Objective To explore the risk factors and outcomes associated with pulmonary hemorrhage in very low and extremely low birth weight infants.Methods Retrospective analysis were performed to predict risk factors for pulmonary hemorrhage in very low and extremely low birth weight infants (birth weight less than 1200g) admitted to NICU of Shengjing Hospital from Jan.2010 to Dec.2015.Infants at similar birth weight without pulmonary hemorrhage were as controls.We compared the characteristics of both maternal and infants.Multivariable Logistic regression models were derived to predict pulmonary hemorrhage.Short outcomes of the infants were assessed.Results Of the 435 neonates,71 developed pulmonary hemorrhage (pulmonary hemorrhage group),364 were as controls (control group).Gestational age[(28.2±1.7)week],birth weight[(936±192)g] in pulmonary hemorrhage group were significantly lower than those in control group[(29.5±2.1)week,(1033±134)g,t=4.776,5.145,P<0.01].Neonatal respiratory distress syndrome(RDS)(76.1%),pulmonary surfactant (PS)use(PS use≥2 courses)[76.1%(9.9%)],patent ductus arteriosus (PDA)(66.2%)were significantly higher than those in control group[41.2%,30.8%(4.1%),38.7%;χ2=33.457,28.970(4.074),32.798,P<0.05].Antenatal corticosteroids utility ratio (21.1%)was lower than that in the control group (41.2%;t=10.177,P< 0.001).Multiple factors Logistic stepwise regression analysis showed that RDS (OR=3.739,95%CI 1.383-10.113,P<0.05 ),PDA (OR=2.206,95%CI 1.205-4.093,P<0.05),and 5 minutes Apgar score <7(OR=2.851,95%CI 1.191-6.828) were independent risk factors of pulmonary hemorrhage,and higher birth weight (OR=0.998,95%CI 0.996-1.000,P<0.05) and the use of antenatal corticosteroids (OR=0.432,95%CI 0.224-0.834,P<0.05) were the protection factors in pulmonary hemorrhage.In pulmonary hemorrhage group,the incidence of intracranial hemorrhage,retinopathy of prematurity and severe bronchopulmonary dysplasia(16.9%,12.7% and 18.3%) were significantly higher than those in control group (5.8%,4.4% and 2.2%;χ2=36.824,7.520 and 33.568,P<0.01);Compared to control group,the mortality in pulmonary hemorrhage group was higher (49.3% vs.14.0%;χ2=46.634,P<0.01).Conclusion Pulmonary hemorrhage in very low and extremely low birth weight infants is associated with multiple factors.Prevention of premature birth and prenatal corticosteroids treatment can help prevent the occurrence of pulmonary hemorrhage.The incidences of poor outcomes are higher in newborns with pulmonary hemorrhage.

ObjectiveTo evaluate the effect of sufentanil preconditioning on acute lung injury induced by intestinal ischemia-reperfusion (I/R) in rats and the role of opioid receptors.MethodsForty-eight male Wistar rats weighing 200-250 g were randomly divided into 6 groups ( n =8 each):sham operation group (group S) ; I/R group; sufentanil preconditioning group (group SPC) ; COTP (μ receptor antagonist) + SPC group; NTD (δ receptor antagonist) + SPC group and nor-BNI (κ receptor antagonist) + SPC group.Intestinal I/R was produced by occlusion of the superior mesenteric artery for 45 min followed by 2 h reperfusion in groups I/R,SPC,COTP +SPC,NTD + SPC and nor-BNI + SPC.Sufentanil 10 μg/kg was injected intravenously at 10 min before ischemia in groups SPC,COTP + SPC,NTD + SPC and nor-BNI + SPC.COTP 1 mg/kg and NTD 5 mg/kg were injected intravenously at 10 min before sufentanil injection in groups COTP + SPC and NTD + SPC respectively,while nor-BNI 5 mg/kg was injected intravenously at 15 min before sufentanil administration in group nor-BNI + SPC.The animals were sacrificed at 2 h of reperfusion,the intestinal tissue was removed for microscopic examination and intestinal damage was assessed and scored according to Chiu.Left lung tissue was also removed for microscopic examination (1 =normal,4 =severely injured).The apoptosis in lung cells was detected using TUNEL and apoptosis index (AI) was calculated.The expression of Bcl-2 and Bax proteins in lung tissues was detected using immuno-histochemistry and Bcl-2/Bax ratio was calculated.ResultsCompared with group S,Chiu's score,lung injury score and AI were significantly increased,expression of Bcl-2 and Bax proteins was up-regulated,Bcl-2/Bax ratio was significantly decreased in the other groups ( P ＜ 0.01 ).Compared with group I/R,Chiu' s score,lung injury score and AI were significantly decreased,Bcl-2 protein expression was up-regulated,Bax protein expression was downregulated,and Bcl-2/Bax ratio was significantly increased in group SPC (P ＜ 0.01 ).Compared with group SPC,Chiu's score,lung injury score and AI were significantly increased,Bcl-2 protein expression was down-regulated,Bax protein expression was up-regulated,and Bcl-2/Bax ratio was significantly decreased in groups COTP + SPC,NTD + SPC and nor-BNI + SPC ( P ＜ 0.01 ).ConclusionSufentanil preconditioning can attenuate lung injury induced by intestinal I/R by activation of opioid receptors in rats.

Objective To investigate the role of sufentanil on intestinal ischemia-reperfusion model of liver cell apoptosis and bel-2/Bax expression,and the opioid receptor-mediated effects in the process.Methods Seventy two healthy adult Wistar rats,weight 200-250 g,either male or female,were randomly divided into 9 groups(n=8),sham operation group(S),ischemia-reperfusion group(IR),sufentanil treated group (SPC),three kinds of opioid receptor antagonist,NTD(δ receptor antagonist,),nor-BNI(κ receptor antagonist),CTOP(μ receptor antagonist)in the intervention groups(NTD + SPC,nor-BNI + SPC,CTOP + SPC),three kinds of opioid receptor antagonist control groups(NTD,nor-BNI,CTOP).by clamping the superior mesenteric artery production model of intestinal ischemia-reperfusion injury,after the end of the experiment,immediately take the left lobe of liver specimens.Immunohistochemical detection of bcl-2/Bax protein expression,terminal transferase labeling(TUNEL)assay of liver cell apoptosis index(AI).Results Compared with IR group,SPC Group bcl-2 expression increased(0.277±0.014 vs 0.230±0.013)(P＜0.05),bcl-2/Bax ratio increased(1.375±0.113 vs 0.819±0.102)(P＜0.05),Bax down regulation(0.202±0.013 vs 0.283±0.025)(P＜0.05),liver cell AI reduced(6.491±1.191vs10.094±1.051)(P＜0.05).Compared with the SPC group,NTD + SPC group,nor-BNI +SPC group,CTOP+SPC group bcl-2 expression decreased(F=59.698,P＜0.05),bcl-2/Bas ratio decreased(F=40.349,P＜0.05),Bax expression was elevated(F=53.765,P＜0.05),liver cells AI elevated(F=76.728,P＜0.05).Conclusion Sufentanil pretreatment inhibit rat intestinal ischemia-reperfusion liver cell apoptosis.δ,κ,μthree kinds of opioid receptor mediate the protective effect of sufentanil,and the effects are equal.

Objective To analyze the effects of miR-26a on proliferation,apoptosis,migration and invasion of uveal melanoma cell.Methods The expressions level of miR-26a in the uveal melanoma cell lines SP6.5 and M23 and normal cell line ARPE-19 was detected by qRT-PCR.The SP6.5 cell line was divided into miR-26a mimics group (transfect with miR-26a mimics) and NC group (transfect with scramble by Lipofectamine 2000).The proliferation and apoptosis ability were measured by CCK-8 assay and flow cytometry.The cell wound scratch assay and transwell assay were used to detect the migration and invasion ability.The expression level of enhancer of zeste homolog 2 (EZH2) protein was measured by Western blot.Results The expressions level of miR-26a in uveal melanoma cell line SP6.5 was 0.250 ± 0.029,M23 was 0.350 ±0.017,which was significantly lower than 1.0 in normal cell line ARPE-19 (all P ＜0.001).The OD450 value at 72 hours,96 hours and 120 hours in miR-26a mimics group (0.69 ±--0.09,1.23 ± 0.15,2.12 ± 0.23) were significantly lower than those in NC group (1.39-0.11,2.35 ±0.25,3.53 ±0.27) (all P ＜0.05).The apoptosis rate of miR-26a mimics group (15.60％ ± 2.30％) was significantly higher than that of NC group (5.00％ ± 0.70％) (P ＜ 0.01).The wound healing rate of miR-26a mimics group (23.7％ ±2.1％) was significantly lower than that of NC group (68.9 ±5.1％) (P ＜0.01).While the invasive cell number (45.1 ± 3.9) was also significantly less than NC group (115.3 ± 8.9) (P ＜ 0.01).The expression level of EZH2 protein in miR-26a mimics group (0.39 ±0.09) was significantly lower than that of NC group (1.0,P ＜0.01).Conclusion MiR-26a is low expressed in uveal melanoma cells.Over expression of miR-26a inhibit the proliferation,migration and invasion of uveal melanoma cell,and promote the apoptosis,which may be associated with down-regulated expression of EZH2.

Objective To investigate the effectiveness of endoscopy and enteral nutrition (EN) in the treatment of acute biliary pancreatitis (ABP) in elderly patients and its impact on prognosis.Methods Eighty-four elderly patients with ABP were randomly divided into two groups,including 42 cases of combination treatment group,42 cases of routine treatment group.The routine treatment group was managed with normal comprehensive treatment,and in combination treatment group,patients were treated with additional endoscopic retrograde cholangiopancreatography (ERCP),endoscopic sphincterotomy (EST) and endoscopic naso-biliary (ENBD) drainage and EN.The clinical symptoms,serum inflammatory cytokines,complications and prognosis were compared.Results The CRP,TNF-α,IL-2,and serum amylase,glucose,AST after treatment were significantly lowered than those before treatment (P ＜ 0.05).In addition,the levels of CRP,TNF-α,IL-2,and serum amylase,glucose,AST,ALB in combination treatment group were significantly lower than those in routine treatment group (P ＜ 0.05).The time to abdominal pain cessation,time to fever cessation,hospital stay in combination treatment group were (4.6± 1.3),(3.7± 1.3),(13.5± 2.7) d,which were significantly lower than those in routine treatment group [(6.1 ± 1.3),(5.5 ± 2.1),(18.1 ± 3.8) d,P ＜ 0.05].The APACHE Ⅱ score of combination group after treatment was (7.l ± 1.8) point,which was significantly lower than that in routine treatment group [(9.2 ± 2.6) point,t =3.41,P ＜ 0.05)].The incidence rates of ARF,ARDS,peri-pancreatic infection and abdominal hemorrhage,in combination group were 7.1％,4.8％,4.8％,4.8％,respectively,which were significantly lower than those in routine treatment group (23.8％,19.1％,21.4 ％,19.1％,P＜0.05).The mortality in combiration group was 4.8％,which was lower than 16.7％ in routine treatment group with no statistical significant.Conclusions It is a safe and effective to treat elderly ABP patients with endoscopy combined with EN,which can significantly reduce complications and mortality.

Objective To establish an HPLC method for determination of 2,3,5,4’-tetrahydroxystibene-2-O-β-D-glucoside(SBGC)and hyperin in the effective fraction of Jiangzhining. Methods HPLC analysis was performed on a C18 column(4.6 mm×250 mm,5 μm),with acetonitrile-0.1% methanoic acid water solution(15.5: 84.5)serving as the mobile phase. The flow rate was 1.0 mL·min-1 ,the wavelength was 340 nm,and the injection volume was 20 μL. Results The calibration curve was linear for SBGC in the range of 24-120 μg·mL-1(r = 0.999 8)and for hyperin in the range of 2.4-12.0 μg·mL-1(r= 0.999 6),respectively.Their average recoveries were 100.07% and 100.14%,respectively.The contents of SBGC and hyperin were 2.26% and 0.23%,respectively Conclusion The method is convenient,precise and reliable for determination of the content of SBGC and hyperin in the effective fraction of Jiangzhining.

Objective To discuss the application of run?through wire stretch technique in the procedure of endovascular therapy for complex subclavian artery occlusive diseases. Methods The clinical data of 22 patients who were diagnosed complex subclavian artery occlusive diseases were retrospectively analyzed from June 2013 to January 2016 in vascular surgery department of Wangjing Hospital .The patients were treated endovascular therapy using run?through wire stretch technique in all procedures successfully. Results The complex subclavian artery occlusive diseases were including long segment occlusion of the left subclavian artery and ostial stenosis or occlusion of the right subclavian artery. The left subclavian artery occlusion patients was 16 and right subclavian artery ostial stenosis or occlusion was 6. The technical success rate was 100%. All patients were using combination of femoral artery and brachial artery approach. Run?through wire stretch technique was used in the procedure of endovascular therapy, which had improved the technical success rate. After the treatment the symptom improvement rate was 88%. The symptoms of upper limb and posterior circulation ischemia were improved. Conlusion Upper limb artery combined femoral artery approachand run?through wire stretch technique can improve the recanalization in the procedure of endovascular therapy for complex subclavian artery occlusive diseases.

Objective To investigate the misdiagnosed vascular vagovagla reflexes (VVR) and the treat-ments during interventional therapy for peripheral anerial disease (PAD). Methods The clinical data of 5 patients with VVRs from 128 PAD patients undergoing interventional therapy so as to analyse the causes for the misdiag-noses and then render pertinent treatment. Results The VVR in the 5 patients belonged to mixed type and all cas-es occurred after intervention and initially misdiagnosed. All patients were recovered well without adverse reaction. Conclusion Intervention therapy for PAD may be susceptible to VVR. Prompt management may bring in a good prognosis when VVR happens.

Objective To investigate the effect of comprehensive nursing intervention on patients with gastroesophageal reflux disease(GERD).Methods 68 patients with GERD from January 201 2 to January 201 5 in the 1 st Affiliated Hospital of Bengbu Medical College were randomly divided into observation group (n =33)and control group(n =35).The symptom scores and life quality scores of the patients in the two groups were compared. Results 4 weeks after discharging,the symptom scores of reflux,heartburn,chest pain,belch in the observation group were (2.5 ±1 .0)points,(2.8 ±1 .2)points,(2.8 ±1 .3)points,(2.1 ±1 .2)points respectively,which in the control group were (4.8 ±1 .6)points,(4.4 ±2.1 )points,(3.8 ±1 .2)points,(3.4 ±1 .4)points respectively,the differ-ences were statistically significant(t =7.34,4.87,4.32,4.71 ,all P <0.05).1 2 weeks after discharging,the symptom scores of reflux,heartburn,chest pain,belch in the observation group were (1 .8 ±0.8)points,(2.2 ±1 .0)points, (1 .5 ±0.4)points,(1 .5 ±0.6)points respectively,which in the control group were (4.7 ±1 .4)points,(4.5 ± 1 .5)points,(3.0 ±0.6)points,(3.2 ±1 .6)points respectively,the differences were statistically significant(t =1 0.98,7.43,6.1 2,6.02,all P <0.05).Meanwhile,the symptom scores of the observation group 1 2 weeks after discharging were lower than those of the observation group 4 weeks after discharging (t =2.96,1 .86,7.55,4.62,all P <0.05).The life quality scores of the observation group were significantly higher than the control group,the differ-ences were statistically significant(all P <0.05).Conclusion Comprehensive nursing intervention can significantly improve symptoms and quality of life in patients with GERD.With the comprehensive intervention of patients under-taking,patients can benefit more.

Objective To investigate the surgical reparation of large coloboma raw surface after facial tumour resection in elderly patients.Methods According to the position and characteristics of tumor as well as the age and tolerance of the patients, full thick skin graft, the skin flaps with subcutaneous pedicle and free skin flap were designed and used in the reparation.Results 24 cases with large coloboma raw surface (5 cm×7 cm-12 cm× 16 cm)were treated by the utilization of three approaches after tumor resection.The large coloboma raw surface in all patients achieved the healing with satisfactory appearance.Conclusions After facial tumour resection, the large coloboma raw surface can be repaired by using the skin graft, skin flaps after tumor resection or free skin flap if designed reasonably.The procedure of operation is simple and the therapeutic effect is satisfactory.