Objective To investigate the effects of different flow volume of continuous 1:1 blood crystalloid cardioplegia on open heart surgery.Methods Retrospective randomized study was performed on 80 patients undergoing valve replacement and congenital heart disease with 1:1 blood crystalloid cardioplegia by minimum-flow continuous perfusion[0.5ml/(kg·min),group A,40 cases],high-flow continuous perfusion[(2.0 ml/(kg·min),group B,40 cases).The changes of creatine kinase(CK),isoenzyme of creatine kinase(CK-MB),lactate dehydrogenase(LDH),lactic dehydrogenase isoenzyme(LDH_1)were detected before operation and at 6,12,24,48,72 h after operation.Results The cardioplegia liquid was (41.72±7.98)ml/kg in group A,(142.09±9.65)ml/kg in group B,there was significant difference between two groups(P<0.05).During the first 72 h postoperative the value of CK,CK-MB,LDH and LDH1 in two groups were increased to different degree,serum enzymes levd increased significantly between 12,24 h after operation(P<0.05)and return to normal at 72h after operation in two groups.Butbetween two groups there was no significant difference(P＞0.05).ConclusionMinimum-flow continuous perfusion of 1:1 blood crystalloid cardioplegia appears to be superior in safety,decrease of myocardial enzymes integrity.

Diffuse large B-cell lymphoma (DLBCL) is the aggressive non-Hodgkin's lymphoma.Rituximab in combination with chemotherapy had improved the outcomes,however,a substantial proportion of these patients transfer into refractory or eventually relapsed lymphoma after using R-CHOP as a front-line treatment regimen with poor prognosis.With the research development on DLBCL and its related gene,it is confirmed that gene biological targeted therapy can improve the prognosis of patients with refractory /relapsed DLBCL (RR-DLBCL).Recently,some new targeted therapies become research hotspots.This review will focus on recent development and future direction of biological targeted treatment in RR-DLBCL.

Acute kidney injury (AKI) is the most common and serious complication in the intensive care unit.The mortality of AKI is still as high as 60％ in critically ill children because of lack sensitive and special early predictive biomarker.Neutrophil gelatinase-associated lipocalin is one of the most promising early diagnose and predict biomarkers for AKI,produced and secreted by kidney tubule cells at low levels,but increasing dramatically in the urine and serum after ischemic, sepsis, or nephrotoxic injury of the kidneys.This review is to summarize the role of neutrophil gelatinase-associated lipocalin as an early biomarker of AKI with different clinical settings in children.

Objective To explore the effect of cognitive therapy on patients with traumatic paraplegia.Methods Toally 100 traumatic paraplegia patients were randomly divided into observation group and control group with 50 cases in each.The control group received routine nursing intervention and the observation group cognitive therapy on the basis of intervention for the control group.The two groups were compared in terms of anxiety,depression,mental health,suicidal ideation and quality of life by the instruments of self-rating anxiety scale (SAS),self-rating depression scale (SDS) and suicide attitude questionnaire (SQA) before and after intervention.Results Before the intervention,the scores by SDS,SAS scores and SQA were insignificant different between the groups (P＞0.05).Mter the intervention,the scores on suicidal ideation in the observation group were significantly higher and the quality of life were significantly higher and the depresion and anxiety and the mental health status were lower than those of the control group (P ＜0.05).Conclusion The cognitive therapy for the patients with traumatic paraplegia can significantly alleviate their depression and anxiety,reduce their suicidal ideation and improve the quality of life.

Objective To investigate the influence of inspired oxygen fraction (FiO2) on the ratio of PaO2/FiO2(P/F) during the implementation of lung protective ventilation strategy in patients with acute respiratory distress syndrome(ARDS) in order to unravel its clinical significance. Method This was a prospective study of 16 selected patients with ARDS treated with mechanical ventilation ( MV ) to get ratio of P/F in range of 100 to 200 by PEEP≥5 cmH2O and high inspired oxygen. After lung recruitment maneuvers by BiPAP with high pressure (PH) of 40 cmH2O for40 s, the MV was maintained the basic requirement for stabilizing the patients for 30 minutes. A series of FiO2 were set at fractions of 0.5,0.6,0.7,0.8,0.9 and 1in random sequence, and the changes of respiratory mechanics, blood gas and hemodynamics under the different concentrations of FiO2 were analyzed by using SPSS version 13.0 software. Results ( 1 ) The ratio of P/F increased as FiO2 increased, and it's significant as FiO2 increased to 0.7 or above. As the fractions of FiO2 were set at 0.5 and 1. O, the ratios of P/F changed in 24.70% ± 23.36% respectively. ( 2 ) Of them,6 patients ( 37.5% ) treated with FiO2 set at 0.5 had the ratio of P/F ＜ 200, and the fraction of FiO2 was increased to 1.0, the P/F ＞ 200. (3) FiO2 and Qs/Qt were negatively correlated ( r = - 0.390, P = O. 027 ),the higher inspired oxygen fraction, the lower shunt. When the fractions of FiO2 were set at 0.5 and 1.0 ,there was a positive correlation between △Qs/Qt and △P/F( r = 0.82, P = 0.005 ). Conclusions The inspired oxygen fraction affects the ratio of P/F, which may be resulted from shunt and it may influence the diagnosis of ARDS.

Imatinib is an effective tyrosine kinase inhibitor, used in the treatment of advanced or inoperable gastrointestinal stromal tumors. Despite its efficacy, resistance is often developed among a portion of patients. Resistance to imatinib can be divided into primary and secondary resistance, with the latter becoming the focus of many recent researches. Research on the mechanisms of secondary resistance may lead to the identification of novel therapeutic strategies.

Objective To observe the short-term fusion rate of using osteophyte filled cage in ante-rior cervical disectomy and fusion. Methods From May 2007 to May 2009, 103 patients receiving anterior cervical disectomy, spine fusion by different surgeons were performed with cages containing exclusively au-tologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space. There are 69 males, 34 females, from 25 to 77 years of age, average 53.6 years. 60 patients received one level fusion. 33 and 10 patients received two-level and three-level fusion respectively. Patients were re-viewed 3 months after operation and fusion was evaluated by X-ray film, reconstructive CT and MR. Results 1. Only 1.9% (2/103) of patients' X-ray films indicate non-fusion (internal fixation failure) while 31.7% (32/ 103) of patients' CT and 30.1% (31/103) of patients' MR indicate non-fusion or being confusing to make a diagnosis. 2. The diagnostic coherence between CT and MR as to evaluate fusion is good (kappa=0.686, P= 0.00). 3. The total fusion rate was 77.7%(80/103) while the highest fusion rate achieved by single surgeon was 90%(18/20). The total one level fusion rate was 80%(48/60) while the highest rate by single surgeon was 88.2%(15/17). The total two-level fusion rate was 78.6%(26/33) while the highest rate by single sur-geon was 90%(9/10). The total three-level fusion rate was 60%(60/100) while the highest rate by single surgeon was 100%(3/3). No statistic significant difference in fusion rate was found between any two of the three groups. Conclusion The method of using osteophyte filled cage can acquire ideal short-term fusion rate in one and two-level anterior cervical disectomy, fusion and plate fixation.

The infrapopliteal arteriosclerosis occlusive disease mainly involves the anterior tibial artery,posterior tibial artery and fibular artery.For the arteriosclerosis occlusive disease of larger arteries of lower extremity,such as iliac artery,femoral artery,etc.,the interventional therapy pattern has been already very mature.However,as the infrapopliteal artery is fine in diameter and the lesion is usually wide with extensive calcification,it is hard to effectively treat the infrapopliteal arteriosclerosis occlusive disease with routine interventional therapy.The therapeutic methods of infrapopliteal arteriosclerosis occlusive disease mainly include surgical treatment,endovascular treatment,drug therapy,and the autologous stem cell transplantation therapy that is still in the research stage at present.This paper aims to introduce the latest progress in interventional therapy for the treatment of infrapopliteal arteriosclerosis occlusive disease in recent years,and to make a prospect for clinical practice in future.

Autoimmunity is influenced by genetic,immune,hormonal,and environmental factors.Viral infections may trigger autoimmunity.It has been established that autoimmunity may be a contributing factor in the pathogenesis of heart disease.Myocarditis is defined as inflammation of the heart muscle associated with impaired function of the myocardium.Myocarditis is considered as the most common cause of dilated cardiomyopathy.Myocarditis may be caused by infectious factors and noninfectious factors,noninfectious factors including autoimmune diseases with myocarditis.To gain a better understanding of autoimmune myocarditis,we summarize the pathogenesis and clinical significance of autoimmune myocarditis.

Atherosclerosis is the pathological basis of ischemic stroke. Peripheral blood leukocytes are involved in the occurrence and progression of atherosclerosis and cause vascular endothelial injury. A series of changes of peripheral immune cel take place after acute ischemic stroke and cause inflammatory cel infiltrating into the brain tissue. The elevated leukocyte count is closely associated with the occurrence and prognosis of coronary atherosclerotic heart disease. Studies have also shown that the elevated leukocyte count may influence the occurrence of ischemic stroke, neurological deficit, recurrence, and death. This article reviews the relationship between peripheral blood leukocytes and ischemic stroke.