Carefully evaluation of cardiovascular function in children with septic shock is the basis of appropriate therapy.Clinical methods of cardiovascular function evaluation include clinical manifestation,hemodynamic momtoring and laboratory test of tissue oxygenation.Evaluation of cardiovascular function should combine all results from different methods and should be dynamically monitored with the development of septic shock.

ObjectiveTo investigate the clinical effect of three-dimensional conformal radiotherapy simultaneously combined with XELOX program(oxaliplatin +capecitabine) for local recurrence of esophageal carcinoma after radiotherapy.MethodsSixty patients with local recurrence of esophageal carcinoma after radiotherapy were divided by random digits table method into treatment group and control group with 30 cases each.The patients in treatment group were treated with three-dimensional conformal radiotherapy simultaneously combined with XELOX program chemotherapy.While control group received three-dimensional conformal radiotherapy.The efficacy between two groups were compared.ResultsThe complete remission rate and efficiency rate in treatment group were significantly higher than those in control group [ 53.3％ (16/30) vs.23.3％ ( 7/30 ),86.7％ ( 26/30 ) vs.63.3％ (19/30) ] ( P ＜ 0.05 ).The 1,2,3-year survival rate and median survival time in treatment group were 65.5％,44.8％,34.5％ and 24.8 months,which were significantly higher than those in control group (48.3％,41.4％,6.9％ and 12.1 months)(P ＜0.01 ).The incidences of radioactive esophagitis,radioactive pneumonia and thrombocytopenia in treatment group were higher than those in control group,but there were no statistical differences between two groups (P ＞0.05).The incidences of nausea,vomiting,leukocyte decrease and anemia in treatment group were significantly higher than those in control group [36.7％(11/30) vs.13.3％(4/30),40.0％(12/30) vs.16.7％(5/30),43.3％( 13/30 ) vs.13.3％(4/30),P ＜ 0.05 ].ConclusionsThree-dimensional conformal radiotherapy simultaneously combined with XELOX program can improve short-term efficacy and long-term survival rate of local recurrence of esophageal carcinoma after radiotherapy.

ObjectiveTo explore the expression of Smad2 in cervical carcinoma and analyze the clinical significance of Smad2.MethodsThe expression of Smad2 in normal uterus group( NE group,n =61 ) and cervical carcinoma group( CC group,n =53 ) were detected by immunohistochemistry to analyze the significance of Smad2 in the cervical carcinoma.ResultsPositive rate of expression of Smad2 protein in NE group was 39.3％,positive rate was 77.4％ in CC group,statistical difference was found between the two groups(P ＜ 0.01 ).The degree of differentiation of cervical cancer was lower,and the Smad2 positive rate was higher,well-differentiated and poorly differentiated were 52.6％ and 91.2％,respectively,and the difference was statistically significante ( P ＜ 0.01 ) ; The invasion of cancer was higher,and the Smad2-positive rate was higher ≤ 1/2 and ＞ 1/2 were 66.7％ and 91.3％,respectively,and the difference was statistically significante ( P ＜ 0.05 ).ConclusionThe expression of Smad2 was less; Smad2 was related to depth of invasion and degree of differentiation of cervical carcinoma,which could be used as clinical diagnosis and prognostic markers.

Mechanical ventilation is an important life support method.Correct parameter adjustment of mechanical ventilation depends on assessment of Patient's respiratory and the effectiveness of mechanical venfilation.Blood gas monitoring is the most important way to assess the effectiveness of mechanical ventilation.Guidance of blood gas monitoring in parameter adjustment of mechanical venfilation is the key of successful mechanical ventilation.

[Summary] Cardiovascular disease ,diabetic nephropathy and diabetic retinopathy are common complications of diabetes ,and are the significant reason of cardiovascular mortality ,end-stage renal disease ,and blindness in adults patients with type 2 diabetes mellitus. At present, the researche on the pathogenesis of diabetic complications mainly focus on oxidative stress and chronic inflammation. In addition, a large number of studies have pointed out that bilirubin has antioxidant and anti-inflammatory effects. Therefore, bilirubin and diabetic complications are closely linked.

Objective To observe the clinical effect by using insulin detemir therapy in children and adolescents with type 1 diabetes mellitus(T1DM).Methods Thirty children and adolescents with T1DM were divided into 2 groups to receive Humulin R and Determir(observation group,n =15) or Humulin R and neutral protamine hagedorn (NPH) (control group,n =15)insulin therapy.Daily insulin dose,glycemic variability,incidence of non-severe and severe hypoglycemia events after the institution of insulin therapy were collected.Results The daily doses of insulin were (1.16 ± 0.30) U/kg in the observation group and(1.21 ± 0.35) U/kg in the control group,respectively.There was no clinically important change between 2 groups(t =0.526,P ＞ 0.05).Within-subject variation in fasting plasma glucose was significantly lower in observation group(29％)than that in control group(65％) (t =5.296,P ＜0.01).One case of severe hypoglycemia event occurred in the observation group,but 5 cases occurred in the control group(t =4.863,P ＜ 0.0l).Two cases of nocturnal hypoglycaemia(22:00-7:00) events occurred in the observation group,7 cases occurred in the control group(t =4.506,P ＜ 0.01).Conclusions Institution of insulin detemir therapy is associated with low within-subject variation in fasting plasma glucose and decreased rates of severe and nocturnal hypoglycemia while dose of insulin did not increase.This makes insulin detemir a valuable new tool for the treatment of children and adolescents with T1 DM.

Objective To establish a method for determination of copper, manganese and cadmium in human urine by transversely heated GFAAS.Methods Matrix modifiers were used and background absorption was deducted, copper, manganese and cadmium in human urine were determined by transversely heated GFAAS after digestion.Results 5 g/L Mg(NO3)2 was taken as the matrix modifier when copper and manganese were determined and 0.3 g/L Mg(NO3)2 and 5 g/L NH4H2PO4 was taken as the matrix modifier when cadmium was determined.Under the designed standard conditions, the detection limits of copper, manganese and cadmium were 0.028-0.060 ?g/L;RSDs were 1.1%-5.1%;Recovery rates were 94.2%-107.5%.Conclusion The method is simple, accurate and sensitive, and is applicable to the determination of copper, manganese and cadmium in human urine.

ObjectiveTo investigate and analyze the influence of modified admission education on im-provement of satisfaction degree of patients with coronary heart disease. Methods300 patients with coronary heart disease were randomly divided into the observation group and the control group with 150 cases in each group after admission. The observation group adopted diversified admission education, while the control group received simple education style, the satisfaction degree of both groups was compared. ResultsThe satisfac-tion degree of the observation group was higher than that of the control group. ConclusionsAdoption of di-versified admission education is beneficial to improve the satisfaction degree of patients, increase their cognition degree, thus make patients cooperate with treatment and nursing better and facilitate their rehabilitation.

Objective:To study the possible therapeutic mechanisms of triptergium wilfordi in treating glomerulonephritis.Methods:Thirty seven patients with IgA nephropathy were detected urine mononeuclear cells densities with flow cytometry during taking triptergium wilfordi tablets,30 healthy people were used as normal control.Results:The patients urine CD3 +?CD4 +?CD8 +?CD14 + and CD44 + cells densities were much higher than normal control's,but obviously decreased after triptergium wilfordi treatment.CD4/CD8 ratio was much lower in patients than in normal control.It increased markedly after treatment.Patients who reached remission initially had a lower CD4 + cell percentage and higher CD14 + cells percentage than those showed no response to triptergium wilfordi treatment.Conclusion:Triptergium wilfordi could modulate kidney immune cell function and adhesive molecule CD44 expression.Its effects were associated with renal immunity.

OBJECTIVE:To establish a method for the dissolution determination of Tamibarotene tablet. METHODS:HPLC was performed on the column of Diamonsil C18 with mobile phase of methanol-water-acetic acid(85∶15∶1,V/V/V)at a flow rate of 1.0 ml/min,detection wavelength was 235 nm,column temperature was 25 ℃,and injection volume was 20 μl. The paddle method was used to determine the dissolution,using pH6.8 phosphate buffer dissolution as medium,medium volume was 900 ml,the rotat-ing speed was 50 r/min,taking samples after 60 min. RESULTS:The linear range of tamibarotene was 0.801-2.804 μg/ml (r=0.999 6);RSDs of precision,stability and reproducibility tests were lower than 3%;recovery was 99.58%-100.90%(RSD=0.25%,n=9);the accumulative dissolution rate of 3 batches of samples was 98.25%,96.54%,92.38%(n=6). CONCLUSIONS:The method simple,accurate with high sensitivity and specificity,and suitable for the dissolution determination of Tamibarotene tablet.