Objective To study the effect of simple peritoneal dialysis on the treatment of severe congenital heart disease(CHD) after operation complicated with low cardiac output syndrome(LCOS) in children with perioperative therapy.Methods After operation,fifty-three cases of severe CHD complicated with LCOS and the application of easy peritoneal dialysis were collected from Jan.to Jun.2013 in Department of Children's Surgical Intensive Care Specialist,Bayi Children's Hospital were collected.Functional parameters of vital organs,e.g.lung,kidney and heart were observed.Ages varied from 2 days to 2 years old,body weight from 2 to 8 kg.It contained 8 cases of complete transposition of great arteries with intact ventricular septum(TGA/IVS),10 cases of Tetralogy of Fallot(TOF),10 cases of pulmonary atresia (PA),6 cases of interruption of aortic arch (IAA),totally anomalous pulmonary venous drainage (TAPVC) in 6 cases,5 cases of coarctation of the aorta (COA),4 cases with right ventricular double outlet (DORV),3 cases with endocardial cushion defect(CAVC),1 case with ventricular septal defect(VSD).Results Fifty cases were completely cured,postoperative simple peritoneal dialysis treatment for 2 to 10 days,living ICU treatment time 2-15 days,urine output returns to normal 1-3 days,serum creatinine,blood urea nitrogen recovery time after 3-10.days,lactic acid to normal time 1-3 days,and 3 cases complicated with severe LCOS received extracorporeal membrane oxygenation therapy for difficult recovery,and postoperative recovery was good.Three cases died.Conclusions Easy peritoneal dialysis is convenient,safe,minimally invasive,inexpensive and effective.It can improve survival rate and reduce complications,shorten the time of mechanical ventilation and ICU residence time,hospitalization time and cost savings.

Objective To observe the characteristics of liver-kidney yin deficiency syndrome in late stage of spontaneously hypertension rats (SHRs). Methods Ten 12-month-old healthy male SHRs were put into syndrome observer group (SHR group), while ten male WKY rats with the same age were set as control group (WKY group). Syndrome differentiation method on rats was employed to transform the four-diagnostic information into general behavior indexes with the same significance. The afternoon anal temperature, tongue color, holding power, ability of learning and memory, serum estradiol and testosterone level were observed, compared and analyzed. Results Compared with the WKY group, rats in the SHR group had higher afternoon anal temperature, redder tongues, poorer strength and claw holding power and their ability of learning and memory was retarded; the level of serum estradiol was lower;the ratio of estradiol to testosterone was higher. All of these were largely in line with deficiency of live-kidney yin syndrome. Conclusion SHRs in late stage show characteristics of liver-kidney yin deficiency syndrome.

Objective To analyze the clinical characteristics of Klebsiella pneumoniae infection in preterm infants. Methods Clinical data of 75 preterm infants infected with Klebsiella pneumoniae treated in BaYi Children's Hospital from February 6,2008 to February 10,2010 were retrospectively analyzed.The difference of auxiliary examination between early-onset and late-onset infection group were compared by two independent samples t test.Spearman correlation analysis and non-conditional Logistic regression analysis were used to analyze the high risk factors and the prognostic factors of Klebsiella pneumoniae infection in preterm infants. Results The incidence of Klebsiella pneumoniae infection was 2.8％ (75/2721) in preterm infants,and the mortality rate was 9.3％ (7/75). There were 71 cases of Klebsiella pneumoniae sepsis and 4 cases of Klebsiella pneumoniae pneumonia.Among 75 cases,63 cases were early-onset infection (onset age≤72 h) and 12 were late-onset infection (onset age＞72 h).All patients presented with poor response,heart rate during quiet sleep ＞ 160/min and low oxygen saturation.The mean corpuscular volume and mean corpuscular hemoglobin concentration in early-onset Klebsiella pneunoniae infection cases were higher than those in late-onset neonates [(128.87±24.60) fl vs (113.72±13.54) fl,t=-2.07,P＜0.05and (38.11±2.15) pg vs (36.98±1.05) pg,t=-2.76,P＜0.05].Low birth weight and caesarean section were associated with early-onset Klebsiella pneumoniae sepsis (r=0.250 and -0.240,P＜0.05). The prognosis of Klebsiella pneumoniae infection was associated with hospital stay and duration of premature rupture of membranes (r=0.368 and 0.318,P＜0.05). Conclusions There were no specific clinical manifestations for Klebsiella pneumoniae infection in preterm infants.Preterm infants with low birth weight,long duration of premature rupture of membranes,delivered by caesarean section and received invasive operation are likely to develop Klebsiella pneumoniae infection.

Objectives To detect genetic causes of dystrophic epidermolysis bullosa (DEB). Methods Next-generation sequencing was used to detect a neonate with DEB. Sanger sequencing was used to confirm the results and detect his parents and grandmother on his mother side from the family. Results The neonate was found to have heterozygous mutation c.6781C>T of exon 86 in COL7A1 gene.This mutation results in R2261X nonsense mutation in typeⅦcollagen. His mother and grand-mother on his mother side have the same mutation. Conclusion Next-generation sequencing technology is a useful tool for the detection of mutations of COL7A1 gene, which is valuable for clinical application.

OBJECTIVETo study the influence of aconite root, a Chinese medicinal herb with hot property, on energy metabolism and gene expression spectrum, and to analyze the possible mechanism of it effect.

METHODThirty two SPF Wistar rats were randomly divided into aconite root group and control group. Decoction of aconite root and NS were intragastrically administrated with the concentration of 10 mL x kg(-1) respectively once a day for 20 days. Temperature, energy intake (EI), digestive energy (DE) and metabolic energy (ME) were measured. The activity of ATPase and succinate dehydrogenase (SDH) in liver was detected by colorimetry. The gene expression of liver was detected with Illumina's rat ref-12 gene array. The differential expression genes were selected, annotated and classified based on gene ontology (GO). Real-time quantitative reverse-transcriptase PCR (Q-RT-PCR) was used to test the accuracy of the array results.

RESULTCompared with the control group, the toe temperature (TT) on the 10th and 20th day after the administration,the EI/BM( body mass), DE/BM, ME/BM and the activity of Na+ - K+ - ATPase, Ca2+ - Mg2+ - ATPase and SDH of liver in the aconite root group increased significantly (P<0.05). There were 592 differential expression genes in aconite root group compared with the control group. Based on Go analysis, the most significant genes was related to metabolic process (lgP = - 15.5897).

CONCLUSIONAconite root could improve the energy metabolism in rats, by influencing the metabolic process of sugar, lipid and amino acid, which may be the main molecular mechanism of warming yang and dispelling cold for the treatment of the cold syndrome according to Chinese medicine theory.

Aconitum ; Animals ; Body Temperature ; drug effects ; Drugs, Chinese Herbal ; metabolism ; pharmacology ; Energy Intake ; drug effects ; Energy Metabolism ; drug effects ; Female ; Gene Expression ; drug effects ; Male ; Oligonucleotide Array Sequence Analysis ; methods ; Plant Roots ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar

Objective To compare the efficacy of ultrasound ablation and laparoscopic lesion resection with uterine artery liga-tion in treating adenomyosis .Methods By using the prospective ,non-randomized controlled clinical study method ,the adenomyosis patients with clinical symptoms and requiring reserved uterus in our hospital from March 2011 to June 2012 were treated by the ul-trasound ablation technique(ultrasound ablation group ,40 cases) and the laparoscopic lesion resection with uterine artery ligation (operation group ,38 cases) .The menstrual blood volume ,dysmenorrhea and treatment satisfaction in postoperative1 ,3 ,6 months were compared between the two groups .Results The menstrual blood volumes in postoperative 1 ,3 ,6 months in the two groups were decreased significantly(P<0 .05) ,the dysmenorrhea symptoms were improved significantly (P< 0 .05) ,the two groups all were satisfied with the treatment effect .The differences between the two groups had no statistical significance (P>0 .05) .Conclu-sion The two methods of the ultrasound ablation technique and the laparoscopic lesion resection with uterine artery occlusion for treating adenomyosis could significantly reduce the menstrual blood volume ,improve dysmenorrheal and obtain higher satisfaction . Both can achieve the same therapeutic effect .

Objective To reduce the incidence of the hypocapnia,the cutoff value of the end-tidal carbon dioxide partial pressure[Pet(CO2)] for predicting the hypocapnia so as to understand the suitable adjustment target and target range of the Pet(CO2) in preterm infants under mechanical ventilation.Methods From Jan.2012 to Oct.2013,96 cases of the preterm infants with respiratory distress syndrome(RDS) who needed mechanical support were selected from the Huaian Maternity and Child Health Care Hospital.Pet(CO2) value of each time point(1 h,24 h,48 h and 72 h after mechanical ventilation) were recorded,while radial artery blood was collected for blood gas analysis.The level of pa (CO2) ＜ 35 mmHg(1 mmHg =0.133 kPa) diagnosed hypocapnia;while the level of Pa (CO2) ＞ 60 mmHg was for diagnosing hypercapnia.The diagnostic cutoff and the suitable adjustment target and adjustment target range of the Pet(CO2) were confirmed by receiver operating characteristic (ROC) curve.Results The data from 381 arterial blood gas analysis results were gained,of which 151 times belonged to hypocapnia,and the rate was 39.6％,the other 230 cases were normal,and no case was of hypercapnia.The area under the ROC curve was 0.895,and the area of the standard error was 0.016.There was a statistical significance in Pet(CO2) value for the diagnosis of hypocapnia(P =0.000).The lower the value of Pet (CO2),the greater the likelihood of hypocapnia,and 95 ％ confidence interval area was 0.864-0.926.The Pet (CO2) optimal diagnostic cutoff value determined in accordance with Youden index was 30.5 mmHg.When Pet (CO2) among 41.5 mmHg,sensitivity was 100％.Conclusions Diagnostic cutoff value for forecasting hypocapnia is 30.5 mmHg.The suitable adjustment target of mechanical ventilation parameter adjustment is 41.5 mmHg for the Pet(CO2).The target range of mechanical ventilation parameter adjustment is 30.6-41.5 mmHg for the Pet(CO2).

The cholinesterase(ChE)and lactate dehydrogenase(LDH)activities in blood smears of 37 patients were observed before and 20 minutes after electroacupuncture.Hegu and Zusanli were mainly chosen as the acupuncture points.Karnovsky method was used to demonstrate ChE,activity,and tetrazolium-formazan reaction for LDH activity. Before acupuncture,all formed elements of blood showed both ChE and LDH acti- vities.In red blood cells ChE and LDH activities were localized at the cell membrane, while in white blood cells they were found throughout the cytoplasm as colored granu- les.The granulocytes showed greater ChE and lesser LDH activities than the lymph- ocytes.The platelets also showed greater LDH and ChE activities,especially the former. On the whole,platelets and leucocytes,as compared with erythrocytes,showed greater activities for ChE and LDH. Under microscopic observation,according to the amount and color of granules,the degrees of GhE and LDH activities for each kind of blood formed elements before and after acupuncture were recorded as different markes,such as +、++、+++ and so on.The degrees of GhE or LDH activity in various formed elements of blood were compared by means of statistical tests.After acupuncture,both GhE and LDH activities of all blood formed elements were increased(p

70 patients including 60 cases under acupuncture anesthesia and 10 cases under drug anesthesia were observed. Before and 20 minutes after acupuncture the blood samples were taken from the patient ear lobes respectively, and in some patients taken once again 24 hrs after acupuncture. The electroacupuncture point Hegu or Zusanli was mainly adopted. As the method for detection of cell-mediated immunity(CMI) in vitro the improved microtechnique of whole blood for E-rosette (active and nonactive) and lymphocyte transformation tests was used. In performance of active rosetting the total leucocyte count and the differential lymphocyte count were done for calculation of absolute number of active rosette forming cells (RFC). The mean value of increase of active RFC was 12.7?1.43, the decrease was 6.8?1.77 after acupuncture. The increment of the absolute number of active RFC was 175?63.59. However no marked effect on the drug anesthesia group was found. In the lymphocyte transformation assay the increase was 12.7?1.49, the decrease was 7.0?2.19, and the enhancement effect still exhibited 24 hrs after acupuncture. In these tests an increase was mostly found in those with a lower or a usual CMI level; a decrease often found in those with a higher CMI level prior to acupuncture. The increase or decrease level in the results of three kinds of test (active, nonactive RFC and lymphocyte transformation) was similar, the increase range was 12～13%, the decrease range 6～7%. As the former compared with the latter, the promotion was prominent by all means.

ObjectiveTo investigate the relationship between the expression of ER,PR,HER-2,Ki-67 and the effective rate of neoadjuvant chemotherapy (NAC) and to study the influence of NAC on expression of ER,PR,HER-2 and Ki-67 in breast cancer.Methods41 patients of breast cancer were performed 2 to 6 cycles of CAF chemotherapy.The expression of ER,PR,HER-2 and Ki-67 was detected by SP immunohistochemical method before and after NAC.ResultsThe effective rate of NAC was 73.17％ (30/41).The positive and negative efficiency rate was 67.86％ (19/28) vs 84.62％ ( 11/13 ) for ER,64.29％ (9/14) vs 77.78％ (21/27 ) for HER-2,70.00％ (14/20) vs 76.19％ ( 16/21 ) for Ki-67.The difference had no statistical significance (P ＞0.05).The positive and negative efficiency rate was 66.67％ (16/24) vs 82.35％ (14/17) for PR.The difference had statistical significance (P ＜ 0.05 ).The expression of ER,PR,HER-2 and Ki-67 before and after NAC changed in 10,8,3 and 9 cases respectively.The difference had no statistical significance (P ＞ 0.05).ConclusionsNAC has no influence on the expression of ER,PR,HER-2 and Ki-67.Patients with PR negative are more sensitive to NAC.The expression state of PR can be used to predict the curative effect of NAC.The expression state of ER,HER-2 and Ki-67 has no significant correlation with NAC.