As the most common disease for children with congenital heart disease ( CHD),congenital cardiovascular malformations have been closely associated with prenatal viral infectiotn.It is important to clarify the etiology of these diseases because the levels of physical and mental health for children with CHD are seriously damaged,and it also improves the levels of preventing and treating these diseases.This review focuses on the way of infection,pathogenesis and prevention measures for intrauterine viral infections leading to CHD.

With the development of modem technology,more and more plastic products are widely used in various fields,while bringing significant convenience to the society,it also leads to more and more environmental estrogen.The influence of plasticizer is increasing,especially on the development of children.Extensive contacting with plasticizer is considered to be closely related with gonadal digenesis,obesity and other problems in children.This review focuses on the latest research results about the basic and clinical experiments of Di (2-ethylhexyl) phthalate (DEHP),which illuminate the effects of DEHP on children's growth and metabolism,and lay foundations for rational clinical intervention and scientific plasticizer's application.

Objective To detect the expression of Bmi-1 and p16 gene in transitional cell carcinoma of bladder(TCC) tissue and explore its clinical significance.Methods The expression of Bmi-1 and p16 gene were detected by real-time quantitative polymerase chain reaction in 61 cases of TCC tissue and 12 cases of normal bladder tissue.Results The expression of Bmi-1 gene in TCC tissue was significantly higher than that in normal bladder tissue (0.242 ± 0.129 vs.0.031 ± 0.011),and the expression of p16 gene was significantly lower than that in normal bladder tissue (0.059 ± 0.021 vs.0.165 ± 0.029),there was significant difference (P ＜ 0.05).The expression of Bmi-1 and p16 gene were highly correlated with pathological grades,clinical stages and tumor recurrence (P ＜ 0.05 or ＜ 0.01).But there were not correlated with age and gender (P ＞ 0.05).There was a negative correlation between the expression of Bmi-1 gene and p16 gene in TCC tissue(rs =-0.714,P＜ 0.05).Conclusions Bmi-1 gene high expression and p16 gene low expression may be involved in the occurrence and development process of TCC.Bmi-1 may decrease the expression of p 16 gene in some ways,and then lead to the occurrence and development of TCC.

Objective:To study influence of intravenous injection urapidil and nitroglycerin micro pump on blood pressure and heart rate (HR) of hypertension patients undergoing tooth extraction.Methods:116 hypertension patients underwent electrocardiographic monitoring tooth extraction in our hospital from January 2015 to October 2016 were enrolled in this study.According to the random number table method,the patients were divided into observation group and control group with 58 cases,the control group was given nitroglycerin plus pump static point to maintain,the observation group was given intravenous urapidil and pump maintenance,compared the changes of systolic blood pressure (SBP),diastolic blood pressure (DBP) and HR in two groups before operation,at anesthesia,10min after anesthesia,in operation,10 min after operation,and compared the adverse reactions condition of the two groups.Results:The levels of SBP and DBP in two groups in operation and 10 min after operation were significantly lower than that before operation,and the SBP and DBP levels in the observation group in operation were significantly lower than control group,the differences were statistically significant (all P＜0.05).The HR in control group in operation,10 min after operation were significantly higher than before operation,while the observation group were significantly lower control group,the differences were statistically significant (P＜0.05).The total incidence of adverse reactions in the observation group was 6.90％(4/58),which has no significant difference than 10.34％ (6/58) in control group (P＞0.05).Conclusion:Intravenous injection urapidil has little effect on blood pressure and HR in hypertension patients undergoing tooth extraction,and with good safety,which is worthy of promotion.

Objective To investigate factors influencing the quality of life (QOL) of cancer patients with bone metastases. Methods Eighty-two cancer patients with hone metastasis were investigated.A questionnaire designed according to European Organization for Treatment of Cancer quality of life questionnaire ( EORTC QLQ-C30),Monroe Dunaway Anderson symptom inventory-Chinese edition (MADSI-C) and hospital anxiety and depression scale (HADS) standards was used to collect the information. Results The average total standardized QOL score of these cancer patients was 53.28±19.20.Among the function subscales,social function got the lowest average score (47.54),while among the symptom subscales fatigue got the highest average score (56.65).According to the MDASI-C,the most serious symptom burdens were fatigue,distress and pain; working and walking experienced the most interference.The symptom burdens correlated significantly with the QOL results.Twenty-four of the patients (29.3％) had been diagnosed with anxiety,and 17 (20.7％) were diagnosed with depression.Anxiety and depression continued to be significantly associated with overall QOL and its various dimensions. Conclusions The results　show that the burden of fatigue and pain,as well as of anxiety and depression are significantly associated with impaired QOL among cancer patients with bone metastasis.Work (housework) and walking were the most severely affected activities.Psychological rehabilitation should be focused on the comprehensive treatment of patients with bone　metastasis along with other appropriate rehabilitation strategies to enhance their overall functioning,relieve their　symptoms and improve their QOL.

Objective To compare the effects of different modes of delivery on arterial oxygen saturation in the fetus.Methods One hundred and twenty ASA Ⅰ or Ⅱ parturients aged 22-32 yr with a single fetus at full term lying in normal headdown position were divided into 3 groups according to the modes of delivery (n =40 each):group cesarean section (group CS) ; group labor analgesia (group LA) and group spontaneous labor (group SL).In group CS cesarean section was performed under epidural anesthesia with 0.5％ ropivacaine.Epidural catheter was placed at L2,3 interspace in groups CS and LA.In group LA labor analgesia was started from the first stage and maintained until complete cervical dilatation.The patients received epidural PCA (PCEA) with O.125 ％ropivacaine plus fentanyl 2 μg/ml.PCEA setting was as follows:a loading dose of 8-10 ml; demand bolus 5 ml;20 min lockout; background infusion 6-10 ml/h.Blood samples were taken from umbilical artery at delivery for blood gas analysis and determination of serum concentrations of lactate,β-endorphin (β-EP) and neuropeptide Y (NP-Y).Apgar score and neurological and adaptive capacity score (NACS) were recorded.Results There was no significant difference in Apgar score,NACS and NP-Y and β-EP concentrations in umbilical arterial blood among the 3 groups.The lactate concentration and the absolute value of BE were significantly higher while pH was lower in group SL than in groups CS and LA.PO2 was significantly higher while PCO2 was lower in group LA than in groups SL and CS,and the lactate concentration and absolute value of BE were significantly lower while pH was higher in group LA than in group SL.Conclusion The 3 modes of delivery have significant effects on arterial oxygenation in fetus but have no clinical significance.

Objective To verify the performance of the ABI ViiA 7 Taqman HBV-DNA detecting system for confirming its sta-bility,accuracy and reliability.Methods According to the evaluation protocols of Clinical and Laboratory Standards Institute (CLSI),the performance of ABI ViiA 7 Taqman HBV-DNA detecting system was assessed in the aspects of precision,accuracy,lin-earity and comparability;the quantitative detection limit validation experiments was performed by diluting specimen until quantita-tive detection limit is lower than the lower limit of detection,and the detection results were compared with the quality target re-quirements and the analysis capability declared by manufacturers.Results The CV in within-run precision of this detection system was 1.485%,1.990% and 0.932% respectively;the total CV was 1.876%,3.361% and 1.891%,respectively;the maximum devia-tion of accuracy was -6.8%;the linear correlation coefficient was 0.998 3;the regression equation was Y =0.974 8X +0.050 7. The linear range was 1.00E2 - 2.00E8;the quantitative detection limit was 100 IU/mL;the comparability of ABIViiA7 and ABI7500:P =0.115,r2 =0.994,the linear regression equation was Y =0.987 2X +0.051 7.Conclusion The ABI ViiA 7 Taqman HBV-DNA detection system has excellent precision,accuracy,sensitivity and linearity and has a good correlation with ABI7500, which can be used for the detection of clinical specimens.

Objective To investigate the value of lung adenocarcinoma classification developed by International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society ( IASLC/ATS/ERS) in predicting the effect of three-dimensional radiotherapy ( 3DRT) after surgery for locally advanced lung adenocarcinoma.Methods The clinical data of 150 patients with invasive lung adenocarcinoma who underwent radical resection and systematic lymph node dissection in Tianjin Medical University from 2010 to 2013 were analyzed, and according to the IASLC/ATS/ERS classification, they were divided into lepidic predominant group (LEP group), acinar predominant group (ACN group), papillary predominant group (PAP group), micropapillary predominant group (MIP group), and solid predominant group (SOL group), and further divided into LEP group, CAN/PAP group, and MIP/SOL group.The overall survival ( OS) and disease-free survival ( DFS) rates were compared between groups.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for survival difference analysis and univariate prognostic analysis, and the Cox proportional hazards model was used for multivariate prognostic analysis.Results Among all the patients, the median OS and DFS rates were 30.8 and 25.8 months, respectively.For the patients in the LEP group, ACN/PAP group, and MIP/SOL group, the median OS rates were 40.0, 32.2, and 28.4 months, respectively ( P=0.005) , and the median DFS rates were 29.2, 25.8, and 24.2 months, respectively ( P=0.011) .For the ACN/PAP group, the patients who received or did not receive radiotherapy had a median OS rate of 37.4 or 25.3 months ( P=0.000) and a DFS rate of 31.1 or 25.2 months (P=0.000).For the MIP/SOL group, the patients who received or did
not receive radiotherapy had a median OS rate of 28.3 or 27.4 months ( P=0.783) and a DFS rate of 25.3 or 24.0 months ( P=0.732 ) .Conclusions The IASLC/ATS/ERS classification helps to predict the prognosis of patients with locally advanced invasive lung adenocarcinoma who receive postoperative radiotherapy.Postoperative radiotherapy can be performed for ACN and PAP patients, while there is no need to perform radiotherapy for MIP and SOL patients .

Objective To study the role of endothelial cells on the inflammatory cytokine release in septic shock through the septic shock serum stimulating human primary endothelial cells (HPAEC) and peripheral blood mononuclear cells(PBMC).Methods PBMC isolated from healthy people by density gradient centrifugation.HPAEC cell surface markers CD144 and von Willebrand factor(vWF) molecule expression by RT-PCR and Western blot.Serum levels of IL-6,TNF-α,MCP-1 from septic shock patients and healthy human detected by ELISA.HPAEC and PBMC were stimulated with the isolated serums and LPS,respectively.ELISA was used to detect the supernatant IL-6,TNF-α,MCP-1 levels.HPAEC membrane molecules ICAM-1 expression was detected by flow cytometry with serum shock and LPS stimulation.Supernatant levels of IL-6,TNF-α,MCP-1 of HPAEC with S1P1 receptor agonist CYM-5442 pretreatment was detected by ELISA after shock serum stimulation.Results Endothelial cell markers CD144 and vWF molecules could be detected in the HPAEC.Levels of inflammatory cytokines IL-6,TNF-α,MCP-1 in patients with septic shock serum were significantly higher than healthy people (P＜0.01).PBMC and HPAEC with LPS or shock serum treatment respectively,compared with normal group,levels of inflammatory cytokines in the culture supernatant were significantly higher(P＜0.01).For PBMC,the level of inflammatory cytokines between shock group and LPS group were not significantly different (P＞0.05).But for HPAEC,levels of inflammatory cytokines in the supernatant of the shock group compared to the LPS group was significantly higher (P＜0.01).Similarly,when two cells after LPS stimulation,IL-6,TNF-α levels of HPAEC's supernatant were significantly lower than PBMC' s (P＜0.01),MCP-1 levels was no difference (P＞ 0.05).But when the stimulation of shock serum,HPAEC of IL-6,TNF-α levels and PBMC no significant difference (P ＞0.05).MCP-1 was significantly increased (P＜0.01).Shock patients serum stimulation S1P1 receptorspecific agonist CYM-5442 pretreatment of HPAEC with pretreatment of S1P1 receptor specific agonist CYM-5442,the culture supernatant of inflammatory cytokines IL-6,TNF-α,MCP-1 levels were significantly lower (P＜0.01).Conclusion Endothelial cells may play a central role on the release of inflammatory cytokine during septic shock.

Objective:To comprehensively investigate the prognostic significance of nodal skip metastasis and lobe-specific me-tastasis for patients with IIIa-N2 non-small-cell lung cancer (NSCLC). Methods:A total of 218 completely resected pN2-NSCLC cases with systematic lymph node dissections from 2008 to 2009 at Tianjin Medical University Cancer Hospital were enrolled. Mediastinal lymph node metastasis was subdivided into continuous metastasis and skip metastasis according to whether N1 lymph nodes were in-volved. Mediastinal lymph node metastasis was also classified into extensive metastasis and lobe-specific metastasis on the basis of whether the lymph nodes involved were within or beyond lobe-specific regions. Overall survival (OS) and disease-free survival (DFS) were compared. Results:For the whole cohort, 5-year OS was 21.6%and 5-year DFS was 16.8%. The 5-year OS for patients with skip metastasis or continuous metastasis were 37.6%and 22.0%, respectively (P=0.008). The 5-year DFS of patients with skip metastasis or continuous metastasis were 29.1%and 15.0%, respectively (P=0.022). The 5-year OS of patients with lobe-specific metastasis and ex-tensive metastasis were 38.3%and 20.4%, respectively (P=0.005). The 5-year DFS of patients with lobe-specific metastasis and exten-sive metastasis were 28.4%and 15.1%, respectively (P=0.009). According to the two patterns, patients were subdivided into three sub-groups:Group A (presence of both skip metastasis and lobe-specific metastasis), Group B (presence of skip metastasis only or lobe-spe-cific metastasis only), and Group C (presence of non-skip metastasis and non-lobe-specific metastasis). The 5-year OS of the three sub-groups were 47.1%(Group A), 28.1%(Group B), and 16.6%(Group C) (P=0.001), and the 5-year DFS of these subgroups were 35.2%(Group A), 20.8%(Group B), and 11.2%(Group C), respectively (P=0.002). Multivariate analysis demonstrated that the combined pat-tern was an independent prognostic factor for both OS and DFS. Conclusion:This combined pattern of lymph node metastasis was a strong prognostic factor for IIIa-N2 NSCLC. This pattern should be considered when predicting prognoses and during the selection of patients that will receive postoperative treatments.