GATA4 gene mutations are common in children with congenital heart disease.More than 120 mutations have been found in ventricular septal defect,atrial septal defects and the tetralogy of fallot.But the relationship between genotype and clinical phenotype has not yet been elucidated.This article summarizes the published germline and somatic mutations of GATA4 gene in human congenital heart disease,and provides insight into the phenotypic spectrum of GATA4 gene mutation.

Objective To study the difference of cerebral infarction patients plasma oxidized low density lipoprotein,circulating endothelial cells,nitric oxide levels and normal people,and study the correlation detection index.Methods 50 patients with cerebral infarction were selected as the observation group,21 cases of normal people were selected as the control group.The oxidized low density lipoprotein,circulating endothelial cells,and nitric oxide were detected.Results The plasma oxidized low density lipoprotein,circulating endothelial cells,nitric oxide levels of the observation group were (687 ±169)μg/L,(9.0 ±1.7)cells/0.9 μL,(52.3 ±16.6)μmol/L respec-tively,which of the control group were (350 ±173)μg/L,(2.5 ±0.5)cells/0.9 μL,(77.4 ±21.1)μmol/L,there were statistifically significant differences between the two groups(t =5.278,8.982,4.371,all P <0.05).Correlation analysis showed that ox -LDL and NO(P =0.013,r =0.782),ox -LDL and CEC(P =0.019,r =0.793),CEC and NO(P =0.021,r =0.952),there were significant correlation.Conclusion Vascular endothelial injury degree will affect the plasma oxidized low density lipoprotein in patients with test results,so the clinical treatment should pay attention to the protection and antiinflammatory treatment on the function of endothelial cells.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Spondylitis, Ankylosing ; therapy ; Young Adult

Objective To compare the anesthetic effect of different inserting time on patients under propofol combined sufentanil anesthesia in gastroscopy.Methods A total of 120 out-patients aged 18-60 years underwent gastroscopy were randomly divided into two groups (A and B,60 cases each).They received sufentanil 0.1μg/kg combined with propofol 1.5 mg/kg intravenously.Gastros-copy was inserted into patients’mouth immediately when the patients’consciousness lost and eyelash reflex disappeared (group A)or 30 s later (group B).When necessary (cough or movement),addi-tional propofol 0.5 mg/kg was added to enhance and maintain anesthesia.HR,BP and SpO2 were re-corded before induction (T0 ),before inserting (T1 ),gastroscopy passing through throat (T2 )and after procedure (T3 ).We observed and recorded cough,hiccup,body movement,recovery time and total dosage of propofol.Results Compared with T0 ,MAP (T1 )of both groups were lower (P <0.05).There was no statistic different in MAP on T2 and T3 .There was no statistic different in HR, MAP and SpO2 on T0-T3 between two groups.The incidence of cough and body movement were lower in group B than in group A (P <0.05).Group B had shorter recovery time and less propofol usage than group A (P <0.05).Conclusion Inserting gastroscopy 30 s after consciousness and eyelash re-flex disappear in propofol combined sufentanil anesthesia can reduce the incidence of cough and move-ment,reduce propofol consumption,and shorten recovery time but without respiratory and haemody-namic adverse effects.

Objective To investigate the expression of adrenomedullin (ADM) and vascular endothelial growth factor( VEGF) in plasm of patients with lung cancer,their correlation,and clinical significance. To explore the potential value of ADM for lung cancer in clinic. Methods The levels of plasms ADM and VECF were measured by means of radioimmunoassay in 66 cases of lung cancer, 31 cases of benign lung disease and 16 cases of healthy persons.Results The expression levels of plasm ADM and VEGF were significantly higher in the patients with lung caner than those in benign lung disease and healthy persons (P <0.05) , ADM in benign lung disease was significantly higher than that in the healthy persons (P <0.05), while VEGF in benign lung disease and healthy persons had no significant difference (P >0.05). The levels of plasm ADM and VEGF in distant metastasis was significantly higher than those with local lymph node metastasis ( P < 0.05 ) ,local lymph node metastasis was significantly higher than those without lymph node metastasis (P <0. 05). The levels of plasm ADM and VEGF were closely related to the local lymph node metastasis, distant metastasis and TNM staging. Furthermore, the expression levels of plasm ADM and VEGF increase with the clinical stage (P < 0.05 ). There was a significantly positive correlation between ADM and VEGF in patients with lung cancer (r = 0.449, P < 0.01) , but there was any correlation between benign lung disease group and healthy group ( P > 0. 05 ). Conclusion ADM and VEGF have synergistic effects in the process of neovascularization in lung cancer; to detect the expression of ADM, VEGF in plasm may be helpful for diagnosis of lung cancer and benign lung, lung cancer clinical staging,to interfere with ADM and its signal transduction pathway may be another new targeted therapy of lung cancer .

Aim To investigate the effect of fenofibrate on focal cerebral ischemia injury in rats and its mechanism.Methods The rat model of global cerebral ischemia/reperfusion injury was established by bilateral common carotid arteries occlusion combined with hemorrhagic hypotension.Fenofibrate (33, 100, 300 mg·kg~(-1)) was intragastriclly administered 30 min before the operation, MK886 (6 mg·kg~(-1)) was given intraperitoneally 30 min before administration of fenofibrate (300 mg·kg~(-1)).Morris water maze was used to evaluate the ability of spatial learning and memory function.HE staining was used to observe pathological morphological changes of hippocampal neurons. NF-κBp65 expression was detected by immunohistochemistry, SOD activities and MDA contents were analyzed by biochemistry, and IL-1β, IL-6, IL-10, TNF-α levels were detected by ELISA.Results Fenofibrate remarkably improved the spatial learning and memory function, obviously prevented the hippocampal neurons from karyopycnosis and losing induced by I/R. Fenofibrate significantly blunted the increase of MDA, NF-κBp65, TNF-α, IL-1β, IL-6, and the decrease of IL-10 and SOD activities of I/R rats.Conclusions Fenofibrate has an obviously neuroprotective effect on global cerebral ischemia/reperfusion damage by activating PPARα.The anti-inflammation and antioxidative stress of fenofibrate may be involved in the protective mechanism.

Objective To investigate the relationship between neonatal health and TCM constitution types of early to mid-pregnancy expectant parents;To provide basis for the targeted interventions for couples of childbearing age before pregnancy-periconceptional TCM constitution. Methods Compiling scales for pregnant couple’ TCM constitution type assessment and postpartum visits to newborns, the research team got access to the information of neonatal physical problems, constitutions and changes of 675 babies’ father and mother who had established maternal manual from April, 2012 to March, 2013 at the Sanlin Community Health Center of Pudong District of Shanghai. Results Early to mid-pregnancy expectant parents mainly had peace constitution type. In detail, 55% of pregnant women had gentle constitution type, while others mainly had qi deficiency, yang deficiency and damp-heat constitution types;76% expectant fathers got peace constitution, while others mainly got damp-heat, yin deficiency and qi deficiency constitution types. Marital pregnancy physique did not change significantly. Compared with the peace constitution type, newborns, whose fathers got damp-heat constitution type, had higher risk of jaundice, and whose mothers got yin deficiency, the babies had higher risk of spits (P<0.05). The constitution types of expectant parents did not have obvious combined action on neonatal health. Conclusion There is a certain relationship between neonatal health and TCM constitution types of early to mid-pregnancy expectant parents. It is necessary to distinguish constitution types of prospective parents, and thus to take targeted health interventions.

Pneumocystis carinii pneumonia (PCP) is a life-threatening opportunistic infection in immunocompromised patients.In recent years,the incidence of PCP has increased significantly since the application of combined chemotherapy,immunosuppressant and hematopoietic stem cell transplantation,with improved long-term efficacy in pediatric blood disease.This review summarizes the clinical manifestations,laboratory and radiological examination,diagnosis,treatment and prophylaxis.Compound Sulfamethoxazole is the most commonly used agent for prophylaxis.It is recommended for the high-risk patients to take PCP prophylaxis,which could decrease the incidence of PCP.

Objective To discuss the association between vitamin D level and the severity of diabetic retinopathy and maculopathy in type 2 diabetes mellitus.Methods 657 patients with type 2 diabetic patients were included in our study and classified into four groups according to their severity of diabetic retinopathy:the non-diabetic retinopathy group(NDR group, n=257) ,the background diabetic retinopathy group(BDR group, n=243), the preproliferative diabetic retinopathy group(PPDR group, n=135) and the proliferative diabetic retinopathy group(PDR group, n=22).The patients were divided into maculopathy(n=563) and non-maculopathy(n=94).Characteristics data were recorded and disease duration, body mass index, blood pressure and other lipid makers were measured and compared among groups.Results Among four diabetic retinopathy groups, 25(OH)D was statistically different (P <0.05), however, compared to diabetic maculopathy group, the level of 25(OH)D in non-maculopathy group was not statistically different.Logistic regression showed that 25(OH)D was significantly associated with the severity ofdiabetic retinopathy(P<0.05), while not with diabetic maculopathy.Conclusion The level of 25 ( OH ) D is closely associated with the severity ofdiabetic retinopathy in patients with type 2 diabetes mellitus, and it might be an important predictor for the severity of diabetic retinopathy.

AIM: To investigate cl in ical usage of drugs for respiratory system diseases. METHODS: Th e in-hospital records from November 2001 to February 2002 were investigated in a hospital. The usage and utilization of the drugs were analyzed with DDDs. Drug interactions were evaluated with a software (Reasonable Medication System). RESULTS: The frequency of use of antimicrobial accounted for 35% in total. The other two kinds were anti-asthma drugs and the removing fever of re ady-made traditional Chinese medicine. Some unreasonable interactions were foun d in this investigation. CONCLUSION: In the hospital, the usage of drugs for respiratory system diseases is rational on the whole, but drugs int eraction should not been neglected.