Objective To evaluate the effect of nasal continuous positive airway pressure (nCPAP) in pediatric patients with respiratory failure after liver transplantation.Method A prospective? randomized controlled clinical trial was conducted during June 1st 2013 to June lst2015 in 71 pediatric patients with respiratory failure after liver transplantation.A total of 66 patients completed the trial and 5 patients quitted.Conventional oxygen therapy group included 35 cases and nCPAP group included 31 cases.The vital sign,blood-gas analysis,intra-abdominal pressure and prognosis were compared between the two groups.Result After nCPAP treatment,the heart rate,respiratory rate,and PCO2 decreased at 4 and 24 h (P＜0.05),oxygenation index was improved at 24 and 48 h (P＜0.05),and intra-abdominal pressure decreased at 48 h (P＜0.05).nCPAP showed better outcome than conventional oxygen therapy (P＜0.05).The incidence of refractory atelectasis,intra-abdominal hypertension,and epilepsy was higher in treatment failure population.Conclusion nCPAP is more suitable for pediatric patients with respiratory failure after liver transplantation,especially for those accompanied with intra-abdominal hypertension.

Objective To discuss the correlation of perioperative brain function state quantitative monitoring results with postoperative cognitive dysfunction (POCD) in elderly patients. Methods The clinical data of 200 patients with lumbar spinal decompression fusion surgery were analyzed retrospectively. They were divided into the POCD group (134 patients) and the non POCD group (66 patients) by Z count scores . The results of test indexes including wavelet index (WLI), concentration index (i_22) and brain activity index (i_20) were compared. Results Perioperative elderly patients Brain function characteristics analysis results of perioperative elderly patients showed that the level of WLI at postoperative day 7(96.24 ± 2.41)was higher than that at preoperative day 1(98.76 ± 2.65) and postoperative day 3(98.68 ± 3.01), and there were significant differences (t=4.475, 4.475, P=0.000, 0.000). The level of i_22 at preoperative day 1, postoperative day 3 and postoperative day 7 had no significant difference (F=7.365, P=0.075). The level of i_20 at preoperative day 1, postoperative day 3 and postoperative day 7 had no significant difference (F=6.663, P=0.068). At preoperative day 1, the level of i_22 in POCD group was significantly lower than that in non POCD group(t=15.875, P=0.000). Conclusions Brain function index of perioperative elderly patients has certain characteristics in different time points, and i_22 may could be considered as a judge index of POCD.

Objective To establish an efficient, effective hepatocyte isolation technique in order to increase cell production and decrease the prime cost. Methods The inferior vena cava below diaphragm was dissected and ligatured, and the inferior vena cava below liver was separated. Subsequently, the liver was perfused with EGTA through the portal vein while the inferior vena cava below liver was opened, and then the liver was harvested. The liver tissue was cut into 1 mm?1 mm?1 mm and digested at 37 ℃ water bath with Ⅳ collagenase for 30-40 minutes, then the hepatocytes were purified and cultured in CO 2 incubator. The production and function of hepatocytes were assessed. Results The isolated hepatocytes using this technique were more than 95% among the all isolated cells. No statistic difference was found in cell production and cell function comparing with traditional technique. But this technique was simplified and more economically. Conclusion This modified hepatocyte isolation technique is efficient and effective. It can ensure the amount of production and purity of hepatocytes.

Objective To explore the toxic effect and application safety of ropivacaine after transversus abdominis plane block for caesarean section.Methods Sixty cases puerperas who were suffered with transversus abdominis plane block for caesarean section in the People' s Hospital of Yan' an were retrospectively analyzed.Blood sample was collected after TAP block at different times and at the same time asked if they had neurotoxicity.The collected blood was measured for the concentration of ropivacaine.The ages,weight,height,BMI and total doses of ropivacaine were compared,and the mean total peak ropivacaine concentrations and the mean time to the maximum concentration in symptomatic and asymptomatic puerperas were compared to assess the reasonable threshold for clinical in symptomatic puerperas and suitable ropivacaine concentration.Results The BMI and total doses of ropivacaine of symptomatic group was (70.30±7.90) kg,(225.80±17.60) mg,significantly higher than the asymptomatic group ((62.60±12.40) kg,(189.00±22.40) mg),the differences were significant(t=4.613,7.143,P＜0.05).The mean total peak ropivacaine concentrations in symptomatic group was increased compared with asymptomatic group ((2.82±0.55) mg/L vs.(1.33±0.47) mg/L,t=0.779,P＜0.05),and the mean time to the maximum concentration in symptomatic group was decreased compared with asymptomatic group ((26.80±5.40) min vs.(39.20±6.30) min,t=4.158,P ＜0.05).Conclusion There is a certain neurotoxicity when applying ropivacaine after transversus abdominis plane block for caesarean section.Ropivacaine concentration 2.2 kg/ml as a reasonable threshold for clinical toxicity in puerperas undergoing TAP block,and 2.5 mg/L ropivacaine is fit for puerperal on lean body mass,and further reduction may be required as puerperal weight increases.

Objective To observe the expression and relevance of human papillomavirus L1 (HPVL1)capsid protein and tumor suppressor gene p16~4A in cervical lesions.Methods The expression of HPVL1 capsid protein and p16INK4A in liquid-based cytology specimens and organization from 210 cases infected with HPV virus were detected by Max-vision immunohistochemistry method.Results In different grade of liquidbased cytology specimens,the positive rates of HPVL1 capsid protein had statistic difference (x 2 =70.50,P ＜ 0.005).The rate in LSIL couples was 68 ％ (34/50),which was the highest in all couples.The positive rates of tumor suppressor gene p16INK4A were increased gradually.In SCC couples,the positive rates was 100 ％(30/30),which was the hishest.In LISL couples,the rate of HPVL1+ p16INK4A-was 32 ％ (16/50),which was the hishest.In SCC couples,the rate of HPVL1-p16INK4A+ was 100 ％ (30/30),which was the highest.In orgnizational specimens,the positive rates of HPVL1 capsid protein in cervical intraepithelial neoplasia had statistic difference (x2 =54.37,P ＜ 0.005).The rate in CIN Ⅰ group was 60.4 ％ (32/53),which was the highest.The positive rates of tumor suppressor gene p16 were increased gradually.In cervical cancer group,the positive rate was 100 ％ (28/28),which was the highest.In CIN Ⅰ group,the rate of HPVL1+ p16INK4A-was 45.3 ％ (24/53),which was the highest.In cervical cancer couples,the rate of HPVL1 (-) p16INK4A(+) was 100 ％ (28/28),which was the highest.Conclusion Detection on the expression of HPVL1 capsid protein and tumor suppressor gene p16INK4A can diverse different levels of cervical lesions and separate cases from aggravated or self-healing,to avoid over-treatment or misdiagnose.

Objective To investigate the effect of vitamin D on pulmonary function in patients with chronic obstructive pulmona-ry disease,and to explore its possible mechanism.Methods Patients with chronic obstructive pulmonary disease admitted in the hospital were randomly divided into 2 groups,one group of patients were given regular COPD treatment (control group,30 cases), the other group of patients were given vitamin D on the basis of conventional therapy(experimental group,30 cases).Pulmonary function test and C reaction protein (CRP)determination in the 2 groups were performed,the contents of PaO2 ,PaCO2 were also determined.Results Compared with the control group,lung function improvement in experimental group were more obvious,and the the number of acute attack significantly reduced(P <0.05).The concentration of CRP in experimental group was significantly lower after treatment than before treatment(P <0.05),while the concentration of CRP in control group didn′t change significantly (P >0.05).Conclusion Vitamin D contributes to the improvement of pulmonary function in patients with COPD,and its mecha-nism might relate to the reduction of inflammatory reaction.

Objective The intra-cranial arteries are more affected in Asian ischemic stroke patients. We thought that tandem or diffuse arterial occlusive disease may be more common among patients with extracranial internal carotid artery (ICAex) occlusive disease. In the current study, the frequency of other co-existing extracranial artery ( EA) or intracranial artery ( IA) stenosis in patients with ICAex occlusive disease and its risk factors were studied. Method One hundred and ninety-eight consecutive patients with ischemic stroke or TIA who were admitted to our hospital from Jan 2001 to May 2008 and who had stenosis (70% ) or occlusion of ICAex were enrolled in the study. All the patients were examined with carotid duplex and transcranial Doppler (TCD). Among them, 75 patients were also examined with DSA, 52 patients with intracranial MRA and 25 patients with extra- and intra-cranial CTA. Extracranial artery stenosis or occlusion were diagnosed with DSA/CTA in 93 patients, and with carotid duplex only in 105 patients. Intracranial artery stenosis was diagnosed with DSA/MRA/CTA in 118 patients, and with TCD only in 80 patients. Patients with presumably cardioembolism such as atrial fibrillation were excluded. Results Among the 198 patients, 172 (86. 8% ) had other combined EA or IA stenosis. One hundred and thirty-five patients (135/198, 68.2%) had other combined EA stenosis, which were more frequently found in the contralateral ICAex (71/198, 35.9%). One hundred and twenty-three patients (123/198, 62. 1%) had combined IA stenosis, which were more frequently found in MCA (75/198, 37.9%). 52 (52/198, 26. 3% ) had ipsilateral terminal ICA and/or middle cerebral artery stenosis. Conclusion Tandem or diffuse arterial occlusive disease is common among patients with steno-occlusion of ICAex . Therefore, it is important to evaluate other EA and IA stenosis before CEA or CAS in Chinese patients.

Dendritic cells (DC) represent a heterogeneous cell population including many subsets. DC subpopulations with different characteristics and functions have been identified. The liver, as an immunological organ, is important in induction of immune tolerance. The unique anatomical architecture and immune properties of the liver have given DC the ability to maintain liver homeostasis and respond quickly to liver tissue damage. This article reviewed the role of hepatic DC subsets in the maintenance of tissue homeostasis and repair of damaged tissue in the liver.

Objective:To prepare and evaluate Shenhuang vaginal thermosensitive in situ gels. Methods:Shenhuang vaginal ther-mosensitive in situ gels( SHV-TISG)were prepared with poloxamer 407 and poloxamer 188 as the materials. The viscosity change at different temperatures and the gelation temperature of SHV-TISG and SHV-TISG diluted by stimulant vaginal fluid were measured,the in vitro drug release of the preparation was evaluated by a membraneless diffusion method,and the safety of SHV-TISG was detected by vaginal irritation test. Results:The preparation showed the vaginal injectability and gelationability in vivo without vaginal irritation. Gel erosion was the principal mechanism of the drug release from the gels. Conclusion:The preparation of SHV-TISG is feasible in tech-nique,and the properties meet the requirements of vaginal topical use.

Objective To observe efficacy and safety of long-term Statins treatment in elderly patients aged over 80 years,and to provide clinical evidence for the rational use of Statins.Methods 224 patients aged 80 years and over were divided into two groups:Statin group given Statins (n=107),and control group not given Statin (n=117).The serum levels of total cholesterol (TC),lowdensity lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured,and liver and renal function,alanine aminotransferase (ALT),creatine phosphokinase (CPK) and epidermal growth factor receptor (EGFR) were tested.Results Pretreatment levels of TC and LDL-C levels were (4.6 ± 1.0) and (2.6 ± 0.8) mmol/L and were decreased to (4.3±0.9) and (2.4±0.6) mmol/L after 1 year treatment (t=3.535,3.448,both P＜0.05).The target rate in statin group for LDL C was 35.5 ％ in patients at very high risk.There were no significant differences in levels of ALT,CK and eGFR between pre-and post-treatment in both two groups [(20.2±9.2) U/L vs.(21.4±12.1) U/L,(86.5±53.9) U/L vs.(86.6±67.5) U/Land (53.1±17.3) ml/min vs.(51.9±18.0) ml/min,all P＞0.05].Compared with pre-treatment,1 year treatment showed that glucose level was increased [(5.9± 1.0) mmol/L vs.(6.0± 1.0) mmol/L,t=2.287,P＜0.05].Conclusions Long-term Statin treatment in elderly patients is safe and effective.We should correctly administer statin drugs,and closely monitor the safety indicators.