Objective To investigate the effect oflevecamitine on nutrition,microinflammation status in ma-intenance hemodialysis (MHD) patients. Methods Forty two MHD patients were selected, who had undergone he-modialysis for at least two months before the study. One gram of levoeamitine was injecfed to the patients at the end of each dialysis treatment for six months. The parameters of inflammation stress were studied. Results After treatment with levocarnitine for six months, the average levels of dry body weight decreased markedly. ( P<0.05 ), The aver-age serum levels of C2reaetive protein (CRP),interleuldn26 (IL26) ,tumor necrosis factor2α(TNF2α), (P<0.01 ). Difference was not significant between serum lipid parameters before and after the treatment. Conclusion Intravenous supplement with levocamitine in MHD patients, appears to be associated with an improvement of nutrition and mieroinflammation status.

[Objective]To summarize the clinical experience on anesthesia techniques for surgery of spinal tumors.[Method]A total of 546 patients undergoing surgery of spinal tumors were retrospectively studied,and the complications of surgery were also collected.[Result]There was no perioperative death.The average degree of blood loss was 1997ml per patient who usually required a large volume of blood transfusion.Acute pumonlary edema were occurred in 3 patients who were suspected to develop larynx edema immediately after operation.A perioperative visual loss following cervical spine surgery was also founded.[Conclusion]It is important to prevent and minimize blood loss by varied techniques during operation.Peventing adverse effect of operative position on patients and protecting their airway are also crucial for spinal surgery.

Objective To compare the effects of autotransfusion and homologous transfusion on milieu interieurand secretion of erythropoietin (EPO) .Methods Thirty patients aged 8-21 yr undergoing surgical correction of kyphoscoliosis were randomly divided into two groups of fifteen: group A and group B. In group A patients received homologous transfusion during operation, while in group B shed blood was collected from operative field and after filtration RBCs were separated by a differential centrifugation and washed in normal saline and reinfused. Anesthesia was induced with fentanyl 2 ?g? kg-1 , propofol 1 mg ? kg-1 and vecuronium 0.1 mg ? kg-1 and maintained with inhalation of isofiurane and 50% N2O in oxygen and intermittent iv boluses of vecuronium and fentanyl. Blood routine, blood gases, electrolytes, plasma osmotic pressure and activated clotting time (ACT) were measured before operation, 2 h after skin incision and at the end of surgery. Blood EPO concentration was measured before operation, at the end of surgery and 24 h after operation. Results MAP and HCO3- were significantly lower during operation in group A than those in group B. Platelet count was significantly lower at the end of operation in group B than in group A but still within normal range. The EPO level increased at the end of operation and returned to preoperative level 24 h after operation in both groups, and there was no significant difference in EPO levels between the two groups. Conclusion Autotransfusion of the washes RBCs is helpful in maintaining the patients milieu interieur. There is no difference in EPO secretion and erythropoiesis between autotransfusion and homologous transfusion.

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.

Evidence-based medicine(EBM)is an inevitable development tendency of clinical medicine education in 21 century.Its core thinking is to combine evidence,personal experiences and patients'actual situation.The thinking of EBM will magnificently promote the conversion of conception and model of clinical education and will make significant influence on clinical teaching,scientific research and clinical practice.

Artery cannulation is one of the clinical skills that should be mastered by the internships of anesthesiology. In consideration of its invasiveness,teachers should carry out the clinical teaching strictly and patiently,and assist the internships to establish a correct opinion on clinical practice. We should train the internships step by step,improve their success rates on artery cannulation and avoid complications as far as possible.

Human papillomavirus-related diseases are worldwide,what more,they may progress into benign or malignant tumors.On the other hand,through antinomy analytical method,scientists have modified E6 and E7 dialectically and make them the core of the HPV therapeutic vaccine, which can speedup the clean out of the virus.

Objectives To compare the clinical features between rhinovirus and respiratory syncytial virus infection in lower respiratory tract in children. Methods From December 2012 to May 2013, direct immunofluorescence assay was per-formed to test RSV in 1 037 nasal aspirate specimens with LRTIs. RT-PCR method was used to test HRV RNA. The medical re-cords of patients with a positive test of HRV or RSV were reviewed and compared. Results The isolating rate for HRV and RSV was 8.78%(91/1 037) and 17.16%(178/1 037) respectively. The frequency of co-infection of HRV with other virus was 18.68%, higher than that of RSV (7.30%,χ2=7.867, P=0.005). The age distribution had significant difference between children infected with HRV and RSV (Z=5.40, P<0.001). 78.38% patients with HRV infection were younger than 3 years old, and 83.03%patients with RSV infection were younger than 1 year old. Dyspnea, hyoxemia and wheezing were more common in pa-tients with RSV infection. Admission occurred much later in the course of the HRV infection (P<0.01). Leukocytosis, eosinophi-lia, and an elevated total serum IgE were more common in patients with HRV infection (P<0.05). Conclusions HRV is one of the important causes of LRTIs in Suzhou. The susceptible population, clinical presentation and laboratory results of HRV infec-tions are different from that of RSV infections.

Objective:To investigate the expression changes of farnesoid X receptor (FXR) in the evolution of normal intestinal mucosa, colorectal adenoma (CRA) and colorectal cancer (CRC), and the correlation of FXR expression with clinicopathological features and prognosis of patients with colorectal tumors.Methods:The UALCAN website tool was used to analyze the expression level of FXR gene transcripts of CRC and normal colorectal tissues in The Cancer Genome Atlas (TCGA) database. The patients undergoing colonoscopy and treatment in the Aerospace Center Hospital from January 2019 to September 2020 were selected, and the immunohistochemistry was used to detect the expression of FXR protein in 100 CRA tissues, 47 CRC tissues and 11 normal colonic mucosal tissues from healthy people (healthy control). Combining with clinical data, the relationship between FXR protein expression and clinicopathological characteristics of patients with colorectal tumors was analyzed. According to the Kaplan-Meier Plotter online database, the median expression level of FXR gene transcripts in CRC patients was analyzed, and the patients were divided into FXR low-expression group and high-expression group, the relationship between the expression of FXR gene and prognosis of CRC patients was investigated.Results:The analysis of data from TCGA database showed that the expression level of FXR gene transcripts in CRC tissues was lower than that in normal colorectal tissues ( P < 0.01). Immunohistochemical examination of the collected tissues showed that the positive rate of FXR protein gradually decreased from the cecum to the rectum. The positive rates of FXR protein in healthy control, CRA patients and CRC patients were 90.9% (10/11), 24.0% (24/100), 6.3% (3/47), and the difference was statistically significant ( χ2 = 35.56, P < 0.01); the positive rate of FXR protein in cancer tissues from CRC patients was lower than that in normal tissues adjacent to cancer [6.3% (3/47) vs. 65.2% (15/23)], and the difference was statistically significant ( χ2 = 27.98, P < 0.01). There was no statistical difference in the positive rate of FXR among CRA patients with different gender, age, maximum diameter of adenoma, and aggression (all P > 0.05). There was also no statistical difference in the positive rate of FXR among CRC patients with different gender, age, tumor site, maximum diameter of tumor, degree of differentiation, TNM staging, and vascular tumor thrombus (all P > 0.05). According to the survival analysis of Kaplan-Meier Plotter online database, the recurrence-free survival of CRC patients with high expression of FXR was better than that of patients with low expression of FXR ( P = 0.003). Conclusions:The expression level of FXR gradually decreases in the intestinal tissues of healthy people, CRA patients and CRC patients. The prognosis of CRC patients with low FXR expression is poor.

Objective: To analyze the association between maternal bisphenol A exposure during early pregnancy and sleep problems among preschool children. Methods: Research subjects were from one of the sub-cohorts(Ma'anshan Cohort) of the China-Anhui Birth Cohort Study (C-ABCS) in Ma'anshan city. The basic situation of pregnant women and sleep information of preschool children were investigated. We selected preschool children whose mother's maternal serum bisphenol A concentrations of the first trimester had been already detected between December 2012 to Januray 2014. 1 259 pairs of mothers and children were included. The concentrations of bisphenol A exposure during early pregnancy were divided into low, medium and high exposure groups according to 25^th percentile (P₂₅) and 75^th percentile (P₇₅) levels. Multivariate multinomial logistic regression model was used to analyze the association between maternal bisphenol A exposure during early pregnancy and sleep-related problems in preschool children. Results: The P₅₀ (P₂₅-P₇₅) of serum bisphenol A exposure level during early pregnancy was 0.231 (0.106-0.512) ng/ml. The sleep-related problems scores of 1 259 preschool children were (16.43±3.82) points. The occasional sleep-related problems were detected about 47.8% (602 cases) and frequent sleep-related problems were detected about 18.3% (230 cases). After the adjustment of the confounding factors such as children's gender, age, BMI, sleep position (lying down, sleeping on one's back), the length of time to sleep and the length of sleep at night, in comparison with bisphenol A low exposure group, the OR (95%CI) value of preschool children with occasional sleep-related problems in maternal bisphenol A high exposure group during early pregnancy was 1.44 (1.01-2.06). After the gender stratification, the results showed that in comparison with bisphenol A low exposure group, the OR (95%CI) value of preschool girls with occasional sleep-related problems in maternal bisphenol A medium and high exposure group during early pregnancy were 1.61 (1.05-2.46) and 2.40 (1.42-4.04), respectively. The OR (95%CI) value of preschool girls with frequent sleep-related problems in maternal bisphenol A high exposure group during early pregnancy was 2.64 (1.34-5.17). However, in boys, there was no statistically significant association between maternal bisphenol A exposure during early pregnancy and sleep-related problems (P>0.05). Conclusion Maternal bisphenol A exposure during early pregnancy might be related to sleep-related problems in preschool children.