Objective To study the treatment and outcome in infants with congenital heart disease after cardiopulmonary bypass. Methods The clinical data of 217 infants with congenital heart disease after cardiopulmonary bypass in Shengjing Hospital from Jan 2005 to Nov 2010 were retrospectively reviewed. Results Eleven infants died and the mortality was 5. 1% ( 11/217 ). Four infants died of severe low cardiac output syndrome,2 died of pulmonary hypertension crisis,2 died of low cardiac output syndrome complicated with acute renal insufficiency, 1 died of severe infection, 1 died of severe hypoxemia,and 1 died of chronic pericardial tamponade. The postoperation length of hospital stay was 7 ～ 52 d, 14 d in average. Conclusion With the improvement of surgical techniques,cardiac surgery with cardiopulmonary bypass on infants can result in good clinical effect. Active and effective treatment can reduce the perioperative mortality after cardiopulmonary bypass.

Objective To explore the expression of Akt in peripheral blood mononuclear cells (PBMCs) and its regulatory role on its downstream molecules forkhead box transcription factor O1 (FOXO1) and Bim in patients with systemic lupus erythematosus (SLE).The role of Akt/FOXO1/Bim signaling pathway on PBMCs apoptosis was clarified.Methods Sixty-three SLE patients and 23 healthy controls were enrolled.PBMC were separated from the peripheral blood specimen.Western blot technique was applied to analyze the expression of Akt,FOXO1 and Bim.Flow cytometry was applied to analyze PBMCs apoptosis.The t-test was used for statistical analysis.Results The apoptosis of PBMCs in patients with active SLE [(16.3±4.0)％] was significantly higher than that of patients with inactive SLE [(5.6 ±2.9)％] and normal controls [(5.2 ±4.2)％,t=4.83,5.05;P＜0.05].The levels of phosphorylation of Akt,FOXO1 and Bim expression was significantly decreased in patients with active SLE as compared with controls and patients with inactive SLE (P＜0.05).However,these indicators had no significant difference between the controls and patients with inactive SLE (P＞0.05).Conclusion ① The results of this study suggest that the expression level of Akt may be a good indicator for disease activity of SLE.Decrease of Akt may promote the occurrence and development of SLE.② Akt activity decline may lead to increased apoptosis of PBMCs.In this process,Akt may regulate its downstream FOXO1 and Bim phosphorylation levels which can enhance their ability to pro-apoptotic.

Objective Poly (ADP-ribose) polymerase (PARP) have been demonstrated to play an important role in systemic lupus erythematosus (SLE). In this study we assessed the expression of PARP on peripheral blood mononuclear cells with active or inacte SLE and tried to investigate the relationship between PARP and cell apoptosis on SLE. Methods Thirty definitive SLE patients and 10 healthy controls were enrolled. PBMC were separated from the peripheral blood samples. Western blot technique was applied to analyze the expression of PARP. Flow cytometry were applied to analyze the cell apoptosis. T test were used. Results The cell apoptosis in active patients with SLE was significantly higher than that of inactive patients with SLE and normal controls (the t values were 4.83 and 5.05 respectively, P<0.05). The level of PARP expression was significantly decreased in active patients with SLE as compared with controls and inactive patients with SLE (the t values were 7.66 and 7.07 respectively, P<0.05). At the same time, the cleavage fragment of PARP increased in active patients. Conclusion The results suggest that PARP may be involved in the pathogenesis of SLE and the expression level may be a good indicator for disease activity of SLE . Decrease of PARP may promote the occurrence and development of SLE. In addition, PARP may play a certain role in adjusting cell apoptosis in patients with SLE.

Objective To explore the relationship between serum creatinine ( Scr ) , blood urea nitrogen ( BUN) and lung image changes in uremic patients .Methods According to the chest CT ,X-ray and related findings , 256 patients with uremia were divided into 84 cases of uremia ( uremic lung group ) and non-uremic lung 172 cases ( non-uremic lung group ) .The chest CT and X-ray examination ,Scr and BUN levels were observed .Results Uremic lung group had five types of image findings,including alveolar edema (67.86%),pulmonary interstitial edema (16.67%),pulmonary congestion syndrome(8.33%),pleural effusion(4.76%) and pulmonary interstitial fibrosis (2.38%).The Scr[(1 145.6 ±236.4)μmol/L]and BUN [(38.9 ±6.1)mmol/L]levels in uremic lung group were significantly higher than those in the non-uremic lung group[(905.3 ±138.9)μmol/L,(23.8 ±5.6)mmol/L](t=8.128,4.782,all P<0.05).Conclusion The image of uremic lung is mainly pulmonary edema ,and radiological and pathological changes are closely related with Scr and BUN levels .

Objective To summarize the management of cardiopulmonary bypass(CPB) for infants below 10 kilograms with congenital heart diseases.Methods From Jan 2010 to Apr 2011,the clinical datas of 122 infants aged from 1.5 months to 2 years with body weight 3 to 10 kilograms,who underwent open heart surgery under mild or moderate hypothermia CPB were retrospectively analyzed.Results Among all the 122 infants,CPB time was 13 ～ 118 min [(62.69 ± 21.48) min],aortic cross-clamp time was 0 to 86 min [(35.47 ± 19.51) min].All patients were spontaneous resuscitation and successfully weared from the machine,no severe complications associated with CPB occurred,3 infants died (2.46％,3/122) after operation.Conclusion Using membrane oxygenator,circuit tubing and artery filter with less priming,and highflow perfusion during CPB,maintaining hemodynamics stable,holding reasonable hematocrit and colloid osmotic pressure,good myocardial protection and ultrafiltration are the significant elements of the management of CPB in infants with weight less than 10 kilograms.

ObjectiveTo assess the reliability and validity of Chinese version of tools in measuring yangsheng.MethodsChinese version of tools in measuring yangsheng was administered to 706 elderly citizens and evaluated for the reliability and validity.ResultsThe fittingness of the both exiting model were unidentified.A model of six factors and twenty-six items was determined using exploratory factor analysis.The fitness of such model was perfect ( RMSEA =0.050,AGFI =0.871,GFI =0.902,NFI =0.903,CFI =0.953 ) and all the construct reliability were more than 0.6 while the average variance extracted were higher than 0.5 except the diet yangsheng factor.The Cronbach's α of Chinese version of tools in measuring yangsheng was 0.918 and Cronbach's α of factors were all above 0.7.ConclusionThe Chinese version of tools in measuring yangsheng appears to have good validity and reliability to estimate the Yangsheng of elderly citizens in China.

Objective To explore the correlation between serum homocysteine(Hcy) levels and behavioral and psychological symptoms dementia (BPSD) in patients with mild to moderate vascular dementia (VaD).Methods Two hundred and ninety-three patients with mild to moderate vascular dementia (aged 40 or over) admitted to the department of neurology of the First Affiliated Hospital of Liaoning Medical College from January 2012 to January 2015.Patients were diagnosed with dementia by NINDS-AIREN criteria,MMSE scores ≤26,Hachinski ischemic scale(≥4) and clinical dementia rating(1≤ C DR ≤ 2).VaD patients were divided into high Hcy(HHcy) group (Hcy≥ 15 μ,mol/L,n=188) and control group(Hcy＜15 μmol/L,n=105).The total scores and the scores of 12 functional domains of behavioral and psychological symptoms in NPI were analyzed by using comparative statistical methods.Results Prevalence of high homocysteine was 64.16％ (n=188) among mild to moderate VaD (n=293).The incidence of BPSD in HHcy group(80.9％) was significantly higher than that in the control group (57.1％),the difference was statistically significant (x2=18.932,P＜0.01).HHcy patients (27.95±5.04) had a significantly higher total score of NPI compared with control patients (16.87± 1.87),the difference was statistically significant (t=3.753,P＜0.01).In terms of scores in 12 functional domains in NPI,the scores in sleep disorders (2.99± 1.40),high (2.10±0.53),irritability/mood swings (2.64± 1.43),abnormal behavior (1.74±0.52),disinhibition (1.40±0.43),agitation (2.02±0.74) were higher than those in control groups (1.85±0.37,0.21±0.05,1.80 ±0.56,0.36±0.09,0.45±0.07,0.68±0.23),all the difference were significant(t=2.327,t=2.012,t=2.136,t=2.066,t=2.050,t=2.007,all P＜0.05).Binary logistic regression analysis showed that there were positive correlation between scores of NPI and plasma Hcy levels (OR=1.164,95％ CI:1.052-1.288,P=0.003).Compared with HHcy group and control group,there were no statistical significance in regard to infarcted brain focus including the frontal lobe,parietal lobe,temporal lobe,occipital lobe,basal ganglia,brain stem and cerebellum (x2=0.528,x2=0.043,x2=0.630,x2=0.166,x2=0.657,x2=1.010,x2=0.019,allP＞0.05).Conclusion High homocysteine levels are correlated with behavioral and psychological symptoms in patients with mild to moderate VaD,including performance of sleep disorders,high,irritability/mood swings,abnormal behavior,disinhibition and agitation.Moreover,the severity of BPSD is positively associated with homocysteine levels.The higher the homocysteine level,the more severe the BPSD.The serum homocysteine levels are no correlated with infarcted brain focus.

Objective To observe the effect of drug edible of herbal medicine granule on vascular endothelial function in patients with coronary heart disease(CHD).Methods A total of 200 cases featuring with cardiovascular blood stasis were chosen from patients who were diagnosed with CHD in Zhengzhou hospital of traditional Chinese medicine from January 2015 to January 2016.All cases were divided into observation group(n=98)and control group(n=102).The observation group was given Xin bao drug edible of herbal medicine granule and conventional drugs,and the control group was given conventional drugs.After 8 weeks of observation,the levels of endothelin(ET-1),nitric oxide(NO)and angiotensin Ⅱ(AngⅡ)were measured by enzyme-linked immunosorbent assay(ELISA).The serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),and TCM clinical symptom score were compared between the two groups.Results The level of TC of the control group was decreased after treatment(P<0.05);the levels of TC,TG and LDL in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of NO,ET-1,Ang-Ⅱ and FMD in the observation group were significantly different from those before treatment(P<0.05).The levels of NO and FMD in the observation group were higher than those in the control group,and the levels of ET-1 and Ang-Ⅱ were lower than those in the control group(P<0.05).After treatment,the scores of TCM clinical symptoms in the observation group were lower than those before treatment(P<0.05).Compared with the control group,the total score of palpitations,the times of shortness of breath and clinical symptoms were lower than those in the observation group(P<0.05).Conclusion Xin bao drug edible of herbal medicine granule could relieve coronary heart disease blood stasis type of patients with vascular tension,reduce its endothelial cell damage and improve its clinical symptoms.

Objective To study the expression of transcription factor FOXO1 and FOXO3a on peripheral blood mononuclear cells (PBMC) in patients with active or inactive systemic lupus erythematosus (SLE) and investigate the effect of FOXO1 and FOXO3a on the clinical features of SLE. Methods Thirty SLE patients and 10 healthy controls were enrolled. PBMC were separated from the peripheral blood. Reverse transcription-polymerase chain reaction (RT-PCR) and western blot were applied to analyze the expression of FOXOI and FOXO3a. Results The level of FOXO1 expression was significantly decreased in active SLE patients compared with controls and patients with inactive SLE (P<0.05). The level of FOXO1 expression in inactive SLE patients was lower than that of the controls (P<0.05). The expression of FOXO1 mRNA was negatively correlated to SLEDAI. However, the level of FOXO3a was similar among the three groups. Conclusion The result suggests that FOXO1 may be involved in the pathogenesis of SLE and the expression level of FOXOI may be a good indicator for the disease activity of SLE.

Objective To observe the effects of Qingjin Huatan Decoction on EGFR/MAPK signaling pathway of airway mucus hypersecretion rats with chronic obstructive pulmonary disease (COPD). Methods Intratracheal instillation of LPS combined with smudging method was used to establish COPD airway mucus hypersecretion rat models. Experimental rats were randomly divided into blank group, model group, Qingjin Huatan Decoction group and clarithromycin group. The blank group was normally fed, while the other three groups were given NS, Qingjin Huatan Decoction, and clarithromycin respectively for gavage, once a day for 30 days. All rats were killed on the 31st day, and pathological changes of lung tissue and mucous glands hyperplasia were observed by HE staining method. The gene expressions of EGFR and MUC5AC in lung tissue were detected by RT-PCR method. The protein expressions of P-EGFR, P-ERK, P-JNK, P-p38 and MUC5AC in pulmonary tissue and airway epithelium were detected by immunohistochemical method. Results Compared with the blank group, mucous glands hyperplasia on airway epithelium, protein expressions of P-EGFR, P-ERK, P-JNK, P-p38 and MUC5AC on airway epithelium significantly increased in the model group (P<0.01); gene expression of MUC5AC of lung tissue increased (P<0.05). Compared with the model group, mucous glands hyperplasia on airway epithelium, P-p38, P-ERK and MUC5AC protein expression on airway epithelium in Qingjin Huatan Decoction group significantly decreased (P<0.05, P<0.01); the protein expression of P-JNK increased significantly (P<0.01). EGFR and MUC5AC mRNA in lung tissue in Qingjin Huatan Decoction group decreased significantly (P<0.01). Conclusion Qingjin Huatan Decoction can reduce airway mucus hepersecrection of COPD by inhibiting ERK and p38 signal pathway on EGFR downstream.