Objective To explore the efficacy and safety of clinical application of bronchofibroscope (BFS) in PICU. Methods Seventy-nine critically ill children in our PICU were operated with BFS in 89 cases and the etiology of these children was analyzed. The blood-gas analysis and oxygenation index both before and after the treatment had been compared, and syndrome was observed as well. For 40 cases in which critically ill children received bronchoalveolar lavage in addition to mechanical ventilation, and the index of respiratory mechanics was analyzed. Analysis and summary had been performed on the culture results of bronchoalveolar lavage fluid in 74 cases. Results The primary disease in these cases was mainly respiratory diseases (64/79). There was no major change in oxygenation index and blood pH ( P ＞0. 05 ) before and after operation with BFS. No severe syndrome,such as sudden cardiac arrest and pneumothorax, was recorded. However,transient decrease in SpO2 was most frequently observed in minor syndromes (15/79). The children treated with mechanical ventilation were recorded with significant decrease in air way resistance ( P ＜ 0. 05 ) after bronchoalveolar lavage. However,dynamic compliance and work of breathing only changed slightly (P ＞0. 05 ). The culture positive rate of bronchoalveolar lavage fluid was 29. 1% (23/79) ,mainly gram-negative bacteria, which coincided with disease spectrum of PICU. Conclusion The application of BFS in PICU can improve salve and tracheobronchial management for critically ill children. The diagnosis and treatment is safe and reliable by strictly grasping the examination indication by BFS under the custody of PICU.

ObjectiveTo study the causes and risk factors of childhood accidental injuries as a reference for prevention.MethodsA retrospective analysis was made on the clinical data of 4 116 cases of childhood accidents admitted to children's hospital of Fudan university from Jan 1,2005 to Aug 31,2009.ResultsThe 4 116 cases with accidental injuries were found to account for 4.35 ％ (4 116/94 579) of all inpatients during the same period.Ratio of male to female was 2.01∶ 1.The most common causes of injury were accidental falls (30.73％,1 265/4 116),traffic accidents (23.71％,976/4 116) and accidental drops (11.59％,477/4 116).Accidental falls were mainly seen in children over one year,traffic accidents mainly occurred in children aged four to seven,while the accidental drops were mainly seen in infants less than oneyear-old.The top three causes of accidental injury with highest mortality rate were airway foreign body,drowning and poisoning.Bone and joint injuries were mostly seen in accidental injury.ConclusionAccidental injury of children has been a serious threat to the lives of children and we should base on the characteristics of children to take preventive measures.

Bromodomain and extra-terminal domain(BET)Bromodomain has become a new target for the treatment of cancers and other human disorders. Nowadays,several classes of its potent and selective small-molecule inhibitors have been identified,many of which are in clinical trials. Preclinical and clinical data have shown that BET Bromodomain inhibitors have good prospects. Howev-er,there are potential therapeutic deficiencies,such as drug resistance. At present,attempts are being made to develop BET Bromodo-main inhibitors and degraders based on polypharmacology,combining BET Bromodomain with other targets of different mechanisms. In this paper,small-molecule kinase/BET inhibitors,small-molecule histone deacetylases(HDAC)/BET inhibitors and BET protein degraders are reviewed,which may provide guidance for further research on BET protein.

Objective To develop a portable aerosol sprayer .Methods With computer aided design(CAD)technology,a three-dimensional model of the aerosol sprayer was built , and the simulation analysis of nozzles was conducted using the computational fluid dynamics ( CFD) technology .Results A model of portable aerosol sprayers was designed .According to simulation analysis , the speed and pressure of aerosol in different locations were obtained and were proved to change with time, providing a theoretical basis for determination of working parameters and structural design parameters of the aerosol sprayer nozzle so that design efficiency and quality could be improved; time and cost could be reduced .Conclusion Through CAD technology,an effective method for rational design and structure optimization of the aerosol sprayer is esta -bished.Hydromechanic problems that used to be solved with physical analogue experiments can be resolved by means of CFD simulation analysis .

ObjectiveTo investigate the therapeutic effect and function mechanism of ginkgo biloba extract (EGb) for severe acute pancreatitis.MethodsFifty - four patients,who were diagnozed according to the inclusion criteria,were divided into two groups at random.They were from the People's Hospital of Anyang City from November 2006 to December 2010.In treatment group,25 patients were treated with integrated EGb and other comprehensive treatment group,and 21 patients completed the treatment; in the the contrast group,the 29 patients were trested with simple comprehensive treatment group,and 23 patients completed the treatment. Comprehensive therapy included Somatostatin and antibiotic,ect. Besides the comprehensive therapy,patients in the treatment group were intra - venously infused with 87.5 mg EGbeveryday.Before the day of treatment,on the 3rd and 7th day after the treatment,blood TNF-α,IL-6 and amylase level were determined.Blood MDA level was measured and Balthazar CT grades was observed before the day of treatment and on the 7th day after the treatment.Abdominal pain,abdominal distension and tenderness were observed.Pancreatic infection incidence rate was compared between the two groups.All experimental data were processed with SPSS version 11. 0 statistical software. Quantitative data were analyzed byRepeated Measurement ANOVA or t - test.Count data were analyzed by x2 test.ResultsThe values of blood TNF-α,IL-6 and amylase level were significantly lower in treatment group than in contrast group on the 3rd and 7th day after the treatment ( P ＜ 0.05 ).The values of blood MDA and Balthazar CT grades were significantly lower in treatment group than in the contrast group on the 7th day after the treatment (P ＜ 0.05 ).There was a significantly shorter period of abdominal pain,abdominal distension and tenderness in treatment group than in contrast group.( P ＜ 0.01 ).The pancreatic infection incidence rate of the treatment group was lower than that of the contrast group ( P ＜ 0.05 ).ConclusionsEGb could alleviate notably the cytokine release,restrain oxidative stress and remove the free oxygen factor,prevent and treat Pancreatic infection and necrosis.

MicroRNAs (miRNAs) are a class of highly conserved non-coding small RNA molecules.They regulate gene expression by inhibiting transcription or translation.Ischemic stroke is one of the major diseases of resulting in death and disability worldwide.The final outcome of its pathological process is neuronal death.Neuronal apoptosis is mainly seen in ischemic penumbra,and saving the neurons in penumbra are the key to the treatment of ischemic stroke.This article reviews the roles of miRNAs in the neuronal apoptosis during cerebral ischemia.

Objective To study the excitability gastrointestinal hormone MTL and inhibitory gastrointestinal hormone SEC expression in the intestinal congestion and the effects of Salvia miltior-rhiza pretreatment at different time limits in 45min of rat hepatic ischemia-reperfusion to explore its possible mechanism and significance. Methods 80 rats were randomly divided into 4 groups: normal control group(CO group), sham-operated group(SO group), injury group(IR group), salvia miltior-rhiza pretreatment group(SM group). Non-invasive artery clamp was used to clip then slacken the he-patic pedicle to produce animal model of ischemia-reperfusion. The clamp time was 45 min. The rats in Salvia miltiorrhiza pretreatment group were injected 40 ml/kg saline with 6 g/kg Salvia Miltiorrhiza from caudal vein 30 min before clamping hepatic pedicle. While in the sham-operated group, the porta hepatis was dissected after laparotomy and hepatic pedicle not clamped. The upper jejunums at differ-ent reperfusion time phases (0 h, 3 h, 12 h, 24 h, 72 h) were made into specimens respectively, and then MTL and SEC immunohistochemical measurement were conducted. Results At 0 min of hepatic ischemia-reperfusion digestive tract congestion, the MTL expression of upper jejunum went down,SEC expression of upper jejunum went up. With the reperfusion time extending, the MTL expression also descended to minimum at 24 h, but SEC expression increased to reach the peak at 24 h. The ex-pression of these 2 hormones gradually returned to normal at 72h. The MTL expression of Salvia milt-iorrhiza pretreatment group was higher, SEC expression of SM group were lower than the IR group in each time phase of reperfusion. Conclusion The intestinal congestive injury caused by liver ischemia can down-regulate the excitability of gastrointestinal hormone MTL and up-regulate the gastrointesti-nal inhibitory gastrointestinal hormone SEC expression at reperfusion to inhibit gastrointestinal motili-ty. Salvia miltiorrhiza preconditioning can partly weaken the descending of jejunal MTL and increasing of the jejunal SEC expression, which may contribute to the early recovery of gastrointestinal motility.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

Objective To thoroughly explore the pathophysiological roles of TIMP-1 during the progressive course of renal diseases, the study was aimed at identifying the functional phenotype of endogenous and exogenous genes in kidneys of human TIMP-1 transgenic mice. Methods Renal histological changes between 3-month-old wild type mice (n=8) and 3-month-old transgenic mice (n=8) were analyzed through PAS staining of paraffin sections. The mRNA and protein expressions of h/mTIMP-1, mTIMP-1, TIMP-2, TIMP-3, MMP-9, MMP-2, and COLⅣ?5 mRNA were detected by Northern blot and Western blot. The activities of gelatinases and TIMP-1 were examined by gelatin zymography and reverse zymography, respectively. Results No difference in histological picture in kidneys was found between wild type and transgenic mice. In contrast with wild type mice, it was found that in kidneys of transgenic mice, the mRNA and protein expressions of h/mTIMP-1 and its activity were up-regulated (P0.05). Conclusion The transgene was expressed steadily in kidneys of human TIMP-1 transgenic mice, and it induced the compensation of MMPs/TIMPs.

[Objective] To search for a new technique for incarcerated annular mixed hemorrhoids (IAMH) . [Methods] One hundred and eighteen cases of IAMH (group A) were treated by double denenate excision-ligation combined with pad preservation and 53 eases (group B) by external-exfoliation and internal-ligation. Cure rate, wound-healing time, anal function and postoperative complications were observed in the two groups. [Results] Cure rate was 96.6% in group A and 84.9% in group B; wound-healing time was (17 ? 5) days in group A and (24 ? 5) days in group B ( P