Objective To assess the risk of emergent endotracheal intubations in pediatric intensive care unite (PICU ) and to de-termine the risk factors of complications .Methods A prospective study was conducted with unified tables to collected data of all e-mergent intubations occurring in PICU between November 2011 and May 2012 .All the children were divided into group of any com-plication and group of no complication .Results (1)69 .1% children of emergent intubations had complications including desatura-tion(67 .9% ) ,bradycardia(29 .8% ) ,vomiting (16 .7% ) .(2)Emergent endotracheal intubations were 1 .7 times more likely to occur off-hours .Off-hours intubations were associated with 2 .7 times the risk of complications as on-hours intubations .(3)In a multivari-ate logistic regression analysis ,the nasal tracheal intubation ,two or more attempts at intubation ,and off-hours intubation were asso-ciated with complications .Conclusion Emergent endotracheal intubation are 1 .7 times more likely to occur off-hours .off-hours in-tubations ,the nasal tracheal intubation ,two or more attempts at intubation ,are associated with complications .

Objective To explore the decision-making processing changes of patients with cerebral infarction in different regions.Methods The patients with cerebral infarction were divided into 21 cases of frontal lobe infarction,11 cases of temporal lobe infarction,19 cases of the medial temporal lobe infarction,25 cases of basal ganglia infarction;25 cases of the anterior infarction,51 cases of the posterior infarction,62 cases of depression,64 cases of anxiety ;and there were 125 cases in normal control group.All subjects completed the test of the six kinds of choice situational problems,and used MMSE to evaluate cognitive function,the Hamilton Depression and anxiety Scale Evaluation to evaluate emotion.Results All cerebral infarction patients (CI group) and normal control group in low-risk and no-risk of loss situation(choice scenario 2),high-risk and the no-risk of gain or loss situation(choice scenario 3 and 4),high-risk and low-risk of gain or loss situation(choice scenario 5 and 6) tended to choose conservative scheme,and the selection probability of conservative scheme were obviously higher than that of the normal group,and the differences were statistically significant (P ＜ 0.05).In choice scenario 3,the basal ganglia infarction group with frontal lobe infarction group,the medial temporal lobe infarction group comparison,the conservative income scheme selection probability increased significantly,all difference were statistically significant (P ＜ 0.01,P ＜ 0.05).In choice scenario 5 of the posterior infarction group,a higher probability of conservative income scheme was selected than the anterior infarction,and the difference was statistically significant (P ＜0.05).Accompanied with depression and anxiety,the basal ganglia infarction tended to select more conservative income program than the frontal lobe infarction group and the medial temporal lobe infarction group in choice scenario 3,and the program infarction group selected a higher probability comparative differences were statistically significant (P＜ 0.01,P＜ 0.05).The posterior infarction group selected a higher probability of conservative income scheme than the anterior infarction in choice scenario 5,and the difference was statistically significant (P ＜ 0.05).Conclusion Cerebral infarction in patients exist decision-making processing abnormally,and perform as income conservative and loss risk averse.Whether associated with depression,anxiety,the basal ganglia infarction and posterior cerebral infarction patients are inclined to income conservative.

Objective To investigate the association between norepinephrine transporter (NET)gene polymorphism and decision-making processing in patients with cerebral infarction.Methods A total of 145 patients with cerebral infarction and 188 normal controls were enrolled in our study.In all subjects,the polymerase chain reaction (PCR) for NET-T182C/G1287A polymorphism assay,gel electrophoresis,image analysis and enzymatic reaction,gene sequencing methods were used.The relationships of NET T182C/G1287A genotypes and alleles with decision-making processing were analyzed in patients with cerebral infarction.All participants completed six kinds of choice situational problems.Results There were significant differences in genotype and allele frequencies of T182C and G1287A polymorphism in NET between the patients with cerebral infarction and control group(for NET-T182C:genotype,x2 =4.437,P=0.049,allele frequency,x2=4.363,P=0.037,OR=0.625,95％CI:0.436-0.895;for NET-G1287A:genotype,x2=8.435,P=0.038,allele frequency,x2=2.765,P=0.036,OR=1.520,95％CI:1.053-2.193).The cerebral infarction patients with three NET-T182C genotypes and T/C alleles all completed six choice scenarios,and the scheme selection probability had no significant difference (all P＞0.05).In high-risk and no-risk loss situation (scenario 4),the scheme selection probability had significant difference in cerebral infarction patients with NET-G1287 A genotypes and G/A alleles (P＜0.05 and 0.05,OR=1.657,95％CI:1.149-2.390),and the patients with GG genotype tended to choose high-risk loss scheme,and the probability was obviously lower than that patients with other two genotypes,the patients with G allele tended to choose high-risk loss scheme,and the probability was obviously lower than that in patients with A allele (all P＜0.05).In other five choice scenarios,the scheme selection probability had no significant difference between the patients (all P ＞0.05).Conclusions NET-G1287A polymorphism may be associated with decision-making processing in patients with cerebral infarction.In the high-risk and no-risk loss condition,patients with GG genotype and G allele have more loss risk aversion.

Objective To study the distribution and molecular characteristics of Vibrio parahaemolyticus(VP) in patients with a‐cute diarrhea ,and provide a scientific basis for the prevention and control of VP infection .Methods From 2010 to 2014 ,62 VP iso‐lates were collected from patients with acute diarrhea ,for serotyping and virulence gene (tdh and tdh) detection of VP .Molecular characteristics analysis was carried out by using multi‐locus sequence typing (MLST) .Results 7 different serotypes were found from the 62 isolates .O3∶K6 was the most common serotype of VP ,accounting for 74 .19% (46 isolates) ,followed by O4∶K68 (6 isolates) .Tdh gene was the mainly virulence gene ,with a percentage of 95 .16% (59 isolates) ,only three isolates were trh positive . 7 STs were found through MLST analysis of 62 VP isolates ,among which ,ST3 was the most important type ,accounted for 85 .50%(53 isolates) .Conclusion O3∶ K6 serotype VP was the most prevalent type .Tdh gene is the most important virulence gene of WP .ST3 was the the dominant epidemic type .

Our college has applied French-English analogy-educating method ( trilingual education )to the medicinal French bilingual-educating course by means of the interactions of different languages. As the kin relations between English and French in the axea of medicine, as well as their interactions from the origin to the modem medical applications, it can be an effective method to use analogy-educating method in the French study course in medicine, which means that the multi-lingual interactions can be used in the bilingual, even the multi-lingual educating activities of bilinguai educating process of other subjects.

Objective To investigate the clinical value of INSURE technology in very low and extremely low birth weight infants requiring respiratory support.Methods From June 2010 to August 2012,83 cases of very low and extremely low birth weight infants who had difficulty in breathing and required respiratory support were admitted into First Hospital of Tsinghua University and divided into two groups:INSURE group (n=41) and mechanical ventilation (MV) group (n=42).Infants in INSURE group accepted intubate-pulmonary surfactant-extubate to continuous positive airway pressure and those in MV group accepted intubation with or without pulmonary surfactant treatment,and mechanical ventilation without extubation.Arterial blood gases at 1 h and 12 h after treatment were compared between the two groups by t test.The incidence of respiratory distress syndrome,ventilator associated pneumonia,air leaking,chronic lung disease,intracranial hemorrhage,retinopathy,leukoencephalomalacia disease were compared with Chi-square test.Hospitalization costs,duration of ventilation,oxygen inhalation and hospital stay were compared by rank-sum test.Results (1) PO2 in INSURE group after one hour of treatment were (78.7 ±11.5) mm Hg(1 mm Hg=0.133 kPa),which were higher than those before treatment [(50.1 ±10.8) mm Hg,t=9.737,P＜0.05]; while PCO2 was lower[(48.3±8.9) mm Hg vs (54.9±11.5) mm Hg,t=-3.428,P＜0.05].PO2 in MV group after one hour of treatment were (80.2±10.0) mm Hg,which were higher than those before treatment [(51.3±9.8) mm Hg,t=10.093,P＜0.05]; while PCO2 was lower[(45.6±9.5) mm Hg vs (57.1±12.8) mm Hg,t=-4.526,P＜0.05].(2) There were no difference in PO2 and PCO2 between the two groups after one hour of treatment (P＞0.05).After 12 hours of treatment,no differences were found in PO2[(89.4±11.5) mm Hgvs (90.2±10.8) mm Hg,t=0.093] and PCO2[(44.2±5.9) mm Hg vs (39.1± 7.3) mm Hg,t=0.126] between INSURE group and MV group (P＞0.05 respectively).(3) The incidence of ventilator associated pneumonia,air leaking,intracranial hemorrhage and chronic lung disease in INSURE group were 7.3％ (3/41),4.9％ (2/41),4.9％ (2/41) and 4.9％ (2/41),which were lower than those in MV group [34.1％ (14/42),x2=27.470; 16.7％ (7/42),x2=8.651;19.0％ (8/42),x2 =8.814; 11.9％ (5/42),x2 =4.275](P＜0.05 respectively).Duration of ventilation,oxygen inhalation,neonatal intensive care unit stay in INSURE group were 5 d (3-7 d),8 d (5-11 d) and 16 d (11-25 d),which were all shorter than those of MV group [8 d (4-12 d),Z=-1.947; 12 d (8-22 d),Z=-2.013; 21 d (12-35 d),Z=-1.782](P＜0.05 respectively).Conclusions INSURE technology could be used in very low and extremely low birth weight infants because of less invasiveness,fewer complications,safety and low-cost.

The molecular targeted therapy method using microRNAs(miRNAs)is gradually stepping into people′s vision. miRNAs affect colorectal cancer progress via abnormal expression in tumor cells or micro-environment. The high or low expressions of miRNAs in specific tissues probably have an impact on the expressions of oncogenes,tumor suppressor genes or other aspects including the surrounding environments,the metastases and the drug tolerance of tumors,thus contributing to curing the colorectal cancer. Nowadays, miRNA has entered the stage of animal experiments.

Objective To explore the clinical characteristics and the treatments on traumatic diaphragmatic rupture and diaphragmatic hernia.Method A retrospective study was carried out in 49 cases of traumatic diaphragmatic rupture and diaphragmatic hernia.Results There were 32 cases with left diaphragmatic hernia,13 cases with right diaphragmatic hernia and 4 cases with bilateral diaphragmatic hernia.One case with closed combined thoraco-abdominal wound and shock,died of multiple organ failure after the surgery,3 cases were diagnosed more than 24 h after injury,the others closed injury patients were diagnosed within 24 h and cured.In patients with open diaphragmatic rupture and diaphragmatic hernia,16 cases underwent laparotomy surgery,5 cases of misdiagnosis experienced re-thoracotomy,7 cases thoracotomy,2 cases changed the thoraco-abdominal surgery.Three cases underwent thoraco-abdominal surgery.Twenty-five cases were cured; 1 patient with suppurative costal chondritis,duration up to 13months.Conclusion Traumatic diaphragmatic rupture and diaphragmatic hernia is easily missed and misdiagnosed,the establish of rational examination preoperatively can reduce complications,misdiagnosis and mortality.

AIM: To investigate the hypothesis that low-molecular weight heparin (LMWH) regulates in vitro cytotrophoblast invasiveness and production of metalloproteinases-2 (MMP-2), tissue inhibitor of metalloproteinas-2 (TIMP-2). METHODS: Chorionic villi tissue of normal 6-8 weeks pregnancy was obtained. Trophoblastic cells were collected by trypsin-collagenase digestion and Percoll gradient centrifugation. The cytotrophoblastic cells were cultured for 24 h and divided into 4 groups according to the concentrations (1.0×10~2 IU/L, 1.0×10~3 IU/L or 1.0×10~4 IU/L) of LMWH adding into the medium. The contents of MMP-2 and TIMP-2 in cell culture supernatants were measured by the method of ELISA. Cytotrophoblast invasiveness was determined by Transwell chamber assay. RESULTS: With the increasing concentrations of LMWH, the invasion activity of cytotrophoblastic cells and MMP-2 secretion were increased. At concentration of 1.0×10~3IU/L, LMWH greatly enhanced cytotrophoblast invasiveness and the expression of MMP-2 (P<0.05). The levels of TIMP-2 were decreased after intervention with LMWH. At concentration of 1.0×10~3IU/L or 1.0×10~4 IU/L, LMWH induced a significant decrease in TIMP-2 expression. No significant difference between group 1×10~3IU/L and group 1.0×10~4 IU/L was observed (P>0.05). CONCLUSION: LMWH might regulate cytotrophoblast invasiveness in vitro by influencing the expression of MMP-2 and TIMP-2 in cytotrophoblastic cells.