Extracorporeal Membrane Oxygenation ; Female ; Heart Failure ; therapy ; Humans ; Infant ; Postoperative Period ; Respiratory Insufficiency ; therapy ; Twins, Conjoined

Objective To study the therapeutic and protective effect of low tidal volume(LTV) ventilation in children with acute respiratory failure.Methods Forty-eight patients with respiratory failure were enrolled in our study.The patients were suffered from severe infection,trauma or after major operation.Besides general treatments,they were all given ventilation with LTV.Blood gas,ventilation parameters and complications related to ventilation were also measured.Results No significant difference was found between the patients with high tidal volume(HTV) and those with LTV in the results of improving respiratory acidosis.But the incidence of(ventilated-)induced lung injury(VILI) was lower in LTV patients.Conclusion LTV ventilation is preferable for children with acute respiratory failure and beneficial for alleviation of VILI.

As seculars,we often feel unhappy,and it seems all of our unhappiness comes from almost every aspect of life,which is unable to escape.Russell′s view of happiness dug out the root of unhappiness from human nature,and tells us happiness could be obtained by expending one′s interests and necessarily giving away something in life.Russell′s great wisdom opens a door for us to the road of happiness.

48 hours.The expressions of leukocyte common antigen(LCA) and intercellular adhesion molecule-1(ICAM-1) in the brain tissues collected during the surgery were detected by immunohistochemistry staining method.Results LCA and ICAM-1 immunopositive cells and microvessels were verified in all 29 cases of ICH groups,and the expressions were more than control group(all P48 hours group were higher than that in 6～24 h group(both P48 hours group.Conclusions Acute inflammatory reaction occurs in acute period of ICH.Expression of ICAM-1 reinforces gradually during early 48 hours since the onset of ICH.

Objective To recognize the developments and achievements of the clinical neuropathology in China from 1955 to 2009.Methods Retrospective survey of literatures related clinical neuropathology published in Chinese Journal of Neurology (CJN) from the first issue in 1955 to the No.12 issue in 2009 was conducted; Total literatures of CJN and literatures of the clinical neuropathology were respectively counted and the percentage of the latter was analyzed in different periods; Proportion of autopsy and biopsy literatures was also analyzed.According to categories of nervous system diseases,their relative percentages were respectively counted.The percentages of clinical neuropathological literatures and autopsy literatures of CJN were compared with the data of the same period of J Neurol Neurosurg Psychiatry (JNNP).Results (1) The percentages of clinical neuropathological literatures in total literatures of CJN were 18.11％ (65/359),20.81％ (103/495),17.05％ (22/129),15.50％ (230/1484),11.58％ (176/1520) and 16.04％ (309/1927),respectively,in 1955-1959,1960-1969,1970-1979,1980-1989,1990-1999,2000-2009.The percentage variation trend in different periods from 1955 to 2009 had significant difference (trend x2 =7.977,P =0.005) ; But there was no significant difference in the variation trend of the percentage of clinical neuropathological literatures between CJN and JNNP from 1955 to 2009.(2) The percentages of autopsy in the total clinical neuropathological literatures of CJN from 1995 to 2009 appeared gradually to decline; Compared with JNNP,the percentages of autopsy in the total clinical neuropathological literatures of CJN during 1980-2009 were lower,and there was significant difference in the variation trend of the percentage of autopsy in the total clinical neuropathological literatures between CJN and JNNP.(3) The main types of neurological diseases in the neuropathological literatures were tumors,infectious diseases and cerebrovascular diseases from 1955 to 1989,while myopathies became the most main disease type during 1990-2009; Compared with the same period JNNP,the clinical neuropathological literatures of the rare and difficult diseases and neurodegenerative diseases in CJN were relatively less.Conclusions Neuropathology is important in the clinical neuroscience research.From 1955 to 2009,main achievements of clinical neuropathological researches in China mainland lie in tumors,cerebrovascular diseases,infectious diseases and myopathies.But in recent years,due to the lack of autopsy cases,it is to the disadvantage of exploring pathogenesis of neurodegenerative diseases and understanding some rare and difficult diseases.

Protective effects of acupuncture on myocardial ischemia in each stage have been confirmed increasingly, while there was no in-depth research in terms of histone modifications. Histone modification is an important part of epigenetics. It is also the focus of molecular biology and basic medical research. In this paper, the relationship of histone modifications and gene expression of heart was first explained. Then, the recent research progress of modified histones, which was the direct alteration of gene expression induced by histone modifications on the degree and prognosis of myocardial ischemic injury, was reviewed. This investigation introduced epigenetic regulation in the protection mechanism of myocardial ischemia by acupuncture. It provided new ideas and directions for the study of molecular mechanism of acupuncture efficacy.

Tumor-associated macrophages (TAMs) exist in the tumor microenvironment,and can be affected by various anticancer treatments and further affect tumor progression.Increasing evidence suggests that many of the clinical antitumor measures can play a unique and effective antitumor effect by regulating the recruitment,polarization and related pro-tumor behavior of macrophages in the tumor microenvironment.Now,tumor microenvironment immune remodeling has become a hot spot in the research of anti-tumor therapy.This paper reviews the related research progress on antitumor effects of TAMs as an therapeutic target.

Objective To explore the clinical features of spongiform encephalopathies occurred in the elderly and causes of misdiagnosis. Methods Clinicopathological diagnosis of a 79 year old man with acute spongiform encephalopathy was reported. Clinical, EEG and MRI characteristics of eight old patients with spongiform encephalopathy in China confirmed by neuropathology were reviewed. Results Elder patients with spongiform encephalopathies had an acute onset and a rapid developing course, and all patients presented with progressive dementia accompanied by various clinical manisfestations of extrapyramidal diseases. EEG recordings with typical periodic sharp wave complexes (PSP) was shown in six cases, and abnormal T2 signal in both basal ganglia by MRI in one case. Three cases were misdiagnosed as cerebral vascular disease and one cse as encephalitis herpes cimplex. Conclusions Spongiform encephalopathy in the elderly should be paid more attention to since their early clinical symptoms are similar to that of the acute cerebral vascular diseases. It is suggested that early diagnosis of spongiform encephalopathy could be made basing on the combination of the typical clinical characteristics and dynamic EEG findings, and brain biopsy if necessary, to avoid nosocomial spreading.

Objective To investigate the features of kidney transplantation in patients over 60 years old.Methods From May 1998 to Oct. 2001,the clinical data of 81 cases over 60 post kidney transplantation were retrospectively analysed and compared with those of 432 patients below 60 age. Results The dialysis time of senile group was longer and the hypoproteinemia was sever than that of control group (P 0.05). The postoperative incidence of pulmonary infection was higher(P

Objective To summarize the experiences of kidney retransplantation from 1978 to Dec. 2002.Methods The clinical data of 86 cases subject to first renal transplantation and 86 cases to second renal transplantation were retrospectively analyzed. The main causes of failure of the first renal transplantation were CAN, while those of the second renal transplantation were HAR, and other complications such as AR, graft rupture and serious graft T.B. PRA or CDC in 31 cases was positive before retransplantation. The clinical data such as antibody-inducing therapy, the protocols of immunosuppression and the survival rates of patients and grafts in these patients were analyzed.Results Survival rates at 1, 3, 5 year of the patient/graft of retransplantation group were 84.8 %/61.6 %, 79.1 %/45.3 % and 58.1 %/41.9 % respectively, while those at 1, 3, 5 years of the patient/graft with the first renal transplantation were 89.5 %/79.1 %, 81.4 %/74.4 % and 67.4 %/58.1 % respectively. No significant difference in the patient survival rates and graft survival rates was observed (P