Objective To investigate the regularity and clinical significance of cortisol(Cor),adrenocorticotrophic hormone(ACTH),atrial natriuetic peptide(ANP) and interleukin-6(IL-6) changes before and after operation stress.Methods The ACTH,Cor,ANP and IL-6 levels in 18 children with abdominal neoplasms(12 male and 6 female,8 cases with sacrococcygeal teratoma,5 cases with hepatoblastoma,and 5 cases with nephroblastoma) were measured before and after operation(24 hours before operation;4,24,48,and 72 hours after operation).Eighteen children were divided into the study group and the control group.The children in the former group were accompanied with stress ulcer,intestinal obstruction and infection shock or even death after operations,while the children in the later group recovered without any complication.The ACTH,Cor,ANP in serum were measured by radioactive immune analysis(RIA) assay,and serum IL-6 level were measured by enzyme linked immunosorbent assay(ELISA).Results In 2 groups,serum levels of ACTH,Cor,ANP,IL-6 increased significantly 4 h after operation.The changes in ACTH and ANP were similar in 2 groups.Cor in the control group reached its peak 24 h after operation,and then decreased gradually to the pre-operation levels 72 h after operation;IL-6 reached its peak 4 h after operation,and then decreased slowly.It was still at a high level in 48 h after operation,and then decreased to pre-operation levels 72 h after operation.But serum Cor,IL-6 in the study group slightly increased 24 h after operation,and were apparently higher than those in the control group(Pa

OBJECTIVEWe aim to explore the central auditory nervous system (CANS) functioning in children with nonsyndromic cleft palates by analyzing the auditory evoked potentials and event-related potentials (ERP).

METHODSA total of 34 children with nonsyndromic cleft palates were recruited as subjects, and 27 normally developed children were selected as the normal controls. Auditory brainstem response (ABR), middle latency response (MLR), and mismatch negativity (MMN) of ERP were selected as indices to observe the function of CANS in children in both groups.

RESULTSAstatistically significant difference between the groups was obtainedin the MMN recording (F = 227.69, P < 0.01), whereas no significant group differences were obtained in the ABR and MLR results (P > 0.05). Children with nonsyndromic cleft palates showed diminished MMN responses compared with the normal controls, whereas ABR and MLR were within the normal range.

CONCLUSIONChildren with nonsyndromic cleft palates are at risk of central auditory discrimination dysfunction. The significant abnormal event-related potentials recorded in children with cleft palates suggest that the dysfunction of CANS maybe located at the cortical level and normal function of CANS was located at the brain stem and sub-cortical level.

Medical care on the battlefield is the core and basis of echelons of care.This review summarizes the background and characteristics of medical care units on the battlefield from the birth and growth of mobile army surgical hospitals before being replaced by forward surgical teams and combat support hospitals, since the United States Armed Forces began to lead the world military revolution during and after the World WarⅡ.Quick adaptation to the combat envi-ronment and the combat modes is the main reason that medical care units on the battlefield are adjusted continuously.This paper may provide some ideas for the development of our medical care units on the battlefield in the future.

Objective To investigate the prognostic factors and survival of patients with bronchopulmonary carcinoid tumors (BPC) after surgical treatment .Methods The clinical data of 87 patients undergoing surgery for BPC from Jan .2002 to Dec .2008 were reviewed retrospectively .Kaplan-Meier method was used to analyze the survival of the patients .The risk factors such as age , gender ,smoking history ,histological type ,tumor size ,were analyzed by Cox proportional hazards regression model .Results The 1-,3-and 5-year overall survival rates were 85 .1% ,71 .3% and 63 .2% .Univariate analysis revealed that age (P=0 .016) ,smoking history(P=0 .007) ,histological type(P=0 .000) ,tumor stage(P= 0 .000) ,tumor size(P= 0 .006) lymph node metastasis(P=0 .000) ,surgery type (P= 0 .045) and postoperative chemotherapy (P= 0 .000) were prognostic factors .Multivariate analysis showed that histological type(P=0 .008) ,tumor stage(P=0 .000) ,lymph node metastasis(P=0 .033) were independent prognostic factor .Conclusion The survival rate of the BPC patient after surgical treatment is high ,histological type ,tumor stage and lymph node metastasis were independent prognostic factors .

Objective To investigate the effect of ulinastatin (UTI) on the expression of brainderived neurotrophic factor ( BDNF ) and remyelination in mice with experimental autoimmune encephalomyelitis ( EAE).Methods Twenty-four C57BL/6 mice were randomly divided into UTI group (U),normal saline treated group (S) and normal control group (N,n = 8,respectively).Demyelinations in the spinal cord were observed by solochrome cyanin staining.The expression of BDNF,myelin basic protein (MBP),and 2',3 '-cyclic nucleotide 3'-phosphodiesterase (CNP) in brain tissue of each group were evaluated by Western blot.Results Average clinical scores in group U at the 12,13,14,22,23,31,33,34 and 35 days were 0,0.25,0.38,0.63,0.63,0.40,0.40,0.40 and 0.40 respectively.They were significantly lower than group S at the same time ( U= 16.00,15.00,14.50,7.50,0.00,14.50,14.50,12.00 and 14.50,all P ＜0.05).Solochrome cyanin staining showed that demyelination of spinal cord in group U was also significantly improved than group S.Expressions of BDNF ( 1.96 ± 0.29),MBP (2.67 ± 0.48 ) and CNP ( 1.75 ± 0.20) in group U were all significantly higher than group S ( There were 0.80 ± 0.15,1.36 ± 0.38 and 1.06 ± 0.18 respectively,all P ＜ 0.05).Conclusions UTI has protective effect on EAE.The possible mechanism is that it could promote remyelination,and protect oligodendrocytes and neurons in EAE model by increasing BDNF expression in brain.

Objective To investigate the correlation between exhaled nitric oxide and lung function (FEV1)in asthmatic children.Methods Fifty three stable asthmatic children aged 5 to 14 years old were recruited from ShengJing Hospital of China Medical University.According to whether the patients were treated with inhaled corticosteroid(ICS)therapy regularly,they were divided into two groups:steroid group and non-steroid group,then fraction of exhaled nitric oxide(FeNO)and lung function were measured.Results In non-steroid group,the levels of FeNO(mean 40.450±25.428 part by billion)were significantly higher than those in the steroid group(mean 19.879±13.845 part by billion),and they were statistically significant.(P = 0.003).The mean FEVI in non-steroid group was(95.152±8.993)%,and the mean FEVI in non-steroid group was(91.350±11.690)%,and there were no significant differences between two groups (P =0.189).Significantly negative correlation was found between FeNO and FEV1 in steroid group(r =-0.465,P = 0.039),but there was no significant correlation between them in steroid group(r = 0.058,P =0.747).Conclusion The levels of FeNO were higher in non-steroid group than those of the steroid group in the stable asthmatic children.FeNO is a good biomarker to evaluate the airway inflammation of asthmatic children.

Cardiovascular Diseases ; Growth Differentiation Factor 15 ; Humans

Objective To study the possible relationships between expression of matrix metalloproteinase(MMP)2,9 and the pathogenesis of preeclampsia in which trophoblast invasion is impaired. Methods MMP-2,9 expression were detected by immunohistochemistry streptavidin-biotin complex (SABC)method in 20 normal term placentae and 20 preeclampsia placentae,respectively.In addition, mRNAs for MMP-2,9 were analyzed by real time PCR in both groups.Results The intensities of both MMP-2 and MMP-9 immunostaining in preeclampsia placentae were significantly declined compared to those of normal term placentae(P

Objective To explore the effect of the continuous quality improvement ( CQI) on shortening the patients ’ waiting time and improving the satisfaction of the waiting time in transfusion room . Methods The CQI procedure including setting up CQI groups , collecting and analysis the data , analyzing the cause, setting goals, making improvement plan and implement method , evaluating effect, summarizing and formulating the consolidation measures etc were carried out , and the patients’ waiting time and the satisfaction of the waiting time in transfusion room were compared before and after the implementation of the CQI . Results The average patients’ waiting time in transfusion room was (18 ±3) min after the implementation of the CQI, and was significantly lower than (30 ±5 ) min before CQI, and the difference was statistically significant (t=20.580, P<0.05).The satisfaction of the waiting time in transfusion room was 89% after the implementation of the CQI, and was significantly higher than 65% before CQI, and the difference was statistically significant (χ2 =9.416, P=0.024).Conclusions The nurses find out the best way to solve the problem and strengthen the team cooperation spirit through the implementation of the CQI and the utilization of team wisdom.The nurse work flow is smoothly, and the performance evaluation mechanism is reasonable , which greatly enhance the work enthusiasm and efficiency , shorten the patients ’ waiting time, and improve the patients’ satisfaction.

IgG4-related disease (IgG4-RD) has been proved to be associated with malignancy.The incidence and risk factors of malignancy development in IgG4-RD were not clear.Nine IgG4-RD patients with malignancies and 27 IgG4-RD control cases were analyzed for risk factors and clinical features.The incidence of malignancy in IgG4-RD was 3.3％,higher than age-controlled general population.Smoking history was significantly more common in patients with malignancies than in the control group (9/9 vs 16/27,P ＜ 0.05).A total of 6/9 malignancies occurred within the first year after the diagnosis of IgG4-RD.Colorectal,biliary and thyroid cancers were the leading types.Smoking history is a risk factor for IgG4-RD associated malignancy.Careful vigilance to monitor malignancy needs to be paid during follow-up.