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 investigate the frequency distribution of proprotein convertase subtilisin/kexin 9 (PCSK9) gene I474V polymorphisms and their relationship with patients with ischemic stroke (IS)of Uygur and Han ethnic groups in Xinjiang Uygur Autonomous Region.Methods The I474V polymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) in 407 patients with IS(including 219 Hans and 188 Uygurs)and 425 health controls (including 255 Hans and 170 Uygurs),and some specimens were sequenced.Results (1) Between IS group and control group,the genotypes Ⅱ and Ⅳ had no statistically significant differences in the levels of triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) ; Total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C) levels had statistically significant differences; LDL-C levels had also statistically significant differences.Between IS and control groups,TC,LDL,HDL-C levels of genotype Ⅱ showed statistically significant difference.In the IS group,TC,LDL-C levels of Ⅳ genotype were significantly higher than the control group,the difference being statistically significant.(2) There was statistically significant difference in the genotype distribution between IS and control groups (9.5％ (77/814) vs 4.5％ (38/850),x2 =16.09,P =0.000).And the distribution of allele frequency was statistically different (18.9％ (77/407) vs 8.9％ (38/425),x2 =17.38,P =0.000).(3) The differences of I474V loci Ⅳ genotype frequency distribution in Xinjiang Uygurs and Hans were statistically significant (27.7％ (52/188) vs 11.4％ (25/219),x2 =17.40,P =0.000; 12.9％ (22/170) vs 6.3％ (16/255),x2 =5.57,P =0.018) ; So did the Ⅴ allele frenquency distribution (13.8％ (52/376) vs 5.7％ (25/438),x2 =15.58,P =0.000; 6.5％ (22/340) vs 3.1％ (16/510),x2 =10.44,P =0.001).(4) There was statistically significant difference in the genotype distribution and allele frenquency distribution between IS group and control group in the Xinjiang Uygurs (27.7％ (52/188) vs 12.9％ (22/170),x2 =11.79,P =0.001 ; 13.8％ (52/376) vs 6.5％ (22/340),x2 =10.44,P =0.001) ; But there was no statistically significant difference in the Hans.Conclusions Ⅱ and Ⅳ genotypes are dominant in the I474V polymorphism loci of PCSK9 gene.The genotype of PCSK9 gene I474V polymorphism is correlated with increasing serum levels of TC and LDL-C.I474V polymorphism is associated with cerebral IS course in Xinjiang region.There is statistically significant difference in the genotype I474V distribution between Uygur and Han groups.I474V polymorphism has a relationship with the occurrence of IS in Xinjiang Uygurs.Ⅳ may be a susceptible genotype and Ⅴ may be a genetic susceptible allele of the Xinjiang Uygurs.

Objective To assess the tolerance of elderly patients with esophageal carcinoma to chemoradiotherapy through.Methods A retrospective analysis of 596 elderly patients with esophageal carcinoma receiving chemoradiotherapy was conducted.Patients were divided into radiachemotherapy group and radiotherapy group,and according to age,patients were divided into four age groups (aged 70-74,75-79,80 80 and 85years and over).The tolerance to treatment was assessed by Charlson index.Results 185 patients completed chemoradiotherapy,113 patients reduced the dose of chemotherapy (reduction group),81 patients unfinished chemoradiotherapy (unfinished CRT group),160 patients completed radical radiotherapy alone (unfinished RT group),and 57 patients incompleted radiotherapy.Further analysis found that the tolerance to treatment in reduction group had significant differences between patients aged ≥ 75 years and ＜ 75 years (x2 =6.815,P=0.009),and between WIC ≥ 1 and ＜ 1(x2 =10.636,P=0.001); the tolerance to treatment in unfinished CRT group had significantly differences between aged ≥ 80 years and ＜80 years (x2 =63.842,P=0.000),and between WIC =0,1 and ≥ 2 (x2 =21.153,P=0.000).Conclusions Further age re-grouping and WIC assessment is necessary before treating esophageal cancer patients.Reduction of therapy dosage is more beneficial for patients aged ≥ 75 years and WIC≥1,and greater caution is required in chemotherapy for patients aged ≥ 80 years and WIC＞1.

TGR5,expressing in many tissue cells,is a kind of bile acid membrane receptor and participates in a variety of metabolic and immune diseases.Activated TGR5 can keep the metabolism system in a steady state by mediating the metabolism of bile acid,lipid,and blood sugar,reducing insulin resistance and increasing the body's energy consumption; TGR5 could regulate the immune responses of mononuclear cell and Kupffer cell in the liver.For example,it can regulate the adaptive immune response by inhibiting the expression and release of inflammatory cytokines in Kupffer cells,and regulating the differentiation and maturation of dendritic cells.This review mainly focused on the function of TGR5 in liver metabolism and immune and further explored the related mechanism,as well as its clinical significance in related liver diseases.

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.

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.