Objective To investigate the relationship between the insertion/deletion(I/D) polymorphism of the angiotensin convcer-(ting) enzyme(ACE) gene and congenital heart disease(CHD) and to quest the predisposing gene of congenital heart disease by analyzing the polymorphism of the ACE gene in patients with CHD.Methods Sixty-eight patients with CHD were served as observing group,sixty-four patients without CHD as control group.We drew DNA of leukocyte from blood by the method of saturation phenol and chloroform and we amplified the ACE gene using the DNA polymerase chain reaction technique.The amplification products were employed electrohoresis in 2% sepharose.the polymorphism of the angiotensin converting enzyme gene was analyzed under ultraviolet lump.Results In the obser-(ving) group,the genotype distribution frequency of the ACE was II in 12(17.65%),DD in 32(47.06%) and ID in 24(35.29%),and in the control group,it was II in 20(31.25%),DD in 10(15.63%) and ID in 34(53.12%).Conclusions The study result clarifies that CHD has close correlation to the polymorphism of the angiotensin converting enzyme gene.The relative risk of DD genotype is higher than that of the others,and DD genotype possibly is the predisposing genotype of CHD D allele perhaps is the susceptibility gene of CHD.

In recent years,China's science research has entered the high-speed development period,which leads to the increase of the investment of science research funds.At the same time,the safety and effectiveness of the science research management and the funds has caused public concern.So the science management of research work including the use of science research funds is of great significance.This paper will analyze the risk of key positions in science research management and put forward corresponding countermeasures,combining the writer's practical experience in hospital.

Accidents, Occupational ; Adult ; Ammonia ; poisoning ; Bronchiolitis Obliterans ; etiology ; surgery ; Female ; Humans ; Lung Transplantation

Objective To detect the routine coagulation indicators in breast cancer patients receiving the trastuzumab treatment and to analyze the influence of the coagulation indicators on clinical treatment response .Methods Totally 67 hospitalized breast cancer patients receiving the trastuzumab treatment in 401 Hospital of PLA from Jan .2006 to Dec .2012 were collected and divided into the effective group(47 cases) and ineffective group(20 cases) according to the curative effect .The levels of PT ,APTT ,TT ,Fib and D‐D were statistically analyzed .The differences of coagulation indicators were compared between the two groups .The correla‐tion between the coagulation indicators with the curative effect was analyzed .Results Compared with the effective group ,PT , APTT and TT in the ineffective group were slightly extended ,while the D‐D level was slightly increased ,the differences were not statistically significant(P> 0 .05);but the Fib level was significantly increased with statistical difference(P< 0 .05) .Conclusion The breast cancer patients with ineffectiveness in the trastuzumab treatment are easily appear the high Fib status .Determining its plas‐ma concentration is conducive to judge the prognosis of the trastuzumab treatment in breast cancer patients .

Objective To identify risk factors associated with repeat use of pulmonary surfactant ( PS) in the treatment of respiratory distress syndrome ( RDS ) in the term and near-term neonate. Methods There were 130term and near-term new borns with RDS who were treated with pulmonary surfactant were enrolled. These infants were categorized into two groups: single-dose group (85 cases) and repeat-dose group (45 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for repeat use of pulmonary surfactant.Results TherepeatutilizationrateofPSwas34.6℅.The incidence of asphyxia,maternal gestational hypertension, X-ray RDS grade 3-4, the age of first dose PS,respiratory support time in the repeat-dose group was significantly higher than in the single-dose group (P<0. 05). PaO2/FiO2 and the cure rate in the repeat-dose group were significantly lower than in single-dose group ( P<0. 05 ) . The incidence of sepsis, pulmonary hemorrhage, shock and patent ductus arteriosus ( PDA) in the repeat-dose group was significantly higher than in the single-dose group ( P<0. 05). Further logistic regression analysis showed that birth asphyxia ( OR=5. 674 , 95℅CI 1. 378 -23. 354 , the age of first dose of PS (OR=1.092, 95℅CI 1.002 -1.191)and PDA(OR =23.499, 95℅CI 2.348 -235.152)were the independent risk factors for repeat use of pulmonary surfactant.Conclusions Birth asphyxia,the age of first dose PS and PDA are the risk factors for repeat use of pulmonary surfactant in the treatment of RDS in the term and near -term neonate.

OBJECTIVE:To investigate the effects of hydrophilic polymers on the stability of self-microemulsifying drug deliv-ery systems (SMEDDS). METHODS:Taking felodipine (FDP) as model drug,the content of FDP was determined by HPLC method. The effects of pure water,0.5% Kollidon VA64,HPMC E5,HPMC K100LV,HPMC K4M,PVP K30 solution,while 0.1%,0.5% and 1.0% HPMC E5 and Kollidon VA64 on residual content of dissolved FDP were determined in SMEDDS. RE-SULTS:The residual contents of dissolved FDP in SMEDDS placed in Kollidon VA64,HPMC E5,HPMC K100LV,PVP K30, HPMC K4M and pure water for 1 h were 92.7%,63.6%,50.2%,46.2%,36.0%and 24.0%,respectively. The order of maintain-ing the supersaturation state was Kollidon VA64>HPMC E5>HPMC K100LV>PVP K30>HPMC K4M>pure water. The residu-al contents of dissolved FDP in SMEDDS placed in 0.1%,0.5%,1% Kollidon VA64 and HPMC E5 and pure water for 1 h were 93.2%,95.1%,96.0% and 48.4%,62.1%,75.1%. CONCLUSIONS:Kollidon VA64 and HPMC E5 can significantly inhibit drug release in SMEDDS and be used as stabilizer of SMEDDS,wherein Kollidon VA64 was better.

Objective To investigate the value of echocardiography in monitoring the treatment of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock (CS).Methods A total of 21 patientss were included into the present study,who were treated by ECMO due to CS in Wuhan Asia Heart Hospital from January 2013 to December 2015.The left ventricular ejection fraction (LVEF) and Tei index were measured by echocardiography before,in the middle of (flow reduced to one half)and immediately after the process of ECMO.The systolic blood pressure (SBP) and the arterial oxygen saturation (SaO2) were also recorded,and the parameters were compared.The differences of LVEF,Tei index,SBP and SaO2 among different phases of ECMO were compared by using one-way ANOVA and LSD-t test.The differences of heart beat rate,the diameters of left ventricle,diameters of inferior vena cava,subsidence rate of inferior vena cava,pulmonary capillary wedge pressure and central venous pressure among different phases of ECMO were also compared by paired-samples t test.Results Compared with the pre-ECMO level,the LVEF increased during and immediately after the ECMO (t=31.952,59.404,both P ＜ 0.01),while the Tei index decreased significantly (t=34.406,58.969,both P ＜ 0.01).Compared with the pre-ECMO level,the SBP,SaO2 and subsidence rate of inferior vena cava all increased during and immediately after the ECMO,while the diameter of left ventricle,pulmonary capillary wedge pressure and central venous pressure all decreased significantly (t=7.382,37.785,-11.286,3.294,13.923,16.971,all P ＜ 0.01 or 0.05).In contrast,there was no significant change for the parameters of heart beat rate and diameter of inferior vena cava.Conclusion When treating CS patients with ECMO,the echocardiography can monitor the cardiac function effectively,and provide important parameters for the clinical doctors to estimate the ECMO efficacy and decide the weaning time.

Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and conventional-transbronchial needle aspiration (C-TBNA) in mediastinal and lung hilar lesions. Method 301 cases of lung hilar and mediastinal lesions were selected from 2010 to 2016. Among them, 183 cases underwent TBNA, and the other 118 cases received EBUS-TBNA technology. During the research, the associations of diagnostic positive rate and complications were analyzed in order to explore the advantage and the value of EBUS-TBNA. Results The positive rates of EBUS-TBNA in central groups (2R, 4L, 4R, 7) were higher than in the peripheral groups (10R, 10L, 11R, 11L) (P < 0.05). When studying the lymph node group 2R, 4R and 7R, the positive rate of EBUS-TBNA is much more significant than conventional TBNA (P < 0.05); When biopsying at the lymph node group R4 and group 7, one needle positive rate of EBUS-TBNA were much more superior than TBNA (P < 0.05), the three needles cumulative positive rate of EBUS-TBNA almost reach the total positive rate(P > 0.05), an approving effect of puncture can be acquired; The accuracy and sensitivity of EBUS-TBNA in the diagnosis of lung hilar and mediastinal lesions were much better than conventional TBNA (P < 0.05), especially the diagnostic positive rate of EBUS-TBNA in benign diseases was higher (P < 0.05); The complications rates in both two technologies were not significantly different (P > 0.05), there were no severe complications during the operations in all cases. Conclusion EBUS-TBNA is useful in diagnosis of mediastinal and hilar lesions of unknown reason, and significant in diagnosis of bronchial and extrabronchial diseases. It is an efficiency and safe operation while further application studies are needed.

ObjectiveTo explore a new simple epicanthoplasty method fit for various types of epicanthus with inconspicuous scar after operation.Methods As the latest studies showed that the anatomical structure of epicanthus is mainly due to the eyelid orbicularis muscle's dislocation at the starting point of the medial canthal tendon,which affects the skin appearance,rather than the traditional view that was merely the excess skin,we released the adhesions between the skin and the inner canthus orbicularis muscle,and corrected the dislocation of orbicularis muscle that was key to the operation,incised along with the line A′→B→A″→ C in the field of interior canthus,separated the subcutaneous fascia tissue,relaxed the subcutaneous fibrous cord,disconnect the orbicularis muscle's attachment point in the inner canthal fold,and then sutured and folded the inner canthal ligament.After sewing up point A′ and point A″,the released skin retracted naturally and formed a new inner canthal contour.ResultsFrom June 2008 to June 2009,57 cases of epicanthus patients accepted this surgery.After operation,the appearance of canthus was nice.Eye fissure got widen,and the scar was not obvious.Also there was a high satisfactory rate.ConclusionsThis method has a broad range of applications.It is suitable for various types of epicanthus correction.

Objective To share our experiences on integrated services in providing fetal diagnosis and postnatal treatment for congenital diaphragmatic hernia(CDH).Methods A retrospective analysis was conducted on 25 pregnancies diagnosed as CDH by both prenatal ultrasound and MRI in Maternal and Children Hospital of Guangdong Province from January 2012 to January 2014.All of the subjects received integral medical management including prenatal management (prenatal diagnosis and consultation), perinatal management (prenatal care and delivery) and neonatal treatment.Results Among the 25 CDH fetuses, 11 were mild, nine were moderate, and five were severe.One severe case, who was diagnosed at 26 gestational weeks, was aborted on demand of the mother.The other 24 cases continued their pregnancy and all delivered after 35 weeks including 13 cesarean sections (one due to twin pregnancy and 12 due to maternal demand) and 11 vaginal birth.The mean gestational age when CDH was diagnosed was (24.5 ± 3.5) weeks, and the 24 women delivered at an average of (37.5 ± 1.4) gestational weeks.The eleven mild cases accepted mask oxygenation.For those 13 moderate or severe CDH cases, all received dexamethasone to promote fetal lung maturity at 32 gestational weeks, seven were intubated before clamp the cord, and the other six did after.These 13 babies accepted high-frequency oscillation ventilation, with a median duration of 58 hours, and some of them treated with inhaled nitric oxide on requirement with a median duration of 52 hours.Except two cases died before operation, the rest 22 cases underwent neonatal surgery.One moderate case died at 48 hours after surgery due to pulmonary hypertension and respiratory failure.Another one severe case withdrew treatment at two months old.The other 20 infants recovered fully.Conclusions Integrated management including prenatal diagnosis and postnatal treatment, provides an effective and streamlined mode for diagnosis and treatment of CDH.Therefore,it might minimize potential medical risks.