Kawasaki disease (KD) is an acute systemic vasculitis and its main life-threatening complications are coronary artery lesions(CAL), including coronary artery stenosis, thrombosis, aneurysm rupture, or sudden death. KD has now surpassed acute rheumatic fever as the leading cause of acquired heart disease in children. Therefore, it is important to identify as early as possible KD patients who are at risk for the development of CAL and intervent them timely. Genetic factors are thought to have important influences on the development and progress of Kawasaki disease and its CAL. In previous reports, several genetic polymorphisms, such as VEGF, MMPs and CD14 gene, were associated with the development of CAL. This review will introduce the study of gene polymorphisms in susceptibility to CAL in children with KD recently.

Objective To investigate the effects of peer education on treatment among patients using 131I with thyroid cancer after surgery.Methods A total of 80 patients using 131I therapy after surgery of thyroid can cerhospitalized from June 2014 to May 2016 were enrolled and randomly divided into two groups.The control group were given routine health care including hospitalized treatment,education,and follow-up examination after discharge from hospital,while the experimental group were given peer education,and the intervention was provided from admission to one month after discharge.Distress level,complication rates and knowledge mastering were compared between two groups.Results The differences of distress level,complication rates and knowledge mastering between two groups were statistically significant(P＜0.05).Conclusion Patients using 131I with thyroid cancer after surgery suffer from significant distress.Peer education can greatly reduce patients' distress,complications after 131I treatment,and improve mastering knowledge.

Objective To analyse the expressions and clinical significances of CXCR4,CXCL12 and PTEN in breast cancer.Methods The expressions of CXCR4,CXCL12 and PTEN in 60 cases of breast cancer were detected by immunohistochemistry technique SABC method.The correlations of levels of CXCR4,CXCL12 and PTEN expression and the age of patient,tumor diameter,histological grade,TNM stage,lymph node metastasis,ER status,Her-2 status,and vessel invasion were analysed.Twenty cases of breast fibroadenoma tissues and 20 cases of normal breast tissues were analysed as controls.Results The expressions of CXCR4 (x2 =48.754,P =0.000),CXCL12 (x2 =47.611,P =0.000) and PTEN (x2 =19.994,P =0.000) in breast cancer,normal breast tissues and breast fobroadenoma showed significant differences.The positive expressions of CXCR and CXCL12 were significantly correlated with histological grade (x2 =11.080,P =0.004;x2 =6.978,P =0.031),TNM stage (x2 =9.819,P =0.007;X2 =10.163,P =0.006),lymph node metastasis (x2 =6.213,P =0.013;x2 =8.031,P =0.005),ER (x2 =12.774,P =0.000;x2 =7.330,P=0.007),vessel invasion (x2 =5.860,P=0.013; x2 =5.185,P=0.020) and Her-2 (x2 =5.487,P =0.019;x2 =4.689,P =0.030).The expression of PTEN in breast cancer was significantly correlated with TNM stage (x2=7.366,P =0.025),lymph node metastasis (x2 =5.511,P =0.019) and ER state (x2 =4.077,P =0.043).There was a positive correlation between the expression of CXCR4 and the expression of CXCL12 in breast cancer (r =0.336,P =0.004).There was a negative correlation between the expression of CXCR4 and the expression of PTEN in breast cancer (r =-0.362,P =0.004).There was a negative correlation between the expression of CXCL12 and the expression of PTEN in breast cancer (r =-0.360,P =0.004).Conclusion The high expression of the chemokine CXCL12 and its receptor CXCR4 and the low expression of PTEN are closely related to the carcinogenesis and metastasis of breast cancer,which may play an important role in the development of breast cancer.

Objective In order to evaluate the efficacy of Diammonium Glycyrrhizinate in the treatment of chronic hepatitis B. Methods The randomized clinical trials(RCTs) that compared the efficacy of Diammonium Glycyrrhizinate and other kind of treatment in chronic hepatitis-B were chosen from CBM disks from 1995 to 2004 and CNKI from 1995 to 2004.A meta-analysis was employed to evaluate the results of these therapies. Results Twenty-four RCTs including 3201 cases were analyzed.Compared with control group,the total RR of efficiency rate of Diammonium Glycyrrhizinate group were 1.378(95%CI 1.243～1.529),showing significant difference(P

Objective To study the variation of serum thyroid hormones in each trimester of pregnancy and their relationship with thyroid peroxidase antibody(TPOAb).Methods Three-hundred and seventy-seven pregnant women in different trimesters were enrolled,the serum TSH,FT3,FT4,TT3,TT4,and TPOAb were determined by ICMA assay.Results Serun TSH in normal pregnant group was gradually increased as the pregnant trimester grew up ( all P＜0.05 ).The median of TSH in positive TPOAb group was higher than that of negative TPOAb group( P＜0.05 ).The prevalences of both clinical and subclinical hypothyroidism in positive TPOAb group were also higher than those in negative TPOAb group( all P＜0.05 ).The prevalences of subclinical hypothyroidism were 23.61％ and 18.04％,while those of clinical hypothyroidism were 0.27％ and 5.84％ by using TT4 and FT4 determination,respectively( P＜0.05 ).Conclusions More attention should be paid to the difference between FT4 and TT4 in hypothyroidism diagnosis during both second and third trimesters of pregnancy.Establishment of normal thyroid hormoues cut-off points in each trimester of pregnancy and screening for TPOAb is necessary.

Objective To investigate the pregnancy opportunity and outcome of patients with sysmetic lupus erythematosus (SLE).Methods We carried out a retrospective analysis of the clinical information of patients who suffered from SLE complicated with pregnancy and were hospitalized to People's Hospital of Peking University from December of 1992 to February of 2012.Chi-square test were used for statistical analysis.Results Forty-nine cases of patients with SLE complicated with pregnancy had 52 pregnancies in total.In 27 cases of planned pregnancies,24 cases(89％ )resulted in live births and 5 cases( 18％ ) had flares during pregnancy.Of the 24 live births,3 cases( 12％)were premature deliveries and 4 cases(17％) had low birth weight infants.In 25 cases of unplanned pregnancies,12 cases (48％) resulted in live births and 20 cases (80％) had flares during pregnancy.Of the 12 live births,6 cases(50％ ) were premature deliveries and 6 cases (50％) were low birth weight infants.The patients in the planned pregnancy group tended to have flares during pregnancy more frequently than those in the unplanned group (P＜0.01),the former were more likely to have live births than the latter (P＜0.01) and were less likely to have premature delivery (P＜0.05).Conclusion Patients with SLE should have planned pregnancy and need collaborative supervision of both rheumatology and immunology department and obstetric department to improve live birth rate,decrease premature delivery and the activity of SLE during pregnancy.

Objective To investigate the relationship between the distribution of nerve fibers in multiple endometriosis lesions and pelvic pain.MethodsFrom Sept.2007 to Sept.2008, 120 endometriosis patients treated in Peking Union Hospital were enrolled in this study, which including 19 cases with stage Ⅰ , 29 cases with stage Ⅱ , 44 cases with stage Ⅲ and 28 cases with stage Ⅳ.The pain symptom was evaluated by visual analogue scales(VAS) score and nerve fibers in multiple endometriosis lesions were detected by immunohistochemical staining.Results The number of nerve fibers in multiple endometriosis lesions were (29.74 ± 17.33)/mm~2 in uterosacral ligament, (24.53 ± 13.34)/mm~2 in vaginal septum, (17.09 ± 10.09)/mm~2 in uterus rectum crux, (6.77 ± 4.21)/mm~2 in peritoneal endometriosis lesions, (0.07 ± 0.25)/mm~2 in endometriosis ovarian cyst wall.The number of nerve fibers in uterosacral ligament was mostly correlated with the degree of pain (r = 0.56).The nerve fibers of uterus rectum crux and vaginalseptum were correlated with defecation pain (r = 0.58 and 0.41) and dyspareunia (r = 0.82 and 0.67),which were significantly higher than those in endometriosis leision in peritoneum and ovary.There was no significant different number of nerve fibers among different stage disease (P > 0.05).Conclusion There was significantly different distribution of nerve fibers in multiple endometriosis lesions, which was correlated with dysmenorrhea, anus pain, dyspareunia and chronic pelvic pain, not with clinical staging.

This paper summarizes the nursing care of patients with extracorporeal membrane oxygenation (ECMO) for postoperative support in heart transplantation. Ten patients suffered from acute graft failure after heart transplantation and applied the extracorporeal membrane oxygenation for postoperative support. All the patients were monitored on electrocardiogram, hemodynamics, body temperature, urine volume, drainage volume, activated coagulation time, liver and renal function, free hemoglobin and colloid osmotic pressure. Nine survivals were discharged with recovery and one patient died. The duration of ECMO support ranged from 40 to 824 hours. When the heart function showed recovered based on bedside UCG. the ECMO could be weaned off uneventfully after 100 hours and the long-term clinical outcomes were good. It is suggested that close monitoring of heart & lung function during ECMO support, proper adjustment of ventilator index, intensive lung & respiratory tract care, prevention of arrhythmia, bleeding, embolism, infections, bedsores and other complications may decrease the mortality of severe patients with heart transplantation.

Objective To investigate the characteristics of serum oxidized low density lipoprotein (ox-LDL) and traditional cardiovascular risk factors of premature coronary artery disease (PCAD). Methods Sixty-six patients with coro-nary atrery disease (CAD) confirmed by angiography were selected to be PCAD group, and 56 patients with normal coronary artery confirmed by angiography were included in control group. The serum levels of ox-LDL, high density lipoprotein choles-terol (HDL-C), triglyceride (TG), creatinine (SCr), uric acid (UA), other serum biochemical indicators and differences of the proportions of male, hypertension, diabetes, smoking history and family history of CAD were compared between two groups. Results (1)There were higher serum values of ox-LDL, TG, SCr, UA, fasting blood glucose (FBG) and proportion of male pa-tients in PCAD group than those of control group (P＜0.05), but there was a lower plasma level of HDL-C in PCAD group than that of control group (P＜0.05). There were significant differences in other indicators between two groups. (2) There were positive correlations between UA, SCr and ox-LDL ( rs were 0.243 and 0.186 respectively, P were 0.006 and 0.034 respective-ly). (3)The logistic regression analysis showed that ox-LDL, HDL-C and SCr were influential factors to PCAD(OR were 1.155, 0.143 and 1.052 respectively). Conclusion Elevations of ox-LDL, HDL-C and SCr are independent predictors of PCAD.

Objective To investigate the effects of nasal tip reduction with inner incision combined with external fixation,namely,to evaluate the formation of bilateral alar groove which is en hanced by external fixation with small splints,after removing interdomal fat pad as well as adjusting alar cartilage to reduce nasal tip.Methods Alar cartilage and interdomal fat pad were exposed via the bilateral nasal vestibular incision to remove fat pad and part of enlarged lateral foot of alar cartilage.After suture of incision,based on the tissue removal,plastic splint was used for external fixation of bilateral nasal tip and alar groove for one week,to enhance the formation of alar groove.Results A total of 143 patients were followed up for more than 6 months after operation.Photographs taken before and after operation were compared,suggesting obviously smaller nasal tip and significant alar groove.Left and right alar groove space was decreased from preoperative (28.23±3.31) mm to post operative (23.72±2.65) mm,and nasal tip alar angle was decreased from (104.02±9.57)°to (87.78± 6.98)°,with statistical significance (P＜0.05).Slightly asymmetric nasal alars were found in 6 patients during follow-up examination,while tiny scars caused by splints (at 0.6 cm from the edge of splints) were found in 1 patient.Conclusions On the basis of nasal tip reduction with inner incision,the method of suture with small splints combined with external fixation is simple,effective and available.