol/L in the control group( P<00.1 ).The tumor volume of BH4 group was (191.05±8.70) mm3, significantly higher than the (103.10±5.03) mm3 in the control group (P<0.01).The expressions of CD34 , K-ras, phospho-eNOS, phospho-Akt and GTPCH were significantly up-regulated in the tumor tissues of BH4 group when compared with those of the control group (P<0.01). Conclusions BH4 recognized as an essential cofactor of eNOS can increase tumor-produced NO by activating the wild-type Ras-PI3K/Akt pathway, thus induces angiogenesis .This might provide a novel and promising way to control the progression of hepatocellular carcinoma through targeting BH 4 synthesis pathway and inhibiting angiogenesis .

O bjective To understand the effects and clinical significance of the 2019 guidelines for the human epidermal growth factor receptor 2 (HER2) detection. Methods:According to the 2014 guidelines, 548 cases of invasive breast cancer with equivocal HER2 (2+) detected by immunohistochemistry (IHC) in Taizhou Enze Medical Center, Zhejiang Province, China from 2013 to 2019 were selected. The results of IHC and HER2/CEPl7 double-probe were reevaluated and divided into groups according to the 2019 guidelines for the comparative analysis.Results:Among the 548 IHC HER2 (2+) invasive breast cancers, the number of positive, equivocal and negative cases for HER2 were 96 (17.52%), 81 (14.78%) and 371 (67.70%), respectively, according to the 2014 guidelines. However, according to the 2019 guidelines, 10 cases (1.82%) were reclassified as IHC 1+, 2 cases in the group 2 were reclassified as negative, and all the originally equivocal cases in group 4 were reclassified as negative. Finally, the total number of positive and negative cases for HER2 were 94 (17.15%) and 454 (82.85%), respectively.Conclusions:After applying the 2019 guidelines, the number of IHC 2+ cases decreases, and the positive rate for HER2 also decreases slightly due to the reevaluation change in groups 2 and 4, leading to reclassification of the cases that were deemed equivocal according to the 2014 guidelines. In general, the new 2019 guidelines are more reasonable and easier to use.