Objective To investigate the early comprehensive intervention on neonatal hypoxic ischemic encephalopathy (HIE) effects and the biological mechanisms.Methods 120 cases of HIE were randomly divided into intervention group and control group.Under the basis of drug treatment,the intervention group were given the different perceptual stimuli,audiovisual stimulation,active and passive limb training early comprehensive intervention,the control group only to normal drug treatment.The mental development index(MDI) and psychomotor develo pmental index (PDI) were applied after 3,6,12,and 18 months.S100B protein levels were detected using enzyme immunoassay.Results MDI score in the intervention group with HIE,from the beginning of the 12 month,was higher than that in the control group,there was significant differences (12th month:(96.6±9.4)vs (86.8±9.5),P<0.01).PDI score from the beginning of the 6 month,was higher in the intervention group with HIE than that in the control group,there were significant differences (6th month:(91.6±9.2)vs (82.2±11.0),P<0.01).Serum S100B protein level has a tendency to fall for all HIE patients with the old growth.Born in two groups of serum S100B protein levels were higher in neonate period,but there was no difference(P>0.05).From the beginning of the 3rd month,serum S100B protein levels in the intervention group were reduced significandy,compared with the control group at each time point level(3rd month:(1.29±0.15)ng/L vs(1.40±0.14)ns/L;6th month:(1.06±0.21)ng/L vs(1.26±0.22)ng/L,P<0.01).Conclusion Early intervention can improve the mental and motor development of children with HIE,and serum S100B protein is involved in the mechanisms.

Objective To summarize the meticulous nursing experience of indwelling urinary catheter between the children with hypospadias during perioperative. Methods 317 cases of indwelling urethral only in the silicone Foley tube, and without other urinary diversion with hypospadias were retrospectively analyzed, summarized the fine points of nursing, including preoperative children with comprehensive risk assessment, standardized preoperative skin preparation and postoperative protective constraint, effective properly fixed catheter keep the urine drainage unobstructed, close observation of urine drainage characteristics, maintain urine collection system tightness, maintain perineal skin clean and improved extubation nursing method, and do a good job after extubation nursing. Results 266 cases were cured with a cure rate of 83.9%(266/317);the incidence of urine leakage in 42 cases, the incidence rate was 13.2%(42/317); 7 cases of urethral stenosis, the incidence rate was 2.2%(7/317); 2 cases of urethral closing, the incidence was 0.6% (2/317), none of the patients had accidental extubation. Conclusions The meticulous nursing has a better effect in hypospadias patients during the perioperative period and it can reduce the incidence of postoperative complications;shorten the time of hospitalization and alleviate the suffering of children;improve the quality of nursing service, which is worthy of clinical application.

AIM: To determine the evolutionary pattern of parenchymal cell apoptosis in multiple organs early after intestinal ischemia-reperfusion(I/R) and its induction mechanisms and the role of apoptosis in triggering SIRS/MODS. METHODS: An I/R model was reproduced by clipping and releasing the superior mesenteric artery in rats and mice. Flow cytometry, electron microscope, DNA agarose gel electrophoresis, TUNEL method, fluorescent and Gomori's silver-HE staining were used to detect apoptosis. Distribution features of apoptotic parenchymal cells in multiple organs were observed. Immunohistochemical staining of HSP 70 and Bcl-2 were performd to study the induction mechanisms of apoptosis.RESULTS and CONCLUSION: 1. Damage of the liver, lung, gut and kidney was appeared in early phase of I/R. The percentages of apoptosis in parenchyma organs increased progressively. The percentages of cell necrosis increased with the prolonged I/R duration. 2. Percentages of apoptosis were much higher near the central veins of liver lobules, in the outer medulla of the kidney, and the antimescenteric border of intestinal mucosal epithelium because of ischemia. 3. The expression of HSP 70 increased and Bcl-2 reduced in the areas mentioned above because of hypoperfusion. 4. Apoptosis of I/R hepatocytes, splenocytes and thymocytes was obviously increased after Kupffer cell blockage with GdCl3, showing the functional state of Kupffer cells may play an important role in SIRS/MODS.

Objective To evaluate the curative effect of LASIK for correcting compound myopic astigmatism.Methods One hundred and sixteen eyes in 68 patients with compound myopic astigmatism had been corrected with LASIK.All patients were followed up for more than 12 months.Meanwhile,all eyes were divided into two groups according to the preoperative astigmatism:group I (-2.25～ -3.00D),group Ⅱ (-3.2.5～ -6.00D).Results In group I :the average refractive cylinder was (- 2.51±0.68) D preoperafion, and had the average of (- 0.51±0.25) D residual astegmatism postoperation.In group Ⅱ :the average refractive cylinder was (- 3.85±0.46) D preoperation, and had the average of (- 0.52±0.22)D residual astigmatism postoperation.There was no statistical difference in astigmatism between the two groups after 12 months.In group Ⅰ and Ⅱ the visual acuity after operation was better than the corrected visual acuity before operation.Conclusion For compound myopic astigmatism LASIK was safe and effective.

Objective To evaluate the effect of clinical pathway management on pediatric capillary bronchitis. Methods Infants with capillary bronchitis admitted to our hospital were selected. Several indices were compared between the infants with and without clinical pathway management including hospital stay, costs of hospitalization, satisfaction in parents of children, cure rate, readmission rate one week after discharge, hospital infection and variation in the process of clinical pathway manage-ment. Results A total of 204 eligible infants were divided into research group (n=96) and control group (n=108). There were no signiifcant differences in sex, age, respiratory rate, heart rate and temperature, and detection rate of respiratory syncytial virus in nasopharyngeal secretion and sputum culture (P>0.05). Compared with the infants in control group, the total drug costs, the an-tibiotics costs and the average length of stay were signiifcantly decreased in infants with clinical pathway management (P<0.05). There were no signiifcant differences in such indices as satisfaction in parents of children, cure rate, readmission rate one week after discharge and hospital infection rate between two groups (P>0.05). In research group, 49 infants (51.04%) completed the clinical pathway management. Positive variance was found in 43 infants (44.79%) and negative variance in 4 infants (4.17%). Two infants (2.08%) dropped out. Conclusions For capillary bronchitis in infants, clinical pathway management has an effect on controlling and reducing the medical expenses, and meanwhile improving the medical quality and satisfaction of patients.

ObjectiveTo explore the clinical characteristics, diagnosis and treatment of neonatalCandida arthritis. Methods The clinical data from one case of neonatalCandida arthritis with swelling and pain in multiple joints as the ifrst symp-toms were reviewed.Results Boy born at 31 weeks' gestational age had the birth weight of 2100 g. The patients was admitted to neonatal intensive care unit after birth and treated with antibiotics for a long time due to infection. At 24 days after birth, blood culture showed the growth ofCandida albicans. At 29 days after birth, the bilateral knee joints showed swelling. TheCandida arthritis was diagnosed through X ray and joint-cavity lfuid culture. The patient was treated with Fluconazole for 13 weeks. When discharged, the joints swelling had been disappeared, while the muscle tension of the double upper limbs was signiifcantly weak. The shoulders had visible slight activities independently. The ifngers, wrists and elbows had less independent activities. The muscle tension of the double lower limbs was slight and the independent activity was more than upper limbs, but the extend was smaller than normal. The palmar grasp relfex was weak. The 30 months follow-up showed that each joint had even length, no abnormality and normal activities. The language and intelligence were normal.Conclusions NeonatalCandida arthritis is mostly combined with or secondary to systemic disseminated candidiasis, and the priority therapy is antifungal drugs. Surgical operation can be considered if necessary, which can improve the prognosis.

Objective To investigate regional ventricular long-axis velocity and adjacent intraventricular flow velocity using dual-pulse wave(PW) Doppler echocardiography synchronously,and to analyze the coupling relationship between regional ventricular long-axis strain and adjacent intraventricular pressure gradients in normal cases using dual-PW Doppler echocardiography.Methods Eighty-six normal subjects aged 19～66 years [mean age (37.49 ± 11.97)years] underwent routine echocardiography and dualPW Doppler echocardiographic exam.Total 18 segments were sampled using dual-PW Doppler (PW/TDI mode) images at basal,mid and apical levels on three standard apical views,and electrocardiogram was recorded simultaneously.Peak early diastolic velocity (emax),peak late diastolic velocity (amax),peak early mitral diastolic inflow velocity (Emax),regional peak early diastolic velocity (Em),regional peak late diastolic velocity (Am) and regional peak early diastolic inflow velocity (E) were measured simultaneously in the same one cardiac cycle.Myocardial variations of left ventricular segments were observed.Em,Am and E of different levels from different ventricular wall were analyzed.The co-relationship between regional ventricular long-axis strain and adjacent intraventricular pressure gradients were calculated and analyzed.Results ①Regional myocardial velocity and regional peak early diastolic inflow velocity in normal subjects declined from basal to apical segments gradually at the same ventricular wall (P ＜ 0.01).② Emax was correlated with emax(r =0.418,P ＜0.001),and E was correlated with Em (posterior septum,r =0.610,P ＜0.001 ；anterior wall,r =0.499,P ＜0.001).③There was a medium correlation between normal longaxis strain in segments and adjacent intraventricular pressure gradients (the global,r =0.412,P ＜0.001 ；posterior septum,r =0.319,P ＜0.005).Conclusions The acquirement of E and Em by dual-PW Doppler showed downtrend of segmental wall movement and regional blood flow from basal segment to apex.Emax is correlated with e E is correlated with Em,and long-axis strain at segments is correlated with adjacent intraventricular pressure gradients partly.Dual-PW Doppler might provide a potential method for the more precise evaluation of left ventricular fluid-solid coupling during diastole.

Objective To investigate efficacy of citalopram on pathological crying after cerebral infarction.Methods 106 patients with pathological crying after cerebral infarction were randomly divided into two groups,treatment group(54 cases) and control group(52 cases).Control group received conventional treatment of cerebrovascular disease.Treatment group taken citalopraml0-20mg orally one time per day for three months based on conventional treatment.The total response rate,effectual time,and Hasegawa Dementia Scale (HDS) scores were compared between two groups after treatment.Results There were significant differences in total response rates (94.4％ and 38.5％,respectively),effectual time(1.98 ± 1.24 and 78 ± 17.95,respectively) and HDS(8.43 ±2.21 and 6.24 ±2.02,respectively) between treatment group and control group (P ＜ 0.01).Conclusion The study suggests that it is effective to treat pathological crying with citalopram and its effect is quick.Citalopram can not only control patient’s pathological crying,but also improve cognitive function.

The variable heavy chain region (VH) genes of 3 untreated patients with B-cell chronic lymphocytic leukemia (B-CLL) were cloned and analyzed. The VH family used was VH3-11, VH3-72 and VH3-33. More than 2% difference from the corresponding germline gene was detected in all the 3 obtained potential functional genes (average 16.7). Mutation pattern analysis indicated evidence of antigen selective pressure observed in 1 of 3 cases. Our findings suggested that the tumor cells originate from post-GC cells.
Amino Acid Sequence ; Gene Rearrangement ; Immunoglobulin Variable Region/*genetics ; Leukemia, B-Cell, Chronic/*genetics ; Molecular Sequence Data ; *Mutation

OBJECTIVE:To effectively prevent and treat antibiotic-associated diarrhea (AAD). METHODS: Take some clinical cases to analyse and summarize the result about multiple micro-ecological preparations such as probiotic yoghurt,lively bacterium preparation and prebiotics being used to prevent and treat AAD. RESULTS: It was showed by cases that probiotic yoghurt and lively bacterium preparations could effectively prevent AAD in patients with AAD risk factors,and the application of micro-ecological preparations exhibited a remarkable efficacy for the patients with AAD. CONCLUSION: Rational application of micro-ecological preparations is conducive to the prevention and treatment of AAD.