Objective To investigate the influence factors of cognitive impairment in epilepsy children with less than 6 years old. Methods Eighty-nine epilepsy children with less than 6 years old were selected. The neuropsychological detection was tested by Gesell developmental diagnostic scale (GDDS), and head imaging examination (CT or MRI) and ambulatory electroencephalogram (EGG) were checked. Results The scores of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal- social behavior were (82.98 ± 14.02), (85.86 ± 13.79), (83.14 ± 13.44), (84.75 ± 3.29) and (84.99 ± 14.37) scores, the average development quotient of the children with epilepsy were greater than 75 scores, and there were no statistical differences among them (P > 0.05). According to the test results of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal-social behavior, the rates of developmental delay children were 21.35% (19/89), 19.10% (17/89), 16.85% (15/89), 24.72% (22/89) and 22.47% (20/89), and the rates of moderate to severe developmental delay were 3.37% (3/89), 3.37% (3/89), 4.49% (4/89), 3.37% (3/89) and 3.37%(3/89). Multivariate analysis results showed that first onset age of epilepsy and head imaging performance were correlated with adaptive behavior, big sports behavior, fine motor behavior and personal-social behavior (P < 0.05). Conclusions The first onset age of epilepsy and head imaging performances are the major factors in cognitive performance in epilepsy children with less than 6 years old, so clinical attention should be paid to improve the prognosis of cognitive outcome of epilepsy children, and improve their life quality.

Objective To explore the association between the daily intake of alcohol and blood pressure in Chinese.Methods With the baseline data of the Qingdao Port Health Study,all subjects aged 18 to 54 yrs including all in-service and retired employees in Qingdao port were selected and divided into seven groups according to their daily intake of alcohol: groups of 0,0～,5～,10～,20～,40～ and 60～g alcohol/d,also stratified by ages.The amount of alcohol intake was assessed by a questionnaire.The cross-sectional association between blood pressure and intakes of alcohol was analyzed with general linear model and Logistic regression.Results In the groups of 25～34,35～44,45～54 yrs old both before and after adjustment,systolic and diastolic blood pressure were linearly increased with the amount of alcohol intake from the 0 g/d group to 60～g/d group.In the group of 18～24 yrs old,there was no obvious relationship between BP and alcohol intake.Logistic regression model showed that odds ratios in the groups of 0～g/d,5～g/d,10～g/d,20～g/d,40～g/d and 60～g/d versus the abstainers was 1.05,1.14,1.08,1.24,1.30 and 2.02,respectively,and the prevalence of hypertension in the 20～g/d group was significantly higher than that in the 0 g/d group and groups of low or moderate alcohol intake.Conclusion An increasing and linear relationship between alcohol consumption and blood pressure was established,and alcohol intake ≥20 g /d is an independent risk factor for hypertension.

Objective To investigate the production of IL-17,IL-4 and IFN-γ in sputum of pediatric patients with asthma.Methods 61 pediatric patients with asthma in stage of exacerbation were enrolled as exacerbation group.and these patients in remission stage after therapy were enrolled as remission group, and 45 healthy children were chose as control group.The percentage of neutrophils and eosinophils were counted in regular way with sputum pigmentation,and the level of IL-17,IL-4 and IFN-γ were detected by enzyme-linked immunosorbent assay.Results IL-17 in exacerbation group Was highest among three groups, and IL-17 in remission group was higher than that in control group.In exacerbation group,IL-4 was higher and IFN-γ was lower than those in other two groups,and no significant difference Was found between remission group and control group.While in exacerbation stage,IL-17 was positive correlated with IL-4,and IFN-γ was negative correlated with IL-17 and IL-4.Conclusions IL-17 and IL-4 are related to the occurrence and exasperating of asthma,and IL-17 is suit for indicating the inflammation of asthma.IFN-γ is a protective factor of asthma.

Objective To analyse the multi-slice spiral CT(MSCT) findings of small cholangiocarcinoma of common bile duct.Methods 15 cases with pathologically verified small cholangiocarcinoma of common bile duct were undergone unenhanced and three-phase contrast-enhanced MSCT scan.The entire morphologic changes of common bile duct were analysed with curved planar reformation(CPR).Results The attenuation of tumor relative to pancreas was iso-density in all cases at plain CT scan,hypo-density in 10 cases,iso-density in 3 cases and hyper-density in 2 cases at arterial phase,hypo-density in 1 case,iso-density in 3 cases and hyper-density in 11 cases at portal phase,iso-density in 5 caaes and hyper-density in 10 cases at delayed phase.The focal wall thickening of common bile duct appeared as circular or eccentric in 13 cases,intraluminal nodule in 2 cases,common bile duct was narrowing sharply in 11 cases and ending abruptly in 4 cases at obstructive level.Conclusion The small cholangiocarcinoma of common bile duct is of certain characteristics at unenhanced and three-phase contrast-enhanced CT scan.

Objective: To establish capillary zone electrophoresis method for determination of sildenafil citrate (Viagra) content in its troche. Methods： Using tetrandrine as internal standard(IS), the electrophoretic separation was achieved with 25 mmol/L borate (pH=7.89) running buffer. And a voltage of 14 kV was applied to the 40 cm×75 μm(i.d) capillary. The analytes were introduced into capillary by siphon (1 s) and determined with on-column monitoring at 214 nm. Results：The determination could be completed within 4 min and the minimum concentration of detection was 5 μg/ml.The analytical results of sildenafil citrate samples demonstrated a good linear relationship within the range of 24-480 μg/ml.The relative standard deviations (RSD) of intra-day was less than 1.58% and that of inter-day was less than 2.46%.The present recoveries were between 95%-105％. Conclusion：The CZE method is accurate, simple, rapid and reliable, so it can be applied to the determination of sildenafil citrate content.

Objective To evaluate the accuracy of stroke volume variation (SVV) in monitoring blood volume during one-lung ventilation in patients undergoing thoracoscopy operation. Methods Twenty-two ASA Ⅰ or Ⅱ patients ( 12 male, 10 female) aged 18-60 yr undergoing thoracoscopy operation under general anesthesia were studied. Anesthesia was induced with midazolam, sufentanil, propofol and rocuronium and maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecoronium. Robertshow double-lumen endobronchial tube was inserted. Correct position of the tube was verified by fiberoptic bronchoscopy. The patients were mechani40 mm Hg. Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor. A loading dose of 6% HES 5 ml/kg was infused over 10 min. MAP, HR, CO and SVV were recorded before and at 3 min after loading dose. The change rate of SVV (SVV) and CI (△CI) were calculated. Increase in CI by 11% was considered effective volume expansion. The ROC curve for SVV in determining the volume expansion efficacy was plotted. The area under the curve for SVV and 95% confidence interval were calculated. Results (1) CO were significantly increased while SVV decreased after a loading dose of HES. (2) During two-lung ventilation 12 patients responded to the 6% HES loading dose.SVV correlated with△CI ( - 0.710, P ＜ 0.05). The volume expansion efficacy was determined by SVV 11.5 % (sensitivity = 82 %, specificity = 92 % ). The area under the curve for SVV and 95% confidance interval were 0.880 (0.580-0.987). (3) During one-lung ventilation 11 patients responded to the 6 % HES loading dose. SVV correlated with CI ( - 0.668 , P ＜ 0.05). The volume expansion efficacy was determined by SVV 9.5 % ( sensitivity = 77 %, specificity = 63 % ). The area under the curve for SVV and 95% confidance interval were 0.971 (0.917-1.024). Conclusion One-lung ventilation does not alter the ability of SVV in monitoring blood volume in patients undergoing thoracoscopy operation.

Objective To realize fine management of medical equipment maintenance,effectively improve the efficiency and save the cost of equipment maintenance.Methods A medical equipment maintenance management module was developed with hospital resource planning system and SQL Server 2008 platform so as to implement informatized management for equipment acceptance check,maintenance,processing and etc.Results The module realized fine management,controlled cost and enhanced social and economic benefits of the hospital.Conclusion The module contributes to medical equipment maintenance management informatization,and is of great significance for the improvement of the hospital.

Objective To explore the effect of upgrade of dialysate quality on the microinflammation in maintenance haemodialysis (MHD) patients. Methods Fifty-three MHD patients in Kidney Center of the First Affiliated Hospital,Medical College,Zhejiang University in January 2003 were enrolled in the prospectively study.The main end-points were survival at 8 years or weaning from haemodialysis during 8-year period including death, receiving renal transplantation or transferring to peritoneal dialysis.The endotoxin level of dialysate and patients' serum levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),C reaction protein (CRP),and albumin were recorded during the observation period. Results After the upgrade of water management system,endotoxin level of dialysate obviously decreased [(0.046±0.012) EU/ml vs (0.454±0.002) EU/ml,P＜0.01],and serum IL-6 [(3.947±3.624) ng/L vs (13.779±7.106) ng/L,P=0.036],TNF-α [(7.935±3.864) ng/L vs (12.804±8.017) ng/L,P=0.012] as well as CRP [(0.194±0.149) mg/L vs (0.561 ±0.309) mg/L,P＜0.01] decreased significantly,while serum albumin increased [(41.900±6.803) g/L vs (38.140±7.083) g/L,P=0.042].Hemoglobin level did not change significantly after the system upgrade,however,the dose of erythropoietin decreased [(93.0±12.7) U·kg-1·week-1 vs (131.0±10.1) U·kg-1·week-1,P=0.015]. Conclusions The upgrade of central dialysis fluid delivery and water management system by application of double reverse osmosis,high frequency heat disinfection and endotoxin filter can improve the quality of dialysate.Improvement of dialysate quality can ameliorate the microinflammation state of MHD patients.

AIM:To investigate the maturation of mice immature myeloid dendritic cells (mDCs) induced by antigen(Ag)85B of mycobacterium tuberculosis, and the expression of TSLPR and OX40L mediated by TSLP in vitro. METHODS:Recombinant mouse GM-CSF ( rmGM-CSF) and rmIL-4 were used to induce bone marrow precursor cells of C57BL/6 mice to differentiate into immature mDCs in vitro.mDCs were identified followed by purification using CD 11c binding magnetic beads .The morphological characteristic of mDCs was observed under inverted phase-contrast microscope and scanning electron microscope .The surface phenotypes of mDCs were determined by flow cytometry .To obtain the opti-mal concentrations of Ag85B and TSLP, immature mDCs were cultured with different concentrations of Ag 85B or TSLP at 0 (control group), 50, 100 and 200 μg/L for 24 h, and the expression of cell surface molecules CD 80, CD86, TSLPR and OX40L was detected by flow cytometry.In addition, the expression of TSLPR and OX40L in Ag85B and TSLP-co-stimula-ted mDCs was determined by flow cytometry .RESULTS:After 7 d of culture in vitro, the cells showed irregular dendritic protrusions under the inverted-phase contrast microscope , and had wrinkles and dendritic splits under scanning electron mi-croscope , conformed to the morphological characteristics of immature mDCs .The mDCs cells expressed higher level of spe-cific marker CD11c, lower level of co-stimulatory molecules CD80 and CD86, which conformed to the phenotype of imma-ture mDCs.The CD80 +and CD86 +cell ratios of mDCs displayed significant increases in 50, 100 and 200μg/L Ag85B or TSLP groups compared with control group (P<0.05).The ratios of TSLPR +and OX40L+cells did not differ among dif-ferent concentrations of Ag 85B groups.The ratios of TSLPR +and OX40L+cells were significantly increased in 100 μg/L and 200μg/L TSLP groups compared with control group and 50μg/L TSLP group (P<0.05).Under the circumstance of optimal Ag85B or TSLP treatment concentration at 200 μg/L, there was significantly decreased in TSLPR and OX 40L cell ratio of mDCs in Ag85B group or Ag85B combined with TSLP group when compared with TSLP group (P<0.05), and no significant difference among Ag85B group, Ag85B combined with TSLP group and control group was observed .CONCLU-SION: Ag85B enhances mDCs maturation by up-regulating the expression of co-stimulatory molecules CD80 and CD86, and inhibit the expression of pro-inflammatory specific molecules TSLPR and OX40L on TSLP-activated mDCs, indicating that Ag85B modifies the development of asthmatic airway inflammation through the pathway of TSLP -activated mDCs.

Contemporary hospital information systems normally contain multiple applications,which are traditionally deployed as one application per server.More servers in the system will incur high system costs,low server efficiency and poor management and maintenance.The information system reform project of Wuxi Maternal and Child Health Hospital called into play the virtualization based on VMware.The project brought forth a number of merits,namely sizably raising efficiency of servers integration,simplifying server group management,reducing cost and promoting hospital informationization.