Objective To investigate the effects of high frequency oscillatory ventilation (HFOV)combined with inhaled nitric oxide(iNO) on neonates with severe meconium aspiration syndrome(MAS).Methods Sixty newborn infants with severe MAS admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Oct 2008 to May 2011 were included for this study.All of them needed mechanical ventilation after birth and oxygenation index (OI) ＞ 30.According to the different ventilation modes,they were randomly divided into conventional mechanical ventilation (CMV) group,HFOV group and HFOV combined with iNO (HFOV + iNO) group,each group had twenty neonates.OI and the rate of air leak and pulmonary hypertension in each group were compared.Results Ventilation after 24 h,OI of HFOV group and HFOV + iNO group were significantly decreased as compared with CMV group (19.0 ± 4.5 vs 11.0 ± 5.3 vs 25.0 ± 7.1,P ＜ 0.05).In HFOV + iNO group,the obvious decline of OI(from 36.0 ± 7.4 to 24.0 ± 5.2) were observed at four hours after treatment.The rate of air leak in HFOV and HFOV + iNO groups was both zero as compared with CMV (5/20,25％).The rate of pulmonary hypertension in HFOV + iNO group was zero and the HFOV group was 30％ (6/20),the CMV group was 40％ (8/20).Conclusion HFOV combined with iNO was preferred treatment for neonates with severe MAS,and they have synergistic effect.

Objective To explore the clinical effect of the improved operation of endoscopic thoracic sympathectomy(ETS)for treatment of palmar hyperhidrosis.Methods The improved operation of ETS was used to 105 patients with palmar hyperhidrosis.T3 sympathetic was blocked in 105 cases with palmar hyperhidrosis.Results Hand sweating disappeared and axillary sweating discreased significantly in all patients.No one had any serious complications such as bleeding and Horner Syndrome except for five patients with pneumothoraces.Compensatory sweating was found in 15 patients following up from 1~12 months after operation.Conclusion The improved operation of ETS is a simple,safe,effective and less complications procedures.

Objective To investigate the expression of Bcl-2 and Caspase-3 in placenta tissue of hypertensive disorder complicating pregnancy (HDCP).Methods One hundred and one placentas with preeclampsia (including 51 mild preeclampsia and 50 severe preeclampsia respectively served as low-grade group and high-grade group) and 62 placentas of normal late pregnant women(served as control group) were analyzed for the expressions of Cnspase-3 and Bcl-2 using immunohistochemistry assay(streptavidin-biotin peroyxidase method).Results The positive expression ratio of Bcl-2 was 66% in high-grade group,75% in low-grade group and 84% in control group.There was no significant difference among the three groups (P＞0.05 ).The positive expression rates of Caspase-3 in high-grade group (64%) and low-grade group (53%)were significantly higher than that in control group (23%)(P ＜ 0.01 ).There was no significant difference between high-grade group and low-grade group (P ＞ 0.05).Negative relationship between the expression of Bcl-2 and Caspase-3 could be found with statistical significance (r=-0.199,P ＜0.05).Conclusions Higher expression of Caspose-3 maybe play an important role in the pathogenesis of HDCP.The role of Bcl-2 in HDCP needs to be studied.

BACKGROUND:Medical stuff have significant impacts on the development of organ donation and transplantation, however, medical students present insufficient knowledge and ambivalent attitude towards organ donation and transplantation. OBJECTIVE:To perform a systemic review on the effectiveness of educational program intervention on medical students’ knowledge and attitudes toward organ donation and transplantation. METHODS:PubMed, WILEY ONLINE LIBRARY, ProQuest Health, Medline, EMbase, CNKI, Wanfang and VIP databases were ful y searched for the published literature of medical students receiving an educational program intervention on organ donation and transplantation. According to the inclusion criteria, randomized control ed trials and quasi-experimental study were evaluated with the standard of Joanna Briggs Institute. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework was used to guide the assessment of the methodological quality of the studies. The outcomes were mainly medical students’ knowledge and attitudes toward organ donation and transplantation.
RESULTS AND CONCLUSION:Eight studies from three countries were summarized. The methods were employed in two studies of randomized control ed trials and quasi-experiment received a high quality rating, five studies received middle quality rating and one study received low quality rating. Educational program increased the knowledge in six studies, and changed the attitudes in six studies. Educational program intervention is a significant strategy to increase medical student’s knowledge about organ donation and transplantation. The majority of involved study are
quasi-experiment study, so more high-quality randomized control ed studies are needed.

Objective To observe the changes of subfoveal choroidal thickness (SFCT) in diabetic patients with non-proliferative diabetic retinopathy (NPDR) and clinically significant macular edema(CSME),and then investigate diabetic SFCT and the relationship of diabetic CT with diabetic retinopathy (DR).Methods The patients were divided into 2 groups according to clinical guidelines of DR in China in 2014,including NPDR CSME + group(21 eyes) and NPDR CSME-group(36 eyes).All patients were underwent best corrected visual acuity (BCVA),intraocular pressure,axial length,slit lamp microscope,indirect ophthalmoscope,EDI-OCT examination,and mean arterial blood pressure measurement.The differences of BCVA,central retinal thickness (CRT) and SFCT between NPDR CSME + group and NPDR CSME-group were studied as well by means of using SPSS 18.0 for data statistics.Results There was no significant difference in gender,age,eye axis and intraocular pressure between NPDR CSME + group and NPDR CSME-group (all P ＞ 0.05).There was significant difference in BCVA between the two groups (P =0.001).The mean SFCT were (328.24 ± 101.92) μm in the NPDR CSME + group and (235.31 ± 66.98) μm in the NPDR CSME-group,and the difference was statistically significant (t =4.156,P=0.000).And plotting changes in CRT against changes in SFCT in patients with CSME revealed a positive correlation(r =0.473,P =0.000).Conclusion SFCT in NPDR CSME + patient is thicker than that in NPDR CSME-patient.And plotting changes in CRT against changes in SFCT in patients with CSME reveals a positive correlation.

Objective To investigate the risk factors of bronchopulmonary dysplasia(BPD)in very low birth weight infant.Methods The clinical data of 49 very low birth weight infants in our NICU from Sep 2006 to Sep 2009 were reviewed,and divided into BPD group(n =15)and without BPD group(n =34).The risk factors of BPD were analysed.Results Compared with the infants without BPD,there were significant differences in gestational age[(29.30 ± 1.48)week vs(30.54 ± 1.60)week],hospital-acquired infection(9 cases vs 10 cases),intrauterine infection(9 cases vs 8 cases),the time for continuous positive airway pressure(CPAP)[(12.47 ± 5.83)d vs(4.24 ± 4.19)d],the time for hyperoxia[(1.47 ± 1.41)d vs (0.18 ±0.63)d],patent ductus arteriosus(5 cases vs 1 cases)(P＜0.05).Logistic regression revealed that intrauterine infection and the time for CPAP were independent risk factors of BPD(P ＜0.05).Conclusion Prophylaxis of intrauterine infection may decrease the mortality and severity of BPD.The prolonged time for CPAP may predict the risk of BPD.

Objective:To evaluate the relationship between chemokine CXC-ligand 16 (CXCL16) and natural killer T cells during renal fibrosis in mice with acute kidney injury (AKI).Methods:Twenty-four healthy male C57BL/6 mice, aged 8-10 weeks, weighing 20-30 g, were divided into 4 groups ( n=6 each) using a random number table method: control group (group C), AKI group, control+ rCXCL16 group (group C-rCXCL16) and AKI+ rCXCL16 group.In AKI-rCXCL16 and AKI groups, folic acid 250 mg/kg was intraperitoneally injected to induce AKI in anesthetized mice, and rCXCL16 0.1 mg/kg and the equal volume of solution were intraperitoneally injected, respectively, at 3, 6, 9 and 12 days after injection of folic acid.The equal volume of solution and rCXCL16 were intraperitoneally injected at the corresponding time points in group C and group C-rCXCL16, respectively.The orbital blood samples were taken on day 14 after injection of folic acid for determination of the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The renal tissues were obtained for measurement of the renal fibrosis size (using Sirius red staining and Masson staining), for determination of the expression of fibronectin (FN), collagen-Ⅲ (Col-Ⅲ) and α-smooth muscle actin (α-SMA) (by immunofluorescence) and expression of interleukin-4 (IL-4), mannose receptor (CD206) and arginase 1 (Arg-1) mRNA (by real-time polymerase chain reaction), and for evaluation of the ratio of CD1d Tetramer + -IL-4 + cells (by flow cytometry). Results:Compared with group C, the serum BUN and Cr concentrations were significantly increased, the renal fibrosis size was increased, the expression of IL-4, CD206, Arg-1 mRNA, FN, Col-Ⅲ and α-SMA was up-regulated, and the ratio of CD1d Tetramer + -IL-4 + cells was increased in AKI and AKI-rCXCL16 groups ( P<0.05), and no significant change was found in the parameters mentioned above in group C-rCXCL16 ( P>0.05). Compared with group AKI, the serum BUN and Cr concentrations were significantly increased, the renal fibrosis size was increased, the expression of IL-4, CD206, Arg-1 mRNA, FN, Col-Ⅲ and α-SMA was up-regulated, and the ratio of CD1d Tetramer + -IL-4 + cells was increased in group AKI-rCXCL16 ( P<0.05). Conclusion:The mechanism by which CXCL16 is involved in the process of renal fibrosis is related to the recruitment of natural killer T cells secreting IL-4 which regulates macrophage M2 polarization in mice with AKI.

ObjectiveTo investigate the clinical efficacy of acupuncture in treating Tourette's syndrome.MethodEighty patients were allocated, using a random number table, to a treatment group of 40 cases and a control group of 40 cases. The treatment group received acupuncture and the control group, Western drug treatment.ResultThe YGTSS score decreased significantly in the two groups of patients after treatment(P<0.01). After treatment, the range of decrease in the YGTSS tic score was larger in the treatment group than in the control group; there was a statistically significant difference (P<0.05). The total efficacy rate was higher in the treatment group than in the control group (P<0.05). The incidences of adverse reactions were significantly lower in the treatment group than in the control group.ConclusionThe effect and safety of treatment for Tourette's syndrome are higher in the treatment group than in the control group.

This study was aimed to observe the effect of Bai-Zhu Fu-Ling (BZFL) Decoction in different proportion-ing on VIP and VIPR1 in Crohn's disease (CD) rats with spleen deficiency syndrome, in order to further explore the immunologic mechanism of BZFL Decoction on CD. The CD rat model with spleen deficiency syndrome was estab-lished using exhaustion and hunger. The model rats were treated by BZFL Decoction with different proportioning, and immunohistochemistry (IHC) was used to detect the expression of VIP and its receptor in colon tissues. The results showed that comparing to the blank control group, the level of VIP and its receptor of the model group significantly increased (P< 0.05). Comparing to the model group, the level of VIP and its receptor in BZFL Decoction B5 group (Rhizoma A tractylodis Macrocephalae:Poria = 12:15), B6 group (Rhizoma A tractylodis Macrocephalae:Poria = 15:12) and B7 group (Rhizoma A tractylodis Macrocephalae:Poria = 18:9) was significantly decreased (P< 0.05). It was con-cluded that the effect of BZFL Decoction of B5 group, B6 group and B7 group was better than other groups in VIP and its receptor which can regulate the VIP and its receptor, inhibit the releasing of inflammatory factors and reduce intestinal inflammation injury.

ABSTRACT:Objective To observe the structural changes of dentin irradiated with Nd:YAG laser under dif-ferent parameters and the changes of calcium-phosphorus ration,and evaluate the optimal parameters of Nd:YAG laser in treating dentin hypersensitivity (DH).Methods The model of dentin hypersensitivity was established by acid etching method.Samples were irradiated with Nd:YAG laser under different parameters.The morphological alterations of the dentin surfaces and Ca-P ratio were examined with scanning electron microscopy (SEM)combined with energy dispersive X-ray microanalysis.Results Compared with those in the control group,dentinal tubules could be blocked partially or totally with no cracks in A-C (30 mj,5 Hz),(30 mj,10 Hz)and (50 mj,5 Hz)groups. Dentinal tubules could be entirely blocked but with cracks in D (50 mj,10 Hz)and E (80 mj,5 Hz)groups.Dentin was carbonized in F (80 mj,10 Hz)group.Compared with that in the control group,Ca-P ratio was decreased sig-nificantly (P <0.05).Conclusion The suitable energy parameter of Nd:YAG laser in treating dentin hypersensi-tivity is (30 mj,10 Hz)and (50 mj,5 Hz).