TBX20 gene, a member of the T-box gene family, plays an important role during heart development and is required for maintaining adult heart function.TBX20 can act as both transcriptional activator and transcriptional suppressor during the development of the heart, and shows complex spatiotemporal regulation.TBX20 is an important candidate transcription factor for the pathogenesis of congenital heart disease(CHD), and its mutation or expression change can lead to the occurrence of CHD.In this paper, the latest research progress of TBX20 gene in the field of heart development is reviewed from the relationship between TBX20 and CHD, the signaling pathway involved in heart development and its interactions with other cardiac transcription factors.

Objective To explore the application of monitored anesthesia care (MAC) under the guidance of bispectral index in surgical treatment of chronic subdural hematoma in elderly patients.Methods Sixty patients (33 males, 27 females, aged 65-85 years, ASA physical status Ⅱ-Ⅳ) undergoing sphenotresia drainage of chronic subdural hematoma from March, 2014 to May, 2015 were randomly divided into BIS-guided monitored care anesthesia group (group M) and local anesthesia group (group C).Propofol and remifentanil were intravenously infused into patients from group M to maintain BIS index 65-75, vital signs stability and no movement.Local anesthesia was performed before skin incision for each patient.The frequency of medication, the incidence of adverse events were record.The satisfied degree of sedation and analgesia were also evaluated.Results The frequency of movement, local anesthesia drug and additional use of esmolol, were significantly less in group M than those in group C.The satisfaction degree of sedation and analgesia were significantly higher in group M than those in group C (P<0.05).There was no significant difference of respiratory depression and airway obstruction between the two groups.No nausea vomiting reflex and respiration occurred in all groups.Conclusion Bispectral index guidance can be safely applied in surgical treatment of chronic subdural hematoma in elderly patients, which can supply more sedative and analgesic satisfaction than local anesthesia.

Objective To study the effects of P53, PCNA, Bcl-2 protein and their relationship in salivary adenoid cystic carcinoma(SACC). Methods These proteins were examined by immunohistochemistry. Results Overexpressions of P53 and PCNA were revealed in ACC samples, they were higher than those in (polymorphous adenomas) PA, but expression of Bcl-2 protein was not different between ACC and PA. In 3 subtypes of ACC, expressions of 3 proteins were different. Conclusion Mutations of P53, Bcl-2 may be involed in the occurrence of SACC, expression of PCNA and mutation of P53 may coexist in the development of the SACC.

Objective To discuss the influence of the progress and result in gastic cancer operation through application of neo-adjuvant chemotherapy in multi-disciplinary team (MDT).Methods Clinical data of the patients treated in MDT model 45 cases and non-MDT model(78 cases) were respectively analyzed,and the index about pathologic change,histologic transform and operative result between the two groups were compared.Results In the index of pathologic change,the incidence of abdominal adherence and ascites and pyloric obstruction in MDT model group were obviously less than non-MDT model group( P ＜0.05 ).In the index of histologic transform,texture of mesentery in MDT model group was more fragile than non-MDT model group( P ＜0.05).In the index of operative results,the operative duration and intra-operative bleeding in MDT model group were less than non-MDT model group (P ＜0.05).Conclusion Neo-adjuvant chemotherapy has certain influence in gastric caneer operation,but the successful operations were performed by standard and correct procedures.Therefore,optimizing combined therapy in MDT model and constructing preoperative evaluation system with neo-adjuvant chemotherapy.

Objective To compare the effect and safety of rituximab plus CHOP (R-CHOP) and CHOP regimens for the treatment of newly diagnosed patients with early-stage primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Methods A total of 65 patients with PG-DLBCL were retrospectively divided into two groups: 35 patients were treated with R-CHOP regimen, the others with CHOP regimen. NHL international efficacy assessment and WHO criteria were used to assess the therapeutic and the adverse reactions respectively. Results The complete remission (CR) rate of R-CHOP group was 74.3 % (26/35), which was significantly higher than that of CHOP group [50.0 % (15/30), P< 0.05], but the adverse reactions rates of two groups had no significant difference (P>0.05). The Kaplan-Meier survival analysis showed that the five-year survival rates of two groups had no significant difference (88.6%vs 75.0%, P>0.05). The PFS of R-CHOP group was better than that of CHOP group (94.4 months vs 74.9 months, P< 0.05). Conclusion Compared with CHOP regimen , R-CHOP regimen increases the therapeutic efficacy in patients with PG-DLBCL, and dose not increase the adverse reactions.

Objective:To explore differential diagnosis value of changes of brain natriuretic peptide (BNP) and N ter‐minal pro brain natriuretic peptide (NT‐proBNP) concentrations in patients with dyspnea .Methods :A total of 150 patients with dyspnea at hospitalization were enrolled and divided into cardiogenic dyspnea group (CD group ,n=51) ,pulmonary dyspnea group (PD group ,n=47) and cardiogenic plus pulmonary dyspnea group (CPD group ,n=52) .Another 40 healthy subjects were regarded as normal control group .Concentrations of BNP and NT‐proBNP were observed and compared among all groups before and after treatment .Results:Before treatment ,compared with normal control group , there were significant rise in plasma concentrations of BNP and NT‐proBNP in CD group ,CPD group and PD group ,that of CD group was significantly higher than those of PD group and CPD group , and that of CPD group was significantly higher than that of PD group , P<0.01 all .Before treatment ,the NT‐proBNP content in CD group ,CPD group , PD group were [ (3356.6 ± 321.2) pg/ml vs . (3156.9 ± 239.8) pg/ml vs .(2563.7 ± 234.20) pg/ml] respectively , comparison among three groups , P<0.01 all .Compared with before treatment ,one week after discharge ,plasma concentrations of BNP and NT‐proBNP significantly reduced in CD group ,CPD group and PD group ,the plasma BNP and NT‐proBNP concentrations of CD group were the highest , those of PD group were the lowest ,and those of CPD group were the middle , P<0.01 all .Conclusion:Plasma BNP and NT‐proBNP concentrations are helpful to differential diagnose whether dyspnea belongs to cardiogenic or pul‐monary diseases .

This paper analyzed the moral construction in the prenatal diagnosis of surgical nursing and nursing features, including:strictness and complexity , professional and comprehensive , collaborative, and independence , carry out from the patients with preoperative evaluation , operation and postoperative effect evaluation every link and detail, with the theory of nursing ethics to guide and standardize nursing , dealing with the relation between various ethic, improve patient satisfaction , based on the premise of mutual modern relationship between nurses and pa-tients.

Objective To study the impact of hepatitis B virus (HBV) infection on the activity of cord hematopoietic stem cells. Methods CD34+ cells were isolated from healthy human cord blood by miniMACS. Cells were cultured in IMDM complete culture medium containing stem cell factor (SCF),fms-like tyrosine kinase 3 ligand (FL), thrombopoietin (TPO), interleukin-3 (IL-3) and 10% fetal bovine serum. High copies HBV were added to the culture system. The proliferation of stem ceils and virus replication were observed. Following the proliferation, dendritic cells (DCs) were induced by adding granulocyte-macrophage colony-stimulating factor and IL-4. Morphous of stem cells and DCs were observed by microscope and the cell surface molecules were detected. Results The proliferation of stem cells infected with HBV was significantly lower than that of healthy stem cells (P＜0.01),and enhanced after adding cytokines (P＜0.01). At the same time, HBV replication was increased after adding cytokines in the culture system (P＜0.01), but the proliferation was still lower than that of healthy stem cells with cytokines in the culture medium (P＜0.05). Dane particles were found in the cytoplasma of stem cells infected with HBV by electron microscope. The expression of CD80,CD86 ,CD1a and HLA-DR on DCs derived from HBV infected stem cells were all lower than those on DCs from non-infected stem cells (P＜0.01). Conclusions HBV could infect CD34+ stem cell and the proliferation of the stem cell could enhance the virus replication. HBV could not only inhibit the proliferation of stem cells,but also down-regulate the immuno-phenotype expression of DCs derived from CD34+stem cells.

Objective To investigate the dynamic changes of serum interleukin(IL)-18,IL-1β and copeptin in acute cerebral infarction(ACI),and analyze the relationship with the serious degree of ACI.Methods The levels of serum IL-18,IL-1β and copeptin were measured by Double-antibody sanduicb enzyme-linked immunosorbent assay(ELISA)in 83 patients with ACI who were admitted to the hospital within 24 h,and neurological impairment were evaluated by European stroke scale(ESS)at the 1st,3rd and 7th day respectively after hospitalization.At the same time,the patients with ACI were compared with 32 normal adults.Results The levels of serum IL-18,IL-1β and copeptin at the 1st,3rd and 7th day after hospitalization were(131.30±31.62),(168.30±28.12),(141.26±24.23)ng/L,(0.35±0.04),(0.82±0.10),(0.52±0.21)μ g/L,and(3.64±0.26),(4.18±0.53),(3.26±2.41)μ g/L respectively.There were significant differences among different times respectively(P＜0.05),furthermore they were higher than those in normal adults[(119.12±27.42)ng/L,(0.21±0.08)μ g/L,(2.63±0.23)μ g/L](P＜0.05).Univariate Logistic regression analysis showed that age,copeptin,IL-18,IL-1β and ESS score was the influencing factor in the serious degree of ACI.There was no significant difference in assessing the serious degree of ACI by receiver operating characteristic(ROC)curve between IL-18 and age,copeptin,IL-1 β,ESS score(P＞0.05).Conclusions The serum levels of IL-18,IL-1β and copeptin are increasing after ACI,indicating that the inflammatory and immune factors may be involved in the development process of ACI.The serum levels of IL-18,IL-1β and copeptin can reflect the serious degree of ACI.

OBJECTIVE: To examine the value of self-treatment for Posterior canal benign paroxysmal positional vertigo (PC-BPPV). The treatment effect was compared between patients treated with modified Epley in outpatient clinic combined with self treatment at home and patients treated by modified Epley alone. METHOD: A randomized controlled trial were carried out in the Department of Otolaryngology Head and Neck Surgery, the Affiliated Sixth People's Hospital of Shanghai Jiao Tong University from December 2012 to May 2013. 147 out of 150 patients with unilateral idiopathic BPPV-PSC were enrolled in follow-up. Among which, 73 patients were allocated in modified Epley-alone group and 74 were allocated in slef-treatment group. RESULT: The success rate was 53.4% in modified Epley-alone group vs 83.8% in self-treatment group (P < 0.01) after 1 week treatment. In the modified Epley-alone group,the success rate of hand repositioning group and chair-assisted repositioning group was 45.9% vs 61.1% (P > 0.05), the risk rate was 0.752, 95% CI (0.486 - 1.163). In the self-treatment group, the success rate of hand repositioning group and chair-assisted repositioning group was 87.5% vs 81.0% (P > 0.05), the risk rate was 1.081, 95% CI (0.888-1.316). Incidence rate of serious complications was 0% in the modified Epley-alone group and 1.3% in the self-treatment group (P > 0.05). CONCLUSION Complementary self-treatment with modified Epley maneuver treated PC-BPPV sooner and more effectively, Compared with modified Epley maneuver alone. And its incidence rate of serious complications didn't increase. Chair-assisted repositioning showed better result than hand repositioning alone, and self-treatment at home can reduce the effect of the gap. We found that complementary self-treatment with modified Epley maneuver had more benefits for patients with PC-BPPV.
Aged ; Benign Paroxysmal Positional Vertigo ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Positioning ; methods ; Self Care ; Treatment Outcome