BACKGROUND: Hypoxia-inducible factor 1α may mediate mammalian cells to adapt hypoxia environment.OBJECTIVE: To observe high altitude hypoxia on the ultrastructure of the lung tissue of hypoxia-inducible factor 1α expression.METHODS: Sprague-Dawley rats underwent high altitude hypoxia intervention for 1, 2, 3 and 30 days. Control group was set. Four high altitude hypoxia groups consisted of Golmud, Qinghai at the altitude of 2 700 m from 5-m above sea level of Xi'an consuming 1 day, Tanggula region at 5 000 m above sea level consuming 2 days, and Tibet Nagqu at 4 500 m above sea level consuming 3 and 30 days, respectively.RESULTS AND CONCLUSION: Light and electron microscopy showed that acute high altitude hypoxia 2 day group presented apparent high altitude pulmonary edema, while the 30 day group of acute high altitude hypoxia of high altitude pulmonary edema was significantly reduced, but hypoxia-inducible factor 1α mRNA expression was significantly increased (P < 0.01). Results demonstrate that hypoxia-inducible factor 1α mRNA expression increase in lung tissues after hypoxic acclimatization can help ameliorate high altitude pulmonary edema.

Consensus ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; diagnosis ; therapy ; Practice Guidelines as Topic

Objective To study the role of local immunity in the female genital tract with non- gonococcal urethritis(NGU).Methods Forty-four cervical secretions from patients with NGU were collected.After treatment with Azithromycin,22 cases were followed up.One month later,pathogen was eliminated in 15 patients.Another 27 un-infected people were included in our study.The level of secretory immunoglobulin A(SIgA)was detected using the automatic special protein analysor,and interferon-?(IFN-?)was quantified by enzyme-linked immunosorbent assay(ELISA).All data were analyzed with ANOVA.Results The levels of SIgA and IFN-?in NGU infected group were(34.29?15.92)mg/L and(97.13?24.00)ng/L respectively,while those of uninfected group were(47.57?19.61)mg/L and(120.71?33.78)ng/L,respectively(all P0.05).Conclusions SIgA and IFN-?secreted by genital tract mucosa may help pre- vent and resist the local NGU infection.However,the effect is limited,and is insufficient to eliminate infection completely and prevent reinfection.

Objective To explore the safety,efficacy and clinical significance of stenting with cerebral protection devices for carotid artery stenosis.Methods 14 patients with carotid artery stenosis were treated by intra-arterial stents implanted.All of them used cerebral protection of filter devices.Results 18 self-expandable stents were successfully implanted in 14 patients.Of them,stroke ictus caused by microemboli in 2 patients ,and they recovered after treatment for 1~3 d,6 patients had transient bradycardia and hypotension.No cerebral infarction could be seen in all cases during the follow-up period.Conclusion Carotid setenting with cerebral protection devices is an effective and safe method in treating carotid stenosis,and it is helpful to reduce the neurological complication.

Objective To evaluate the accuracy of methods in echocardiographic measurements of right ventricular (RV) volume.Methods Forty-six healthy volunteers were examined by two dimensional echocardiography (2-DE),real time three-dimensional echocardiography (RT-3DE) and cardiac magnetic resonance imaging (cMRI) within 24 hours.2 DE adopts three methods to measure RV volume,the first is Simpson,the second is the half ellipsoid method,and the last is biplane area-length method.In RT 3DE,RV volume were calculated respectively by tri-plane method and TomTec 4D RV-function CAP software.In cMRI,RV volume was calculated by Argus software.Right ventricular end diastolic and end-systolic volume (RVEDV,RVESV) were measured respectively.Then the echo measurement were compared to cMRI.Consistency of two methods was evaluated by Bland-Altman analysis.Results ①As compared to cMRI,Simpson,the half ellipsoid method and tri-plane method underestimated RV volume,with statistical significance(P ＜0.05).Biplane area-length method and TomTec 4D RV-Function CAP had no significant statistical difference (P ＞ 0.05).② The result of correlation analysis was as follows:RV volumes from Simpson and tri-plane method had bad correlation with those from cMRI (r =0.3-0.4).RV volumes from TomTec,half ellipsoid method and biplane area length method correlated highly with those from cMRI(r =0.7-0.8).③The Bland-Altman analysis of echo methods with cMRI showed that each measurement by TomTec and biplane area-length method had a smaller limit of the agreement and a smaller difference average.Conclusions Tom-Tec 4D RV-Function CAP in RT-3DE and biplane area length method in 2-DE can measure RV volumes accurately.

Objective:To explore diagnostic value of dynamic electrocardiogram (DCG) combined esophageal electro‐physiological examination (EEE) for sick sinus syndrome (SSS) .Methods :A total of 74 cases suspecting SSS ,who presented 24h mean heart rate <55 beats/min in DCG ,were selected .After DCG examination ,all subjects received EEE . Diagnostic value of single and combined examinations wereexplored .Results:Compared withthe SSS positive rate of single DCG and single EEE(87.8% ,86.5% ) ,theSSS positive rate ofDCG combined EEE(97.3% ) was sig‐nificantly rose ,P<0.05 both .Conclusion:Dynamic electrocardiogram combined esophageal electrophysiological ex‐amination can evaluate sinus node function from different angles ,which can significantlyincrease SSS diagnose rat .

Objective Ritodrine hydrochloride(RH) combined with radix salviae mihiorrhisa(RSM) is ap- plied to treat fetal growth ristriction(FGR). Curative effect was recorded during observation. Methods 62 pregnant women with slowly growing fetuses were divided into two groups randomly. Group A(test group) :including 31 preg- nant women who received RH combined with RSM treatment. Group B(control group) :including the other 31 preg- nant women who only received RSM treatment. Group B received 250ml of fat emulsion injection. One time every three days within one week. At the same time,gronp B also received injection of 500ml 10 % dextrose, coenzyme A 100U ,ATP 40mg,vitamin C 2g,dextran-40 and compound salvia injection 10ml one time a day,ten days in all. Be- sides the above-mentioned medicament for group B, group A received RH 100ml injection every day. Ten days was a period of treatment. After the treatment, uterine height, abdominal circumference, weight were measured and bipari- etal diameter, head circumference, abdominal circumference were checked by B-type ultrasonic inspection. After birth,weight of the baby and weight of placenta were measured too. Results Measurement indexes from group A, weight of the new-born baby and weight of placenta are obviously higher than those from group B. Conclusion RH combined with RSM can obviously extend blood vessel, loose placenta, improve blood circulation, accelerate cell metabolism, make microeirculation better, reduce permeability of capillary vessel, keep placenta's function and help foetus' growth.

Objective To summarize the perioperative nursing of patients with post-thoracotomy atelectasis treated with bronchoalveolar lavage combined with pulmonary insufflation.Methods Before operation,the nursing measures included the full preoperative preparation,full anesthesia and mental care.During the operation,the nursing focused on intensified monitoring,close cooperation with doctors in manipulation of bronchoalveolar lavage and pulmonary insufflation.After operation,the postoperative nursing was performed.Results The lung recruitments were successful in all the 12 patients.Compared to pre-operation,the arterial oxygen saturation(SaO2)and arterial oxygen partial pressure(PaO2)6 hours after treatment were significantly improved(P<0.05) while the CO2 partial pressure(PaCO2)was significantly decreased(P<0.05).There were no severe complications and no recurrence of pulmonary atelectasis.All the patients were successfully discharged.Conclusions The bronchoalveolar lavage combined with pulmonary insufflation is effective in treating post-thoracotomy atelectasis.To ensure the smooth treatment,perioperative nursing is also contributive.

Multidisciplinary treatment of rectal cancer and precise surgical strategy and total mesorectal excision(TME) are the basis for effective treatment of rectal cancer.At present,the best scheme of neoadjuvant therapy for rectal cancer has not been established.The neoadjuvant chemotherapy,neoadjuvant short and long range radiotherapy,radiotherapy adverse reaction,the timing of surgery for rectal cancer are summarized as follows.

Objective To investigate the treatment methods for primary gastric lymphoma (PGL) and analyze the prognostic factors.Methods The clinical data of 55 patients with PGL who were admitted to the First Affiliated Hospital of Dalian Medical University from July 2002 to December 2007 were retrospectively analyzed.Operation,medication or operation combined with medication were applied to patients according to the pathological type,clinical staging,infection of helicobacter pylori and complications.Patients were followed up via phone call till February 2013,and the location,diameter,pathological type,clinical stage of the PGL and the treatment methods were recorded for prognostic analysis.The survival rate was calculated by Kaplan-Meier method,and the univariate analysis of survival was done by Log-rank test.Multivariate analysis was done by COX regression model.Results The PGL located at the gastric antrum in 26 cases,body of the stomach in 17 cases,fundus of the stomach in 5 cases,gastric cardia in 3 cases,body and antrum of the stomach in 4 cases.There were 46 patients with ulcerous PGL,5 with nodular PGL and 4 with diffused and infiltrated PGL.There were 53 B cell lympboma,1 T cell lymphoma and 1 undefined tumor.Of the 53 patients with B cell lymphoma,36 were with mucosa-associated lymphoid tissue lymphoma (MALTL) and 17 with diffuse large B-cell lymphoma (DLBCL).There were 23 patients in stage Ⅰ,23 in stage Ⅱ,4 in stage Ⅲ and 3 in stage Ⅳ.Of the 55 patients,23 received operation,14 received medication,17 received operation + medication,and 1 left untreated.Fifty-three patients had complete follow-up data.The median time of follow-up was 60 months (range,7-132 months).The 1-,3-,5-year cumulative survival rates were 91％,79％ and 72％.The results of univariate analysis showed that tumor diameter,pathological type and clinical staging were risk factors influencing the prognosis of PGL patients (x2 =9.34,6.59,88.01,P ＜ 0.05),while the treatment methods did not influence the prognosis of PGL patients (x2 =3.63,P ＞ 0.05).The results of multivariate analysis showed that DLBCL,clinical stages Ⅲ and Ⅳ were independent risk factors influencing the prognosis of PGL patients (OR =5.758,2.231,95％ confidence interval:2.536-13.073,1.370-3.625,P ＜ 0.05).Conclusion Multi-disciplinary team treatment should be recommended for PGL patients.Pathological type (DLBCL) and clinical stages (stage Ⅲ and Ⅳ) are the independent risk factors influencing the prognosis of PGL patients.