Objective To study the application CT scans in Nuss procedure for pectus excavatum. Metlhods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008 The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation, the deformity in relation with adjacent tissue and associated different disorder. Results Nuss procedure was successfully performed in all 648 patients. The preoperative CT scan showed medium deformity of the pectus excavatum in 73 cases ( 11.27% ) and severe deformity in 575 cases (88.73%). Morphologic classification of the pectus excavatum were symmetric type in 407cases (62.81% ) , eccentric type in 83( 12.81% ) ,and unbalanced type in 158( 24.38% ). 116 cases with pectus excavatum were associated with other different disorders, among them 55 cases ( 17.9% )were diagnosed by CT scan. 28 cases received stimultanously operation for their abnormalities. Conclusion CT scan is a useful tool for evaluation the deformity degree and morphology classification, direct the operation, reduce the complications and find other different disorders. It should be a routine examination before Nuss procedure.

Objective To investigate the influence of retinoic acid receptor (RAR-α,RAR-β and RAR-γ)-mediated all-trans retinoic acid (ATRA) on renal tissue cell proliferation and apoptosis in rats with diabetic nephropathy,and to analysze the possible mechanism. Methods Male SD rats were randomly divided into normal control group (group N,n=10) and diabetic model group (n=20).Diabetes was induced by streptozotocin(STZ) injection.After successful modeling,the model rats were randomly divided into diabetes group (group D,n=10) and ATRA treatment group (group T,n=10).Rats in group T received ATRA 10 mg·kg-1·d-1 by gavage from the 2nd day of successful modeling for 8 or 12 weeks,meanwhile group N and group D received same volume distilled water.In each group,5 rats were sacrificed respectively at the 8th week or the 12th week,then biochemical markers were measured and kidney pathology was examined.Apoptosis index(AI)of renal tissue cells of each group was tested by TUNEL.The expressions of RAR-α,RAR-β and RAR-γ in renal tissues were tested using indirect immunofluorescence.The expressions of type Ⅰ collagen and laminin as proliferation indicators,along with Smac and caspase-3 as the correlated factors of apoptosis in renal tissue of each group were tested by immunohistochemistry staining.The mRNA expressions of Smac and caspase-3 were tested using real-time fluorescence quantitative PCR. Results Compared with group N,24 h urine protein,serum creatinine,blood urea nitrogen,ratio of kidney weight/body weight increased significantly (P＜0.05,respectively) in group D,and further increased with observation time.Compared with the group D,24 h urine protein and ratio of kidney weight/body weight decreased in group T (P＜0.05,respectively).Compared with group D,the group T presented minor pathological changes.TUNEL assay indicated that compared with group N,the group D showed an obvious increase in renal cell apoptosis in time-dependent manner,and the group T showed a decrease compared with the group D (P＜0.01,respectively).Compared with group N,the expression of RAR-α and RAR-β positive cells number in group D were decreased (P＜0.01,respectively).Compared with group D,the expression of RAR-α and BAR-β positive cells number in group T increased (P＜0.01,respectively).Renal tissues of each group did not show expressions of RAR-γ.After 12 weeks,compared with group N,expressions of type-Ⅰ collagen,laminin,Smac and caspase-3 protein in the glomerular mesangial area and basement membrane of renal tissues in group D increased significantly (P＜0.01,respectively),and enhanced with time.Compared with the group D,expressions of type Ⅰ collagen,laminin,Smac and caspase-3 protein in group T decreased (P＜0.01,respectively).Compared with the group N,group D had an obvious increase in the mRNA expressions of Smac and caspase-3,and a significantly decrease in group T (P＜0.01,respectively). Conclusions ATRA may prevent the cell proliferation and apoptosis in diabetic renal tissue through its receptor-mediated pathway,and may protect rats against diabetic nephropathy.

Objective To investigate the clinical features of neonatal invasive fungal infection(IFI) so as to guide diagnosis,prevention and treatment of IFI.Methods Seventy-six neonates with IFI admitted to the Neonatal Intensive Care Unit (NICU) at Children's Hospital of Fudan University from 2004 to 2014 were included in the study.Pathogens,clinical manifestation,risk factor exposure,laboratory findings,complications,and clinical outcome of neonatal IFI were analyzed.Results Seventy-six cases were diagnosed as IFI between 2004 and 2014,with an yearly increasing trend.Sixty-eight patients were premature infants (89.5％).Of the 76 cases,except one with unknown birth weight,11(14.7％),34(45.3％),20(26.7％)and 10 (13.3％) cases had birth weight ＜ 1 000 g,(≥ 1 000-＜1 500) g,(≥ 1 500-＜2 500) g and ≥ 2 500 g,respectively.The pathogens were mainly Candida (74/76,97.4％),including 26 cases of Candida albicans (34.2％).However,the incidence of non-Candida albicans infection was increasing.Candida guilliermondii was the most common in nonCandida albicans,accounting for 29.2％ (14/48).All Candida albicans were sensitive to fluconazole.One strain of Candida glabrata was resistant to fluconazole.The most common risk factors included use of broad-spectrum antibiotics(93.3％,56/60),parenteral nutrition(70.0％,42/60),central vein catheterization(53.3％,32/60),invasive ventilation(40.0％,24/60) and history of abdominal surgery(21.7％,13/60).Clinical manifestations of IFI included temperature instability,frequent apnea,increased requirement of respiratory support and feeding intolerance.Among all cases,six were diagnosed as central nervous system infection.Of the patients who received cranial MRI,46.8％(22/47) showed multiple abnormal signals in cerebral parenchyma.Fiftytwo patients were cured and seven patients died before discharge,including one death due to fungal infection.Conclusions There is an increasing trend of IFI cases in NICU,especially in premature infants.Non-Candida albicans has become the main pathogenic fungus.There are no specific clinical manifestations in neonatal IFI.Use of broad-spectrum antibiotics,parenteral nutrition and central venous catheterization are common risk factors,and preventive measures should be taken in high-risk infants.In addition,IFI in neonates may affect important organs such as central nervous system,thus early treatment is necessary in suspected patients.

Objective To investigate the effects of magnesium isoglycyrrhizinate on liver function of patients with gastrointestinal cancer following chemotherapy.Methods From Apr.2012 to Dec.2015,a total of 168 cases of patients with gastrointestinal cancer following chemotherapy were enrolled,and were randomly divided into observation group(84 cases) and control group(84 cases).Each of the two groups was divided into A group(42 cases) and B group(42 cases) according to the treatment methods.Patients of observation group(including observation A group and observation B group) were treated with magnesium isoglycyrrhizinate,while patients of control group(including control A group and control B group) were treated with glutathione.Patients of A group(including observation A group and control A group) were treated with FOLFOX4 regimen,while patients of B group(including observation B group and control B group) were treated with XELOX regimen.The incidence of abnormal liver function and changes of the levels of liver function of each group were analyzed and compared.Results After the appropriate treatment,the abnormal rate of liver function of observation group were significantly lower than control group(P<0.05).After treatment,levels of liver function parameters in observation group and control group were all significantly increased(P<0.05),and those in control group were higher than observation group(P<0.05).After treatment,levels of liver function parameters in observation A group and control A group were all significantly increased(P<0.05),and those in control A group were higher than observation A group(P<0.05).After treatment,levels of liver function parameters in observation B group and control B group were all significantly increased(P<0.05),and those in control B group were higher than observation B group(P<0.05).Conclusion Magnesium isoglycyrrhizinate could be with protection effects on liver function of patients with gastrointestinal cancer following chemotherapy,which might be worthy of promotion.

The study reports the detection of neuroprotective effect of 10 kinds of coumarin derivatives and explores their possible mechanism. MTT method was used to screen the neuroprotective effect of 10 coumarin derivatives on neurotoxic agents (Aβ25-35 and rotenone) or OGD (oxygen-glucose deprivation). A compound with better protective effect was obtained. Then the effect of this compound on neurotoxic agents on PC12 was detected by the morphological observation. Furthermore, the effect of compound 3 on microglia with lipopolysaccharide (LPS) induced inflammation was detected. And the inflammatory factor was tested. Finally, direct free radical scavenging ability was detected. Compound 3 was found to be the best compound through three neurons toxic models. Not only compound 3 ameliorated cell viability reduced by three neurons toxic models, but also significantly inhibited the production of inflammatory factor (TNF-α and IL-1β). And its free radical scavenging ability is very good, especially the effect on superoxide anion, which is comparable with vitamin C. The significant scavenging effect of compound 3 on superoxide anion might be the mechanism of the neuroprotection. Compound 3 as a potential neural cell protective agent merits further investigation.
Animals ; Coumarins ; chemistry ; Free Radical Scavengers ; chemistry ; Inflammation ; Microglia ; drug effects ; Neurons ; drug effects ; Neuroprotective Agents ; chemistry ; PC12 Cells ; Rats

Objective To investigate the influence of electrocardiogram(ECG)-controlled dose modulation on exposure dosage and image quality of cardiac CT imaging in a cardiac phantom with simulated fluctuant heart rate.Methods The basal heart rate of the cardiac pulsating phantom was set as 60 bpm.the experimental situations were divided as 6 groups according to different heart rates.The cardiac imaging was performed on the cardiac phantom when the ECG-controlled dose modulation was firstly turned off.The exposure dosage of each scan sequence was documented.The standard deviation of the CT values of the phantom was measured on the central slice after coronal reformation of the raw data.The quality of 2D and 3D images were scored.Thell cardiac imaging was performed when ECG modulation was on and set as four groups according to different modulation parameters.All the data were documented as before.The results from the five groups with and without ECG modulation current were analyzed bv F test and comparative rank sum test using the statistical software SPSS 10.0.Results Statistical analysis showed no significant difference(P＞0.05)between the SNR of images(SD value was 27.78 and 26.30)from the groups that full mA output at wide reconstruction phase(69%～99%)when the heart rate was fluctuant(≥7.5 bpm).There was also no significant difference(P＞0.05)between the quality of the 2D and 3D images.But there was a significant difference(P＜0.01)between the SNR of images(SD value was 26.78 and 29.90)that full mA was only used at 85%reconstruction phase when the heart rate Was fluctuant(≥7.5 bpm).The exposure dosage was remarkably reduced when the ECG modulated current was on than when it Was off under fluctuant heart rate.Furthermore.there were significant difierence(P＜0.01)among the difierent ECG modulated current parameter groups.The exposure dosage can be reduced by 44.7%under the situation that the heart rate was fluctuant.Whell the fluctuation of the heart rate was≤12.5 bpm,there wag no obvious relationship between the fluctuation of the heart rate and the exposure dosage (the variation was from 0.1 to 1.1 mSv),but if the heart rate fluctuation was＞12.5 bpm,the exposure dosage would increase obviously (from 0.6 to 1.7 mSv).Conclusion For cardiac imaging with 16-slice row CT,the application of ECG modulated current can effectively reduce the exposure dosage without compromising the image quality even if heart rate was fluctuant.

Aim:To develop a rapid high-performance liquid chromatography-mass spectrometry (HPLC-MS) method for the quantification of tiopronin in human plasma.Methods:Cysteine was chosen as antioxidant and firstly added into the whole blood firstly.After adding mycophenolic acid as internal standard (IS) and 1 mol/L HCl into the plasma,the samples were extracted with acetic ether and then determined by HPLC-MS.The chromatographic separation was performed on a Shim-pack VP-ODS C18 column (250 mm×2.0 mm,5 μm) using methanol-0.1% acetic acid (70∶30) as mobile phase with a flow rate of 0.2 mL/min.Results:The assay exhibited a linear range of tiopronin between 30～4 000 ng/mL.The precisions for intra- and inter-batch were all within 8.5%.The extraction recoveries were more than 70%.The total HPLC-MS analysis time was within 7.5 min per a run.The fully validated method was successfully applied to quantify tiopronin in human plasma for a bioavailability study.Conclusion:The assay proved to be accurate,sensitive,selective and convenient.The fully validated method can be applied to study the pharmacokinetics and bioavailability of tiopronin and tiopronin formulations in human.

Objective To access the development of thoracic volume of pectus excavatum use of Nuss operation used CT-basedpulmonary volumetric evaluation.Methods 98 patients with pectus excavatum in Beijing Children's Hospital under Nuss operation were documented.All patients had CT scan pre-and postopration.The CT-scan's data were calculated as lung's volume by handdraw-layers summation method.The lung's volume result was compared,and enquiry the position in CT lung volume developmental scale.Results The lung's volume was elevated 28.3％ after operation.The development of thoracic volume was keep with age,70％ was maintained and 15％ was elevated.Conclusion Nuss operation can prevent the decrease of thoracic volume in pectus excavatum.

Objective To investigate the improvement of postpartum pelvic floor by rehabilitation training assessed with three-dimensional transperineal ultrasound . Methods One hundred cases of healthy postpartum women were randomly divided into two groups :control group and training group .The control group received the customary education ,and the training group received pelvic floor rehabilitation training . At 6 and 12 weeks postpartum ,levator hiatus area ,thickness of the levator ani muscle ,bladder neck mobility ,and bladder posterior horn were measured with three-dimensional transperineal ultrasound in all the subjects . Meanwhile ,the muscle strength situations were tested . Results At 12 weeks postpartum ,the anal levator hiatal area ,bladder neck mobility and bladder posterior horn in the training group were lower than those of the control group[ ( 21 .6 ± 3 .2) cm 2 vs ( 25 .6 ± 2 .4 ) cm 2 ,( 27 .9 ± 5 .3) mm vs ( 31 .5 ± 5 .9) mm ,( 126 .3 ± 21 .2)° vs (135 .3 ± 11 .6)°] ( P < 0 .05) . Compared with control group ,the thickness of the levator ani muscle increased in training group [ ( 13 .6 ± 2 .3) mm vs ( 15 .3 ± 2 .5) mm ] ( P < 0 .05) . The incidence of stress urinary incontinence in the training group ( 5% ) was significantly lower than the control group ( 12 .5% ) at 12 weeks postpartum ( χ2 = 5 .487 , P = 0 .025) . The muscle strength had no significant difference at 6 weeks postpartum . At 12 weeks postpartum ,the pass rate of class Ⅰ muscle fiber was 78 .5% ,and that of class Ⅱ muscle fiber was 83 .3% in the training group ;the pass rate of class Ⅰ muscle fiber was 28 .5% ,and class Ⅱ muscle fiber was 37 .3% in the control group , the improvement was significant at 12 weeks postpartum . Conclusions The result of the transperineal real-time ultrasonographic evaluation of post-natal pelvic floor rehabilitation training has high consistency with the measurement of muscle strength . The ultrasound examination is simple and accurate ,and has highly applicable value in evaluating the effect of post-pelvic rehabilitation training .

Objective To investigate the correlation between serum amyloid A (SAA) and disease activity (DAS28) in patients with rheumatoid arthritis (RA). Methods Forty-four patients with RA, 35 patients with systemic lupus erythe-matosus (SLE), 18 patients with osteoarthritis (OA) and 30 healthy controls (HC) were enrolled in this study. The levels of SAA were measured by ELISA. Erythrocyte sedimentation rate (ESR) was measured by the Westergren method. The value of serum C reactive protein (CRP) was examined by immunonephelometry assay. The correlation between SAA and DAS 28, ESR and CRP was assessed, respectively. Results The SAA levels were significantly higher in RA group than those of SLE, OA, and HC groups (P<0.05). The serum ESR and CRP levels were both higher in RA group than those of OA and HC groups (P>0.05), but there was no significant difference between RA group and SLE group. There was positive correlation between SAA and DAS28, ESR, and CRP levels (rs=0.790, P<0.001;rs=0.674, P<0.001;rs=0.679, P=0.004), respective-ly. Conclusion SAA may be a new serological marker to assess disease activity in RA.