Objective To summarize the clinical features of patients suffering from pulmonary embolism (PE) with D-dimer ＜ 0. 5 μg/mL in order to raise the diagnostic accuracy and reduce the mortality rate of PE. MethodsD-dimer-negative patients with suspected PE were admitted from January 2006 through December 2009. A comparison of clinical features including clinical manifestations, vital signs, laboratory and ancillary findings between 16 patients finally diagnosed PE and 41 patients without PE. ResultsCompared with patients without PE, the D-dimer-negative patients with PE usually had past history of venous thromembolism (VTE) or recent surgery. The symptoms of chest tightness, acute dyspnea, tachypnea, lower extremity edema and typical S I QⅢTⅢ changes of ECG were more often occurred in patients with PE than those in patients without PE of control group. ConclusionsD-dimer test is a good screening test for acute PE because its negative predictive value is high, but when the patients have acute dyspnea, lower extremity edema, previous history of VTE or/and recent surgery and ECG SI QⅢ TⅢ changes, even if D -dimer ＜ 0. 5 μg/mL, clinicians also should pay attention to and if necessary, further tests should be considered to confirm the diagnosis of PE.

Anxiety disorders are the commonest emotional disorders in children, who may be at increased risk of the later develop-ment of other types of mental disorder. Early diagnosis and intervention should be applied. In this article, epidemiology, major factors rele-vant and effective therapy of anxiety disorders in preschool children are summarized.

Objective To investigate the relationship between rs7903146-T/C polymorphism of transcription factor7-like 2 gene (TCF7L2) gene and gestational diabetes mellitus in Han population of Liaoning province.Methods The rs7903146-T/C polymorphism was detected in 115 healthy Han controls and 113 patients with gestational diabetes mellitus by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.Results There were three genotypes:CC,CT,and TT; and their frequencies in control group and patients were 95.65％/84.96％,4.35％/15.04％,and 0/0,respectively.The allele frequency T of rs7903146 in control group and the patients was 2.17％ and 7.52％,respectively.There was statistical difference between two groups.Conclusions The rs7903146-T/C polymorphism of TCF7L2 might be associated with gestational diabetes mellitus in Liaoning Han population.

Objective To study the features of Kawasaki disease (KD)with liver damage and investigate the possible related factors,and to improve the understanding of liver damage in KD patients.Methods The clinical data of 75 KD patients admitted from 2008 to 2013 were collected to retrospectively analyze the clinical features of liver damage,as well as routine blood test,C-reactive protein (CRP),erythro-cyte sedimentation rate (ESR),liver function,and abdominal ultrasound.Categorical data were analyzed by chi-square test;continuous data were expressed as mean ±standard deviation;comparison between groups was made by t test and multivariate stepwise regression analy-sis.Results The incidence of abnormal alanine aminotransferase (ALT)level in 75 cases was 32%,and 79.2% of these patients had a serum ALT level of less than 200 IU/L,including 3 patients with hepatomegaly,1 patient with jaundice,and 1 patient with splenomegaly, which accounted for 12.5%,4.2%,and 4.2%,respectively,of patients with liver damage.CRP and ESR were not found to be related to liver damage (t=1.560,P=0.123;t=1.291,P=0.201).There was significant difference in platelet count between patients with liver damage and controls (t=-3.228,P=0.003).No significant difference in white blood cell (WBC)count increase was found between the liver damage group and control group,but simultaneous increase in WBC count and platelet count was significantly associated with an in-creased risk of liver damage (P<0.05).Conclusion CRP and ESR are not found to be significantly related to the development of liver damage,but there is a close relationship between liver damage and abnormal platelet count.WBC count shows a certain relationship with liv-er damage.Clinicians should pay attention to these factors and take timely measures for intervention.

WNT5A is associated with embryonic development and the development, invasion, metastasis and chemoresistance of tumor cells. The WNT5A signal in different tumors is specifically mediated by a number of factors, including receptors, downstream targets, inhibitors and external influences from tumor microenvironment and extracellular matrix. Eventhough it is still under debate whether WNT5A functions as a tumor suppressor or a promoter, WNT5A signal transduction pathway is closely associated with various tumor behaviors.

BACKGROUND:Left ventricle volume or volume index and left ventricle mass or mass index are commonly used to evaluate left ventricle remodeling. Recently,real-time three dimensional echocardiography (RT3DE) has been attempted to evaluate left ventricle remodeling index (LVRI),and it is believed that LVRI can serve as new index to evaluate left ventricle reconstruction clinically. OBJECTIVE:To assess application of RT-3DE in evaluating left ventricular remodeling in patients with hypertension. DESIGN,TIME AND SETTING:Case-control observation was performed at the Department of Ultrasonography,First Hospital of Liaoning Medical University from September 2008 to September 2009. PARTICIPANTS:A total of 90 hypertension patients and 30 normal people were selected. The hypertension patients were divided into 3 subgroups according to interventricular septum,left ventricle myocardial thickness and end-diastolic diameter:normal configuration,concentric hypertrophy and eccentric hypertrophy groups with 30 cases in each group. METHODS:Three dimensional echocardiography of 90 patients and 30 controls was performed. Left ventricular end-diastolic volume (EDV),left ventricular end-diastolic epicardial volume (EDVepi) were measured by RT-3DE; left ventricular mass (LVM),left ventricular mass index (LVMI),left ventricular end-diastolic epicardial volume index (EDVI),LVRI were calculated and compared with two-dimensional echocardiography (2DE) Simpson biplane method. MAIN OUTCOME MEASURES:LVRI,LVMI,and EDVI detected by RT-3DE and 2DE Simpson biplane. RESULTS:LVRI,EDVI,LVMI measured by RT-3DE and 2DE were significantly different in hypertension patients (P 0.05). The LVRI measured by RT-3DE,2DE and EDVI,LVMI measured by 2DE were significantly correlated in normal control,normal configuration and concentric hypertrophy group (P 0.05). CONCLUSION:Real-time three-echocardiographic LVRI can serve as a new approach for evaluating left ventricular remodeling in clinic.

ObjectiveTo study effect of rehabilitation on the sequelae of encephalitis. Methods 41 patients were divided into two groups, Group A( only treated with traditional Chinese medicine)and group B ( treated with both traditional Chinese medicine and rehabilitation). Each patient was evaluated before and after the treatment. Result The treatment in the group B was significantly better than that in the group A (P<0.05), especially in motor function. Conclusion Comprehensive rehabilitation is an effective therapy on the sequelae of encephalitis, which shortens the course of the sequelae and improves the motor function and speech.

Objective To explore the nutritional status and it's relative factors of patients with Parkinson's disease ( PD) .Methods One hundred and eighty PD patients were sellected in this study.All the motor and non-motor symptoms of PD patients were evaluated by PD scales, and mini Nutritional Assessment ( MNA )-SF questionnaires were used to evaluate their nutritional status.Results The differences of PD duration, Unified PD Rating Scale Ⅲ ( UPDRSⅢ) , H-Y stage and non-motor systems between normal nutritional status and abnormal nutritional status PD patients were statistically significant (P<0.05-0.01).The forward binary Logistic regression model indicated that H-Y stage (OR=2.35,95%CI:1.24-4.45,P=0.007) and depression (OR=1.39,95%CI:1.25-1.67,P<0.001) were closely associated with abnormal nutritional status.Conclusion The disease itself, motor systems and non-motor systems are closely associated with nutritional status in PD patients.

BACKGROUND:To improve the survival rate of transplanted tissue, most scholars focus on cel therapy, particularly cel-assisted fat grafting.
OBJECTIVE:To analyze the effect of recombinant adenovirus-mediated hypoxia inducible factor 1alpha (HIF1α) mutant on survival rate of transplanted fat particles through transfection of adipose-derived mesenchymal stem cels.
METHODS:Recombinant adenovirus-mediatedtriple-mutantHIF1αwas inserted into an adenovirus pAdEasy-1 system, folowed by viral packaging and titer determination. Human adipose-derived mesenchymal stem cels were cultured, passaged and identified, and subsequently transfected with three kinds of viruses and blank vector (experimental group with transfection of the triple mutantof HIF1α;positive control group; negative control group; blank control group). Transfection efficiency was determined using enhanced green fluorescent protein labeling. Additionaly, MTT assay was used to detect cel proliferation.
RESULTS AND CONCLUSION:The recombinant adenovirus was successfuly constructed and packaged in line with transfection requirements. Moreover, adipose-derived mesenchymal stem cels were successfuly identified by adipogenic, osteogenic and chondrogenic induction and could be used asseed cels for subsequent experiments. RT-PCR results showed that HIF1α mRNA expression in the experimental group and positive control group was significantly higher than that in the other two groups (P< 0.05). Western blot analysis showed that the relative absorbance value in the experimental group was significantly higher than that in the other three groups (P< 0.05). A significant increase in the cel proliferation was found in the experimental group, significantly different from the other three groups (P<0.05). Therefore, our findings indicate that transfection of adenovirus-mediated triple-mutant HIF1α not only can sustain the expression of target protein in transfected adipose-derived mesenchymal stem cels under normoxic conditions, but also can promote the proliferation of transfected adipose-derived mesenchymal stem cels.

ObjectiveTo investigate the changes of serum growth hormone (GH)/insulin-like growth factor- Ⅰ ( IGF- Ⅰ ) in patients with traumatic long bone fractures and the related clinical significance.MethodsTwenty-one patients with traumatic long bone fractures from the same trauma care center treated between November 2009 and April 2010 were enrolled in the study..There were 14 males and 7 females,at age range of 22-60 years (mean 45.0 years).Seventeen patients (81％) were with closed trauma and four ( 19％ ) with open trauma.Enzyme Linked Immunoadsorbent Assay (ELISA) was used to determine the levels of serum GH and IGF- Ⅰ within 14 days after fractures and the relationship between changes of GH-IGF- Ⅰ axis and injury severity score (ISS) was further analyzed.Eight patients with normal GH/IGF- Ⅰ were set as control group.ResultsThe GH level in the peripheral blood was significantly higher at day 1 after fractures ( P ＜ 0.05 ),and rapidly declined and stabilized at day 5 compared with the control group.The GH level in the patients with ISS≥ 18 points was sigmficantly higher than that in those with ISS＜18 points at day 1 after fractures (P＜0.05).The IGF- Ⅰ level in the peripheral blood in the patients with 1SS≥ 18 points was significantly higher than that in those with ISS ＜ 18 points at days 5-10 after fractures ( P ＜ 0.05 ).ConclusionThe hypothalamus GH-IGF- Ⅰ axis plays an important role in early metabolism and fracture healing during the acute phase of traumatic long bone fractures.