ObjectiveTo investigate the association between R405Q polymorphism of GLI1 gene and tetralogy of fallot(TOF).Methods In the case-control study,the R405Q polymorphism of GLI1 gene in 112 children with TOF and 200 healthy controls were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The distribution of genotype and allele frequency at R405Q polymorphism site were analyzed and to investigate its relationship with the risk of TOF.ResultsThe distribution of genotype frequency at R405Q polymorphism site was not different between TOF group and the healthy control group(x2 =5.317 ,P = 0.07) .However, the distribution of allele frequency at R405Q polymorphism site was significantly different between TOF group and the healthy control group (x2 = 6.790, P = 0.009) , and the relative risk for TOF in A allele carriers was higher than that in G allele carriers (OR = 1.561,95％ CI 1.116 ～ 2.185) Conclusion The R405Q polymorphism of GLI1 gene is associated with TOF and people with A allele have higher risk with TOF.GLI1 gene might be the genetic susceptibility gene of TOF.

Objective To explore the effect of positive end expiratory pressure (PEEP) on arterial oxygenation and intrapulmonary shunt during one-lung ventilation (OLV) and pulmonary function during perioperation. Methods Forty patients with normal pulmonary function,ASA I - II :scheduled for pulmonary lobectomy, were divided into control group and PEEP group by random digits table with 20 cases each. Patients were induced by double-lumen tubes under intravenous anesthesia and were received 10 ml/kg tidal volume, 12 frequents/min breathing rate during the two-lung ventilation (TLV), secondary reduced to 6 ml/kg tidal volume, 16-18 frequents/min breathing rate without PEEP (control group) or with 5 cm H2O cm H2O =0.098 kPa) PEEP (PEEP group) during OLV.Hemodynamics and respiratory mechanical parameters were continuously monitored, lung function before operation and at 72 h after operation was detected. Results Compared to before OLV,arterial oxygen tension (PaO2), arterial oxygen saturation (SpO2), oxygenation index (OI) were decreased and intrapulmonary shunt ratio (Qs/Qt) was increased in control group and PEEP group at 30 min after OLV (P < 0.01 or < 0.05). However,PaO2 and SpO2 and OI were higher and Qs/Qt was lower in PEEP group than that in control group at the same time point (P<0.05). In addition, FEV1%, FVC% and FEV1/FVC were (121.8 ± 25.0% ,(117.2 ± 24.3)% , (87.6 ± 15.7)%before operation and (84.9 ± 21.6)%, (77.2 ± 18.3)% , (70.5 ± 12.5)% at 72 h after operation respectively in control group, (116.9 ±24.5)% , (112.1 ±23.6)% , (85.3 ± 13.8)% before operation and (96.3 ± 20.4)%, (88.1 ± 19.8)% , (78.4 ± 10.2)% at 72 h after operation respectively in PEEP group. Although decreased in control group and PEEP group at 72 h after operation comparing with preoperation (P< 0.01 or < 0.05 ), FEV1%, FVC% and FEV1/FVC were higher in PEEP group than those in control group at 72 h after operation (P<0.05). Conclusion Appropriate PEEP increases arterial oxygenation,reduces Qs/Qt and improves pulmonary function during OLV,reduces the risk of hypoxernia and lung injury induced by OLV during perioperation.

Objective To investigate the quality of life of children with leukemia and the related factors.Methods The descriptive and interrelated design was used in this study.80 children with leukemia were interviewed using"the QOL instrument for children".Results The level of QOL was "generally satisfied"among children with leukemia.Mostly,the level of QOL among depression,anxiety and physical perception was less satisfied.QOL was significant related with gender,relationship in the family,performance in the schooll,relationship with peer,and personality,and was not related with place of living,whether the child was the single child in the family,disease classification and stage of ehemothrapy.Conclusions The evaluation of QOL of children with leukemia is very important.Interven-tions should be performed to improve QOL of children with leukemia,especially boy,and ehidren who are introversive.or have worse relationship with family and peers,or worse performance in the school.

Objective To evaluate the effects of pegylated interferon plus ribavirin on naive and retreated chronic hepatitis C (CHC) patients.Methods A total of 67 CHC patients were divided into naive group (n =35) and retreat group (n =32) based on their treatment history.And their virological responses [rapid virological response (RVR),early virological response (EVR),virological response to etravirine (ETR) and sustained virological response (SVR)] and risk factors were analyzed.Results ①RVR and EVR of naive group were 60％ (n =21) and 77％ (n =27),respectively,and the retreat group were 28％ (n =9),53％ (n =17).The differences between the two groups were significant (both P ＜ 0.05).On the contrary,CHC patients in both groups might achieve similar ETR and SVR rates (P ＞ 0.05) ; ② The relapse rate in the retreat group was higher than that in the naive group (22％ vs.10％).But the differences had no statistical significance (P ＞ 0.05) ; ③ CHC patients in the retreat group could achieve similar responses,including RVR,EVR,ETR and SVR (P ＞ 0.05) whether treated previously with standard interferon or pegylated interferon; ④ According to muhivariable logistic regression analysis,the retreated genotype 1 CHC patients has a lower SVR rate compared with naive genotype non-1 counterparts (OR =0.29 and 0.26,all P ＜ 0.05).Conclusions CHC patients in the naive group could achieve higher virological responses and a lower relapse rate compared to those in the retreat group.The previous treatment regimeu has no significant effect on virological responses of CHC patients retreated with Peg-IFN plus ribavirin.Genotype 1 and retreatment are both risk factors of achieving SVR.

Objectives:To understand the medical students'cognition of violence injury medical and the impact of medical injury events reports on medical students.Methods:A sample survey was conducted among 480 medical students in a medical university using self-developed questionnaire.Results:A total of 63.67％ of the medical students get violence injury events information through television news;more than 90％ of medical students were concerned about the media reports of violence injury medical events.The media reports of violence injury medical events had an important impact on medical students,and especially television reports had the greatest impact.41.2％ of the students would enhance their awareness of protection;37.9％ of medical students thought that work passion and enthusiasm would decline;the impact of reports on men was bigger than women (P ＜ 0.05).Conclusion:The report of violence injury medical events has an important impact on medical students.The media should improve self-discipline,create a harmonious public opinion environment and promote the healthy development of doctor-patient relationship.

AIM: To investigate the effect of vascular cell adhesion molecule-1(VCAM-1) modified human umbilical cord blood stromal cells(hUCBSCs) on the expansion of hematopoietic stem cells/progenitor cells in vitro.METHODS: After the VCAM-1-pcDNA3.1(+) eukaryotic expression vector was constructed successfully,the recombinant vector was transfected into hUCBSCs via liposome mediation.The expression of the VCAM-1 was detected by semiquantitative RT-PCR and immunocytochemistry.The expansion abilities of hematopoietic cell in vitro under different conditions were compared,including cytokine stimulation,hUCBSCs feeder layer and VCAM-1 modified hUCBSCs feeder layer etc.The effect on hematopoietic reconstitution of different expanded hematopoietic cell groups was compared after CFU-GM,CFU-E and CFU-Mg semi-solid culture were proceed,respectively.RESULTS: The positive clone and NeoR gene detection proved that recombinant vector had been transfected into hUCBSCs.The results of semiquantitative RT-PCR and immunocytochemistry manifested that VCAM-1 was high expressed not only at transcriptional level in the stable-transfected hUCBSCs(P

Objective:To investigate the efficacy of Silybinin meglumine on hepatic fibrosis rats and possible mecha -nisms.Methods:The liver fibrosis rats were randomly divided into 4 groups,the model group,Silybinin meglumine 120 mg/kg group, Silybinin meglumine dose group 60 mg/kg and Silybinin meglumine low dose group 30 mg/kg,and the control group.All groups had been treated for 4 groups.Results:No deaths rat.Compared with the control group ,the reduced body weight ,less dynamic,dark hair, decreased liver and spleen indexes ,increased ALT,AST,TBIL,TG,TC and LDLC,and the decreased ALB, and the increased LXRαand SREBP1c had been observed in the model group (P<0.05).Compared with the model group ,better activity and body weight ,the in-creased liver and spleen indexs decreased ALT ,AST,TBIL,TG,TC and LDLC,and the increased ALB , and the decreased LXRαand SREBP1c had been observed in the Silybinin meglumine groups (P<0.05),in a way of dose-depended.Conclusion: The Silibinin meglumine can treat liver fibrosis ,by improving liver function,lowing lipid and decreaseing LXRαand SREBP1c expression in liver tis-sue.But the mechanism of two proteins reduced remains for further investigation .

Objective To evaluate the relationships of the serum levels of matrix metalloproteinase-9 (MMP-9), intercellular adhesion molecule-1 (ICAM-1) and adiponectin with the mild cognitive impairment (MCI) in senile metabolic syndrome (MS)patients. Methods The 74 cases with MS and 30 health controls (control group) were enrolled. Mini-mental state examination (MMSE), montreal cognitive assessment (MoCA), digit-symbol test (DST), auditory verbal memory test (AVMT), trail making test(TMT), sunderland clock drawing test (CDT) and verbal fluency test (VFT) were applied to evaluate cognitive function. Based on the cognitive assessment, MS patients were divided into two groups: 39 cases with MCI (MS+MCI group) and 35 cases without cognitive impairment (MS group). The levels of MMP-9, ICAM-1 and adiponectin were measured by ELISA. Biochemical variables were measured by routine methods in all subjects. Results (1)MS+MCI group showed the higher levels of BMI, SBP, FBG and MMP-9 (all P＜0.05) and lower level of adiponectin (P＜0.05) than did the MS group. And MS group had higher levels of MMP-9 and ICAM-1 (P＜0.01) and lower adiponectin level (P＜0.01) than did the control group. (2)Spearman's correlation analysis showed that the serum levels of MMP-9 (r=-0.794, P＜0.001) and ICAM-l (r=-0.501, P＜0.001) were negatively correlated with adiponectin. However, MMP-9 was positively correlated with ICAM-1 (r=0.481, P=0.006). (3)Multiple linear regression analysis indicated that there was linear relationship of MoCA with MMP-9 (β=-3.438, P=0.0019), adiponectin (β=1.337, P=0.006), SBP (β=-0.058, P=0.003) and FBG (β=-0.227, P=0.049). (4)Stepwise logistic analysis showed that both high MMP-9 (OR=1.007) and low adiponectin (OR=0.359) were risk factors for the decline of cognitive function. Conclusions Elderly patients with MS may show deterioration in memory, calculation and visuospatial perception. Elevated inflammatory factors might contribute, in combination with abnormal metabolism, to MCI. MMP-9 might contribute to neuronal degeneration. However, adiponectin could strongly counteract the risk factors for cognitive impairment.

Objective To investigate the factors influencing basic rehabilitation service needs of people with disability at Zhabei District in Shanghai .Methods Primary rehabilitation demands and services of 10 311 disabled persons in Zhabei District were surveyed.Results The screening rate of persons with disability having primary rehabilitation demands was 83.5%. And the gender, age, type of disability, disability level, education, employment might be the factors affecting the primary rehabilitation demands of people with disability.Conclusion The primary rehabilitation service demands vary in deferent types of people with disability. The various services based on the extensive rehabilitation services should be provided to deferent categories of people with disability.

Objective To understand the status of special rehabilitation service demands of people with disability at Zhabei District in Shanghai and to provide the basis for the policy development.Methods Screen rate (SR) was used to indicate the level of demand of rehabilitation service, the data were analyzed with SPSS 13.0 statistical software.Results There were 4 349 persons with disability who demanded the special rehabilitation service; the SR of “on-site rehabilitation service” demands was the highest among the whole persons with disability; the SR of “personalized allotment of supplies and appliances” demands of the intellectual disability and mental disability was lower than the other types; the SR of special rehabilitation service demands of the female, the elderly, the low cultural level, the unemployed and the people with severe disability were relatively higher.Conclusion The form of “on-site rehabilitation services” needs to improve based on the demand of the disabilities; “personalized supplies and appliances” for the intellectual disability and mental disability needs to further develop; the rehabilitation services targeted to the female, the elderly, the low cultural level, the unemployed and the people with severe disability need to improve.