At present,nutrition therapy plays a very important role in critically ill children,which can impact on the development and outcome of the disease by the process of metabolism and immunity.Immune-modulating nutrients,such as glutamine,which is a current hot topic,but now there is a little research in it in critically ill children,and this paper summarizes the approach,the dose and the efficacy of glutamine in critically ill children,aiming to offer reference in clinics.

Objective To study the relationship between throid hormone and chronic heart failure in patients and its clinical significance. Methods The free thriiodothyronine( FT3 ), the total thriiodothyronine(TT3 ), the free thyroxine(FT4 ), the total thyroxine (TT4 ), the rebellion thriiodothyronine ( rT3 ), the thyroid stimulating hormone (TSH) in 100 patients with chronic heart failure and 50 normal people were determined by particle glimmer. Results The levels of T3 in patients with chronic heart failure were markedly lower than those in normal controls;The heart failure in low thriiodothyronine state case was severe. Conclusion The level of T3 in elderly patients with chronic heart failure was decreased, and it was correlated with the severity of heart failure.

Objective To investigate the effect of oxycodone and sufentanil with equivalent dose on hemo-dynamics and stress response in general anesthesia induction. Methods One hundred and twenty ASA I orⅡpa-tients with abdominal surgery were randomly divided into oxycodone group(group O,n=60)and sufentanil group (group S,n = 60). Anesthesia was induced with iv oxycodone 0.20 mg/kg(group O)or sufentanil 0.25 μg/kg (group S)respectively,together with iv propofol 2.0 ~ 2.5 mg/kg and cisatracurium 0.2 mg/kg. The patients were tracheally intubated using a single-lumen endotracheal tube. Mean arterial pressure(MAP),heart rate(HR),plas-ma levels of epinephrine(E)and norepinephrine(NE),cortisol(Cor)and blood sugar(Glu)and the occurrence of bucking before anesthesia induction(T0),immediately before intubation(T1),at the moment of intubation(T2), 1 min(T3)and 5 min(T4)after intubation were observed. Results Compared with these at T0,MAP and HR in 2 groups were lower at T1(P<0.05)and no significant difference was found in 2 groups(P>0.05). MAP and HR were significantly higher at T2 and T3(P < 0.05)and compared with those in group O,MAP and HR in group S were increased more significantly at T2 and T3(P<0.05). MAP and HR increased slightly at T4 in 2 groups but no significant difference was found in 2 groups(P>0.05). Plasma levels of E ,NE,Cor and Glu increased obviously at T2 and T3 in 2 groups(P < 0.05)and they were even higher in group S(P < 0.05). Plasma levels of E ,NE , Cor and Glu increased slightly at T4 in 2 groups but no significant difference was found in 2 groups(P > 0.05). Conclusion Compared with sufentanil ,oxycodone of equivalent dose used for general anesthesia induction can effectively keep smooth on hemodynamics and decrease stress response.

OBJECTIVE:To study the pathogenic organism of sepsis in children with tumor and its drug sensitivity for references of clinical medication.METHODS:The drug sensitivity of hemoculture samples of children with neoplastic hema-tologic disorder was detected by paper disk method.RESULTS:Of the total109pathogenic bacteria isolated from hemoculture samples,60(55.0%)were gram-positive(G + )bacteria,47(43.1%)were gram-negative(G - )bacteria and2(1.8%)were fungi.Vancomycin,teicoplanin and aminoglycosides were more sensitive to G + bacteria,while carbopenems and cefoperazone/sulbactam were more sensitive to G - bacteria.CONCLUSIONS:In treating sepsis in children with tumor,the choice of drugs should be based on the drug sensitivity test,the possibility of G + and G - bacteria infections should be considered in empiric treatment and the possibility of mycotic infection should also be considered after long-term administration of antibacterials.

Objective To investigate the role of the clock gene promoter methylation in aging. Methods C57BL mice of 4- (young, n=9) and 20- (old, n=10) month-old were determined the promoter methylation level of clock genes (Per1/2, Bmal1/2, Cry1/2, Clock, Npas2) in the stomach, spleen, vascular, kidney and striatum with methylation-specific polymerase chain reaction (MSP). Results The incidence of promoter methylation of Cry1, Bmal2 and Npas2 in spleen increased in old mice (P<0.05), while the promoter methylation of Per1 in stomach decreased (P<0.05), and the promoter methylation of Bmal1 in vascular increased (P<0.05). Conclusion Promoter methylation of some clock genes is involved in process of aging in a tissue-specific way.

Purpose: To evaluate the clinical efficacy of V AD regimen in the treatment of newly diagnosed stage III multiple myeloma (MM). Methods:26 patients with newly diagnosed stage Ⅲ multiple myel oma were treated with VAD regimen. VAD solution consisted of vincristine (VCR) , doxorubicin(ADR),dexamethasone (Dex).Three continuous treatments in one treatm ent course were considered evaluable.Evaluation included results of serum myelom a protein(M-protein); renal function; proteinuria of 24-hours; bone marrow ; per ipheral blood et al.The side reactions were recorded. The clinical efficacy eval uation was divide into complete response(CR),partial response(PR),minimal-respon se(MR), no change(NC) , plateau progression.Results:5 cases achieved CR(19.3%), 13 cases PR(50%),6 case s MR (23%), 2 cases no change (7.7%). Overall response rate was 92.3%, median su rvival duration was 7 to 84 months (29.6?17months). Conclusions:Achieved marked clinical efficacy with VAD agent in newly diagnosed stage III multiple myeloma. Especially,the patients with renal failure and serious clinical manifestation improved rapidly and significantly.

Objective To discuss the therapeutic effect of chemoradiotherapy on 74 patients with early stage nasal NK/T cell lymphoma and their prognostic factors. Methods 74 patients with early nasal NK/T cell lymphoma that were treated in Shanxi Cancer Hospital from January 2005 to November 2013 were analyzed retrospectively. Among them, 28 patients received radiotherapy alone, 10 patients received concurrent chemoradiotherapy and 36 patients received alone. In 36 patients with chemotherapy, 25 cases were treated with CHOP (cyclophosphamide+doxorubicin+vincristine+prednisone), 4 cases were treated with DICE (dexamethasone + etoposide + cisplatin + isofosfamide) and 7 cases were treated with L-asparaginase +dexamethasone+ifosfamide+methotrexate + etoposide. According to Ann Arbor classification, 60 patients were stage Ⅰ and 14 patients were stage Ⅱ. Kaplan-Meier test was used for survival analysis, log-rank method was used for single factor analysis, and Cox proportional hazard model was used for multi factor analysis. Results All patients completed the treatment. 24 patients were died. 3-year overall survival (OS) rate was 72.5 %. The OS rate in simple radiotherapy group was 92.7 %, simple chemotherapy group was 62.3%, and the concurrent chemoradiotherapy group was 79.1%. The OS rates in simple radiotherapy and simple chemotherapy groups had statistical difference (χ2 = 10.676, P< 0.05), The difference in the simple radiotherapy and concurrent chemoradiotherapy groups was not statistically significant (χ2= 2.019, P> 0.05). In radiotherapy alone group, the rates of complete remission (CR), partial remission (PR), stable rate and progress rate of disease were 89.3%(25/28), 7.1%(2/28), 3.6%(1/28), and 0;in chemotherapy alone group, they were 55.6 % (20/36), 25.0 % (9/36), 8.0 % (3/36), and 11.1 % (4/36); in concurrent chemoradiotherapy group, they were 80.0 % (8/ 10), 10.0 % (1/10), 0, and 10.0 % (1/10), respectively. There was significant difference between radiotherapy group and chemotherapy group (χ2 = 8.584, P< 0.05); there was no significant difference between radiotherapy group and concurrent chemoradiotherapy group (χ2=0.556, P>0.05). Single factor analysis showed that age, ECOG score, B symptoms, Ann Arbor stage, IPI and treatment options were related to the prognosis. Multivariate analysis showed that age, ECOG score and Ann Arbor stage were independent prognostic factors. Conclusions As the main treatment method of early stage nasal NK/T cell lymphoma, radiotherapy can obtain good short-term curative effect and long-term curative effect. Age, ECOG score, B symptoms, Ann Arbor stage, IPI and treatment options are related to survival prognosis. Age, ECOG score and Ann Arbor stage are the independent prognostic factors.

Objective To analyze behavioral changes related to HIV/AIDS and trends of HIV epidemic among female sex workers(FSWs),and to provide information for integrated HIV prevention and evaluation of interventions.Methods Continuous surveillance was provided in 41 sites from 2005 to 2007,when cross-sectional surveys were conducted among institution-based and street based female sex workers,and blood samples were faken.Result The rate of using condoms in the last commercial sex activities among the surveyed FSWs was:73.7%,81.1% and 81.5% in the respective 3 years from 2005 to 2007;while the rate of consistently using condoms in sex with clients during the last month was:49.3%,56.4% and 5.4% in the respective 3 years.Female sex workers who had injecting drug use were identified in one third surveillance sites.The rate of awareness of HIV/AIDS transmission among the FSWs was 62.4%,57.3% and 64.8%,respectively.The proportion of the FSWs who attended HIV VCT services was 10.9%,16.6% and 24.9%,respectively.The proportion of the FSWs who received intervention service within the last year was 51.3%,78.8% and 89.8%,respectively.The HIV detection rate was 0.0%(median value)in all the 3 years while the syphilis detection rate was 0.6%,1.0% and 1.15% respectively.Conclusion Rate of condom use and HIV awareness need to be further enhanced among female sex workers.The rate of condom use in the last sex with clients may be over estimated.The proportion of female sex workers who have received intervention service tends to increase;the coverage of behavioral intervention,voluntary counseling and testing and public education is increased gradually.HIV prevalence rate among female sex workers is generally low,but relatively high in some regions.High risk behaviors,such as unprotected sex and injecting drug use are not uncommon among FSWs.All this means that behavioral intervention is a long-term tough task,and to ensure its effectiveness and sustainability integrated HIV/AIDS prevention and control program will be needed.

As a hot topic, biomarkers can provide reliable evidence for the individualized treatment of non-small cell lung cancer. With the further study of molecular biology and development of new drugs,biomarkers have shown a broad prospect in clinical application. Combining with the research in recent years,this review describes the progress in biomarkers for non-small-cell lung cancer.

Objective To investigate the clinical manifestations and possible mechanism of the multiple sclerosis (MS) combined with uveitis Methods Two cases of MS combined with uveitis were clinically observed by electro physiological, brain MRI and oligoclonic band (OB) examinations,the cases were analyzed and subjected to assessment Results Case1, a 56-year-old man had symptoms of one month′s numbness and twenty-day sudden decrease of visual acuity Viusal evoked potential (VEP)showed a postponed latent period of bilateral P100 waves Brain MRI showed multifocal T 2 Wight Image high signs in subcortical white matter of frontal and parietal lobes OB was postive Case 2: a 35-year-old woman, had recurrence of decrease of visual acuity of bilateral both eyes for 12 months and bilateral lower-limbs numbness Latent period of VEP P100 waves and BAEP I-V waves were postponed Brain MRI showed multifocal round-like T 2 Wight Image high signs in white matter of frontal and parietal lobes OB was postive Referring to the essay reported ,MS combined with uveitis was moetly moderate in manifestations Their causes were uncertain It is suggested that MS is not due to auto-antigen but due to S100-? protein derived from star-like cells Conclusion MS combined with uveitis ,unlike other one ,was clinically moderate and the pathological mechanism is unclear It is suggested that autoantigen such as S100-? protein derived from star-like cell results in MS and uveitis, not in MBP