Objective To analyse effect of dobutamine on C-reactive protein,D-dimer,BNP and blood gas analysis in children with neonatal pulmonary hypertension.Methods 46 patients who were diagnosed with neonatal pulmonary hypertension in our hospital were collected.All patients were randomly divided into experimental group and control group, 23 cases in each group.Control group was treated with sedation, maintenance of water electrolyte balance, blood pressure, anti-infection,experiment group was treated with dobutamine hydrochloride injection 5μg/(kg· min) intravenous infusion, continuous for 48 h on the basis of conventional therapy, after treatment,the levels of peripheral blood C-reactive protein, D-dimer and BNP and blood gas analysis effect were detected in all patients.Results Compared with control group post-treatment, the serum level CRP,D-dimer, BNP were lower in experimental group ( P <0.05 );the PaO2 and SpO2 levels were higher, the PAH level was lower in experimental group ( P <0.05 ) . Conclusion The dobutamine can significantly reduce the serum CRP, plasma D-dimer and BNP levels in children with neonatal pulmonary hypertension, reduce pulmonary hypertension.

Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007, 113 patients including chronic gallstone cholecystitis (n=55), inactive cholecystolithiasis (n=46) and gallbladder polyps (n=12) were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation, 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC, 3 months and 6 months after LC were (5?2) mm, (8?2) mm and (6?2) mm respectively. And in chronic gallstone cholecystitis patients they were (5?2) mm, (9?2) mm and (6?2) mm respectively, in inactive gallstone cholelithiasis patients they were (5?2) mm, (8?2) mm and (6?2) mm respectively, and in gallbladder polyps ones they were (5?2) mm, (7?2) mm and (5?2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.

Objective To study the anesthetic effect and influence to circulatory and respiratory function of target controlled infusion(TCI)and intravenous injection of propofol anesthesia in elderly patients undergoing colonoscopy.Method 50 patients above 55 years of age undergoing colonoscopy were randomly allocated to 2 groups.The TCI group received target controlled infusion of propofol with a target concentration of 3?g/ml.The injection group received intravenous injection of 2mg/kg propofol with addition of 20-50mg propofol for each time at intervals during anesthesia when necessary.BP,HR,SpO2,and limb motion were detected during colonoscopy operation,and the time of eye-open and word-response after colonoscopy were also recorded.Results No significant difference was found in colonoscopy time and limb motion response between the two groups.Patients in TCI group consumed more propofol and opening of eyes was delayed compared to those patients in the injection group(P

The hepatic arteriographic findings and interventional treatment results in forty cases with recurrent primary liver cancer after surgery were reported.The angiograph- ic manifestations were divided into three types:type Ⅰ recurrence on edge,11 cases (27. 5%);type Ⅱ intrahepatic diffusion),23 cases (57.5%);type Ⅲ (insidious recurrence),6 cases (15%).The characters of angiographic findings were as follows:the feeding vessels relatively not rich pale staining of tumor nodules,the common multiple focuses and small tu- mor nodule (diameter of tumor

Objective To introduce a new classification system for femoral intertrochanteric fractures and propose classification to assist surgical management.Methods A total of 176 cases of femoral intertrochanteric fractures treated from September 2007 to October 2011 were enrolled in the study.X-ray and three-dimensional spiral CT reconstruction were performed to define fracture shape,location,number of major fragments and displaced direction.As combined with the intraoperative findings and cadaveric anatomical study,the femoral intertrochateric fractures was simulated using a three-dimensional entity of normal proximal femur produced by Mimics 11.1 program.A new classification system for femoral intertrochateric fractures was proposed.Results The new system categorized intertrochateric fractures of the femur into five types (Type Ⅰ,Type Ⅱ,Type Ⅲ,Type Ⅳ and Type Ⅴ) based on the integrity or destruction of the medial column,lateral column and posterior column set and divided on the basis of bone connection of femoral head-neck fracture fragments with the bone in intertrochanteric region.Conclusions The new classification system with introduction of three-column concept is brief and practical and has a clear definition of fracture stability.Besides,the new classification-based treatment is recommended.

Objective To study the effects of up-regulated gene-4 (URG-4) on colon cancer cellproliferation.MethodsColon cancer cell line with high expression of URG-4 was selected.The recombinant URG-4 siRNA retroviral vector was constructed and packaged by PT67 cell,then retroviral particles which can express URG-4 siRNA in mammal cell and its negative control were obtained.Expressions of URG-4 in MKN45,SW480,LoVo,HCT116,HT29 were detected by RT-PCR and Western blot,respectively.Recombinant virus (interference group),original virus (negative control group) and the same amount of PBS (blank group) were used to transfect LoVo cells respectively.Stably transfected cell lines were screened.The growth condition of cell lines in each group was assayed by MTT.All data were analyzed by the one-way analysis of variance and the t test.Results Sequencing results confirmed the successful construction of retroviral which expressed siRNA,the relative expression levels of URG-4 mRNA in MKN45,SW480,LoVo,HCT116,HT29 were 0.58 +0.02,0.63 ±0.03,0.81 ± 0.01,1.01 ± 0.02,0.91 ± 0.04 and the expression levels of URG-4 protein in the 5 cell lines were 0.73 ±0.02,0.85 ± 0.03,1.42 ± 0.01,0.80 ± 0.30,0.80 ± 0.04,respectively.High expression of URG-4 was observed in the LoVo cells.The expression of URG-4 mRNA in the LoVo cells in the interference group was 0.55 ±0.03,which was significantly lower than 1.15 ±0.02 of the negative control group and 1.15 ±0.01 of the blank group ( t =- 5.179,- 9.285,P ＜ 0.05 ).The inhibition rate of URG-4 mRNA in the interference group was 52.6％.The expression of URG-4 protein in the interference group was 0.82 ± 0.05,which was significantly lower than 1.46 ± 0.07 of the negative control group and 1.54 ± 0.04 of the blank group (t =-4.239,-3.704,P＜0.05).The inhibition rate of URG-4 protein in the interference group was 43.6％.The LoVo cells in each group grew exponentially.Compared with the negative control group,the cell growth of the interference group was inhibited during day 3 to day 6,which had statistical significant difference ( t =- 6.436,-6.045,-6.434,-4.285,P＜0.05).ConclusionInterference of the expression of URG-4 can inhibit the growth of LoVo cells.

Objective To analyze the literatures on arthroplasty treating femoral neck fracture in the elderly so as to evaluate the value of arthroplasty in treating femoral neck fracture in the elderly. Methods The literatures published from 1991 to 2007 on arthroplasty treating femoral neck fracture in the elderly were retrieved via PubMED and Ovid database to compare the mortality. Dislocation, revision and Harris score after operation. The heterogeneity was tested and the data dealt by meta-ana]ysis. Then, we talculated the OR value and 95% confidence interval. Results The study included 10 related pa-pers involving hemi-arthroplasty(HA)and total hip arthroplasty(THA)treating femoral neck fracture in the elderly. There was no statistical difference between HA and THA in aspect of mortality. No heteroge-neity existed in dislocation and revision, with the Q value of 4. 03 and 2. 78 respectively(P>0. 1). THA had a high dislocation rate but lower incidence of revision, in comparison with HA. The heterogeneity of Harris score was confirmed with the Q value of 23. 94(P<0. 1), with relative risk(RR) of 0. 79, OR of 0. 35 and 95% CI of 0. 23-0. 53. Conclusions As for hip function recovery, THA is better than he-mi-arthroplasty and THA should be the first choice for femoral neck fracture. However, for patients who can not tolerate operation or have anticipated life span less than 5 years, hemi-arthroplasty should be cho-sen.

Objective To observe the effects of myriocin(ISP-1) on improvement of glomerular messangial cell(GMC) apoptosis and on gene expression profiles of cell cycle regulatory proteins in GMC.Methods Rat GMC was cultured with 100 ?mol/L ISP-1 for 6,12,24,and 48 h,apoptosis was evaluated through flow cytometry,Hoechst33258/PI fluorescence stainig and DNA fragmentation analysis was carried out under Sepharose electrophoresis to observe the changes of apoptosis and DNA fragmentation.Gene expression profiles of cell cycle regulatory proteins were detected by SuperArray Real-Time PCR microarray analysis.The expression of Bax and Bcl-2 proteins was investigated by Western blotting.Results ISP-1 could significantly induce GMC apoptosis in a time-dependent manner,which was the most significant after 48 h.Apoptosis bodys of GMC were observed by Hoechst/PI fluorescence staining,and a typical ladder pattern was identified in DNA electrophoresis.SuperArray Real-Time PCR microarray analysis revealed that ISP-1 could up-regulate the expression of genes involved in DNA damage,apoptosis and cell cycle regulation,such as Rad51,Atm,Brcal,caspases,cyclinA2,cyclinC,chek1,cyclinB1,cyclinB2,cyclinD2,cyclinF,Cdc25a,and P27.Western blotting showed that ISP-1 could significantly up-regulate Bax protein expression and down-regulate Bcl-2 protein expression,respectively.ConclusionISP-1 could induce GMC apoptosis in a time-dependent manner,propabably through influencing gene expression of cell cycle regulatory proteins and apoptosis proteins.

This paper describes the role,method and experience,and working model of medical ethics in large-scale hospitals,and holds that the modern hospital management mode has transformed from scientific management to humanism-based management,whose essence is the transformation of managing concept,and the embody of management ethics and management culture.Important connotations and primary task including employing virtue in hospital management,obeying legal regulations in medical practice,and conducting humanistic medicine should be emphasized and concerned in hospital management.