Objective To investigate the the curative effect of pidotimod combined with Yanhuning for children with refractory mycoplasma pneumonia(RMPP).Methods90 patients with RMPP from January 2013 to January 2015in shengzhou maternal and child health care hospital were divided into 3 groups, including Yanhuning group(A group), azithromycin combined with Yanhuning group(B group)and pidotimod combined with Yanhuning group(C group).And the total effective rate, the clinical symptoms, immune function parameters were analyzed.ResultsThe regulation of immune function in C group was more significant than that in A group and B group, the prognosis was better, and the repeated times and continuous time were decreased (P<0.05).ConclusionPidotimod combined with Yanhuning treatment of RMPP can regulate the immune function of children, improve clinical symptoms, it is worthy of popularization.

Objective To investigate the protective effects of different ATP-sensitive potassium (K_ ATP) channel openers. Pinacidil and Diazoxide, on myocardium injury in isolated rabbit hearts caused by ischemia/reperfusion and the possible changes after application of ATP-sensitve potassium channel blocker, 5-HD. Methods Observation was made on rabbit hearts perfused with a Langendorff apparatus. Forty rabbits were randomly divided into five respective groups: 1. Pinacidil (Group P), 2. Diazoxide (Group D), 3. 5-HD+Pinacidil (Group HP), 4. 5-HD+Diazoxide (Group HD) and 5. the control (Group C). All groups were subjected to 40 minutes of occlusion, followed by 20 minutes of reperfusion as cardiac arrested by cold cardioplegia. Any one of Pinacidil, Diazoxide , Pinacidil or Diazoxide mixed with 5-HD was infused 15 minutes before cardioplegic heart rested in the experimental group. Cardiac tissue ultrastructure, hemodynamics variables, levels of adenine nucleotides and lipid peroxide of the myocardium were measured. Results (1) In Group P, Group D and Group HP, the recovery of myocardial contractility and heart rate after reperfusion was faster but MDA level and the amount of albumen released were lower than Group C. Moreover levels of myocardial adenosine triphosphate (ATP) were much higher compared with Group C. (2) In Group HP the recovery of myocardial contractility and heart rate was not as good as Group P, but its myocardium MDA level and amount of albumen released was higher than group P. Conclusion ATP-sensitive Potassium Channel openes may enhance myocardial protection against ischemia /reperfusion injury. The above effect of myocardial protection was only partially closed down by ATP-sensitive potassium channel blocker: 5-HD. The mitoK_ ATP channels on myocardium may be an important pathway of protection during ischemia/reperfusion process.

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

Objective To investigate intraoperative changes of internal environment in infants undergoing living related liver transplantation (LRLT), and to explore appropriate treatment measures. Methods Twenty-five infants undergoing LRLT were retrospectively studied, including 12 males, 13 females, with age of (3. 4 ± 4. 6) months (ranging from 2-11 months), weight of (6. 8 ±1. 3) kg (ranging from 3. 1-8. 8 kg). Arterial blood samples were collected before the operation, at preanhepatic phase (5 min before cross-clamping), at anhepatic phase (5 min before opening inferior vena cava), 5 and 30 min after the opening inferior yena cava respectively, and at the completion of the surgery the pH value, bases excess (BE), the levels of sodium, potassium, calcium, glucose and lactate were determined. Results There were large fluctuations to the internal environment during operation. Compared with the preoperative values, the intraoperative concentrations of Na+ had no significant change; The pH value and blood level of K+ had no significant change at pre-anhepatic phase and anhepatic phase (P＞0. 05), the pH value was decreased at anhepatic phase Ⅰ (P＜0. 01 )and returned to the preoperative level at the end of the operation, and the blood level of K+ decreased at anhepatic phase and lasted till the completion of the surgery (P＜0. 01 ). The blood level of Ca2+ was decreased at pre-anhepatic phase and neohepatic phaseⅡ (P＜0. 05), and recovered at the end of the operation. Blood glucose concentration was increased significantly at preanhepatic phase to neohepatic Ⅱ, and still kept at the higher level until the end of operation. The lactate concentrations were increased significantly at pre-an.hepatic phase to neohepatic Ⅱ (P＜0. 01 ), and recovered at the end of operation. The BE was decreased at pre-anhepatic phase to neohepatic Ⅱ (P＜0. 05), and recovered at the end of the operation. Conclusion There are significant disruptions which are unique and inter-related to the internal environment parameters in infants during the operation of LRLT.Monitoring and accurate intraoperative managements for different physiological status at different phases are critical for the success of LRLT in infants.

Objective To evaluate the role of 5-HT5A receptors (5-HT5A R) in activation of astroglia in the spinal dorsal horn in a rat model of neuropathic pain induced by vincristine. Methods Forty adult male SD rats weighing 180-200 g were randomly divided into 4 groups ( n = 10 each): control group (group C);neuropathic pain group (group P);Ad-X-HK group (group B) and Ad-5-HT5A-siRNA group (group S). Neuropathic pain was induced by repeated intraperitoneal (IP) injection of vincristine 0.1 mg/kg according to the method described by Weng et al in group P, B and S. On the 2nd day after the last IP injection, the animals received artificial cerebrospinal fluid, Ad-X-HK and Ad-5-HT5A-siRNA 25 μl administered intrathecally (IT) in group P, B and S respectively. Paw withdrawal threshold to mechanical stimulus was measured before and on the 7th day after IT administration. The animals were then sacrificed. The lumbar segment ( L4.5 ) of the spinal cord was removed for determination of 5-HT5A R and GFAP expression. Results Body weight and paw withdrawal threshold were significantly decreased after repeated IP vincristine administration in group P compared with group C. IT Ad-5-HT5A-siRNA reduced pain threshold further in group S compared with group P. Repeated IP vincristine significantly increased the expression of 5-HT5A R and GFAP in spinal dorsal horn, and IT Ad-5-HT5A-siRNA significantly decreased the expression of 5-HT5A R while increased the expression of GFAP in spinal dorsal horn in group S compared with group P. Conclusion 5-HT5AR is involved in the inhibition of astrocyte activation, resulting in reduction of vincristineinduced neuropathic pain.

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.

Background:Dysregulation of microRNA expression is involved in the carcinogenesis of many tumors,expression of miR-504 has been observed in many tumors,but its expression in primary hepatocellular carcinoma(HCC)has not been reported. Aims:To explore the expression and clinical significance of miR-504 in HCC tissues and cells. Methods:Tumor and para-cancerous tissue in 85 HCC patients were collected. Five liver cancer cell lines and immortalized liver cell line were conventionally cultured. Effect of miR-504 expression on HepG2 cells proliferation was determined by CCK8 assay. The expression of miR-504 was determined by real time fluorescent quantitative PCR. Relationships between expression of miR-504 and clinicopathological features and prognosis of HCC patients were analyzed. Results:Compared with normal liver cells,expression of miR-504 was significantly downregulated in five liver cancer cells(P < 0. 05). Up-regulation of miR-504 inhibited proliferation of HepG2 cells,and down-regulation of miR-504 promoted proliferation of HepG2 cells. miR-504 expression in tumor tissue was significantly decreased than that in corresponding para-cancerous tissue. Expression of miR-504 was correlated with tumor differentiation(P = 0. 002),TNM stage(P = 0. 021),alpha fetoprotein(P = 0. 012)and portal vein tumor thrombus(P = 0. 003),but not with gender,age,tumor size and tumor number. Survival in HCC patients with lower miR-504 expression was significantly shorter than that in patients with high expression(P < 0. 05). Conclusions:Expression of miR-504 is downregulated in HCC,and is correlated with the prognosis of patients,suggesting that miR-504 can be used as an independent predictor for prognosis of HCC patients.

Objective:To analyze the clinical characteristics of functional esophagogastric junction outflow obstruction (EGJOO) and to improve the knowledge of functional EGJOO.Methods:From January 2015 to December 2019, at the Gastrointestinal Motility Center of The First Affiliated Hospital with Nanjing Medical University, 91 patients who underwent high resolution esophageal manometry (HREM) and met the EGJOO criteria of Chicago Classification for esophageal motility disorders, 3rd edition and excluded organic diseases by examination such as gastroscopy or upper gastrointestinal radiography were collected. The clinical manifestations, treatment methods, effect and clinical outcome of patients with functional EGJOO, the HREM parameters of patients with different clinical manifestations as well as symptoms and HREM parameters of patients with different treatments were analyzed. Least significant difference test or Tamhanes T2 test, Mann-Whitney U or Wilcoxon test, chi-square test or Fisher exact test were used for statistical analysis. Results:The most common symptom of 91 functional EGJOO patients was dysphagia (34/91, 37.4%). The lower esophageal sphincter pressure (LESP) and the intrabolus pressure during relaxation of the lower esophageal sphincter (IBP LESR) of patients with dysphagia were both higher than those of patients without dysphagia (30.95 mmHg (26.27 mmHg, 39.37 mmHg) (1 mmHg=0.133 kPa) vs. 27.35 mmHg (24.60 mmHg, 34.87 mmHg); (8.25±4.64) mmHg vs. (5.69±4.65) mmHg), and the differences were statistically significant ( Z=2.076, t=2.539; P=0.038, 0.013). Thirty patients (33.0%) had no special treatment, 52 patients (57.1%) were treated with medication, and nine patients (10.0%) underwent peroral endoscopic myotomy (POEM). The incidence of dysphagia before treatment and maximum intrabolus pressure of patients who underwent POEM were both higher than those of patients without special treatment and medication treatment (8/9 vs 43.3%, 13/30 and 25.0%, 13/52; 21.80 mmHg (15.45 mmHg, 28.95 mmHg) vs. 12.20 mmHg (10.00 mmHg, 18.10 mmHg) and 13.70 mmHg (11.07 mmHg, 17.82 mmHg)), and the differences were statistically significant (Fisher exact test, Fisher exact test; Z=2.814, 2.390; P=0.023, P<0.01, P=0.005, 0.017). The incidences of delayed esophageal emptying or esophageal dilation of patients who underwent POEM, without special treatment and with medication treatment was 6/9, 5/14 and 3/18, respectively, and the differences were statistically significant among three groups (Fisher exact test, P=0.039). Among them, the incidence of delayed esophageal emptying or esophageal dilation of patients received POEM before treatment was higher than that of patients with medication treatment (Fisher exact test, P=0.026). The symptoms of 24.2% (22/91) was spontaneously relieved, and two patients (2.2%) developed type Ⅱ achalasia during follow-up. Conclusions:The main manifestation of patients with functional EGJOO is dysphagia. Patients with significantly increased LESP and IBP LESP are more likely to have dysphagia. Patients with obvious signs of esophageal gastric junction obstruction are more inclined to choose POEM treatment. Some patients with functional EGJOO can relieve themselves, and a few patients can develop achalasia.

[Objective] To evaluate the significance of plasma endothelin in tubal pregnancy (TP) and to observe the regulatory effect of kidney-reinforcing, blood-activating and blood-stasis-removing Chinese herbal medicine on endothelin (ET) level. [Methods] Plasma ET level and ET-positive rate were detected in 40 cases of TP, 20 of intrauterinc pregnancy (IP) and 20 of chronic pelvic inflammation (CPF) and the relationship between the two above indexes in the patients were analyzed. TP patients were randomized to three groups; group A (n = 15) was treated with No. 1 Yishen Huoxue Pills (6g, tid) and Penyankang mixture (25mL, tid) for two treatment courses; group B (n = 15) was treated with aspirin (257ng, qd) for two treatment courses; group C ( n - 10) was not given any medicines. [Results] ET-positive rate and plasma ET level in postoperative TP patients were higher than those in IP patients ( P .05) . Chinese herbal medicine could decrease ET-positive rate and plasma ET level in postoperative TP patients (P

Objective To find a more suitable approach to pediatric anesthesia during laparoscopic operation to alleviate stress response.Methods Forty patients,1 to 3 years of age,ASA grade Ⅰ-Ⅱ,underwent general anesthesia(group GA)and combined general epidural anesthesia(group GEA)during their laparoscopic operation.Heart rate(HR),mean arterial pressure(MAP),ECG,SPO2,PETCO2,blood gas,plasma epinephrine,plasma norepinephrine,plasma IL-6 and IL-10 were monitered and recorded five minutes before anesthesia(T0),pre-pneumoperitoneum(T1),5 min after pneumoperitoneum(T2),30 min after pneumoperitoneum(T3),30 min after operation(T4)and 24 h after operation(T5).Results(1)HR,MAP of group GA were increased obviously at T2,T3,T4 compared to T0(P0.05).Significant difference was found at T1,T2,T3 and T4 between group GA and group GEA(t=4.749,10.349,13.632,10.051,P0.05).Plasma IL-10 at T1,T2,T3,T4 were higher than that at T0 in both groups(P