A total of 60 infants with severe persistent pulmonary hypertension (PPHN) at our NICU from January 2006 to December 2012 were divided into research group[(n =32,high-frequency oscillatory ventilation(HFOV) plus sildenafil)]and control group (n =28,HFOV only).Mean pulmonary arterial pulmonary arterial (MPAP),blood gas analysis,oxygenation index (OI),PO2 to fraction of inspired oxygen ratio (PO2/FiO2) before and after treatment were compared between two groups.After 3-day treatment,MPAP (mm Hg)(32 ±6) vs.(43 ±9)mm Hg,PCO2(mm Hg)(36 ±9) vs.(43 ±9),OI(56 ±22) vs.(85 ±21) in research group were significantly lower than those in control group(P ＜ 0.05) ; in comparison with control group,PO2(mm Hg) (89 ±15) vs.(72 ±22),PO2/FiO2(mm Hg) (223 ± 18) vs.(196 ±24) in research group were significantly higher(P ＜ 0.05).The time of ventilation use (d) (5.4 ± 1.3) vs.(6.3 ± 1.6) in research group was shorter than that of control group(P ＜0.05) while research group showed a higher clinical efficiency rate(％) (81.2 vs.50.0) (P ＜0.05).A combination of HFOV and sildenafil for severe PPHN can significantly reduce MPAP,shorten the duration of ventilation use and improve cure rate.

Objective To analyze the prognosis of 225 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods, and investigate the practicality and predictive value of the clinical staging. Methods From March 2001 to July 2007, 225 patients with esophageal carcinoma received 3DCRT treatment. The prescribed doses were ranged from 5000 -7000 cGy with the median dose of 6400 cGy, 25 patients received accelerative radiation of 300 cGy per fraction after conventional radiotherapy of 3000 -4000 cGy, 57 patients received concurrent chemotherapy with or without consolidation chemotherapy. All the patients were divided into subgroups of different T stages, different N stages and different TNM stages. Local control rates, survival rates were observed and Cox regression analysis were performed to search valuable prognostic factors. Results The following-up rate was 99. 6%. The 3-and 5-years following-up number were 116 and 33 patients, respectively. The 1 -,3-,and 5-year local control rates were 77. 2% ,48.2% and 34. 5%, respectively. The 1-,3-,and 5-year overall survival rates were 68.4% ,33.7% and 20. 8%, respectively. The median survival time was 20 months. There were significant difference between survival curves for T1-4 stages, N0-2 stages and Ⅰ - Ⅲ stages with x2 value of 13.07,20. 49 and 17.16, with P value of 0. 004,0. 000 and 0. 000, respectively. For the group of stage Ⅰ, Ⅱ and Ⅲ, the 1-,3-,and 5-year survival rates were 89.4% ,56. 1% ,and 37.8% ;69.6% ,32. 4% ,and 18.0%and 47. 2%, 19. 5%, and 13. 0%, respectively. According to the result of Cox regression analysis, the tumor length of CT scan, clinical N stage, short term restlt were most valuable predictive factors.Conclusions The clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately, clinical N stage may have more closely association with prognosis, however, some details of the staging program need more consummate.

Objective To discuss the clinical features of HbeAg-negative chronic hepatitis B patients associate with non-alcoholic fatty liver disease (NAFLD), to value the effect of combining treatment on fatty liver influence and antivi-ral therapy. Methods Nighty eight chronic hepatitis B patients with non-alcoholic fatty liver disease (NAFLD) (Liver pa-thology G≥2 or S≥2,HBV DNA>1 × 105 copies/mL), were observed and given antiviral therapy with interferon alpha 1 b for 24 weeks. These patients were divided into combined treatment group (55 cases treated with interferon alpha 1 b combined with Jian Gan Jiang Zhi pills) and control group (43 cases treated with interferon alpha 1 b) in accordance with random num-ber table. All these patients took Leucoson to prevent blood cells reduction. The combined treatment effect was analyzed by observing and comparing biochemical serum change and HBV DNA negative conversion ratio between two groups. Re-sults After 24 weeks of antiviral therapy in Chronic hepatitis B patients with negative HBeAg associated with NAFLD, ALT and AST decreased significantly in both treatment group and control group. And this change is more obvious in treat-ment group than in control group. TC and TG in treatment group and TC in control group were also dropped with treatment (P<0.05). There is significant difference on HBV DNA negative conversion ratio between treatment groupand control group (98.2%vs 86.0%,P<0.05). Conclusion The combination of antiviral treatment and anti fatty liver treatment can obviously improve liver function and blood lipids, increase negative conversion ratio of HBV DNA for chronic hepatitis B patients asso-ciated with NAFLD.

Objective PSGL-1 is specifically expressed in leucocytes.The aim of this study was to explore the changes of myeloid-derived suppressor cells (MDSCs) in the spleen and bone marrow in PSGL-1-deficient mice.Methods PSGL-1 -/-mice were used in the experiment.After identification of the offsprings, flow cytometry was used to test the expression of CD11b and Gr-1 in C57 and PSGL-1 -/-mice.Results Compared with the C57 mice, the expression of MDSCs was up-regulated in the PSGL-1-deficient mice ( P <0.001).Conclusion The expression of MDSCs is upregulated in PSGl-1-deficient mice.

Objective To study the clinical effects of pulmonary recruitment maneuvers combined with pressure regulation volume control (PRVC) in the treatment of severe respiratory distress syndrome (RDS) in premature infants.Method From July 2015 to September 2016,preterm infants of grade Ⅲ-Ⅳ RDS who received PRVC treatment in neonatal department of Huai'an Maternal and Child Health Hospital were assigned into recruitment maneuver group and control group (without recruitment maneuver) using randon number table.The ventilator parameters were observed at 1,2,6,12,18 h and 24 h after ventilation.Recovery rate,duration of oxygen therapy and ventilation,duration of hospital stay,incidence of second dose of pulmonary surfactant and complications were compared between two groups.Result A total of 18 cases were included in recruitment maneuver group and 19 cases in control group.The recovery rate of recruitment maneuver group was higher than control group (16/18 vs.10/19).The duration of oxygen therapy [(6.6 ± 2.3) d vs.(11.8 ± 3.0) d],duration of ventilation [(4.1 ± 2.3) d vs.(6.4 ± 2.8) d],duration of hospital stay [(26.7 ± 7.0) d vs.(33.0 ± 8.4) d] in recruitment maneuver group were significantly shorter than control group (P ＜ 0.05).The proportion of bronchopulmonary dysplasia (1/18 vs.8/19),retinopathy of premature (1/18 vs.7/19),patent ductus arteriosus that require medication closure (1/18 vs.7/19)and incidence of second dose of pulmonary surfactant (2/18 vs.9/19) in recruitment maneuver group were significantly lower than control group (P ＜ 0.05).While the complication of air leak,necrotizing enteritis,Ⅲ-V grade intracranial hemorrhage showed no significant differences between the two groups (P ＞ 0.05).Conclusion Recruitment maneuvers combined with PRVC in treatment of severe RDS premature infants can improve recovery rate and oxygenation.It can also shorten the duration of oxygen therapy,ventilation and hospital stay.It can reduce the incidence of bronchopulmonary dysplasia and retinopathy of premature.It is worth spreading in clinical practice.reduce the incidence of bronchopuhmonary dysplasia and retinopathy.It is worthy of promotion.

Objective To study on imagination features of tumor thrombi in the portal vein of primary liver cancer (PLC). Methods We established a new type system of tumor thrombi, with Ⅰ 0 to Ⅳ, a total of 5 types and 8 sub-types in the portal vein of PLC based on normal intrahepatic portal vein anatomy and growing features of the tumor thrombi. The relationship between the types and the imaging diagnosis of 130 PLC cases with tumor thrombi in the portal vein was studied. Results 85%(110/130) cases of PLC with tumor thrombi in the portal vein belongs to type Ⅱ or Ⅲ when being first diagnosed in the hospital. The resectability rates for type Ⅰ, Ⅱ, Ⅲ, Ⅳ were 62%(5/8), 16%(10/62), 10%(5/48), 0 (0/12), respectively, and chemoembolization therapy (TACE) was given in 38%(3/8), 40%(25/62), 27%(13/48), 16%(2/12), respectively. Conclusions The new types of tumor thrombi are helpful for diagnosis and treatment of PLC with tumor thrombi in the portal vein.

Objective To study the relationship between gastroesophageal varices and bleeding and portal venous tumor thrombi in patients with hepatocellular carcinoma(HCC). Methods From Jan. 2000 to Jan. 2003, 84 HCC patients with portal vein tumor thrombi were divided into Ⅰ～Ⅳ groups according to Ⅰ～Ⅳ types of tumor thrombi. The grade of gastroesophageal varices, the median survival time and the death cause for group Ⅰ～Ⅳ were retrospectively analyzed. Results Mild grade of gastroesophageal varices accounted for 64.7%, 6.0%, 85.7%,100%, respectively in group Ⅰ(n=17), Ⅱ(n=26),Ⅲ( n=35) and group Ⅳ(n=6),respectively. Severe varices were found in less than 5% in all four groups. The median survival periods were 10.1, 7.2, 5.7 and 3.0 months, respectively (P=0.0001). Most cases died from esophageal and gastric variceal bleeding and hepatic failure, with each accounting for about 50% of the mortality in all the 4 groups. Conclusions Portal venous tumor thrombi of HCC patients was not the major cause leading to esophageal and gastric varices and bleeding.

Objective To investigate the clinical and neuroimaging features of Vogt-KoyanagiHarada syndrome ( VKH ).Methods Cerebrospinal fluid ( CSF ), neuroimaging examination, clinical manifestation and pharmacotherapy features were investigated in 5 patients diagnosed as VKH. ResultsAll 5 patients were diagnosed as uveitis in the early stage of disease.All patients suffered “ headache”.Meningeal irritation sign was appeared in 3 cases. The MRI enhanced scan of all 5 cases showed abnormal enhancement of meninges. CSF examination showed increased leukocyte number ((4--196) × 106/L). All patients were alleviatedwith combination therapyof high dose of steroid with cyclophosphamide.ConclusionsVKH is a systemic disease that usually involving the uvea, central nervous system, internal ear and the skin. MRI and CSF examination are valuable for diagnosis. High dose of steroid combined with cyclophosphamide is an effective therapeutic strategy.

Objective To test the effect of the cluster management strategy in the hospital of ICU patients, in order to ensure the safety of the transhipment of the ICU patients. Methods From February 2016 to November 2017, 351 cases of ICU patients in a three class first class cancer hospital were selected as the subjects, including 182 cases in the control group from February 2016 to December 2016 and 169 cases in the experimental group from January 2017 to November 2017. The patients in the control group carried out conventional traditional transport management measures, and the patients in the experimental group were transported by cluster management strategy. The incidence of adverse events in the hospital transhipment was observed and compared. Results The test group received the cluster management strategy intervention ICU hospital transport of patients with adverse events (associated with disease, correlation, and transfer of personnel information, poor communication pipeline displacement, arteriovenous catheter prolapse, monitor lead loose, monitor micro pump power supply, and related equipment) rates were 15.38％(26/169), 9.47％(16/169), 3.55％(6/169), 2.96％(5/169), 2.37％(4/169), 2.37％(4/169), 2.96％(5/169), 5.92％(10/169), significantly lower than the control group were 29.12％(53/182), 26.92％(49/182), 10.44％(19/182), 7.69％(14/182), 7.14％(13/182), 7.69％ (14/182), 11.54％ (21/182), 20.33％ (37/182), the difference was statistically significant (χ2=3.835-17.695, P<0.01 or 0.05). Conclusion Cluster management strategy can improve the safety of ICU patients in hospital transport, and suggest extensive clinical promotion.