Objective To investigate the effects of different flow volume of continuous 1:1 blood crystalloid cardioplegia on open heart surgery.Methods Retrospective randomized study was performed on 80 patients undergoing valve replacement and congenital heart disease with 1:1 blood crystalloid cardioplegia by minimum-flow continuous perfusion[0.5ml/(kg·min),group A,40 cases],high-flow continuous perfusion[(2.0 ml/(kg·min),group B,40 cases).The changes of creatine kinase(CK),isoenzyme of creatine kinase(CK-MB),lactate dehydrogenase(LDH),lactic dehydrogenase isoenzyme(LDH_1)were detected before operation and at 6,12,24,48,72 h after operation.Results The cardioplegia liquid was (41.72±7.98)ml/kg in group A,(142.09±9.65)ml/kg in group B,there was significant difference between two groups(P<0.05).During the first 72 h postoperative the value of CK,CK-MB,LDH and LDH1 in two groups were increased to different degree,serum enzymes levd increased significantly between 12,24 h after operation(P<0.05)and return to normal at 72h after operation in two groups.Butbetween two groups there was no significant difference(P＞0.05).ConclusionMinimum-flow continuous perfusion of 1:1 blood crystalloid cardioplegia appears to be superior in safety,decrease of myocardial enzymes integrity.

Acute kidney injury (AKI) is the most common and serious complication in the intensive care unit.The mortality of AKI is still as high as 60％ in critically ill children because of lack sensitive and special early predictive biomarker.Neutrophil gelatinase-associated lipocalin is one of the most promising early diagnose and predict biomarkers for AKI,produced and secreted by kidney tubule cells at low levels,but increasing dramatically in the urine and serum after ischemic, sepsis, or nephrotoxic injury of the kidneys.This review is to summarize the role of neutrophil gelatinase-associated lipocalin as an early biomarker of AKI with different clinical settings in children.

Diffuse large B-cell lymphoma (DLBCL) is the aggressive non-Hodgkin's lymphoma.Rituximab in combination with chemotherapy had improved the outcomes,however,a substantial proportion of these patients transfer into refractory or eventually relapsed lymphoma after using R-CHOP as a front-line treatment regimen with poor prognosis.With the research development on DLBCL and its related gene,it is confirmed that gene biological targeted therapy can improve the prognosis of patients with refractory /relapsed DLBCL (RR-DLBCL).Recently,some new targeted therapies become research hotspots.This review will focus on recent development and future direction of biological targeted treatment in RR-DLBCL.

Objective To explore the effect of cognitive therapy on patients with traumatic paraplegia.Methods Toally 100 traumatic paraplegia patients were randomly divided into observation group and control group with 50 cases in each.The control group received routine nursing intervention and the observation group cognitive therapy on the basis of intervention for the control group.The two groups were compared in terms of anxiety,depression,mental health,suicidal ideation and quality of life by the instruments of self-rating anxiety scale (SAS),self-rating depression scale (SDS) and suicide attitude questionnaire (SQA) before and after intervention.Results Before the intervention,the scores by SDS,SAS scores and SQA were insignificant different between the groups (P＞0.05).Mter the intervention,the scores on suicidal ideation in the observation group were significantly higher and the quality of life were significantly higher and the depresion and anxiety and the mental health status were lower than those of the control group (P ＜0.05).Conclusion The cognitive therapy for the patients with traumatic paraplegia can significantly alleviate their depression and anxiety,reduce their suicidal ideation and improve the quality of life.

Objective To compare the characteristics of respiratory distress syndrome(RDS) between early preterm infants and late preterm(LP) infants,and to investigate the high-risk factors and clinical characteristics of RDS in LP infants.Methods A total of 240 premature infants with RDS treated in our hospital from January 2014 to January 2015 were selected and divided into 2 groups according to the gestational age(GA),143 cases in early preterm group (GA <34 weeks) and 97 cases in LP group(GA 34-36 weeks).The basic situation,high risk factors in perinatal period,clinical characteristics,treatment and prognosis in RDS premature infants were retrospectively analyzed.Results The delivery mode in the LP group was mainly dominated by cesarean section,the cesarean section rate reached 83.51%,which was significantly higher than that in the early preterm group (P<0.05).The premature occurrence rate caused by cesarean section because of premonitory uterine rupture was higher (27.84%);the treatment effect of pulmonary surfactant(PS) and noninvasive assisted ventilation therapy in the LP group was inferior to that in the early premature group,moreover the mechanical ventilation rate was higher,the duration of mechanical ventilation was longer;the incidence rates of pulmonary hypertension and intrauterine infection were higher than those in the early preterm group.Conclusion LP infants with RDS are mainly dominated by cesarean section without onset of labor process,intrauterine infection may be its risk factor,PS use is effective,but its effect is more poor than that in the early preterm group,the mechanical ventilation rate in the LP group is higher,but the prognosis is good.

Objective To observe the influence of ulinastatin for the gastrointestinal function and inflammatory stress state of patients with severe acute pancreatitis.Methods 46 patients with severe acute pancreatitis in our hospital from October 2015 to July 2016 were randomly divided into control group and observation group with 23 cases in each group, the control group was treated with routine treatment of severe acute pancreatitis , the observation group was treated with ulinastatin on the basic treatment of control group, then the serum gastrointestinal hormones before and after meal and inflammatory stress indexes of two groups at different time before and after the treatment were compared .Results The serum gastrointestinal hormones before and after meal and inflammatory stress indexes of two groups before the treatment were compared,the differences were not significant,while the serum gastrointestinal hormones and inflammatory stress indexes of observation group after the treatment were all better than those of control group,the differences were all significant(all P<0.05).Conclusion The ulinastatin can significantly improve the gastrointestinal function and inflammatory stress state of patients with severe acute pancreatitis, so the application value in the patients with severe acute pancreatitis is higher.

Objective To observe the short-term fusion rate of using osteophyte filled cage in ante-rior cervical disectomy and fusion. Methods From May 2007 to May 2009, 103 patients receiving anterior cervical disectomy, spine fusion by different surgeons were performed with cages containing exclusively au-tologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space. There are 69 males, 34 females, from 25 to 77 years of age, average 53.6 years. 60 patients received one level fusion. 33 and 10 patients received two-level and three-level fusion respectively. Patients were re-viewed 3 months after operation and fusion was evaluated by X-ray film, reconstructive CT and MR. Results 1. Only 1.9% (2/103) of patients' X-ray films indicate non-fusion (internal fixation failure) while 31.7% (32/ 103) of patients' CT and 30.1% (31/103) of patients' MR indicate non-fusion or being confusing to make a diagnosis. 2. The diagnostic coherence between CT and MR as to evaluate fusion is good (kappa=0.686, P= 0.00). 3. The total fusion rate was 77.7%(80/103) while the highest fusion rate achieved by single surgeon was 90%(18/20). The total one level fusion rate was 80%(48/60) while the highest rate by single surgeon was 88.2%(15/17). The total two-level fusion rate was 78.6%(26/33) while the highest rate by single sur-geon was 90%(9/10). The total three-level fusion rate was 60%(60/100) while the highest rate by single surgeon was 100%(3/3). No statistic significant difference in fusion rate was found between any two of the three groups. Conclusion The method of using osteophyte filled cage can acquire ideal short-term fusion rate in one and two-level anterior cervical disectomy, fusion and plate fixation.

Objective To investigate the influence of inspired oxygen fraction (FiO2) on the ratio of PaO2/FiO2(P/F) during the implementation of lung protective ventilation strategy in patients with acute respiratory distress syndrome(ARDS) in order to unravel its clinical significance. Method This was a prospective study of 16 selected patients with ARDS treated with mechanical ventilation ( MV ) to get ratio of P/F in range of 100 to 200 by PEEP≥5 cmH2O and high inspired oxygen. After lung recruitment maneuvers by BiPAP with high pressure (PH) of 40 cmH2O for40 s, the MV was maintained the basic requirement for stabilizing the patients for 30 minutes. A series of FiO2 were set at fractions of 0.5,0.6,0.7,0.8,0.9 and 1in random sequence, and the changes of respiratory mechanics, blood gas and hemodynamics under the different concentrations of FiO2 were analyzed by using SPSS version 13.0 software. Results ( 1 ) The ratio of P/F increased as FiO2 increased, and it's significant as FiO2 increased to 0.7 or above. As the fractions of FiO2 were set at 0.5 and 1. O, the ratios of P/F changed in 24.70% ± 23.36% respectively. ( 2 ) Of them,6 patients ( 37.5% ) treated with FiO2 set at 0.5 had the ratio of P/F ＜ 200, and the fraction of FiO2 was increased to 1.0, the P/F ＞ 200. (3) FiO2 and Qs/Qt were negatively correlated ( r = - 0.390, P = O. 027 ),the higher inspired oxygen fraction, the lower shunt. When the fractions of FiO2 were set at 0.5 and 1.0 ,there was a positive correlation between △Qs/Qt and △P/F( r = 0.82, P = 0.005 ). Conclusions The inspired oxygen fraction affects the ratio of P/F, which may be resulted from shunt and it may influence the diagnosis of ARDS.

Imatinib is an effective tyrosine kinase inhibitor, used in the treatment of advanced or inoperable gastrointestinal stromal tumors. Despite its efficacy, resistance is often developed among a portion of patients. Resistance to imatinib can be divided into primary and secondary resistance, with the latter becoming the focus of many recent researches. Research on the mechanisms of secondary resistance may lead to the identification of novel therapeutic strategies.

Objective To explore CT findings of pulmonary non‐tuberculosis mycobacteria (NTM ) disease .Methods Forty‐two patients with pulmonary NTM disease confirmed by the biphasic medium flora identification (NTM group) ,and 60 patients with lung tuberculosis (TB group) confirmed by the tubercle bacillus cultivation and flora identification in our hospital were included in the ret‐rospective analysis .9 CT signs and distribution features of the lesions were analyzed and compared between the two groups .The difference was statistically significant if P<0 .05 .Results Pulmonary NTM disease was more common in female patients (χ2=5 .500 ,P=0 .019) ,and the mean age was significantly older than that of the tuberculosis (t=3 .456 ,P=0 .001) .The detection rate in the right middle lobe and left tongue section was high in NTM group than in TB group (χ2 =8 .361 ,P=0 .004) .Logistic regression showed that bronchiectasis and bronchial stenosis or occlusion were independent risk factors for the NTM disease .They were important signs for the differential diagnosis from tuberculosis .Conclusion MSCT findings of pulmonary NTM disease have certain characteristic , which are helpful for the diagnosis .