In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.

Objective To investigate the effect of levosimendan on pulmonary artery pressure in patients with pulmonary hypertension undergoing mitral valve replacement.Methods Twenty-four ASA Ⅱ or Ⅲ and NY-HA class Ⅱ or Ⅲ patients,aged 35-60 yr,with mean pulmonary artery pressure (MPAP) ＞ 30 mm Hg,undergoing mitral valve replacement were randomly divided into 2 groups (n =12 each):control group (group C) and levosimendan group (group L).In group L,a loading dose of levosimendan 24 μg/kg was injected intravenously after aortic unclamping,followed by infusion of levosimendan at a rate of 0.2 μg· kg-1 · min-1 until 1 d after operation.Group C received the equal volume of normal saline.HR,MAP,MPAP,pulmonary capillary wedge pressure (PCWP),cardiac index (CI) were recorded at 5 min after induction (T0),at the end of CPB (T1) and at 1 h after operation (T2),and the pulmonary vascular resistance (PVR) and rate-pressure product (RPP) were calculated.The improvement in pulmonary hypertension was recorded.Results PCWP was significantly lower and CI higher at T1,2 in both groups,and HR was significantly higher at T1,2 and MPAP lower at T2 in group C,and MPAP and PVR were significantly lower at T1,2 in group L than at T0 (P ＜ 0.05).HR,MPAP and PVR were significantly lower and CI was significantly higher at T1,2,RPP was significantly lower at T2 and the improvement in pulmonary hypertension was higher in group L than in group C (P ＜ 0.05).Conclusion Levosimendan can improve pulmonary hypertension without increasing the myocardial oxygen consumption and with a significant increase in myocardial contractility in patients with pulmonary hypertension undergoing mitral valve replacement.

There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China,whereas researches on children from urban low-income families are scarce.This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China.There were 169 children aged 25-60 months recruited from Xiangtan and Jilin,two cities with a population of 2.81 million and 4.26 million respectively,in China in this cluster cross-sectional study.Data were collected on demographic and socioeconomic characteristics,the feeding practices and the incidence of anemia and diarrhea.The results showed that the prevalence of low birth weight and macrosomia was 7.l％ and 9.5％ for the two cities,respectively,which was higher than that for other cities in China (1.5％ and 5.9％).Of all the sampled children,14.6％ and 8.2％ suffered anemia and diarrhea,respectively.Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia (OR=4.9).Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence (OR=1.4).In conclusion,the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high.The growth and nutritional status of these children is greatly affected by feeding practices.A series of measures should be taken by relevant government departments to improve the health of these children.

Objective: To compare the effects of pericardium patch aortoplasty and pulmonary patch aortoplasty for treating the infants with aorticcoarctation (AC) combining hypoplastic aortic arch in order to provide a better surgical choice in clinical practice.
Methods: A total of 57 patients with AC combining hypoplastic aortic arch treated in our hospital from 2009-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups: Pericardium patch aortoplasty group,n=26 and Pulmonary patch aortoplasty group,n=31. The changes of the pressure gradient at post-operation and follow-up period were compared.
Results: There were 2/57 (3.5%) patients died, 1 in Pericardium patch aortoplasty group by pulmonary hypertension crisis, the other 1 in Pulmonary patch aortoplasty group by respiratory distress syndrome. No renal failure or neurological complication occurred in neither groups. The cardiopulmonary bypass time, aortic clamping time, ventilator time and ICU stay time were similar between 2 groups,P>0.05. Selective cerebral perfusion time in Pericardium patch aortoplasty group was shorter than Pulmonary patch aortoplasty group (30.5 ± 8.6) s vs (35.6 ± 10.3) s,P<0.05. By ultrasound estimation, the post-operative AC pressure gradients were decreased than they were before, as in Pericardium patch aortoplasty group (9.5 ± 7.5) mmHg vs (39.9 ± 15.5) mmHg and in Pulmonary patch aortoplasty group (11.8 ± 11.3) mmHgvs (39.2 ± 14.5) mmHg, bothP<0.05; while post-operative pressure gradients were similar between 2 groups,P>0.05. Follow-up study was conducted in 51 patients for (17.6 ± 16.6) months, Pericardium patch aortoplasty group had 6 patients with re-stenosis, 3 of them would receive balloon angioplasty and 3 would be continuously followed-up; Pulmonary patch aortoplasty group had 6 patients with re-stenosis, 2 of them ifnished balloon angioplasty and their pressure gradients were obviously decreased, 4 would be continuously followed-up. Kaplan-Meier curves presented that Pulmonary patch aortoplasty group was superior to Pericardium patch aortoplasty group in re-stenosis occurrence during follow-up period.
Conclusion: Both pericardium patch aortoplasty and pulmonary patch aortoplasty were effective for treating the patients with AC combining hypoplastic aortic arch, the early post-operative efifcacy was similar, while the mid-term follow-up result was better in pulmonary patch aortoplasty.

The brown slime inside pipeline of the polluted mineral waters well was analyzed. It was confirmed that the brown slime was a biofilm formed mainly by growth of bacteria contaminant, using microscope analysis. After treated with HCl, the brown crystals and mycelioid matter presented in slimes disappeared. It was verified these were metal deposits. The samples produced Prussia blue deposits by dropping K 4Fe(CN) 6 and HCl, which proved that the metal deposits were iron compound. Also it was believed the biofilm was produced by growth of iron bacteria, mixed with deposits of iron compound. The iron bacteria have been isolated from the slimes and cultured in the laboratory. The colony on agar plate also produced Prussia blue deposits after treated with K 4Fe(CN) 6 and HCl. The cells form of pure culture was the same as that in the samples by electronmicroscope analysis. Therefore, It indicated that the bacteria on biofilm inside pipeline were iron bacteria mainly.

Objective To investigate the changes and significance of concentration of soluble intercellular adhesion molecule-1(sICAM-1) in cerebrospinal fluid (CSF) of bacterial meningitis(BM) in rabbits. Methods A total of 36 rabbits were randomly divided into m eningitis group, meningitis cefotaxime-treated group and control group. BM indu ced by escherichia coli(Ec) via cerebellomedullary cistern inoculated. Normal sa line was injected in control group. CSF was sampled in different time. The conce ntration of CSF sICAM-1 was detected by ELISA.Results 1.There was a low concentration of sICAM-1 in CSF in 85 percent of normal rabbi ts.2.In meningitis group, there was a sharp rise in the concentration of CSF sIC AM-1 at 6 hours after Ec was inoculated, reached a peak level at 12 hours, and t here was higher concentration of CSF sICAM-1 between 6 and 24 hour than that at 0 hour.3.In meningitis cefotaxime-treated group, the concentration of CSF sICAM -1 at 6 hour and 12 hours was similar to meningitis group, the time that get pe ak level was at 24 hours that at 12 hours after making use of antimicrobial agen t.The peak level was higher than meningitis group. The concentration of CSF sICA M-1 decreased markedly at 48 hours that made use of antimicrobial agent 36 hour s later,but the concentration was still higher than the peak level of meningitis group.Afterwards, with the time of making use of antimicrobial agent lengthened ,the concentration of CSF sICAM-1 decreased gradually.4.Experimental results in dicated by correlating analysis to these data that there was positive correlatio n in the concentration of CSF sICAM-1 with the brain water content.Conclusions sICAM-1 participates in the pathological process of BM, and contributes to the damage of blood brain barrier and the formation of brain edema.There is importan t significance that drugs which can resist the discharge of sICAM-1 will be impl ied. J Appl Clin Pediatr,2005,20(2):163-165

OBJECTIVEIntends to create mathematical model and analysis of correlation between Chinese medicinal characteristics and immunoregulatory activity based on literature informatics.

METHODThe numbers of the Chinese medicines with immune effects were worked out within the framework of "The China Pharmacopeia" of 2005 edition, from the literature publicized since 1980. The correlation and mathematical model were figured out between Chinese medicinal characteristics including biological classification, different tastes, channel tropism as well as the parts used and immunoregulatory activity based on the statistical software SPSS.

RESULTThe results showed that the immunoregulatory activity was related to the five tastes of Chinese medicines, and the pungent medicines had less immune effect. The Chinese medicines of underground parts had more immune effect compared with other parts of the medicine. Medicines acting upon heart and kidneys were more powerful as for the immune effects (P <0.05). The coincidence was 74.7% between mathematical computing and original classification.

CONCLUSIONThere are correlations,between Chinese medicinal characteristics and immunoregulatory activity. The mathematical model based on these results can be used for immunopharmacology.

Adjuvants, Immunologic ; isolation & purification ; pharmacology ; Databases, Factual ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Models, Theoretical ; Plants, Medicinal ; chemistry ; classification

OBJECTIVESTo investigate the value of R2*map for quantitatively tracing superparamgnetic ironoxides (SPIO) labeled endothelial progenitor cells (EPCs).

METHODSThe EPCs were isolated from Balb/c mice bone marrow and cultured in vitro. After 7 days, expression of acetylated low-density lipoprotein (acLDL) and Ulex europaeus agglutinin-1 (UEA-1), two markers of EPCs, was observed by double staining using fluorescence microscope, the expression of stem cell antigen-1 and vascular endothelial growth factor receptor-2 (VEGFR-2) was confirmed by flow cytometry. EPCs were labeled by incubating with 50 microg/ml SPIO and 6 microl/ml lipofectamine2000, SPIO labeled EPCs were observed under transmission electron microscope (TEM). Labeled and unlabeled EPCs were mixed with 10 g/L agarose and scanned using a 3.0T MR scanner, R2* map and R2 map images were obtained on workstation.

RESULTAfter 7 days of in vitro culture, most of the cells showed characteristics of EPCs. There was no morphological difference between SPIO labeled EPCs and unlabeled EPCs. R2* and R2 values exhibited a linear correlation with the number of labeled cells in the agarose gel. Compared to R2, R2* was a better indicator of the number of labeled cells.

CONCLUSIONMR R2* map can be used to trace SPIO labeled EPCs quantitatively.

Animals ; Cells, Cultured ; Endothelial Cells ; cytology ; Ferric Compounds ; chemistry ; Magnetic Resonance Imaging ; methods ; Magnetics ; Mice ; Mice, Inbred BALB C ; Nanoparticles ; chemistry ; Stem Cells ; cytology

Objective To investigate the epiderniology of fungemia and provide evidence for clinical therapy.Methods A retro- spective survey was done with the 31 cases of fungemia in our hospital from August 2004 to November 2005.Results More than 80% of the patients suffered from two and more underlying diseases.Over a half of infections developed following placement of catheters.And 83.9% of the patients had a history of antimicrobial agents use before blood culture.The pathogens of 24 (77.4%) cases were associated with Candida spp.Only 3 strains were C.albicans.The mortality rate of candidemia was 45.8%.Different Candida species had different resistance rates to antifungal agents.Conclusions Fungemia patients often have serious underlying diseases.Most fungemia cases were candidemia caused by non-C.albicans.Some fungal pathogens are re- sistant to fluconazole and itraconazole.

BACKGROUNDCompensatory sweating (CS) is one of the most common postoperative complications after thoracic sympathectomy, sympathicotomy or endoscopic sympathetic block (ESB) for palmar hyperhidrosis. This study was conducted to examine the relevance between CS and the sympathetic segment being transected in the surgical treatment of palmar hyperhidrosis, and thus to detect the potential mechanism of the occurrence of CS.

METHODSBetween October 2004 and June 2006, 163 patients with primary hyperhidrosis were randomly divided into two groups, T(3) sympathicotomy (78 patients) and T(4) sympathicotomy (85), who were operated upon under general anesthesia via single lumen intubation and intercostal video-mediastinoscopy (VM).

RESULTSNo morbidity or mortality occurred. Palmar hyperhidrosis was cured in all patients. Follow-up (mean (13.8 +/- 6.2) months) showed no recurrence of palmar hyperhidrosis. The difference of rates of mild CS in groups T(3) and T(4) was of no statistical significance. The rate of moderate CS was significantly lower in group T(4) than in group T(3). No severe CS occurred.

CONCLUSIONThe rates of occurrence and severity of CS are lowered with the lower sympathetic chain being transected.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Hyperhidrosis ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Prospective Studies ; Sweating ; Sympathectomy ; adverse effects ; methods ; Thoracic Surgery, Video-Assisted