Through the simulation based on a two-dimensional whole-heart electrophysiological model, the effect of ventricular electrical activity on the precordial cardioelectrical field as well as the ECG manifestation have been discussed. Such effect can vary with the changed excitation sequence of ventricles and the changed active and passive electrical properties of cardiac tissues. As the result, many abnormal ECG waves can form. By carefully analyzing such effect, the correlation among ECG waveforms recorded at different lead locations can be revealed and the significance of ECG manifestation can be fully explored.As a case of analyzing, some ECG waves at certain right chest lead locations can get a proper explanation.

Objective: To evaluate the effect and safety of Beyond cold light tooth whitening kit on bleaching the teeth changed in color with age. Methods: 426 teeth changed in color with age in 32 patients were bleached with Beyond cold light tooth whitening kit, and 431 teeth changed in color with age in 32 patients were bleached with Aulen bleaching agent as control. The changes of teeth color were evaluated by VITA shade guide matching, and the sensitivity of tooth was recorded. Results:The highly effective rate (89.7%) of experimental group was significantly higher than that(73.3%) of control group(P0.05). Conclusion: Beyond cold light tooth whitening kit is proved to be an effective, safe and quick method of bleaching the teeth changed in color with age.

We invented an efficiently approach to building whole-heart electrophysiological model with cellular automata style massive parallel computing. In this paper, we introduce the simulation facilities of a model we built and the potential application of such model. The first use is to solve the forward problem of electrocardiogram. Simulating arrhythmia ECG and accurately interpreting the significance of various irregular waveforms will be the key goal. Investigating the dynamic property of cardioelectrical activity at cellular and channel levels is the second application, aiming at revealing the mechanism of the generation and sustentation of arrhythmia. Third, the model can be used to research the impacts of artificial interventions on cardioelectrical activity. Electrical defibrillation and pace-making as well as the use of channel block agents are all cases.
Arrhythmias, Cardiac ; etiology ; physiopathology ; Computer Simulation ; Electrocardiography ; methods ; Electrophysiology ; Heart ; physiology ; Humans ; Models, Cardiovascular

BACKGROUND:Recent studies found that some factors play important role in the process of denervated muscle atrophy, especial y the feak-headbox transcription factor, is the key element to regulate the denervated muscle atrophy.
OBJECTIVE:To investigate the effect of RNA interference on inhibiting feak-headbox 3a gene expression in vitro.
METHODS:The myoblast cel line L6 were cultured in the 6-wel cel culture plates, then pEGFP-N1 and smal
interfering RNA recombinant plasmid with the same ratio was transfected under the Lipofectamine2000 mediation to optimize the transfection efficiency of the detection system;2μg smal interfering RNA recombinant plasmid of feak-headbox 3a gene were transfected with myoblast cel line L6 for 48 and 72 hours.
RESULTS AND CONCLUSION:At 48 hours after pEGFP-N1 and siRNA recombinant plasmid transfection, a large number of bright green fluorescent displayed under fluorescence microscope with higher transfection efficiency. Real-time quantitative PCR analysis showed that there were significant differences in the sequences of feak-headbox 3a-Ⅰ, feak-headbox 3a-Ⅱ, feak-headbox 3a-Ⅲ, feak-headbox 3a-Ⅳ on feak-headbox 3a mRNA when compared with the control group at 48 and 72 hours after trasfection (P<0.05), and the inhibition effect was more significant at 72
hours after transfection when compared with that at 48 hours after transfection. Western Blot gray analysis showed that there were significant differences in sequences of feak-headbox 3a-Ⅰ, feak-headbox 3a-Ⅱ, feak-headbox 3a-Ⅲ,
feak-headbox 3a-Ⅳ on feak-headbox 3a mRNA when compared with the control group at 48 and 72 hours after
trasfection (P<0.05), and the inhibition effect was more significant at 72 hours after transfection when compared with that at 48 hours after transfection, which was same with the effect on mRNA level. RNA interference in vitro can
significantly inhibit the fork-head transcription factor feak-headbox 3a gene expression, and the inhibition effect of feak-headbox 3a gene smal interfering RNA recombinant plasmid transfected with the sequence on the mRNA and protein level of feak-headbox 3a is not clear, which can provide new idea for the gene therapy of RNA mediated denervated skeletal muscle atrophy.

Objective To evaluate the value of the change of B-type natriuretic peptide(BNP) in predicting weaning outcome of patients with mechanical ventilation in ICU.Methods We carried out a prospective cohort study on patients in ICU at Fuxing Hospital from July 2013 to January 2014.Patients expected to use mechanical ventilation for more than 24 hours were enrolled in our study.The plasma concentration of BNP was measured at the beginning of spontaneous breathing trial(SBT) and 2 hours after.According to the outcome of SBT,patients were divided into SBT failure group (group A),weaning failure group (group B) and weaning success group (group C).The levels of BNP before and after the SBT were compared among three groups.The receiver operating characteristic (ROC) curve analysis was used to evaluate the changes of BNP (△BNP) and the rate of change (△BNP％) in predicting weaning outcome.Results A total of 56 patients were enrolled in our study,12 in group A,11 in group B and 33 in groupC.In groupC,both△BNPand△BNP％ [7.0,(-1.2,45.5) ng/L;6.1 (-2.1,11.5)％]were significantly lower than those in group A [88.0 (58.0,140.0) ng/L,P ＜ 0.05;20.5 (15.3,40.3) ％,P＜0.001]and group B[46.0 (17.5,91.2) ng/L,P＜0.001;24.3(13.0,32.5) ％,P＜0.001].The area under ROC curve (AUC) of △BNP％ to predict weaning success was 0.88 [95％ CI 0.79-0.97;P ＜0.001] and the cut-off value is 13.4％ with relatively high sensitivity(84.8％)and specificity(82.6％).The AUC of △BNP to predict weaning success was 0.80 [95％ CI 0.69-0.92;P ＜ 0.001] and the cut-off value is 80ng/L with high sensitivity 93.4％ and mediocre specificity (47.9％).Conclusion Either △BNP％ or △BNP in the SBT can predict weaning outcome,in which △BNP％ seems better than △BNP.

Objective To analyze the operation of the diagnosis-related groups ( DRGs) pilots for inpatients in the new rural cooperative medical system in Yulin city of Shaanxi province. Methods The medical records of 33306 inpatients discharged from the 3 pilot hospitals between January and July in 2017 were analyzed, aided by expert discussions, on-site assessment and medical records examinations. Results By the end of July 2017, the DRGs grouping tool had been running stably. The DRGs enrollment rates of discharged inpatients were all up to 99% in the 3 pilot hospitals. The coefficient of variation ( CV) was higher than 1 only in a few DRGs. The average length of stay and the average hospitalization expenses growth rate were both found declined. However, there also exist problems in the pilots, namely incomplete regulations for DRGs, low clinical path coverage rate, hysteretic supervision and assessment, uneven quality of medical records management and so on. Conclusions The pilots operated smoothly as evidenced in their initial success. Yet the following recommendations were raised for the improvements: To strengthen the organization and leadership to improve the DRGs related supporting system in pilot hospitals; To strengthen the promotion and application of clinical paths for standardization of the medical service process;To improve the DRGs assessment program and establish DRGs operation monitoring and tracking analysis system; To strengthen the training of medical record coding staff to improve continuously the quality of medical records.

Objective:To analyze the implementation of medical emergency team (MET) in Fuxing Hospital of Capital Medical University, and to investigate the characteristics such as the time, department, disease, cause of the MET calls, in order to provide a basis for the improvement of MET's implementation.Methods:A retrospective study was conducted. MET calls that received between January 1st, 2015 and December 31st, 2018 at Fuxing Hospital were collected. The calls' information included the quarter, time, and the patients' gender, age, admission time, department, admission diagnosis, the reason for the calls, the operation and outcome of the MET upon arrival.Results:A total of 846 MET calls were occurred during 4 years from 2015 to 2018. The frequencies of the first and third quarter were relatively high with 28.0% (237/846) and 26.5% (224/846), respectively. The events mainly occurred during the day (08:00-19:59) with 611 calls (72.2%). There were more men [64.3% (544/846)] than women [35.7% (302/846)]. The calls were mainly from the elderly over 60 years old, and gradually increased with age, which distributed the most in patients aging 80-89 years old, accounting for 51.5% of all calls (436/846). Among all the MET events, 80.5% (681/846) were from department of internal medicine, 18.8% (159/846) were from department of surgery, and 0.7% (6/846) were from department of gynecology and obstetrics. The top 3 diseases reported in the calls were respiratory diseases [31.6% (267/846)], nervous system diseases [20.8% (176/846)] and circulatory diseases [9.9% (84/846)]. The reason of MET calls showed that abnormal pulse oxygen saturation [SpO 2, 27.8% (235/846)] were the most among 4 vital signs. After MET rescue, 7.3% (62/846) of the patients died, 48.7% (412/846) were transferred to intensive care unit (ICU) for further treatment, and 41.9% (354/846) remained under observation. Conclusions:The frequency of MET calls in Fuxing Hospital of Capital Medical University was relatively stable over the years, mostly received in the daytime (08:00-19:59) of the first and third quarter. Most of the patients were male aged 80-89 years old. The most MET calls were from department of internal medicine and due to respiratory disease. SpO 2 was the most common abnormal indicator. According to the above characteristics, MET can focus on them in the future.

Objective To evaluate the impacts of DRGs payment reform on patients, medical insurance fund and hospitals, then to steadily promote the payment reform. Methods The reimbursement data of inpatients covered by NCMS yet beyond the single-disease payment were collected from two DRGs pilot hospitals from January 2016 to June 2018. Such means as descriptive statistics, t test and method of interrupted time series analysis were used to compare the changes found in the average out-of-pocket payment, actual reimbursement rate, average per-hospitalization compensation, average length of stay, and average hospitalization expense before and after the DRGs payment reform. Results After the reform, the average out-of-pocket payment and average length of stay began to fall slightly instead of the increasing trend (β3 were -72.79,-0.11, respectively, and P<0.01), the upward trend of average hospitalization expense slowed down ( β3 was -113. 55, and P<0.01), actual reimbursement rate and the average per-hospitalization compensation stayed the original growth trend (β3 were 0.10,-31.15, respectively, and P values were 0.08, 0.09, respectively). Conclusions DRGs encourages the hospitals to curb the average hospitalization expenses, with the growth trend kept at a slower pace. The payment reform does not increase the financial burden of patients, and tends to ease such pressure on funds, but the long-term effect remains to be seen.

Objective:To explore the effects of deleted in lung and esophageal cancer 1 (DLEC1) on osteosarcoma cells and the underlying mechanism.Methods:Immunohistochemical staining for DLEC1 was scored in sixteen paired osteosarcoma tissues and adjacent normal tissues obtained. The present study was conducted on human osteosarcoma 143B cells which were randomly divided into two groups, pDC316-DLEC1 transfection group and pDC316-Null transfection group. Differences in the proportion of EdU-positive cells, cell cycle distribution, proportion of apoptosis cells, number of migrating and invasive cells, expression of epithelial-mesenchymal transformation (EMT) markers (E-cadherin and vimentin), relative protein expression levels of NF-κB, AKT and ERK signaling pathways were assessed between the pDC316-DLEC1 and pDC316-Null transfection groups in in vitro study. The subcutaneous inoculation model and tail vein injection model were developed to evaluate the differences in subcutaneous tumor volume, subcutaneous tumor weight and pulmonary tumor nodules between the above two groups in in vivo study.Results:The DLEC1 immunostaining scores for osteosarcoma tissues and adjacent normal tissues were 2.88±1.15 and 4.25±1.06, respectively. The proportions of EdU-positive cells (36.47%±1.90% vs 51.47%±2.89%) and S phase cells (33.31%±0.61 vs 43.77%±1.47%) were decreased, while G0/G1 phase cells (46.87%±0.73% vs 35.47%±1.14%) and apoptotic cells (13.83%±1.01% vs 3.30%±0.26%) were increased in the pDC316-DLEC1 transfection group compared to those in the pDC316-Null transfection group. Decreased number of migrating cells (199.00±12.53 vs 369.67±10.02) and invasive cells (104.67±9.07 vs 299.67±12.06) and relative expression of vimentin mRNA (0.59±0.02 vs 1.00±0.02) and protein (0.54±0.08 vs 1.00±0.00) were observed in the pDC316-DLEC1 transfection group, while relative expression of E-cadherin mRNA (2.40±0.05 vs 1.00±0.02) and protein(1.98±0.10 vs 1.00±0.00) in the pDC316-DLEC1 transfection group were higher than those in the pDC316-Null transfection group. The relative protein expression of NF-κB (p65), p-AKT (Ser473) and p-ERK (Thr202/Tyr204) in the pDC316-DLEC1 transfection group were decreased by 51.67%±4.04%, 64.67%±5.51% and 48.67%±4.73% compared to those in the pDC316-Null transfection group. In in vivo study, 143B cells in the pDC316-DLEC1 transfection group formed smaller (320.00±145.22 mm 3vs 798.00±221.94 mm 3) and lighter (0.49±0.17 g vs 0.88±0.14 g) subcutaneous tumors and less metastatic lung nodules (7.71±1.80 vs 20.86±3.53) compared with those in the pDC316-Null transfection group. Conclusion:Overexpression of DLEC1 could suppress the NF-κB/AKT/ERK signaling pathways in 143B cells, which further induces G0/G1 arrest and apoptosis that ultimately inhibits cell proliferation and reduces the metastatic potential through reversing EMT.