Objective Qualitative research was used to study the psychological experience of caregivers of children with Down syndrome so as to give them necessary support. Methods Objective sampling method was used to select 8 children with Down syndrome caregivers as the research object, using unstructured interviews to collect data and carefully read, analyze, encode and collect the records of interviews, and then sublimate the theme concept reflecting the psychological experience of the research object. Results A total of 4 themes had been raised:the pain and helplessness of the child, the stress and exhaustion of the body, the feeling of hopeless, the desire for support and understanding. Conclusions The psychological stress of the main caregivers of Down syndrome is great, we should help them relieve the pressure, instruct them to train the children correctly, make them strengthen their self-confidence and take better care of their children.

Objective:To compare the performance of chemiluminescent microparticle immunoassay ( CMIA) and enzyme-linked immunosorbent assay ( ELISA) for the determination of Anti-PR3 and Anti-MPO.Methods:Concentration of Anti-PR3 and Anti-MPO in serum samples from 166 patients with autoimmune diseases and 50 healthy donors were determined by using CMIA (Method A) and ELISA(Method B),respectively.The results from both assays were analyzed and compared by statistical methods .Results:Method A showed better intra-assay reproducibility and inter-assay reproducibility than Method B for the determination of high ,medium and low levels of control serum .Both methods met the accuracy requirement .The correlation coefficient of Anti-PR3 and Anti-MPO were 0.987 8 and 0.989 6 for Method A and Method B ,respectively.And the Kappa coefficients were 0.897 and 0.882 for Method A and Method B,respectively.Conclusion:The performance of Method A is superior to Method B for the deter-mination of Anti-PR3 and Anti-MPO, which makes Method A to be a potentially better choice for clinical application .

Objective To investigate the expression and significance of IDO and c-myc in bladder urothelial carcinoma.Methods IDO mRNA expression from fresh tumor and mucosa specimens from 20 cases were detected by fluorescence quantitative PCR,and SP was used to detect the IDO,c-myc protein in paraffin-embeded specimens from 84 cases and mucosa specimens from 22 cases.Results In bladder urothelial carcinoma,IDO,c-myc protein expression level had no relationship with age and sex.Expression of IDO protein in invasive bladder urothelial carcinoma was significantly higher than that of no-invasive (x2 =5.600,P =0.018).With the increase of the histological grade (x2 =20.268,P =0.000) and UICC stage (x2 =12.075,P =0.007),the positive expression rate of IDO protein was increased.There was not positive expression of c-myc protein in normal bladder tissue,but in bladder urothelial carcinoma,44 cases (52.4 ％) were positive expression (x2 =10.733,P =0.001).The expression of c-myc protein had no relationship with the histological classification,histological grade and UICC stage.In bladder urothelial carcinoma tissue,IDO protein expression level was positively correlated with c-myc protein expression (r =0.205,P =0.047),and was positively correlated with the histological classification,histological grade and UICC stage (r =0.258,P =0.018; r =0.491,P =0.000; r =0.365,P =0.001).Expression of IDO mRNA in bladder urothelial carcinoma (7.696 1±1.745 2) was significantly higher than that in normal bladder tissue (6.397 0±1.205 1)(t =2.367,P =0.023).The average expression level of IDO mRNA in bladder urothelial carcinoma of Ta-T1 stage was 6.803 4±1.567 5,which was significantly lower than that in T2-T4 stage (9.183 8±0.690 3) (t =4.955,P =0.000).The average expression levels of IDO mRNA in grade Ⅰ,Ⅱ,Ⅲ bladder urothelial carcinoma were 7.058 7±1.771 5,7.934 2±1.530 5,9.290 7±0.574 5,respectively,which were increased with the grade increasing (t =2.729,P =0.011).Conclusions The high expression of IDO correlates with bladder urothelial carcinoma progression,and expression of c-myc is irrelevant with bladder urothelial carcinoma progression,but maybe associate with bladder urothelial carcinoma occurrence.IDO may be a predictive factor of prognosis.IDO and c-myc may be therapeutic target in the treatment of bladder urothelial cancer.

Objective To investigate the expression and significance of bin 1,C-myc in bladder urothelial carcinoma.Methods SP method was used to detect the expression of bin 1,C-myc protein in paraffin specimens from bladder urothelial carcinoma of 84 cases and mucosa of 11 cases,and its relationship with clinical pathological charac-teristics was analyzed.Results The positive expression rate of bin1 in normal bladder tissues was 81.81%,that in bladder urothelial carcinoma was 46.43%,the difference was not significant (χ2 =4.873,P=0.051).No expression of C-myc was observed in normal bladder tissue ,the positive expression rate of C-myc in bladder urothelial carcinoma was 52.38%,the difference was statistically significant (χ2 =10.733,P=0.001).The expression of bin1 in invasive bladder urothelial carcinoma was significantly lower than the non-infiltrating type(χ2 =7.685,P =0.007),with increased histological grade and UICC stage ,the positive rate of bin1 expression decreased (χ2 =15.817,P=0.000;χ2 =11.104,P=0.010).The expression of C-myc had no relationship with the histological classification ,histological grade and UICC stage .Correlation analysis showed that the expression of bin 1 was negatively correlated with histologi-cal classification,histological grade and UICC stage (r=-0.302,P=0.005;r=-0.411,P=0.000;r=-0.302, P=0.005).With the increased expression of bin1,C-myc expression decreased,but the difference was not statistical-ly significant.Conclusion Low expression of bin1 or loss of bin1expression were associated with the progression of bladder urothelial carcinoma , the expression of C-myc was related with bladder urothelial carcinoma lesions .The results suggest that bin1 may be predictive factor for prognosis of urinary bladder urothelial carcinomas ;bin1,C-myc may be viewed as molecular targets for tumor chemotherapy .

Objective:To analysis the clinical characteristics of pulmonary hypertension (PH) complicating pregnancy, then to explore the delivery time and the monitodng as well as the treatment during perinatal peri-od.Methods:The data of 10 cases with PH treated in our hospital from June 2005 to January 2009 were retro-spectively analyzed.Reaults:1 case was primary pulmonary hypertension(PPH) ; 9 cases were secondary PH (SPH), in which 4 cases were rheumatic heart disease and 5 cases were congenital heart diseases.3 cases were slight PH,6 cases were moderate PH, and 1 were severe group.4 cases NYHA class were Ⅰ～Ⅱ and 6 cases NYHA class were Ⅲ～Ⅳ.4 cases were term delivery,5 cases were premature delivery, and 1 got artifi-cial abortion.8 cases were cesarean section, and 1 was vaginal delivery.2 cases were very low birth weight infants, 1 infant was death and 1 mother was death.Conclusions:The patient of PPH should avoid concei-ving.For SPH patients whether to conceive depends on cardiac function, the level of pulmonary arterial pres-sure and should better get pregnancy after surgery or medication.It should terminate pregnancy in the first tri-mester for moderate or severe patients.Cesarean section is more suitable for those in the second or third tri-mester.The prognosis of the mother and neonate depends on several factors.

Since the beginning of clinical use in the 1970s,hemoglobin A1c (HbA1c) has become the standard tool for monitoring glycemic control in patients with diabetes.The role of the HbA1c test was broadened in 2010,when the American Diabetes Association added HbA1c as a diagnostic criterion for diabetes.However,hemoglobin variants,various clinical scenarios and drugs may yield false results that would mislead clinical diagnosis and treatment.

Objective To study the effect of night large dose of sodium valproate on epileptiform discharges,and cognitive function of benign childhood epilepsy with centrotemporal spikes. Methods Ninety cases of benign childhood epilepsy with centrotemporal spikes were randomly divided into treatment group and control group (n= 45), both groups received regular total doses of sodium valproate therapy 25-30 mg?kg-1 ?d-1 . Patients in the treatment group received treatment that night doses of sodium valproate was double of morning doses. Every night dose was (17.96±1.21) mg?kg-1 , and every morning dose was (8.92±0.62) mg?kg-1 . The control group received the same dose [(13.37±0.80) mg?kg-1 ] of sodium alproate therapy twice a day, morning and evening. The epileptiform discharges, cognitive function, therapy effect were compared between two groups. Results Total effective rate of treatment group was 82.22% which were was significantly higher than that of the control group 62.22%(P<0.05);Epileptiform discharges reduction of treatment group was significantly higher than that of the control group (P<0.05), the effective rate of EEG improvement (84.44%)in treatment group was significantly higher than that in the control group 66.67% (P<0.05); FIQ, VIQ, PIQ in treatment group were significantly higher than those in the control group (P<0.05); There were no statistical differences of adverse reactions between two groups. Conclusion Night large dose of sodium valproate treatment can help control epileptic discharge, increase the plasma concentration, improve cognitive function, and therapy effect.

Objective The existing standards of skeletal development for Chinese were revised in this study due to the accelerated growth and development of Chinese children in the past 20 years.Methods Seventeen thousand and four hundred and one (17,401) healthy children of Han nationality (8,685 boys, 8,716 girls), aged 0～20 years, from cities of Shanghai, Guangzhou, Wenzhou, Dalian and Shijiazhuang were served as the sample for standardization. The radiographs were evaluated by a single observer using TW3 method. Furthermore, the new skeletal maturity events were chosen in 4, 5, 6, 7 stages of first metacarpal, proximal and middle phalanges, as well as in 5, 7 stages of radius and 5 stage of ulna in accordance to TW3-RUS. As a result, each stage was divided into two new stages. The fusion stages of radius and ulna were divided to 4 phases. The skeletal maturity scoring was computed by “scaling of categorized attributes” to minimize the overall disagreement between the different bones totaled over the standardizing sample. The new method is called RUS-CHN. The means and standard deviations of maturity score transformed by logarithm in each age group were calculated, and were fitted by quadratic and linear functions of age, respectively.Results The percentile standards of TW_3-C RUS, TW_3-C Carpal, RUS-CHN skeletal maturity scores were established. The revised standards are designated as “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05”. Ages of the complete maturity of TW_3-C RUS, TW_3-C Carpal and RUS-CHN standards are 16, 13.5 and 18 years in boys and 15, 11.5 and 17 years in girls, respectively. In the verified sample of 2,438 children (1,301 boys, 1,137 girls), aged 1～19 years, the differences between skeletal age and chronological age of all age groups were mostly 0.0～0.3 year in TW_3-C RUS, TW_3-C Carpal and RUS-CHN skeletal maturity standards.Conclusion “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05” are applicable to contemporary Chinese children.

Objective To observe the effects of valsartan and propranolol on the colonic mucosal microcirculation and submucosal ultra-structure changes in rats with portal hypertensive colopathy (PHC).Methods Portal hypertension(PHT) with cirrhosis was induced by composite factors after 42 days in rats.Rats were divided into a normal control group,a cirrhotic PHT model group,a treatment group with valsartan 20 mg/kg once daily,a treatment group with propranolol 22.5 mg/kg twice daily and a combination treatment group with propranolol and valsartan.The rats were treated for 15 days. The rats in the normal control group and the cirrhotic PHT model group were given water only.At the end of study,portal venous pressures(PVP) were measured.The submucosal vascular areas and metrical diameters of phlehectasia were measured by light microscope.The ultra-structure was observed by trans mission electron microscope.Results Compared to the cirrhotic PHT model group,PVPs were significantly decreased in the valsartan,propranolol,and combined groups (P

Objective To investigate the role of CD4+CD25+regulatory T cells and CD4+CD25gigh regulatory T cells in peripheral blood and decidua in the pathogenesis of intrahepatic cholestasis of pregnancy (ICP).Methods Peripheral blood and decidua CD4+CD25+regulatory T ceHs and CD4+CD25high regulatory T cells in 30 ICP patients(15 mild ICP and 15 severe ICP)and 28 normal pregnant women were analyzed by flow cytometry.Results The percentage of CD4+CD25+ regulatory T cells and CD4+cD25high regulatory T cells in the CD4+T cells population in both peripheral blood and decidua in ICP patients were significantly lower than those in control women[(7.96±1.32)%vs(17.05 ±2.86)%,(17.18±2.27)%vs(32.01±3.88)%;(0.78±0.22)%vs(1.71±0.69)%,(2.25±0.89)%vs(8.30±1.13)%;P<0.01].Meanwhile,a significantly higher percentage of CD4+CD25+regulatory T ceHs and CD4+CD25high regulatory T cells in the C4+T cells population was observed in all decidua samples compared to peripheral blood both in ICP patients(P<0.01)and in control women(P<0.01).In addition,the percentages ofCD4+CD25+ regulatory T cells and CD4+CD25high regulatory T ceHs in the CD4+ T cell population in both decidua and peripheral blood in severe ICP[(15.94±1.95)%,(7.17±1.17)%,(1.87±0.90)%,(0.68±0.19)%]were lower than those in mild ICP [(18.43±1.90)%,(8.74±0.96)%,(2.62±0.72)%,(0.89±0.20)%] and normal pregnancy(all P<0.05).Conclusions CD4+CD25high regulatory T cell may play all important role in the pathogenesis of ICP and control of disease progression.