Objective To discuss curative effects of naloxone in treatment of newborns with hypoxic-ischemic encephalopathy(HIE).Methods 100 newborns with HIE were divided into two groups at random,the naloxone therapeutic group and the is routine therapeutic group.The therapy effects were compared.Results The total effective rate of naloxone therapeutic group was 92%,and the total effective rate of matched control group was 72%.There were outstanding differences between two groups.Conclusion Naloxone shall be used to treat newborn with HIE based on the correct judgment of symptom and suitable treatment as early as possible.It's an effective way to black the development of the state of HIE,and to relieve the brain injury.

Objective To discuss the curative effect and clinical significance of sclerosing foam agent in the treatment of chronic venous diseases (CVD) with incompetent perforating veins.Methods 65 cases of C4,C5,C6 CVD (a total of 84 limbs) underwent foam sclerotherapy closure for incompetent perforating vein.Patients were followed-up for 3 months,ultrasonography was used to observe the closure of perforating veins and the curative effect.Results 7 patients (9 limbs) were lost to follow-up,all with grade C4.In the 66 (C4,C5) limbs,pigmentation significantly subsided in 45,partial regression in 9,no change in 2.In the 9 limbs with grade C6,complete healing of ulcer in 5,partially healed in 3.Ultrasound observed satisfactory perforating vein closure.Conclusion Foam sclerotherapy closure for incompetent perforating vein has satisfactory effect,with good short-term curative result.

Objective To study the effect of mechanical ventilation guided by esophageal pressure on hemodynamics and oxygen metabolism of severe acute pancreatitis (SAP) swine model with intra-abdominal hypertension (IAH) Methods By self-controlled study,SAP model was made by infusing sodium taurocholate (5％) into the pancreatic duct in 6 domestic swine.Mechanical ventilator mode was volumeassist control with tidal volume 10 ml/kg ; FiO2 40％ and PEEP 5 cm H2O (routine ventilation) given to SAP model swine.After 3 h ventilation,pneumo-peritoneum was made with N2 gas to increase the intraabdominal pressure (IAP) to 25 mm Hg in SAP swine.Three more hours later,PEEP was adjusted as the measurement of esophageal pressure (Pes guided ventilation) to such a level that trans-pulmonary pressure stayed above 0 cm H2O during end-expiratory occlusion.During the investigation period,heart rate (HR),cardiac output index (CI),central venous pressure (CVP),mean arterial pressure (MAP) and pulmonary arterial wedge pressure (PAWP) were continuously recorded with the aid of Swan-Ganz catheter and ECG monitor,and oxygen partial pressure of artery (PaO2) and carbon dioxide partial pressure of artery (PaCO2) were measured by blood-gas analysis.In addition,systemic oxygen delivery (DO2) and systemic oxygen consumption (VO2) were calculated by using the data of blood-gas analysis of arterial and central venous blood.Results No swine model was subjected to barotrauma.After routine mechanical ventilation,there were significant differences in HR,CI,MAP,CVP,PAWP,Ppeak,Pplat,Pes,pulmonary compliance (Cstat),PaO2,and DO2 between SAP and IAH in swine (all P ＜ 0.05).Compared with routine ventilation,however,PaO2 and Cstat improved significantly with lower CI and increased Pplat after PEEP adjusted according to measurements of esophageal pressure (all P ＜ 0.05).The lactate decreased significantly after esophageal pressure guided ventilation (all P ＜ 0.05).There were no significant changes in PaCO2,HR,MAP,CVP and PAWP in IAH swine after mechanical ventilation with routine parameters (all P ＞ 0.05).Conclusions There were remarkable effects on oxygen metabolism in response to mechanical ventilation guided by esophageal pressure.In case of clinical application of mechanical ventilation,the results of this study are in favor of setting transpulmonary pressure according to measurements of esophageal pressure in SAP patients with IAH in an early stage.

190-kilodalton glycoprotein (P190) of Plasmodium falciparum. precursor of the major surface protein of merozoites, is considered a promising candidate for blood stage malarial vaccine. We designed six primers according to the sequence of MAD20 strain, with a GC clamp and BamHI site at the 5'- end of each one, and a GC clamp and Xbal site at the 3'- end of each one. The primers were synthesized by phosphoramidite approach (User's Manual of ABI Company) and purified using HPLC. Three fragments in the second, third and fourth conserved regions of P190 gene of Plasmodium falciparum FCC1/HN strain isolated from the blood of patients in Hainan Province of China were amplified by the polymerase chain reaction (PCR) technique. The amplified fragments were subcloned into pUC18 vectors and sequenced using the dideoxy chain termination method. All three regions of P190 gene of FCCl/HN strain also were highly conservative as compared with P190 gene of MAD20 (Papua New Guinea isolate), K1 (Thailand isolate), Wellcome (West Africa isolate) and CAMP (Malaysia) strains of Plasmodium falciparum. The C at position 81 in the second conserved block of P190 gene of FCC1/HN isolate was substituted by T, which did not change the amino acid determined by the coden corresponding to the substitution.

Objective To evaluate spiral CT in diagnosing vascular complications of pancreatitis. Methods The clinical and surgical results and the CT findings of 316 patients with acute or chronic pancreatitis were comparatively analyzed. Special attention was paid to the CT findings of the patients with peritoneal hemorrhage and vascular abnormality. CT Hu of celiac blood effusion was measured. Pseudoaneurysms, phlebothrombosis and venous thrombosis of peripancreatic vessels in CT enhancement were carefully analyzed. Results Acute pancreatitis was found in 275 out of the 316 patients, and chronic pancreatitis in 41 cases. Among those with acute pancreatitis, 20 had peritoneal cavity vascular complications. In the 13 cases of peritoneal cavity hemorrhage(including 5 patients complicated with digestive tract hemorrhage), CT identified 11 with as regional or diffuse slight high density fluid collections, and failed in 2 cases. CT scans detected gastric varices in 4 out of 7 patients with digestive tract hemorrhage. Of those with chronic pancreatitis, CT found celiac artery pseudoaneurysm in one, spleen artery pseudoaneurysm in one and splenic vein thrombosis with gastric varices in one. Conclusions (1)Regional or diffuse slight high or high density fluid collections were common CT findings of peritoneal cavity hemorrhage. (2)Enhanced spiral CT scanning could demonstrate peripanreatic vascular pseudoaneurysms. (3)Varices in gastric fundus and necrosis in pancreatic body and tail often indicate the formation of spleen venous thrombosis.

Objective: To investigate the prevalence of overweight and obesity and relation of body mass index (BMI) to body fat percentage and waist circumference in Chinese healthy adults. Methods: 1005 healthy adults were divided into five groups by BMI,which was made by WHO's recent classification of BMI for Asian adults. Anthropometric measurements (waist and hip circumference , skinfold thickness and ratio of waist and hip circumference) and bioelectrical impedance analysis (BIA) were done in subjects. Results: The prevalence of overweight and obesity classⅠin males were significantly higher than in females. The prevalence of obesity classⅡwas lower both in males and in females. Females had higher percent body fat than males measured by BIA and by skinfold thickness measurements. BMI was significantly correlated with waist circumference in all age groups. Waist circumference was more than 80 cm in overweight females, and more than 90 cm in obesity classⅠin males. Conclusion: The age of overweight and obesity in males was younger than in females. The body fat in females was higher than in males. BMI cut off points for obesity diagnosis are over estimated much more than BIA and skinfold thickness measurements for percent body fat in adults. It should be noted that age, sex and physical activity need to be considered besides BMI when obesity is diagnosed.

Objective To explore the diagnosis value of morphology changes of pleomorphic megakaryocytes in the bone marrow (BM) smears and BM sections in chronic MPD(CML-CP, ET,PV and PMF). Methods BM aspiration was taken in 182 patients of MPD aspiration and biopsy examination was performed synchronously to obtain the BM smears and BM sections samples. The BM smears were subjected to Wright/Giemsa stain and immunohistochemistry stain, while the BM sections were subjected to Haematoxylin-Giemsa-Fuchsin stain. The morphology of pleomorphic megakaryocytes was classified into five groups, which were Ⅰ type ( inclusion type), Ⅱtype ( hypolobulated muclei type), Ⅲ type ( giant hyperlobulated nuclei type), IV type (micro pyknotic type), and V type(extrusion type). The size of megakaryocytes clusters was recorded as no clusters(0) , predominantly small clusters of fewer than 6 cells (1) or predominantly large clusters of at least 6 cells (2) . The detection rates of various types of pleomorphic megakaryocytes and megakaryocytes clusters were both analyzed in the BM smears and BM sections. Results In CML-CP group, the detection rates were (3. 73±3. 84)% , (14.19 ±7. 62)% ,(5.99 ±4.67)%, (34. 37 ±10.79)%, (9.45 ±6. 87)%, (32. 28 ±7. 67)% and 3.13 ±2. 30)% ,(12.61 ± 9.28)%,(4.94±4.27)%,(35.26±9.63)%,(9.47 ±5.89)%,(34.58 ±6.81)% for I tⅠype,Ⅱ type,Ⅲ type, Ⅳtype and Ⅴ type pleomorphic megakaryocyte in BM smears and BM sections. There were no significantly differences between the BM smears and BM sections(t value were 0.524,0.510,0.645, 0.239,0.011,0. 869,all P>0.05). In ET group, the detection rate of I type [ (6.17 ±2. 89)% ] in BM smears was significantly higher than that in BM sections [ 2.42 ± 1. 28) % ] (t = 7. 183, P < 0. 01) , while the detection rate of V type [ (6. 28 ± 3. 34) % ] in BM smears was significantly lower than that in BM sections [ (10. 18± 4.03) % ] (t = 3.940, P < 0.01). Besides these, the detection rates of other types were not significantly different between the BM smears and BM sections(t value were 0.079,0. 122,1.643, 1. 638,all P>0. 05). In PV group, the detection rate of V type in BM smears [ (6. 55 ±4. 11)% ] was significantly lower than that in BM sections [ (10. 30±3. 34) % ] (t = 2. 351, P < 0.05 ). However, the detection rates of the other types were not significantly different between the BM smears and BM sections (t value were 1. 635,0. 301,0. 132,0. 704,0. 681 ,all P' >0. 05). In PMF group, the detection rate of IV type in BM smears [(13.05 ±5.24)%] was significantly lower than that in BM sections [(29.14± 8. 72) % ] (t = 5. 245, P < 0. 01). And the detection rate of normal type in BM smears [ ( 33. 58 ± 14.39)% ] was significantly higher than that in BM sections [(23. 01±7.96)%] (t =2. 132,P<0. 05). Besides these, the detection rates of the other types were not significantly different between BM smears and BM sections( t value were 0. 787,0.646,2.062,0. 869, P > 0. 05 ) . In CML-CP and PV groups, the detection rates of size of clusters were not significantly different between the BM smears and BM sections (x~2 = 2. 772, P > 0. 05 ). In ET group, the detection rate of small clusters (1) in BM smears was obviously higher than that in BM sections, however, the detection rate of larger clusters (2) in BM smears was obviously lower than that in BM sections (x~2 = 13. 748, P < 0.01). In PMF group, the detection rate of no clusters(0) in BM smears was obviously higher than that in BM sections, however, the detection rate of large clusters(2) in BM smears was obviously lowers than that in BM sections (x~2 =18.741 ,P<0. 01). Conclusions Both BM smears and BM sections can be applied to observe pleomorphic megakaryocytes. The morphology changes of pleomorphic megakaryocytes have certain reference values for identification of MPD subtypes and differential diagnosis.

Objective To evaluate the effects of folic acid supplement on subjects with different 5, 10-methylenetet-rahydrofolate reductase (MTHFR) genotypes. Methods One hundred and eleven healthy women were divided into CC, CT and TT groups according to their MTHFR C677T genotypes. In each group subjects were randomly sub-divided into interven-tion (400 μg/d folic acid supplement) and control (usual diet) groups. The plasma folate, red blood cell (RBC) folate and plasma homocysteine (Hcy) concentration were measured at baseline and two months after intervention. Results The plasma folate was lower and the plasma Hcy was higher in the TT genotype than those in CC or CT genotypes (P＜0.05 or P＜0.01). After two months of intervention, the levels of plasma folate, RBC folate concentration increased while the plasma Hcy concen-tration decreased in all three intervention groups. Although the plasma folate concentration increased the most obvious in TT genotype than that of CC and CT genotypes, P＜0.05), the plasma Hcy concentration decreased the most obvious in TT geno-type than that of CT genotype, P＜0.05). Logistic regression analysis showed that the MTHFR TT genotype was a risk factor of high Hcy concentration, which was 8.078 times compared with that of CC genotype (P＜0.05). Conclusion Folic acid sup-plement can significantly increase plasma folate and red cell folate concentration, and reduce plasma Hcy concentration in all MTHFR genotypes. TT genotype was the most dangerous in disorder of folic metabolic and high Hcy concentration. However, low-dose folic acid supplement cannot reduce the risk of high Hcy concentration.

Objective To evaluate left ventricular torsion (LVtor) and twist of different segments in systolic phase of healthy infants, children and adolescents with two-dimensional ultrasound speckle tracking imaging (STI). Methods One hundred and seventeen healthy subjects aged from 3 days to 15 years were divided into 5 groups: infants (3 days-2 years), pre-school age children (3-5 years), school age children (6-9 years), preadolescent (10-12 years) and adolescent age (13-15 years). Basal and apical short-axis images of left ventricle were acquired to analyze torsion of every segment and LV torsion. The peak twist (Ptw) of left ventricular was calculated, and the values of different groups were compared. Results ①Seen from the apex level, the normal LV performed wringing motion with clockwise rotation at the base and counterclockwise rotation at the apex in infants, children and adolescents. ②Seen from the short-axis basal level, torsion angle was the biggest in inferior, but the smallest in anterior in same age group (P<0.05). In different age group, there was no statistical difference in torsion angle at basal level. ③Torsion angle of short axis apex level increased with age increasing, and reached peak in adolescents. No statistical difference was found in torsion angle of every segments in apical level among subjects in the same age group. ④Torsion angle of every segment in apical and basal level changed with age increased while ventricular wall rotating mainly with apical plane gradually. In adolescents, significant difference was found in torsion angle in same segments between basal and apical plane (P<0.01). ⑤Torsion of the basal plane of left ventricular changed with age increasing, but no statistical difference was found. Torsion of the apical plane of left ventricular increased with age increasing (P<0.05). Ptw of left ventricular increased with age increasing, and reached the peak in preadolescence and adolescence. ⑥No statistical difference was found in all parameters of torsion and rotation between males and females. Conclusion LVtor in every segment in apical plane and Ptw of left ventricular increase with age increasing before adolescence.

Objective To investigate the effect of different sealing methods of urokinase plus heparin on long-term dialysis catheter thrombolysis.Methods63 patients were treated with maintenance hemodialysis from central venous catheters with catheter thrombosis as a clinical study.The patients were divided into observation group and control group by simple random method.In the observation group, 31 cases were treated with urokinase and heparin mixed solution from the ends of the arteriovenous catheter of permanent double-laryngeal dialysis tube for 24 hours for 3 consecutive days.32 patients in the control group, from the permanent dual-chamber dialysis catheter arterial and vein at both ends with a micro pump pumped urokinase, maintained for 2hours.ResultsThere was no significant difference in thrombolytic success rate between the two groups.The catheter retention time in the observation group was significantly longer than that in the control group, the dialysis blood flow rate, the solute clearance index and the urea clearance index were significantly higher than those in the control group.The incidence of venous pressure and hemorrhagic adverse events was significantly lower than that of the control group (P<0.05).ConclusionUrea kinase plus heparin mixture is simple and easy to operate, which avoids the risk of excessive localized or systemic hemorrhage caused by excessive urokinase into the blood circulation of patients.It is worthy of popularization.