Objective To investigate the value of salivagram in the diagnosis of pediatric pulmonary aspiration.Methods A total of 469 pediatric patients (age:6 weeks-16 years,average age (4.5±3.1) years;229 males,240 females) underwent salivagram.Signed informed consents were obtained.99Tcm-SC (11.1 MBq,100 μl) was dropped into the root of tongue.After the dropping,the posterior dynamic acquisition was started for 60 min,and then the anterior and posterior static images were acquired for 5 min.All patients were followed up for 3-6 months after the salivagram,and the salivagram results were analyzed.If radioactivity was shown in the main bronchus or bilateral lung fields,the pulmonary aspiration was diagnosed.Results Salivagram demonstrated positive results in 20.7％ (97/469) of the patients.However,3 patients with pulmonary aspiration showed negative results.There was no false positive result on salivagram.Conclusion Salivagram shows good results in the diagnosis of pediatric pulmonary aspiration.

Objective To explore the humanoid figure specialist nursing rounds in the heart of rotation of the role of nurse training. Methods The nurses receiving rotary nurse training from April to October 2013 were set as a control group , in which traditional nursing ward rounds were used. Those during November 2013 to May 2014, were set as experiment group, in which the human figure nursing ward rounds were used. The two groups were compared in terms of satisfaction of inpatients and effects of the nursing ward rounds. Result The level of inpatient′s satisfaction in the experiment group was significantly higher than that of the control group and the effect of nursing ward rounds was significantly better than that of the control group (all P<0.05). Conclusion The nurse′s rotation training on humanoid figure specialist nursing rounds in the cardiology department can improve the inpatients'satisfaction and the effect of nursing ward rounds.

Objective To establish a new method for assessing the effects of environmental factors on human health.Methods Based on the environment part of the frame for comparative risk assessment(CRA) of WHO,the frame and index system for environmental contamination risk assessment which accorded with the situation in China was developed.With the prevalence of different exposure level,RR and the choice of counterfactual scenario,the potential impact fraction(PIF) was estimated.Then an example on the study of liver cancer related with water pollution was used to show the new frame.In this example,the contaminated water was regarded as the environmental factor,incidence of liver cancer was regarded as variable of health,and the analysis was performed with spatial interpolation,counterfactual analysis and CRA theory.Results The quantity of COD of river water in this area was estimated with ordinary Kriging interpolation,and the accumulated exposure of COD was calculated with the trend of annual COD,and the number of population exposed to COD was estimated at same time.In accordance with the different level of pollution and the RR relate to liver cancer,the trend with monotonically increasing showed.At same time,the values of PIF illuminated that 75.72% in male and 66.39% in female would avoid death for liver cancer if the level of contaminated water could be reduced to the level of the control areas.Conclusion The frame includes CRA,spatial analysis and counterfactual analysis is a good approach to assess the health effects of environmental factors.

Objective To evaluate medium-term results in critical limb ischemia (CLI) patients undergoing endovascularly revascularization based on concepts of angiosomes.Methods Clinical data were reviewed on 612 CLI patients who had isolated below-the-knee (BTK)lesions and were treated by endovascular technology from June 2006 to May 2012.Following the angiosome model of perfusion,286 patients (357 limbs)were treated by directly revascularizing the feeding artery.326 patients (455 limbs)were treated by revascularizing non-feeding artery to improve perfusion to ulcer indirectly.Primary endpoints included ulce-healing rate as of 3 months,amputation-free survival( AFS),freedom from major amputation (FFMA) and recurrence rate of CLI.Results During follow-up(mean,24 ± 18 months),ulce-healing rate during 3 months of direct treatment group was obviously higher than that of indirect group (82.4％ vs.66.4％,X2 =26.16,P ＜0.05).The fourth year AFS was 48％ ±5％ vs.37％ ±6％,t =3.44,P ＜0.05,and the fourth year FFMA was 73％ ±4％ vs.58％ ±3％,t =4.61,P ＜0.05.In recurrence rate of CLI,there wasn't significant difference between direct group and indirect group(42％ ±5％ vs.45％ ±6％,t =- 0.64,P ＞ 0.05 ).Conclusions Following the angiosome model of perfusion,direct revascularizing the feeding artery of CLI patients can obviously improve ulcer-healing rate during 3 months,medium-term AFS and FFMA.

Objective To explore the value of neutrophils gelatinases related lipid a carrier protein (NGAL),renal injury molecule-1 (KIM-1) and serum creatinine (SCr) for early diagnosis in adult cardiac surgery after acute renal injury (AKI).Methods Blood and urine samples of 65 cardiac surgery patients before and 24,48,72 h after surgery were collected,SCr,urine NGAL and KIM-1 levels was detected,among whom AKI occurred in 34 cases(AKI group),did not occur in 31 cases (non AKI group),and they were compared with 20 cases of healthy physical examination (control group).Logistic regression model was used to judge the value of early diagnosis of SCr,urine NGAL and KIM-1.Results The incidence of AKI after cardiac surgery was 52.31％ (34/65).The SCr,urine NGAL and KIM-1 levels in AKI group and non AKI group before and 24,48,72 h after surgery were significantly higher than those in control group [SCr:(62.44 ±22.26),(77.38 ±24.38),(98.24 ±25.02),(98.14 ±45.26)μmol/L and (56.67 ±21.68),(59.25 ± 15.58),(55.40 ±22.91),(40.10 ±23.45)μmol/L vs.(16.43 ±5.01)μmol/L;urine NGAL:(4.81 ±0.65),(9.48 ±3.29),(11.87 ±3.93),(7.66 ± 1.52) μg/L and (4.67 ±0.53),(8.89 ± 2.64),(11.46 ± 3.60),(7.47 ± 1.63)μg/L vs.(2.87 ± 0.48) μg/L; KIM-1:(47.93 ± 5.54),(61.89 ± 12.44),(100.21 ± 27.32),(67.69 ± 8.72) μ g/L and (47.12 ± 4.08),(56.38 ± 9.27),(90.14 ± 27.26),(69.40 ±8.90) μ g/L vs.(32.21 ± 12.54)μ g/L] (P ＜ 0.01).Urine NGAL and KIM-1 levels in AKI group and non AKI group 24,48,72 h after surgery were significantly higher than those before surgery (P＜ 0.01).SCr,urine NGAL and KIM-1 levels in AKI group 24 h after surgery were significantly higher than those in non AKI group (P＜ 0.01).Twenty-four hours after surgery,the sensitivity and specificity of urine NGAL,KIM-1 in the diagnosis of AKI,compared with that of SCr had no statistical significance (P ＞ 0.05).Conclusions The adults who accept extracorporeal circulation cardiac surgery appear high incidence of AKI.Twenty-four hours after surgery,early biological markers-urine AKI,KIM-1,has similar sensitivity and specificity with traditional diagnostic gold standard of SCr.

Objective To investigate and compare the actions of vecuronium and atracurium on adult and embryonic-type nicotinic acetylcholine receptors (?-and ?-nAChR) at skeletal muscle cell membrane. Methods The adult and embryonic nAChRs were heterologously expressed in HEK 293 cells. Peak currents induced by actions of vecuronium and atracurium at ?-and ?-nAChR were recorded in HEK 293 cells, using whole cell patch clamp technique. Results Vecuronium and atracurium competitively inhibited ?-and ?-nAChR in HEK 293 cells. The inhibitor concentrations for half-maximal response (IC50) for vecuronium and atracurium ate-nAChR were (8.3 ? 2.6) ?mol/L and (24.2 ? 10.5) ?mol/L respectively; The IC50 values for vecuronium and atracurium at e-nAChR were (55.0 44 28.4) ?mol/L and (183.2 ? 39.2) ?mol/L respectively.Conclusion According to IC50 values for both adult and embryonic type nAChR, vecuronium is more potent than atracurium on e-and 7-nAChR. Embryonic nAChR is less sensitive to vecuronium and atracurium than adult-type nAChR.

Objective To investigate the effects of pancuronium on nicotinic acetylcholine receptors (nAChRs) in pheochromocytoma cells (PC12 cells) and to determine if pancuronium has direct effects on PC cells.Methods PC12 cells (purchased from Institute of Cytology, Chinese Academy of Science) were cultured in DMEM containing penicillin and glutamine. nAChR in PC12 cells were stimulated with different concentrations of Ach ( 10, 30, 100, 300, 1 000 ?mol?L-1 ). Ach-mediated inward currents were recorded using whole-cell patch clamp technique with holding potential set at - 80 mV. To investigate the effects of pancuronium on nAChR in PC cells, the PC12 cells were perfused with different concentrations of pancuronium (0.01,0.1, 1, 10, 100, 1 000 ?mol ? L-1 ) before Ach 1 ?mol?L-1 was added. Results Inward currents were elicited by stimulation of nAChR with Ach in a concentration-dependent manner. 93.7% of nAChRs could be activated by 1 ?mol ? L1 Ach. Pancuronium reversibly suppressed the currents in a concentration-dependent manner compared to the control currents elicited by 1 ?mol?L-1 Ach. 1 ?mol?L-1 pancuronium could almost completely suppressed the currents elicited by 1 ?mol ? L-1 Ach.Conclusion Pancuronium could inhibit nAChR in PC12 cells and reduce catecholamine release.

Objective To explore the correlations between the levels of serum 25 ( OH) D and age, blood sugar, blood lipid, blood pressure and insulin levels in patients with subcortical arteriosclerotic encephalopathy . Methods A total of 100 patientswith subcortical arteriosclerotic encephalopathy ( SAE) and 50 healthy persons were enrolled in the study.ELISA was adopted to determine serum 25(OH)D levels in two groups.Meantime, fasting glu-cose, blood lipid, blood pressure and insulin levels were measured and compared between two groups .Results The systolic blood pressure , diastolic blood pressure , fasting glucose , total cholesterol and insulin levels in SAE patients were significantly higher than those in the healthy control (p<0.05).The serum 25(OH)D levels in SAE patients were significantly lower than that in the healthy control (p<0.01).There were no significant differences in triglycer-ide and lipoprotein between two groups (p>0.05).The serum 25(OH)D levelswere negatively related with age, SBP, DBP and fasting glucose(p<0.05,p<0.01) but not correlative with TC, TG, LDL, HDL, and insulin levels in SAE patients.Conclusion The serum 25(OH)D levels in SAE patients are reducedby playing a regulative role in the occurrence and development of SAE throughaffectingthe energy metabolism .

Objective To assess the depression and cognition function in patients with severe obstructive sleep apnea (OSAHS) , and to study the relationship between the depression and severity of OSAHS, cognition disorders. Methods A total of 74 OSAHS patients (OSAHS group) and 39 normal controls ( control group) which all diagnosed by polysomnography (PSG) were chosen, and they were assessed the state of depression by self-rating depression scale ( SDS) and for cognition disorders by mini-mental state examination ( MMSE ). Results The score of SDS in OSAHS group was significantly higher than that in the control group(P<0.01). In patients with OSAHS , the score of SDS was positively correlated with apnea hyponea index ( AHI) , which was negatively correlated with mean level of SaO_2 ( MSaO_2 ) and the lowest SaO_2 ( LSaO_2 ) (P<0.01 ). The score of MMSE in OSAHS group was significantly lower than that in the control group, which was negatively correlated with AHI(P<0.01) and positively correlated with MSaO_2 and the lowest LSaO_2(P<0.01 ). The score of SDS was negatively correlated with MMSE( r= -0.505, P<0.01). Conclusion OSAHS patients exit depression and cognition disorders, which was correlation to intermitten hypoxemia in frequently.

Objective To retrospectively analyse the adverse reactions and complications of Graves' disease after thyroid arteries embolization.Methods 41 patients of Graves' disease underwent interventional embolization have been analysed with its adverse reactions and complications. Polyvinyl alcohol or bletilla microspheres and micro coils were used in these patients. Results Laryngopharyngeal and neck pain occurred in all patients. T 3 and T 4 increased in 3 days to one week after the procedure. Thirty of them showed fever. Dystopic embolism happened in two cases with one of transitory hypoparathyroidism. No hypothyroidism or hypoparathyroidism or hoarseness occur during long term follow up.Conclusions The adverse reactions and complications of Graves disease after thyroid arteries embolization may occur. Some of them are preventable and curable.