Patent ductus venous is a kind of the congenital portosystemic shunts (CPSS). In recent years, the related case report increased gradually, but the domestic research is rare. In this article, we review the current diagnosis and treatment of neonatal patent ductus venous based on literature available.

High resolution melting ( HRM) analysis is a real-time PCR based technique which can detect DNA sequence polymorphism .Immediately after routine PCR with saturated fluorescent dye , melting transition of the amplicon was monitored and fluorescence was collected .According to the different melting curve, single base differences can be distinguished .HRM is a low -cost, single -step, closed -tube, accurate and rapid method , which has aroused general concern .Rapid and sensitive detection of the clinical pathogens is critical to diagnosis of infectious diseases .However , clinical research on application of HRM in infectious disease pathogen identification and drug resistance , especially melting curve analysis based bedside technology integration will provide strong support for the diagnosis and treatment of infectious diseases.

Objective To investigate the clinical application of alpha lipoic acid on early diabetic nephropathy(DN).Methods Seventy patients with early diabetic nephropathy were randomly divided into two groups.Patients in control group were treated with regular glycemic control methods,while patients in treatment group were received alpha lipoic acid 300 mg static drop treatment for two weeks beside regular treatment.High sensitivity C reaction protein,microalbuminuria and urine creatinine were measured before and after the treatment.Microalbuminuria and urine creatinine were re-measured three months later.Results At the end of two weeks treatment,the levels of high sensitivity C reaction protein in the treatment group decreased from (3.92 ± 4.56) mg/L to (2.24 ± 2.49) mg/L,and there was significant difference (t =2.803,P ＜ 0.05).Microalbuminuria decreased from (127.18 ± 76.91) mg/L to (84.50 ± 122.87) mg/L,and there was significant difference (t =2.501,P ＜ 0.05).The ratio of microalbuminuria and urine creatinine in treatment group decreased from(28.95 ± 30.49) mg/mmol to(13.76 ± 20.83) mg/mmol,and there was significant difference (t =3.616,P ＜ 0.05).While there was no significant difference in the control group before and after regular waglycemic control.At three months after treatment,there were no significant difference regarding of microalbuminuria,the ratio of microalbuminuria and urine creatinine between treatment and control groups (P ＞ 0.05).Conclusion Alpha lipoic acid might be with ability of decreasing the levels of microalbuminuria of diabetic nephropathy in the short term,but further study is needed to verify whether alpha lipoic acid can decrease the level of microalbuminuria in the long term.

Objective To study the safety,efficiency and feasibility of increase the aminotic fluid volume by transabdominal amnioinfusion(AI). Methods Thirty-three patients were selected according to the following criteria: oligohydramnios or borderline oligohydramnios found by B ultrasound ,indications of vaginal delivery and with cephalic presentation,and who is ready to receive AI. After located by puncture bougie,at most 380 ml saline solution at 37℃ were infused into the amniotic cavity. Results AI was accomplished in 32 of 33 cases (96.97%). Premature rupture of membrane occurred in one case (3 03%). No placental abruption and infection or other complications happened. Twety-five patients (75.76%)successed in vaginal delivery. Cesarean sections were performed in 8 cases (24 24%) because of encephalopelvic disproportion,cord prolapse and fetal distress. No neonatal asphyxia happened. Conclusion Amnioinfusion can effectively increase amniotic fluid volume,create favorable conditions of vaginal delivevy for oligohydramnios and decrease the incidence of cesarean section as well as improve perinatal outcome.

Objective To compare the efficacy of balloon dilation and YAG laser endouretertomy in treatment of secondary ureteric stricture . Methods 32 patients with secondary ureteral stricture were randomly divided into balloon dilatation group and holmium laser cut group, 16 cases in each, respectively. The two kinds of treatment efficacy was compared after two years postoperative follow-up. Results The clinical results of the two groups showed no statistical differences at the third, sixth and twelfth month follow-up (P > 0.05), and there were no statistical differences in the overall effective rates (P > 0.05). The clinical results of the two groups showed no statistical difference at the twenty-fourth month follow-up (P < 0.05), and the overall effective rates had statistical difference (P < 0.05). Conclusions Balloon dilation and YAG laser endouretertomy in treatment of secondary ureteral stricture have the same short-term clinical effects. But the middle-term efficacy of YAG laser endouretertomy is superior to that of balloon dilation.

Objective To evaluate the effect of emulsified isoflurane post-conditioning on the mitochondrial function during lung ischemia-reperfusion (I/R) in rats in an in vitro experiment.Methods Twenty-four SPF healthy male Sprague-Dawley rats,weighing 250-300 g,were used in the study.After the animals were anesthetized,the lungs were removed,connected to the perfusion system and then divided into 4 groups (n=6 each) using a random number table:control group (group C),group I/R,emulsified isoflurane post-conditioning group (group EI) and intralipid post-conditioning group (group IL).After 20 min of equilibration,the lungs were continuously perfused for 105 min in group C,and the lungs were subjected to 45 min ischemia followed by 60 min reperfusion to establish the model of lung I/R injury in the other three groups.During the reperfusion period,the common perfusate was used in group I/R,the perfusate containing 1.68 mmol/L emulsified isoflurane was used in group EI,and the equal volume of perfusate containing 30％ intralipid was used in group IL.At the end of the equilibration (T0),immediately after beginning of reperfusion (T1) and at 30 and 60 min of reperfusion (T2.3),the arterial oxygen partial pressure (PaO2),airway resistance,pulmonary compliance and tidal volume (VT) were recorded.The right upper lobe of the lung was removed at T3 for determination of wet to dry weight ratio (W/D ratio).The right middle lobe of the lung was removed at T3 for pathologic examination with light microscope.The contents of reactive oxygen species (ROS),NAD+ and ATP in lung tissues were detected.Results Compared with group C,the PaO2,pulmonary compliance and Vr were significantly decreased,and the airway resistance was increased at T1-3,and the W/D ratio and ROS content were increased,and NAD+ and ATP contents were decreased at T3 in I/R,EI and IL groups (P＜0.05).Compared with I/R and IL groups,the PaO2,pulmonary compliance and VT were significantly increased,and the airway resistance was decreased at T2.3,and the W/D ratio and ROS content were decreased,and NAD+ and ATP contents were increased at T3 in group EI (P＜0.05).The pathologic changes of lungs were significantly attenuated in group EI as compared with group I/R.Conclusion The mechanism by which emulsified isoflurane post-conditioning attenuates lung I/R injury is related to decrease in mitochondrial dysfunction in rats in an in vitro experiment.

This study reviewed the reasons for encounter (RFE),diagnoses and the diagnostic categories of patients aged 0-14 y in general practice clinic affiliated to a tertiary hospital from June 2011 to May 2012.The results showed that the most frequent RFE was cough,at a rate of 29.6 per 100 encounters;the second one was fever (21.4％) and the third was nasal problems (9.5％).Medical examinations,skin rashes and follow-up encounters occurred at equal rates (5.2％).The most frequent diagnosis was acute upper respiratory tract infection (41％).Medical examination (6.3％),other viral diseases (5.1％),pneumonia (3.6％) and no detected disease (3.6％) were also common diagnoses.The diagnostic categories included all systems,and the problems of the respiratory system (56.4％) were most common.The results suggest that pediatric care comprises a very important part of primary care.

Coding region instability determinant (CRD) is one of the influence factors of oncogene c-myc.Coding region instability determinant-binding protein (CRD-BP) can connect with CRD in order to protect CRD from nuclease attack,prevent rapid degradation of c-myc mRNA,and increase c-myc protein content.Beta-transducin repeats-containing protein (β-TrCP) can affect cell growth,differentiation,apoptosis and oncogenesis by regulating multiple signaling pathways and cell cycle.The overexpression of CRD-BP can upregulate the expression of β-TrCP and both of them play important roles in the tumorigenesis,progression,metastasis and invasion of colorectal cancer.

Objective To explore the association of lipid metabolism and bomocysteine with hypertensive disorders in pregnancy and observe the inflammatory reaction and the pathological change of placenta.Methods We conducted a prospective randomized placebo-controlled study.Seventy-four cases with hypertensive disorders in pregnancy were recruited as the experimental group and 77 cases of normal pregnant women were recruited as matched control group from Aug.2008 to Mar.2010.The relationship between lipid metabolism and homocysteine was analyzed.Results There was significant difference between the two groups in body-mass index before pregnancy(29.03±4.52 vs.23.99±5.90,t =5.88),cholesterol[(6.16±1.48)mmol/L vs.(5.01±1.05) mmmol/L,t =5.52],low density lipoprotein[(3.46±1.35) mmol/L vs.(2.26±0.86) mmol/L,t =6.54]and C-reactive protein[(29.04±14.90) mmol/L vs.(15.48±4.57) mmol/L,t =7.62](P ＜ 0.05).No significant difference was found on triglycerides[(3.29±1.03) mmol/L vs.(3.49±1.37) mmol/L],high density lipoprotein[(1.84±0.40) mmol/L vs.(1.88±0.35) mmol/L],homocysteine [(8.77±2.65) mmol/L vs.(8.40±2.03) mmol/L]and neonatal weight[(3547±519)g vs.(3431±461)g](P ＞ 0.05).Significant difference exists in placenta pathology of infarction(54.55％ vs.31.04％),villi dysplasia,fit nodules form and hypoxia(65.46％ vs.39.66％)(P ＜0.05).Conclusion We should detect lipid,homocysteine and C-reactive protein by dynamic combinational ways,pay more attention to women with high BMI before pregnancy,and value placenta pathology research on hypertensive disorders in pregnant women.This has high clinical significance in revealing the etiology of hypertensive disorders in pregnant women and improving pregnant outcomes.

Objective To discuss the appropriate timing of providing enteral nutrition through nasojejunal tube for patients with severe craniocerebral injury.Methods 126 cases of patients were divided into 3 groups randomly,providing enteral nutrition through naso-jejunal tube for the first group,the second group and the third group within 12～24 hours,48 hours later and 72 hours later after injury respectively.The nutrition situation of 3 groups was recorded 6 hours later,48 hours later,on the 5th day and the 10th day,including indicators such as total serum protein,blood albumin,serum creatinine,etc and complication cases of diarrhea,hemorrhage of digestive tract,palirrhea,aspiration,inhalation pneumonia and so on within 2 weeks after injury.Results In terms of indicators of albumin,creatinine 48 hours after injury and total protein,albumin and creatinine on the 5th day and 10th day,the first group were better than the second and third group,there were statistic differences between the three groups.Complication comparison within 2 weeks after injury:the difference of palirrhea cases among the three groups was significant,the third group had a higher ratio than the first and second group.And there was no statistic difference in the other indicators like diarrhea,hemorrhage of digestive tract,aspiration and inhalation pneumonia.Conclusions It is high time that patients with simple severe craniocerebral injury are provided with enteral nutrition through naso-jejunal tube within 12 to 24 hours,which can improve patients nutrition situation without the increase of the complications.