ObjectiveThis system review for the medicine of children gastroesophageal reflux disease(GERD) will provide the latest evidence based medicine evidence for pediatric clinical medication.MethodsThe documents of randomized controlled clinical trials of children GERD,which had been published in domestic and foreign journals from the year 2000 to 2010,had been retrieved and screened by the study inclusion criteria.According to the Jadad evaluation questionaire,the documents' quality had been evaluated.The efficiency rates of treatment were calculated respectively by the merger of same medicines,and the meta-analysis of different drugs had been done for evaluating the effect of different pharmacological therapeutic agents.In addition,the adverse events occurred during treatment were analyzed.ResultsThere were 31 documents fitting inclusion criteria.2 015 cases of children ( 1039 cases in treatment groups and 976 cases in control groups) had been included in these randomized controlled clinical trials.In these documents the agents included:cisapride ( 18 articles ),erythromycin ( 8 articles ),motilium ( 5 articles ).The merger efficiency rates of these medicines were cisapride (93.43％ ),erythromycin (92.86％ ),motilium (93.06％) respectively.There were no significant difference in the efficiencies of the three drugs in the treatment of GERD ( P＞0.05 ).In addition,the results of meta-analysis about treatment inefficiency,used with the postures therapy and support therapy as controls,were cisapride OR=0.15 ( OR 95％ CI0.11～0.20),erythromycin OR =0.08 ( OR 95％ CI 0.04～0.14 ),motilium OR=0.03 ( OR 95％ CI 0.01～0.07).Furthermore,their adverse effect rates were cisapride 0.72％ ( diarrhea 0.58％,somnolence 0.14％ ),erythromycin 0.96％ ( drug rashes 0.48％,slight increase of GOT 0.48％ ),motilium 1.50％ (diarrhea 1.50％ ).ConclusionThe efficiencies of smaller doses of erythromycin were better than cisapride,and not better than motilium;but the adverse effect rates were better than cisapride,and not better than motilium.In summary,smaller doses of erythromycin is better currently in the treatment of GERD.Attention should be paid in the use of erythromycin,since it accounted for slight increases in GOT or drug rashes approximately.

Objective To investigate whether Shenfu(SF) injection has protective effect on circulation function in infants undergoing cardio-pulmonary bypass.Methods Thirty-six patients within 3 years old with congenital heart disease were randomly divided into SF injection group(n=18) and control group(n=18).The SF group were treated with 1 mL/kg SF intravenous injection after inducing of anesthesia,the control group were infused with 1 mL/kg saline intravenously.The changes of hemodynamics during surgery,time needed for sinus rhythm emerging on electrocardiogram(ECG) after arteriae aotra patency dose of vaso-active drugs intra-and postoperatively and recovery time during postoperative period were observed.Results In SF group,mean artery pressure(MAP) was higher and heart rate(HR),central venous pressure(CVP) lower than control group(P

0.05).The addition of sIL-6R to group SFT6 restored UCB cells expansion to a higher extent than in group SFT,SFT6 and SFTs(P0.05).Conclusion:The IL-6/sIl-6R in combination with SCF,FL and TPO could enhance the expansion of cord blood CD34+ cells and their expression of CD49d,CD62L and CXCR4.

Objective To explore the relationship between high sensitive C-reactive protein (hs-CRP) and blood stasis syndrome (BSS) in patients with coronary heart disease (CHD). Method Hs-CRP in 45 patients of CHD of BSS type, 50 CHD patients of non BSS type and 50 healthy subjects (control) was determined. Levels of endothelin (ET), nitricoxide (NO), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), total cholesterol (TC), and low density lipoprotein cholesterol (LDL-C) were also measured. Results The level of hs-CRP, TC, LDL-C and ET/NO was markedly increased in the patients of BSS comparing with non BSS and control group, the difference was significant (P

Objective To elucidate the effect of ex vivo expansion of umbilical cord blood (UCB) mononuclear cells (MNCs) on their implantation capability and the hematopoietic reconstitution, and to find a feasible way of applying ex vivo expanded UCB MNCs to clinical transplantation.Methods UCB MNCs were cultured in short-term in serum-free medium with different early acting cytokines combinations in order to observe the amplification result and cells apoptotic difference. The 6-day expanded cells were transplanted into sublethally irradiated NOD/SCID mice to assess the implantation and the hematopoietic reconstitution of the survival mice.Results UCB MNCs reached the best amplification result between day 6 and day 10 with the contribution of SCF, FL, IL-6 and IL-3 in common and the presence of Annxin V on the surface of cells obviously decreased. Six weeks after transplantation, CD45, CD34, CD33, CD3 and CD19 antigen could be detected by FCM on BM, spleen and thymus cells of the alive mice and the human specific Alu and Cart-Ⅰ repetitive sequence could be detected in the DNA obtained from peripheral blood by PCR.Conclusion After 6-day effective expanding with SCF+FL+IL-6+IL-3 UCB MNCs can be implanted into NOD/SCID mice successfully and contribute to reconstitute the multiple hematopoiesis.

Objective To design a wireless oxygen concentration monitoring device to solve the existing problems.Methods The device was composed of an oxygen sensor,an oxygen sensor line,an oxygen concentration monitoring host and a display terminal.HT67F489 was used as the main control chip,KE-25 oxygen concentration sensor was applied to collecting oxygen concentration data,and then through the T82 module wireless transmission of the data was executed to the display terminal of the App software.Results Clinical trials proved the measure value by the device was the same to that by the equipped meter,which facilitated the medical engineer find the faults in the shortest time.Conclusion The device gains advantages in easy installation,stable performances,high accuracy and anti-interference against physical environment,and thus has high social and economic benefits.

Objective: To investigate the mediating effect of insomnia among mobile phone addiction, aggressive behaviors and self-perceived identity among university students. Methods: A total of 740 university students were sampled from five universities in Binjiang District, Hangzhou City using a cluster random sampling method. The mobile phone addiction, aggressive behaviors and self-perceived identity were assessed using the Mobile Phone Addiction Index Scale, the Athens Insomnia Scale, the Chinese college students' version of the Buss-Perry Aggression Questionnaire, and the Self-Perceived Identity Scale, and the mediating effect of insomnia among mobile phone addiction, aggressive behaviors and self-perceived identity was examined using Process macro program and Bootstrap method. Results: A total of 740 questionnaires were allocated, and 700 valid questionnaires were recovered, with an effective recovery rate of 94.59%. The respondents included 221 men (31.57%) and 479 women (68.43%), and there were 607 respondents with a specialty of medicine (86.71%). There were 331 participants detected with mobile phone addiction (47.29%), 90 with aggressive behaviors (12.86%) and 289 with low-level self-perceived identity (41.29%), and the prevalence rates of mild, moderate, severe and extremely severe insomnia were 28.00%, 26.14%, 26.43% and 19.43% among respondents, respectively. Mobile phone addiction had a direct predictive effect on aggressive behaviors (β=0.301, P<0.001) and self-perceived identity (β=-0.129, P<0.001), and presented an indirect predictive effect on aggressive behaviors (effect of mobile phone addiction on insomnia: β=0.083, P<0.001; effect of insomnia on aggressive behaviors: β=0.999, P<0.001; effect of insomnia on self-perceived identity: β=-0.698, P<0.001). The contributions of mediating effects caused by insomnia were 21.61% and 31.02% to total effects. Conclusions Insomnia presents partial mediating effects among mobile phone addiction, aggressive behaviors and self-perceived identity among university students. Mobile phone addiction may directly affect aggressive behaviors and self-perceived identity, and indirectly affect aggressive behaviors and self-perceived identity via insomnia.

Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.

Objective To evaluate the efficacy and adverse effect of brachial plexus block with morphine and ropivacaine for postoperative analgesia in children. Methods Forty-five children undergone upper extremity surgery were randomly divided into three groups (n = 15) , ie, Croup A (brachial plexus block with ropivacaine), Croup B (brachial plexus block with ropivacaine and subcutaneous injection of morphine) and Croup C (brachial plexus block with morphine and ropivacaine). The analgesic effect and the analgesia maintenance time were recorded by FLACC method at 1, 2, 4, 6, 8, 12, 24 hours after operation. The adverse reactions were observed 48 hours after operation. Results There was no statistical difference between Croup A and Croup B in the analgesia maintenance time and the number of cases without analgesic therapy at each time point (P > 0. 05). Compared with Croup A or Croup B, the analgesia maintenance time in Croup C were significantly extended and the number of cases without analgesic therapy at 4, 6, 8, 12, 24 hours after operation were significantly increased (P < 0.05). The adverse effect was fairly light in three groups. Conclusion Brachial plexus block with morphine and ropivacaine may extend analgesia maintenance time effectively and safely in children undergone upper extremity surgery.

Objective To prepare a new type of micropore porcine acellular dermis matrix with the aid of laser (LPADM),and to validate the healing effect of the LPADM through the phrase Ⅰ composite transplanting on the back of the full- thickness skin defects in SD rats.Methods In vitro,the allogeneic fibroblasts were separately cultured with the LPADM (LPADM group) or the non-pore PADM (non-pore LPADM group),while fibroblasts cultured by pure medium were used as control.After culture of 1 day,3 days and 5 days,the contents of IL-10,IL-6,TGF-β1,LN,VEGF expressed by fibroblasts were determined by double-antibody sandwich ELISA method.In vivo,the phrase Ⅰ transplantations of LPADM graft with split-thickness autologous skin were carried on the backs of the full-thickness cutaneous defects of SD rats.The healing condition was observed and analyzed by histological tests.Results The differences of the absorbance value between the LPADMgroup,PADM group and control group in each day were not statistically significant (F=0.050-1.763,P＞0.05).The transplantation of LPADM graft with split-thickness autologous skin graft resulted in high rate of surviving without signs of rejection 3 weeks later.After 1-month of transplantation,the regenerated skin was well enough to be lifted without any serious scars.Conclusions The phrase Ⅰ transplantation of LPADM graft with split-thickness autologous skin graft can accelerate the healing process of full-thickness skin wounds with high biological safety.