Adolescent ; Female ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Lymphohistiocytosis, Hemophagocytic ; genetics ; Mutation ; Signaling Lymphocytic Activation Molecule Associated Protein

Objective To estimate the arterial-to-end-tidal carbon dioxide tension difference (Pa-ET CO 2 )in children with cyanotic or acyanotic congenital heart diseases;evaluate whether hyper-ventilation can reduce the tension difference or not;analyze the effect of sevofleurane on Pa-ET CO 2 . Methods One hundred and twenty patients (male 60 cases,female 60 cases,aged 1 month-6 years, ASA class Ⅱ or Ⅲ)undergoing selective cardiac surgery were randomly divided into 6 groups (n =20 each)based on right-to-left or left-to-right intracardic shunts:group A1,cyanotic with sevoflurane of 0.5 MAC;group A2,cyanotic with sevoflurane of 1.0 MAC;group B1,acyanotic with sevoflurane of 0.5 MAC;group B2,acyanotic with sevoflurane of 1.0 MAC;group C1,cyanotic with no inter-vention factors;group C2,acyanotic with no intervention factors.All the children received general an-aesthesia after placing an intravenous and arterial catheter.The value of PET CO 2 ,SpO 2 ,PaCO 2 , SaO 2 ,Hct and temperature(nasopharyngeal temperature and rectal temperature)were obtained before operation,after hyperventilation(the control groups without hyperventilation)and five minutes before surture sternum.Results The values of Pa-ET CO 2 were more than the normal one in six groups before operation.The value of Pa-ET CO 2 in group B1 was less than that in group A1,that in group B2 was less than that in group A2 and that in group C2 was less than that in group C1 before operation (P <0.01).Compared with the time point before operation,the values of Pa-ET CO 2 in groups A1,A2,B1 and B2 decreased significantly after hyperventilation (P < 0.05 or P < 0.01 ).Moreover, this reduction was more significant in groups B1 and B2.Compared with the time point before operation, the values of Pa-ET CO 2 in groups B1,B2,C2 increased significantly (P <0.01)and that in groups A1, A2,C1 decreased significantly (P <0.05)at 5 minutes before surture sternum.There was no statisti-cal difference at three different time points between group A1 and A2,B1 and B2.Conclusion The value of Pa-ET CO 2 in cyanotic children increased more significantly than that in acyanotic children.Hy-perventilation can reduce the value of Pa-ET CO 2 especially in acynanotic children with pulmonary con-gestion.The concentration (from 0.5 MAC to 1.0 MAC)of sevoflurane had little effect on the value of Pa-ET CO 2 .

Objective This study was carried out to investigate the relationship among the partial plasma hormones associated with the stress,main indices of liver function as well as psychical status in the patients with viral hepatitis(VH).Methods Five indices of liver function,plasma cortisol(CT) and angiotensin Ⅱ(ATⅡ) were detected,the psychical tests were simultaneously carried out by survey item life events units(LEU),symptoms checklist 90(Scl-90).Results Both CT and ATⅡ ascended in the acute period of various types VH and correlated with many indices of liver function(P

AIM:To explore the regulatory effect of microRNA-3666 (miR-3666) on the expression of its tar-get gene phosphatase and tensin homologue deleted on chromosome ten (PTEN) in leukemic cells.METHODS: miR-3666 expression levels in normal peripheral blood mononuclear cells and leukemic cells were determined by quantitative real-time PCR.miR-3666 targeting PTEN 3'-untranslated region (3'UTR) was predicted by TargetScan software .3'UTR of PTEN was inserted in the dual luciferase reporter vector psiCHECK 2.The reporter activity was evaluated by the Dual-Lu-ciferase Reporter Assay System after the luciferase promoter vector and miRNA were co -transfected into HEK293T cell line. K562 cells were transfected with synthetic miR-3666 inhibitor ( anti-miR-3666) or a synthetic control miRNA ( anti-miR-C) .The expression of PTEN protein in the above transfected K 562 cells was determined by Western blotting .RESULTS:miR-3666 was up-regulated in the human leukemic cell lines and primary leukemic cells compared to normal peripheral blood mononuclear cells .The results of dual luciferase assays validated PTEN as a specific target gene of miR-3666.Inhi-bition of miR-3666 resulted in an up-regulation of PTEN protein expression in the K 562 cells.CONCLUSION:miR-3666 is over-expressed in leukemic cells .The abnormal over-expression of miR-3666 may play a key role in leukemia due to the down-regulation of PTEN .

OBJECTIVEDesign and make triple cannula dual-lumen vacuum extractor to improve effect of decompression in operation of intestinal obstruction.

METHODSTriple cannula dual-lumen vacuum extractor was applied in 32 patients who underwent operation of intestinal obstruction from 2012 to 2015 in our hospital. The effect of intestinal decompression and patient prognosis were observed.

RESULTS32 patients that used triple cannula dual-lumen vacuum extractor had good recovery except for one patient abdominal incision with fatty liquefaction. The other patients had one-stage healed without any complication such as intestinal fistula, abdominal infection etc.

CONCLUSIONApplication of triple cannula dual-lumen vacuum extractor in operation for intestinal decompression could avoid contamination of abdomen and injury of intestinal mucosa, which had satisfied effect of intestinal decompression and promoted the effect of operation for intestinal obstruction.

Objective To compare the clinical data of patients with chronic hepatitis B virus (HBV) carriers and chronic hepatitis B so that to provide pathological evidence for management of chronic HBV carriers with different alanine aminotransferase (ALT) levels.MethodsLiver biopsies were performed in totally of 292 cases of chronic HBV infection.The subjects were divided into HBV carrier group (G0-G1 and S0-S1) and hepatitis group (G＞ 1 and/or S＞ 1) according to the pathological diagnosis. The relationships between different age subgroups, different ALT level subgroups and pathological diagnosis were analyzed. Meanwhile,other clinical,biochemical,and iconographic indexes which were possibly related to the pathology diagnosis were compared. The multivariate analysis was done by Logistic regression equation (withdrawal method, maximum likelihood method) to definite the independent influencing factors of pathologically diagnosed with chronic HBV carrier.ResultsAmong the 292 patients,140 (47.9％) were pathologically diagnosed with chronic HBV carries and 152 (52.1％)were chronic hepatitis B. There were statistical differences between ≤35 years group and 36-40 years,＞40 years group (x2 =3.936 and 8.534,respectively; P =0.047 and 0.003,respectively). There were statistical difference among patients with ALT＜0.5×upper limit normal (ULN),(0.5-1.0) ×ULN,(1.1-1.5) ×ULN,(1.6-2.0) ×ULN and ＞2.0 × ULN (x2 =55.314,P＜0.01),while there was no significant difference between (1.1-1.5) × ULN and ＞2.0 × ULN (x2 =3.810,P=0.051). Multivariate analysis indicated that course of disease,alcohol consumption,ALT,HBV DNA level and the surface of liver (smooth or not smooth)detected by ultrasonography were independent influencing factors of pathological diagnosis of chronic HBV carriers (OR =0.995,0.224,0.516,1.308 and 0.270,respectively; P=0.005,0.007,0.000,0.025 and 0.001,respectively).ConclusionLiver biopsy is much meaningful in patients with age ＞35 years old and ALT (1-2)× ULN.

OBJECTIVE:To evaluate the cost and effectiveness of Shenmai injection and Salvianolate for injection in adjuvant treatment of coronary heart disease with heart failure. METHODS:In prospective randomized controlled clinical study,103 pa-tients with coronary heart disease with heart failure were randomized into 2 groups:55 patients in group A received Shenmai injec-tion 50 ml added into 5% Glucose solution 250 ml intravenously on the basis of routine treatment,once a day;48 patients in group B received Salvianolate for injection 200 mg added into 5% Glucose solution 250 ml intravenously on the basis of routine treatment,once a day;treatment course lasted for 2 weeks. The improvement of clinical indicators and ADR were observed before and after treatment;2 drug treatment programs were evaluated and analyzed with pharmacoeconomics. RESULTS:Total effective rates of group A and B were 89.09% and 72.92%,with statistical significance(P<0.05);the incidence of ADR in group A and B were 9.09% and 12.50%,there was no statistical significance(P>0.05). The cost-effectiveness ratio of group A was significantly lower than that of group B,with statistical significance(P<0.05);the results of sensitivity analysis was consistent with it,indicat-ing the cost of Shenmai injection was in low level. CONCLUSIONS:Shenmai injection is more economic in adjuvant treatment of coronary heart disease with heart failure.

Objective To study the influence of high quality nursing mode on the quality of life in endoscopic retrograde cholangiopancreatography (ERCP) patients. Methods A total of 292 patients with ERCP were randomly divided into control group and observation group with 146 cases in each group by the randomized block design method. The control group was given the conventional nursing care. The observation group was given the high quality nursing care based on the conventional nursing care. The score of Quality of Life of the World Health Organization (WHOQOL- 100), Quality of Life Index of Gastrointestinal Tract (GIQLI), Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale(VAS) before and after nursing care were observed and compared. The difference impact of two kinds of nursing mode on nursing quality between two groups was evaluated. Results WHOQOL-100 score in the observation group after treatment, including physiology and psychology and environment and social relations state such as grading, was respectively (59.3 ± 6.0), (61.8 ± 7.2), (60.3 ± 6.2), (62.8 ± 7.3) points and GIQLI index included self-conscious symptom and body physiological status and daily and social activities,such as state of emotional and psychological and the overall score, was respectively (79.8±4.9), (19.8±1.8), (14.7±1.9), (19.2±2.8), (105.7±6.6) points, which was (50.9±6.3), (52.5±6.7), (51.4±5.6), (53.4±7.1), (67.2±4.8), (15.6±1.9), (10.2±1.8), (16.3±2.3), (94.4 ± 6.2) points in control group, the difference between two groups was statistically significantly(t=1.876-2.327, P<0.05). HAMA score and SAS scores and SDS score and VAS score in the observation group after nursing was respectively (24.28 ± 4.78), (29.48 ± 6.54), (30.55 ± 7.32), (4.55 ± 1.18) points and respectively (36.68 ± 5.39), (41.72 ± 6.03), (42.65 ± 7.21), (6.07 ± 1.17) points in the control group, the difference between two groups was statistically significantly(t=2.876-4.012, P<0.05). Conclusions High quality nursing mode of ERCP in patients with perioperative patients of psychological and physiological all have different degrees of improvement and is suitable for popularization and application in clinic.

Objective To explore the impact of cardio cerebral vascular diseases (CVD) on life expectancy among residents in Shandong Province,develop effective preventive measures for the high-risk population and provide guidance for the health care resource allocation.Methods Based on the death monitoring data of the disease in Shandong Province in 2012,we calculated the crude mortality and standardized the mortality rate of the disease.We designed life tables with all causes of death and with eliminating causes of CVD death and analysed life expectancy with and without them examined.Results In 2012,crude mortality rate of CVD was 320.16/100 000 (SMR 252.85/100 000) in Shandong Province.The death rate of CVD was of 46.30％ of all deaths reported by monitoring system.The mortality rate of CVD in male and female were 332.99/100 000 and 307.02/100 000,respectively.The mortality rate of CVD in rural and urban areas were 341.84/100 000 and 267.28/100 000,respectively.The mortality of CVD increased with age and growed rapidly after the age of 60.Life expectancy of urban and rural areas was 79.20 years and 78.14 years,respectively.After eliminating causes of CVD death,life expectancy for eliminating causes of CVD death in urban and rural areas increased 8.51 years and 10.02 years,respectively.Life expectancy for eliminating causes of CVD death in male and female increased 8.02 years and 11.10 years,respectively.Conclusions Life expectancy of urban and rural areas,the male and female for eliminating causes of CVD death than that of all causes of death were greatly extended.Reducing the death caused by CVD to increase health life expectancy have important public health significance.

Objective To discuss the relationship between repetitive variable deceleration with a short interval (RDSI) in labor and neonatal acidosis.Methods One hundred and seventy-seven electronic fetal heart monitoring (EFM) patterns within one hour preceding delivery in term singleton pregnancies were collected in Peking University Third Hospital between February 2011 to October 2013.Continued EFM were recorded before delivery.Analysis was conducted on general information of both mothers and babies,including pregnant complications,duration of labor,cord and placental factors,nature of amniotic fluid,Apgar score and neonatal cord blood gas.RDSI was defined as that over 50％ intervals between two decelerations (the end of the last deceleration to the beginning of the next one) ≤ 60 s which appeared repetitevly in a period of 20 minutes.Independent sample t test,rank sum test,Chi-square test and Fisher's exact test were applied for statistics and receiver operating characteristic curve was obtained from the information of those with RDSI.Results Twenty-four of the 177 women with RDSI were assigned to the study group (24 cases,13.6％) and the rest 153 cases without RDSI to the control group.Background information of women in the two groups was comparable according to the maternal age,gestational weeks at delivery and duration of labor (all P ＞ 0.05).The occurrence of meconium stained amniotic fluid in the study group was higher than that of the control group [16.7％ (4/24) vs 5.2％ (7/153),x2=5.204,P=0.045],while the pH and base excess value of the neonatal blood gas in the study group were lower [7.20 (7.13-7.28) vs 7.29 (7.25-7.33),Z=-4.490;-6.10 (-4.67 to-9.62) mmol/L vs-3.20 (-4.90 to-1.55) mmol/L,Z=-5.044;P ≤ 0.01] resulting a higher rate of neonatal acidosis [50.0％(12/24) vs 7.8％ (12/153),x2=31.456,P ＜ 0.01].No significant difference was found in the incidence of neonatal asphyxia between the two groups.The area under the curve was 0.774 (95％CI:0.579-0.969).Conclusion RDSI in labor might indicate a high risk of neonatal acidosis.