AIM: To investigate the mechanisms underlying the protective effect of kidney ischemic preconditioning on rabbit myocardium in case of ischemia-reperfusion and the possible role of oxygen free radicals in the process. METHODS: Animals were divided into four groups: ischemia/reperfusion(I/R), classical ischemic preconditioning(CIPC), kidney ischemic preconditioning (KIPC) and superoxide dismutase in combination with kidney ischemic preconditioning(SOD+KIPC). The endo genous myocardial pretective material, nitric oxide(NO) and 5'-nucleotidase(5'-NT) were checked in four groups. RESULTS: As compared with I/R group, both CIPC and KIPC could ameliorate left ventricular function, reduce plasma PLA 2 activity and arrhythogenic rate also, the myocardial 5'-NT and NO production were significantly higher than that of the rabbit of I/R group. However, the protective effect on rabbit myocardium was significantly weakened by the SOD administration before the ischemic preconditioning. CONCLUSION: Protective effect of KIPC on myocardium may be due to increase in endo genous myocardial protective materials, oxygen free radicals may play an important role in the endo genous myocardial protective material release.

Objective To investigate the influence of comprehensive intervention on improving the quality of life of idiosyncratic infants and young children.Methods A control study Was conducted on 106 idiosyncratic patients aged 6 months to 1 year with specific genetic background,eczema and wheezing under allergen test and comprehensive intervention via a randomized double-blind method.The onset of symptoms and measurement of immunological function were compared after 18 months.Results Serum IgG and IgA increased(all P＜0.05),wheezing and eczema attacks decreased significantly(all P＜0.01),sleep and emotion also improved significantly in the treatment group after 18 months(all P＜0.05).Milk and eggs were the most common allergen for infants and young children.Conclusion Idiosyncrasy and environmental factors were risk factors for allergic diseases.Early childhood was a critical period influencing the occurrence of allergic diseases in children.Early intervention could reduce the incidence of allergic diseases in children and improve the quality of life of idiosyncratic infants and young children.

AIM: To study the relationship between myocardial HSP70 and PKC during myocardial ischemic preconditioning(IPC). METHODS: PKC inhibitor, polymyxin B(PMB) and PKC activator, phorbol 12-myristate 13-acetate(PMA) were applied to the models of myocardial ischemia/reperfusion in vivo and in vitro in rabbits, respectively, and the ventricular functions, PLA 2 in the serum, and the expression of mycardial HSP70 mRNA were examined.RESULTS: IPC decreased PLA 2 activity, improved the left ventricular function and increased the expression of myocardial HSP70 mRNA. Howerer, all these effects of IPC could be blocked by PMB. Interestingly, PMA mimicked IPC with attenuating the injuries of cardial myocytes and increasing myocardial HSP70 mRNA expression. CONCLUSION: PKC is involved in the myocardial HSP70 expression in case of ischemic preconditioning.

AIM To compare the protective effects of norepinephrine preconditioning(NEPC)and ischemic preconditioning(IPC)on myocardial ischemic/reperfused injury in rats in vivo . METHODS Rats were divided into control, ischemia/ reperfusion, classic IPC and NEPC groups. After 20 min reperfusion, several indexes including cardiac function indexes, MDA were tested, the myocardial ultrastr ucture and the injury reaction of catalase observed. RESULTS Both IPC and NEPC could protect myocardial ultra structure, ameliorate left heart function, decrease cardiac MDA content and protect the activity of catalase. CONCLUSION Extra micro norepinephrine preconditioning as a non injury method can mimic the protective effects of classic IPC and shows its clinical values.

Objective To study the effects of dichloroacetate (DCA) on cell colony-forming,cell invasion and cell migration of the bladder cancer cells and to study the underlying mechanism.Methods The bldder cancer cells T24 were randomly divided into two groups:the observation group and the control group.Cells in the observation groups were treated with 5 mmol/L,10 mmol/L and 20 mmol/L dichloroacetate,and the control group was treated with the same amount of dimethyl sulfoxide.Colony formation assays were detected with Giemsa staining.Cell wound scratch assay and Transwell assay were applied to evaluate the ability of the T24 cell invasion and migration.Realtime PCR and Western blot were applied to detect the expression of the epithelial-mesenchymal transition (EMT)-related marker,including E-cadherin,N-cadherin,vimentin,Snail and Slug.Results Compared with the control group,the colony formation assays of T24 cells constantly decreased along with the increased doses in the observation group(P ＜ 0.01).The cell wound scratch assay showed that the scratch width of the observation groups were significantly higher along with the increased doses and prolonged time than that in the control group (P ＜ 0.01).The transwell assay showed that the invasion ability of the observation groups were significantly discreased along with the increased doses than that in the the control group (P ＜ 0.01).The expression levels of E-cadherin mRNA and protein in combination the control group were higher than those in the the observation groups (P ＜ 0.05).However,the expression levels of N-cadherin,vimentin,Snail and Slug mRNAs and proteins in combination the control group were lower than those in the the observation groups (P ＜ 0.05).Conclusion Dichloroacetate can inhibit the colony-forming,invasion and migration of bladder cancer T24 cells,and its mechanism may inhibit the expression of epithelial mesenchymal transition in T24 cells by down-regulating the expression of nuclear transcription factor Snail and Slug.

We reported a case of mosaic trisomy 2.The patient was a 29-year-old gravida who underwent amniocentesis at 20 weeks of gestation because of high risk of trisomy-21 in the first trimester screening.The test result revealed a karyotype of 47,XN,+2[10]/46,XX[40].At 26 gestational weeks,the fetus was found severe fetal growth restriction and oligohydramnios which was considered to be at risk of mosaic trisomy 2.The pregnancy was terminated at 27+ gestational weeks.The fetus had obviously abnormal appearances,including dolichocephaly,low-set ears,and micromandible.Autopsy was not performed due to the parents' refusal.

Objective To study the effect of vaginal delivery on maternal and child outcomes in re-pregnancy patients with scarred uterus after cesarean section.Methods A total of 50 repregnant women after cesarean section in our hospital were as study group,another 50 pregnant women without cesarean section in the same period were selected as control group.The patients in the control group applied vaginal delivery,and the re-pregnant patients after cesarean section in the study group applied vaginal delivery.The incidence of hospital stay,body mass of infants,bleeding volume,puerperium infection rate and infant Apger score,incidences of intracranial hemorrhage,pneumonia and asphyxia were observed and compared.Results There was no significant difference in the hospital stay,neonatal body mass,blood loss,puerperium infection rate,1 min and 5 min Apgar scores between the study group and the control group after delivery (P ＞ 0.05).Meanwhile,there were no significant differences in the incidence of intracranial hemorrhage,pneumonia and asphyxia between the two groups (P ＞ 0.05).Conclusion Vaginal delivery for re-pregnant women after cesarean section had no impact on hospitalization time,infants'body mass,bleed loss volume,puerperal infection rate.So vaginal delivery should be given to re-pregnant women in accordance with vaginal delivery to ensure health of newborns,improve safety of childbirth,so it is worthy of clinical promotion.

Objective To study the effect of vaginal delivery on maternal and child outcomes in re-pregnancy patients with scarred uterus after cesarean section.Methods A total of 50 repregnant women after cesarean section in our hospital were as study group,another 50 pregnant women without cesarean section in the same period were selected as control group.The patients in the control group applied vaginal delivery,and the re-pregnant patients after cesarean section in the study group applied vaginal delivery.The incidence of hospital stay,body mass of infants,bleeding volume,puerperium infection rate and infant Apger score,incidences of intracranial hemorrhage,pneumonia and asphyxia were observed and compared.Results There was no significant difference in the hospital stay,neonatal body mass,blood loss,puerperium infection rate,1 min and 5 min Apgar scores between the study group and the control group after delivery (P ＞ 0.05).Meanwhile,there were no significant differences in the incidence of intracranial hemorrhage,pneumonia and asphyxia between the two groups (P ＞ 0.05).Conclusion Vaginal delivery for re-pregnant women after cesarean section had no impact on hospitalization time,infants'body mass,bleed loss volume,puerperal infection rate.So vaginal delivery should be given to re-pregnant women in accordance with vaginal delivery to ensure health of newborns,improve safety of childbirth,so it is worthy of clinical promotion.

Objective To explore the effects of nursing human resources training and performance appraisal information management in a grassroots hospital. Methods From January 2017, Beilun branch hospital, the First Affiliated Hospital of Zhejiang University, carried out self-developed nursing human resources training and performance appraisal information management. We selected 50 nurses before information management (between July to December 2016) and 50 nurses after information management (between January to June 2017) as subjects. And then, we compared the theoretical examination achievements, operation examination achievements, the score of nursing quality and satisfaction with training of nurses before and after implementation. Results After information management the scores of theoretical examination achievements, operation examination achievements, the score of nursing quality of nurses were (93.48±1.95), (94.98±1.87) and (95.43±1.05) respectively higher than those before information management with significant differences (t=17.088, 18.035, 20.392;P<0.01). The satisfaction rate of nurses increased from 64.00% to 96.00% with a significant difference (χ2=16.000,P<0.01). Conclusions The application of information management in nursing human resources training and performance appraisal in a grassroots hospital can improve theoretical and operation examination achievements, increase satisfaction with training of nurses and improve nursing quality. It is worth to be popularized and applied in grassroots hospitals.

Objective:To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis.Methods:From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis.Results:(1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent ( κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95% CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher ( RR=4.16, 95% CI: 2.38-7.14; RR=2.38, 95% CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups ( P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions:Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.