Objective To explore the clinical value of dynamic electrocardiogram ( DCG) in the diagnosis of coronary artery damage (CAD) in children with Kawasaki disease (KD).Methods A total of 125 cases of children with KD admitted to hospital in recent years was analyzed , without CAD as the control group (83cases), and others as the experimental group (42cases).All cases were undertaken DCG and electrocardiogram (ECG).The results of heart rate, heart Rhythm, and voltage changes were compared be-tween two groups .Results The abnormal rate of total ECG and DCG in the control group was significantly lower than the experimental group ( P <0.01 ) , The total ECG and DCG abnormal rate was no difference in control group ( P >0.05 ) , but DCG abnormal rate of experimental group was significantly lower than ECG (χ2 =15.30, P <0.01).The sensitivity, specificity, Youden index, and diag-nostic accuracy of normal ECG , DCG and Joint were 59.5%, 86.7%, 0.463 , and 77.6%;95.2%, 94.0%, 0.892 , and 94.4 %;95.2%, 84.3%, 0.796 , and 88.0%.Common ECG results were lower than DCG and joint ( P <0.05 ) , But DCG results were sim-ilar with the joint ( P >0.05 ) .Conclusions DCG test provides scientific parameter in the diagnosis of CAD in children with KD , and is superior to normal ECG , but the value of Joint is the same .

Objective To analyze the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA).Methods The clinical characteristics,laboratory test,therapeutic regimen,pathology and imaging diagnosis in 23 cases with EGPA from the First Affiliated Changhai Hospital of Second Military Medical University within June 2007 to January 2013 were retrospectively analyzed.Results There were 14 males and 9 females,with the age ranged from 21 to 68 years.The mean age was (42±9) years.The overall prevalence of asthma was 78％(18/23).The allergic rhinitis accounted for 61％(14/23).The maxillary sinuses were the most frequendy involved,which accounted for 57％(13/23).Skin involvement was 57％(13/23),peripheral neuritis was 70％(16/23).Central nervous system involvement presented cerebrovascular event.Cardiac involvement accounted for 48％(11/23),digestive system involvement accounted for 17％(4/23).The outcome of auxiliary laboratory test revealed that 96％(22/23) patients expressed significantly higher levels of IgE and 70％(16/23) patients carried anti-neutrophil cytoplasmic antibodies (ANCA) which were presented as the perinuclear ANCA (p-ANCA).The patchy infiltrates of lung CT scan accounted for 69％ (11/23).EMG showed mononeuritis multiplex and symmetric sensory motor neuropathy.The abnormal ratios of ECG and Echocardiography were 48％(11/23),79％(11/14) respectively.The pathological manifestations were necrotizing vasculitis,eosinophilic tissue infiltration,and extravascular granulomas.Conclusion Our results confirm the heterogenicity in clinical presentation and lack of specificity.Early diagnosis and treatment will be helpful for good prognosis.

Objective The aim of this study was to explore the effects of health education intervention on asthma control level for asthma patients through the survey of general demographic information,asthma clinical characteristics of patients with asthma,the Asthma Control Test (ACT),and pulmonary function examination.Methods 126 asthma patients were selected from the clinic and randomly divided into the health education group and the control group.All the patients were followed up for 3 months.In our study,we would scored them in terms of demographic data,clinical features of asthma,asthma cognitive level,medication compliance and Asthma Control Test (ACT) and pulmonary function examination before and after the health education for all patients respectively,and compared the data of the above parameters obtained before and after the intervention and the data from the health education intervention group and the control group.Results In our study,10 cases were lost to follow-up,and 116 cases completed the study at last.There were 68 patients in the health education intervention group and 48 patients in the control group.The results showed that patients with acute attack times,ACT score,pulmonary function indicators and asthma control situations of the health education intervention group after 6 months’ health education,were significantly improved,and the difference was statistically significant.Otherwise,comparison of the contents above of the control group before and after intervention,it was not statistically significant.Meanwhile,com-pared with the control group,the contents above of the health education intervention group were improved with statistically significant differences.Conclusions The standardized health education can improve the quality of life significantly,decrease the asthmatic symptoms,reduce the times of acute onset,which results in maintenance of asthma control,meanwhile the pulmonary function of patients with asthma will improve,so that more patients can live as normal or nearly normal people.

Objective evaluate the role of vagus nerve?muscarinic cholinergic receptor ( M recep?tor) pathway in mitigation of myocardial ischemia?reperfusion (I∕R) injury by intrathecal morphine postcon?ditioning in rats. Methods Seventy adult male Sprague?Dawley rats in which intrathecal catheters were suc?cessfully placed without complications, weighing 250-350 g, were randomly assigned into 7 groups ( n=10 each) using a random number table:sham operation group (Sham group), I∕R group, intrathecal morphine postconditioning group ( MP group) , vagal transection ( VT) group, VT+ intrathecal morphine postcondi?tioning group (VT+MP group), atropine (ATP, M receptor antagonist) + morphine postconditioning group ( ATP+MP group) , and ATP group. Myocardial I∕R was produced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion. Morphine ( 3μg∕kg, 10μl) was in?trathecally infused over 5 min starting from onset of reperfusion in MP group. Normal saline 10 μl was in?trathecally infused over 5 min starting from onset of reperfusion in NS group. The bilateral vagus nerves were transected at 10 min before reperfusion in VT+MP group. Atropine ( 0?1 mg∕kg, 0?5 ml) was intravenously infused over 5 min starting from 10 min before reperfusion in ATP+MP group. The occurrence of cardiac ar? rhythmia ( premature ventricular contractions ( PVCs) and ventricular tachycardia ( VT)∕ventricular fibrilla?tion ( VF) ) within the first 30 min of reperfusion was recorded. The rats were sacrificed at 120 min of reper?fusion, and myocardial specimens were obtained for determination of myocardial infarct size ( IS) as a per?centage of area at risk (AAR). IS∕AAR ratio was calculated. Results Compared with Sham group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly increased in the other groups. Compared with I∕R group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly decreased in MP group. Compared with MP group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly in?creased in VT+MP and ATP+MP groups. Conclusion Vagus nerve?M receptor pathway is involved in miti?gation of myocardial I∕R injury by intrathecal morphine postconditioning in rats.

Objective To determine the effects of curcumin microemulsion on proliferation and apoptosis of the human leukemia cell line K562 cells.Methods The curcumin microemulsion was prepared with the routine procedure.MTT assay was used to determine cell proliferation in cultured K562 cells,flow cytometry analysis was applied to examine cell apoptosis,and WT1 mRNA was determined with RT-PCR.The results about curcumin microemulsion were compared with these on curcumin.Results The prepared curcumin microemulsion was a stable clear solution with diameter of 10-100 nm.Curcumin microemulsion inhibited K562 cell proliferation by 24％,46％,68％with a 24 h incubation at dose of 2.5 μg/ml,5.0 μg/ml,and 10.0 μg/ml respectively,whereas curcumin reduced the proliferation by 6％,14％,25％at equal concentrations.WT1 mRNA level of curcumin microemulsion group(0.190±0.036)was reduced stronger than that of curcusin group(0.456±0.047).Conclusions Microemulsion is a great carrier for curcumin.Curcumin microemulsion is more effective in inhibiting proliferation,pro-apoptosis,and reducing WT1 gene expression than curcumin.A strong basis of medical value for the use of curcumin microemulsion to treat tumors is provided.

Objective To investigate current status of learned resourcefulness in pregnant women,and to identify its influencing factors.Methods With convenient sampling,a self-made General Data Questionnaire and the Chinese version of Self-Control Schedule (C-SCS) was used to survey 360 pregnant women in the antenatal clinic in one three-class hospital in Guangzhou.Results The mean score of learned resourcefulness in pregnant women was (115.00±14.42) and its influencing factors included education degree,gravidity,pregnancy school training and planed pregnancy.Conclusions Learned resourcefulness in pregnant women loads upper level.Medical staff should take targeted interventions to strengthen it and facilitate the mental well-being of pregnant women.

Objective To investigate the application of field work logs in collection of the disaster information in medical rescue of earthquake.Methods The self-designed work logs were made according to the condition of the wounded in the medical rescue of Lushan earthquake.Through the field work logs,we got first hand information which facilitate statistics,inquiry and subsequent follow-up work.Results By using the field work logs,the rescue workers guaranteed the collection of original data timely and accurately,supplied a number of rich and a-list clinical data and also facilitated the masses in disaster areas looking for their relatives.Conclusions The application of field work logs played a pivotal role in medical rescue of Lushan earthquake.It can be widely extended as a general manner in emergency disaster rescue after further perfection.

Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

Objective To study the clinical efficacy of intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA) for the treatment of ischemic cerebrovascular disease caused by cerebral thrombosis. Methods A total of 245 patients accepted by our hospital during May 2013 and July 2015 were divided into the observation group (n=148) and the control group (n=97). All patients were given conventional process for controling blood pressure and blood lipids. Patients in observation group received intra-arterial thrombolysis with rt-PA, while patients in control group accepted conventional treatment. At the time of admission, the demographic characteristic, vascular influencing factors, baseline clinical findings, laboratory findings and neurological deficits were collected. The improvement of neurological function was evaluated by the modified Rankin scale 3 months after treatment. The levels of fibrinogen (FIB), D-Dimer, activated partial thromboplastin time (APTT) and thrombin time (PT) were measured before and 24 h after the treatment. Results There were no significant differences in demographic characteristic and general clinical data between the two groups ( P>0.05). The proportion of patients with improved neurological function was significantly higher in observation group than that of the control group (83.11％vs. 53.61％, P<0.05). There were no significant difference in coagulation index and fibrinolysis index before treatment between the two groups (P>0.05). Twenty-four hours after the treatment, the levels of FIB, D-Dimer, APTT and PT were significantly improved in the observation group compared with those before treatment. The level of FIB was significantly decreased, D-Dimer was significantly increased, APTT and PT were significantly prolonged in observation group compared with those of control group (P<0.05). Conclusion The rt-PA can effectively dissolve thrombosis and correct the coagulation system and fibrinolytic system.

Objective To investigate the role and mechanism of RSPO1 in osteoblasts differentiation.Methods The xCELLigence system was used to study the toxicity and role of RSPO1 on the C2C12 cells proliferation.Alkaline phosphatase (ALP) activity was measured by using a phosphatase detection kit.The expression of osteoprotegerin (OPG) was determined using enzyme-linked immunosorbent assay (ELISA).Wnt/β-catenin signaling was evaluated using the TOPflash T cell factor (TCF) luciferase reporter assay.Western blotting assay was performed to confirm the accumulation of β-catenin protein.T test was used for statistical analysis.Results RSPO1 had no effect on the C2C12 cells proliferation,and it produced no toxicity to C2C12 cells.RSPO1 alone resulted in a slight increase in the activity of ALP (2.85±0.08 vs 1.74±0.21,t=3.014,P＜0.05) and the expression of OPG (1.29±0.13 vs 1.00±0.21,t=3.348,P＜0.05),whereas the combination of RSPO1 and Wnt3A significantly amplified ALP activity (81.37±5.08 vs 1.74±0.21,t=31.31,P＜0.01) and OPG protein expression (5.26±0.60 vs 1.00±0.21,t=6.99,P＜0.01).RSPO1 synergized with Wnt3A to activate TCF activity and induce accumulation of β-catenin (3.28±0.18 vs 1.00±0.21,t=10.94,P＜0.05).However,RSPO1 alone had no effect on the TCF activity and β-catenin accumulation (1.25±0.08 vs 1.00±0.21,t=2.225,P＞0.05).Conclusion Our study has revealed that RSPO1 synergized with Wnt3A in activating Wnt/β-catenin signaling pathway to induce osteoblasts differentiation,which demonstrate the therapeutic potential of RSPO1 for RA.