Objective To investigate the valuable echocardiographic parameters and to evaluate theright heart function of patients with pulmonary hypertension in ICU. Methods From March 2015 to February 2016,30 patients with pulmonary hypertension in the intensive care unit(ICU) of Dongzhimen hospital were enrolled in the experimental group,and another 33 patients without pulmonary hypertension in ICU were enrolled in the control group. All of the patients were given bedside echocardiography examination. Results Significant differences in the right atrial diameter and area ,the base diameter of the right ventricle ,the intermediate diameter portion ,the distal inner diameter of the proximal end of the right ventricular outflow tract ,the main pulmonary artery diameter ,the Tei index and the E/A were observed between the two groups. However ,no significant differences in the right ventricular free wall thickness,TAPSE,RVFAC,VREF and DT were foundbetween the two groups. Conclusion Tei index,the diameter of the right heart and the main pulmonary artery diameter are proposed to be the promising echocardiographic parameters to evaluate the right heart function of patients with pulmonary hypertension in ICU.

Objective To investigate the expression of minichromosome maintenance protein 7 (MCM7) in sinonasal squamous cell carcinoma (SNSCC),and evaluate its relationship with tumor differentiation and prognosis of patients.Methods Using immunohistochemistry,MCM7 expression in SNSCC and nasal polyps with chronic sinusitis (NPCRS) were studied,and relationships between markers and clinicapathological features were analyzed.Results In NPCRS,MCM7 positive cells were mainly distributed in the epithelial basal layer and the expression rate was low,whereas in SNSCC,MCM7 positive cells were diffuse and the expression rate was high.MCM7 expression was significantly higher in SNSCC than in NPCRS (P ＜ 0.001) and related to tumor differentiation (P =0.001),increasing gradually with decreasing degree of differentiation.The overall 3-and 5-year survival rates of patients with SNSCC were 61.3％ and 46％,respectively.The 3-year survival rates for patients with stage Ⅰ and Ⅳ were 90％ and 25.6％,respectively,and the 5-year survival rates were 70％ and 17.1％,respectively;the difference was statistically significant (P ＜ 0.001).The 3-and 5-year survival rates of MCM7-negative patients were 36.0％ and 18.0％,respectively,and those of MCM7-positive patients were 59.9％ and 34.2％,respectively;the difference was not statistically significant (P =0.297).Conclusion In SNSCC,MCM7 expression is significantly increased,inversely associated with the degree of tumor differeutiation,and unrelated to the survival rates of patients.

Objective To explore the effect of double silicone balloon catheter used as nasal packing materials after functional endoscopic sinus sur?gery(FESS). Methods Totally 80 patients(47 males and 33 females,median age of 43 years)with bilateral chronic sinusitis who underwent en?doscopic surgery under general anesthesia were randomly divided into two groups,each group with 40 patients. The hemostatic sponge group used he?mostatic sponge for postoperative nasal packing and the hemostatic catheter group used double silicone balloon catheter plus medical sponge. Patients were observed for postoperative pain,ventilation and bleeding after packing removal to evaluate efficacy. Results Double silicone balloon catheter was superior to hemostatic sponge in ventilation maintenance(mean scores:78.8 vs 2.32)and pain relief(mean scores:0 vs 5.26),the difference was statistically significant(P<0.05). Moreover,double silicone balloon catheter was also superior to hemostatic sponge regarding to nasal bleeding after packing removal. Conclusion Double silicone balloon catheter is a preferable material for nasal packing after endoscopic surgery,which has reliable hemostatic effect and can better maintain the nasal ventilation,reduce pain in patients,and improve the patient's quality of life during treat?ment.

Objective To investigate the level of B7-H1 and its counter-receptor PD-1 expression in mDC and different subsets of T lymphocytes in HIV infected individuals in China and to analyze the correlation between the level of B7-H1/PD-1 and disease progression, and to demonstrate that PD-1/PD-L1-dependent inhibition is operating in HIV infected patients.Methods Percentage of B7-H1 and PD-1 expression in mDC, CD+4 T cells and CD+8 T cells from thirty-six untreated HIV infected patients and 20 health controls were selected and detected by flow-cytometry, its correlations with CD+4 T cell absolute counts and plasma viral loads were analyzed.Results The percentage of B7-H1 expression in mDC, CD+4 T cells and CD+8 T cells (mean 15.21, mean 20.63, mean 13.5)were higher than that of health controls (all P<0.05).The percentage of PD-1 expression in CD+4 T cells and CD+8 T cells (mean 17.91, mean 19.21)were higher than that of health controls (P<0.05, P<0.05). The level of B7-H1 and PD-1 expression were inversely correlated with CD+4 T-cell counts(mDC+B7-H1+:r=-0.647, P<0.01;CD+4B7-H1+:r=-0.489, P=0.002;CD+8B7-H1+:r=-0.372, P=0.026;CD+4PD-1+:r=-0.374, P=0.025;CD+8PD-1+:r=-0.455, P=0.005) and positively correlated with HIV viral load(mDC+B7-H1+:r=0.662, P<0.01;CD+4B7-H1+: r=0.426, P=0.01;CD+8B7-H1+:r=0.531, P=0.001;CD+4PD-1+:r=0.362, P=0.03;CD+8PD-1+:r=0.380, P=0.022).Conclusion The level of B7-H1 and PD-1 expression was associated with HIV disease progression, which provides a useful marker to define disease progression of HIV infection.

Objective:To analyze the system of first contact in community health institutions for migrant workers in Shenzhen city with the stakeholder theory. Methods:The report forms of the Social Insurance Fund Administration Bureau and the health bureau of Shenzhen city were used to analyze. All stakeholders of this policy were interviewed. Results:The system of first contact in community health institutions was good for all stakeholders. The number of in-sured migrant workers grew steadily, the business volume of community health service centers increased significantly, and the fund ran smoothly. Conclusions:The effects of the system of first contact in community health institutions for migrant workers in Shenzhen city were obvious. All the stakeholders felt satisfied with the policy.

Objective To investigate work stress state of nursing home staff and to analyze the influential factors affecting work stress.Methods Stratified random sampling method was adopted to investigate 180 nursing assistants by self-designed questionnaire,Work Stress Scale(WSS),Simplified Coping Style Questionnaire and internal-external locus of control scale investigation.Results Totally 174 valid questionnaires were collected.Variance analysis revealed there were significant differences of age and other factors.Stepwise multiple regression analysis showed five variables entered the equation,including workexpenence education level number of the cared ages work scheduline coping stule and explain 56.7％ of the total variable.Conclusion Nurse managers should pay attention to and improve achievement sense and mental adjustment ability of nursing assistants,to build a well-organized support system to reduce the workload.

Objective: To explore the effect of obesity on the treatment for femoral neck fracture in patients with SuperPATH hip replacement. Methods: Seventy patients who were treated with SuperPATH hip replacement in the Second People's Hospital of Wuxi from January 2014 to January 2017 were selected in the study.Based on their body mass index(BMI), the patients were divided into obesity group(BMI≥30kg/m²) (23 cases), overweight group(BMI: 25-30kg/m²) (22 cases), and normal group(BMI: 18.5-25kg/m²)(25 cases). The incision length, operation time, blood loss, blood transfusion rate, pain score, hip joint function score, imaging measurement results and postoperative complications were compared among the three groups. Results: All 70 patients received the operation successfully.The incision length of the obesity group was (7.4±0.2)cm, which of the overweight group was (7.2±0.1)cm, which of the normal group was (7.1±0.8)cm, the difference among the three groups was statistically significant (F=24.671, P<0.001). The patients were followed up for 9-13 months.The acetabular anteversion angle, acetabular abduction angle, pain score, mobility of hip joint, walking ability score in the obesity group were (17.8±1.2)°, (40.9±3.4)°, (1.26±0.61)points, (95.43±7.89)°, (8.10±0.27)points, respectively, which in the overweight group were (16.7±3.3)°, (42.9±2.9)°, (1.23±0.58)points, (96.78±3.22)°, (8.20±0.92) points, respectively, which in the normal group were (15.8±2.7)°, (43.9±5.1)°, (1.24±0.78)points, (97.12±6.44)°, (8.20±0.48)points, respectively.The difference of acetabular abduction angle among the three groups was statistically significant (F=9.803, P=0.002). In the obesity group, there were two cases of incision infection, two cases of deep venous thrombosis and one case of pulmonary complication, the incidence rate of complications was 5%.In the overweight group, there was one case of superficial incision infection, and one case of deep vein thrombosis, the incidence rate of complications was 2%.In the normal group, there was one case of deep venous thrombosis, the incidence rate of complications was 1%.The difference of incidence rate of complications among the three groups was statistically significant(χ²=15.31, P<0.01). Conclusion Obesity increases the surgical risk of SuperPATH total hip replacement, and more attention should be attached to perioperative and post-operative treatment for such patients.

ObjectiveTo investigate the survival and differentiation of autologous bone-marrow mononuclear cell (ABM-MNCs) after transplanted to infarcted area and border area, and the effect of ABM-MNC on the cardiac function.Methods40 male big-ear Japanese rabbits were divided randomly into the transplanted group and control group with 20 animals in each group. Acute myocardial infarction model was made by ligating left anterior descending artery. 7 days later, Brdu labeled ABM-MNCs were injected into myocardium in the transplanted group, while the control rabbits were injected with saline. Six weeks later, tests of histology and immunohistochemistry were performed.ResultsViable cells labeled with Brdu can be identified in the infarcted area, and myocytes and endothelial cells labeled with Brdu can also be found in the border area, these cells demonstrated myogenic differentiation with the expression of α-actin by immunostaining. While, no cells labeled with Brdu were found in the control group. Moreover, the vessel density of the transplanted group in the borders of the infarction was higher than the control group (P<0.05), but there was no difference in infarcted area between two groups (P>0.05).At the 6 weeks after experiment, the cardiac function was improved in both groups, but there was a significant difference between two groups (P<0.05).ConclusionABM-MNCs injected into the infarcted myocardium can survive in both the infarcted and border areas, and differentiate into endothelial cells and other cells which are able to obtain the characters of myocytes, and increase the vessel density in border area, improve the cardiac function.

Objective To detect the alternation of the level of CTLA-4 expression in T cells and regulatory T cells, and to study the relationship between CTLA-4 expression in T cells and regulatory T cells and disease progression of HIV infected Chinese. Methods Fifty-eight untreated HIV-1 infected patients were enrolled and the level of CTLA-4 expression in T cells and regulatory T cells were detected by flowcytometry. CD4+T cell numbers, viral load, level of CD95, HLA-DR, CD38 expression on T cells were measured to study the relationship between the level of CTLA-4 expression and disease progression of HIV infected patients. Results We found that the level of CTLA-4 expression in CD4+T cells continuously increased in long term nonprogressors (LTNP), asymptomatic HIV infected patients (HIV) and AIDS patients (P<0.05). The level of CTLA-4 expression in CD4+T cells was significantly correlated with CD4+T cell counts, the frequency of CD8+ CD38+T cells, CD4+CD95+T cells and CD8+CD95+T cells (P<0.05). There had no difference in the level of CTLA-4 expression in CD8+T cells among all groups and neither did we find the relationship between the level of CTLA-4 expression on CD8+ T cells and the CD4 counts, viral load, activation or apoptosis of T cells. The level of CTLA-4 expression in regulatory T cells of LTNP group was significantly lower than that of HIV and AIDS group (P<0.05). The level of CTLA-4 expression in regulatory T cells was significantly correlated with CD4 counts, the frequency of CD4+HLA-DR+T cells and CD8+HLA-DR+T cells (P<0.05). Conclusion The level of CTLA-4 expression in CD4+T cells and regulatory T cells is correlated with disease progression and the level of the activation of immune system of HIV infected Chinese and may play a role in the immune balance in HIV infection.

Objective To study the association of CD4+CD8+Foxp3+ regulatory T cells with the HIV long term non-progressors(LTNP) in China. Methods Seventy-four HIV-1 infected patients (LTNP group, HIV group and AIDS group)and 16 normal controls were enrolled and the frequency of CD4+CD25+Foxp3+ regulatory T cells were detected by flow cytometry. To study the correlation between CD4+CD25+Foxp3+ regulatory T cells and disease progression, the absolute CD4+ T cells, viral load, apoptosis and activation of T cells were also examined. Results The frequency of CD4+CD25+Foxp3+ regulatory T cells in LTNP group was significantly lower than that in HIV and AIDS group (P<0.05). The frequency of CD4+CD25+Foxp3+ regulatory T cells was inversely related to CD4+ T cells and closely related to viral load and CD38, CD95 expression on CD4, CD8+ T cells (P<0.05). Conclusion The frequency of CD4+CD25+Foxp3+ regulatory T cells of HIV infected LTNP is significantly lower than typical progressors, which indicates that alternation of regulatory T cells may play a protective role in LTNP.