Objective To compare the count of circulating endothelial cells (CECs) between patients with reversible pulmonary hypertension (RPH) and irreversible pulmonary hypertension (iRPH) by flow cytometry in order to find a new biomarker to distinguish RPH from iRPH.Methods Ninety pulmonary hypertension associated with congenital heart disease patients treated in our hospital between September 1,2013 to March 31,2014 were enrolled in this study.According to the mean pulmonary arterial pressure (mPAP) measured by echocardiography in six months after treatment,the patients were separated into 2 groups:iRPH group(mPAP≥50 mmHg),RPH group(mPAP ＜50 mmHg).Results Totally the clinical data of 87 patients were enrolled in the statistic analysis,86 patients finished the follow-up in 6 months after the surgery,1 patient died from pulmonary hypertensive crisis.The count of CECs was not correlated with the extent of pulmonary hypertension(P =0.925).The number of CECs was higher in iRPH group than that of RPH group(0.46‰ vs.0.09‰,Z =-5.021,P =0.000).And also the age of patients in iRPH group was elder than that of patients in RPH group [(43.1 ± 37.4) months vs.(9.3 ± 12.6) months,t =-5.079,P =0.000].Conclusion The count of CECs is significantly increased in iRPH patients.It could be used as one biomarker to distinguish RPH from iRPH.

Objective To study the effect of tail-suspending on myostatin(MSTN)expression in the soleus muscle of rats.Methods The MSTN mRNA levels in soleus muscle of tail-suspended and normal control rats were measured and compared.Results The MSTN mRNA in soleus muscle of tail-suspended rats was 2.2 times(hind limb unloading for 14 days)and 3.5 times(hind limb unloading for 30 days) higher than that in normal control rats (P<0.05).The relative wet weight of the soleus muscle in tail-suspended rats was decreased by 11%(unloading 14 days)and 1 9%(unloading 30 days),respectively,compared with that in normal control rats.Conclusion The expression of MSTN mRNA is elevated in the soleus muscle of tail-suspended rats,probably due to atrophy of the soleus muscle.

Objective To understand the true feelings of the patients with cervical intraepithelial neoplasia, and explore effect in patients with cervical intraepithelial neoplasia negative psychological experience. Methods Adopted purposive sampling,13 patients were in-depth interviewed,and the method of phenomenological analysis data were used. Results Analyzed of the psychological experience of patients with cervical intraepithelial neoplasia,extracted five topics: psychological overload,life was affected, the sick didn't adapt to the reality,self-assessment was low, the lack of information of disease. Conclusions The patients with cervical intraepithelial neoplasia have more negative psychological experience, and are in lack of information associated with disease and not satisfied. Nursing staff should take effective measures according to the actual situation of patients to promote their physical and mental rehabilitation.

Objective To detect micronuclei (MN) induced by nickel chloride (NiCl2) using a flow cytometry-based method, so as to study the mutagenecity of this chemical. Methods The micronucleated reticulocytes (MN-RET) in peripheral blood of NIH mice exposed to 0.75 mg/kg colchicines (COL), 40.0 mg/kg of cyclophosphamide (CP) and 5.0, 10.0 and 20.0 mg/kg of NiCl2 were detected by a flow cytometry-based method, in which anti-CD71-FITC and PI were used to stain cells and malaria-infected erythrocytes were employed as biological standards of micronuclei to optimize cytometry. Results Although COL or CP induced significant increase in the frequency of MN-RET in peripheral blood, MN formation in peripheral reticulocytes was not significantly affected by exposing to different concentration of NiCl2. Conclusion The results of flow cytometric analysis in the present paper do not support that NiCl2 exposure may induce significant MN-RET increase in peripheral blood in NIH mice.

Objective To study the risk factors of prolonged postoperative recovery after the total cavopulmonary connection(TCPC) in the current era.Methods Data on all patients admitted to the cardiac intensive care unit (CICU) after a TCPC between January 2013 and March 2014 were retrospectively analyzed.We excluded all patients who died and required TCPC takedown.The study cohort was further divided into a prolonged recovery group that included patients with 75％ ile for duration of mechanical ventilation or pleural drainage,and a standard recovery group which included all other patients.A multivariable logistic regression model was used to compare demographic,anatomic,and physiological variables between the prolonged and standard recovery groups.Then,the cohort was separated into a high volume resuscitation group and a low volume resuscitation based on the 75％ ile for volume resuscitation(ml/kg) administered on the first three days after the TCPC.Results Totally 118 TCPC operations were performed.Of the study population (n =118),the median age was 3.8 years (3.1 to 4.8 years) and median weight was 14.8 kg(13.3 to 17.1 kg).The most common diagnosis was double outlet of right ventricle (n =47,39.8％).The extracardiac conduit fenestrated TCPC was the most common surgery(n =79,66.9％).Within the study population,43 (39.8％) patients met criteria for prolonged recovery.Univariate risk factors for prolonged recovery included higher preoperative mPAP(P =0.022),atrioventricular valve regurgitation (P =0.000),longer total bypass time (P =0.044),higher postoperative central venous pressure (P =0.000),AST (P =0.001),ALT (P =0.010),NT-proBNP (P =0.000),SaO2 (P =0.012),I n-otropic score (P =0.001),higher incidence of arrhythmia (P =0.000),low cardiac output syndrome (P =0.000),need for peritoneal dialysis (P =0.000),and requirement for greater volume resuscitation during the 72 postoperative hours(75％ for the entire group,P =0.000).In a multivariable Logistic model,need for greater volume resuscitation (OR 10.860,95 ％ CI 2.681,43.987) and the higher postoperative central venous pressure (OR 1.446,95 ％ C I 1.113,1.879) were the only two independent risk factors for prolonged outcome after the TCPC.Conclusion The need for high volume expansion and higher central venous pressure were the risk factors of mediate prolonged recovery.

Objective To investigate the multidrug-resistance reversal action and mechanism of dihydroartemisin (DHA) on human colon cancer cell line HCT8/ADR. Methods The cytotoxicity of dihydroartemisin combined with doxorubicin(DOX) was determined by methyl thiazolyl tetrazolium(MTT) assay and cell apoptosis was observed by flow cytometry. Western blot assay was used to measure the autophagy. Results The combined treatment with dihydroartemisin and doxorubicin significantly enhanced the cytotoxicity in HCT8/ADR cells and effectively increased the apoptotic level. Autophagy was also induced by the combined treatment , which maybe played a crucial role in the regulation of doxorubicin-sensitization of HCT8/ADR cells. Conclusion The results indicated that dihydroartemisin can reverse multidrug resistance through increasing the doxorubicin-sensitivity of HCT8/ADR cells.

Objective To compare the clinical efficacy of percutaneous kyphoplasty (PKP) by balloon dilatation between unipedicular and bilateral pedicle approach for the treatment of osteoporotic vertebral compression fractures (OVCF). Methods From January 2012 to March 2014, 56 patients with single-level or double- level OVCF were randomly divided into two groups. 29 patients with 33 vertebral bodies were performed by PKP through unipedicular approach and 27 patients with 31 vertebral bodies through bipedicular approach , used PMMA bone cement filling vertebral. The clinical data of patients were prospectively analyzed and the clinical efficacy was compared between two groups. Results The VAS scores, Beck value, Cobb angle and ODI scores after operation improved in both groups (P < 0.01),but there were no significant difference between two groups(P > 0.05). The operative time, X-ray exposure time and volume of bone cement in unilateral group were less than that of bilateral group(P < 0.01). There were no significant difference in the incidence of bone cement leakage ,the pain relief and the incidence of complications between two groups (P > 0.05). Conclusion Both unipedicular and biopedicular PKP are significant improvement for the OVCF, vertebral strengthen showed similar efficacy, but the former has easy operation procedure, can shorten operative time and reduce X-ray exposure time and less volume of bone cement.

Objective To evaluate the risk factors,diagnostic index of the restrictive right ventricle physiology(rRV) and the impact of the mid-term outcome of the patients.Methods Eighty patients(30 in rRV group and 50 in non-rRV group) undergoing TOF repair admitted in our department from Oct 2011 to May 2012 were studied.Perioperative clinical data were collected and echo data were recorded after operation.Mixed linear regression for repeated measures was used to compare the variables and analyze the correlations.Results Patients in rRV group were younger with longer cardiopulmonary bypass(CPB) time,aortic cross clamp time,ventilation time,intensive care unit and hospital stay compared with those in non-rRV group(P<0.01,respectively).The younger patients with longer CPB time had high risk of rRV by logistic regression analysis.Within 7 days post operation,the increase of saturation of venous oxygenation and decrease of oxygen extraction ration were slower in rRV group than those in non-rRV group(P<0.05,respectively).Lactate decreased in both groups,but was higher in rRV group throughout the 7 days(P=0.03).NT-proBNP was higher in rRV group throughout the 7 days than that in non-rRV group.NT-proBNP≥4750pg/ml often indicated the patients in the state of rRV.CRP slightly increased in 1-2 days post operation,and decreased thereafter,and the decrease was slower in rRV group(P=0.08).With regard to the mid-term outcome,there was no significant differences in the incidences of the obstruction of the right ventricle outflow and main pulmonary artery,the stenosis of the branch of pulmonary artery and the degree of the pulmonary valve regurgitation.Conclusion rRV is associated with significantly higher levels of NT-proBNP and CRP.The incidence of rRV correlates with age on operation and positively correlates with CPB time.NT-proBNP would be regarded as an indicator of the incidence of rRV.The study indicated the rRV would have impact on the early outcome of the patients but there was no significant effect on mid-term outcome.

Objective To study the protective effect and mechanism of lactulose on the renal function in acute cholelithiasis with obstructive jaundice. Methods Fifty five cases of acute cholelithotic obstruction were randomly assigned into lactulose group (group L, n=28) and control group (group C, n=27), and 50% lactulose (group L)or 10% glucose (group C ) was administered orally for 3 days before the operation , respectively. The systemic and portal blood endotoxin (ET), blood urea nitrogen (BUN) and endogenous creatinine clearance rate (Ccr) were measured periodically. Results (1) In group L, the level of systemic vein ET and BUN were significantly lower than that in group C (P0.05); and the systemic vein ET and Ccr decreased significantly on 9d (P

Objective Investigate the clinical features,diagnosis and treatment of the scimitar sydrome.Methods A retrospective analysis of clinical data of six children with scimitar syndrome from 2008 to 2014,including clinical symptoms and signs,chest X-ray,echocardiography,chest CT and cardiac catheterization,treatment outcome and follow-up and review of the literature.Results Six patients with scimitar syndrome were diagnosed between 2008 and 2014.There were 3 girls and 3 boys;5 cases ＜ 6 kg in weight.Scimitar syndrome was suspected in 5 cases because of extroversion,and diagnosed by color Doppler echocardiography in all 6 when a scimitar vein was detected entering the inferior vena cava.Computed tomography confirmed the diagnosis in all patients.One patient had horseshoe lung,3 had a unilobar right lung,3 had a hypoplastic right lower lobe.Three patients had severe pulmonary arterial hypertension,1 had moderate to severe pulmonary arterial hypertension,and 2 had moderate pulmonary arterial hypertension.All patients had lower respiratory tract infections,volume loss of the right lung,a normal or hyperinflated left lung,dextroversion of the heart,and scimitar arteries from the descending aorta.4 cases of pulmonary venous drainage correction surgery,3 underwent body-pulmonary embolism,1 case of 9-year-old asymptomatic children without surgery,and 1 patient with heart failure,severe pulmonary hypertension,pulmonary infection,septicemia died before surgery.Conclusion Clinically,found children with heart of dextrocardia position,growth retardation,recurrent lung infections,unexplained right heart failure,pulmonary hypertension,should consider the possibility scimitar syndrome.Early diagnosis and early treatment of pulmonary venous drainage and pulmonary vascular embolization,can significantly improve the clinical symptoms in children and reduce mortality.