OBJECTIVE:To develop a method for the determination of midazolam in child plasma.METHODS:Plasma level of midazolam in twenty two ICU children with mechanical ventilation was detected by solid-phase extraction-HPLC after treatment with midazolam for 24h.The separation was performed on Zorbax Eclipse XDB C18 column with acetonitrile — 7.56mmol? L-1 ammonium sulfate(gradient elution) as mobile phase.The flow rate was 1.0mL? min-1,the column temperature was 25℃ and the wavelength of UV detector was 254nm.RESULTS:The calibration curves for midazolam had a good linearity over the range of 0.05～ 25.00mg? L-1(r=0.999 8).The average recovery for midazolam was 99.29%.Both the intra-day RSD and inter-day RSD were less than 4%.The limits of quantitation for midazolam was 0.01mg? L-1.CONCLUS-ION:The method is sensitive,accurate,simple and rapid,and applicable for clinical blood drug level monitoring of midazolam.

OBJECTIVE To investigate the distribution of pathogenic bacteria and clinic antibiotics usage in children′s hospital and provide basis for reasonable use of antibiotics. METHODS K-B disk agar diffusion method was adopted to detect drug susceptibility in vitro.Chi-square test was used to analyze the data. RESULTS Among all the pathogenic bacteria the proportion of Gram-negative bacteria was 67.1%,the first five predominant species were Escherichia coli,Klebsiella pneumonii,Enterobacter cloacae,Pseudomonas aeruginosa and Acinetobacter calcoaceticus/baumannii,accounted for 21%,16%,6.3%,6.0% and 6.0%,respectively.Piperacillin,cefuroxime and cefotaxime showed resemble curves of time-antimicrobial resistance. CONCLUSIONS Gram-negative bacteria are the main pathogens in children′s hospital.Resistance rates of most bacteria against the second and the third generation cephalosporins have increased markedly.Obvious mutiple-antimicrobial resistance exists among antibiotics with resemble structures and antimicrobial mechanisms.The trend of change in antibiotics′ resistance is parallel with that of the drug′s quantity used.Rotative principles may be applied to the usage of antibiotics.

Objective:To investigate the compensation of the anterior alveolar bone thickness in skeletal class Ⅲ patients treated with orthodontic-surgical treatment.Methods:The samples consisted of 54 ske-letal classⅢpatients treated with orthodontic-surgical treatment.Lateral cephalograms were taken before treatment.Descriptive statistics were calculated for corresponding variables,and the differences between the samples and the norms from Peking University normal occlusion sample library were assessed by inde-pendent-sample t test.Correlation analyses were performed to find associations between skeletal charac-teristics and anterior alveolar bone thickness.According to skeletal anteroposterior discrepancy/vertical type (ANB,criteria=-4°;SN-MP,criteria=37.7°),the samples were allocated into group A (severe anteroposterior discrepancy/hypodivergent vertical type,n=1 1 ),group B (moderate anteroposterior dis-crepancy/hypodivergent vertical type,n=1 6),group C (severe anteroposterior discrepancy/hyperdiver-gent vertical type,n=1 4),and group D (moderate anteroposterior discrepancy/hyperdivergent vertical type,n=1 3),and one-way ANOVA with SNK multiple comparison test were performed.Results:The anterior alveolar bone thickness of the skeletal class Ⅲ patients were thinner compared with norm values (P<0.05 ).Correlational analyses showed that,both the upper and lower anterior alveolar bone thick-ness was correlated with the skeletal vertical discrepancy (P<0.05 ),but the anteroposterior type was only correlated with the lower anterior alveolar bone thickness (P<0.05).For the 4 groups according to skeletal anteroposterior discrepancy/vertical type,hypodivergent vertical type had thinner lower ligual and total bone thickness (LP,LW,P<0.05).while for upper alveolar bone thickness (UW),group C and group B exhibited the thinnest and thickest (the values of UW were 7.86 mm and 9.05 mm).Conclusion:The upper and lower anterior alveolar bone thickness of skeletal classⅢpatients are thinner compared with normal occlusion.Different skeletal anteroposterior discrepancy/vertical type results in differences in the anterior alveolar bone thickness,so decompensation should be treated differently and carefully.

Recent studies suggest that changes of cervical vestibular-evoked myogenic potential (cVEMP) could be observed postoperatively, which reflects the degree of damage to saccule caused by cochlear implant (CI). The waveform of cVEMP can display the influences of surgical methods, ear disease condition, machine status and other factors on saccule, therefore it shows important clinical value in diagnosis and treatment. Two possible changes of cVEMP may be observed after CI. One is negative response and the other is impairment, which reflects surgical injury to saccule with varing degree. However, a uniform quantitative conclusion in cVEMP parameters is still expected. By reviewing the studies in cVEMP of CI reciepients, a typical changing pattern was discovered and a more comprehensive understanding about vestibular changes after cochlear implant was achieved.
Cochlear Implantation ; Humans ; Vestibular Evoked Myogenic Potentials

Objective To investigate the predictive value of red cell volume distribution width RDW),RDW to platelet ratio (RPR),aspartate aminotransferase (AST) to platelet ratio index APRI),fibrosis index based on the 4 factor (FIB-4) and aspartate-alanine aminotransferase ratio (AAR) in assessing esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between December 2013 and July 2015,a total of 190 patients with HBV-related cirrhosis and no previous history of endoscopic therapy for EV hospitalized at the Department of Hepatology,Tianjin Third Central Hospital were enrolled.Upper gastrointestinal endoscopy were conducted in all patients to diagnose EV.According to the morphology and degree of EV as well as bleeding risk,patients were categorized into mild,moderate and severe stages.RDW,platelet counts,alanine aminotransferase,aspartate aminotransferase were tested,and RPR,APRI,FIB-4,AAR were calculated.Spearman correlation was used to evaluate the association between EV and these indexes.Receive operating characteristic (ROC) curves were generated and the areas under the curves (AUC) were calculated to assess the performance of these indexes in predicting esophageal varices bleeding (EVB).Results RDW ([16.78±2.27]％),RPR (0.41±0.18),FIB4 (8.99±5.91),APRI (2.09[1.35,2.90]) in patients with EVB were all significantly higher than those ([14.37±1.86]％,t=-7.449;0.19±0.09 [t=-8.132];5.72±3.92 [t=-3.658];1.29 [0.70,2.39;z=-2.996]) without EVB (all P＜0.05).However,AAR had no statistical significance between two groups (t =1.216,P=0.226).Both of EV and EVB had positive correlation with RDW,RPR,FIB-4 and APRI (all P＜0.05) and no correlation withAAR(P＞0.05).RDW (F=9.604),RPR (F=47.530),FIB-4 (F=18.071) and APRI (H=12.320) showed statistically significant differences among patients with different stages of EV (all P＜0.05),whereas AAR showed no difference (F=1.177,P=0.320).The AUC of RPR (0.896) for EVB was highest,followed by RDW (0.824,P＜0.05).AUC of FIB-4 and APRI was 0.690 and 0.642,respectively,with no statistical difference (P＞0.05).The optimal cut-off levels of RDW,RPR,FIB-4 and APRI were 14.450 (sensitivity:88.24％,specificity:64.03％),0.209 (sensitivity:96.10％,specificity:69.10％),6.912 (sensitivity:66.67％,specificity:73.38％) and 1.338 (sensitivity:76.47％,specificity:51.08％),respectively.Conclusions RPR and RDW are closely correlated with EV in HBV-related cirrhotic patients,which are of clinical importance in predicting EVB.Both of them can be used as clinical screening methods and RPR may be superior to RDW.Although FIB-4 and APRI are correlated with EV,their predictive value of EBV are low.

Objective： To study the role of mechanical stress on osteoblast-like characteristics expressed by human periodontal ligament cells in vitro. Methods： Human periodontal ligament cells (hPDLC) were cultured by explant method. We investigated the gene expression for osteoblast-like marker proteins in periodontal ligament stimulated by cyclical mechanical force in vitro by in situ hybridization with non-radioisotopic oligonucleotide probe for alkline phosphatase (ALP) and osteocalcin (OCN). Results： Human periodontal ligament cells exhibited a stronger signal for ALP mRNA stimulated by cyclical mechanical force, and exhibited a moderately intense positive signal for OCN mRNA—OCN was a marker of differentiated osteoblast-like cells. Conclusion： These findings suggest that mechanical force plays role in differentiation from hPDLC to osteoblast-like cells.

Objective To explore the relationship between intestinal fatty acid binding protein(FABP2) gene G54A polymorphism and obesity,the effect of mutant 54A FABP2 gene on serum lipids metabolism.Methods The total of 84 subjects with obesity and 60 subjects with normal weight were involved in this study.The G54A FABP2 gene allele and genotype frequencies were detected by polymerase chain reaction (PCR)-restriction fragment length polymorphism(RFLP) technology.The automatic biochemical Analyzer was used to detect triglyceride(TG),high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C) levels.Results The results of study on FABP2 gene polymorphism revealed as followed:in obese groups,the frequencies of GG,GA,A/A genotypes was 19.0%(16/84),73.8%(62/84) and 7.2%(6/84),respectively;in control group,the frequencies of G/G,G/A,A/A genotypes was 38.3%(23/60),58.3%(35/60),3.3%(2/60),respectively;the differences between two groups was statistically significant(χ2=6.97,P<0.05).In obesity group,the frequencies of alleles were 56.0%(94/168) for 54G and 44.0%(74/168) for 54A;in the control group,the frequencies of alleles were 67.5%(81/120) for 54G and 32.5%(39/120) for 54A;the differences between two groups was statistically significant(χ2=3.92,P<0.05).The plasma biochemical variables results showed as followed:in obesity group,the carriers of A/A homozygous genotypes and G/A heterozyous genotypes both had significantly higher plasma TG((2.36±0.82) mmol/L,(2.06±0.59) mmol/L,respectively)and LDL-C((3.94±0.96) mmol/L,(3.29±0.55) mmol/L,respectively)level than those with GG wild genotype(t=2.206,2.575,2.632,2.278;P<0.05).The level of HDL-C in the carriers of A/A homozygous genotypes((1.23±0.34) mmol/L)and in the carriers of G/A heterozyous genotypes((1.21±0.26) mmol/L) were not significantly different than those with GG wild genotype((1.29±0.31) mmol/L,P>0.05).The carriers of A/A homozygous genotypes had significantly higher plasma LDL-C((3.94±0.96) mmol/L)level than thosewith G/A wild genotype((3.94±0.96) mmol/L vs.(3.29±0.55) mmol/L,t=2.476,P<0.05),but the plasma TG((2.36±0.82) mmol/L vs.(2.06±0.59) mmol/L;P>0.05) and HDL-C((1.23±0.34) mmol/L vs.(1.21±0.26) mmol/L;P>0.05) level had not difference.Conclusion The FABP2 gene G54A polymorphism is related to obesity and lipid metabolism abnormality.The allele encoding in FABP2 gene may be a potential factor contributing to promoting lipid metabolism abnormality.

Tumor derived microparticles are released by activated or apoptotic tumor cells.They are ex-tracellular vesicles which are 0.1~1.0μm in diameters.Tumor derived microparticles carry abundant bioactive molecules,such as nucleic acids and proteins,which resemble that of the parental cell.In this review,we summa-rize the role of tumor derived microparticles in the occurrence,development,diagnosis and treatment of tumor.

Objective To investigate and analyze the clinical learning environment and professional identity among undergraduate nursing students, and discuss the relationship between two variable, so as to provide basis for ensuring the stability of the nursing staff. Methods 288 undergraduate nursing students who were practicing in Tianjin 3A grade hospital were evaluated using questionnaires about clinical learning environment and professional identity. The correlation analysis was performed between two variable. Besides, multiple regression analysis was used to identify factors that affect the nursing students′ professional identity. Results The total score of 288 nursing students′clinical learning environment and their professional identity was (3.44±0.66) points and (3.65±0.55) points respectively, which were at the middle level. The score of clinical learning environmental was positively correlated with professional identity score (P<0.01). The result of multiple regression analysis showed that professional selectivity had influence on nursing students′ professional identity. With controlling the demographic variables, undergraduate nursing students′ clinical learning environment could explain 58.2% of professional identity. Conclusions Undergraduate nursing students′ clinical learning environment and professional identity are at the middle level. Hospitals should pay more attention to the relationship that clinical learning environment have influence on undergraduate nursing students′professional identity.Measures should be taken to ensure the stability of the high-quality nursing personnel.

Objective:To evaluate dendritic cells induced immune response against hepatocellular carcinoma by pulsed CD34+ hematopoietic stem cells originated dendritic cells with p53 gene.Methods:CD34+ hematopoietic stem cells were harvested after mobilization by chemotherapy and G-CSF.CD34+ hematopoietic stem cell apheresis was induced to differentiate into dendritic cells by cytokine cocktail IL-4,GM-CSF and TNF-?.On day 7,dendritic cells were transfected with plasmid pEGFP-C3/p53 DNA.The CTL response triggered by p53 pulsed dendritic cells was assayed by MTT method.Results:Dendritic cells originated from CD34+ cell apheresis had typical dendritic stick and expressed high level CD1a,CD11c,CD80,CD86,and HLA-DR molecules.After being pulsed with p53 gene,dendritic cells expressed green fluorescence protein and immunofluorescence assay(Cy3 labeled anti-P53 antibody)showed that transfected dendritic cells emitted red fluorescence.Dendritic cells inducing CTL response against HMCC97 cells(P53 positive)and HepG2 cells(P53 negative)were assessed by MTT method.P53 pulsed dendritic cells could induce P53 specific immune response against HMCC97 cells and the cytotoxin rate was(49.3?4.6)% compared with pEGFP-C3 transfection group [(25.4?4.1)%] and control group[(24.8?3.8)%](P0.05).Conclusion:P53 gene transfecting hematopoietic stem cell apheresis originated dendritic cells could induce specific CTL response against P53-expressing hepatocellular carcinoma cells.P53 may be a potential candidate for dendritic cell based immunotherapy of cancer.