Objective To study the relationship between angiotensin Ⅱ type 1 receptor (AT_~1 R) gene polymorphism and carotid atherosclerosis and pathogenesis in primary hypertension . Methods Polymerase chain reaction combined with restriction enzyme digestion and ultrasonography were used to measure AT_~1 R gene polymorphism and carotid artery intima-media thickness (IMT) separately in 150 patients with primary hypertension compared with 100 controls . Results The frequencies of AC genotype and C allele of AT_~1 R gene in patients were higher than those of control ~(P

Objective To investigate the role of interstitial collagenase in the pathogenesis of acute lung injury induced by hyperoxia outside of sealed cages and breath room air,and to study the mechanism of The severity of lung injury.Methods Seventy-two C57BL/6 mice were divided into normal control group,hyperoxia for 24 hours group,hyperoxia for 48 hours and hyperoxia for 72 hours group randomly,18 mice in each group.The hyperoxia group exposedin sealed cages with＞95%oxygen,and the control group were put in the inspiratory room.The expression of interstitial collagenase mRNA and protein in lung tissues was studied by reverse transcript-polymerase chain reaction(RT-PCR)and immunohistochemistry.Results Hyperoxia caused acute lung injury in mice.by The expression of interstitial collagenase mRNA in lung tissues was increased after 24 hours of hyperoxia compared with their control group[0.59±0.11 vs 0.07±0.01,q=3.t5 P＜0.01],the expression was higher at 72 hours of hyperoxia(0.68±0.12,q=3.78 P＜0.01).Immunohistochemistry study showed interstitial collagenase protein was mainly expressed in cytoplasm of airway epithelial cells,while Ⅱ type alveolar epithelial cells mainly and vascular smooth muscle cells in hyperoxia mice.The expression of interstitial collagenase protein in airway epithelium significantly increased at 24 hours of hyperoxia compared with their control group[(28.54±9.60) vs (13.48±4.32)q=2.62 P＜0.05],and the expression level was lower after 48 and 72 hours of hyperoxia(20.32±5.68) vs, (15.24±4.65).Conclusion Hyperoxia cause acute lung injury in mice;interstitial collagenase play an important role in the development of hyperoxia-induced lung injury in mice.

OBJECTIVE:To investigate the risk,advantages and disadvantages and countermeasures of new drugs,generic drugs and imported drugs in different transfer opportunities,and to provide basis for improvement of development strategy for phar-maceutical enterprises. METHODS:The analysis was done in accordance with relevant regulations on transferable projects in the process of applying for registrations of new drugs,generic drugs and imported drugs. The transfer period and risk were explored and countermeasures were put forward. RESULTS & CONCLUSIONS:Transferable projects included intellectual property rights (patents,patent application,technical secrets,application information,non-disclosed data,etc.)and ownership rights(clinical tri-al approvals,new drug certificates,drug approval number,pharmaceutical product registration certificates,imported product regis-tration certificates,etc.)in the process of applying for registrations. There are 4 opportunities for drug technology transfer,opportu-nity 1 is before applying clinical trial approvals after the completion of non-clinical research such as pharmacology,toxicology;op-portunity 2 is ahead of clinical trial after the acquirement of clinical trial approvals;opportunity 3 is new drug technology transfer;opportunity 4 is production technology transfer. The new drugs have 4 transfer opportunities,generic drugs and imported drugs can transfer in opportunity 1,2,4. Different transfer opportunities present different risks and profits. The risk gradually decreases with the further promotion of drug registration process,while the innovation decreases at the same time. Pharmaceutical enterprises should combine with the policy,market and their own features to select a suitable transfer period.

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.

A rapid headspace gas chromatography tandem mass spectrometric ( HS-GC/MS ) method was established for the analysis of volatile fatty acids ( VFAs ) in the feces. Feces were suspended by 6%phosphoric acid aqueous solution (1:2 m/V) and sealed in the headspace bottle for HS-GC/MS analysis. The HS-GC/MS method was optimized as follows: agitator temperature ( temp. ):80 ℃, syringe temp.:80 ℃, sample incubation time: 30 min, injection: 1 mL without split-flow. The chromatographic separation was performed on a DB-FFAP capillary column (30m×0. 25 mm×0. 25 μm) with injection port temp.:250 ℃. The temperature program ( initial temp. at 50 ℃ within first 1 min, and raised to 200 ℃ by 10 ℃/min) was employed by fixing the flow of carrier gas (high purity helium) at 1. 0 mL/min. The electron energy at -70 eV for electron impact ( EI ) ionization, ion source temp.: 250 ℃, transfer line temp.:280 ℃, the voltage of electron multiplier at 0. 95 kV. The spectra were recorded in the range of m/z 33-200 for full scan. The established HS-GC/MS method could be applied to analyze VGAs in the feces from human and rat appropriately. There are nine VFAs identified in the feces from human, and eight VFAs detected in the feces from rat by retrieving the NIST library, comparing with the standards and analyzing the MS data. Furthermore, the relative percentage contents of acetic acid, propionic acid and butyric acid accounted for roughly 85% of all VFAs by area normalization. The method is simple and sensitive, and it can be used to rapidly detect VFAs in the feces from human and rat.

Objective: To explore the clinical and echocardiography characteristics between noncompaction of ventricular myocardium (NVM) and dilated cardiomyopathy (DCM) combining hypertrabeculation in order to distinguish NVM from DCM.
Methods: Our research included 2 groups of patients: NVM group,n=31 and DCM combining hypertrabeculation group, n=50. The basic information as gender, age, family history, symptoms, ECG, plasma levels of BNP and echocardiography were recorded and examined in all patients; the size of cardiac chambers, myocardium, endocardium and hemodynamics were particularly focused. The trabeculation was analyzed by 17 segments method.
Results:①Compared with NVM group, the patients in DCM combining hypertrabeculation group had the worse cardiac classiifcation, higher plasma levels of BNP (P<0.05) and more obvious cardiac dilatation.②The patients in NVM group had the most trabeculation segments (9.82 ± 2.02) and the apical (17th segment) was involved, patients had the higher ratio of noncompacton/compaction (NC/C) as (2.84 ± 0.61), there were (4.12 ± 2.68) segments with NC/C > 2.③The patients in DCM combining hypertrabeculation group had the less trabeculation segments (5.56 ± 1.56) and the apical was seldom involved, patients had the lower ration of NC/C as (1.91± 0.42), there was at most 1 segment with NC/C > 2. All P<0.05.
Conclusion: Echocardiography is a simple, practical and noninvasive method to distinguish NVM from DCM. NVM could be diagnosed by obvious left ventricular apex involvement with NC/C >2 in at least 2 segments of free ventricular walls.

OBJECTIVEThe mainstay of therapy in patients with septic shock is early and aggressive intravenous fluid resuscitation. However the type of intravenous fluid that would be ideal for managing septic shock has been intensely debated. In this study, the authors observed the effects of 3% hypertonic saline solution compared with normal saline solution as early fluid resuscitation in children with septic shock.

METHODIn this prospective study, 44 septic shock children seen in the intensive care unit (ICU) of the Children's Hospital Affiliated to Capital Institute of Pediatrics were enrolled from January 2012 to January 2014, of whom 33 were male and 11 were female. Patients were randomly divided into two groups: normal saline group (NS group, 24 patients) and 3% hypertonic saline group (HS group,20 patients). There were no significant differences between the 2 groups of patients in age, gender, pediatric critical illness score (PCIS), oxygenation index (OI = PaO2/FiO2), arterial lactate, initial hemodynamic parameters, serum sodium and treatment at time of admission. Patients in NS group received normal saline guided by standard therapy. Those in HS group received 6 ml/kg 3% hypertonic saline as a single bolus over 10 min to 15 min with a maximum of 2 boluses and other standard therapy. Heart rate (HR), mean arterial blood pressure (MAP), arterial lactate, oxygenation index, urine output, serum sodium, lactate clearance rate, PCIS, fluid infusion volume, vasoactive - inotropic score, mechanical ventilation time , as well as incidence of multiple organ dysfunction syndrome (MODS), and 28 days in - hospital mortality were recorded for all patients.

RESULT(1) HR, MAP in both groups were significantly higher after infusion than those on admission. There were no significant difference in HR and MAP at 1h, 3h, 6h and 24h after infusion between NS group and HS group. (2) OI in HS group was significantly higher than that on admission at 3 hours after infusion [(321. 8 ± 50. 7) vs. (296. 5 ± 58. 2) mmHg, t = -2. 50, P = 0. 018 ]), and it was significantly higher at 24 hours after infusion in NS group (325. 7 ± 62. 6) vs. (304. 2 ± 70. 4) mmHg, t = -2.60, P=0.016]. There were no significant differences in OI at 1h, 3h, 6h and 24h after infusion between NS group and HS group. (3) At 1 hour after infusion, serum sodium in HS group was significantly higherthan that in NS group [(138.3 ± 3.8)vs. (135.0 ± 3.5) mmol/L, t=8.77, P=0.005], and then no significant difference at 3h, 6h and 24h after infusion between two groups. (4) At 6 hours and 24 hours after treatment, fluid infusion volume in HS group was markedly less than that in NS group [6 h: (39. 2 13. 9) vs. (60. 8 ± 22. 4) ml/kg, t = 14. 21, P =0. 000; 24 h: (102. 9 ± 27. 7) vs. (130. 6 ± 33. 2 ) ml/kg, t= 8. 85, P = 0. 005]. Urine output had not significant different between the two groups. (5) There were no significant differences in 24h PCIS, 24h lactate clearance rate, vasoactive - inotropic score and mechanical ventilation time between the two groups. The incidence of MODS (80. 0% in HS group, 70. 0% in NS group) and mortality rate(5. 0% in HS group, 8. 3% in NS group) were similar in both groups.

CONCLUSIONThe 3% hypertonic saline was effective as resuscitation fluid in pediatric septic shock with respect to restoration of hemodynamic stability without obvious side effects. Hypertonic saline could more rapidly improve oxygenation and need less fluid infusion volume compared with normal saline.

Arterial Pressure ; Child ; Female ; Fluid Therapy ; Heart Rate ; Hemodynamics ; Humans ; Intensive Care Units ; Male ; Multiple Organ Failure ; Prospective Studies ; Resuscitation ; Saline Solution, Hypertonic ; therapeutic use ; Shock, Septic ; therapy ; Sodium Chloride ; therapeutic use

Background The aspheric intraocular lenses(IOLs)can reduce ocular spherical aberration to some degree.However,the clinical effect depends more on the IOL proper alignment.It becomes more important to study the IOL position in eye,Objective This study was to analyze the position alteration of IOL after phacoemulsification combined with implantation of one-piece soft IOLs.Methods In this prospective control study,80 eyes of 40 patients with age-related cataract were enrolled.The phacoemulsification with IOL implantation was performed in all the eyes.Decentration and tilt of IOL in the nasal superior,superior temporal,inferior temporal and nasal inferior quadrants(the intersection point of the system optical axis and the IOL maximum cross plane were regarded as the ordinate origin)were measured by rotating Scheimpflug camera(Pentacam Oculus)in 3 months postoperatively under the mydriasis condition.Written informed consent was obtained from each subject prior to this trial.Results In the right eye group,the IOL decentered toward temporal in 26 eyes(65％)and infratemporal in 16 eyes(40％).IOLs tilted temporally in the horizontal plane in 37 eyes(92.5％)and tilted inferiorly in the vertical plane in 34 eyes(85.0％).In the left eye group,IOLs decentered temporally 33 eyes(82.5％)and 20 IOLs (50％)infratemporally,IOLs tilted temporally in the horizontal plane in 37 eye(92.5％)and 36 IOLs(90％)tilted inferiorly in the vertical plane.There was no statistical difference for the intercomparsion of horizontal/vertical decentration in various quadrant in the right eye(F =0.221,0.792,P＞0.05).The obvious elevated horizontal decentration was found in the supertemporal and infratemporal quadrants compared with supernasal quadrant in the left eyes but there was no significant difference in the vertical decentration among 3 quadrants(F=0.576,P＞0.05).Decentrations were positively correlated with the tilt in both horizontal and vertical plane(right eye horizontal plane:r=0.374,P=0.002;right eye vertical plane:r=0.402,P=0.001 ;left eye horizontal plane:r=0.377,P=0.002；left eye vertical plane:r=0.347,P=0.002).Conclusions The one-piece soft IOLs(Adapt AO)decenter toward temporal mostly in 3 months after surgery,especially infratemporally in the eye.And the optical axis of the IOL tilt toward infratemperol mostly in both right and left eyes.The decentration and tilt are consisted in the corresponding direction between the right and left eyes.The position of the IOLs showed mirror symmetry between right and left eyes.The IOLs decentration show the positively correlation to tilt whatever in horizontal and vertical plane.

Objective To learn the present efficiency of medical equipments at public hospitals in Liaoning province, and provide scientific basis for rational distribution of such resources, and for control of medical expenses.Methods Data envelop analysis (DEA) was used to appraise the deployment efficiency of 2 784 such equipments worth over 100 000 yuan per unit, with equipments randomly sampled from 31 public hospitals in the province.Results The equipment deployment at public hospitals in Liaoning was found at a low level.9.7% of the hospitals were found as relatively efficient, 3.2% of them as in relatively weak efficiency, while 87.1% of them relatively inefficient.Gaps were found between urban hospitals and tertiary hospitals, and rural hospitals and secondary hospitals in their deployment efficiency, as evidenced in overinvestment of equipments and insufficiency of competent operators.Conclusions Hospitals should strengthen their scientific management of the equipments, and emphasize human resource investment, thus elevating the efficiency of equipment deployment.

Electronics ; organization & administration ; Health Promotion ; Humans ; Occupational Health Services