Abstract As a common critically illness among neonates and notably premature infants, respiratory failure is one of the major factors for neonatal deaths. Ventilator, an effective tool for assisted ventilation, is effective to remarkably improve respiratory failure; however, the conventional mechanical ventilation is likely to cause a series of injuries and complications. Therefore, noninvasive ventilation is commonly used in clinical practices. Noninvasive high-frequency oscillatory ventilation is an emerging noninvasive respiratory, in which tracheal intubation is replaced with nasal plug and mask to transfer high-frequency airflow to the airway. It facilities rapid correction of the imbalance of ventilation blood flow ratio, reduction of carbon dioxide retention, increase in oxygen saturation, and reduction in incidence of complications and risk of failure in ventilator withdrawal, which has been employed for the treatment of respiratory failure among neonates. The review descries the applications of noninvasive high-frequency oscillatory ventilation in respiratory support among neonates with respiratory failure, so as to provide insights into the management of respiratory failure among neonates.

The activation of NK cell , mediated by natural killer group 2 ( NKG2 ) family receptor , plays an important role in antiviral immune response and disease progression after hepatitis B virus (HBV) infection.To explore the NKG2 receptors-mediated NK cell activation and its mechanism may be of value for anti-HBV targeting immune treatment .This article reviews the recent research progress on the role of NK cells and its NKG2 family receptors in immunity of chronic HBV infection and its mechanisms .

Objective To investigate the effect of inhibiting the expression of Navl. 8 sodium channels by an antisense oligodeoxynudeotide(ODN) on visceral hypersensitivity. Methods The visceral hypersensitivity animal models induced by giving neonatal Sprague-Dawley rats colorectal distention(CRD) after postnatal days 8, 10 and 12. Animals were injected intrathecally either Navl. 8 antisense ODN (research group) or mismatch ODN (control group) twice a day for 3 days at the 8th week. After that, the expression of Navl. 8 in each group was examined by RT-PCR, and abdomiral withdrawal reflex(AWR) score and spinal c-Fos expression were evaluated to assess whether the intervention can relieve the visceral hypersensitivity. Results After intrathecal injection with the antisense ODN, the expression of Navl. 8 in each group decreased.AWR score and the number of c-Fos positive neurons in the spinal cord, especially in the area 1 and 3, decreased in the model group, while they did not change in the control group. Conclusions Interventing the expression of Nav1.8 may relieve the visceral hypersensitivity in this model of irritable bowel syndrome.

Objective: To construct a core competency training indicator system for high-level public health talents using the Delphi method, so as to provide insights into optimization of high-level public health talents training. Methods: Based on review of publications pertaining to core competency training for high-level public health talents, in combination with public health priorities and development needs in China, a preliminary indicator system was constructed. Twenty public health experts were invited for two rounds of Delphi expert consultation. Indicators were screened based on the frequency of full marks, mean score and coefficient of variation (CV), and the weight of indicators was determined using the Entropy weight method. The effectiveness of the Delphi expert consultation was evaluated using the active degree, authority coefficient and the consistency degree. Results: Twenty experts participated in the consultation, including 12 men, and there were 6 experts at ages of 30 to 39 years, 8 at ages of 40 to 49 years, and 6 at ages of 50 years and older. There were 17 experts with an educational level of master and above, 19 with senior professional titles and all experts had working experiences for 10 years and longer. The active degrees were 95.24% and 100.00% for two rounds of consultations, and the overall authority coefficient was 0.87. Following two rounds of consultations, all CVs were reduced to below 0.25, and the coordination coefficients were all statistically significant (P<0.05), with a higher coordination coefficient in the second round of consultation than in the first round. The constructed core competency training indicator system for high-level public health talents included four primary indicators, including health protection, health service improvement, health promotion, and essential quality, with weights of 0.388, 0.310, 0.122 and 0.180, 11 secondary indicators, with high weights seen for protection of human health from threats (0.178), monitoring and assessment of health service utilization (0.157) and promotion of health service quality and access (0.112), and 70 tertiary indicators, with high weights seen for Chinese writing (0.038), capability for health policy suggestions (0.034) and global perspective (0.030). Conclusion The core competency training indicator system for high-level public health talents constructed in this study may provide insights into training of high-level public health talents.

Objective To investigate the effects of percutaneous coronary intervention(PCI) and conventional drugs on autonomic nervous system and C-reactive protein (CRP)in the patients with unstable angina pectoris combined by QRS complex fragment. Methods A total of 60 patients aged (46.2± 10.3) years with unstable angina combined by QRS complex fragment were randomly divided into drug therapy group and PCI group (n=30 for each group).The changes of heart rate variability (HRV) including SDNN,SDANN,rMSSD,PNN50,HF and LF,heart rate turbulence(HRT) such as TO and TS,and CRP were measured before and 1 month after treatment. Results The values of SDNN[(88.2±20.6)ms vs.(122.5 ± 15.5)ms; (86.9± 23.4)ms vs.( 106.7± 18.8)ms],SDANN [(76.2±9.3)ms vs.(105.3±5.2)ms; (74.3±10.4)ms vs.(89.8±7.6)ms],rMSSD[(18.6±7.9)ms vs.(49.3± 4.3)ms; (19.3± 7.4)ms vs.(29.4± 5.2)ms],PNN50 [(5.5± 2.8)％ vs.(9.1 ±1.8)％; (5.3±2.1)％ vs.(7.2±3.2)％],HF[(219.4±131.6) Hz vs.(292.5±125.5) Hz;(217.2±133.2) Hz vs.(213.2±120.2 ) Hz] and LF[(459.6±135.2) Hz vs.(345.1±175.1) Hz ;(445.8± 144.3) Hz vs.(396.1 ± 182.3) Hz] were improved after treatment as compared with pretreatment in PCI group (t=9.4,15.69,8.37,4.68,3.26,3.57,P＜0.01 or 0.05) and in drug therapy group (t=7.3,12.36,6.98,2.94,4.89,5.01,P＜0.01 or 0.05),respectively.The changes of above indexes were more remarkable in PCI group than in drug therapy group(t=8.90,13.75,7.52,3.27,4.21,4.01,P＜0.01 or 0.05).The values of turbulence onset(TO) [(0.45±0.44)％ vs.(0.16±0.20)％,t=15.63,P＜0.01; (0.49±0.38)％ vs.(0.32±0.26)％,t=16.78,P=0.001] and turbulence slope (TS) [(2.12±0.13)ms/RR vs.(2.98±0.25)ms/RR,t=14.36,P=0.001; (2.15±0.19)ms/RR vs.(2.51±0.11)ms/RR,t=19.52,P=0.001] and CRP [(5.74±2.46)mg/L vs.(2.61±1.22)mg/L,t=12.49,P=0.001; (5.81±2.35)mg/Lvs.(3.56±1.43)mg/L,t=9.76,P=0.01] were also improved after treatment as compared with before treatment in PCI and drug therapy groups,respectively,and the the changes in TO (t=15.95,P＜0.001),TS (t=18.13,P=0.001) and CRP(t=10.73,P=0.001) were more obvious in PCI group than in medicine group. Conclusions PCI may obviously reduce inflammatory response,provide more myocardial blood supply and improve autonomic nervous function in the patients with unstable angina pectoris combined by QRS complex fragment.

Objective To evaluate the application of health education in patients with cholecystectomy. Methods From October 2009 to July 2010, 93 patients in our hospital with cholecystectomy were randomly divided into the control group (45 cases) and the observation group(48 cases). The control group was given routine nursing care, the observation group received perioperative health education in addition to the routine nursing care, then compared the nursing effect of two groups. Results In the observation group, the patients' knowledge and awareness rate of their own disease was 95.8%, and the control group was 80.0%, the difference was statistically significant between two groups. The recovery of gastrointestinal function in the observation group was significantly better than the control group, the difference was statistically significant between two groups. Conclusions Health education can enable patients with cholecystectomy correct understanding of their disease, eliminate negative emotions, and help the recovery of gastrointestinal function in patients, which is worthy of attention.

Objective To investigate the efficacy and safety of intrathecal chemotherapy combined with concurrent radiotherapy in patients with leptomeningeal metastases from solid tumors.Methods The clinical and follow-up data of 29 patients with leptomeningeal metastases from malignant solid tumor who had intrathecal chemotherapy combined with concurrent radiotherapy were retrospectively analyzed.The treatment regimen was that 12.5-15.0 mg of methotrexate intrathecal injection once a week for 8 successive weeks combined with whole brain irradiation to a total dose of 40 Gy,20 fractions or with lumbosacral spinal canal irradiation to a total dose of 50 Gy,20-25 fractions.Results Nineteen patients completed the concurrent therapy and 19 patients were dead.There were 9 patients with complete remission of symptoms,11 with obvious improved symptoms,6 with alleviated symptoms,and 3 with no relief.All of the 29 patients,were followed up for 0.4-15.0 months.The median survival was 5 months.The 6-month survival rate was 48％ (11/23),excluding 4 patients with follow-up time less than 6 months and 2 patients noncancer deaths.The main toxicities were myelosuppression,methotrexate-related mucositis,chemical nerve root injuries,chemical meningitis,chronic neurotoxicity,seizures,and radiation-related mucositis.The incidence of severe toxicity was 17％ (5/29).Conclusions Combination of intrathecal methotrexate with concurrent radiotherapy can effectively alleviate the symptoms and improve the life quality of patients.The therapy with low incidence of severe toxicity and good tolerance has the trendency to prolong the median survival.

Objective To investigate the relationship between the mechanism of gynecomastia and serum hormone levels ,as well as liver function in male patients with liver cirrhosis .Methods Forty‐six male patients with liver cirrhosis and gynecomastia were collected as gynecomastia group from March 2013 to March 2014 ,and at the same period seventy male patients with liver cirrhosis but without gynecomastia were studied as non‐gynecomastia group . The condition of mammogenesis and maximum of breast thickness were measured by bilateral breast ultrasound .Hormones including luteinizing hormone (LH) ,follicle‐stimulating hormone (FSH) , prolactin (PRL) ,estradiol (E2) ,progesterone (PRGE) ,and testosterone (T);liver function including alanine aminotransferase (ALT) ,aspartate aminotransferase (AST) ,total bilirubin (TBil) and serum albumin (Alb);blood coagulation function including prothrombin time (PT) ,platelet count (PLT) were examined and the Child‐Pugh scores were calculated .t‐test was performed for results comparison between gynecomastia group and non‐gynecomastia groups .Chi‐square test was used to compare the difference in drinking rate between two groups . The patients of gynecomastia group and non‐gynecomastia group were further divided into Child‐Pugh Grade A ,B and C subgroups according to Child‐Pugh scores and the patients of gynecomastia group were divided into subgroups according etiology such as posthepatitic cirrhosis ,alcoholic liver cirrhosis and posthepatitic cirrhosis combined with alcoholc cirrhosis .Single factor analysis of variance was applied to compare the laboratory findings between subgroups ,and least‐significant difference mothod was used to further compared the differences between two subgroups .Results Among forty‐six male patients with liver cirrhosis and gynecomastia ,the mean thickness of breast was (7 .56 ± 2 .84) mm .All the differences of TBil ,Alb ,PT and Child‐Pugh score of Child‐Pugh grade patient were statistically significant between gynecomastia group and no gynecomastia group ((96 .72 ± 75 .86)μmol /L vs (60 .57 ± 54 .00)μmol /L ,(29 .12 ± 4 .90) g/L vs (33 .86 ± 6 .86) g/L ,(19 .06 ± 4 .76) s vs (15 .54 ± 2 .57) s ,11 .54 ± 0 .91 vs 10 .33 ± 0 .57 ,respectively ,t=2 .79 ,-4 .33 ,4 .58 ,2 .22 ,all P<0 .05) . The alcoholic drinking rate of gynecomastia group (74% (34/46) vs 53% (37/70)) increased ,and the difference was statistically significant compared with that of non‐gynecomastia group (χ2 =5 .183 , P<0 .05) .There was no statistically significant difference in E2 levels between gynecomastia group and non‐gynecomastia group (P>0 .05) .PRL and E2/T ratio ((404 .49 ± 297 .26) mU/L and 68 .74 ± 46 .37) were higher than those of non‐gynecomastia group ((279 .77 ± 111 .57) mU/L and 13 .60 ± 11 .55) ,and T was lower than that of non‐gynecomastia group ((7 .15 ± 5 .74) nmol/L vs (15 .46 ± 8 .53) nmol/L) ,and the differences were statistically significant (t=2 .72 ,7 .90、-6 .27;all P<0 .05) .Among patients with gynecomastia ,breast of patients with alcoholic liver cirrhosis was significantly thicker than that of patients with posthepatitic liver cirrhosis ((9 .25 ± 3 .59) mm vs (6 .67 ± 2 .48) mm) ,while the level of PRGE was lower than that of patients with posthepatitic liver cirrhosis ((0 .61 ± 0 .51 ) nmol/L vs (1 .49 ± 1 .47 ) nmol/L ) , and the differences were statistically significant (F= 3 .634 and 2 .674 ,both P< 0 .05) .Along with the severity of liver injury ,E2 level of gynecomastia group gradually increased ,however there was non‐statistically significant difference compared with non‐gynecomastia group (P>0 .05) .T level of gynecomastia group gradually decreased ,and those of Child‐Pugh B ,C subgroup ((8 .20 ± 7 .58) nmol/L and (4 .18 ± 3 .76) nmol/L) were siginificantly lower than that of Child‐Pugh A subgroup of non‐gynecomastia group ((17 .64 ± 9 .04) nmol/L ,F=9 .37 ,P<0 .05) .The E2/T levels of gynecomastic group gradually increased .There was significant difference in E2/T level between Child‐Pugh C subgroup of gynecomastia group (105 .49 ± 94 .42) and Child‐Pugh A grade subgroup of non‐gynecomastia group (11 .38 ± 9 .60 ,F=12 .57 ,P<0 .05) .Conclusions There are different degrees of sex hormone disorder in the serum of male patients with liver cirrhosis and gynecomastia which is more significant in PRL ,T and E2/T .T and E2/T level are correlated with the degree of liver functional impairment .Gynecomastia in alcoholic liver cirrhosis is more severe than that of posthepatitic liver cirrhosis .

Objective To look for and confirm the downstream regulated gene of microRNA (miRNA)-148a in pancreatic cancer cell line.Methods The target gene regulated by miRNA-148a was predicted through bio-informatics analysis.The plasmid containing desired gene and with luciferase 3'-untranslated region (3'-UTR) reporter was constructed.Pancreatic cancer cells BXPC-3 were transfected with analogs and inhibitors of miRNA-148a by liposomes.The activity of luciferase was measured to determine whether miRNA-148a directly connected with desired gene.The expression level of miRNA-148a was changed in BXPC-3 cells,and the changes of target gene v-verb-b2 erythroblastic leukemia viral oncogene homolog 3 (awian) (ErbB3) expression were detected by Western blot at protein level.The data were analyzed by one way ANOVA.Results There was a conservative binding site of ErbB3 with miRNA-148a detected by bio-informatics analysis,miRNA-148a directly combined with ErbB3 and the activity of luciferase decreased to (25.00+47.00) ％ of the negative control (F=4.66,P＜ 0.01).After miRNA-148a overexpression,the gray value of ErbB3 expression in BXPC-3 cells decreased to (26.16±4.69)％ of control group (F=6.563,P＜0.05).Conclusion miRNA-148a directly targeted and regulated the expression of ErbB3 in pancreatic cancer cell line BXPC-3.

Objective Clinical effects of dot from body skin irradiated xenogeneic skin improved composite graft.Methods Selected 80 patients with severe burn patients randomized after admission on the basis of conventional treatment,3-5 days line Crust treatment group transplanted autologous point-like skin irradiation pigskin coverage.Results Treatment of patients in group one week dressing see irradiated pigskin Tiefu full two weeks the pigskin was dry scab-like.Wound healing treatment group (29 ± 5) days (P ＜ 0.01) was significantly shorter than the control group(39 ±4) days.Wound healing rate of treatment is significantly higher than the control group (P ＜0.01).Wound infection rate reduced greatly reduce labor intensity and dressing,and reduce pain.1 year after scar formation in patients with good flexibility and functionality.Conclusions Punctate since improved composite body skin irradiated xenogeneic skin transplantation can improve skin graft survival rate,promote wound healing,treatment of a large area of the burn wound repair is feasible and effective.