Objective To investigate the effect of patent ductus arteriosus(PDA)on myocardial injury of premature infants.Methods From May 1,2010 to January 31,2011,110 preterm infants with gestational age from 28 to 36 weeks accepted echocardiography examination,and their blood samples were collected to determine cardiac troponin T(cTnT)and creatine kinase MB isoenzyme (CK-MB)levels 72 h and 3 d after deliveries.All subjects were divided into two groups according to the echocardiogram results:PDA group(n=44)and control group(n=66).The infants with PDA were treated with ibuprofen,and then echocardiography was taken again.cTnT and CK-MB were re-measured in both groups.Chi-square test,t-test,multi-variate linear regression and Spearman rank correlation test were perfomed for statistical analysis.Results Before treatment,cTnT[(0.259±0.134)μg/L]and CK-MB[(7.31± 2.69)μg/L]level of PDA group were significantly higher than those[(0.083±0.054)μg/L and(5.71±1.88)μg/L]of control group(t=9.557 and 2.588,P＜0.01 and ＜0.05,respectively).For 34 infants with successful treatment,cTnT and CK-MB levels decreased markedly to(0.062 ± 0.039)μg/L and(5.34 ± 1.50)μg/L,respectively(t =9.268 and 5.974,all P＜0.05),compared with those levels before treatment.For the ten infants failed to close ductus,the cTnT and CK-MB levels[(0.193±0.049)μg/L and(6.93±1.63)μg/L,respectively],were lower than those before treatment(t=1.525 and 0.766,all P＞0.05),while higher than those of the control group(t=9.068 and 4.055,P＜0.05).Level of cTnT positively related to the duration of ventilation,PDA and respiratory distress syndrome,while did not relate to gender,gestational age and birth weight.CK-MB level was associated to gender,gestational age,birth weight,duration of ventilatory support and PDA.In PDA group,the cTnT level was positively related to the diameter of the ductus,but not related to any indicators in echocardiography.Conclusions Symptomatic PDA could cause myocardial injury in preterm infants.The changes of blood cTnT and CK-MB were consistent with the severity of PDA.Serial measurements of blood cTnT and CK-MB might help to make early diagnosis and treatment for premature infants with PDA and myocardial injury.

Oral English teaching for Chinese postgraduates has always been focused on the drill of language skills,thus little attention was paid to the cultivation of students' thinking ability. This pa-per explored into the definition and theoretical basis of critical thinking and gave a case analysis of how to integrate the cultivation of critical thinking skills into the oral English classrooms in an effec-tive way. The questionnaire and interview among students showed that questioning,controversial dia-logue,debate and survey can help students to form the habit of critical thinking in an effective way and are also proved to be popular among medical postgraduates.

Objective To explore the effect of various information means in the training of newly recruited nurses and to provide a practical basis for comprehensive and thorough development of the training. Methods Nurses who are enrolled in 2015 were chosen as the test group. Its applications can be in the form of Mobile APP,office software,online software and We Chat public platform. Afterwards,the effect of various information means can be judged by comparing the test results with the nurses who are enrolled in 2013 (the control group). The nurses in the test group were surveyed in the form of questionnaires to evaluate the training effect. Results The scores of theory ex amination and nasal feeding in the test group were higher than those of control group(P<0.01). The 93.8 percent of the nurses in test group believe that training is beneficial to the understanding and consolidation of knowledge as well as to improve the ability of self-learning. Also the training effect is prominent. Conclusion The various information means in the training of newly recruited nurses can improve training efficiency and enhance training effectiveness.

Objective To establish a reproducible mouse model of hepatic veno-occlusive disease (HVOD) after allogeneic bone marrow transplantation (aallo-ABMT) and explore its pathogenesis.Methods Balb/c mice were randomly divided into three groups:(1) normal saline (NS) control group; (2) total body irradiation (TBI) group; (3) allogeneic bone marrow transplantation (allo-BMT) group.Liver weight,total bilirubin (TBil),tumor necrosis factor α (TNF-a),interleukin 6 (IL-6) and monocyte chemotactic protein 1 (MCP-1) were detected on the day 0,5,10,15 and 20 after transplantation.Hepatic vein and sinusoid congestion,infiltration of inflanmatory cells,and damage to hepatic cells and vascular endothelial cells were observed under the light microscopy after HE staining.Fibrosis of hepatic sinusoids and venule was observed under the light microscopy after Masson staining.Results Liver weight and TBil levels were elevated at 5th day and reached the peak at 15th day after all-ABMT.The changes of hepatic congestion and edema were obviously observed and there was infiltration of inflammatory cells at 5th and 10th day after alloABMT.At 15th and 20th day,hepatic congestion,edema and necrosis were reduced and liver damage was mainly presented with liver fibrosis and inflammatory infiltration.All mice died within 10 days after TBI,and hepatic congestion and edema were aggravated.As compared with NS control group,TNF-α,IL-6 and MCP-1 concentrations were significantly increased after all-ABMT.Conclusion A reproducible mouse model of hepatic veno-occlusive disease after all-ABMT was successfully established,and the pathogenesis was closely related to endothelial damage caused by total body irradiation,inflammatory cell infiltration and increased concentrations of cytokines.

Objective To analyze the serotypes of enteroviruses(EVs) isolated from patients with influenza-like illness in Beijing in 2017. Methods Oropharyngeal swab specimens were collected from pa-tients with influenza-like illness in eight districts of Beijing from July 2017 to October 2017. EVs were detec-ted by real-time PCR. Specific primers were synthesized and used to amplify the VP1 fragments of EVs. PCR products were sequenced and the results were compared with the reference sequences by using Basic Lo-cal Alignment Search Tool(BLAST) to identify the serotypes of isolated EVs. Results A total of 666 spec-imens were collected and 91 (13.66%) were positive for EVs. VP1 sequences of 66 EVs were successfully amplified and BLAST analysis revealed that these strains belonged to 14 serotypes,including seven serotypes of EV-A species,six serotypes of EV-B species and one serotype of Rhinovirus species. The predominant se-rotypes were CVA2 and CVA6. Eight out of 14 CVA6 strains that were collected in Shunyi District shared high homology. All seven CVB5 strains were collected in Shijingshan District and grouped into one cluster. Conclusion EVs causing influenza-like illness in Beijing in 2017 belonged to 14 serotypes and CVA2 and CVA6 were the predominant serotypes.

Objective:To evaluate the diagnostic value of intestinal regional oxygen saturation（rSO 2）and fecal calprotectin in the occurrence and severity of necrotizing enterocolitis（NEC）in premature infants. Methods:A prospective observational study was conducted among premature infants admitted to Quanzhou Children's Hospital from October 2019 to December 2022. Intestinal rSO 2 was monitored within two hours of diagnosis of NEC，and fecal calprotectin was measured. Results:A total of 60 patients were included, including 30 cases with NEC and 30 cases without NEC, 14 cases of medical NEC, 16 cases of surgical NEC, and eight infants died due to NEC. Infants with NEC had lower intestinal rSO 2 [49（30，60）% vs. 66（60，69）%] and higher calprotectin levels [479（297，886）μg/g vs. 203（113，275）μg/g] than those in infants without NEC ( P<0.01). The levels of intestinal rSO 2 were lower in surgical NEC than those in medical NEC，and were lower in the death group than that in the survival group ( P<0.01)，but no similar difference was found in the levels of calprotectin. ROC curve analysis showed that intestinal rSO 2 combined with calprotectin had a sensitivity of 73%，a specificity of 100%，and the largest area under curve of 0.91 in the diagnosis of NEC. Intestinal rSO 2 had an optimal cut-off value of 31% in predicting death in infants with NEC，with a sensitivity of 100%，a specificity of 95%，and an area under curve of 0.99. Conclusion:Intestinal rSO 2 and fecal calprotectin can effectively identify the presence of NEC，and their combined detection can improve the diagnostic efficiency. Intestinal rSO 2 is a good predictor of the severity of NEC，but not fecal calprotectin.

OBJECTIVETo explore the function of nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP3) inflammsomes in liver damage after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSThe study presented a murine (BALB/c-based) model of allo-HSCT. Chimera rate was measured by flow cytometry. The hematoxylin-eosin, Masson's trichrome, immunohistochemistry staining were used to observe the pathology changes in liver, then measured the degree of liver damage. Inflammation cells and NLRP3 were measured by Western blot, cytokines IL-1β, IL-18 and NLRP3 related genes were tested with real-time quantitative polymerase chain reaction (q-PCR).

RESULTSHematopoietic stem cells had been successfully transplanted, the chimera rate was geater than 97% on the 10th day. Liver damage occurred after allo-HSCT and suffered infiltration of inflammation cells, which reached the peak on day 15, then moved to moderate; the cytokines IL-1β, IL-18 had the similar trend with liver injury, and reached the highest level on day 15, their mRNA expressions increased by (1.19 ± 0.40) fold and (1.64 ± 0.76) fold, respectively; Meanwhile, caspase-1 had the similar trend, its mRNA expression increased by (3.51 ± 0.46) fold on day 15; the inflammasomes NLRP1, NLRP3, NLRC4 and NLRP5 expressed in liver on day 15 of post-allo-HSCT, and NLRP3 inflammasome expressed highest among them. The mRNA and protein level of NLRP3 inflammasomes were kept with the serious degree of the liver damage, its mRNA expression increased by (2.91 ± 0.41) fold on day 15.

CONCLUSIONNLRP3 inflammsome expressed in liver injury during allo-HSCT in mice, and may be one of the important factors contributed to liver injury.

Animals ; Carrier Proteins ; metabolism ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Inflammasomes ; metabolism ; Liver ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; NLR Family, Pyrin Domain-Containing 3 Protein ; Postoperative Period