Objective To review the clinical changes and the management experience of hemodynamics after orthotopic heart transplantation.Methods Orthotopic homologous heart transplantation was performed on 25 cases from January 2000 to October 2003. The hemodynamic changes were monitored after operation with Swan-Ganz catheter and color Dopplor ultrasound. The therapy strategy was regulated when the monitor index and the clinical situation were referenced.Results PAWP, PASP, CVP, CO and CI were increased on the operation day. From the first day to the 7th day, PAWP, PASP and CVP were increased with right ventricle enlarged and sometimes arrhythmia and hydrothorax occurred. After strengthening heart, diuresis and stretching vessel, the hemodynamic changes of 23 cases were inversed and two cases’ conditions got worse. The two patients died of multiple organ failure on the 16th and 23rd day respectively.Conclusion The hemodynamic changes often occur at the early term after orthotopic heart transplantation. The main change is the right ventricular failure. It is important for the patient’s condition recovery and prognosis to monitor the hemodynamic changes and analyze the cause in order to direct the therapy.

Objective To improve the speed and accuracy of bacteria detection, and develop the test of 16S rRNA genes PCR amplification plus gene chip hybridization to diagnose neonatal sepsis. Methods Bacterial 16S rRNA genes were detected in blood and CSF samples of 125 suspected neonatal sepsis, and the results were compared with blood culture, CSF culture, and non-specific diagnostic parameters (WBC, PLT, CRP). 30 non-infectious neonates were regarded as the negative control group. Gene chip test were performed by extraction of DNA, primers and probes design, PCR amplification, preparation of gene chip, hybridization, laser scan and reading of the results. 18 specific probes, including universal 1, universal 2, Gram positive bacterial probe, Gram negative bacterial probe 1, Gram negative bacterial probe 2, Staphylococcus aureus, Staphylococcus epidermidis, CoNS (Coagulase Negative Staphylococcus), Escherichia coli, Haemophilus influenzae, Listeria monocytogenes, Streptococcus pneumoniae, Streptococcus agalactiae, Bacteroides fragilis, Bacillus, Meningococcus, Corynebacterium, Propionibacterium, were used in the test. Results The positive rate of PCR test was 51.2% in 125 blood samples, and was significantly higher than the positive blood culture (25.6%), or the indicator of two abnormal non-specific parameters (32.8%) (P

Objective To evaluate the effect of isoflurane post-conditioningon the expression of pro apoptotic proteins in the conical neurons exposed to oxygen-glucose deprivation and restoration (OGD/R) in rats.Methods Primary cortical neurons isolated from male Sprague-Dawley rats (within 24h after birth),were cultured in vitro and inoculated in 6-well culture plate (2 ml/well) at a density of 1 × 106/ml.The cells were divided into 3 groups (n =12 each) using a random number table:control group(group C),OGD/R group,and isoflurane post-conditioning group (Ⅰ group).In OGD/R group,the cells were incubated in glucose-free BBS aerated with 95 ％ N2 for 30 min followed by restoration of 2-glucose supply for 1 h.At 24 h of incubation,the cells were collected for detection of neuronal apoptosis (.using Hoechst/PI staining),caspase-3 expression (by Western blot),expression of Bid,Bim and Puma mRNA (by PCR),and expression of Bid,Bim and Puma (by Western blot).Apoptosis rate was calculated.Results Compared with S group,the apoptosis rate was significantly increased,and the expression of caspase-3 and Bid,Bim and Puma mRNA and protein was upregulated in OGD/R group.The apoptosis rate and expression of caspase-3 and Bid,Bim and Puma mRNA and protein were significantly lower in Ⅰ group than in OGD/R group.Conclusion Isofluranepost-conditioning inhibits apoptosis in the cortical neurons exposed to OGD/R through down-regulating pm-apoptotic proteins in rats.

Objective To design a set of quality control management platform of ECG monitor in order to evaluate the quality of ECG monitor quickly and objectively and monitor and record the whole course of quality control.Methods The quality control platform was designed with the existing ECG monitor quality control methods, the existing detection devices, database technique and digital recognition technique based on neural network.Results The platform could be used for the intelligent data acquisition, data recognition, data analysis and statistics of ECG monitor quality control.Conclusion The platform may enhance the quality control of ECG monitor greatly.

To develop intelligent informatized system for the quality control of ECG monitor. Based on the platform of PowerBuilder and SQL Server and using scientific management process as the standard, the informa-tized system was developed to cover all aspects of ECG monitor quality control. This informatized system, which closely accorded with related laws and regulations, had graded authority, clear responsibilities, multi functions and easy operation. Computer information technology plays an important role in scientific management system of ECG monitor quality control.

Aim To investigate the effect of U50488H(a selective κ-opioid receptor agonist)and isoproterenol(ISO,a β-adrenergic receptor agonist)on ventricular arrhythmias and Cx43 during myocardial ischemia and reperfusion in rats.Methods 60 rats were randomly divided into five groups,ie,normal control group,I/R group,ISO+I/R group,U50488H+ISO+I/R group,Nor-BNI+U50488H+ISO+I/R group.The incidence of ventricular arrhythmias and arrhythmia score were determined. The expression of Cx43mRNA was tested by RT-PCR.The expression of Cx43 protein in myocardial cell was tested by an immunohistochemical approach with a quantitative imaging system.Results ① Compared with the I/R group,arrhythmia score was increased with administration of ISO(P<0.05).U50488H intravenously injected before ISO significantly decreased the arrhythmia score(P<0.05).② Compared with the normal control group,the expression of Cx43 mRNA was decreased in the I/R group(P<0.05).With administration of ISO,the amount of Cx43 mRNA was not significantly increased.③ Compared with normal control group,total and phosphorylated Cx43 proteins were significantly decreased in the I/R group(P<0.05),and the phosphorylated Cx43 was also decreased with administration of ISO.Compared with ISO+I/R group,phosphorylated Cx43 was increased with administration of U50488H (P<0.05).Conclusion κ-opioid receptor agonist U50488 H antagonizes the arrhythmias through the regulation of Cx43 during myocardial ischemia and reperfusion via inhibiting β-adrenergic receptor pathway.

ObjectiveTo compare the clinical effect of percutaneous iliosacral screws osteosynthesis (PISO) and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation,and evaluate their safety and practicality.MethodsFrom March 2004 to October 2010,37 patients with vertical unstable pelvic fractures were admitted to our department.Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray's guide.The perioperative parameters and postoperative imaging indexes were compared and analyzed.ResultsAll patients were followed up for 6 months to 26 months,with an average of 15 months.There were statistical significances between the PISO group and open reduction internal fixation group in operation time,blood loss,postoperative pain,mean fever time and hospital stay.The two groups showed no significant difference on postoperative X-evaluation of reduction effect.The average healing time was 3.2 months and the difference was not statistically significant between two groups.PISO group had no complications such as infection,bent nails or broken nails.ConclusionThrough compared and analyzed the two groups in treating unstable pelvic fractures,the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly,less damage and blood loss,milder pain and quicker recovery.But it demands higher operation techniques.Adequate preoperative preparation and postoperative patients' cooperation can reduce complications incidence.The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.