Hypocalcemia often exists in critical illness children. Most of the sick children do not have an underlying disease of calcium homeostasis, and the mechanism of the hypocalcemia is complicated. Abnormal values of blood calcium may be a sign of critical illness and normalize spontaneously with resolution of the primary disease process. Hypocalcemia may be a autoprotection , and it may be harmful if we try to correct it. This article focuses on the theory and clinical treatment of hypocalcemia in critical illness children.

Objective To study the prognosis of patients with unstable angina in PCI adverse events factor analysis,and the function of CYP2C 19 gene mutations.Methods From May 2013 to May 2015,226 cases of PCI postoperative patients,after surgery all took aspirin + clopidogrel maintenance to treat for 1 years,analyzed CYP2C19*1,CYP2C19*2,CYP2C19 *3 genotype with fluorescent polymerase chain reaction (PCR),the patients were followed up for 6 months.According to the result of detection of genotype divided into wild type group (CYP2C19 *1/*1),the mutation of mixed group (CYP2C19 *1/*2 and CYP2C19 *1/*3) group and mutations in pure form group (CYP2C19 *2/*2 and CYP2C19 *3/*3).Observed the occurrence of unstable angina of three groups prognosis.Results The mutation of mixed to form and mutation of pure form had a record of hospital clinical adverse events (61.9％ and 45.3％) was significantly higher risk of wild group (42.4％),with statistical significance (P ＜0.05);Logistic regression analysis of diabetes and CYP2C19 genotype with PCI postoperative patients with unstable angina occurred in hospital records of clinical adverse events had good correlation (R =3.424,P=0.009 and R =5.679,P =0.001).Conclusion The CYP2C19 gene mutations and diabetes patients with unstable angina PCI postoperative prognosis is closely related,the lack of CYP2C19 gene type are more likely to affect the prognosis of unstable angina,provide reliable basis for further research.

OBJECTIVE:To investigate clinical efficacy and toxic and side effects of bevacizumab combined with chemothera-py in the treatment of advanced gastric cancer. METHODS:84 patients with advanced gastric cancer were randomly divided into combination group and chemotherapy group,with 42 cases in each group. Chemotherapy group received FOLFOX4 chemotherapy regimen(oxaliplatin+calcium folinate+fluorouracil);combination group was additionally given bevacizumab 7.5 mg/kg intravenous-ly,d1,on the basis of chemotherapy. A treatment course lasted for 21 d,and both groups received 3 courses of treatment. The short-term efficacy,the quality improvement of life,serum tumor marker before and after chemotherapy and the toxic and side ef-fects were compared between 2 groups. RESULTS:The effective rate in combination group(57.14%)was significantly higher than chemotherapy group(35.71%),improvement rate of life quality in combination group was higher than chemotherapy group,reduc-tion rate of life quality in combination group was lower than chemotherapy group,the differences were statistically significant(P<0.05);after chemotherapy,the serum CEA and CA199 levels were significantly decreased in both groups,the decrease of combina-tion group was more significant than that of chemotherapy,with statistical significance(P<0.05). The incidence of decrease in leu-cocytes,platelet and hemoglobin,periphery neurotoxicity,nausea and vomiting,liver and kidney function in combination group was higher than in chemotherapy,but there was no statistical significance (P>0.05). CONCLUSIONS:Bevacizumab combined with chemotherapy is effective in the treatment of advanced gastric cancer and don’t increase toxic and side effects.

Objective:To construct a suppression subtractive library of suppression-related genes from c serotype Streptococcus mutans (S.mutans). Methods:After being isolated from virulent and avirulent strain of S. mutans respectively, the intact and high-pure genomic DNAs were digested with restriction enzyme AluⅠ. The digested DNA of the avirulent strain ligated with an adaptor was used as tester DNA, and that of the virulent strain as driver DNA. Then the suppression subtractive hybridization(SSH) was carried out, the efficiency of ligation and subtraction were detected respectively. The subtracted fragments were inserted into vector pCR2.1 using T/A cloning kit and transformed into E. coli TOP10F' competent cells. The white colonies were selected to construct the suppression subtractive library. Results: Through electrophoresis of AluⅠ-digested DNAs, a smear ranged from 0.1 to 2.0 kb was observed. The ligation efficiency of tester DNA with adaptor was at least higher than 25 percent. The subtraction efficiency confirmed the success in enrichment of differential genes between virulent and avirulent strain of S. mutans. In the subtracted group, the appearance time of the 23S rRNA gene in both tester and driver DNA was later than that in the unsubtracted group by twelve cycles. It suggested that suppression subtractive hybridization happened indeed. Then the subtracted fragments were cloned and the suppression-related gene library between virulent and avirulent strain of S. mutans was constructed. Conclusions:The suppression subtracted library of suppression-related genes has been constructed.

Objective:To explore avirulent strain-specific new genes or new functions of already known genes from Streptococcus mutans of serotype c.Methods:Twenty-six DNA fragments unique to avirulent strain of Streptococcus mutans were sequenced.The sequences of these presumptive avirulence DNA fragments were subjected to homology search through BLASTn and BLASTx in public database,and their putative biological functions were analyzed.Results:The size of the DNA fragments ranged from 113 bp to 776 bp.The average G+C content was 38.27%,similar to that of the gene-codingsequences in Streptococcus mutans strain UA159 whose genome sequences were just completed.Seven clones were picked repeatedly.Of the nineteen DNA fragments,eight potentially represented new DNA fragments were registered in GenBank.The remaining DNA fragments showed high homology to known genes of Streptococcus mutans strain UA159.Conclusions: The gene analysis and identification supply the groundwork for further study of gene functions of the avirulent strain of Streptococcus mutans serotype c.

Visfatin is a recently discovered adipokine secreted by visceral adipose tissue,corresponds to pre-B cell colony-enhancing factor(PBEF), which is composed of 473 amino acid coding a 52kDa polypeptide and expressed in bone marrow,liver,muscle and so on.Visfatin binds and activates the insulin receptor,exerting insulin-mimetic effects;promotes adipose tissue to differentiate,synthesis and accumulate,which is correlated with obesity;promote vascular smooth muscle cell to mature,participating in the processes of inflammatory response and cell differentiation and apoptosis.The multi-function of visfatin increases new contents of correlated disease pathogenesis and new targets of disease management.

Objective To investigate the effect of L-carnitine combined with psychological intervention on nutritional status and inflammatory status in maintenance hemodialysis patients. Methods 75 cases of maintenance hemodialysis patients treated in our hospital from September 2016 to December 2016 were randomly divided into control group(n=37) and study group(n=38)by single and double number method (hospital visit order). The control group in the hemodialysis treatment combined with Levocarnitine; the study group in the use of L-carnitine combined with psychological intervention. Results There were no significant differences in ALB, Hb, BMI, IL-6 and CRP between the two groups before treatment. After the corresponding treatment, the improvement of ALB, Hb, BMI, IL-6, CRP and other inflammatory indexes and nutritional indexes in the study group were better than those in the control group(P<0.05). Conclusion The application of L-carnitine in maintenance hemodialysis patients combined with psychological intervention can significantly improve the body's Micro inflammatory status and nutrition indicators, has positive significance to protect the patients' quality of life and physical and mental health.

Objective To investigate the relationship between bacteria biofilm and bacterial culture in patients with chronic rhinosinusitis (CRS). Methods Ninety patients with CRS were enrolled in the study. Five patients with deviation of nasal septum and 10 healthy subjects served as controls. Mucosa of uncinate process or near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery. All specimens were processed for bacterial culture and scanned by electron microscopy. Pearson test was performed to analyze the relationship between the presence of bacterial biofilm and the results of bacteria culture. Results The scanning electron microscopy showed bacterial biofilms in 64 (71.1%) out of 90patients with CRS, while the positive rate of bacteria culture in the study group was 66.7% (60/90). No bacterial biofilm and bacterium was detected in the control group and 26 culture-negative individuals in study group. Pearson correlation analysis showed a statistically association between bacterial biofilm and bacterial culture in CRS ( r = 0. 901, P = 0. 000). Conclusion Positive results of bacteria culture are highly correlated with the presence of bacterial biofilm in CRS patients.

The relationship between C936T polymorphism at 3'-untranslated region of vascular endothelial growth factor (VEGF) gene and diabetic nephropathy (DN) was analysed in 194 type 2 diabetic patients. The frequencies of genotype CC and allele C were significantly higher in DN group than those in non-DN group and control group. Allele C and genotype CC of VEGF may be a genetic marker susceptible to DN.

Objective To investigate the risk factors of postoperative infection in patients with liver transplantation.Methods Clinical data and laboratory findings of 1 1 3 patients undergoing liver transplantation admitted in Beijing Chaoyang Hospital,Capital Medical University during January 201 1 and December 201 4 were retrospectively analyzed.Among 1 1 3 patients,postoperative infection occurred in 35 patients,multivariate Logistic regression analysis was performed to identify the risk factors of postoperative infection.Results Univariate analysis showed that length of hospital stay,model for end-stage liver disease (MELD)score,preoperative use of antibiotics,duration of postoperative respirator use,length of ICU stay, dosage of albumin,days of parenteral nutrition,intra-abdominal hemorrhage,fasting blood glucose,blood concentration of immunosuppressant (FK506 ),the duration of prophylactic use of antibiotics and pleural effusion were associated with postoperative infection (t =2.56,3.1 9,2.71 and 5.05;χ2 =3.87,5.75,4.66 and 5.46;Z =4.88,3.69,5.86 and 3.90;P <0.05 or <0.01 ).Multivariable logistic regression analysis showed that preoperative use of antibiotics (OR =35.03,95% CI:6.48 -94.64,P <0.01 ),duration of postoperative respirator use (OR =1 .02,95%CI:1 .01 -1 .04,P <0.01 ),days of parenteral nutrition (OR =1 .20,95%CI:1 .07 -1 .35,P <0.01 ),postoperative fasting plasma glucose(OR =1 .46,95%CI:1 .1 0 -2.1 6,P <0.05),the duration of prophylactic antibiotics use (OR =1 .1 0,95%CI:1 .33 -1 .86, P <0.05),and pleural effusion(OR =5.70,95%CI:1 .02 -31 .84,P <0.05 )were independent risk factors of postoperative infection.Conclusion Taken account of possible risk factors,effective prevention and control measures should be taken to prevent postoperative infection after liver transplantation.