Objective To investigate the clinical effect of milrinone in the treatment of children with congenital heart disease complicated by severe pneumonia and heart failure. Methods 94 patients with congenital heart disease complicated with severe pneumonia and heart failure in our hospital from March 2014 to February 2016 were selected,and randomly divided into experimental group and routine group,47 cases in each groups. The routine group were treated with conventional treatment, the experimental group in the conventional group received routine treatment based on the same given milrinone treatment. The clinical efficacy, symptom disappearance time and adverse reactions were compared between the two groups. Results The treatment in the experimental group the total efficiency (93.62%) was significantly higher than that of the conventional treatment group with the total effective rate (78.72%), significant difference, statistically significant (P<0.05); the experimental group in children with fever, cough, rales and other symptoms disappeared time is lower than the conventional group, the data had significant difference, has statistical significance (P<0.05); two groups of patients during treatment were not any serious adverse reactions, the adverse reaction condition no difference does not have statistical significance.Conclusion The clinical effect of milrinone in the treatment of children with congenital heart disease complicated by severe pneumonia and heart failure significantly, clinical efficacy, low incidence of adverse reactions, worthy of promotion.

Objective Bone cement joint prosthetic aseptic loosening always occurs in the bone cement-bone interface, while the mechanical strength of the interface mainly depends on the microstructure and adhesive strength.The aim of this study was to ex-plore the bone microstructure and the cement bone interfacial biomechanics of osteoarthritis(OA) and rheumatoid arthritis(RA), and also discuss the correlation. Methods Twenty trabecular bone specimens of tibial plateaus were taken from OA and RA patients who underwent total knee arthroplasty( TKA) .The microstructural parameters of the trabecular bone specimens were measured by Skyscan1176 microcomputed tomography.The bone specimens were made into cementbone models, which were tested by INSTRON strength tester.The association of bone microstructure and interfacial shear stress was analyzed subsequently. Results ①Bone volume fraction ( BV/TV) ( r=-0.313) , trabecular thickness ( Tb.Th) ( r=-0.340) ,trabecular spacing ( Tb.Sp) ( r=0.345) of OA had obvious correlation to shear strength (P<0.05).The cement-bone interfacial strength of medial tibial plateaus[(87.45±52.50)N] was lower than lateral tibial plat-eaus[(177.25±71.11)N] of OA (P<0.05).②Bone volume fraction (BV/TV)(r=0.343), trabecular number (Tb.N)(r=0.391) of RA had obvious correlation to shear strength (P<0.001).The cement-bone interfacial strength of lateral tibial plateaus[(62.23±46.22) N] was lower than medial tibial plateaus[(79.20±56.37N)] of RA (P<0.05).③The interfacial strength of OA[(132.35±76.64)N] was higher than RA[(71.05±51.55)N] (P<0.05). Conclusion There are differences of microstructure between OA and RA, which lead to the distinction of strength of cement -bone interface.And it has a certain guiding role of analyzing the biomechanics in TKA.

Aims To construct the N-terminal Strep-tagged ( NS-tagged) fusion protein expression vector, and to apply the vector to express NS-tagged fusion proteins of Chlamydia RNA polymerase subunit. Meth-ods By using PCR method, NS fusion protein tag and a new multiple cloning sites (MCS) were inserted into pET21c-DH plasmid by primers to replace the original T7 protein tag and MCS. The newly introduced Not I cutting site was chosen for self-ligation of PCR prod-uct. Then, the cyclized PCR product was transformed into DH-5α competent cells. The positive clones were selected by PCR and sequencing. To get NS-tagged fu-sion proteins of chlamydial RNA polymerase subunits, the α, β and β′ subunits were inserted between BamH I and Sal I cutting sites of the newly constructed ex-pression vector. Then, the NS-α, NS-β and NS-β′ ex-pression vectors were transformed into Arctic Express expression cells. The fusion protein expression statuses of transformed cells were identified by Commassie blue staining and Western blot. Results The NS-tagged fusion protein expression vector pET21c-NS-MCS was successfully constructed, and NS-α, NS-β and NS-β′fusion proteins were obtained by using this newly con-structed expression vector. Conclusions In this pro-ject, we constructed an NS-tagged fusion protein ex-pression vector and applied it to express NS-α, NS-βand NS-β′ fusion proteins. Our study can lay a solid foundation for the study of transcriptional regulation of Chlamydia genes.

ObjectiveTo understand the relationship between mycoplasm load in bronchoalveolar lavage lfuid (BALF) with the status of Th1/Th2 immune response in children withMycoplasma pneumoniae pneumonia (MPP).MethodsThe levels of IL-4, IFN, IL-8 , TNF-α in BLAF and total IgE, ECP in serum from 90 children with MPP were measured by ELISA.MP DNA in BALF was detected quantitatively by lfuorescent real-time PCR. Children with MPP (n=90) were divided into two groups of low MP-DNA load (n=24) and high MP-DNA load (n=26) according to the copies of MP DNA in BALF. The cytokines in BALF, and total IgE and ECP in serum were compared between the two groups. The relationship between the levels of cytokines in BLAF and the copies was evaluated.ResultsThe levels of IL-4 and the IL-4/IFN ratio in BALF from the high DNA-load group were signiifcantly higher than that of the low group (t=4.280, 2.076, allP<0.05). The level of IL-4 was signiifcantly correlated with the copies of MP-DNA in BALF from children with MPP (r=0.509,P<0.05). The percentage of total IgE and ECP positive result in serum from the high DNA-load group is higher than that of the low group. (χ2=24.638, 6.392,allP<0.05).Conclusion Infection with high-load MP in children may cause the imbalance of Th1/Th2. And the Th2 cytokines response seems predomi-nant.

Electrocardiography ; Humans ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

OBJECTIVETo observe the efficacy of Xingnaojing Injection (XI) in treatment of sepsis-associated encephalopathy (SAE).

METHODSTotally 65 SAE patients were retrospectively analyzed at EICU from September 2010 to September 2013. They were assigned to the control group (32 cases) and the treatment group (33 cases) according to whether they received XI. Patients in the control group received anti-infection and symptomatic support, while those in the treatment group were intravenously injected with XI at 20 mL per day for additional 7-10 days. The fever clearance time, Glasgow coma scale (GCS), C-reactive protein (CRP), neuron-specific enolase (NSE), and improvement of electroen-cephalogram (EEG) were observed in the two groups.

RESULTSCompared with the control group, the fever clearance time was shortened, CRP levels decreased, GCS score and efficacy of EEG was alleviated in the treatment group after treatment with statistical difference (P < 0.05). No adverse reaction occurred during medication.

CONCLUSIONX1 was safe and effective in treatment of SAE.

C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Injections ; Phosphopyruvate Hydratase ; metabolism ; Sepsis-Associated Encephalopathy ; drug therapy ; Treatment Outcome

Objective To evaluate the effect of colonoscopy with a transparent hood on the adenoma detection rate.Methods A prospective randomized controlled trial was performed.A total of 376 patients,who underwent colonoscopy for screening colorectal polyps,were randomly allocated to 2 groups:transparent hood group (TH group,n =190) and conventional colonoscopy group (CC group,n =186).Only one endoscopist performed all the colonoscopy examinations,recorded the withdrawal time,bowel preparation status,the number,shape,location,size of adenoma when withdrawing the endoscope.All the adenoma were removed under the colonoscopy.The pathological results were recorded,and the data and relative factors were analysed.Results A total of 317 adenomas were detected in 175 patients:172 adenomas in 99 patients of TH group,145 adenomas in 76 patients of CC group.Total ADR was 46.54％.ADR of TH group was 52.11％ and ADR of CC group was 40.86％ (P =0.029).A total of 40 adenomas were found behind the fold,32 in TH group and 8 in CC group(P ＜ 0.01).In cecum and transverse colon,there were more adenomas in TH group than in CC group.In cecum,there were 23 adenomas found in TH group,6 adenomas in CC group(P ＜0.05).In transverse colon,there were 46 adenomas in TH group,25 adenomas in CC group (P ＜ 0.05).In descending colon and rectum,there were more adenomas in CC group than in TH group.In descending colon,there were 16 adenomas TH group,and 30 adenomas in CC group.In rectum,there were 14 adenomas in TH group,24 adenomas in CC group(P ＜0.05).There was no significant difference in size or shape of adenomas found between two groups.Conclusion Colonoscopy with transparent hood for screening can increase the adenoma detection rate,especially the adenoma behind the fold.

BACKGROUND:Adherent migration of vascular smooth muscle cells and proliferated remodeling of vessel walls following vascular endothelial injury play a key role in onset of restenosis after percutaneous transluminal coronary angioplasty,while expression and phosphorylation activation of focal adhesion kinase are attacked during this period.OBJECTIVE:To observe the interventional effect of angiotensin receptor antagonist,telmisartan,on the expression and activation of focal adhesion kinase during vascular-injured remodeling.DESIGN:Randomized controlled animal study.SETTING:Shenzhen Center for Chronic Disease Control and Prevention;Department of Cardiology,Affiliated Hospital of Xianning Medical College;Department of Cardiology,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology.MATERIALS:The experiment was carded out in the Cardiovascular Laboratory,Wuhan Tongji Hospital from March to May 2005.A total of 36 male Wistar rats weighing 300-360 g were randomly divided into control group,model group and treatment group with 12 in each group.METHODS:Aortal restenosis models were established after endothelial denudation.Foley's tube technique was used to strip vascular endothetium of rats in the model group and the treatment group;while,rats in the control group and the model group were fed and drunk normally; in addition, rats in the treatment group were also given 5 mg/(kg·d) telmisartan solution.Thirty clays after successive administration,vessels at injured sites were collected to observe the morphological changes and extract RNA and protein.Reverse transcriptase polymerase chain reaction (RT-PCR) was used to measure mRNA expression of focal adhesion kinase and Westem blot technique was USod to measure total protein and phosphorylated protein of focal adhesion kinase.MAIN OUTCOME MEASURES: Proliferation of vessel wall at injured sites; mRNA expression, total protein and phosphorylated protein of focal adhesion kinase at injured sites at 30 days after administration.RESULTS:A total of 36 rats Were involved in the final analysis.Thirty days after operation, aortic tunica intima was thickened in the model group, mRNA expression of focal adhesion kinase was increased, and total protein and phosphorylated protein were higher in the model group than those in the control group;however,proliferation of tunica 5ntima vasorum was lightened in the treatment group, activity of mRNA expression of focal adhesion kinase was decreased, and total protein and phosphorylated protein were lower in the treatment group than those in the model group.CONCLUSION: Telmisartan can remarkably relieve proliferation of tunica intima after denudation and inhibit expression and activation of focal adhesion kinase after vascular injury.Effect of telmisartan on vascular-injured remodeling may be related to inhibiting expression and activation of focal adhesion kinase.

Objective To explore the clinical features and pathogenic genes of sialidosis. Methods The clinical data and genetic test results of a family with sialidosis were retrospectively analysed. Results The proband was a 13-year-old girl who presented with limb pain at age 7, followed by progressive vision loss and convulsive seizure. In addition, she also had the sign of ataxia. Fundus examination showed optic atrophy in her eyes. Visual evoked potential showed that the latency of binocular P100 was significantly prolonged. The elder brother of the proband showed similar manifestation. PCR was used to amplify the exons and exon-intron boundaries of the NEU1 gene, and DNA direct sequencing was used to detect the mutation in this gene. It was found that both proband and her brother carried two known pathogenic heterozygous mutations in the NEU1 gene, c.239C>T (p.P80L) and c.544A>G (p.P80L) respectively from both their mother and father of normal phenotype. Conclusion The causative mutation of the NEU1 gene in the family of sialidosis has been defined.

Biomarkers ; blood ; Biopsy, Needle ; utilization ; Hepatitis C ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; pathology