Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

Accidents, Occupational ; Acetic Anhydrides ; Adult ; Blast Injuries ; complications ; therapy ; Burns, Inhalation ; etiology ; therapy ; Humans ; Lung Injury ; etiology ; therapy ; Male ; Middle Aged

Objective To understand the incidence of renal involvement of children with non Hodgkin′s lymphoma and to recognize its different CT findings. Methods The thoracic and abdominal plain and contrast enhanced CT of 30 cases of NHL in children were reviewed and all cases were confirmed by pathology. The changes in both pre and post chemotherapy were analysed in the 10 selected cases with renal involvement. Results CT demonstrated 6 cases of multiple masses and 1 case of multiple patchy lesions in bilateral kidneys. Two cases of single mass and 1 case of multiple masses were detected in single kidney. Conclusion The incidence of renal involvement of children with non Hodgkin′s lymphoma is relatively high. CT can clearly demonstrate the renal involvement of NHL, which is helpful for clinical stage, especially in the evaluation of the therapeutic effects. Hence, abdominal plain and contrast enhanced CT scan should be done in children with NHL.

Objective To invetigate the effect and safety of sufentanil mixed levobupivacaine on postoperative analgesia in pediatric caudal block anesthesia.Method Sixty pediatric patients (2 ～ 6 years old) who were undergoing elective abdominal surgery,such as repair hernia of high ligation,were randomly divided into three groups with 20 cases each.after intravenous induction,0.25％ levobupivacaine was injected in sacrum tube in group Ⅰ,0.5 μg/ml sufentanil mixed 0.25％ levobupivacaine and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine were injected in sacrum tube in group Ⅱ and group Ⅲ respectively.The analgesia effect,the analgesia time,recover time and adverse reaction were observed and recorded 2,4,8,12,16,24 hours after the surgery.Results The analgesia effect in group Ⅱ、Ⅲ were significantly better than the group Ⅰ when 4、8、12 hours after the operation(P ＜0.05),and the analgesia effect in groupⅢ were significantly better than the group Ⅱ when 8 hours after the operation (P ＜ 0.05).There were no significant differences in three groups when 2、16、24 hours after the operation(P ＞0.05),the analgesia time in group Ⅱ、Ⅲ were significantly longer than the group Ⅰ (P ＜ 0.05),and the analgesia time in group Ⅲ were significantly longer than the group Ⅱ (P ＜ 0.05).There were no differences in the recovery time of three groups (P ＞ 0.05).There were no adverse reactions in three groups.Conclusions 0.5 μg/ml and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine may be used on postoperative analgesia in pediatric caudal block anesthesia safely and analgesia effect and time were more better and longer than 0.25％ levobupivacaine singly.The analgesia effect in group with 1.0μg/ml sufentanil mixed 0.25％ levobupivacaine was the best in three groups with the fewest side effects.

WHO proposed the concept of intrinsic capacity in the World Report on Aging and Health in 2015.As the basis of functional ability in the elderly, intrinsic capacity plays an important role in maintaining the quality of life and promoting healthy aging.However, research on intrinsic capacity is still in its infancy.This article reviews research progress on intrinsic capacity, including the concept, domains, screening methods and its impact on the health of the elderly, in order to provide a reference for further research on this subject.

Objective To explore the status of early postoperative social relationship quality and hope level in patients with breast cancer and analyze the correlation between them. Method A questionnaire survey was conducted among 100 patients with breast cancer using the social relationship quality scale and Herth hope scale. Results The total score and expected total score of early postoperative social relationship were (47.86±6.10)and (30.81±1.86), respectively. There was a positive correlation between the two groups (r=0.324,P<0.05). Conclusions The quality of social relations in the postoperative patients with breast cancer is positively correlated with the level of hope. Nursing staff should give breast cancer patients hope and strength at the same time, helping them understand and use social relations to improve the quality of life.

For promoting the quality evaluation of Gardenia resource,a UPLC method for the determination of 4 compounds (geniposidic acid,geniposide,crocin-1 and crocin-2) in Gardeniae Fructus was established.The UPLC separation was performed on an Waters Acquity UPLC BEH-C18 (2.1 mm× 100 mm,1.7 μm) column eluted with the mobile phases of acetonitrile-0.1％ formic acid solution in a gradient mode at a flow rate of 0.3 mL· min-1.The detection wavelengths were 240 nm and 440 nm,respectively.Under the optimum conditions,the calibration curves of four analysis were linear in the range of 0.0065-0.0096 μg· mL-1,with correlation coefficients more than 0.9995.The limits of detection (LODs) of four analysis were in the range of 0.0386-0.1875 μg· mL-1.As the results of determination of 4 compounds of 12 batches of Gardeniae Fructus showed,there was great differences between the contents of the 4 compounds,the contents of geniposide were 2.44％-6.96％,while the contents of crocin-1 were 1.26％-3.04％.In addition,fingerprints of 12 batches of Gardenia resources were built using ChemPattern software,and analysis and exploration over the detection results of several samples were carried out using multivariate statistical method (similarity analysis,principal component analysis and cluster analysis).The present study provided a reference to value the importance of this method in the quality evaluation and quality control of Gardeniae resources and slices.

Objective To establish a rapid staining method for facilitating initial identification of Legionella pneumophila in amoebal trophozoite. Methods Acanthamoeba polyphaga and Legionella pneumophila were co-cultured under laboratory condition. At consecutive time points during the culture, smears of the cultured products were made on glass slides for staining purposes. Different types of stainings including Gram′s staining, Gimenez staining, Giemsa staining and immunofluorescence were used to determine the best method for the identification of amoebal pathogens. Results Gimenez staining technique is simpler and yields better results as compared with the other three stainings. Gimenez stain gives the best color and contrast for amoeba and amoebal Legionella Amoeba trophozoites and/or cysts showed a distinct purplish blue with amoebal Legionella in red. Amoebal Legionella can be distinguished clearly at an earlier time of co-culture, providing a proper sensitivity. It takes only 10 minutes to finish the operation. The other techniques require the use of expensive reagents, are relatively time-consuming, and involve complex staining procedures. Conclusion Gimenez staining is of value for the initial identification of amoebal pathogens, and it is suitable for laboratory diagnosis.

OBJECTIVE To investigate the clinical distribution and resistance of Alcaligenes xylosoxidans,discussing risk factors of nosocomial infection and measures of prevention and treatment.METHODS We retrospectively analyzed 1323 isolated strains of Al.xylosoxidans in our hospital from Sep 2004 to Aug 2006.RESULTS For specimen from which Al.xylosoxidans was examined,sputum accounted for 99.85%,being the highest percentage.Al.xylosoxidans was especially distributed at respiratory ward(46.94%) and intensive care unit(ICU) ward(12.77%).Then was cardiovascular ward,endocrinology ward and hematology ward.The antibiotic drugs which had the high drug-resistance rate(i.e.more than 98%) were aminoglycoside(amikacin and gentamicin),quinolone(ciprofloxacin) and cefepime.But the drug-resistance rate to carbapenems,?-lactam/?-lactamase inhibitor combinations and the third generation cepholosporins(cefoperazone and ceftazidime) was less than 5%.CONCLUSIONS It is important for clinic to strengthen the disinfection for hospital environment and to use antibiotic drugs reasonably in order to control colonization and spread of Al.xylosoxidans in hospital.

Objective To explore the clinical characteristics and treatment of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The clinical data of 67 children with PSVT were analyzed retrospectively, and the therapeutic effects of different treatments were compared. Results The clinical manifestations of infants were paleness, shortness of breath, irritability and sweating, and children showed chest tightness, palpitations, abdominal discomfort and fatigue. The curative effect of electric cardioversion, transesophageal atrial pacing, physical therapy, and drug therapy was statistically different (P<0.05), The different cardioversion rates of them were observed for the treatment of paroxysmal supraventricular tachycardia. The cardioversion rate of transesophageal atrial pacing, was the highest, and the rate of physical therapy was the lowest. There was no significant difference in the cardioversion rate between propafenone, digoxin and amiodarone. Conclusion The clinical manifestations of PSVT in infants are atypical and easily to be ignored. There are many methods for treatment of PSVT. The vagus nerve can be stimulated first, and, if no response, either drugs or electric cardioversion and transesophageal atrial pacing can be used. The cardioversion rate of transesophageal atrial pacing is higher. The drug effectiveness for the treatment of PSVT depends on many factors, and our choice of medication varies from person to person.