Objective To investigate effect of continuous veno-venous hemofiltration on treatment of children with acute re-spiratory distress syndrome .Methods A total of 84 cases of children with acute respiratory distress syndrome were divided into control group (n= 42) and observation group (n = 42) .Control group was given conventional therapy including etiological treat-ment ,mechanical ventilation ,fluid management and anti-inflammatory treatment .Besides conventional therapy similar to control group ,observation group was administrated continuous veno-venous hemofiltration .Gender ,age ,admission critical illness score (PICS) ,clinical manifestations ,blood gas indexes (PaO2 ,SaO2 ) and oxygenation index (OI = PaO2 /FiO2 ) before and after treat-ment ,duration of mechanical ventilation ,pediatric intensive care unit (ICU) hospitalization days and mortality in above two groups were analyzed retrospectively .Results There were not significant difference in gender ,age and admission critical illness score (PICS) of two groups(P> 0 .05) .PaO2 ,SaO2 and OI of observation group were higher than that of control group in the third and fifth day after treatment (P < 0 .05) .The average ICU hospitalization day of observation group was shorter than that of control group (P< 0 .05) .Mortality of observation group was lowered compared with control group (P< 0 .05) .Conclusion Veno-venous hemofiltration could effectively reduce duration of mechanical ventilation and mortality in treatment of children with acute respirato -ry distress syndrome ,which is worth clinical popularization .

Objective To explore the changes of human mitochondrial COXI,ND1 and ND6 genes expression induced by ionizing irradiation.Methods Changes of human COXI,ND1 and ND6 gene expression were detected by RT-PCR and Real-time PCR 8 h after the irradiation in human lymphoblastoid cell lines,which were exposed to 1-10 Gy 60Co γ-rays.And the dose-effect relationships between expression changes of the genes and the doses were analyzed.The changes of these three genes expression were also analyzed at different post-radiation time-points between 0.5 h and 72 h after irradiation of 5 Gy in order to explore the time-effect.Results The expression of three genes COXI,ND1 and ND6,showed either the dose-effect or the time-effect after irradiation.The gene expression levels of three genes up-regulated generally and the peak change time-point was 4 h after irradiation.Conclusion Ionizing radiation,msht induce the changes of mitochondrial gene expression,and the gene expression level is up-regulated.

Objective To investigate the feasibility of laparoscopic surgery for hydronephrosis caused by retroper-itoneal fibrosis.Methods Reported the diagnosis and treatment procedure and result of 1 case of hydronephrosis caused by retroperitoneal fibrosis on left side,who underwent laparoscopie surgery.Investigated the feasibility of hydronephrosis caused by retroperitoneal fibrosis with literature review.A 55-year-old female patient had interrupt-able left lower extremity swollen with nausea and vomiting for five months.The blood test showed progressive eleva-ting of creatinine and urea nitrogen.The highest creatinine value was 503 μmol/L.The computerized tomography showed renal atrophy on right side and there was a stenosis on crossing place between inferior segment on left ureter and iliac blood vessels,also there is a soft tissue image in front of aorta and around iliac blood vessels,the superior ureter was dilated.We set double J tube into left ureter before surgery with semi-reclining position toward right side,set trocar cannula through 1 era,4 em below the umbilicus as well as the same two points on lateral external oblique muscle of abdomen,set laparoscope from 1 cm below the umbilicus.We found the abdominal membrane pale and touch as tabular.There was serious eonglutination between middle segment ureter and around iliac blood vessels after we cut open retroperitoneal membrane.We carefully dissected the ureter for 9 cm and soluted the eonglutination a-round the ureter,then set the ureter into abdominal cavity and closed retroperitoneal membrane.Results The pa-tient recover well after surgery and sutured out after 5 days,pulled out the double J tube after I month.The patient had low back pain ,fever and oliguria after the double J tube was pulled out and recovered with spasmolysis,analge-sia and antibiosis treatment after 2 days.The voiding volume and renal function became normal.The B-type ultra-sound test showed hydronephrosis on left side was lessened.The ultrasound test after 3 months result showed hydro-nephrosis was significantly lessened than before surgery and renal function was normal.Conclusions The laparo-scopic ureterolysis surgery for retroperitoneal fibrosis is minimally invasive,less suffering and quick recovery.Be-cause of few case report and short follow-up time is more eases and long-term follow-up are needed to elucidate the therapeutic efficacy of this treatment.

Objective To investigate the relationship between metabolic syndrome (MS) and education level in Su-Xi-Chang area to provide evidence for healthcare policy making. Methods A clustered sampling of 6798 subjects from Su-Xi-Chang areas of Jiangsu Province was included. Questionnaires and physical examinations were completed to collect clinical data. Logistic regression was used to analyze weather education level could be an independent risk factor of MS. Results Significant differences were found in waist circumstance (WC) ,systolic blood pressure (SBP) and fasting blood glucose (FBG) among participants with different education level. Significant differences were also existed in triglyceride and diastolic blood pressure (DBP) between subjects with higher and lower education level ( P＜0. 05 ). In single-factor or multivariate analysis, education level was negatively correlated with the prevalence of MS (P＜0. 05 ). Conclusions Education level may be an independent risk factor of MS. People with low and moderate education level have higher risk of MS. Therefore,it is recommended that health-related information should become an integral part of the compulsory education system.

Objective To investigate the relationship between metabolic syndrome (MS) and diet style in the elderly. Methods The 781 old people were consecutively selected. Related data were collected by means of questionnaires and physical examinations. And logistic regression was performed to analyze if moderate and high fat diet were risk factors of MS. Results The total prevalence rate of MS in old people was 40. 7%, with 36.7% in old males and 55.4% in old females,and the prevalence rate of MS was higher in old women than in old men (P=0. 000). The significant differences in waist circumferences among three groups of low, moderate and high-fat diet [(86.0±9.3) cm vs. (88.8±8.5) cm vs. (90. 0±7.9) cm, respectively (all P＜0.05)]were found. Fasting blood glucose showed a significant difference between two groups of low and high-fat diet, with the results of (5.78 ± 0.98) mmol/L and (6.27 ± 1.80) mmol/L, respectively ( P＜0. 05 ). The logistic regression analysis showed that odds ratio for people with moderate and high-fat diets were 1. 541 ( 1. 092-2. 174) and 2. 293 ( 1. 317-3. 994), respectively (P＜0.05), which indicated that moderate and high-fat diet was independent risk factors for MS in old people. Conclusions Both moderate and high-fat diets are risk factors of MS in old population, low fat diet with food balance is recommended to old population in order to decrease the prevalence of MS.

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Objective To explore the changes of human mitochondrial COX Ⅰ , COX Ⅱ and COX Ⅲ genes expression induced by ionizing irradiation. Methods Changes of human COX genes expression were detected by RT-PCR and Real-time PCR 8 h after the irradiation in human lymphoblastoid cell lines,which were exposed to 1-10 Gy60Co γ-rays. The protein levels were detected by flow cytometry and the COX activity was measured by colorimetry. The dose-effect relationships between the expression changes of the genes and the doses were established. The changes of these genes expression were also analyzed at different post-radiation time-points between 0. 5 h and 72 h after irradiation of 5 Gy in order to explore the time-effect. Results The expression of 3 genes at mRNA level was up-regulated. A good dose-effect relationship was showed for COXⅠ and COX Ⅲ at dose range of 0-3 Gy and 0-8 Gy for COX Ⅱ ( F COXⅠ=116. 62, FCOXⅡ = 17. 89, FCOXⅢ = 8.20, P ＜ 0. 05). For the time-effect after irradiation, the gene expression levels of COX Ⅱ and COX Ⅲ genes were up-regulated and the peak change occurred at 4 h after irradiation. For COX Ⅰ gene, the mRNA expression levels were down-regulated during 0.5-72 h( FCOXⅠ =31.99, FCOXⅡ = 19.47, FCOXⅢ = 20. 64, P ＜0. 05 ). At the protein level, the levels of COX Ⅰ and COX Ⅱ were lowered in lower doses and enhanced in higher doses, and the levels of COX Ⅲ were decreased at all dose levels (FCOX Ⅰ = 16.96, FCOXⅡ = 32.5, FCOXⅢ = 6. 51, P ＜ 0. 05 ). The protein levels of COX Ⅰ and COX Ⅱ were enhanced during 4-72 h and 8-72 h respectively after 5 Gy irradiation ( FCOX Ⅰ = 14.68,FCOXⅡ = 17. 18, FCOXⅢ =2. 52, P ＜0. 05). The activities of COX were lowered at different dose levels and different time-points. Conclusions Ionizing radiation might induce the changes in mitochondrial COX Ⅰ,COX Ⅱ and COX Ⅲ gene expression, and lead to the reduction of the COX activities.

Objective To investigate the dose-effect relationship of mRNA level of sensitive mitochondrial genes in human lymphoblastoid cells induced by ionizing radiation.Methods Seven human sensitive genes,including ND3,Cyt b,COX Ⅰ,COX Ⅱ,COX Ⅲ,ATPase6 and ATPase8 were chosen.Changes of mRNA level of these genes were detected by RT-PCR and Real-Time PCR at 24 h after irradiation in human lymphoblastoid cells,which were exposed to 0 - 15 Gy of 60 Co γ-rays.Results The expression of these 7 genes at mRNA level was up-regulated 24 h after irradiation in human lymphoblastoid cells.The level of gene expression of COX Ⅰ,which belongs to complex Ⅳ of mitochondrial respiratory chain,was most obvious,and the peak occurred after irradiation of 8 Gy,which was 13 times of the control group.A good dose-effect relationship was showed for COX Ⅲ gene expression at dose range of 3 -10 Gy as well as 3 - 15 Gy for other 3 genes including ND3,ATPase6 and ATPase8.Conclusions Gene expression levels of COX Ⅲ,ND3,ATPase6 and ATPase8 24h post-irradiation at certain irradiation dose range could be used for radiation damage biomarkers.

Objective To get a molluscicide from Reineckea carnea which is effective on Oncomelania hupensis but has low poison on fish. Methods Methyl soaking, column chromatography and HPLC were used for isolation of molluscicidal component from Reineckea carnea. Results The snail mortality with Reineckea carnea powder was 86.0% for 72 h immersion and 100.0% for 120 h at the concentration of 17.5 mg/L, but the fish mortality was 0 at the concentration of 130 mg/L, indicating that Reineckea carnea had different effects on the two kinds of animals . The fraction A was obtained from Reineckea carnea by methyl immersion, column chromatography. The snail mortality with A was 84.4% for 144 h at the concentration of 10 mg/L, indicating that A had high molluscicidal effect on Oncomelania hupensis. After A being isolated by HPLC, 99.98% RC-Ⅰ was obtained from it . RC-Ⅰ was determined by API2000 LC/MS and other spectrum, and it was deduced to be one of steroidal glycosides. Conclusion Reineckea carnea contains a high effective molluscicidal component.

Objective To investigate the feasibility of the CT texture analysis (CTTA)in differentiating autoimmune pancreatitis (AIP)from pancreatic ductal adenocarcinoma (PDAC).Methods 25 patients with AIP and 31 patients with PDAC who confirmed by pathological or clinical underwent pretreatment three-phase contrast-enhanced CT were enrolled.Histogram parameters (mean CT values,median CT values,25 th,75 th percentile CT values,skewness,kurtosis,entropy and uniformity)were derived from CT images through texture analysis.The differences of histogram parameters between AIP and PDAC groups were compared.ROC and AUC were used to evaluate the diagnostic efficacy of histogram parameters in differentiating AIP from PDAC.Results The values for mean CT values,median CT values,25 th,75 th percentile CT values and uniformity of AIP were significantly higher than those of PDAC group,while the values for entropy of AIP were significantly lower than those of PDAC group in arterial phase,portal phase,and delay phases (all P＜0.05). There were no significant differences in kurtosis and skewness between AIP and PDAC groups (all P＞0.05).The uniformity in portal phase achieved the optimal diagnostic accuracy in differentiating AIP from PDAC (AUC＝0.973 ),the cutoff value was 0.797,the corresponding sensitivity and specificity were 92% and 9 6.8%,respectively.Conclusion CTTA can be used as a quantitative analysis method for differential diagnosis between AIP and PDAC,providing a reference for clinicians to select therapeutic schedules.