The hemodynamic effects of dextran and nitroprusside on acute pericardialtamponade were investigated on dogs. The result showed that dextran increased CO andMSAP significantly (all P

Objective To evaluate the significance and expression of the GDNF/GFRα1/RET genes in distal rectum with Congenital Anorectal Malformations(ARMs) Methods Specimens were collected from resected colon which is 3 cm away to the anus and the distal of rectum in 12 ARMs patients. Haematoxylin and Eosin (HE) staining, immunohistochemical (IHC) staining and reverse transcription PCR (RT-PCR) were used to test RET, GDNF and GFRα1 expression in the differ-ent site of samples with ARMs. Results Expression of ganglia and RET, GDNF and GFRα1 were all negative in distal rec-tum in 12 ARMs patients. Ganglionic cells were found in tissues 3 cm away from the anus where RET, GDNF and GFRα1 expression were also positive in those ARMs patients. Expression of RET, GDNF and GFRα1 were strong positive in middle and low imperforate anus indicated by brown color and week positive in high imperforate anus indicated by yellow color. One case of faeces contamination and one case of loose motion without anal incontinence were found in post-op follow up of high ARMs patients. By contrast, one case of rectal mucosa prolapse and one case of occasional faeces contamination which recov-ered with hip bath were found in post op follow up in middle or low ARMs. Conclusion The unsatisfactory anorectal func-tion is possibly related to the decrease or lost of neurotrophic factors (GDNF/GFRα1/RET) and ganglia in the myenteric plex-uses post plastic surgery in ARMs patients.

Objective To investigate the relationship between the methylation of RET (proto-oncogene, RET) and Hirschsprung disease (HD), and understand its significance in the development of intestinal wall ganglion cells. Methods Twenty-one surgical removal specimens, which were all dilation segment of HD in Tianjin Children’s Hospital, were used as experimental group, and 5 samples of non-HD normal colon tissues were used as control group. The bisulfite sequencing (BSP)-direct detecting method was used to detect RET CpG island methylation status. The expression of RET protein was detected by immunohistochemistry in experimental group and control group. Results In the experimental group 12 cases (57.14%) were found methylation, but no methylation was found in control group. The average optical density of methylated RET protein was 0.201±0.015 in 12 cases. The average optical density of un-methylated RET protein was 0.364±0.023 in 9 cases (P<0.05). Conclusion RET CpG island methylation reduced protein expression levels of RET. The corollary RET gene methylation may influence the expression levels of RET protein, thereby affecting the ganglion cell development, and thus participating in the occurrence of HD.

[Objective] To establish a content determination method of Berberine hydrochloride in San Yu Ointment by HPLC.[Methods] RP-HPLC was performed to determine Berberine hydrochloride on a column of Agilent Zorbax Eclipse XDB-C8(4.6?150mm,5?m)at 20℃; Acetonitrile-0.1 % H3PO4 (50∶50)(Adding 0.1 g C12H25NaO4S to every 100 mL)was used as mobile phase,the flow rate was 1.0 mL?min-1.The detection wavelength was at 265 nm.[Results]A good linearity can be found in the range of 39.40 ~394.0 ng,and the regression equation was Y = 4.073?103x+2.248 ? 103 (r=0.9992).The recovery was between 97.9 %~100.9 %,and the average recovery rate was 99.4 %,RSD was 1.5 %.[Conclusion]The method is simple,rapid,accurate and available,which can be used to control the quality of San Yu Ointment.

objective To analyze the risk factors of sepsis,and to elucidate the efficacy of high-flux hemofihration(HVHF)in the treatment of sepsis and the initiate opportunity of HVHF treatment on sepsis complicated with acute kidney injury(AKI). Methods Clinical data of 152patients with sepsis undergoing HVHF treatment were retrospectively analyzed.APACHE Ⅱ,APACHE Ⅲ and SAPS Ⅱ score evaluation before treatment and 24 h,48 h.72 h after treatment were performed.According to 28-day survival,patients were divided into survival group and death group.Clinical indicators before and 24 h,48 h,72 h after treatment were compared between groups.Risk factors influencing prognosis of patients were examined by multivariate regression analysis.Influence of AKI stages on prognosis of patients was studied. Resalts Lung and alimentary tract were the most frequent infection sites of sepsis.Twenty-eight days after HVHF treatment,74 patients (48.68%)survived,seventy-eight patients (51.32%)died among 152patients,and 4 patients(2.63%)needed sequent renal replacement therapy.Twenty-eight-day mortality was significantly lower than the mortality 88.78%±17.72%predicted by APACHE Ⅲ.APACHE Ⅱ,APACHE Ⅲ and SAPS Ⅱ Sscores decreased remarkably (P＜0.01) 24 hours after treatment.Age,number of dysfunctional organ,APACHE Ⅱ,APACHE Ⅲ,SAPS Ⅱ scores,undedying diseases,shock,AKI,severe acute pancreatitis,alimentary tract hemorrhage,cataphora and pressor agent were correlated with 28-d survival rate.Underlving diseases and APACHE Ⅲ were independent risk factors.Renal function recovery rate in AKI stage 1 was higher than that in AKI stage 2,3(P＜0.05).Twenty-eight-day mortality of patients without AKI was lower compared to AKI stage 1,2,3(P＜0.05),but 28-day mortality was not significantly different among AKI stage 1,2,3. Conclusions Prognosis of patients with sepsis is poor.HVHF can improve biochemical indicators and prognosis of patients effectively,and increase survival rate.Underlying diseases and APACHE Ⅲ are independent risk factors of 28-day mortality of sepsis patients.Twenty-eight-day mortality of non-AKI patients is obviously lower compared to AKI stage 1,2,3patients.AKI stage is correlated with 28-day renal function recovery rate,but not obviously correlated with 28-day mortality.

The early screening and early diagnosis of biliary atresia is the key to improve the 5-year native liver survival rate,jaundice-free-native-liver survival rate and overall survival rate.So far,the neonatal jaundice,especially that caused by surgical cholestasis exists the lack of awareness.Because of this reason,the delay depletion jaundice patients did not receive early diagnosis and treatment until the severe complications happened.So,it has often missed the best period of operation for the biliary atresia.Called for local medical health governments to formulate the effective early screening methods of biliary atresia and the reasonable schedule of postnatal follow-up,and improving the ability of basic unit medical staff in well understanding cholestasis disease in order to achieve early diagnosis and treatment.Consequently,it will improve the situation of diagnosis and treatment of biliary atresia in our country.

Objective To investigate the use of cardiopulmonary auscultation model in clinical skills teaching, and students' feeling about this teaching form. On the basis of this teaching model, we have reflected on the teaching mode. Methods Through the questionnaire survey, 145 medical stu-dents of grade 2009 were asked to investigate their learning experience about cardiopulmonary aus-cultation model and other aspects of it. Results There are 71.7% students liking cardiopulmonary auscultation model in teaching; 96.5% students can establish contacting abnormal cardiopulmonary auscultation signs with cardiovascular diseases after the training; There are 91.7% students thinking teaching hours about auscultation model is not enough. For the open question “what do you think is the difficulty of cardiopulmonary auscultation learning?” The representative answer is: I think car-diopulmonary auscultation is unable to recognize visual things. Conclusion Cardiopulmonary aus-cultation model can successfully improve the students' clinical skills and achieve good teaching effect. Students have a positive and supportive attitude to it.

Objective To analyze the changes of primary disease and demography of patients with end-stage renal disease (ESRD) who started dialysis between 2008 and 2013 in Zhejiang province, in order to provide statistical support for the improvement of dialysis quality.Methods The study retrospectively reviewed all the incident ESRD patients on dialysis registered in Zhejiang Dialysis Quality Control Center from 2008 to 2013.Their demographics and primary cause were investigated.Stratified analysis based on dialysis modality, duration and age were conducted.Results A total of 26 310 incident ESRD patients who started dialysis between 2008 and 2013 in Zhejiang were selected, among which 14 886 cases were male and 11 424 cases were female (male: female: 1.30: 1).The study gave priority to patients aged 45 and above (73.9％), with an average age of (55.7± 16.1) years.The top primary disease was chronic glomerulonephritis (51.3％), followed by diabetic nephropathy (17.3％) and hypertensive nephrosclerosis (6.4％).From 2008 to 2013, the incidence of dialysis was 46.3, 60.1, 71.2, 85.8, 104.1, and 119.9 per million population respectively.The average age of patients was increased year by year, from 52.4, 53.3, 54.8, 56.0, 56.9, to 57.6 years.The share of peritoneal dialysis, as well as the promotion of diabetic nephropathy in primary disease was on the rise.With the increase of age, the proportion of primary diseases such as diabetic nephropathy and hypertension nephrnsclerosis was increased.Conclusions In Zhejiang province, incident dialysis patients increase annually.More males than females are on dialysis.The average age and proportion of peritoneal dialysis are rising.The leading cause is chronic glomerulonephritis, but the incidence of diabetic nephropathy is on the increase, which requires attention.

Ischemic stroke is an important cause of death and disability.Hemorrhagic transformation (HT) is a serious complication of acute ischemic stroke,especially in patients receiving intravenous thrombolytic therapy.Identifying patients at high risk of HT is very important for improving stroke outcomes.Some studied have shown that several serum biomarkers can be used to predict HT risk in patients with acute ischemic stroke.This article reviews the serum biomarkers of HT after acute ischemic stroke.

Background and purpose: In recent years, more and more clinical researches on the neuroendocrine carcinoma of the breast were carried out at home and abroad. Although there are quite a lot of the retrieved documents of NEBC at home and abroad, but large-scale reports are rare, besides, the epidemiology, diagnosis, treatment and prognosis were different;more research are needed to analyze NEBC. This paper mainly discussed the NEBC clinical diagnosis, treatment and prognosis. Methods: A retrospective analysis was carried out, 25 cases of Tumor Hospital Afifliated to Xinjiang Medical University from Jan. 2004 to Jun. 2013 were pathologically diagnosed as NEBC by clinical data and the follow-up. Results:The average age of 25 NEBC patients was 58.2 years old, without clinical and imaging characteristic features, immunohistochemistry staining showed that, the estrogen receptor (ER) and progesterone receptor (PR) positive rates were 76%and 64%. No one showed HER-2 strong positive. The follow-up was 9-115 months. Besides, 1-, 2-and 5-year overall survival (OS) rates were 100%, 95%and 88%, the disease-free survival (DFS) rates were 96%, 90%and 78%. Conclusion:The age of the patients with NEBC in this study was lower than the data abroad. Age, tumor size, pathological staging may be related to the prognosis of NEBC, and postoperative comprehensive treatment options need further study.