Adult ; Cell Separation ; methods ; Endothelial Cells ; cytology ; Humans ; Stem Cells ; cytology

The incidence of birth defect in China is still high,which is not only affected by genetic factors,but also affected by heavy metals in surrounding that prejudices foetus' normal development.Heavy metal is a kind of inorganic pollutants with high toxicity.Excessive intake of lead,cadmium,arsenic or mercury,and the insufficient intake of zinc,calcium and copper may both lead to at least 1 kind of birth defect.The interactions between heavy metals also affect the outcomes of pregnancy.This paper reviewed different relationships between heavy metals and birth defect recording to relevant achievements such as animal experimentations and epidemiologic study made by researches from at home and abroad in recent years.It is advised to intake adequate zinc and copper and avoid being exposed to harmful metals to make sure the effective reduction of the incidences of birth defects.This paper will also point out the direction of future research about the relationship among the birth defects and heavy metal.

Objective To follow up long-term clinical events and compare the long-term prognosis between partial and complete revascularization in octogenarians with coronary artery disease.Methods A total of 108 patients aged 80-88 years who underwent elective percutaneous coronary intervention (PCI) in cardiology department of Huashan Hospital were divided into complete revascularization group (n=47) and partial revascularization group (n=61).They were followed up for long-term major adverse cardiovascular events from Jan.1 2005 to Dec.31 2008.Results There were no statistically significant differences in age,percent of female,prevalence of hypertension,diabetes,hyperlipidemia,unstable angina,smoking and renal dysfunction between the groups(all P＞0.05).And the angiography results showed no difference at the number and location of coronary artery lesions,including prevalence of single-vessel disease [15 cases(24.6％)vs.8 cases (17.0％)],dual-vessel disease [18 cases(29.5％) vs.15 cases(31.9％)] and that of tri-vessel disease [28 cases(45.9 ％) vs.24 cases (51.1 ％)] between partial and complete revascularization groups (all P＞0.05).The follow-up time in two groups were (1235±508)d and (1216±560)d (t=0.24,P＞0.05).All-cause death [ 10 cases ( 16.4 ％) vs.8 cases ( 17.0％)],cardiovascular death [8 cases (13.1％) vs.7 cases(14.9％)],hospitalization with angina [12 cases (19.7％) vs.9 cases (19.1 ％)],with hypertension [7 cases( 11.5 ％)vs.5 cases (10.6 ％)],with cardiac arrhythmia [5cases(8.2％) vs.4 cases(8.5％)],with chronic heart failure [4 cases(6.6％)vs.3 cases(6.4％)],and with all-cause cardiovascular disease [33 cases (54.1％) vs.25 cases(53.2％)] had no significant differences between partial and complete revascularization groups (all P ＞ 0.05).Conclusions Long-term prognosis of partial and complete revascularization is similar in octogenarians with coronary artery disease.

A blood film slide taken from a patient previously diagnosed as vivax malaria in Mojiang County, Yunnan Province, showing atypical forms. The ring forms had multinuclei, and the late trophozoites trended to form band. The schizonts and gametocytes were somewhat alike to Plasmodium vivax. PCR amplification confirmed that the patient was infected by P.knowlesi.

Objective To observe the clinical efficacy and safety of dexmedetomidine on analgesic effect in patients after thyroid surgery.Methods A total of 102 patients after thyroid surgery were divided into control group and treatment group,each group 51 cases.Patients in both groups were given thyroid operation.Patients in both groups were given sulfentanyl 10 μg + 0.375％ ropivacaine mixture 20 mL before operation,granisetron hydrochloride injection 5 mg by intravenous drip,once a day after operation.Control group was given midazolam hydrochloride injection 0.03 mg · kg-1 by intravenous drip before operation.Treatment group was received dexmedetomidine hydrochloride injection 1 μg · kg-1 by intravenous drip before operation.The clinical efficacy,3-endorphin (3-EP),interleukin-6 (IL-6),C-reactive protein (CRP) and adverse drug reactions in two groups were observed.Results After treatment,total effective rates in treatment and control groups were 92.16％ (47/51 cases) and 78.43％ (40/51 cases),with significant difference (P ＜ 0.05).After treatment,β-endorphin in control group and treatment group were (268.47 ± 29.58),(284.47±30.05) pg· L-1,CRP were (4.47 ±0.54),(4.07 ±0.42)mg · L-1(P＜0.05).The adverse drug reactions in treatment group were lethargy,respiratory depression,nausea and vomiting,the incidence of adverse drug reactions was 5.88％ (3/51 cases).The adverse drug reactions in control group were itching,respiratory depression,drowsiness,nausea and vomiting,the incidence of adverse drug reactions was 11.76％ (6/51 cases,P ＞ 0.05).Conclusion The analgesic effect of dexmedetomidine after thyroid surgery is effective with high safety.

Objective To evaluate the clinic efficacy of sufentanil and remifentanil by target- controlled infusion (TCI) combined with propofol in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixty patients,ASA Ⅰ ～ Ⅱ,undergoing elective EBUS-TBNA were randomly divided into group S ( sufentanil group),group R (remifentanil group) and group SR (sufentanil + remifentanil group),each group were twenty patients.The anesthesia of all groups is propofol intravenous anesthesia with 2％ lidocaine topical anesthesia,to controll BIS between 50 and 60 during surgery.Heart rate(HR),mean arterial pressure(MAP) pulse oxygen saturation( SpO2 ) and respiratory rate (RR) were recorded and compared 5mins after entering room(T0),30mins after the beginning of surgery(T1 ) and after surgery(T3).Arterial blood gas and the times of cough during surgery were also recorded and compared in all groups.The use of propofol and lidocaine,the wake-up time,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were also obtained.Results ( 1 ) RR decreased distinctly in group R and PaCO2 increased distinctly in group S and group R compared with that of group SR (P ＜0.05) during surgery.(2)The times of cough and the wake-up time lessened distinctly in group R and group SR compared with that of group S ( P ＜0.05 ).(3) The use of propofol and lidocaine,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were similar in all groups ( P ＞ 0.05 ).Conclusion Sufentanil compounded remifentanil by TCI combined with propofol is a safe and feasible anesthesia option for EBUS-TBNA,which provides better efficacy,high satisfaction and less side effects compared with using alone of sufentanil and remifentanil respectively.

In order to optimize acupuncture protocol for stephenipodia after stroke, related papers of the recent 20 years are retrieved. Interrelated factors which may influence the therapeutic effect of acupuncture are analyzed through the aspects such as acupoints, needling methods and opportunities of acupuncture. It is held that importance should be attached on relation between acupoints and anatomy during acupoint selection. Different acupuncture protocol can be adopted in different phases of stephenipodia according to its time of occurrence. And it is found that the combination of acupuncture and rehabilitation can reinforce the therapeutic effect. Relationship between effect of acupuncture and patient's condition, acupoint selection and prescription, acupuncture manipulations (including directions, angles, reinforcing and reducing, quantity of stimulus) are worth to be further studied. On the base of the above all mentioned studies, optimization can be carried out on selection of acupoints and acupuncture manipulations. And therapeutic effect can be enhanced when the optimized acupuncture protocol is combined with rehabilitation therapies.
Acupuncture Points ; Acupuncture Therapy ; Foot Diseases ; etiology ; therapy ; Humans ; Stroke ; complications

Objective To understand the characteristics of molecular epidemiology of enterovirus 71(EV71) in children with hand, foot and mouth disease (HFMD) in Shanghai area during the first half year of 2009. Methods Seventy-three throat swabs and 38 stool samples were collected from 95 hospitalized children with clinical diagnosis of HFMD in Children's Hospital of Fudan University during April to May 2009. TaqMan real-time reverse transcription-polymerase chain reaction (RT-PCR) and nest RT-PCR were used to detect EV71 VP1, followed by gene sequencing analysis. Results Six of the 73 throat swabs were EV71 positive with the detection rate of 8.2%. In the 38 stool samples, 24 were EV71 positive with the detection rate of 63.2%. Twenty-eight nested RT-PCR positive samples were sequenced and the genetic analysis showed that 27 were C4 subtype,which were absolute dominant strain and the other one was C2 subtype. The isolated strain from a fatal case was C4 subtype and there was no obvious mutation found in VP1 region. Conclusions EV71 is an important pathogen in HFMD children in Shanghai area during April to May 2009. C4 subtype strains are absolutely dominant, and accompanied by epidemic strains of subtype C2.

Objective To explore the factors related with difficulty of laparoscopic cholecystectomy(LC) for acute calculus cholecystitis.Methods A total of 245 patients were retrospectively divided into two groups:easy group(123patients)and difficult group(122patients,including 32patients of conversion to OC)based on surgery time and LC or OC.Results There were statistical differences between the groups in regards to preoperative body temperature,white blood cell count,surgical timing,the thickness of gallbladder wall,gallbladder volume,and diameter of common bile duct(all P

Objective To investigate and analyze the death situation of children aged under 5 year old in a class 3A hospital during 2007-2015 to provide a basis for formulating corresponding interventional measures to reduce the disease mortality of children.Methods The medical records of children death in this hospital during 2007 2015 were retrospectively analyzed.Results The mortality rate of children under 5 years old in this hospital during 2007-2015 showed a decreasing trend year by year.There was the statistically significant difference in the mortality rates among different years,between male and female (3.58 ％vs.2.10％) and between rural family registers and non-rural family registers(P＜0.05);the neonatal mortality rate was highest (50.45 ％);the top 5 places of death causes were premature delivery or low birth weight newborns,respiratory system diseases,nervous system diseases,congenital diseases and accidents.Conclusion The key for reducing the children mortality rate is to strengthen the perinatal health care,strengthen prenatal examinations and pregnant examinations,prevent the occurrence of respiratory system disease,pay attention to the influence of various factors on children health and prevention and treatment of accidents.