Objective To explore the instruction value of the color Doppler ultrasonography for the diagnosis and treatment of the pediatric intussusceptions .Methods Retrospective study the color Doppler ultrasonographic performance of 114 patients with diagnosis of pediatric intussusception in the affiliated hospital of Zunyi medical college ,from October 2009 to June 2012 ,reviewed the case ,groups were compared according to the ways of therapeutic methods .Results All the 114 cases of children of the intus-susception are subject to air enema reset or surgery cured confirmed .Age younger than 12 months intussusception children ,air ene-ma reset were more likely to success ;the diameter of concentric circles levy,the length of sleeve for and the thickness of bowel wall were smaller ,the more suitable for outsiders air enema reset .The blood supply of scabbard of bowel wall and the mesenteric was rich ,the air enema reset had a higher success rate ,blood supply was poor and the success rate was lower .The success rate of air enema reset was influenced by the part of intussusception .Conclusion Combined use of conventional color ultrasonic and high fre-quency probe checking ,can raise the diagnosis rate of pediatric intussusception ,the primary lesion confirmed and the detection rate in the position of the disease ,provide guidance for clinical choice reduction treatment .

Objective To investigate the effects of hydrogen gas on the myocardial injury in rats with endotoxemia.Methods Forty-eight healthy male Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 4 groups (n =12 each ):control group (group C ),hydrogen gas control group (group HC ),endotoxemia group (group E) and hydrogen gas + endotoxemia group (group LH).Endotoxemia was induced by intraperitoneal lipopolysaccharide (LPS) 20 mg/kg in groups E and LH,while the equal volume of normal saline was given in groups C and HC.After LPS administration,the rats were exposed to the air containing 2％ hydrogen gas for 6 h in groups HC and LH,and the rats were exposed to the air for 6 h in groups C and E.Blood samples were taken from the abdominal aorta after 6 h inhalation of hydrogen gas to determine the serum level of cTnI.The hearts were then removed to determine the content of TNF-α and IL-6 and expression of phosphorylated nuclear factor κB ( NF-κB) inhibitory protein (p-IκB-α) and p38 mitogen-activated protein kinase (p-p38MAPK) in the myocardial tissues.Results Compared with group C,no significant change was found in the levels of cTnI,TNF-α and IL-6 and expression of p-IκB-α and p-p38MAPK in group HC ( P ＞ 0.05),and the levels of cTnI,TNF-α and IL-6 were significantly increased and the expression of p-IκB-α and p-p38MAPK was up-regulated in groups E and LH ( P ＜ 0.05).Compared with group E,the levels of cTnI,TNF-α and IL-6 were significantly decreased and the expression of p-IκB-α and p-p38MAPK was down-regulated in group LH ( P ＜ 0.05).Conclusion Hydrogen gas can reduce the myocardial injury in rats with endotoxemia,and inhibition of the p38MAPK and NF-κB pro-inflammatory pathway and reduction of the inflammatory response of myocardial tissues are involved in the mechanism.

Objective To analyze the risk factors leading to prolonged mechanical ventilation following valve replacement surgery with the purpose of improving the management of these patients.Methods The risk factors of prolonged mechanical ventilation at preoperative,operative and postoperative clinical data of 307 patients who underwent valve replacement surgery were retrospectively analyzed.Binary Logistic regression model was used to assess the factors.Results The time of mechanical ventilation after valve replacement surgery was (15 ± 35) h,and 31.6％ (97/307) of these patients underwent prolonged mechanical ventilation (＞ 8 h).Age ≥ 65 years (P =0.003),smoker (P =0.024),left ventricular ejection fraction (LVEF) preoperative (P =0.002),duration of operation (P =0.000),aortic block time (P =0.046),cardiopulmonary bypass time (P =0.030),number of replaced valve (P =0.001),volume of postoperative chest drainage (P =0.000) and postoperative complications (P =0.010) were risk factors of prolonged mechanical ventilation.Logistic regression analysis showed that LVEF (P =0.026),duration of operation(P =0.037),aortic block time (P =0.001),cardiopulmonary bypass time (P =0.013),number of replaced valve (P =0.017),volume of postoperative chest drainage (P =0.020) and postoperative complications (P =0.014) had extremely affection.Conclusions Greater importance should be attached to healthcare education,early treatment to avoid multivalvular involvement,preoperative heart function regulation,lower duration of operation especially aortic block time and cardiopulmonary bypass time,lower postoperative chest drainage and better preservation of organs during operation to decrease the rate of prolonged mechanical ventilation and optimize the clinical quality.

Objective To investigate the correlation of possible risk factors with acute renal injury (AKI) after coronary artery bypass surgery (CABG) and explore if the incidence of AKI could be lower by off-pump CABG for kidney protection.Methods Two hundred and nine patients who underwent coronary artery bypass surgery in Nanjing First Hospital from September 2010 to November 2013 were recruited.The patients were divided into AKI group (fifty-five cases) and non-AKI group (one hundred and fifty-four cases) according to the AKI criteria and compared the possible risk factors between two the groups by univariate analysis and multivariate analysis.Results The index of female gender,body mass index,age,hypertension,basic serum creatinine,ejection fraction,the number of coronary atherosclerosis,cardiopulmonary bypass,IABP for circulatory support,postoperative low cardiac output,lactate in AKI group were higher than that in non-AKI group by univariate analysis (P ＜ 0.05).And basic serum creatinine,ejection fraction,cardiopulmonary bypass,postoperative low cardiac output showed a significantly statistical difference between two group by multivariate analysis.Conclusions Cardiopulmonary bypass,basic serum creatinine,ejection fraction,postoperative low cardiac output were independent risk factors.Off-pump CABG could benefit for kidney protection.

Objective To test the hypothesis that interleukin-18 (IL-18) in the urine and serum sample are early biomarker for acute kidney injury (AKI) in patients after coronary artery bypass graft surgery (CABG).Methods Eighty patients who underwent CABG were recruited.The patients were divided into AKI group and non-AKI group according to the AKI criteria.The urine and serum sample were collected at pre-operation and 2 h,4 h,6 h,8 h,12 h,24 h after the CABG.The urine and serum IL-18 value were test by ELISA method.Receiver-operating characteristic cue(ORC) and the area under the cure(AUC) asses the sensitivity and specificity of IL-18 for AKI.Results Thirteen of eighty cases(16.25％) developed postoperative AKI according to the AKI criteria.Diagnosis with creatinine was only 24-48 hours after CABG.The serum and urinary concentrations of IL-18 at mostly each time point after CABG in AKI patients were significantly higher than those in non-AKI patients(P ＜ 0.01).Urinary and serous concentrations of IL-18 peaked at 4 h after CABG in AKI patients.ROC curve showed AUC in urinary and serous concentrations of IL-18 at 2 h ＞ 0.8 ; Concentrations of IL-18 in urine and serum at 2 h were the powerful independent predictors of AKI by logistic regression analysis.Conclusion IL-18 in urine and serum after CABG surgery were the powerful independent predictors of AKI.

Objective To investigate the expressions of epidermal growth factor receptor (EGFR), cyclooxygenase-2 (COX-2) and P63 protein in non-small cell lung cancer (NSCLC) and their relationship with TNM staging and lymph node metastasis of NSCLC. Methods Seventy-eight paraffin-embedded specimens of NSCLC from 1998-2005 were collected in this study. Inclusion criteria included no chemotherapy or radiotherapy before operation. Pathological diagnosis was made after operation: 43 squamous carcinoma and 35 adenocarcinoma, 45 with lymph node metastasis and 33 without, 13 in stage Ⅰ, 19 in stage Ⅱ, 28 in stage Ⅲ and 18 in stage Ⅳ. The expressions of EGFR, COX-2 and P63 were determined by immunohistochemical staining (S-P). Results The expression rates of EGFR, COX-2 and P63 were 65.4% (51/78), 61.5% (48/78) and 56.4% (44/78) respectively in 78 cases of NSCLC. Significant difference in the expressions of COX-2 and P63 was found between squamous carcinoma and adenocarcinoma (P0.05). The positive rate of EGFR and COX-2 protein expressions in NSCLC of stage Ⅲ-Ⅳ and NSCLC with lymph node metastasis was significantly higher than that in stage Ⅰ-Ⅱ and NSCLC without lymph node metastasis (P0.05). Conclusion Over-expressions of EGFR and COX-2 may play an important role in invasion and metastasis of NSCLC. COX-2 and P63 may be valuable markers in differentiating pulmonary squamous cell carcinoma from pulmonary adenocarcinoma.

Objective To study the expression and function of miR-145 in papillary thyroid carcinoma (PTC).Methods PTC tissues and adjacent tissues were collected from 43 cases.Expression of miR-145 in PTC tissues and adjacent tissues was detected with RT-PCR.miR-145 analogue was used to transfect TPC-1cell to upregulate miR-145 expression.Brdu-ELISA method was used to detect the proliferation of TPC-1 cell.Flow cytometry instrument was used to detect the apoptosis and cell cycle of TPC-1 cell.Results RT-PCR test showed that relative expression of miR-145 in thyroid carcinoma tissue was 0.369±0.082,significantly lower than 1.029-±0.365 in tissue adjacent,and the difference was statistically significant (t=3.129,P=0.000).The expression of miR-145 in patients whose biggest tumor size ≥ 1 cm was lower than patients whose biggest tumor size ＜1 cm.Compared with patients with single tumor,the expression of miR-145 in patients with multiple tumor was lower,and the dif ferences were statistically significant (P＜0.05).miR-145 expression was enhanced by miR-145 analogue.Compared with negative control,the proliferative ability of thyroid cancer cell TPC-1 was suppressed significantly,and the difference was statistically significant (P＜0.05).In addition,up-regulation of miR-145 expression could block thyroid cancer TPC-1 in G2/M phase.The apoptosis rate of thyroid cancer cell TPC-1 increased significantly (P＜0.05).Conclusions miR-145 expression is decreased significantly in PTC tissue,and is associated with clinical pathological features.Up-regulation of miR-145 expression can inhibit thyroid cancer cell proliferation,block the cell cycle,and promote apoptosis,miR-145 may play an important role in occurrence and development of thyroid cancer.

Abstract: Objective To explore the effect of family rehabilitation on growth and development of children with hypoxic ischemic encephalopathy (HIE). Methods 80 children with moderate HIE were divided into control group (n=40) and observation group (n=40). The control group received routine intervention and nursing, and the observation group accepted family rehabilitation in addition. Mental development index (MDI) and psychomoter developmental index (PDI) were compared when they were 3 and 6 months old with intellectual development testing, and their development quotients (DQ) were compared at the age of 1 year. Results The MDI and PDI scores were higher (P<0.01) in the observation group than in the control group when they were 3 and 6 months old. The DQ were higher (P<0.05) in the observation group than in the control group when they were 1 year old. Conclusion Family rehabilitation can promote the development of intelligence in children with HIE.

Objective To explore the effect of indoxyl sulfate (IS) on the differentiation, maturation and immunological function of human monocyte derived dendritic cells (mDCs), in order to provides evidence for mechanism of IS in atherosclerosis. Methods Human peripheral blood mononuclear cells isolated by double gradient centrifugation were cultured for immature mDCs by rhGM?CSF and rhIL?4 in vitro. All cases were randomly divided into PBS group, LPS group(1 μg/mL), IS.1 group(30 μmol/L), IS.2 group(300 μmol/L)and IS.3 group (600 μmol/L). The phenotypic maturation of mDCs was evaluated by flow cytometry (FCM) and functional maturation of mDCs was analyzed by measuring FITC?dextran uptake and ELISA. Results IS significantly upregulated the expression of CD80, CD83, CD86 and MHC II key membrane molecules on mDCs, while downregulating phagocytosis and increasing the secretion of IL?12p70 by mDCs (P<0.05). And the LPS and IS showed typical morphology with rough surface, long protrusions and fusiform. 300 μmol/L IS is the most appropriate stimulus concentration. Conclusion Stuctural, phenotypic and functional maturation of dendritic cells derived from human monocytes can be induced by indoxal sulphate at defined concentrations, which may be one of the mechanisms involved in the process of atherosclerosis.

Objective In attempt to improve the reconstruction of small defects in the facial and frontal regions, we developed a modified radial artery perforator-based free flap. Methods The free proxi-mal radial forearm flap was based on the distal perforator of the radial artery and the concomitant radial vein. The vascular pedicle passed through deep fascia. The free flap was transferred to repair the defects of the fa-cial and frontal regions. Results In 6 patients with frontal defects and 4 patients with facial defects, all flaps survived completely. After following up for 6-12 months, flaps underwent plastic surgery to become thin-ner. The flaps of 10 cases were good in skin texture and color at recipient sites. The scars were cosmetically acceptable. The superficial sensibility recovered well. Conclusion A modified radial artery perforator-based free flap was useful in coveting small defects of the facial and frontal regions.