Objective:To identify the differentially expressed genes and pathways of minimal change disease (MCD) by bioinformatics analysis, and to explore the pathogenesis of MCD.Methods:The gene expression omnibus (GEO) under the National Center for Biotechnology Information (NCBI) platform of the United States was used, and the data chips GSE104948 and GSE104954 containing MCD information were selected. The data set contained the gene expression array data of 19 cases of MCD renal biopsy tissue and 36 cases of normal renal tissue. The online tool GEO2R was used to analyze data and screen differentially expressed genes, and DAVID 6.8 database was used to perform GO and KEGG functional enrichment analysis of differentially expressed genes and network analysis of genes involved in metabolic pathways. The String 11.0 database and Cytoscape 3.7.2 software were used to analyze the relationship between MCD differentially expressed genes and perform visual analysis. At the same time, the CytoHubba plug-in was used to analyze the degree of association of protein interaction networks and screen key expressed genes.Results:A total of 302 highly expressed differentially expressed genes were identified by online tool GEO2R. GO analysis showed that the products of these differential genes were mostly located in the extracellular matrix, exosomes, pernucleus and other regions, exerting cell adhesion molecule binding, deoxycytidine deaminase activity, protein homodimerization activity, 2'-5'-oligoadenylic acid synthase activity and other functions, as well as participating in the formation of extracellular matrix, cell lysis, cell apoptosis, inflammatory response, immune response and other biological processes. KEGG analysis showed that differentially expressed genes were enriched in local adhesion, NOD-like receptor and other signal pathways. Combining the results of GO analysis and Cyto Hubba analysis, the PYCARD gene was screened out as the key gene that induced the inflammatory response in MCD kidney. Conclusions:The inflammatory response may be involved in the occurrence and development of MCD, and the PYCARD gene may be a key gene in the induction of inflammatory response in MCD.

Objective To evaluate early and mid-term results in infants,weighing less than 2 500 g,who underwent early cardiac surgery on cardiopulmonary bypass (CPB).Method Since November 2003 to December 2007,28 consecutive infants of less than 2 500 g underwent early cardiac surgery on CPB in Children's Hospital Affiliated to Fudan University.Sixteen infants were male,and 12 infants were female.The mean pregnancy period was 34 weeks (30 to 41 weeks) ,and 14 patients were premature,and the mean birth weight was 2 010 g(1 370-2 500 g).Mean age at operation was 27.46 d (range 1～61 d),and mean weight was 2 391 g (range 1 500～2 500 g).Deep hypothermia circulatory arrest was used in 9.Indications for surgery were:ventricular septal defect (10 infants),transposition of great arteries (6 iofants),totally anomalous pulmonary venom return (5 infants),pulmonary atresia with intact ventricular septum(2 infants),coarctation of aorta (1 infants) ,interrupted aortic arch (1 infants),cortriatriatum(1 infants),abnormal original of fight pulmonary artery (1 infants).Resuits Two (7.14%) infants died after operation at early phase.Mean duration of mechanical ventilation and intensive care unit stay were 113.9 h and 14.4 d,respectively.During follow-up (mean 16.87 months),one died.Two patients needed reintervention.About 84.4% infants didn' t need reintervention at the end of 12-month followup.Conclusions If medicine is aseless,infants woth low birth weight and congenital heart defect can obtain satisfactory outcome after CPB.Perioperative proration for virtual organs should be payed attention to.

Objective A retrospective study was undertaken to evaluate the outcomes of the newborns with pulmonary atresia with intact ventricular septum(PAIVS),in order to delineate strategies for the optimal management of PAIVS. Methods From July 2003 to July 2008,17 neonates with PAIVS underwent surgical treatment.The mean age at operation was(1 5.6±8.6)d and the mean weight was(3.54±0.44)kg.Initial surgical treatment included:Blalock-Taussig shunt (BT shunt)in 2 cases,closed pulmonary valvotomy and BT shunt in 1 case,right ventricular outlet tract reconstruction(RVOTR)in 2 cases,RVOTR and BT shunt in 11 cases. Results The mean duration of mechanical ventilation and intensive care unit stay were(35.5±35.1)h and(8.7±5.9)d,respectively.Two early deaths were reported inside the hospital(2/17,11.8%).Multivariable analysis demonstrated that mechanical ventilation before surgery was the risk factor for in-hospital mortality(r=1.02,P<0.01).The rest 15 cases were followed up with the average time of 19 months(2 months to 5 years)and no death was reported. Conclusions Neonates with PAIVS should be operated early.Individualized treatment strategy and regular follow-up are helpful to achieve better short-term outcome.

Objective To compare the efficacy of inhaled Iloprost and nitric oxide( NO)in infants with moderate or severe pulmonary hypertension(PH)after congenital heart disease surgery. Methods This was a prospec-tive randomized study in Children's Hospital of Fudan University from January 2011 to January 2014,including 40 in-fants who suffered from moderate to severe PH after heart surgery. Their ages ranged from 1 to 24 months. Their weight ranged from 3. 2 to 11. 0 kg. They were randomly allocated to inhale NO( NO group,n = 20)or Iloprost( Iloprost group,n = 20). Iloprost group was given Iloprost with 50 ng/(kg·min)for 10 min and then combined with NO 20 × 10 - 6 for 10 min;NO group was first given 20 × 10 - 6 of NO for 10 min,then combined with Iloprost 50 ng/(kg·min) for 10 min. Heart rate,systolic blood pressure,pulmonary artery pressure(PAP)and central venous pressure were recor-ded continuously. At the same time,the concentration of nitrogen dioxide and methemoglobin after inhaling NO was de-tected. Results Inhaled Iloprost and NO caused significant reduction in PAP(t = 4. 670,P = 0. 009;t = 3. 762,P =0. 004)and pulmonary - to - systemic pressure ratio(Pp/ Ps)(t = 16. 974,P = 0. 000;t = 9. 682,P = 0. 000)but signifi-cant increase in oxygen index separately. The combination had no additional effect compared with single application. In term of the reduction of PAP,there was no significant difference between inhaled Iloprost and NO(F = 2. 742,P =0. 129). The levels of nitrogen dioxide and methemoglobin were not above the normal limits. Conclusions Moderate to severe PH after cardiac surgery was significantly reduced by inhaled NO and Iloprost. They had similar effects. However, the combination of both vasodilators failed to prove more potent than either substance alone. Compared with the potential toxicity of NO,the individual differences and the complex transmission,Iloprost may be more reasonable and feasible for the postoperative treatment of PH.

Objective To explore the relation of early time secretion function of Beta cell in newly diag-nosed type 2 diabetic patient and the changes of body weight following intensification therapy of insulin. Methods 237 newly diagnosed type 2 diabetic patients were divided into 1 kg lower group, the 1-5 kg group, the 5 kg above group. The maximum body weight and waist circumference were recorded. The present body weight and waist circum-ference were measured according to OGTT study, meanwhile,30 minuets blood sugars, the insulin and the C-peptide (C-P) level and the blood pressure(BP) and the insulin resistance index (HOMA-IR), the early insulin secretion index (△I30/△G30) was calculated. All cases were treated for 14 days. Results Early time secretion function of Beta cell in the group keeping above lose weight 5 kg was the worst, after treatment insulin secretion level were in-creased 1.12 times and 1.86 times in 1 kg lower group than in the 1-5 kg group and above 5 kg group. Conclusions Early time secretion function of Beta cell in newly diagnosed type 2 diabetic patient is correlated with the maxi-mum body weight decrease.

Objective:To observe the effects of moxibustion pretreatment on Glutathione Peroxidase(GSH-Px),Superoxide Dismutase(SOD),and Malondialchehyche(MDA)in gastric mucosa of rats with stress ulcer,and to investigate the mechanism of moxibustion pretreatment preventing the oxidized injury of gastric mucosa.Methods:Forty-eight healthy SD rats were randomly allocated into 4 groups,namely control group,model group,acupoint moxibustion group,and non-acupoint moxibustion group.The ulcer model was developed by restraint and water immersion stress,Ulcer index(UI)was calculated with Guth method,and the contents of GSH-Px,and MDA and SOD activity in the gastric tissues were measured with chromatometry method.Results:Compared those in the model group and nonacupoint moxibustion group,moxibustion at Zusanli(ST 36)could decrease the UI(P<0.01)and MDA(P<0.05)contents,and increase the activity of GSH-Px(P<0.01)and SOD(P<0.05).Conclusion:Pretreatment of moxibustion at Zusanli(ST 36)could promote the recovery of gastric injury in rats induced by restraint and water immersion stress by enhancing the activity of GSH-Px and SOD,and lower MDA content.

Objective Through observing the clinical effect and the changes of gastrointestinal hormones caused by the treatment of different moxibustion time of the superficial gastritis patients due to the spleen and stomach weakness,to investigate the regulation of the dose-effect relation and the adjustment function on gastrointestinal hormone of serum of patients caused by the warming and nourish effect with moxibustion.Methods Eighty-four superficial gastritis Patients due to the spleen and stomach weakness were divided into group 1(treated by warming moxibustion for twenty minutes)(n=28),group 2(treated by warming moxibustion for forty minutes)(n=28),and drug(n=28)groups.The changes of the content of the Prostaglandin E2(PGE2)、Somatostatin(SS)and Epidermal growth factor(EGF)were observed before and after treatment between 3 groups and the clinical effect in different time.Results ①All 3 groups were compared after treatment,their clinical effect had no significant difference(P＞0.05):②Compared with pre-treatment,the superficial gastritis symptom score had a very significant difference after the treatment(3.07±1.54)、(3.11±1.40)、(3.79±2.25)and during the 1 month follow-up(2.25±1.32)、(2.57±1.10)、(4.11±2.48),(P＜0.01);③After treatment,the content of the PGE2 of the serum was increased obviously,compared with pre-treatment.There was a significant difference in each group(33.751±1.267)pg/ml、(33.774±8.583)pg/ml、(32.583±8.259)pg/ml,(P＜0.05);After warming moxibustion for forty minutes,the content of the EGF of the serum was increased obviously,compared with pre-treatment,showing a significant difference(1.331±0.823)pg/ml,(P＜0.05).Conclusion ①All of the three treatment methods had significant curative effect,and the curative effect had no significant difference among these 3 groups.But the moxibustion groups were markedly higher than the drug group in long-term result;②The moxibustion had established adjustment function on gastrointestinal hormone of the superficial gastritis patients due to the spleen and stomach weakness,which suggested that the gastrointestinal hormone may participate in its onset and the process of pathology and physiology.

Objective: To observe the effect of electroacupuncture (EA) on the electrogastrogram and gastric antrum ghrelin in rats with diabetic gastroparesis (DGP). Methods: Fifty Sprague-Dawley (SD) rats were randomly divided into group A, group B, group C, group D and group E, 10 rats in each group. Group A was the blank control group without intervention. Group B, Group C, Group D and Group E were treated with single dose intraperitoneal injection of 2% streptozotocin (STZ), combined with 8-week high glucose and high fat diet to establish DGP rat models. Group B was the model group without treatment. Group C was the EA at acupoint group, was treated with EA at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6). Group D was the EA at non-acupoint group, was treated by EA at the control points of Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6). Rats in the metoclopramide control group received 1.7% metoclopramide solution [10 mL/(kg·bw)] by gavage. Rat's blood glucose level was measured by blood glucose meter; gastric emptying rate was detected using phenol red as a marker; the electrogastrogram was detected by BL-420F biological function system; the protein level of ghrelin was detected by enzyme-linked immunosorbent assay (ELISA); the expression of ghrelin mRNA was detected by real-time polymerase chain reaction (RT-PCR). Results: Compared with group A, the blood glucose of group B, C, D and E were significantly increased before and after the treatment (all P<0.01); after treatment, the gastric emptying rate of group B was significantly decreased (P<0.01), the migration rates of small intestine in group B, C, D and E were significantly lower (all P<0.01), and the protein content of ghrelin in group C was significantly decreased (P<0.01); the expressions of ghrelin mRNA were significantly increased in group B, C, D and E (all P<0.01), the mean amplitudes of electrogastrogram in group B and D were significantly decreased (both P<0.01). After treatment, compared with group B, the blood glucose of group C was significantly decreased (P<0.05), the gastric emptying rate and small intestine migration rate were significantly increased in group C and E (P<0.05, P<0.01), the small intestinal migration rate was significantly increased in group D (P<0.05), the expression of ghrelin in protein and mRNA in group C was significantly lower (P<0.01), the expression of ghrelin mRNA in group E was significantly lower (P<0.05), and the mean amplitude of electrogastrogram in group C was significantly increased (P<0.05). After treatment, compared with group D, the protein and mRNA expressions of ghrelin in group C were significantly decreased (P<0.01). After treatment, compared with group E, the protein expression of ghrelin in group C was significantly decreased (P<0.01). Conclusion: EA at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6) could regulate the blood glucose level of DGP model rats, enhance electrogastrogram activity, promote gastric emptying, and regulate ghrelin expression in protein and mRNA.

This study summarized the nursing experience of 2 pediatric heart transplant surgeries.Perioperative care included preoperative maintenance of cardiac function,volume management,infection prevention measures,and psychological preparation.Early postoperative care involved circulatory monitoring,management of right heart dysfunction,use of immunosuppressants,observation of rejection reactions,control of postoperative infections,nutritional support,psychological care,and home continuity care.The postoperative rehabilitation effect of the children is satisfactory after multi-team special treatment and nursing care.The postoperative hospitalization time for the 2 patients were 20 and 30 days.After discharge,2 patients showed good recovery during follow-up.

Objective : To investigate the changes of α2-macroglobulin in different stages of radiotherapy in patients with nasopharyngeal carcinoma, and to explore its feasibility as a marker of serum markers reflecting radiotherapy injury. Methods : We collected the blood samples of 23 cases of newly diagnosed patients with nasopharyngeal carcinoma before the simple radiotherapy, the 10, 20, 30 and 33 times after simple radiotherapy, detected the α2- macroglobulin levels. The difference among the five stages was analysed by paired t-test using SPSS17.0 software package. Results : The serum level of α2- macroglobulin elevated with the increase of number of radiotherapy. After 10 times’ radiotherapy, the serum α2-MG concentration in patients with nasopharyngeal carcinoma was significantly higher than that before radiotherapy (12.04 ± 5.72 vs. 10.81 ± 5.38 U/L), the difference was statistically significant (t=4.818, P < 0.05). After 20 times’ radiotherapy, the serum α2-MG concentration in patients with nasopharyngeal carcinoma was significantly higher than that before radiotherapy (12.26 ± 5.77 vs. 10.81 ± 5.38 U/L), and the difference was statistically significant (t=5.237, P < 0.001). After 30 times’ radiotherapy, the serum α2-MG concentration in patients with nasopharyngeal carcinoma was significantly higher than that before radiotherapy (12.91 ± 5.55 vs. 10.81 ± 5.38 U/L), the difference was statistically significant (t=6.076, P < 0.05). At the end of radiotherapy, the serum α2-MG concentration in nasopharyngeal carcinoma patients was significantly (13.43 ± 6.05 vs. 10.81 ± 5.38 U/L) higher than that before radiotherapy (t=5.189, P < 0.05). Conclusion The serum level of α2- macroglobulin changes with the radiotherapy, so it can be a serum marker reflecting the damage of maxilla induced by ionizing radiation.