Objective To evaluate the diagnostic value of 99mTc-dimercaptosuccinate acid(DMSA) renal cortical scintigraphy for the identification of distinguishing between upper urinary infection(UUTI) and lower upper urinary infection(LUTI).Methods Two hundred and seventy-five children (111 males,164 females)ranging from 44 days to 15 years old,presented with urinary tract infection underwent 99mTc-DMSA renal cortical scintigraphy.The images were scored as normal (indicating LUTI) and abnormal (indicating acute pyelonephritis or renal scarring).Results Of 275 children with UTI,95 cases had normal images diagnosed as LUTI,41 males,54 females;and 180 cases had abnormal images,70 males,110 females.One hundred and seventy-four cases were diagnosed as acute pyelonephritis,6 cases were diagnosed as renal cortical scars,56 cases were single renal involved and 118 cases were both renal involved,and 22 cases repeatedly underwent renal cortical scanning after therapy.Sixteen of 18 cases with acute pyelonephritis completely recovered normal or obviously ameliorated after 0.5 to 2.0 years,2 cases did not show any improvement after 0.5 to 1.5 years,4 cases with renal scarring,and showed little change on repeated images after 1.0 to 1.5 years.Conclusions The 99mTc-DMSA renal scintigraphy is very useful in differentiating the children with urinary tract infection.It also can be used to determine the extension,degree and nature of UUTI,and might play an important role in the treatment and follow-up observation in children with UUTI.

Objectives To investigate the association between health belief and medication adherence in hypertensive patients.Methods A total of 232 hypertensive patients who visited Outpatient Department of Huashan Hospital between October 2013 and May 2014 were recruited in this cross-section study.The degree of medication adherence was measured with Morisky scale and health belief was evaluated with questionnaires of Health Belief Model (HBM).Results Of the 232 participants,61 (26.3％),51 (22.0％) and 120 (51.7％) showed low,medium and high medication adherence in Morisky scale,respectively.Logistic analysis showed that the perceived susceptibility (P ＜ 0.001),and cues to action (P =0.004) were positively correlated,and perceived barriers (P ＜ 0.001) was negatively correlated with medication adherence of patients.Conclusion Effective interventions to improve antihypertensive medication adherence should increase perceived susceptibility,cues to action,and reduce the barriers to medication adherence of patients.

Objective To analyze retrospectively the correlation between the difficult airway and thyromental height by three-dimensional reconstruction among the Chinese. Methods Eithty patients who had been scanned by helical CT in the head and neck were allocated into two groups according to Cormack-Lehane grading:paients with Ⅰ-Ⅱ grade were allocated into group 1, and paients with Ⅲgrade were allocated into group 2. Reconstructed images were obtained by AW4.4 workstation and the following parameters were recorded and analyzed:the length from the oral to the under jaw(a), the length from the under jaw to the skin of the neck (b), the vertical distance from the under jaw to the neck was equal to thyromental height(c), the vertical distance from the oral to the cervical vertebra(d), the angle with the under jaw as the vertices and with two lines (a and b) for edge (angle ofα). Results The c value in two groups had no significant difference:(3.97 ± 0.82) cm vs. (3.64 ± 0.62) cm, P>0.05. The d value in group 2 was significantly higher than that in group 1:(8.69 ± 0.48) cm vs. (8.25 ± 0.80) cm, P<0.05. The c/d value and c/a value in group 2 were significantly lower than those in group 1: 0.42 ± 0.07 vs. 0.48 ± 0.12, 0.80 ± 0.18 vs. 0.95 ± 0.25, P<0.05. Conclusions Thyromental height by three-dimensional reconstruction has no significant differences in evaluating the difficult airway among the Chinese. The ratio of the vertical distance from the under jaw to the neck and the vertical distance from the oral to the cervical vertebra, and the ratio of the vertical distance from the under jaw to the neck and the length from the oral to the under jaw shows negative correlation with difficult airway.

Objective To retrospectively review the efficacy and side effects of intense pulsed light (IPL) and red light emitting diode (LED) in the treatment of steroid-dependent dermatitis.Methods Seventy patients with steroid-dependent dermatitis mainly manifesting as facial telangiectasis were treated with IPL for an average of 3.49 sessions with a 4-week interval.The energy density of IPL varied from 20 to 23 J/cm2,pulse width from 2.6 to 5.0 ms,and delay from 15 to 20 ms.Meantime,197 patients with steroid-dependent dermatitis,who mainly presented with facial skin sensitivity,were treated with red LED (633 ± 3 nm wave length) twice a week for an average of 4.23 sessions.The energy density of red LED was 128 J/cm2,and the irradiation lasted 20 minutes at each treatment.The efficacy and adverse reactions were assessed and recorded for each treatment.Results The total response rate was 88.57％ for IPL,and 83.76％ for red LED.There was a significant difference in the clinical efficacy between triple-pulse and double-pulse IPL (x2 =8.14,P ＜ 0.05).No severe adverse reaction was observed in any of the patients.Conclusion IPL and red LED are both effective in treating steroid-dependent dermatitis.

Objective To investigate the characteristics of sagittal anatomic structure of the upper airway in patients with ankylosing spondylitis using three-dimensional reconstruction based on computed tomography (CT).Methods Thirty-one male patients with ankylosing spondylitis,aged 20-60 yr (AS group),and 41 common patients (male) without difficult airways,aged 20-60 yr (control group),who underwent spiral CT scan of the head and neck using Helical CT from January 2007 to February 2011 in our hospital,were enrolled in the study.Reconstructed images of the upper airway were obtained using AW4.4 workstation and six distances (D1-D6) and four angles (α-δ) were recorded and analyzed:(1)D1,the arc distance between the upper central incisor and root of epiglottis; D2,the distance between the upper central incisor and root of epiglottis; D3 and D4,the lengths of maxilla and mandible ; D5,the distance between the root of epiglottis and midpoint of glottis; D6,the distance between the end of mandible and midpoint of glottis; (2) angle α,the angle of line D2 and D5; angle β,the angle of line D2 and the lower edge of the upper central incisor to the midpoint of glottis; angle γ,the angle of line D4 and D6; angle δ,the angle of the point of the lower edge of the upper central incisor to the trailing edge of the hard palate and then to the root of epiglottis.Results Compared with control group,no significant change was found in D1,D2,D3,D4 and D5 (P ＞ 0.05),and D6,angle α and angle δ were significantly increased,whereas angle β and angle γ were decreased in AS group (P ＜ 0.05).Conclusion The anatomic structure of the upper airway has the characteristics of specific changes and a laryngoscope blade with a large degree of curvature may be helpful for successful tracheal intubation in patients with ankylosing spondylitis.

Objective To investigate the effects of P-selectin gene knockout on the biological characteristics of mice. Methods P?selectin knockout (PKO) mice and C57BL/6 mice were housed in SPF environment. To make sure that the mice were pure PKO mice by gene identification. To determine the general condition, the activity status, reproduction of P?selectin knockout mice were observed and tested. HE staining was used to observed the histological morphology and struc?tures of 6?week?old and 18?week?old P?selectin knockoutout mice. Results PKO mice and C57 mice have similar multiplica?tion, there was no significant difference in reproduction and blood routine test. The stuctures of liver, spleen, lung and kid?ney were normal. Conclusions P?selectin knockout has no significant effects on reproduction, blood routine test and major organs. This research provides animal model theoretical basis for further study on the effects of P?selection in diseases.

Objective To assess the efficacy and safety of multimodal analgesia with different doses of nalbuphine combined with flurbiprofen on patients who received intravenous patient -controlled analgesia(PCIA) after thoracotomy.Methods Sixty patients underwent thoracotomy,ASA Ⅰ -Ⅱ,18 -65 years old,who underwent postoperative PCIA,were randomly divideded into three groups according to the digital table,nalbuphine 60 mg group (N60 group),nalbuphine 80 mg group(N80 group)and nalbuphine 100 mg group (N100 group),20 cases in each group.All patients were given 150mg flurbiprofen,a total of 100mL.PCIA solution:the background dose was 2mL/h, PCIA dose of 0.5mL,locking time of 15min.10min before surgery,each patient was intravenously given flurbiprofen 50mg,given a loading dose of 0.1mL/kg when closed chest.All patients were followed up for 48h.The incidence of adverse reactions such as vital signs,number of times,visual analog scale(VAS)score,sedation score,nausea and vomiting were recorded.Results There were no significant differences in the age,gender,body mass index and surgery duration among the three groups(all P >0.05).The vital signs were stable within 48h after operation.The VAS scores of N60 group were higher than the other two groups(N80 group:t =7.94,6.35,6.49,5.21,5.63,all P =0.00;N100 group:t =8.41,9.10,5.80,8.07,8.18,all P =0.00)at 4,6,8,24 and 48h after operation(all P <0.05).The VAS score of N80 group 48 h after operation was lower than that of N100 group(t =2.30,P =0.03),and the difference was not statistically significant in remaining(all P >0.05).The effective /actual compression ratio of PCIA of N80 group and N100 group were significantly higher than that of N60 group (t =7.30,8.35,all P <0.05). There were no differences in the incidence of adverse reaction among the three groups(group N80:χ2 =0.17,0.23, 1.03,all P >0.05;group N100:χ2 =3.14,0.23,1.03,all P >0.05).Conclusion Postoperative PCIA with nalbu-phine (80 mg)combined with flurbiprofen(150 mg)has significant analgesic effect and lower costs.

Objective To investigate the effects of Thomas solution in combination with nitroglycerine of different concentrations on rat cardiac preservation for 8 h. Methods Thirty Wistar rats were selected,and Langendorff heart perfusion models were established.Rats were randomly divided into Thomas solution group,Thomas solution+4?10-6 mol/L nitroglycerine group and Thomas solution+4?10-5 mol/L nitroglycerine group(n=10).After hypothermic preservation(4 ℃)for 8 h,the cardiac function of each group was determined.Tissues of left ventricular wall were obtained,and changes of myocardial ultrastructure were observed by electron microscopy. Results Compared with Thomas solution group,the cardiac function was significantly improved and the myocardial ultrastructure injury was less severe in Thomas solution+4?10-5 mol/L nitroglycerine group after hypothermic preservation(4 ℃)for 8 h,while there was no significant difference in myocardial ultrastructure injury and cardiac function between Thomas solution group and Thomas solution+4?10-6 mol/L nitroglycerine group. Conclusion Thomas solution in combination with 4?10-5 mol/L nitroglycerine can significantly improve the preservation effects for isolated hearts in rats.

Objective To investigate the effects and mechanism of visfatin on matrix metalloproteinases-9(MMP-9)expression and invasive activity in macrophages.Methods THP-1 monocytes were induced into macrophages.To investigate the effects of visfatin on MMP-9,cells were divided into 2 groups:①macrophages+visfatin 12 h;②macrophages+visfatin 24 h.The concentrations of visfatin in each group were:0(control),50,100,200,400 ng/mL.MMP-9 mRNA and protein expression were analysed by RT-PCR and Western blotting,and MMP-9 invasive activity was assayed by gelatin zymography.To investigate the mechanism of visfatin on MMP-9,cells were divided into 5 groups:①macrophages without stimulation(control);②macrophages pretreated with MAPK p38,ERK1/2,JNK pathway inhibitor for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h;③macrophages pretreated with retinoid X receptors(RXR)nature ligand or peroxisome proliferators-activated receptor ?(PPAR?)natural/synthetic ligand for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h;④macrophages stimulated with visfatin(200 ng/mL)for 24 h;⑤macophages+visfatin(200 ng/mL)for different time(5,10,15,30,60 min).MMP-9 expression,PPAR? expression,and the effect of visfatin on MAPK phosphorylation were analysed by Western blotting.Results Visfatin not only significantly enhanced MMP-9 mRNA and protein expression in macrophages(P

Objective To assess the efficacy of Sevoflurane-Remifentanil anesthesia in pediatric fiberoptic bron-choscopy (FOB) compared with a Propofol-Remifentanil regimen. Methods 60 children scheduled for fiberoptic bronchoscopy were randomly divided into two groups ( = 30 in each group): In group S, patients received Sevoflu-rane inhalation and intravenous infusion with Remifentanil. In group P, patients received total intravenous anesthesia with Propofol and Remifentanil. Standard laryngeal mask airways (LMA) were inserted into all children in two groups after anesthesia and fiberoptic bronchoscopy was carried out via LPA. MAP, HR, SpO2, PETCO2 and BIS were record-ed before anesthesia (T0, baseline), before FOB (T1), 2 min after FOB (T2). Then assess the effect of general anesthe-sia. Procedure time, recovery time and incidence of adverse events were also recorded. Results HR, MAP and SpO2 at T1 and SpO2 at T2 in group P were significantly lower than those in group S. PETCO2 at T1 and MAP, HR, PETCO2 at T2 in group P were significantly higher than those in group S. Better quality of anesthesia, less respiratory depression, and less interruption needed during procedure were found in group S. Conclusion Compared with Propofol-based to-tal intravenous anesthesia, Sevoflurane inhalation via laryngeal mask combined with intravenous Remifentanil pro-vides a superior profile in pediatric fiberoptic bronchoscopy.