It is still controversial whether or not the severe pneumonia is associated with heart failure in children.Currently,we pay more attention to the pathophysiological procedure of heart failure,such as pneumonia complicated with respiratory failure,shock and myocardial injury.Pay attention to the cardiopulmonary interaction mechanism and systemic inflammatory response.According to different pathophysiological mechanisms,guide the treatment by monitoring the hemodynamic status.

Adult ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; Male ; Middle Aged ; Occupational Health ; Young Adult

[Summary]_ Severe hypertriglyceridemia is the third common cause of acute pancreatitis following after alcohol abuse and cholelithiasis. Moreover, it is also an important risk factor of cardiovascular events. However, the cases of severe hypertriglyceridemia caused by autoimmune disease were rare in clinical, which would bring the difficulty for diagnosis and treatment. A better understanding of the clinical characteristics, possible pathogenesis, and corresponding therapy of the disease would be helpful, which would reduce the risk of complications, and finally improve both the survival rate as well as quality of life of these patients.

Objective:To analyze the value of Kang'ai injection on gastric cancer patients’ chemotherapy.Methods: Chosen gastric cancer patients with chemotherapy between December 2012 to December 2013 in our hospital as study subject, randomly divided into control group received conventional chemotherapy and observation groups received Kang'ai injection combine with chemotherapy, compared term effect after chemotherapy, immune function and quality of life scores.Results: 1)Observation group patients’ complete remission and partial remission after chemotherapy were significantly higher than control group patients(x2=2.471,x2=2.748;P<0.05); 2)Observation group patients’ IL-6, TNF-α, CD3+, CD4+ value was significantly higher than control group after receiving chemotherapy, CD8+ value was significantly lower than control group patients(t=2.627,t=2.462,t=2.748,t=2.846,t=2.735;P<0.05); 3)two groups of patients’ life quality scores before chemotherapy was no significant,after chemotherapy observation group patients’ life quality scores were significantly higher than control group patients(t=2.637,t=2.647,t=2.983;P<0.05).Conclusion: Kang'ai injection can significantly improve the effectiveness of chemotherapy in patients with gastric cancer,and optimize immune function, while improving the quality of life after chemotherapy.

[Summary] In newly diagnosed diabetic patients, fasting plasma glucose, HbA1C , and plasma lipid profiles were measured to analyze the association between HbA1C and plasma lipid profiles. HbA1C might affect plasma lipid profiles in newly diagnosed diabetic patients. Higher HbA1C was associated with the worse plasma lipid profiles and more severe insulin resistance.

Objective To construct the eukaryotic expression vector for mouse microRNA miR-21 and identification its expression activ-ity in 293 cells. Methods The genomic sequence containing pre-miR-21 was amplified from mouse genomic DNA by PCR and cloned into the pRC/CMV plasmid. The constructed recombinant plasmid pRC/CMV-mmu-miR-21 was transfected to 293 cells by lipofectamine 2000, and the stably transfected cells were screened with G418,from which total RNA was extracted for detecting the expression of mature miR-21 by northern blot. In the meantime,a luciferase report plasmid examing the activity of miR-21 named pmiR-21-Luc reporter was also construc-ted,and luciferase activity analysis indicated the product of pRC/CMV-mmu-miR-21 indeed had biological activity. Results Both restriction enzyme digestion analysis and sequencing proved the recombinant plasmids were constructed correctly. The miR-21 was highly expressed in the screened clones of 293 cells and it had good biological activity. Conclusion The eukaryotic expression plasmid of mouse miR-21 was successfully constructed,which laid the foundation of further investigation of the role of miR-21 during skin wound healing.

Objective To investigate the clinical parameters,risk factors,treatment and clinical outcomes of pneumocystis pneumonia(PCP) in children without human immunodeficiency virus(HIV). Methods Retrospective a-nalysis was made for the clinical features,risk factors,treatment and prognoses of the non-HIV infected severe PCP pa-tients hospitalized at Pediatric Intensive Care Unit( PICU) of Children′s Hospital Affiliated to Capital Institute of Pedi-atrics. Results During April of 2010 to April of 2014,there were 10 cases of non-HIV infected severe PCP in PICU of Children′s Hospital Affiliated to Capital Institute of Pediatrics. All of the patients had predisposing diseases,in which 3 cases had connective tissue diseases,2 cases had acute leukemia,3 cases had severe pneumonia and 2 cases had con-genital immunodeficiency. The main clinical manifestations of those 10 patients were fever, cough, tachypnea and obvious dyspnea. All patients developed respiratory failure. The median value of Pediatric Critical Illness Score was 79. The median arterial oxygen pressure was 58 mmHg(1 mmHg=0. 133 kPa). The median oxygenation index was 103 mmHg. The median alveolo-arterial oxygen partial pressure difference was 43. 8 mmHg. The median CD4+T-lympho-cytes counts was 169 ×106/L. Eight patients on admission had mixed infection. Acute respiratory distress syndrome (ARDS) occurred in all of the patients,and 7 cases of them had multiple organ dysfunctions. All of the patients re-quired ventilation support. The median day for invasive mechanical ventilation days was 11 and the median day for non-invasive ventilation days was 6. The pneumothorax occurred in 5 patients. All patients received trimethoprim-Sulfame-thoxazole as initial therapy and Caspofungin treatment in combination in 7 cases of the patients. Six patients had nosoco-mial infection. The median time of PICU stay was 15. 5 days. Six patients survived and the mortality was 40%(4/10 cases) . Conclusions PCP is a kind of fatal diseases which occurred in patients with immunocompromised conditions and concurrent ARDS or multiple organ dysfunctions. Diagnostic suspicion and mechanical ventilation therapy with lung protective ventilation strategies may improve the clinical outcomes of non-HIV-infected PCP in children.

Objective To evaluate the left ventricular (LV) systolic dyssynchrony after the acute myocardial infarction (AMI) with two-dimensional speckle tracking echocardiography (STE). Methods STE were performed in 65 patients within 72 h of AMI and compared with 60 age- and sex-matched healthy volunteers. The peak longitudinal strain (LS_(peak)) was measured at LV myocardium. LV dyssynchrony was defined as an interval ≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (TAS-POST). Size of myocardial infarction (MIS)was confirmed by wall-motion score index (WMSI). Results The LS_(peak) and LV ejection fraction (LVEF) were lower, and WMSI and TAS-POST were larger in AMI patients compared with controls. Forty-two patients had developed LV dyssynchrony (64.62%), and there were strong correlation between LV dyssynchrony (TAS-POST) and LS_(peak), LVEF, and WMSI (MIS). MIS was the most independent predictor for systolic dyssynchrony. Conclusion AMI with normal QRS can induce LV dyssynchrony, which is mainly determined by MIS. STE is a reliable technique for accurate evaluation of LV synchrony.

Objective To assess the value of two-dimensional speckle tracking echocardiography (2D-STE) of predicting the acute response to cardiac resynchronization therapy (CRT) in patients with congestive heart failure. Methods Twenty-four patients with congestive heart failure scheduled for CRT were included. 2D-STE was performed within 7 days of implantation with device ON and OFF. Left ventricular (LV) dyssynchrony was defined as an interval ≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (T_(AS-POST)) with 2D-STE. Acute hemodynamic response was measured as LVdp/dt, and percentage change in LVdp/dt was used to classify responders (Δdp/dt%＞25%) and nonresponders (Δdp/dt%≤25%). Results Fifteen patients (62.50%) were classified as acute responders. Compared with nonresponders, the responders demonstrated significant increase of LV ejection fraction and reduction of TAS-POST after CRT-ON. T_(AS-POST)was the only determinants of Δdp/dt%＞25%. T_(AS-POST)≥130 ms prognosticated acute response to CRT with sensitivity of 86.24% and specificity of 70.38%. Conclusion CRT can immediately increase the LV systolic function and synchrony. 2D-STE is highly predictive for acute response to CRT.

Objective To evaluate the value of real-time three-dimensional echocardiography（RT3DE）to predict the long-term response to cardiac resynchronization therapy（CRT）.Methods Twenty-six patients with heart failure were scheduled for CRT.RT3DE was performed before and one year after the pacemaker implantation,and left ventricular（LV）dyssynchrony was defined as the maximum difference（Tmsv 16-Dif）and standard deviation（Tmsv 16-SD）when the minimum systolic volume of 16 segments was reached.Patients were divided into re-sponders and non-responders according to a reduction ≥15 % in LV end-systolic volume（LVESV）after CRT.Results Seventeen patients（65.4 %）were classified as responders.Compared with non-responders,the responders demonstrated a significant increase in LV ejection fraction,and reduction in Tmsv 16-SD.Tmsv 16-SD was a determinant factor for Δ LVESV ≥15%.Tmsv 16-SD 〉3.5% could be employed to evaluate the short-term response to CRT with 80 % sensitivity and 77 % specificity.Conclusions CRT can increase the LV systolic function and synchrony.RT3DE is highly predictive for long-term response to CRT