Obstructive sleep apnea hypopnea syndrome(OSAHS)is a serious health hazard in children.It can cause damage to multiple systems, including cardiovascular, metabolic, endocrine and neurocognitive systems, especially for cognitive impairment.OSAHS may cause sleep fragmentation and intermittent ventilation abnormalities due to repeated partial or total upper airway obstruction, resulting in hypoxemia and hypercarbia, affect attention, intelligence, memory, language, executive function, etc.

Objective To measure and predict the hospital resources to be saved by reducing one day of stay in average in China,predict its future impacts,and to probe into the importance of less average days of stay for hospital resource deployment.Methods A mathematical model was used for quantitative analysis of the actual impacts of one less day of stay in China′s hospitals for the hospital resources,and the gray forecasting model was used to predict the hospital resources so saved by achieving so during 2013 to 2025.Results One hospital day less could save 9.41% of a hospital′s total bed resources.According to the growing trend of hospital beds in China and the deployment relationship,it is predicted that more hospital resources will be saved by one hospital day less in average from 2013 to 2025.Conclusions Shorter average days of stay and optimal deployment of hospital resources,should be based on quality of care.Less ineffective waiting time to shorten average days of stay can be breakthrough to improve the comprehensive efficiency of health resources.

Objective To study the effect of tamoxifen on the proliferation and apoptosis of germ cells and to evaluate its clinical application to idiopathic oligospermia. Methods 41 oligospermia patients were treated with tamoxifen.Testicular tissues obtained by Tur Cut biopsy needle,both before and after the treatment,were observed under electron microscopy,the incidence of apoptosis and PCNA expression in germ cells being detected. Results Testicular pathological changes in different degree were observed on electron microscopy.Compared with the normal controls.PCNA proliferation index (PI) was lower ( P

Objective To study the ultrastructural changes in three different zones of benign prostatic hyperplasia(BPH). Methods The ultrastructural changes in peripheral,transitional and central zones(PZ,TZ and CZ)of prostates from 10 patients with BPH were observed with transmission electron microscopy. Results Glandular epithelia layers in TZ of BPH were increased.The stroma in TZ was mainly composed of smooth muscle cells (SMC) of vigorous proliferation and fibroblasts.Mast cell and lymphocyte with cytoplasma membrane merge were observed in this zone.In PZ and CZ of BPH, SMC showing degenerative changes,such as,nuclear pyknosis,dilatation of perinuclear space and vacuolation of cytoplasma were frequently seen. Conclusions There are significant differences in the ultrastructure of three zones in BPH.

Objective To investigate the pathophysiological mechanism of proliferation and apoptosis in spermatogenic cell of idiopathic oligospermia. Methods Forty one patients with oligospermia were included in the trial.Testicular tissues,which were obtained with Tru Cut needle biopsy,were observed under light microscope.Expressions of p16 and PCNA,incidence of apoptosis in spermatogenic cells were detected by immunohistochemistry and in situ 3′ DNA end labeling technique. Five testicular samples which were proved to be normal by examination served as controls. Results Proliferation index (21.6?13.1)% in testes of patients was lower than the normal controls (45.4?5.7)%, P

Objective To investigate the selective killing effect of adenoviral mediated herpes simplex virus-thymidine kinase/ganciclovir (HSV-tk/GCV) suicide gene system controlled by human telomerase reverse transcriptase (hTERT) promoter on bladder cancer cells in vitro. Methods Bladder cancer cell line 253J and human fibroblast cell line MRC-5 were transfected by the recombinant adenovirus of different multiplicities of infection (MOI),and the infection rate was measured by observing the expression of enhanced green fluorescent protein (EGFP) under the fluorescent microscopy.Ad-hTERT-HSV/tk and Ad-CMV-HSV/tk were transduced into 253J and MRC-5,followed by GCV treatment. The relative survival rate of cells in presence of prodrug GCV was measured with MTT method. Results Recombinant adenovirus Ad-hTERT-EGFP could selectively infect 253J cells,with the infection rate associated with the increasing MOI of recombinant adenovirus (P

BACKGROUND:Menstrual blood-derived mesenchymal stem cels are proved to be a new type of adult stem cels. To date, little is reported on the methods of establishing this kind of cel lines systematicaly.
OBJECTIVE:To isolate, culture, identify and finaly establish menstrual blood-derived mesenchymal stem cel lines.
METHODS:Menstrual blood-derived mesenchymal stem cels were isolated from the menstrual blood of healthy female donors and cultured accordingly using density gradient centrifugation method. Cel morphology and proliferation characteristics were observed, and proliferative ability was detected by cel counting kit-8 assay. Cels were colected periodicaly for karyotype analysis. Expressions of cel surface antigens such as CD34, CD38, CD44, CD45, CD73, CD90, CD105 and Oct-4 were analyzed using flow cytometry. Cel pluripotency were identified by inducing adipogenesis and osteogenesis in vitro.
RESULTS AND CONCLUSION:We successfuly established four menstrual blood-derived mesenchymal stem cel lines from the menstrual blood of six healthy volunteers. The cultured cel lines had a typical spindle shape and kept normal 46, XX karyotype. The cels grew rapidly and entered into the logarithmic growth phase at 48 hours after passaging. The results of flow cytometry showed that menstrual blood-derived mesenchymal stem cels were positive for CD44, CD73, CD90, CD105 and Oct-4, while negative for CD38, CD34 and CD45. Menstrual blood-derived mesenchymal stem cels were positive for oil red O staining at 22 days after adipogenic induction and also positive for alizarin red staining at 2 weeks after osteogenetic induction. In conclusion, our study suggests that menstrual blood-derived mesenchymal stem cels with stable karyotype and pluripotency can proliferate quickly, and we can provide a new resource for stem cel therapy and regenerative medicine through establishing the menstrual blood-derived mesenchymal stem cel lines.

OBJECTIVE:To improve high-alert medication management in our hospital. METHODS:According to assessment criteria of JCI,referring to the problems of high-alert medication management in our hospital,PDCA(plan,do,check,action)cy-cle method,reverse fishbone diagram and other methods were adopted to formulate and implement relevant countermeasures. Com-pliance rate of 29 departments was evaluated within 12 months after the implementation of countermeasures. RESULTS:Relevant emergency measures were formulated for 2 negative factors by reverse fishbone diagram;whole-course and orderly quality control of high-alert medication was conducted through establishing high-alert medication management institutions,formulating high-alert medication management system and quality measurement criteria,strengthening staff training and education,improving hospital in-formation system,etc. The compliance rate of departments increased from 53% in Jan. to 100% in Jun.(P<0.05),and kept sta-ble until Dec. CONCLUSIONS:PDCA cycle improves the systemization and standardization of high-alert medication management and multiple department cooperation,and contributes to the safety of drug use.

Objective:To evaluate the accuracy of ultrasound-measured airway indicators in predicting difficult laryngoscopy.Methods:A total of 104 American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-70 yr, undergoing elective operation under general anesthesia, were selected.The airway was evaluated before induction of anesthesia, body mass index (BMI), neck circumference, mouth opening, thyromental distance and modified Mallampati classification were recorded, and mandibular condylar mobility, distance from skin to under surface of tongue, hyomental distance and distance from skin to epiglottis were measured by ultrasound.Anesthesia induction was performed after the end of measurement, and direct laryngoscopy was performed after mask pressure ventilation.Cormack-Lehane (CL) grade was recorded, and difficult laryngoscopy was defined as CL grade≥2b.The patients were divided into non-difficult laryngoscopy group (group NDL) and difficult laryngoscopy group (group DL) according to the view obtainable during laryngoscopy.The factors of which P values less than 0.05 would enter the logistic regression analysis.The accuracy of each index in predicting difficult laryngoscopy was evaluated using the area under the receiver operating characteristic curve (AUC) and 95% confidence interval (CI). The critical value was determined according to Youden index, and the sensitivity and specificity were calculated. Results:Compared with NDL group, BMI, depth of epiglottis and the incidence of modified Mallampti≥grade Ⅲ were significantly increased, and the mouth opening and thyromental distance were decreased in goup DL ( P<0.05). The AUC (95%CI) of modified Mallampti classification and the depth of epiglottis for difficult laryngoscopy prediction were 0.728 (0.619-0.836) and 0.833 (0.743-0.924), respectively.When the critical value of depth of epiglottis was 2.125 cm, the sensitivity and specificity of predicting difficult laryngoscopy were 65.71% and 89.86%, respectively. Conclusion:Ultrasound-measured depth of epiglottis can accurately predict the difficult laryngoscopy.

Objective: To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants. Methods: A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old. Results: Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively). Conclusion Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system.