Patent ductus arteriosus (PDA)is a common disease among premature neonates and the management of which has always been a challenge to the neonatologists. Early treatment has been advocated as the first-line approach, and drug induced closure is yet the most effective, inexpensive, and convenient method. During the last two decades,indomethacin was often given as conservative treatment, and its closure rate in PDA was approximately 46% ～ 89%. However,indomethacin may increase the number of undesirable or harmful effects including renal damage, intraventricular hemorrhage, necrotizing enterocolitis, and enterobrosis,etc. Recently,ibuprofen is rapidly emerging as a new promising drug for treatment of PDA in preterm infants with closure rate of 73.0% ～95.5%. It is used as standard therapy to close PDA,and it has less influence on the hemodynamics of kidneys, brain and gastrointestinal tract. The surgery is needed in patients with drug treatment failure and cardio-pulmonary function damage.

Objective To observe the serum estradiol level in newborns at different gestational age and the infants with retinopathy of prematurity (ROP), and explore the relationship between these changes and ROP. Methods A total of 178 newborns hospitalized in the Children's Hospital of Fudan University were enrolled in the study. They were divided into three groups based on the gestational age, ＜ 32 weeks group, 32-37 weeks group and term group. The three groups were further divided into non-oxygen and oxygen subgroups. Infants with birth weight less than 2000 g were evaluated for ROP and those diagnosed as ROP were under ROP group (n=6). Serum estradiol levels were measured every week from birth to discharge with radioimmunoassay. Results Serum estradiol levels of newborns quickly declined after birth. In the non-oxygen subgroups, serum estradiol levels in 32 ～ 37 weeks group were remarkably higher than those of term group in the first week [(3506±1376) pmol/L vs (1717±179) pmol/L,P＜0. 05] and the third week [(1431±92) pmol/L vs (996±102) pmol/L, P＜0. 05]; Serum estradiol levels in ＜32 weeks group was only remarkably higher than those of term group in the first week [(3173± 1369) pmol/L vs (1717± 179) pmol/L,P＜0. 05]; Serum estradiol level in the ＜32 week group was (560±355) pmol/L, lower than that in the 32-37 weeks group [( 1124 ± 128) pmol/L] (P＜0. 05). There was no difference of serum estradiol levels in the oxygen and non-oxygen subgroups of the same group. There was no significant difference of serum estradiol levels between the ROP group and ＜32 weeks group. Serum estradiol levels in ROP group was lower than that of premature group without ROP at 29 and 32-36 weeks of corrected gestational age, but no statistical difference was shown. Conclusions Very low serum estradiol level in premature infants may be related to the development of ROP, but further clinical studies are required.

Objective To investigate the changes of serum soluble Fas (sFas) and soluble Fas-ligand (sFasL), and the relationship betweenthe level of serum sFas or sFasL and the infarct volume in patients with acute cerebral infarction (ACI). Methods Sixty patients with ACI (female 28, male 32) served as study group and 30 healthy subjects (female 18, male 12) served as control group. An enzyme-linked immunosorbent assay was used to detect the levels of serum sFas and sFasL in both groups, and the differences of the sFas and sFasL concentration were compared between the two groups. Results The levels of serum sFas at 48 hours, at day 7 and 14 in the ACl group were 6. 27 ± 1.48 ng/L, 4. 99 ± 1.15 ng/L, and 3.74 ± 0.58 ng/L,respectively, and they were all significantly higher than 3.00 ± 0. 38 ng/L in the control group (P <0. 05). The levels of serum sFasL at 48 hours, at day 7 and 14 in the ACI group were 4.40 ± 1.32 ng/L, 3. 19 ± 0.94 ng/L, and 1.91±0.45 ng/L, respectively. They were significantly higher than 1.15 ±0.21 ng/L in the control group (P<0.01). The levels of sFas (1.91 ± 0.45) ng/L, respectively, and they were all significantly higher than (4.98 ±0.91) ng/L(t = 12.12 ,P <0. 01)and (3.58 ±0. 87) ng/L(t =5.35 ,P <0.01) in the small infarction group. The levels of serum sFas and sFasL in patients with ACI showed positive correlation (r =0. 748, P =0. 01). Conclusions High serum sFas and sFasL may indicate larger infarct volume in patients with ACI.

Objective Use McGurk effect paradigm materials to explore the role of lip-Reading for hearing-impaired children in phonetic identification.Methods Thirty-six severe prelingually hearing-impaired children and thirty-six normal healthy children(binaural PTA≤20 dB HL)were recruited in the study.The test material was composed of audio and video,including/ba/,/da/,/bi/,/di/,/bu/,/du/six stimulation sounds which were video recorded as pronounced.Under 3 different conditions,the two groups were evaluated for the accuracy of audi-tory responses.Results The accuracy of auditory responses of hearing-impaired children group was 0.71 ±0.19, 0.96±0.07,0.11 ±0.16 for auditory-only mode,audio -visual consistent mode and audio -visual inconsistent mode,respectively,0.93±0.10,0.96±0.11,0.54±0.23 for normal hearing children in auditory-only mode,audi-o-visual consistent mode and audio-visual inconsistent mode,respectively.Conclusion The Audio-visual con-sistent mode is the best one and the lip-reading can help hearing-impaired children in phonetic identification.

Objective To explore the role of CGRP and progesterone along with it on the etiopathology of PIH. Methods 8 specimens of umbilical vein endothelial cells from women with PIH were cultured. Four groups were divided when cultured cells were confluent: the sera of normal pregnancy women (group 1), the sera of women with PIH (group2), the mixture of the sera of women with PIH and the injection of progesterone (group3), and the same amount of media (group 4). The cultured cell were added respectively into the four different kinds of media. After 24h of incubation, the concentration of endothelin (ET) and CGRP in media were measured by radioimmunoassay. Results 1. Comparing with group1, the concentration of CGRP in group 2 decreased and ET increased significantly. Statistic difference of ET/CGRP was found between the two groups. 2. Comparing with group 1, the concentration of CGRP in group 3 was unchanged and ET increased obviously. No difference of ET/CGRP was shown between them. 3. Comparing with group 3, in group 2, the concentration of CGRP decreased obviously and that of ET unchanged. Significant difference of ET/CGRP was found. Conclusions Progesterone, along with CGRP, might delay the onset and progressing of PIH.

Objective To estabolish an optimal animal model of oxygen-induced retinopathy(OIR) suitable for examining pathogenesis and therapeutic intervention for retinopathy of prematurity(ROP). Methods Fifty-four 7-day-old C57BL/6J mice were devided into two groups. Twenty-seven mice in hyperoxic group were exposed to 75% oxygen for 5 days and then to room air for another 5 days. Twenty-seven mice in normoxic control were exposed to room air for 10 days. The proliferative neovascular response was estimated by observing the vascular pattern in adenosine diphosphate-ase(ADPase) stained retina flat-mounts and quantitated by counting the number of new vascular cell nuclei extending into the internal limiting membrane in cross-sections. Results Angiography in ADP ase stained retina flat-mounts delineated the entire vascular pattern. Hyperoxia-induced neovascularization occurred at the junction between the vascularized and avascular retina in the mid-periphery in all mice exposed to hyperoxia. After 5 days of exposure to hyperoxia at postnatal day 12(P12),the larger central radial vessels became tortuous and constricted and central perfusion became decreased obviously. After return to room air for 2 days at P14,neovascularization was seen. This response was maximal at P17. There was a mean of 44 neovascular nuclei per cross-section extending into the vitreous in hyperoxia compared to less than 2 nuclei in the normoxia control ( P

Objective To study the prognosis of polymyositis(PM) and dermatomyositis(DM) patients and its influence factors.Methods Sixty DM and 30 PM patients diagnosed according to the diagnostic criteria of Bohan and Peter in our hospital during 2000-2008 were used as study subjects.The patients were followed up till their death or to August 2009.Gender,age of disease onset,disease course,serum creatine kinase,interstitial lung disease,heart involvement,connective tissue disease(CTD),malignancies,and treatment with corticosteroids,immunoglobulin and immunosuppressive agents were assessed as predictive factors for the prognosis of patients.Characteristics of muscular biopsy from 20 cases were analyzed.Results The median age of the 90 patients(29 males and 61 females) was 51 years(range 6-74 years).The male and female ratio was 1∶2.The most commonly involved muscles were the proximal muscles of limbs(83.3%),followed by neck muscles(25.6%),laryngea pharyngeal muscles(12.2%) and masticatory muscles(2.2%).Among the 42 patients(46.7%)with lung disease,interstitial lung disease and hear involvement were found in 29(32.2%)and 13(14.4%)patients,respectively.Of the 13 patients complicated by connective tissue disease,DM and PM accompanying connective tissue disease were diagnosed in 9 and 4,respectively,and DM and PM accompanying malignancies were observed in 2 patients.Muscular or skin biopsy was performed for 23 patients,which showed typical inflammatory infiltration in 13,dermatomyositis in 3,and no significant lesion in 2 patients,respectively.Of the 18 patients who died during the follow-up,5(16.67%) and 13(21.67%) died of PM and DM,respectively.Seventy-two patients survived.Their 1-,5-,and 9-year survival rate was 90%,84.4%,and 80%,respectively.The complete and partial remission rate was 22.2% and 36.7%,respectively,with a relapse rate of 20%.Advanced age of disease onset(P=0.003 8),interstitial lung disease(P=0.011 3) and malignancies(P=0.004 9) were main causes of death.Malignancy(RR=6.34,P=0.001 2)was the factor for poor prognosis and long-term treatment with hormones and immunosuppressive agents is the protective factor for PM and DM.Conclusion Complete and partial remission can be achieved in 58.9% patients with DM and PM.Advanced age of disease onset,interstitial lung disease and malignancy are the factors for poor prognosis of such patients.Long-term treatment with corticosteroids and immunosuppressive agents are the protective factors.

AIM:Capillary electrophoresis fingerprints(CEFP) and quantitative analysis methods of Radix Scutellariae were established. METHODS:All experiments were carried out in an uncoated fused silica capillary(75 cm?75 ?m i.d.,effective length 63 cm) with a 50 mmol/L sodium borate solution(contained 5% acetonitrile,pH 9.30) under 12 kV while the detection wavelength was set at 280 nm and naproxen was selected as the internal standard. RESULTS:8 co-possessing peaks were selected in the CEFP taking naproxen referential peak.The similarities between each of the ten places and the referential CEFP of Radix Scutellariae were evaluated both the qualitative similarity S_F and the quantitative similariy Q,the apparent quantitative similarity R. CONCLUSION:The method of the CEFP and quantitative analysis are rapid,simple and accurate with a good repeatability and can be used for the quality control of Radix Scutellariae.

An 70-year-old male come for swallowing pain 5 years, turning worse 10 months. Laryngoscopy showed a tumor with rough surface at the laryngeal surface of epiglottic. Outpatient pathology: poorly differentiated carcinoma of the larynx. CT: the root of epiglottic is slightly thickened. He accepted the partial laryngectomy, tracheotomy, bilateral functional neck dissection. Pathology: atypical carcinoid of larynx.
Aged ; Carcinoid Tumor ; pathology ; Epiglottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; Laryngectomy ; Laryngoscopy ; Larynx ; pathology ; Male ; Neck Dissection ; Tracheotomy

OBJECTIVE To prevent and control the incidence of nosocomial infection,and improve the inner quality of nosocomial infection management.METHODS A total of 49 363 cases of inpatients in the recent four years were retrospectively analyzed.RESULTS Of them 2 409 cases were infected,the incidence was 4.88%.The lower(respiratory) tract ranked the first place (34.16%) and the highest infected rate was in medicine(department)((8.29%).) Totally 505 isolates of bacteria were found,of which Gram-negative ones accounted for 45.15%,(Gram-)positives 25.15%,fungi were for 29.70%.CONCLUSIONS The incidence of nosocomial infection is(connected) with following factors such as age,inpatient factor,invasive diagnosis and treatment manipulation,the misusage of(antibiotics),and the environment quality.