Objective To study the potential effects of telomerase inhibitor on the apoptosis of bladder cancer cells. Methods A phosphorothioate oligonucleotide (PS ODN) with sequence 5′ d(TTAGGG) 3′, as the telomerase inhibitor, was incubated with a bladder cancer cell line EJ. Such treated cells were studied with many approaches for the telomerase activity, the growth status and the morphological changes. Results The PS ODN inhibited the telomerase activity in the cells, arrested the cell growth, and induced the apoptosis of the cells. Conclusions The apoptosis of bladder cancer cells could be induced by PS ODN with 5′ d(TTAGGG) 3′ sequence as a telomerase inhibitor.

Objective To investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI), and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods A total of 231 hospitalized children with acute LRTI were investigated from May 2013 to April 2014. The 5 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction, including respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV) and rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific immunoglobulin E level measured using immunofluorescence experiment was over 0.35 IU/mL. Results RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infections were more prevalent in asthma exacerbations compared to other LRTIs. AV was more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

Objective To identify the risk factors for severe acute lower respiratory infections (ALRI) in children and to provide scientific basis for prevention and treatment of ALRI. Methods Several databases including Pubmed, Databases-Medline (Ovid), Embase, CINAHL and Global Health Library, CNKI, VIP and Wanfang Date were searched (1990.1-2014.12) for references. All selected studies were about risk factors of ALRI in children. The screening and quality evalua? tion of the literature data was conducted independently by two reviewers according to the inclusion and exclusion criteria. Stata 11.0 software was used for Meta-analysis. Results Meta-analysis of 27 included literature showed that seven risk fac?tors were significantly associated with severe ALRI:low birth weight, lack of exclusive breastfeeding, crowded household, ex?posure to indoor air pollution, malnutrition, living in a house with smokers or smoking in pregnant and HIV-exposed unin?fected condition. Conclusion The above seven risk factors play the important role in the development of ALRI in children. Furthermore, it emphasizes the need for further studies investigating other potential risk factors to decrease the possibility of childhood ALRI.

Objective To observe the clinical curative effect of enteral nutrition (EN) liquid rich in omega-3 polyunsaturated fatty acids (ω-3PUFA) for patients suffering from acute respiratory distress syndrome (ARDS) and treated with mechanical ventilation.Methods A prospective study was conducted, 40 patients with ARDS admitted and treated in the intensive care unit (ICU) and respiratory department in the Traditional Chinese Medicine Hospital of Huzhou from May 2007 to October 2016 were enrolled, and they were randomly divided into a study group and a control group, each group 20 cases. The same heat EN support of different prescriptions was given respectively in the two groups, nasal feeding with EN emulsion rich in ω-3PUFA (TPF-T) was applied in the study group, while in the control group, nasal feeding with EN suspension liquid of protein fiber type (TPF) was given, and the target energy established for the two groups was 104.0 - 125.5 kJ·kg-1·d-1. In the two groups, before and after treatment for 7 days, the changes of nutrition indexes [total protein (TP), albumin (ALB)], inflammatory index [C-reactive protein (CRP)], immune indexes (T cell subgroup CD4, CD8 and CD4/CD8), blood gas analysis indexes [arterial blood oxygen partial pressure (PaO2), oxygenation index (PaO2/FiO2)] and mechanical ventilation time, the length of stay in ICU and fatality rate were observed; the occurrences of false aspiration, feeding tube obstruction, high blood sugar, excessive water, diarrhea, constipation, etc. complications related to the process of the treatment were observed in the two groups. Results After treatment, the levels of TP, ALB, CD4, CD4/CD8, PaO2, PaO2/FiO2 in two groups were higher than those before treatment, the levels of CRP and CD8 were lower than those before treatment, and the improvement degrees of indexes in study group were superior to those in the control group [TP (g/L): 59.9±4.8 vs. 58.6±4.1, ALB (g/L): 31.9±3.4 vs. 31.1±4.4, CRP (mg/L): 25.8±18.5 vs. 38.1±24.9, CD4: 0.30±0.05 vs. 0.28±0.04, CD8: 0.21±0.03 vs. 0.19±0.04, CD4/CD8: 1.57±0.39 vs. 1.55±0.42, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 152.7±15.8 vs. 140.6±22.2, PaO2/FiO2 (mmHg): 304.5±32.1 vs. 280.2±44.1]; the survival patient mechanical ventilation time (days: 7.1±2.2 vs. 9.2±3.5) and length of stay in ICU (days: 10.4±2.8 vs. 12.6±3.6) were significantly shorter in study group than those in control group (allP < 0.05), and fatality rate was 15.0%in both groups.Conclusion The EN liquid rich in ω-3PUFA is more beneficial to the recovery of respiratory function than EN of protein fiber type in patients with ARDS, and the former EN also can shorten the mechanical ventilation time and the length of stay in ICU.

Objective To discuss the clinical effects of hemiarthroplasty for the treatment of intertrochanteric comminuted fracture in aged patients.Methods From June 2006 to June 2010,91 cases with intertrochanteric comminuted fractures were treated by hemiarthroplasty using Zweymtüller long-stem cementless implant.There were 35 males and 56 females,with an average age of 81.2 years (range,75-94 years).There were fresh fractures in 75 cases and old fractures in 16 cases.According to classification of Evans-Jensen,there were 36 cases with type Ⅲ fracture and 55 with type Ⅳ.Osteoporosis was graded by Singh index,and there were 51 cases with level Ⅲ and 40 with level Ⅱ.The interval between injury and operation was 2-10 d (average,3.5 d).Results The surgery lasted 30-50 min (average,39 min).The blood loss was 320-610 ml (average,405 ml).The hospital stay was 14-21 d (average,16.5 d).Two cases who experienced with the infection of the respiratory system after operation,recovered through routine treatment.Thirty-seven cases were followed up for 15 to 38 months (average,24.5 months).According to the Harris score,the overall rate of excellent or good result was 83.8％ (31/37).Conclusion Hemiarthroplasty using Zweymüller long-stem cementless prosthesis is reliable option for intertrochanteric comminuted fracture in the aged patients.

Objective To explore the application value of pulmonary artery monitoring program for intracranial and cervical artery angiography with dual-energy CT.Methods Sixty patients performed intracranial and cervical artery angiography with dual-energy CT were divided into two groups according to the random number table.Group A (optimization group,30 patients):the monitoring points were located in the main pulmonary artery,with threshold 150 HU,trigger delay time 8-9 s,pitch 0.9,and the iohexol (350 mg I/ml) 60-65 ml.Group B (conventional group,30 patients):the monitoring points were located in aortic arch,with threshold 100 HU,trigger delay time 5 s,and the iohexol (350 mg I/ml)60-70 ml.Patients with the body weight less than 75 kg were injected with the flow rate of 4.0 ml/s,and those weight greater than 75 kg or with body mass index (BMI) greater than 27 kg/m2 were 4.5 ml/s,following 40 ml saline solution with the same flow rate respectively.All images were transferred to Siemens Syngo workstation for further processing and analysis.The attenuation values were measured on axial images in the common carotid artery,internal and external carotid artery,vertebral and basilar artery,the horizontal segment of the middle cerebral artery,the subclavian vein of injection side,the proximal,middle and distal segment of jugular vein,the straight sinus and the superior sagittal sinus.Two experienced observers blinded independently evaluated the image quality of CTA,the impact of contrast material residues artifacts of subclavian vein of injected side and the affect of venous return factors on arterial image display.Images of volume rendering technique(VR),the maximum intensity projection (MIP),and curved planar reformation (CPR) were reconstructed using dual energy bone removal and Inspace and 3D software.The mean intraluminal attenuation of contrast material (HU),the volume of contrast material and the mean image quality scores were compared with t test between the two groups.Chi-square test was used to compare of image contrast agents residual artifacts,the absence segments of the root of the neck artery,and the degree of the jugular vein return in two groups.Results The mean CT values were 372-414 HU for each segment of artery showing no significant differences between two groups (P ＞ 0.05).In group A,the CT values of the jugular vein in proximal,middle,distal segment of the two sides were (95 ± 36),(95 ± 36),(131 ±58),(133 ± 57),(174 ± 68),and (180 ± 66) HU respectively.In group B,CT values were (135 ± 58),(137 ±59),(170 ±58),(181 ±58),(218 ±62),and (224 ±68) HU.The CT value of jugular venous in group A was significantly lower than that in group B (t =-3.30--2.54,P ＜ 0.05).Case numbers of contrast agent residual artifacts of injection side subclavian vein and the absence segments of root of the neck artery at the beginning in group A (5,11) were less than that in group B (12,24) (x2 =4.02,5.65,P ＜0.05).The degree of the jugular vein return in group A were lesser severely than that in group B (x2 =6.79,6.37,P ＜0.05).Below the level of carotid artery bifurcation:slight 5 patients,severe 1 patient in group A vs.slight 15 patients,severe 9 patients in group B.Above the level of carotid artery bifurcation:slight 9 patients,severe 6 patients in group A vs.slight 12 patients,severe 17 patients in group B.Image quality scores of group A (3.84 ± 0.40) was higher than that of group B (3.64 ± 0.63) (t =4.26,P ＜0.05).Conclusions Pulmonary Artery Monitoring combines with 60-65 ml contrast material optimization scheme for intracranial and cervical artery angiography with dual energy CT can significantly reduce the degree of jugular venous return and contrast material residues artifacts of subclavian vein of injected side.This technique is helpful to improve the work efficiency and image quality.

Objective To investigate the curative effect of sodium nitroprusside in the treatment of EV71-related pneumoedema/pneumorrhagia and hypotension in this study. Methods This was a retrospective study of a total 10 children with EV71-related pneumoedema/pneumorrhagia treated with sodium nitroprusside using case-control methods. The clinical manifestations and outcomes of the 10 children (present cohort) were compared with those of 8 children (past cohort) who had EV71-related pneumoedema/pneumorrhagia without sodium nitroprusside. Results Among these 10 patients,all were at the appearance of pneumoedema/pneumorrhagia, cardiac arrhythmia and hypotension. Two patients showed severe cardiac arrhythmia, two patients showed cardiac arrest for many times. All 10 patients were treated with mechanical ventilation and other conventional treatments. At the first time of the manifest of hypotension,sodium nitroprusside were put into practice in all 10 patients. Ten patients were treated with intravenously sodium nitroprusside in the stage of hypotension by maxi30 min ～ 1 h,the patients showed an improvement in vultus,pulse and peripheral circulation and decrease of heart rate and elevation of blood pressure after 30 min ～2 h,but at least 2～6 h later,the blood pressure tended to stabilize at normal standard. Conclusion Hypotension is the intensive stage in EV71-related hand,foot and mouth disease ,and the shock syndrome caused by acute left ventricular disorder is related to sympathetic nerve activity. Sodium nitroprusside can effectively reduce the cardiac afterload,and correct shock and improve the prognosis.

Objective To evaluate the imaging quality and radiation doses of dual-source computed tomography (DSCT) coronary angiography at a low tube voltage in patients with medium and low heart rate.Methods Eighty-five patients[heart rate (HR) ＜ 91 beats per minute (bpm); body mass index (BMI) 17. 51-30. 00 kg/m2]suspected of coronary artery disease received retrospectively ECG-gating coronary angiography with dual-source CT scanner (Somatom Definition, Siemens) at a tube voltage of 100 kVp. For all patients, no beta-blocker was used before CT scan. According to the HR, the patients were divided into three groups: Group A, HR ≤ 59 bpm, n = 27; Group B, HR 60-69 bpm, n = 29; Group C,HR ≥70 bpm, n = 29. All images were transferred to a workstation for postprocessing. The best R-R interval reconstruction images of all groups were evaluated. The value of pitch, CT volume dosage index (CTDIvol), dose length product (DLP)and effective dose (ED)were recorded. The pitch, the score of imaging quality of coronary artery segments and the radiation dose were compared with one-way ANOVA. The influence of HR on image quality and radiation doses of coronary artery was analyzed. Results The value of pitch in Group A, Group B and Group C was 0. 241 ± 0. 025, 0. 286 ± 0. 034 and 0. 335 ± 0. 036,respectively. The mean score of imaging quality of coronary artery segments in Group A, Group B and Group C was 4. 78 ± 0. 26, 4. 66 ± 0. 56 and 4. 70 ± 0. 46, respectively. The value of CTDIvol in Group A,Group B and Group C was (18.06 ±5. 16), (19. 62 ±7. 15) and (17. 50 ±7. 13) mGy, respectively. The value of ED in group A, Group B and Group C was (4.23 ± 1.76), (4.59 ± 1.75) and (4.12 ±1.39) mSv, respectively. There was statistical difference in value of pitch among the three groups (F =60. 00, P= 0. 00). There were no statistical difference in score of imaging quality, CTDIvol and value of ED among the three groups (F = 0. 53, P = 0. 59; F = 0. 83, P = 0. 44 ; F = 0. 86, P = 0. 43). Conclusion Medium and low HR have little influences on image quality of dual-source CT coronary angiography at a low tube voltage. When the auto ECG-gating is selected, there is little influence on radiation dosage as well.

Objective To evaluate the effect of tirofiban injection in coronary artery occlusion by suction catheter on the opening time of the coronary artery occlusion , the improvement of the blood flow and the incidence of adverse events in 30 days. Methods A total of 97 patients with acute myocardial infarction in recent 4 years were included , whose culprit vessels were subtotal occlusion or total occlusion by angiography and were randomly divided into thrombus aspiration group (group A) and tirofiban injection in occlusion and thrombus aspiration group (group B). The opening time of the coronary artery, the improvement of the blood flow and the incidence of adverse events in 30 days were compared between two groups. Results The opening time of the coronary artery occlusion in group A was shortened when compared with group B but the blood flow arriving TIMI III grade in group B was shorter (P < 0.05). No-reflow incidence in group B was lower while the proportion of blood flow arriving TIMI III grade was higher than that in group A in early phase (P < 0.05). The incidence of adverse events in 30 days was decreased in group B when compared with group A ,but the difference wasn't statistically significant (P > 0.05). Conclusion Direct tirofiban injection in coronary artery occlusion could effectively shorten the opening time of the coronary artery occlusion reduce no-reflow incidence , and improve coronary perfusion but could not decrease the incidence of adverse cardiovascular events in 30 days.

Objective To investigate the distribution, clinical diagnosis and treatment methods of the extrapulmo-nary complications in children with mycoplasma pneumoniae (MP). Methods The clinical data of 1 100 patients confirmed the diagnosis of mycoplasma pneumonia and with the positive serum MP-IgM test were collected in this study. The distribu-tion and clinical characteristics and MP-DNA detection rates were compared between 417 patients with extrapulmonary com-plications and 683 cases without complications. The occurrence of various complications in a four-year period was analyzed. Clinical data were compared between fiberoptic bronchoscopy lavage group and non-surgical group. Results The MP-DNA detection rate and the length of hospital stay were higher in patients with pulmonary complications than those of patients without complications. The most common types of extrapulmonary complications were liver damage, skin rashes and gastrointestinal reactions , but less severe. Encephalitis, nephritis and myocarditis were rare complications, but severe and occult. The fatal hemophagocytic lymphohistiocytosis (HLH) was also visible in patients. Bronchoscopy lavage was conducive to the recovery of the disease. Conclusion MP pneumonia showed high incidence and risks of extrapulmonary complica-tions, which required careful clinical observation and inspection, the dynamic monitoring laboratory markers and comprehen-sive treatment as well.