This paper summarized nursing points for caring 23 cases undergoing pediatric heart transplantation,including:characteristics of accessing and protection of hearts,collaboration in pediatric heart transplantation,nursing of capacity management,temperature controlling,extracorporeal membrane oxygenation and delayed sternal closure during surgeries.The average length of hospitalization for 23 cases was 24.5±8.3 days,1 case died from primary graft failure after 19 months,the rest of 22 cases survived,and cardiac function recovered to NYHA class Ⅰ-Ⅱ.

0.05);the frequencies of IFN-? gene +874 site T and A allele showed significant difference between case group and control group(P0.05).Conclusion T allele of IFN? gene+874 site might have a relationship with generation of ovarian cancer,TT genotype might be susceptibility genotype for ovarian cancer.

Background Measurement of corneal thickness is of great significance for the design of refractive surgery and the diagnosis of eye diseases,measuring equipments and technology develop rapidly in recent years.Optovue iVue OCT is a new frequency-domain optical coherence tomography (OCT),to compare its results with those of Pentacam and Visante OCT is helpful to objectively assess the clinical value of Optovue iVue OCT.Objective This study was to investigate the repeatability of corneal thickness measurement with Optovue iVue OCT and the comparatbility with Pentacam three-dimensional anterior segment analysis diagnostic system and Visante OCT.In addition,this study attempted to analyze the distribution of average corneal thickness in each quadrant by Optovue iVue OCT.Methods The corneal thicknesses of the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones 1 mm away from the center of the cornea were measured in 45 right eyes of 45 subjects with myopia using Optovue iVue OCT,Pentacam and Visante OCT in Tianjin Eye Hospital.Interclass correlation coefficient (ICC) was used to analyze the repeatability of measurement by Optovue iVue OCT.The agreements between Optovue iVue OCT and Pentacam or Visante OCT were evaluated by Bland-Altman test.The corneal area of 1.0-2.5 mm away from the center was divided into eight quadrants and the average corneal thickness of each quadrant was measured and analysis with Optovue iVue OCT.Results No significant difference was found in corneal thickness values for 3 times by Optovue iVue OCT (P=0.546).The ICC by Optovue iVue OCT was 99.92％,99.99％,99.96％,99.99％,99.99％ and 99.97％ at the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones respectively.There were significant differences among the 3 kinds of methods (P =0.000,0.001,0.000,0.003,0.002,0.000).The measured values of Optovue iVue OCT were significantly lower mean 24.20 μm than those of Pentacam (P=0.000,0.001,0.000,0.003,0.004,0.000),but only the value at 12:00 zone of Optovue iVue OCT was evidently declined in comparison with that of Visante OCT (P =0.016),there were no significant differences between all the other zones (P =1.000,0.447,0.239,1.000,1.000).While the mean corneal thickness value from Pentacam lowed by 14.01 μm in comparison with Visante OCT,all zones had significant differences (P =0.009,0.005,0.034,0.017,0.008) except the central point (P =0.056).Based on the Optovue iVue OCT,the thinnest zone was at temporal quadrant in 23 eyes (accounting for 51.11％) and at superior quadrant or super nasal quadrant in 21 eyes (both at 46.66％).Conclusions Optovue iVue OCT measurement of corneal thickness is of high repeatability and is consistent with Visante OCT in myopic eye.Optovue iVue OCT shows evident difference from Pentacam in the measurement of corneal thickness.The thinnest point of the cornea is mainly in the inferior temporal quadrant and the thickest point is commonly in superior quadrant and nasal superior quadrant based on Optovue iVue OCT.

Objective:To compare the fit of Co-Cr basal crowns fabricated by three kinds of technology. Methods:18 laser cured resin dies were divided into A, B and C groups(n=6) randomly. Co-Cr basal crowns of group A, B and C were made by traditional casting technology, CAD/CAM cutting metal technology and direct metal laser sintering technology( DMLS) respectively. The crowns were cemented to the corresponding dies and the basal crowns and dies were embedded in methyl acrylic. The thickness of the cement layer of the samples was measured under a stero microscope. Data were analyzed with SPSS13. 0 statistical software. Results:Marginal gap of group A, B and C was (66.08 ±3.90) μm, (29.21 ±3.31) μm and (24.96 ±2.99) μm respectively(P<0.01). Internal gap of group A, B and C was (114. 10 ± 27. 66) μm, (73. 69 ± 31. 31) μm and (79. 89 ± 33. 63) μm respectively(A vs B or C, P<0. 01, B vs C, P>0. 05). Conclusion:DMLS technology may make the best marginal fit, CAD/CAM and DMLS technology may pro-duce better internal fit. The marginal fit and the internal fit of the crowns prepared by the 3 methods can meet the clinical requirements.

Objective To investigate the effects of SPARC (secreated protein acidic and rich in cysteine) and its peptide on proliferation, apoptosis and cell cycle of human mesangial cells cultured in vitro, and explore the possible mechanism. Methods Mesangial cells were incubated in the media with various concentrations of SPARC and its peptide cultured in vitro. Cell proliferation was assessed by MTT colorimetric assay. Cell cycle and apoptosis index were analyzed by flow cytometry. The expression of cyclinD1 and p21Wafl proteins in response to SPARC and its peptide in HMC was determined by Western blot. Results Various concentrations of SPARC and its peptide could significantly inhibit the proliferation of mesangial cells in dose- and time-dependent manner, regulate the cell cycle at phrase G-0/G1 increased while cells phrase S reduced, and could also induce apoptosis. Under the stimulation of SPARC and its peptide, the expression of cyclinDl in HMC decreased markedly meanwhile the expression of p21Wafl increased significantly. Conclusions SPARC and its peptide can effectively inhibit HMC proliferation and regulate cell cycle progression. The mechanism may be mediated by inhibiting cyclinDl and stimulating p21Wafl expression, subsequently blocking cells passing through G-S check point, which will be useful for treating mesangial proliferative glomerulonephritis.

OBJECTIVE To analyze the effect of advanced glycation end products(AGEs) on apoptosis of cultured mouse spiral ganglion cells(SGCs) and expression of receptor of AGEs(RAGE). To explore the pathway of AGEs in promoting apoptosis of SGCs. And to explore the possible mechanism of neural presbycusis. METHODS The effect of AGEs on apoptosis of SGCs was studied by Tunel technique and fluorescence microscope. The expression of RAGE mRNA was assayed by Real time RT-PCR. RESULTS AGEs induced apoptosis of cultured SGCs. The effects were dose-dependent and time-dependent. Meanwhile RAGE mRNA expression was enhanced in apoptosis cells. CONCLUSION AGEs induced apoptosis in SGCs,which may be mediated by RAGE. And this may be one of the mechanisms of neural presbycusis.

Objective To investigate the clinical value of multidisciplinary team (MDT) assessment for chronic constipation.Methods The clinical characteristics of 346 patients with chronic constipation who were admitted to the Third Peolep's Hospital of Hangzhou from January 2010 to December 2013 were multidisciplinarily assessed.The muhidisciplinary team was involved surgeons from the department of colorectal surgery,urology,gynecology,psychiatry and psychology,and tools including questionnaires,defecography,anorectal manometry,colon transit study,urodynamic tests,gynecological examination were applied in the study.The measurement data with normal distribution were presented as (x) ± s,the comparison between groups was analyzed using the ANOVA,and the count data were analyzed using the chi-square test.Results Three hundred and forty-six patients who met criteria of this research were selected,including 86 males and 260 females with the ratio of 1 ∶ 3;the mean age was (55 ± 11)years.Of the 346 patients,slow transit constipation accounted for 7.52％ (26/346),defecatory disorder for 60.98％ (211/346),and mixed constipation for 31.50％ (109/346).A total of 93.85％ female patients (244/260) had anterior rectocele,75.43％ (261/346) patients had internal rectal mucosal prolapse,66.76％ (231/346) patients had perineum descending,23.99％ (83/346) had achalasia or inappropriate contraction of internal anal sphincter,18.79％ (65/346) had puborectalis rectocele muscle thickening,5.49％ (19/346) had rectal prolapse.A total of 82.37％ (285/346) patients were involved in other subjects than colorectal surgery.A total of 28.61％ (99/346) patients presented with urinary symptoms,including 65 cases with stress urinary incontinence,23 cases with unstable bladder and 19 cases with bladder neck obstruction (some patients had multiple urological systoms).The incidence of reproductive organ prolapse in female patients was 31.92％ (83/260),the incidence of uterine prolapse and anterior vaginal prolapse were 26.15％ (68/260) and 29.23％ (76/260),respectively.Patients with anxiety and/or depression accounted for 36.13％ (125/346).The male and female patients of slow transit constipation,defecatory constipation and mixed constipation were 10 vs 16,30 vs 79,46 vs 165,respectively,the age was 60 ± 12,56 ± 11,52 ± 10,showing no significant differences (x2=4.046,F =2.877,P ＞ 0.05).In the three kinds of constipation,patients with urinary diseases accounted for 26.92％ (7/26),26.61％ (29/109) and 29.86％ (63/211),patients with gynecological diseases accounted for 11.54％ (3/26),20.18％ (22/109),27.49％ (58/211),patients with psychological diseases accounted for 38.46％ (10/26),39.45％ (43/109),34.12％ (72/211),respectively,showing no significant difference (x2=4.090,P ＞ 0.05).Conclusion MDT assessment for patients with chronic constipation can reflect comprehensively clinical characteristics of chronic constipation,therefore multidisciplinary team should be emphasized in clinical diagnosis and treatment of chronic constipation.

Objective To explore the diagnostic value of three-dimensional ultrasound parameters-vascularity index (VI) and the volume of kidney in chronic kidney disease (CKD). Methods A total of 80 CKD patients at different stages and 30 healthy adults were enrolled in the study. VI and the renal volume were calculated with three-dimensional ultrasound, while resistance index (RI), cortical thickness (CT) and the volume of kidney were calculated with two-dimensional ultrasound, and the correlation of those parameters were analyzed statistically. Results VI of CKD2 patients reduced significantly compared with the control group, and RI of CKD3 patients increased significantly, CT of CKD3 patients reduced significantly. The diagnostic sensitivity, specificity and diagnostic value of VI in patients with early and late CKD were all higher than thpse of RI. Compared with the control group, three-dimensional ultrasound of renal volume and two-dimensional ultrasound volume of CKD 1 patients increased significantly, three-dimensional ultrasound volume of CKD2 patients reduced significantly, and two-dimensional ultrasound volume of CKD4 patients reduced significantly. There was significant negative correlation among VI, three-dimensional ultrasound volume, CT, two-dimensional ultrasound volume and pathological change scoring (r=-0.67, -0.52, -0.43, -0.52). Conclusion VI and three-dimensional ultrasound volume can detect renal function damage more earlier and sensitively than RI and two-dimensional ultrasound volume.

Objective To investigate the relationship between serum albumin, bilirubin and cognitive impairment in patients with mild cognitive impairment (MCI). Methods Serum albumin, total bilirubin, direct bilirubin, indirect bilirubin were analyzed in 89 cases of MCI and 82 cases of cognitively normal control. All of the cases underwent neuropsychological testing by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The risk factors of MCI were subject to Logistic regression analysis. Results The serum level of total bilirubin in MCI group were significantly lower than that in controls (P < 0.05). There was no significant difference in albumin between MCI and control group (P > 0.05). The bilirubin level was positively correlated with MMSE scores and MoCA scores (including attention, delayed recall and abstract) (P < 0.05), while no significant correlation between serum albumin level and scores of MMSE and MoCA (P > 0.05) by using Spearman correlation analysis. Logistic regression analysis showed that age, education level, diabetes and serum bilirubin levels were independent risk factors for MCI. Conclusion Our data show that decreased serum level of bilirubin is positively related to cognitive impairment.

Objective To observe the effect ofprostaglandin E1 intravenously in the improvement of the function of renal glomeruli and renal tubules in hypertensive patients complicated with microalbuminuria.Methods Totally 60 hypertensive patients complicated with microalbuminuria and nocturia who had received losartan for above 12 weeks,according to random number table method were divided into treatment group and control group,with 30 cases in each group.Original antihypertensive drugs were used continuously in treatment group and control group,and patients in treatment group received prostaglandin E1 intravenously for 3 courses of treatment,with losartan and other antihypertensive drugs routinely.Using self-contrast before and after treatment and contrast with control group,the change of urinary level of microalbumin (mALB),osmotic pressure,β2-microglodulin (β 2-MG) and N-acetyl-β-D-glucosaminidase (NAG) were compared.Results The blood pressure after treatment in both groups were decreased,but there was no statistically significant difference compared with that before treatment (P ＞ 0.05).After treatment of 12 weeks,urinary levels of mALB,β 2-MG and NAG in treatment group were lower than those in control group [(88.6 ± 14.2)μg/min vs.(123.9 ± 14.8) μg/min,(0.84 ±0.41) mg/L vs.(1.61 ±0.49) mg/L,(30.2 ± 10.5) U/L vs.(75.7 ± 12.8) U/L],and osmotic pressure was higher than that in control group [(591 ± 71) mmol/L vs.(454 ± 67) mmol/L],the difference had statistical significance (P ＜ 0.01).Conclusion Prostaglandin E1can reduce the renal ischemic state in early stage of hypertensive renal damage and can improve renal function.