The prevalence of the metabolic syndrome (MS) in children has increased over the last decade.Research shows that the microelements including zinc,copper,iron,chromium,and selenium are relevant with the development of childhood MS.This article summarizes the recent advances in the relationship between microele-ments and MS.

Endomyocardial Fibrosis ; Fibroblasts ; Humans ; Myocardium ; pathology

Objective To assess the diagnostic value of apparent diffusion coefficient (ADC) in the classification of solid nodules of brain parenchymal tuberculosis and response evaluation of patients.Methods Brain parenchymal lesions of 128 patients,with clinically and (or) pathologically confirmed brain parenchymal tuberculosis were analyzed retrospectively.Results Significant differences were observed in the average ADC values between enhanced areas and edematous areas of homogeneously enhancing and ring-enhancing lesions in all 128 patients before treatment(P<0.05).In 52 patients, the average ADC values of enhanced areas and edema areas in homogeneously enhancing and ring-enhancing lesions were significantly different before and after the treatment(P<0.05).Conclusion The ADC values in different areas of solid nodules of brain parenchymal tuberculosis are different, so can be used as a supplement to magnetic resonance imaging diagnosis and classification.After anti-tuberculosis treatment, the ADC values can be used as an observational indicator in follow-up.

Objective To observe the changes of urinary microalbumin(UMA),and explore the relation between early impairment of renal function and level of UMA in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods OSAHS patients(n=67)and healthy control subjects(n=82).Then body parameter,serum creatinine(SCr),blood urea nitrogen(BUN),glomerular filtration rate(GFR)and UMA were determined in both groups.Furthermore,linear correlation was performed between UMA and body parameter,SCr,BUN,GFR and sleep-breathing parameters of patients with OSAHS,respectively.Results UMA level was higher in OSAHS patients than that in control subjects(P＜0.01).UMA level in OSAHS patients was correlated positively with body mass index(BMI),apnea hypopnea index(AHI),percentage of sleep time below 90% oxygen saturation (SaO2＜90%)and percentage of sleep time the total duration of apnea/hypopnea,respectively,and those were correlated negatively with the lowest SaO2 and the average lowest SaO2 respectively,but those had no correlativity with age,stature,waistline,neckline,SCr,BUN and GFR(P＞0.05).Conclusions UMA level increases in patients with OSAHS.The detection of microalbumin in urine is helpful in early diagnosis in OSAHS renal damage patients.

Objective To investigate the effect of percutaneous eoronary intervention (PCI) on the prognosis of acute ST-segment elevation myocardial infarction (ASTEMI) in the elderly.Methods The 1318 ASTEMI patients in our hospital from June 1998 to June 2008 were retrospectively analyzed. Among them, 338 (25.6%) elderly patients were over 60 years old, and 316patients consistent with inclusion and exclusion criteria were consecutively enrolled in our research.Then they were divided into two groups: PCI group (136 cases, 43.0%) and conservative drug treatment group (180 cases, 57. 0%). The clinical data of study objects were collected. Then they were followed up regularly for two years. Results There were no statistically significant differences between the two groups in mean age, gender, hypertension, diabetes, dyslipidemia, excess smoking,wine and family history (all P＞ 0.05). And there were no statistically significant differences in anterior wall STEMI, Killip Ⅲ-Ⅳ class, thrombolysis therapy and malignant ventricular arrhythmia (all P＞0. 05). Most of the objects proceeded therapeutic lifestyle improvements, such as giving up smoking, restricting wine, regulating diet, losing weight and insisting on exercises, and so on.Secondary prevention drugs of acute myocardial infarction including angiotensin converting enzyme inhibitor, angiotensin receptors blockers, beta receptor, aspirin and statins were regularly administrated in the two follow-up years. In the retrospective research, incidence rates of reinfarction, NYHA (New York Heart Association) Ⅲ-Ⅳ class heart function and one-month mortality were much higher in conservative treatment group than in PCI group (17.2% vs. 2. 2%, OR=9. 224,95% CI: 2. 756-30. 857; 31.1% vs. 8.1%,OR=5.132, 95%CI: 2. 568-10. 257; 8. 3% vs. 1.5%,OR= 6. 091, 95% CI: 1. 369-27. 105, respectively; all P ＜ 0. 01). Above all, one and two-year mortalities were much higher in conservative treatment group than in PCI group (21.1% vs. 2. 2 %,OR=11.864, 95%CI: 3.577-39.349; 32.2% vs. 4.4%, OR=10.301, 95%CI: 4.289-24.736,respectively; all P＜0. 01). Conclusions PCI may reduce the re-infarction, NYHA Ⅲ-Ⅳ class heart function and one-month mortality, especially so in view of the one and two-year mortality. PCIcan significantly improve the prognosis of ASTEMI in the elderly.

The training of airway management plays a vital role in standardized residency training plan during the rotation in the department of anesthesiology.Problem based-learning and airway simulation practice should be applied step by step based on the different requirements of standardized residency training plan.The training should be started from mask ventilation to endotracheal intubation,meanwhile clinical thinking ability and teamwork ability should be cultivated for the residents so that they can master the technique of airway management skillfully whenever and wherever.

AIM: To study the signal pathway involved in up-regulation of LPS-induced HO-1 expression by CCK-8. METHODS: Forty-two SD rats were divided into 7 groups (six rats each) randomly as follows: control group, LPS group, LPS+SP600125 (JNK-specific inhibitor) group, CCK-8+LPS group, CCK-8+LPS+SP600125 group, CCK-8 group and CCK-8 +SP600125 group. Lungs from the rats in these 7 groups were excised 6 h after the agents were administered. HO-1 mRNA expression was examined by RT-PCR. The protein expression of HO-1 was detected by Western blotting and immunofluorescence flow cytometry (FCM). RESULTS: There were significant positive expression of HO-1 mRNA in LPS group compared to control group. CCK-8 enhanced LPS-induced HO-1 mRNA expression and CCK-8 alone induced HO-1 mRNA expression as well. The mRNA expressions of HO-1 in LPS group, CCK-8+LPS group and CCK-8 group were 3.01 (P<0.01), 5.88 (P<0.01) and 3.45 (P<0.01) times as many as that in control group, respectively. SP600125 inhibited the mRNA expression of HO-1 induced by CCK-8 and (or) LPS. The change of HO-1 protein expression was in accordance with that of HO-1 mRNA expression by Western blotting and immunofluorescence FCM. CONCLUSION: These results suggest that JNK/c-Jun signal pathway plays an important role in the up-regulation of LPS-induced HO-1 expression by CCK-8.

BACKGROUND:After cerebral tissue ischemia and anoxia in young rats,the cerebral edema gets serious, and the levels of nitric oxide (NO) and malondialdehyde (MDA) decrease. Radix Astagali seu Hedysari has the pharmacological effects of enhancing immunity, anti-anoxia and improving myocardial ischemic reinfusion injury.OBJECTIVE: To investigate the influences of Radix Astagali seu Hedysari (huangqi) on contents of NO and MDA in brain tissue of young rats with cerebral injury after cerebral ischemia and anoxia.DESIGN:A randomized and controlled trial.SETTING: Department of Pediatrics, Second Hospital, Hebei Medical University; Department of Internal Medicine, Institute of Traditional Chinese Medicine, Hebei Medical University; Department of Pathophysiology, Hebei Medical UniversityMATERIALS:The experiment was conducted from January to April 2004at Department of Pathophysiology, Hebei Medical University. Total 40 SD rats, 7-day old, were at random divided as normal control group, model group, humgqi low-dose group and huangqi high-dose group, with 10 rats in each group. Huangqi injection (The content in 10 mL injection is consistent with 20 g raw drug) was provided by Institute of Traditional Chinese Medicine of Hebei Medical University (produced in Chengdu Di'ou Jiuhong Pharmaceutical Factory, Batch No. 0005028).METHODS:Except rats in normal group, those in the rest groups, under conscious and local anesthesia, were all given common carotid artery ligation, establishing cerebral injury model due to ischemia and anoxia. Rats in normal group were intraperitoneally injected 0.1 mL normal saline; rats in model group were intraperitoneally injected 9 g/L normal saline, 0.1 mL each day; rats in huangqi low-dose group and huangqi high-dose group were respectively given 0.1mL, 0.5 mL huangqi injection, once a day, intraperitoneally. Cerebral blood flow was detected immediately, 2 and 4days after injection. Then the rats were decapitated for collecting the brains to measure the water content in brain, the contents of NO and MDA.MAIN OUTCOME MEASURES: [1] Water contents in brains of rats in every group. [2] Cerebral blood flow, and the contents of NO and MDA.RESULTS:Totally 40 rats were involved in the trial and all entered in the final result analysis. [1] The water content in brain of each group: Compared with normal group, the content in model group was increased immediately after model establishment [(87.316±0.275)%, (88.259±0.297)% ,P ＜ 0.05 ],and did not return to the normal level at the second day [(86.973±0.265)%,(88.173±0.445)%,P ＜ 0.05]; compared with model group, the content in huangqi high-dose group was obviously decreased at second day[(88.173±0.445)%, (86.542±0.141)% ,P ＜ 0.05]. [2] Measurement of cerebral blood flow: compared with control group, the blood flow in model group was obviously decreased immediately after model establishment[(231.88±13.33), (139.54±10.58)mV,P＜ 0.05], and did not return to normal level till the 4th day [(234.57±14.38), (145.38±13.33)mV,P ＜ 0.05];compared with model group, the blood flow in huangqi low-dose group and huangqi high-dose group, at day 4, was obviously increased [(145.38±13.33),(288.45±12.89), (313.82±21.74)mV,P ＜ 0.01]. [3] The contents of NO and MDA: The contents in model group, immediately after model establishment, were obviously higher than those in normal control group [(26.55±5.23 ), ( 19.67±7.17 )μmol/L,P ＜ 0.05; (7.88±2.55), (4.22±0.12) μmol/L, P＜ 0.01], and at day 4, were significantly higher than those in normal control group [(48.65±17.06), (18.65±2.12)μmol/L,P ＜ 0.01; (5.29±0.68),(4.06±0.39)μmol/L,P ＜ 0.05]; compared with model group, the contents in huangqi low-dose group and huangqi high-dose group were obviously decreased at day 4 [(48.65±17.06), (23.77±12.79), (24.67±11.54)μ mol/L,P＜ 0.01; (5.29±0.68), (4.51±2.30), (3.68±0.39)μmol/L,P ＜ 0.01].CONCLUSION:Huangqi could obviously reduce cerebral edema from ischemia and anoxia, increase cerebral blood flow. It could decrease the contents of NO and MDA that is metabolite of free radical injury, thus playing its role to inhibit lipid peroxidation injury.

Objective To summarize and analyze the effect of hand hygiene(HH)cost on the incidence of health-care-associated infection (HAI),evaluate continuous improvement method,and provide data for hospital manage-ment.Methods The cost of HH project and incidence of HAI in a hospital from January 2013 to June 2014,as well as HH compliance in the first half year of 2014 were investigated.Results Semiannual statistics were performed, the cost of HH project in the first half of 2013,second half of 2013,and first half of 2014 were 283 490,414 232, and 522 345 yuan respectively,compared with the first half of 2013,the cost of HH in the first half of 2014 in-creased by 84.26%;incidence of HAI were 3.13%,3.33%,and 3.03% respectively,difference was significant(χ2=10.37,P <0.001).In the first half of 2014,HH compliance rate increased from 35.00% in January to 59.49% in June.The top three factors that affecting the implementation of HH were busy work,had no time for handwashing;inadequate HH facilities or supplies;inadequate knowledge about HH.Conclusion Increasing the investment of HH products can improve HH compliance and reduce the incidence of HAI.

Objective To evaluate the clinical effect of splenic internal jugular shunt for Budd Chiari Syndrome (BCS). Methods A retrospective analysis was made on the clinical data of 21 patients of BCS who underwent this operation. Results There was no death in 21 patients receiving this operation, The average post operative reduction of FPP was 0.97Kpa.2 suffered postoperative lung infection . Abdominal incision infection occurred in one patient. Tweenty cases were followed up for one month to forty five months. Lower extremity varicose veins and abdomen wall varicose veins basically disappeared a month postoperatively; ascites vanished completely 3 months postoperatively,and lower limb ulcer healed 6 months postoperatively. Seventeen patients followed by CDFI showed that no thrombus was found in their artificial vessel. Barium meal studies in 12 cases displayed that oesophageal varicose veins had basically disappeared during the follow up period. Conclusions Splenic jugular shunt bridged by artifical vessel is safe,effective and less traumatic for patients with type III and some patients with type II Budd Chiari syndrome. It is currently the best choice for treatment of BCS.