Objective To investigate the value of the E-selectin,IL-6 and TNF-α for the diagnosis of myocardial damage in children.Methods The E-selectin,IL-6 and TNF-α levels were detected in 62 patients with myocardial damage and 62 children without myocardial damage.The values of the E-selectin,IL-6 and TNF-α for the diagnosis of myocardial damage were analyzed by the receiver operating characteristic (ROC) curve.Results E-selectin levels were (45.16 ± 5.34) and (15.37 ± 4.65) μg/L,respectively in the patients with myocardial damage and the control group,and the difference between the two groups was significant(P ＜ 0.001).IL-6 levels were (21.31 ± 5.28) ng/L and (17.09 ± 4.62) ng/L,TNF-α levels were (27.22 ± 8.56) ng/L and(21.46 ± 8.08) ng/L,showing no significant difference (P ＞ 0.05).ROC curve analysis showed that AOC of E-selectin in the diagnosis of myocardial damage was 0.945 with 95％ CI 0.899 ～0.991 (sensitivity:0.801,specificity:0.999,Youden Index:0.800),and the cutoff value was 29.93 μg/L.Conclusion E-selectin can be used as one of the diagnostic indices for myocardial damage in children,which has great diagnostic value.IL-6 and TNF-α are of limited value in the diagnosis of myocardial damage.

Aim To investigate the effects of antioxidant probucol on vascular smooth muscle cells(VSMCs) apoptosis induced by H2O2.Methods H2O2 (1 mmol?L-1) was used to induce VSMCs apoptosis.The VSMCs were treated with probucol(100,10,1 ?mol?L-1) for 6 hours.For the evaluation of apoptosis,Annexin V-FITC staining,Hoechest33258 staining and the TUNEL assay were used.The expressions of ASK-1 and Trx-1 were detected by Western blot analysis.Results H2O2 could promote the apoptosis of VSMCs,increase the expression of ASK-1 and decrease the expression of Trx-1.Probucol could attenuate the apoptosis induced by H2O2 in a dose-dependent,down-regulate ASK-1 expression and increase Trx-1 expression.Conclusion Probucol can antagonize the apoptosis of VSMCs induced by H2O2.The mechanism may be correlated with a decreased expression of ASK-1 and an increased expression of Trx-1.

Objective To study the impact of severe idiopathic pulmonary arterial hypertension (IPAH) on pregnancy outcome and to investigate the effect of multidisciplinary approach during pregnancy on the pregnancy outcome in pregnant woman with severe IPAH.Methods Between March 2007 and November 2013,10 pregnant women with severe IPAH undergoing treatment in Beijing Anzhen Hospital were studied retrospectively.Hemodynamic measurements,medical therapy,manner of delivery,anesthetic administration,multidisciplinary management and outcomes were assessed.Results All 10 cases were first diagnosed at the mean of (24 ± 3) weeks during the pregnancy.The systolic pulmonary artery pressure (sPAP) estimated by transthoracic echocardiography was (95.6 ± 1.3) mmHg (1 mmHg =0.133 kPa).Seven cases of class Ⅲ and 3 cases of class Ⅳ were recorded by World Health Organization functional class.One patient underwent pregnancy termination at gestational age of 21 weeks with no maternal death or complications,nine patients continued pregnancy and all the patients underwent cesarean section.The mean pregnancy length was (31 ± 5) weeks.Nine had cesarean deliveries during continuous epidural anesthesia,and one during general anesthesia.There were three maternal deaths in hospital (5,2,3 days postpartum),and seven patients were alive,and the average hospitalization days was (8 ± 4) days.One fetus lost with cesarean section.Two were term delivery,and seven cases were premature delivery.The average weight is (1 948 ± 731) g and nine were alive and no malformation.Conclusions Because of maternal mortality in patients with severe IPAH remains prohibitively high,patients should continue to be counseled to avoid pregnancy.Women with severe IPAH who become pregnancy should be followed by multidisciplinary approach,and cesarean deliveries during continuous epidural anesthesia are a relatively safe way for pregnancy termination in patients with severe IPAH.

Objective To observe the expression of heparanase(HPA)in kidney of diabetic nephropathy(DN)rats and to investigate the role of HPA in the pathogenesis of proteinuria in DN rals. Methods DM rat models induced by intraperitoneal injection with streptozotocin were constnmted.Twenty-six rats were randomly divided into heahhy control group(n=6),DM6-week group(n=10)and DM 12-week group(n=10).Relative kidney weight(RKW),blood glucose,BUN,Scr,24-hour urine volume and(t 24-hour proteinuria quantilation were measured,and renal morphology was observed after 6 and 12 weeks.The expression of HPA was examined by immunohistochemistry and reverse transcription PCR. Results (1)Conq)ared with the control group,RKW,blood glucose,BUN,24-hour urine volume and 24-hour proteinuria quantitation of DM groups increased markedly(P＜0.05 orP＜0.01).(2)Compared to the control group,the expression of HPA mRNA and protein in DM groups increused significantly(P＜0.01).(3)HPA protein and mRNA were positively correlated with the quantification of urinary prolein (r=0.783,P＜0.01;r=0.793,P＜0.01). Conclusion The increased expression of HPA maybe parlicipate in the pathogenesis of proteinuria in DN.

Objective To study the expression of epidermal growth factor receptor (EGFR) in cervical car-cinoma and cervical intraepithelial neoplasia(CIN),and to elucidate its relation with the genesis, infiltration, metas-tasis and prognosis of cervical carcinoma. Methods EGFR was determined by means of S-P immunohistochemistry in tissue of 100 cases of cervical carcinoma,60 cases of CIN and 40 cases of controls. Results The overexpression rates of EGFR were 0% (0/40), 51.67% (31/60),78.00% (78/100), respectively in normal cervical epithelium, CIN and cervical tumor tissues. The overexpression rate of EGFR was significantly higher in cervical tumor tissue than in control group(P<0.01). The overexpression of EGFR didn't demonstrate significant association with clinical staging, tumor size, pathological type, differentiation, cervical invasion depth, cervical canal invasion, lymphnode me-tastasis or the prognosis of cervical neoplasm (P>0.05). Conclusion Overexpression of EGFR is worsened with the severity of cervical lesion, suggesting that overexpression of EGFR is correlated with the genesis of cervical neo-plasms,which may be a valuable biological indicator of cervical carcinoma,but is not correlated with clinical patho-logical features and prognosis of cervical carcinoma.

Objective To discuss the application of fallopian tube obstructive infertility combine traditional Chinese and western medicine treatment the curative effect and nursing. Methods Selected 100 cases of infertility patients from September 2010 to December 2011 in our hospital. Control group were given oviduct intubation through fluid,observa-tion group in the oviduct intubation through fluidtechnology on treatment of traditional Chinese medicine. The situation of tubal patency in the control group and observation group and the effect evaluation on the patients with anxiety and depression were compared. Results In the control group after treatment, the blocking extent eased, from 86% to 40%, unobstructed degree increased from 5% to 45%, with significant difference before the treatment (P<0.05); Observation group after treatment, the blocking extent eased, from 86% to 40%, unobstructed degree increased from 6% to 88%, with significant difference than before treatment (P<0.05); unobstructed degrees after treatment, the observation group was obviously higher than that of control group, the difference was statistically significant(P<0.05).After treatment, two groups of patients with anxiety and depression were improved, the anxiety and depression of observation group was sig-nificantly lower than the control group,the difference was statistically significant(P<0.05). Conclusion Salpingitis us-ing dredging technology to have certain effect, but combined with traditional Chinese and western medicine treatment of fallopian tube obstruction curative effect is distinct.

Objective: To explore positive psychological wellbeing of outstanding impoverished college students, and to provide reference for targeted mental health education. Methods: By using in depth interview, twenty two outstanding impoverished college students from an undergraduate university in Dongguan were recruited and interviewed during April to May 2021. Results: Qualitative analysis showed 9 characteristics in positive psychological wellbeing among these outstanding impoverished college students:gratitude( n =20), independence( n =15), sincerity( n =13), hard working( n =12), friendliness( n =11), studious( n =11), self cognitive adjustment( n =11), self discipline( n =11) and persistence( n =11), among which gratitude and independence were the core attributes. Factors associated with these positive psychological wellbeing mainly included the following aspects:family related factors [family function( 72.7 %), family teaching(63.6%), family emotional support(59.1%), parental attention in education( 36.4 %)], and family function scored the highest; peer related factors [peer influence(45.5%) and peer emotional support( 45.5 %)]; and teacher related factors [teachers emotional support(40.9%) and teachers teaching(27.3%)]. In addition, other factors such as personal practical experience, national policy support and school atmosphere also had certain impacts. Conclusion Outstanding impoverished college students demonstrate positive psychological wellbeing. It should pay more attention to the positive psychological characteristics of impoverished college students, to explore factors associated with positive psychological qualities from various aspects, to pay attention to the role of social and emotional support, and to implement education to enhance positive psychological traits among impoverished college students.

As a common clinical syndrome, portal hypertension can cause severe complications including gastroesophageal varices, ascites, and hepatic encephalopathy in patients with chronic liver diseases, which indirectly affects the prognosis of cirrhotic patients. At present, hepatic venous pressure gradient (HVPG) is the gold standard for the evaluation of portal hypertension, but its clinical application is limited by invasiveness and high cost. Therefore, the development of noninvasive and accurate measurements for portal pressure is crucial in the diagnosis, risk stratification, outcome monitoring, and prognosis prediction. This article reviews the latest advances in noninvasive examinations of portal hypertension in clinical practice and emphasizes the research and development of noninvasive techniques, HVPG standardization, and precise risk stratification management.

Purpose: Progressive familial intrahepatic cholestasis (PFIC) is a rare genetic autosomal recessive disease caused by mutations in ATP8B1, ABCB11 or ABCB4. Mutational analysis of these genes is a reliable approach to identify the disorder. Methods: We collected and analyzed relevant data related to clinical diagnosis, biological investigation, and molecular determination in nine children carrying these gene mutations, who were from unrelated families in South China. Results: Of the nine patients (five males, four females) with PFIC, one case of PFIC1, four cases of PFIC2, and four cases of PFIC3 were diagnosed. Except in patient no. 8, jaundice and severe pruritus were the major clinical signs in all forms. γ-glutamyl transpeptidase was low in patients with PFIC1/PFIC2, and remained mildly elevated in patients with PFIC3. We identified 15 different mutations, including nine novel mutations (p.R470HfsX8, p.Q794X and p.I1170T of ABCB11 gene mutations, p.G319R, p.A1047P, p.G1074R, p.T830NfsX11, p.A1047PfsX8 and p.N1048TfsX of ABCB4 gene mutations) and six known mutations (p.G446R and p.F529del of ATP8B1 gene mutations, p.A588V, p.G1004D and p.R1057X of ABCB11 gene mutations, p.P479L of ABCB4 gene mutations). The results showed that compared with other regions, these three types of PFIC genes had different mutational spectrum in China. Conclusion The study expands the genotypic spectrum of PFIC. We identified nine novel mutations of PFIC and our findings could help in the diagnosis and treatment of this disease.

Objective To explore the safety and cosmetic effect of nipple-sparing modified radical mas tectomy and immediate tissue expander implantation with single circumaereolar incision.Methods 30 patients were enrolled in Peking Union Medical College Hospital between Jan.2014 and Dec.2015.All the patients were categorized according to surgical incision (single circumaereolar incision group vs double incisions group).Data on clinicopathological parameters,average hospital stay,complications and overall cosmetic effect were retrospectively collected.Data was performed with Chi-square test,Fisher exact test and t-test.Statistical significance was defined as P＜0.05.Results 19 patients were enrolled in single circumaereolar incision group,and 11 patients in double incisions group.There was no significant difference for operation duration (P=0.093) and average hospital stay (P=0.339).After follow-up for 19.1 months,ranging from 8 to 31 months,no patients developed seroma or arm lymphedema.There was no statistical significance between the two groups in terms of sensation in nippleaereolar area (P=0.973),bilateral symmetry (P=0.650) and overall cosmesis (P=0.483).Conclusion single circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation can be one of the preferable surgical procedures with benefits of minimal invasiveness,reliable oncological safety and decent cosmetic effect.