Objective To explore the clinical diagnosis of tetralogy of Fallot( TOF) children with concurrent DiGeorge syndrome ( DGS ) . Methods Retrospective analyses were conducted for the clinical characteristics of 715 TOF children with concurrent DGS at Henan Provincial People′s Hospital and the Third Affiliated Hospital of Zheng-zhou University from January of 2008 to October of 2014. Among them,there were 78 definite cases of thymic aplasia (DGS group),including 45 boys and 33 girls with an age range of(9. 12±4. 35) months and a body mass range of (7. 28±2. 34) kg. And the remainder was designated as non-DGS group(NDGS group),including 387 boys and 250 girls with an age range of(8. 21±5. 61) months and a body mass range of(8. 19±3. 47) kg. In DGS group,genetic screening uncovered 10 cases of chromosome 22q11. 2 gene deletion. And based upon this result,DGS group was fur-ther divided into genetic and clinical diagnosis subgroups. The genetic diagnosis group had 10 cases,including 6 boys and 4 girls with an age range of(8. 12±4. 15) months and a body mass range of(6. 28±2. 74) kg,the clinical diagnosis group had 68 cases,including 39 boys and 29 girls with an age range of(8. 19±4. 37) months and a body mass range of (7. 05±2. 39) kg. Results No statistical difference existed in age,body mass or preoperative developmental status of pulmonary vasculature between DGS group and NDGS group(P>0. 05). And the preoperative incidence of recurrent pneumonia was obviously higher in DGS group than that in NDGS group(P<0. 001). The probability of concurrent hy-pocalcemia and facial malformation was higher in DGS group than that in NDGS group. However,there was no statistical difference(P>0. 05). And an inter-group comparison of T lymphocyte immunity defect had no statistical difference(P>0. 05). The duration of on-machine and intensive care unit stay was markedly longer in DGS group than that in NDGS group(P<0. 001). And the probability of concurrent hypocalcemia and facial malformation was higher in genetic diag-nosis subgroup than that in clinical diagnosis subgroup. However,there was no statistical difference(P>0. 05). And an inter-group comparison of T lymphocyte immunity defect had no statistical difference ( P>0. 05 ) . Conclusions With diverse clinical manifestations,DGS patients may have non-specific findings of cellular immunity defect,hypocalcemia or facial malformation. TOF children with concurrent thymic aplasia should raise an alert so that effective interventions may be adopted to boost their long-term quality of life.

OBJECTIVE:To explore the methods of clinical pharmacists providing pharmaceutical care for a patient with N-methyl-D-aspartate receptor(NMDAR)encephalitis complicating with multiple organ infections. METHODS:Taking one clinical case as breakthrough point,the points of pharmaceutical care provided by clinical pharmacists for NMDAR encephalitis complicat-ing with multiple organ infections were analyzed,so as to put forward the suggestions in the field of antibiotics selection,medica-tion approach based on pharmacokinetics,ADR disposal and nutrition support. RESULTS:Clinical pharmacists applied pharmaceuti-cal care to resolve ADR as abnormal liver enzyme timely,and the symptom had been improved gradually. Then the patient was dis-charged from the hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care and screen the possible risk of drug use to avoid the occurrence of severe ADR.

Objective To study the effects of thymus transplantation(TT)combined with CD4--DLI on T cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods BALB/c mice were randomly divided into three groups:hematopoietic stem cell transplantation (HSCT group),hematopoietic stem cell transplantation combined with thymus transplantation(TT group)and hematopoietic stem cell transplanta-tion combined with thymus transplantation plus CD4+ T cell-depleted lymphocyte infusion(CD4--DLI group). On day-1,the mice were treated with the lethal dose of radiotherapy. On day 0,C57BL/6 mice were used as donor for hematopoietic stem cell transplantation. The mice were sacrificed on 5 days,2 weeks,4 weeks and 3 months after transplantation,respectively. The peripheral blood and spleen cells of mice were collected for determinations of T cell surface antigen,T cell receptor,naive T cells and intracellular cytokines. HE staining was used to assess the development of donor thymus. Results TT and CD4--DLI did not impair each other′s effects on T cell reconstitu-tion. TT combined with CD4--DLI increased the number of T cell reconstruction. CD4--DLI promoted the effect of TT on enlargement naive CD4+and CD8+T cell pool. Combination of TT and CD4--DLI enhanced the cytokine pro-duction of T cells. Conclusion TT combined with CD4--DLI had no side effects on TCR repertoire and thymus. Conclusion TT combined with CD4--DLI can enhance the reconstitution of T cell number and function via thymus dependent and thymus independent mechanism.

The treatment of breast cancer is becoming more individualized and minimally invasive,which makes sentinel lymph node biopsy becoming the standard treatment for axillary in patients with early-stage breast cancer who are negative in clinical axillary lymph nodes.Tracers image sentinel lymph nodes or lymphatic vessels for the successful detection of sentinel lymph node biopsy.Tracers selection is also more diverse,such as nano carbon mixed suspension,methylene blue,radioisotope,indocyanine green,etc.Different tracers and combined applications have their advantages and limitations.As for the selection of tracing methods,many factors need to be weighed.

In this study, ivabradine hydrochloride (IVB) was prepared as elementary osmotic pump tablets whose administration frequency was reduced to once daily. The dissolution method was developed, and effects on drug release profiles were evaluated by single factor analysis involving suspending agents, osmotic active agents and aging process. Orthogonal test was carried out at 3 levels on 3 factors including the amount of polyoxyethylene (PEO) in the core, polyethylene glycol (PEG) percentage and weight increase of controlled-release film coatings. The final formulation consisted of IVB (16.25 mg), PEO N80 (60 mg), hypromellose E5 (10 mg), lactose (111.75 mg), magnesium stearate (2 mg); and the film coatings consisted of PEG (15%), cellulose acetate (85%), with a weight increase of 7.5%. In vitro drug release behaviors were investigated. Prepared tablets exhibited similar release profiles in different pH dissolution media, with no risk of dose dumping in 40% ethanol solutions. The osmotic pressure differences inside and outside the membrane drove drug release. IVB osmotic pump tablets could reduce the frequency of administration and improve patients'' compliance, thus with better application values.

Objective To analyze the impact of controlled hypotension(CH)by cerebral oxy-gen saturation(rSO2)monitoring on brain protection and cognitive function in anesthetized patients.Methods A total of 200 patients undergoing rSO2-monitored CH were enrolled.Patients were divid-ed into normal group(n=137)and postoperative neurocognitive disorder(PND)group(nt=63)based on whether they developed PND after surgery.Preoperative clinical data were collected.Univa-riate analysis was performed to identify factors influencing the occurrence of PND in rSO2-monitored CH patients.Multivariate binary logistic regression analysis was used to screen for independent risk factors.A predictive model was constructed based on the identified independent risk factors,and its predictive value was evaluated using receiver operating characteristic(ROC)curve analysis.Results Age,intr-aoperative blood loss,vascular surgery,20-minute rSO2 monitoring values,20-minute central venous pressure(C VP),history of hypertension,stroke and operative time were identified as factors affecting the occurrence of PND in rSO2-monitored CH patients(P＜0.05).Independent risk factors for PND included age＞55 years,high CVP during 20 minutes of surgery,low rSO2 monitoring values during 20 minutes and undergoing vascular surgery(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for the predictive model was 0.855.Conclusion Clinically,the risk of PND in rSO2-monitored CH patients(age＞55 years,undergoing vascular surgery)can be reduced by controlling intraoperative CVP to minimize blood loss and by timely adjustment of treatment plans based on rSO2 monitoring results.

Objective? To explore the cognition and attitude towards palliative care of family members among elderly chronic diseases patients and to analyze its influencing factors. Methods? From October 2017 to April 2018, we selected 180 family members of elderly chronic diseases patients at Peking Union Medical College Hospital as subjects by convenience sampling. All of them were investigated with the self-designed cognition and attitude towards palliative care questionnaire. The simple correlation was used to analyze the influencing factors of cognition and attitude towards palliative care of family members among elderly chronic diseases patients. Results? A total of 166 valid questionnaires were collected. There were 85 (51.2%) family members of elderly chronic diseases patients understanding palliative care, 133 (80.1%) of them agreeing with implementing palliative care. The reasons of supporting palliative care included that relieving the pain on the deathbed, patients had the right to choose, long-term torment of disease. There were statistical differences in the cognition and attitude towards palliative care among family members with different ages, education levels, occupations, incomes and patients' ages. Conclusions? Family members of elderly chronic diseases patients have insufficient understanding of palliative care with a high approval rate. The higher the approval rates, education levels and ages of family members are, they agree more with palliative care.

Objective To analyze the impact of controlled hypotension(CH)by cerebral oxy-gen saturation(rSO2)monitoring on brain protection and cognitive function in anesthetized patients.Methods A total of 200 patients undergoing rSO2-monitored CH were enrolled.Patients were divid-ed into normal group(n=137)and postoperative neurocognitive disorder(PND)group(nt=63)based on whether they developed PND after surgery.Preoperative clinical data were collected.Univa-riate analysis was performed to identify factors influencing the occurrence of PND in rSO2-monitored CH patients.Multivariate binary logistic regression analysis was used to screen for independent risk factors.A predictive model was constructed based on the identified independent risk factors,and its predictive value was evaluated using receiver operating characteristic(ROC)curve analysis.Results Age,intr-aoperative blood loss,vascular surgery,20-minute rSO2 monitoring values,20-minute central venous pressure(C VP),history of hypertension,stroke and operative time were identified as factors affecting the occurrence of PND in rSO2-monitored CH patients(P＜0.05).Independent risk factors for PND included age＞55 years,high CVP during 20 minutes of surgery,low rSO2 monitoring values during 20 minutes and undergoing vascular surgery(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for the predictive model was 0.855.Conclusion Clinically,the risk of PND in rSO2-monitored CH patients(age＞55 years,undergoing vascular surgery)can be reduced by controlling intraoperative CVP to minimize blood loss and by timely adjustment of treatment plans based on rSO2 monitoring results.

An expression vector pET-28a-mGM-CSF-X10-βhCGCTP37 plasmid containing the βhCG and mGM-CSF gene was designed and constructed. The fusion protein was induced by lactose and purified by ammonium sulfate precipitation and DEAE-cellulose anion exchange column. Then dendritic cells(DC)in C57BL/6J mice were extracted and sensitized by the fusion protein to obtain DC vaccine. The DC vaccine was inoculated to C57BL of / 6J mice with prostate cancer RM-1. The results indicated that the anti-tumor effects of DC group and DC combined with paclitaxel(DP)group were superior to that of paclitaxel(Pac)group(P< 0. 01), and the anti-tumor effect of DP group was better than that of DC group. Thus, the constructed DC vaccine can inhibit the growth of prostate cancer, and have synergistic anti-tumor when used with paclitaxel.

Objective:To explore the effects of apatinib on the proliferation and apoptosis of FLT3-ITD mutant acute myeloid leukemia (AML) cells, and to explore the related mechanisms.Methods:The logarithmic growth phase FLT3-ITD mutant AML cell lines MV4-11 and MOLM-13 were treated with different concentration of apatinib for 48 hours. The cell proliferation was detected by CCK-8 method. Flow cytometry was performed to examine the effect of apatinib on apoptosis. The cell mitochondrial membrane potential changes were detected by JC-1. Then the expression changes of vascular endothelial growth factor receptor 2 (VEGFR2) pathway-related proteins were examined by Western blot.Results:Apatinib had proliferation inhibitory effects on both MV4-11 and MOLM-13 cells, and the half-maximal inhibitory concentration (IC 50) at 48 hours was (2.23±0.42) μmol/L and (4.08±2.62) μmol/L, respectively. After exposure to apatinib with increasing concentrations (10, 20, 30, and 40 μmol/L) for 48 h hours, the percentage of apoptotic cells was significantly increased in MV4-11 cells [(81.95±1.15)%, (88.80±0.23)%, (97.46±0.49)%, and (99.29±0.05)%] and MOLM13 cells [(47.30±0.87)%, (67.00±3.71)%, (82.60±2.89)%, and (98.06±5.34)%] in a dose-dependent manner, and the differences were statistically significant ( F = 6 915.0, P < 0.01; F = 5 385.0, P < 0.01). Detection of mitochondrial membrane potential by JC-1 method showed that after MV4-11 and MOLM-13 cells were treated by 10, 20, 30, and 40 μmol/L apatinib for 24 hours, the JC-1 aggregate/monomer mean fluorescence intensity (MFI) ratios were 0.45±0.06, 0.19±0.07, 0.12±0.03, 0.09±0.01, and 0.84±0.05, 0.66±0.13, 0.35±0.11, 0.27±0.02, which were different from the control group (0.67±0.15 and 0.97±0.42), and the differences were statistically significant ( F = 372.3, P < 0.05; F = 276.4, P < 0.05). Western blot was performed to detect different concentration of apatinib (2.5, 5.0 and 10.0 μmol/L) on the MV4-11 cells for 24 hours, the results showed that apatinib could down-regulate the phosphorylation of VEGFR2, Src and Stat3 in a dose-dependent manner. Conclusions:Apatinib can inhibit cell proliferation and induce apoptosis in AML with FLT3-ITD mutation. The possible mechanism is related to the down-regulation of phosphorylation of VEGFR2 and its downstream targets Src and Stat3.