Down Syndrome ; complications ; Humans ; Infant, Newborn ; Male ; Pleural Effusion ; complications ; congenital

Purpose:To study the effect of early restrictive fluid resuscitation (EFR) on inflammatory and immune factors in patients with severe pelvic fracture (SPF).Methods:A total of 174 SPF patients in the Department of Orthopaedics,the First Affiliated Hospital of Chengdu Medical College from July 2015 to June 2018 were involved in this study and divided into EFR group (n =87) and control group (n =87) using the random number table method.Conventional fluid resuscitation (CFR) was performed in control group,and EFR was performed in EFR group.The incidences of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) during rescue,successful rescue rate,blood transfusion volume,fluid input,and resuscitation time were compared between the two groups.The parameters including prothrombin time (PT),hematocrit (HCT),platelet (PLT) and blood lactate (BL) at the 4th hour after fluid resuscitation were recorded.The levels of inflammatory factors (TNF-α,IL-6,CRP) and immune factors (CD3+,CD4+,CD8+,CD4+/CD8+) were compared between the two groups before treatment and 7 days after treatment.The revised acute physiologic and chronic health evaluation system and the sequential organ failure assessment scores were adopted for evaluation before treatment and 7 days after treatment.Results:The incidences of ARDS and MODS during rescue in EFR group were significantly lower than those in control group (p=0.015 and 0.010 respectively),and the successful rescue rate in EFR group was significantly higher than that in control group (p =0.011).The blood transfusion volume,fluid input,resuscitation time in EFR group were significantly lower than those in control group (p =0.016,0.002 and 0.001 respectively).At the 4th hour after fluid resuscitation,PTand BL in EFR group were significantly lower than those in control group (p =0.021 and 0.003 respectively),while HCT and PLT in EFR group were significantly higher than those in control group (p =0.016 and 0.021 respectively).On day 7 after treatment,TNF-α,IL-6,CRP and CD8+ in EFR group were significantly lower than those in control group (p =0.003,0.004,0.007 and 0.003 respectively),while CD3+,CD4+ and CD4+/CD8+ in EFR group were significantly higher than those in control group (p =0.004,0.000,0.007 respectively).On day 7 after treatment,the revised acute physiologic and chronic health evaluation (APACHE) system and the sequential organ failure assessment (SOFA) scores in EFR group were significantly lower than those in control group.Conclusion:EFR can effectively eliminate inflammatory factors,improve immune function,maintain the stability of blood components,reduce the incidences of ARDS and MODS,and elevate the successful rescue rate in patients with SPF.

Objective To discuss effect on prevention of postpartum hemorrhage of caesarean section by us- ing calcium gluconate combined with oxytocin and misoprostol.Methods 385 cases of caesarean section were select- ed and randomized into O(Oxytocin) group and OM(Oxytocin+ Misoprostol) group and COM (Calcium gluconate+ Oxytocin+Misoprostol)group.Results The mean operative blood loss in O group and OM group and COM group were (300?50.24)ml,(220?30.83) ml,(150?45.52) ml.The amount of the mean operative blood loss of COM group was significantly lower than those of O group and OM group(P＜0.05).The amount of bleeding of 2 hours after delivery in O group and OM group and COM group were (400?45.52)ml,(260?60.43)mi and(210?50.54) ml.The amount of bleeding of COM group was significantly lower than those of O group and OM group (P＜0.05).Conclusion The prevention by used calcium gluconate combined with oxytocin and misoprostol is efficient in reducing the amount of postpartum hemorrhage of caesarean section.The operation of medicine is easy and safe and economic.

[Summary] According to urinary albumin excretion rates ( UAER) , 256 patients with type 2 diabete mellitus (T2DM) were divided into normal albuminuria (NA), microalbuminuria (MA), and clinical nephropathy (CN) groups while 108 healthy subjects as control group. The analysis of variance of single factor was applied to examine lipoprotein(a), triglyceride, total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), cystatin C, and homocysteine. The correlations of lipoprotein ( a ) with urinary albumin excretion rate ( UAER ) and glomerular filtration rate ( eGFR ) were analyzed by Pearson correlation analysis. The sensitivities of lipoprotein ( a ) were evaluated in diagnosis of diabetic nephropathy ( DN) by receiver operating characteristic curve. The results showed that lipoprotein ( a) levels in NA, MA, and CN groups were gradually increased, with a significant increase in CN group(P<0. 05). Pearson correlation analysis revealed that lipoprotein (a) was positively correlated with systolic pressure, TC, cystatin C, and UAER(all P<0. 05) and negatively correlated with fasting blood glucose and eGFR (P<0. 05). The area under the ROC curve of lipoprotein(a) was 0. 639, with the sensitivity 66. 4% and specificity 55. 9% in the optimal cutoff value of 8. 41 mg/dl. These results suggest that lipoprotein(a) may serve as an index for monitoring DN based on its better correlation with UAER and eGFR.

AIM: To investigate serum vascular endothelial growth factor (VEGF) level in patients with bladder transitional cell carcinoma(BTCC) and its clinical significance. METHODS: ELISA method was used to examine the serum VEGF level in 42 cases of bladder transitional cell carcinoma and in 10 cases of normal people as control. The change of VEGF in blood of the pre-operation and post-operation patients with BTCC was also compared. RESULTS: The VEGF level in blood of the patients was higher than that of the normal people, in spite of pre-operation, post-chemotherapy, and post-operation, but VEGF level decreased obviously after chemotherapy or operation. In addition, the plasma VEGF level was related to the grade and invasion of tumor. CONCLUSION: Detecting serum VEGF level can help us to assess the change of tumor and therapeutic effect.

SMART-RACE was performed after isolating the total RNA of Armillariella tabescens to amplify the full-length cDNA of arabinosidase (GenBank Accession No. AJ620046). Bioinformatics analysis was used to analyze the code frame of arabinosidase, to predict its structure and function. Recombinant plasmid pPIC9-AF was constructed and then electroporated into methylotrophic yeast Pichia pastoris GS115. The secreted 6 ? His fusion protein was purified to analyze its enzymology property. This arabinosidase had high activity at 30-35℃ under acid condition, and was stable within wide range of pH and temperature. It maintained about 80% activity at the range of pH4. 0-8.0 and 20-40℃,wider than many other cloned arabinosidase. So it was worthy to go step further to study this enzyme, and recombinant expression provided a chance of highly expressing arabinosidase.

Background The aspheric intraocular lenses(IOLs)can reduce ocular spherical aberration to some degree.However,the clinical effect depends more on the IOL proper alignment.It becomes more important to study the IOL position in eye,Objective This study was to analyze the position alteration of IOL after phacoemulsification combined with implantation of one-piece soft IOLs.Methods In this prospective control study,80 eyes of 40 patients with age-related cataract were enrolled.The phacoemulsification with IOL implantation was performed in all the eyes.Decentration and tilt of IOL in the nasal superior,superior temporal,inferior temporal and nasal inferior quadrants(the intersection point of the system optical axis and the IOL maximum cross plane were regarded as the ordinate origin)were measured by rotating Scheimpflug camera(Pentacam Oculus)in 3 months postoperatively under the mydriasis condition.Written informed consent was obtained from each subject prior to this trial.Results In the right eye group,the IOL decentered toward temporal in 26 eyes(65％)and infratemporal in 16 eyes(40％).IOLs tilted temporally in the horizontal plane in 37 eyes(92.5％)and tilted inferiorly in the vertical plane in 34 eyes(85.0％).In the left eye group,IOLs decentered temporally 33 eyes(82.5％)and 20 IOLs (50％)infratemporally,IOLs tilted temporally in the horizontal plane in 37 eye(92.5％)and 36 IOLs(90％)tilted inferiorly in the vertical plane.There was no statistical difference for the intercomparsion of horizontal/vertical decentration in various quadrant in the right eye(F =0.221,0.792,P＞0.05).The obvious elevated horizontal decentration was found in the supertemporal and infratemporal quadrants compared with supernasal quadrant in the left eyes but there was no significant difference in the vertical decentration among 3 quadrants(F=0.576,P＞0.05).Decentrations were positively correlated with the tilt in both horizontal and vertical plane(right eye horizontal plane:r=0.374,P=0.002;right eye vertical plane:r=0.402,P=0.001 ;left eye horizontal plane:r=0.377,P=0.002；left eye vertical plane:r=0.347,P=0.002).Conclusions The one-piece soft IOLs(Adapt AO)decenter toward temporal mostly in 3 months after surgery,especially infratemporally in the eye.And the optical axis of the IOL tilt toward infratemperol mostly in both right and left eyes.The decentration and tilt are consisted in the corresponding direction between the right and left eyes.The position of the IOLs showed mirror symmetry between right and left eyes.The IOLs decentration show the positively correlation to tilt whatever in horizontal and vertical plane.

AIM:To investigate the effects and mechanism of anti-vascular endothelial growth factor ( VEGF) assisted pars plana vitrectomy ( PPV) in the treatment of proliferative diabetic retinopathy ( PDR) . ·METHODS: A total of 92 patients ( 92 eyes ) with PDR treated by PPV were divided into the simple PPV group (41 patients with 41 affected eyes) and the combined treatment group ( 51 patients with 51 affected eyes ) according to whether the patient underwent intravitreal injection of Ranibizumab ( IVR) . The combined treatment group was treated with IVR at 5-7d before PPV. The surgical time, times of electrocoagulation, silicone oil filling rate, the incidence of postoperative complications, LogMAR BCVA of affected eyes, levels of VEGF and pigment epithelium derived factor ( PEDF ) in aqueous humor and vitreous body were compared between the two groups. ·RESULTS:The surgical time was shorter, the times of electrocoagulation was less, the silicone oil filling rate and the incidence rates of iatrogenic retinal hole and vitreous body hematocele were lower in the combined treatment group than in the simple PPV group (P<0. 05). Levels of VEGF and PEDF in aqueous humor and vitreous body of the combined treatment group during PPV were lower than those in the simple PPV group (P<0. 05). The LogMAR BCVA of the affected eyes of the combined treatment group in 3mo after surgery was better than that of the simple PPV group (P<0. 05). ·CONCLUSION:IVR combined with PPV can reduce the perioperative levels of VEGF and PEDF, reduce the times of electrocoagulation and the incidence of iatrogenic retinal hole and vitreous body hematocele, and improve the visual acuity of patients with PDR.

Objective To investigate the impact of accountable and kindred-like nursing and the practice of quality care.Methods 100 primiparas who gave birth three months before the accountable and kindred-like nursing were selected as the control group,while 100 primiparas who gave birth three months after accountable and kindred-like nursing were selected as the observation group.Tow groups' understanding of health education knowledge and skills,satisfaction with nursing when discharged,nomination rate of the most satisfactory nurse and compliance behavior after discharged were compared.Results In the observation group,62 cases had fully understood,28 had basically understood and 10 had not understood the health education knowledge when discharged,while in the control group the numbers were respectively 30,56 and 14.In the observation group,75 cases had fully understood,19 had basically understood and 6 had not understood the health education skills when discharged,while in the control group the numbers were respectively 28,58 and 14.The understanding of health education knowledge and skills were much better in the observation group than in the control group,and the differences were statistically significant (x2 =21.13,44.40,respectively; P ＜0.05).After being discharged,the compliance behaviors including pure breastfeeding,newborn massage and baby swimming of the observation group were also better than the control group (49 vs 27,58 vs 27,47 vs 18,respectively),and the differences were statistically significant (x2 =9.93,20.14,19.16,respectively; P ＜0.05).There were no significant differences in infant buttock nursing between two groups (P ＞ 0.05).The satisfaction of nursing and nomination rate of the most satisfactory nurse were also much higher in the observation group (99 vs 93,82 vs 53,respectively),and the differences were statistically significant (x2 =10.86,19.17,respectively ;P ＜ 0.05).Conclusions Accountable and kindred-like nursing can enhance the effect of health education,compliance behaviors,so as to improve the satisfaction degree of puerperants and their families with nursing service.

OBJECTIVETo investigate the clinical characteristics of children with Castleman's disease and to improve doctors' awareness of this disease.

METHODSClinical characteristics of 5 cases with Castleman's disease were observed and analyzed and relevant reports in literature were reviewed.

RESULTS(1) All the five patients' histories were long, and the first symptoms of them were painless lymphnode enlargement, and all of them were at school age; 3 patients' abdominal lymphnodes were enlarged, mediastinum lymphnodes enlarged in 3 cases, cervical lymphnodes were involved in 3 cases; (2) The clinical subtypes: the disease in 3 cases was localized Castleman's disease (LCD), all of their pathological subtype was hyaline vascular variant (HV). The rest of them were multicentric Castleman's disease (MCD), whose pathology was plasma cell variant (PC), and both of them had a febrile symptoms; (3) The white blood cells, C-reactive protein and ferritin levels were all elevated to different extents. Four of them had viral infections, and their cellular immune function was abnormal; (4) The LCD patients' prognosis was good after the complete resection. There is no standard therapy for MCD, the available therapies include antiviral, immune modulatory regimens, CD20 B cell monoclonal antibody and chemotherapy, but the prognosis was worse than that of LCD.

CONCLUSIONSCastleman's disease is rare in children, which can be misdiagnosed because it has no specific manifestations. The prognosis depends on the subtype.