Objective To investigate the association of C3435T genetic polymorphism of MDR1 gene with paliperidone plasma concentration in the patients with schizophrenia by detecting the paliperidone plasma concentration change and C 3435T genetic pol‐ymorphism of MDR1 gene during medication process .Methods The paliperidone plasma concentration in 61 patients with schizo‐phrenia was detected by adopting the liquid chromatography tandem mass spectrometry at the end of 1 ,2 ,4 ,6 weeks after medica‐tion .Meanwhile C3435T MDR1 genotype was determined by adopting the LDR‐PCR method .The paliperidone plasma concentra‐tions in the patients with different genotypes and different alleles were compared .Results Among 61 patients with schizophrenia , CC ,CT and TT genotypes accounted for 24 .59% (15/61) ,63 .30% (38/61) and 13 .11% (8/61) respectively ,in which the propor‐tion of heterozygote CT was significantly higher than that of homozygote CC and TT (P<0 .05) .The proportion of C and T allele were 55 .74% and 44 .26% respectively(P<0 .05) .The paliperidone plasma concentration at 4 detection time points in the patients with TT genotype at 4 time points was significantly higher than that in the patientis with CC genotype ,and paliperidone plasma concentration only at the end of 1 week in TT genotype was significantly higher than that in CT genotype ,CT genotype was higher than CC genotype (P<0 .05) .The paliperidone plasma concentration at 4 detection time points in the patients of T allele was higher than that in the patients with C allele ,but statistically significant difference was only found at the end of 1 week (P<0 .05) .Conclu‐sion The C3435T genetic polymorphism of MDR1 gene has certain relationship with paliperidone plasma concentration in the pa‐tients with schizophrenia .

Objective To evaluate the function of the domestic sickbeds set up by our hospital in the prevention and cure of non infectious chronic diseases. Methods A perspective study was made through offering health education, guidance and home treatment to 116 cases using domestic sickbeds and employing the method of self management. In addition, the clinical treatment results of the patients and the rate of their satisfaction towards domestic sickbeds were surveyed, analyzed and assessed. Results Through long term follow up visits, it was found that compared with the intermittently standardized group and the completely non standardized group, the control rate of chronic diseases in the standardized group with systematic management and treatment was significantly higher while the rates of complications and mortality were much lower (P

Objective 　To assess the association between the gene of complement C4A, C4B deficiency and schizophrenia. Methods　192 patients with schizophrenia and 142 healthy controls were tested with the amplification restriction fragment length polymorphism (Amp-RFLP) technique.Results　The frequency of C4AQ0/C4AQ0 homozygote was higher in the patient group than in the control group (χ2=8.54, P＜0.01). The relative risk (RR) of C4AQ0/C4AQ0 homozygote for schizophrenia was 6.8. There was no increased frequency of C4B deficiency in patients with schizophrenia (χ2=0.11, P＞0.05, RR=0.73).Conclusions　These results indicate that there is a positive association between complement C4A dificiency and schizophrenia. Moreover, our study did not support a widespread association between a deficiency in complement component C4B and schizophrenia.

Objective To investigate the effects of DRD1 rs265981,rs4532,rs686 and rs265976 polymorphisms on response to clozapine in resistant schizophrenic patients.Methods DRD1 genotype was determined by SNaPshot SNP technique for 154 patients with resistant schizophrenia.Clinical symptoms were evaluated by Positive and Negative Syndrome Scale (PANSS),and the responder was defined as a reduction of 50％ on PANSS score from baseline after the patients were administered orally clozapine for 8 weeks.Results The frequencies of rs265981 genotypes,alleles and rs265976 genotypes had significant differences between clozapine responder group (88 cases) and nonresponder group(66 cases) in total clinical efficacy ( x2 =10.215,P =0.004 ; x2 =4.082,P =0.041 ; x2 =14.083,P =0.007 ).The frequencies of rs265976 genotypes had significant differences between clozapine response (58 cases) and nonresponse (96 cases) to negative symptom ( x2 =9.805,P =0.046).Conclusion The polymorphisms of DRD1 gene rs265981 and rs265976 may relate with clinical response to clozapine in resistant schizophrenias.rs265981 T/T,allele T and rs265976 genotype A/A are likely to be predictive factors to the improvement of total clozapine therapeutic effects.rs265976 genotype A/A are likely to be predictive factors of negative symptom with treatment of clozapine.

Objective To assessment the effect of autologous mastoid cortical bone to cover the mastoidetomy defect via transmastoid and posterior tympanotomy approach surgical technique during cochlear implantation in a ‐dults .Methods A total of 58 adults patients with profound sensorineural hearing loss accepted cochlear implantation from January 2010 and June 2014 ,which were using autologous mastoid cortical bone to cover the mastoidetomy de‐fect via transmastoid and posterior tympanotomy approach surgical technique .By observing postoperation complica‐tion the effect of surgery was evaluated .ABR were obtained for each patients at first ,third and sixth month after op‐eration .The patients which were not using autologous mastoid cortical bone to cover the mastoidetomy defect via transmastoid and posterior tympanotomy proach surgical technique acted as control group .Results No depression was found in the postauricuhtr site .None of the patients had experienced any immediate or delayed postoperative in ‐fection complication such as wound infection ,post - auricular abscess ,acute otitis media ,chronic otitis media ,in‐tracranial complication and necrotic of cortical bone .Autologous cortical bone cap had grew together with remnant cortical bone in all cochlear implantation patients .All implanted processor were in a good position ,all patients had good results after turning on the implant .The ABR thresholds were elevated about 70 dB compare to pre - operation values(P< 0 .05) .There was no significant difference compare to control group (P> 0 .05) .Conclusion The tech‐nique of autologous mastoid cortical bone to cover the mastoidetomy defect in cochlear implantation surgery can pre ‐vent depression of the postauricuhtr site ,remain stability of the implanted processor ,and have a good aided hearing thresholds after operation .

Objective To investigate the changes of intestinal floras in elderly patients with first-episode untreated schizophrenia and to analyze the role of intestinal floras in schizophrenia .Methods Thirty elderly patients(≥60 years old) with first-episode un-treated schizophrenia treated in our hospital from July to October 2016 were selected as the observation group ,while 30 healthy peo-ple undergoing physical examination in the same period were selected as the control group .The bifidobacterium ,lactobacillus and bacteroides of stool samples in the two groups were tested by 16SrRNA real-time fluorescence quantitative PCR (qPCR) .Results The bifidobacterium content of stool samples in the observation group was significantly lower than that in the control group ,while the bacteroides content was significantly higher than that in the control group ,moreover the ratios of bacteroides/lactobacillus and bacteroides/bifidobacterium in the observation group were significantly increased ,the difference was statistically significant (P<0 .05);the lactobacillus content had no obvious difference between the two groups .Conclusion The phenomena of intestinal flora disorder and intestinal flora disproportion exist in elderly patients with first-episode untreated schizophrenia .Intestinal flora may be involved in the pathogenesis of schizophrenia .

According to the super-position principle of the reinforcement of biological activities, a series of novel E-substituted 2, 3-diaryl propenoic acyloxy phosphonate derivatives were designed and synthesized. And the structures of the target compounds were confirmed by IR, 1H NMR, 13C NMR and elemental analysis. Furthermore, the cytotoxicities of all compounds on A-549, SGC-7901 and EC-109 in vitro were evaluated by MTT assay, and some of them showed good antitumor activity. Among the active compounds, especially, the IC50 value of compound 3e was (12.7 ± 1.9) μmol x L(-1) against A-549 cells, similar to cisplatin [IC50 = (8.0 ± 1.5) μmol x L(-1)], compounds 3g and 3k had better inhibition effect on EC-109 cells growth, with the IC50 values of (9.5 ± 1.8) μmol x L(-1) and (11.5 ± 0.9) μmol x L(-1) respectively, and compounds 3i and 3k exhibited good cytotoxic property on A-549, SGC-7901 and EC-109, which were worth further investigation.

Objective To explore the expression of EphB4 and VEGF in esophageal cancer tissues and their relationship with microvessel density (MVD ) ,and analysis the curative effect of postoperative esophageal cancer radical under thoracoscope . Methods Theexpression of EphB4 and VEGF was detected by immunohistochemistry in tumor specimens from 76 cases of esopha-geal squamous cell carcinoma and paratumor normal specimens ,used CD34 as marker to count MVD .According to the situation of expression of EphB4 and VEGF ,we analysis their relationship with lymph node metastasis rate ,recurrence and 5-year survival rate . Results The positive expression rate of EphB4 and VEGF in cancerous tissue (57 .89% and 61 .84% ) ,were significantly higher than that in tissue adjacent to carcinoma(0 and 7 .89% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in high MVD values of patients (67 .44% and 76 .19% ) ,were significantly higher than thatin low MVD values of patients (45 .45% and 44 .11% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in the patientswith lymph node metastasis group and associ-ated with recurrence ,were significantly higher than that of group without lymph node metastasis and group without recurrence (P<0 .05) .The positive expression rate of EphB4 and VEGF in patients of greater than or equal to 5 years of survival rate(45 .00% and 45 .45% ) ,were significantly lower than in patientsof Less than 5 years of survival rate (80 .36% and 85 .19% )(P<0 .05) .Conclu-sion EphB4 and VEGF are highly expressed in esophageal cancer tissue ,which may be closely associated withmicrovessel density , and lymph node metastasis ,recurrence and 5 years survival rate ;the curative effect of positive expression rate of EphB 4 and VEGF is poor .

Objective To investigate the influence of chondrocytes originating from different source on early chondrogenic differentiation of bone marrow mesenchymal stem cells (MSCs) in isolated co-culture system.Methods We applied hanging cell culture system to culture chondrocytes of different origin (osteoarthritis chondrocyte cells,nomal chondrocyte cells,infant chondrocyte cells) and controls.These chondrocytes and MSCs of the same origin were cultured in the common medium in a separated condition,and observed by microscope at 3,6,9,12 day after co culture.Expression levels of aggrecan,collagen type Ⅱ (Col 2),cartilage-specific transcription factor (Sox-9) in MSCs of different origin were determined by Real-time PCR.Results MSCs showed obviously morphological differentiation induced by chondrocytes of different origin at 12 day after coculture as compared with controls.Real-time PCR analysis showed that SOX9 mRNA level was stimulated by 1.7-fold,1.6-fold and 1.2-fold (all P＜0.05) and aggrecan mRNA level was increased by 2.8-fold,2.2-fold and 1.3-fold (all P＜0.05) in infant chondrocytes group,nomal chondrocytes group,osteoarthritis chondrocytes group respectively as compared with controls while COL2 mRNA level had no significant differences among the four groups.Corresponding protein signal level had obvious differences among the four groups,especially in infant chondrocytes as compared with osteoarthritis chondrocytes and nomal chondrocytes.Conclusions Isolated co-culture system may indirectly promote MSCs differentiation to chondrocytes by local micro-environment regulation.Chondrocytes of different origin have different effects on MSCs differentiation,but they could promote MSCs differentiation to chondrocytes.

Objective:To summarize the clinical experience of changing the membranous pulmonary system during extracorporeal membrane oxygenation(ECMO) in infants after congenital heart disease opration with cardiopulmonary bypass.Methods:From January to September in 2019, 6 cases of congenital heart disease with cardio-pulmonary bypass in our hospital were analyzed retrospectively, whose membrane obstruction occurred during ECMO treatment and replaced successfully.The hemodynamics and blood gas before and after replacement of ECMO system were observed, and the experience was summarized.Results:Six patients(3 males and 3 females), aging from 1 to 3 months and weighing from 3.0 to 4.9 kg, were received VA-ECMO adjuvant therapy.The ECMO system replacement process was smooth and took 175-209 s. The hemodynamic of the children was stable.The ECMO support time was 134-249 h. After the improvement of cardiac systolic function, all children were successfully withdrawn and survived.Conclusion:The improved method of liquid replacement in ECMO system can make full use of the blood components in the original system and avoid the loss of blood tangible components.According to the plan of rapid replacement, the risk of replacement will not be increased.