This paper summarized nursing points for caring 23 cases undergoing pediatric heart transplantation,including:characteristics of accessing and protection of hearts,collaboration in pediatric heart transplantation,nursing of capacity management,temperature controlling,extracorporeal membrane oxygenation and delayed sternal closure during surgeries.The average length of hospitalization for 23 cases was 24.5±8.3 days,1 case died from primary graft failure after 19 months,the rest of 22 cases survived,and cardiac function recovered to NYHA class Ⅰ-Ⅱ.

0.05);the frequencies of IFN-? gene +874 site T and A allele showed significant difference between case group and control group(P0.05).Conclusion T allele of IFN? gene+874 site might have a relationship with generation of ovarian cancer,TT genotype might be susceptibility genotype for ovarian cancer.

Background Measurement of corneal thickness is of great significance for the design of refractive surgery and the diagnosis of eye diseases,measuring equipments and technology develop rapidly in recent years.Optovue iVue OCT is a new frequency-domain optical coherence tomography (OCT),to compare its results with those of Pentacam and Visante OCT is helpful to objectively assess the clinical value of Optovue iVue OCT.Objective This study was to investigate the repeatability of corneal thickness measurement with Optovue iVue OCT and the comparatbility with Pentacam three-dimensional anterior segment analysis diagnostic system and Visante OCT.In addition,this study attempted to analyze the distribution of average corneal thickness in each quadrant by Optovue iVue OCT.Methods The corneal thicknesses of the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones 1 mm away from the center of the cornea were measured in 45 right eyes of 45 subjects with myopia using Optovue iVue OCT,Pentacam and Visante OCT in Tianjin Eye Hospital.Interclass correlation coefficient (ICC) was used to analyze the repeatability of measurement by Optovue iVue OCT.The agreements between Optovue iVue OCT and Pentacam or Visante OCT were evaluated by Bland-Altman test.The corneal area of 1.0-2.5 mm away from the center was divided into eight quadrants and the average corneal thickness of each quadrant was measured and analysis with Optovue iVue OCT.Results No significant difference was found in corneal thickness values for 3 times by Optovue iVue OCT (P=0.546).The ICC by Optovue iVue OCT was 99.92％,99.99％,99.96％,99.99％,99.99％ and 99.97％ at the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones respectively.There were significant differences among the 3 kinds of methods (P =0.000,0.001,0.000,0.003,0.002,0.000).The measured values of Optovue iVue OCT were significantly lower mean 24.20 μm than those of Pentacam (P=0.000,0.001,0.000,0.003,0.004,0.000),but only the value at 12:00 zone of Optovue iVue OCT was evidently declined in comparison with that of Visante OCT (P =0.016),there were no significant differences between all the other zones (P =1.000,0.447,0.239,1.000,1.000).While the mean corneal thickness value from Pentacam lowed by 14.01 μm in comparison with Visante OCT,all zones had significant differences (P =0.009,0.005,0.034,0.017,0.008) except the central point (P =0.056).Based on the Optovue iVue OCT,the thinnest zone was at temporal quadrant in 23 eyes (accounting for 51.11％) and at superior quadrant or super nasal quadrant in 21 eyes (both at 46.66％).Conclusions Optovue iVue OCT measurement of corneal thickness is of high repeatability and is consistent with Visante OCT in myopic eye.Optovue iVue OCT shows evident difference from Pentacam in the measurement of corneal thickness.The thinnest point of the cornea is mainly in the inferior temporal quadrant and the thickest point is commonly in superior quadrant and nasal superior quadrant based on Optovue iVue OCT.

Objective To explore the diagnostic value of three-dimensional ultrasound parameters-vascularity index (VI) and the volume of kidney in chronic kidney disease (CKD). Methods A total of 80 CKD patients at different stages and 30 healthy adults were enrolled in the study. VI and the renal volume were calculated with three-dimensional ultrasound, while resistance index (RI), cortical thickness (CT) and the volume of kidney were calculated with two-dimensional ultrasound, and the correlation of those parameters were analyzed statistically. Results VI of CKD2 patients reduced significantly compared with the control group, and RI of CKD3 patients increased significantly, CT of CKD3 patients reduced significantly. The diagnostic sensitivity, specificity and diagnostic value of VI in patients with early and late CKD were all higher than thpse of RI. Compared with the control group, three-dimensional ultrasound of renal volume and two-dimensional ultrasound volume of CKD 1 patients increased significantly, three-dimensional ultrasound volume of CKD2 patients reduced significantly, and two-dimensional ultrasound volume of CKD4 patients reduced significantly. There was significant negative correlation among VI, three-dimensional ultrasound volume, CT, two-dimensional ultrasound volume and pathological change scoring (r=-0.67, -0.52, -0.43, -0.52). Conclusion VI and three-dimensional ultrasound volume can detect renal function damage more earlier and sensitively than RI and two-dimensional ultrasound volume.

Objective To observe the effect ofprostaglandin E1 intravenously in the improvement of the function of renal glomeruli and renal tubules in hypertensive patients complicated with microalbuminuria.Methods Totally 60 hypertensive patients complicated with microalbuminuria and nocturia who had received losartan for above 12 weeks,according to random number table method were divided into treatment group and control group,with 30 cases in each group.Original antihypertensive drugs were used continuously in treatment group and control group,and patients in treatment group received prostaglandin E1 intravenously for 3 courses of treatment,with losartan and other antihypertensive drugs routinely.Using self-contrast before and after treatment and contrast with control group,the change of urinary level of microalbumin (mALB),osmotic pressure,β2-microglodulin (β 2-MG) and N-acetyl-β-D-glucosaminidase (NAG) were compared.Results The blood pressure after treatment in both groups were decreased,but there was no statistically significant difference compared with that before treatment (P ＞ 0.05).After treatment of 12 weeks,urinary levels of mALB,β 2-MG and NAG in treatment group were lower than those in control group [(88.6 ± 14.2)μg/min vs.(123.9 ± 14.8) μg/min,(0.84 ±0.41) mg/L vs.(1.61 ±0.49) mg/L,(30.2 ± 10.5) U/L vs.(75.7 ± 12.8) U/L],and osmotic pressure was higher than that in control group [(591 ± 71) mmol/L vs.(454 ± 67) mmol/L],the difference had statistical significance (P ＜ 0.01).Conclusion Prostaglandin E1can reduce the renal ischemic state in early stage of hypertensive renal damage and can improve renal function.

Objective: To study the role of estrogen receptor (ER) and progesterone receptor (PR) in the formation of cholesterol calculus and investigate the effects of Shengqing CapsuObjective: To observe the effects of Huzhang Gout Granule (HZGG), a compound traditional Chinese herbal medicine, on cyclooxygenase (COX) and 5-lipoxygenase (5-LOX) activities, the two important oxidases in the course of inflammation, so as to investigate the possible anti-inflammatory mechanism of HZGG. Methods: After stimulating the blood sample of healthy volunteer with calcium ionophore A23187, concentration of thromboxane B(2) (TXB(2)) in the healthy volunteer's blood was detected by enzyme-linked immunosorbent assay (ELISA) to observe the effects of HZGG at low- and high-dose on the activity of COX-1, with aspirin as control drug. The concentration of prostaglandin I(2) (PGI(2)) in the healthy volunteer's blood sample, in which aspirin was added to destroy activity of COX-1 beforehand and which was stimulated with lipopolysaccharide, was detected by ELISA method to observe the effects of HZGG on the activity of COX-2, with celecoxib as control drug. In the animal experiment, 40 rats were implanted with sponges soaking in 0.5% arachidonic acid solution in the back to induce inflammatory effusion. Content of leukotriene B4 (LTB4) in the polymorphonuclear leukocytes (PMNs) from the inflammatory effusions was detected with reversed-phase high-performance liquid chromatography (RP-HPLC) to observe the impacts of different doses of HZGG on the activity of 5-LOX, with dexamethasone as control drug. Results: The concentration of TXB(2) in the low-dose HZGG group was higher than those in the high-dose HZGG group and the aspirin group (P<0.05). The concentrations of PGI2 in the low- and high-dose HZGG groups were higher than that in the celecoxib group (P<0.05), but there was no significant difference between the low-dose HZGG group and the high-dose HZGG group (P>0.05). The content of LTB4 in the blank control group was higher than those in the low-dose HZGG group, the high-dose HZGG group or the dexamethasone group (P<0.05) Conclusion:HZGG can reduce the releasing of inflammatory mediators, such as TXB2, PGI2 and LTB4, by inhibiting the activities of COX and 5-LOX.

Objective To investigate the effect of dezocine on emergence agitation (EA) during recovery from sevoflurane-based anesthesia in children.Methods Ninety ASA Ⅰ or Ⅱ children,aged 3-6 yr,weighing 14-31 kg,were randomized into 3 groups (n =30 each):fentanyl group (group F),dezocine group (group D)and control group (group C).Anesthesia was induced with inhalation of 8 ％ sevoflurane and iv injection of atracurium 0.5 mg/kg and remifentanil 1 μg/kg and maintained with inhalation of 2％-3 ％ sevoflurane and infusion of remifentanil at 0.1-1.0 μg· kg-1 · min-1.In groups F,D and C,fentanyl 2 μg/kg,dezocine 0.05 mg/kg and the equal volume of normal saline were injected intravenously 10 min before the end of surgery,respectively,and inhalation of sevoflurane was stopped at the end of operation.The extubation time and length of stay in the postanesthesia care unit (PACU) were recorded.Agitation and the duration were recorded when the children were in PACU.The degree of EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Pain was evaluated using the Children' s Hospital of Eastern Ontario Pain Scale (CHEOPS) and sedation was measured with Ramsay score.The complications such as respiratory depression,postoperative nausea and vomiting were recorded within 24 h after operation.Results Compared with group C,the incidence of EA and PAED scores were significantly decreased and the duration of EA was shortened in groups F and D,CHEOPS scores were decreased at each time point after operation and Ramsay scores were increased at T1 in group F,and CHEOPS scores were decreased and Ramsay scores were increased at each time point after operation in group D (P ＜ 0.05).Compared with group F,the incidence of EA and PAED scores were significantly decreased,CHEOPS scores were decreased at each time point after operation,and Ramsay scores were increased at T2 (P ＜ 0.05),and no significant change was found in the duration of EA in group D (P ＞ 0.05).There was no significant difference in the extubation time and length of stay in the PACU between the three groups (P ＞ 0.05).Conclusion Dezocine 0.05 mg/kg can safely and effectively prevent EA during recovery from sevoflurane-based anesthesia in children and produces better efficacy than fentanyl.

Objective To investigate the clinical value of multidisciplinary team (MDT) assessment for chronic constipation.Methods The clinical characteristics of 346 patients with chronic constipation who were admitted to the Third Peolep's Hospital of Hangzhou from January 2010 to December 2013 were multidisciplinarily assessed.The muhidisciplinary team was involved surgeons from the department of colorectal surgery,urology,gynecology,psychiatry and psychology,and tools including questionnaires,defecography,anorectal manometry,colon transit study,urodynamic tests,gynecological examination were applied in the study.The measurement data with normal distribution were presented as (x) ± s,the comparison between groups was analyzed using the ANOVA,and the count data were analyzed using the chi-square test.Results Three hundred and forty-six patients who met criteria of this research were selected,including 86 males and 260 females with the ratio of 1 ∶ 3;the mean age was (55 ± 11)years.Of the 346 patients,slow transit constipation accounted for 7.52％ (26/346),defecatory disorder for 60.98％ (211/346),and mixed constipation for 31.50％ (109/346).A total of 93.85％ female patients (244/260) had anterior rectocele,75.43％ (261/346) patients had internal rectal mucosal prolapse,66.76％ (231/346) patients had perineum descending,23.99％ (83/346) had achalasia or inappropriate contraction of internal anal sphincter,18.79％ (65/346) had puborectalis rectocele muscle thickening,5.49％ (19/346) had rectal prolapse.A total of 82.37％ (285/346) patients were involved in other subjects than colorectal surgery.A total of 28.61％ (99/346) patients presented with urinary symptoms,including 65 cases with stress urinary incontinence,23 cases with unstable bladder and 19 cases with bladder neck obstruction (some patients had multiple urological systoms).The incidence of reproductive organ prolapse in female patients was 31.92％ (83/260),the incidence of uterine prolapse and anterior vaginal prolapse were 26.15％ (68/260) and 29.23％ (76/260),respectively.Patients with anxiety and/or depression accounted for 36.13％ (125/346).The male and female patients of slow transit constipation,defecatory constipation and mixed constipation were 10 vs 16,30 vs 79,46 vs 165,respectively,the age was 60 ± 12,56 ± 11,52 ± 10,showing no significant differences (x2=4.046,F =2.877,P ＞ 0.05).In the three kinds of constipation,patients with urinary diseases accounted for 26.92％ (7/26),26.61％ (29/109) and 29.86％ (63/211),patients with gynecological diseases accounted for 11.54％ (3/26),20.18％ (22/109),27.49％ (58/211),patients with psychological diseases accounted for 38.46％ (10/26),39.45％ (43/109),34.12％ (72/211),respectively,showing no significant difference (x2=4.090,P ＞ 0.05).Conclusion MDT assessment for patients with chronic constipation can reflect comprehensively clinical characteristics of chronic constipation,therefore multidisciplinary team should be emphasized in clinical diagnosis and treatment of chronic constipation.

Objective To investigate the clinical value of the Classification of acute pancreatitis2012.Methods Medical records and clinical data of patients with acute pancreatitis (AP) who were admitted to First Affiliated Hospital of Guangxi Medical University between October 2009 and September 2012 were retrospectively reviewed and analyzed.Patients were divided into mild acute pancreatitis (MAP),moderately severe acute pancreatitis (MSAP),and severe acute pancreatitis (SAP) groups according to the Classification of acute pancreatitis-2012.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,computed tomographic severity index (CTSI) scores among the 3 groups were compared.Results One hundred and sixty-six patients with AP (119 males and 47 females) were included,and 76 were MAP,65 MSAP and 25 SAP.The average interval between AP onset and hospital admission was (2.27 ± 1.46) d.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,CTSI scores increased with the severity of AP.The corresponding values in SAP group were 21 cases (84.0％),(23.8 ± 13.6) d,(53900 ± 30260) Yuan,48.0％ (12/25) and (5.76 ± 13.8) d,96.0％ (24/25) and (5.00 ± 2.40) d,(3.76 ± 1.30) score,(8.52 ± 4.24) score,(5.44 ± 3.48) score.Seventy-nine patients developed local complications,among them 34 was acute peripancreatic fluid collection,45 was acute necrosis collection.The incidence of acute necrosis collection in SAP group was significantly higher than that in MSAP group (68.0％ vs 44.6％,P =0.047),but the incidence of acute peripancreatic fluid collection in SAP group was significantly lower than that in MSAP group (16.0％ vs 46.2％,P =0.016).Organ failure occurred in 42 patients,among them 35 cases were respiratory failure,2 cases were renal failure,and 5 cases were respiratary and renal failure.The incidence of organ failure in SAP and MSAP group was 100％ and 26.2％,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Classification of acute pancreatitis-2012 is a simple and convenient system,which can predict the severity of AP and appropriate for clinical application.

Objective To investigate the distribution and expression of trefoil factor 3(TFF3) in the eosinophilic cells and basophilic cells in the pars distalis of the rat pituitary .Methods The immunohistochemiscal staining technique was used to show the coexpression of TFF3/growth hormone (GH),TFF3/prolactin (PRL),TFF3/thyrotroph (TSH), TFF3/adrenocorticotropin (ACTH),TFF3/follicle stimulating hormone (FSH),TFF3/luteinizing hormone (LH) in two contiguous slices .Results The immunoreactive products of TFF 3 and chromophil cells were brown granules , mainly expressed in cytoplasm .ACTH positive signals were expressed in the cell membrane and mainly located in the pars distalis hypophyseos.TFF3 existed in parts of GH,PRL,TSH,ACTH,FSH and LH cells in contiguous slices, accounting for 19.4%, 22.4%, 9.2%, 6.5%, 35.7%, 8.3%, respectively , in which FSH was the most , PRL and GH were less . Conclusion TFF3 expresses in GH, PRL, TSH, ACTH, FSH, and LH cells in the pars distalis , which enriches the morphological data for the location of TFF 3 in gland cells of pars distalis hypophyseos .