This paper summarized nursing points for caring 23 cases undergoing pediatric heart transplantation,including:characteristics of accessing and protection of hearts,collaboration in pediatric heart transplantation,nursing of capacity management,temperature controlling,extracorporeal membrane oxygenation and delayed sternal closure during surgeries.The average length of hospitalization for 23 cases was 24.5±8.3 days,1 case died from primary graft failure after 19 months,the rest of 22 cases survived,and cardiac function recovered to NYHA class Ⅰ-Ⅱ.

Objective To explore the effect of ranolazine on the fast sodium channel current (INa) in rabbit atrial myocytes and the existence of use-dependent blockade. Methods Standard whole cell patch clamp technique was used to study the effect of ranolazine on the fast sodium channel current and the use-dependent blockade caused with different frequencies (1Hz, 3.3Hz and 5Hz) to stimulate the cells. Results The 30μmol/L ranolazine significantly reduced INa with an IC_(50) value of (25.6±1.8)μmmol/L and produced a frequency-dependent inhibitory effect on INa with obvious use-dependence. Conclusion Ranolazine can inhibit the fast sodium channel current in rabbit atrial myocytes and indeed has a use-dependent effect.

Objective To analyze the screening markers of minimal residual disease (MRD) in children with acute lymphoblastic leukemia( ALL), and to evaluate its clinical application and express characteristic. Methods Thirty-five patients with childhood acute lymphoblastic leukemia treated in our hospital from 2008.11-2009.12 were enrolled into this study. Bone marrow samples were taken to isolate sing-nucleus cells. Four-color fluorochrome labeled monoclonal antibodies were applied to analyze the cell immunophenotypes when meet the demand like these: low expression of CD38, CD45; high expression of CD58,CD21, CD22; co-expression of CD34 and Cu, and the expression of abnormal chromosome related antigen CD66c. After staining of surface and intracellular antigen, sample should be detected for leukemia-associated immunophenotypes by four-color FCM with double parameters. The leukemic cell populations located in flow cytometry dot plot different from those of normal were considered to be the effective screening markers.Results Total of cases of 31 patients at least had one MRD marker, coverage is 88.6%. 21/35 (60%)had 2 or more than 2 selection markers; TdT/CD10/CD34/CD19 is the most common four-color combination, followed by CD38/CD10/CD34/CD19, CD45/CD10/CD34/CD19, other index is rare. Conclusion TdT/CD10/CD34/CD19 was the most common four-color selection markers should be as regular and preferred detection ones. Study showed the immune phenotype Pro-B is lack of effective selection markers. Two or more interest markers should be improved the accuracy of MRD significantly.

Objective To analyzed the expression and clinical characteristics of CD 20 marker in children with B-lineage acute lymphoblastic leukemia ( B-ALL) and evaluated its medical significance in assessing the prognosis of disease.Methods From November 2008 to July 2012,125 cases of children with B-lineage acute lymphoblastic leukemia were collected from Shanghai Children ′s Hospital,including 79 males and 46 females, aged between 2 months to 14 years old.Flow cytometry based immunophenotyping and Minimal Residual Disease ( MRD) screening were applied to these children when newly diagnosed ,and MRD monitoring was again carried out after 35 days of induction remission therapy to those bears the MRD markers.These 125 patients were divided into CD20-positive group and CD20-negative group, and the corresponding clinical characteristics ,stage of immunophenotype ,MRD,risk stratification,and overall survival rates were recorded and compared.Data were statistically analyzed by using SPSS 16.0 software including χ2 test,t-test,standard deviation test and survival test.Results A total of 125 children with ALL-B,the group of CD20-positive were 48 while CD20-negative groups were 77,with a median age of 6 years old,and the median follow-up time of 30 months.Multivariate Cox regression Analysis showed that there was no clear correlation between CD20 expression level with age ,sex,white blood cell count at diagnosis ,fusion-gene,the stage of immunophenotype as well as risk stratification.The MRD-positive incidence at 35 days in the CD20 positive group was 35.4%,much higher than that of the CD20-negative group (16.9%),which is statistical significance (χ2 =5.236,P<0.05),while the overall survival rate (OS) for the CD20 positive group is 75.0%,much lower than that of the CD20 negative group (84.4%,χ2 =4.160,P<0.05).Conclusions CD20 positive expression level in children with B-lineage acute lymphoblastic leukemia at diagnosis demonstrates negative correlation with the overall survival rate of the patient ,indicating its usefulness as an additional joint marker for the current regimens to incorporate CD 20-targeted monoclonal therapy.

BACKGROUND:Maxil ofacial malformation limits the function of the mandible, produces the overload of the temporalmandibular joint leading to oral diseases. OBJECTIVE:To measure the characteristics of mandibular movement in populations with various types of dental occlusion. METHODS:Thirty-three volunteers (1 male and 32 females, mean age 21.71 years) meeting the inclusion criteria were enrol ed from Dalian Medical University, China and divided into four groups:normal control (n=10), Angle’s class I, II, III malocclusion (n=10, 8, 5). The protrusion, lateral, opening motion trace of mandibular central incisor and the right mandibular first molar, and the trace from mandibular postural position to intercuspal position were measured using the mandibular kinesiograph. The features of different occlusal patterns were analyzed using SPSS 17.0 software. RESULTS AND CONCLUSION:In the trace of protrusion, lateral, opening and closing motion, there were significant differences in the trace of the right mandibular first molar’s Max.Slant between Angle’s class II malocclusion group and the other three groups (P<0.05). In the trace of open wide and close fast, there were significant differences in the trace of mandibular central incisor in vertical distances between normal control group and Angle’s class I, III malocclusion groups (P<0.05);there were significant differences in the trace of mandibular central incisor in Max.Slant between normal control group and Angle’s class I malocclusion group (P<0.05);there were significant differences in the trace of the right mandibular first molar in vertical distances between Angle’s class II malocclusion group and the other three groups (P<0.05);there were significant differences in the trace of the right mandibular first molar in Max.Opening velocity between normal control group and Angle’s class II, III malocclusion groups (P<0.05). There were no significant differences in free space between the four groups (P>0.05). These results indicate that there are differences in the trace of mandibular central incisor and the trace of the right mandibular first molar in range and speed between different occlusal patterns. We can draw a conclusion that malocclusion has effects on the direction, range and speed of mandibular movement.

Objective:To investigate the clinical effect of minimally invasive catheterization based on computer 3D-Slicer software system in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods:Three hundred and fifty patients with HICH treated in People′s Hospital of Lanling County in Shandongfrom June 2019 to June 2020 were selected as the research object. According to the operation method, they were divided into 3D-Slicer group (175 cases) and CT group (175 cases). They were treated with 3D-Slicer software-assisted minimally invasive catheterization and minimally invasive soft-channel drainage under CT localization, respectively. The general conditions of the surgery, hematoma clearance rate and laboratory indexes, oxidative stress index and prognosis were compared between the two groups.Results:The intraoperative blood loss, the hospitalizationtimein the 3D-Slicer group were lower than those in the CT group: (81.42 ± 12.33) ml vs. (101.54 ± 11.71) ml, (15.67 ± 3.71) d vs. (17.22 ± 3.52) d; the success rate of one-time successful puncture to preset position in the 3D-Slicer group was higher than that in the CT group: 100.00%(175/175) vs. 81.14%(142/175), there were statistical differences ( χ 2 = 34.26, P<0.05). The hematoma clearance rate after the surgery for 1, 3 and 7d in the 3D-Slicer group were higher than those in the CT group:(87.93 ± 8.54)% vs. (66.43 ± 7.99)%, (92.48 ± 10.31)% vs. (89.52 ± 11.74)%, (96.37 ± 10.22)% vs. (94.30 ± 9.25)%, there were statistical differences( P<0.05). After the surgery for 7 d, the levels of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) in the 3D-Slicer group were higher than those in the CT group: (121.36 ± 10.59)U/L vs. (109.14 ± 9.05) U/L, (92.80 ± 8.63) μg/L vs. (81.45 ± 9.11) μg/L, (24.64 ± 5.43) U/L vs. (20.84 ± 3.47) U/L; while the level of malondialdehyde (MDA) was lower than that in the CT group: (4.42 ± 0.57)μmol/L vs. (5.19 ± 0.51) μmol/L, there were statistical differences ( P<0.05). After the surgery for 3 months, the rate of favorable prognosis in the 3D-Slicer group was higher than that in the CT group 73.71%(129/175) vs. 62.29%(199/175), there was statistical difference ( χ2 = 5.25, P<0.05). Conclusions:Minimally invasive catheterization based on 3D-Slicer software system in the treatment of HICH can not only improve the clinical efficacy, but also shorten the hospitalization time, reduce intraoperative blood loss, and improve the prognosis.

In recent years, the aging process of China′s population has accelerated, and the number of disabled people has skyrocketed. It is urgent to improve the health benefits of family bed services. The author found that there was a lack of synergy in policies, service subjects and content, and service concepts in the practical process of family bed services in various regions of China, which limited the effectiveness of services. The author put forward the theoretical framework of integrated family bed service, combined the service practice experience of six cities, namely Guangzhou, Shanghai, Beijing, Shenzhen, Nanjing and Hohhot, and put forward specific suggestions on building integrated family bed service. Among them, department collaboration could be the source power of system integration, institutional linkage could improve service continuity, service concept and incentive mechanism could promote each other, and modern technology could promote functional integration.

Objective To investigate the compliance of secondary prevention and the relationship with the long-term outcomes in patients undergoing percutaneous coronary intervention(PCI).Methods 589 patients undergoing PCI were followed-up,and factors including major adverse cardiac events(MACE)),smoking status and the usage of antiplatelet agents,angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB),statins,beta blocker,calcium channel blocker and nitrates were recorded.Results The average follow-up time was 18.92 months.At discharge,588 patients(99.83%)were prescribed clopidogrel for(7.89±4.96)months;there were 31 patients(5.26%)who completely discontinued antiplatelet therapy during follow-up.At discharge,the prescription rate of aspirin,ACEI/ARB,beta blocker,statins,calcium channel blocker and nitrates was 98.98%,41.94%,63.50%,83.02%,19.69%and 46.52%respectively,whereas at follow-up,these were decreased to 94.4%,35.99%,55.86%,65.89%,17.49%and 35.31%.At follow-up,there were still 105 current smokers(17.83%).Complete cessation of antiplatelet therapy and current smoking were related to the increased risk of non-fatal myocardial infarct(9.68%v.s.1.08%,P＜0.01);smoking(4.76%v.s.0.83%,P＜0.01)andMACE(19.35%v.s.6.45%,P＜0.01);smoking(11.43%v.s.6.20%,P＜0.05).Conclusion Most patients can adhere to secondary prevention during follow-up,however,the compliance with secondary prevention should be improved further.Cessation of antiplatelet therapy and current smoking contribute to poor prognosis.

Objective:To investigate the effect of different cleaning methods on the cleaning effect of Da Vinci robotic electrosurgical instruments and the feasibility of adenosine triphosphate(ATP) fluorescence detection technology for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.Methods:A total of 180 electrosurgical instruments were divided into control group and test group by random digits table method from June 2018 to June 2019 after robotic surgery. For the control group, 90 cases were manually cleaned to complete the device cleaning process, and for the test group, 90 cases were mechanically cleaned to complete the device cleaning process. Through visual observation, magnifying glass examination and ATP fluorescence detection technology, the cleaning effect of the two methods and the correlation between the evaluation results obtained by ATP fluorescence detection technique and traditional inspection method were compared.Results:The qualified rate of visual observation, magnifying lens examination and ATP fluorescence detection in the control group were 95.56%(85/90), 86.67% (78/90) and 84.44% (76/90), respectively, and that in the test group were 100.00% (90/90), 97.78% (88/90) and 98.89% (89/90), respectively. The test group was higher than the control group. The difference between the two groups was statistically significant ( χ2 values were 4.310, 7.745, 12.291, P<0.05 or 0.01). In the control group, there was a positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.374, P < 0.01), and a significant positive correlation between the qualified rate of magnifying lens examination ( r value was 0.538, P < 0.01). In the test group, There was also a significant positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.754, P < 0.01), and between the qualified rate of magnifying lens examination( r value was 0.556, P < 0.01). Conclusions:Mechanical cleaning is used to clean Da Vinci robotic electrosurgical instruments, which is superior to traditional manual cleaning. ATP fluorescence detection technology is feasible for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.

The early life period is a rapid period, as well as a critical/sensitive period for brain development. Proteins, long-chain polyunsaturated fatty acids (LCPUFAs), iron, zinc, iodine, folate, choline, vitamins A, D, B6, and B12, all play a role in key neural development processes and thus influence brain development. Different brain regions or circuits have specific critical periods during different stages of development that depend on specific nutrients. Any nutrient deficiency during this period, even if corrected with supplementation, may still affect the trajectory of brain development and result in long-term cognitive and behavioral impairment. This article elucidates the effects of major nutrient deficiencies during early life on brain development, the possible sensitive/critical timing, and the impacts on long-term cognitive and behavioral development, providing insights for the prevention and intervention of nutritional diseases and psychiatric developmental disorders, and the promotion of early childhood development.