Objective To analyze and evaluate the 48 selected highly polymorphic SNP loci in Chinese Han population on genetic and forensic aspects.Methods Samples from 200 unrelated Han individuals in East China were collected.48 X-SNP polymorphic genetic markers were selected according to the information providedby NCBI and HapMap,and then were typed by SNPlex~(TM) System for establishing genetic data.Results The 48 X-SNP loci were highly polymorphic markers in East China Han population except rs6527549,and their polymorphism information contents(PIC)were all above 0.32,the discrimination power(DP)in females and males were above 0.56 and 0.40 respectively,the probability of exclusion(PE)in duos and trios were above 0.20 and 0.32 respectively.In addition,linkage disequilibriums were observed among some loci.Conclusion The 48 X-SNP loci union is suitable for developing high-throughout automated research and also useful for special parentage testing.

PurposeTo evaluate and describe fetal cardiac development and hemodynamics high risk pregnancy by using ultrasound technique. Methods Two-hundred and thirty-three pregnancies were prospectively studied by using the detailed fetal echocardiographic procedure( fetus gestational age from 19 weeks to 39 weeks). Cardiac chamber size, internal diameter of great arteries were documented together with the presence of inflow and outflow wave patterns. In utero diagnoses of variety of congenital heart defects were also conducted. ResultsCardiac chamber size and internal diameter of great arteries showed a positive correlation with the increasing of gestational age. Left and right ventricles were demonstrated the same size during whole fetal observational period. Blood flow through mitral valve and tricuspid valve were typically 'M' type. By comparing 'e' wave and 'a' wave, this inflow blood velocity pattern was dominant by 'a' wave, though the ratio of a/e gradually decreased during the fetal development period. Blood velocity in aorta and pulmonary artery remained steady along with the gestational age. The detection rate of verity types of congenital heart diseases in this sample population was 5.7% (13 cases) ,the major problem was the complex heart malformation. The occurrence of fetal cardiac arrhythmia was 14 cases (16 % ), with the majority of atrial premature beat. Conclusions Fetal echocardiography can be used to evaluate and monitor the change of cardiac anatomy, structure and hemodymanics during the different gestational age. This has provided a new approach to the further understanding of fetal cardiac development, and is importantto the screening of congenital heart disease during pregnancy.

Objective T o observe and analyze the confirm ed cases of paternity testing, and to explore the m utation rules of ST R loci. Methods T he m utant ST R loci w ere screened from 20723 confirm ed cases of paternity testing by G oldeneye 20A system .T he m utation rates, and the sources, fragm ent length, steps and increased or decreased repeat sequences of m utant alleles w ere counted for the analysis of the characteristics of m utation-related factors. Results A total of 548 m utations w ere found on 19 ST R loci, and 557 m utation events w ere observed. T he loci m utation rate w as 0.07‰-2.23‰. T he ratio of pater-nal to m aternal m utant events w as 3.06:1. O ne step m utation w as the m ain m utation, and the num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences. T he repeat se-quences w ere m ore likely to decrease in tw o steps m utation and above. M utation m ainly occurred in the m edium allele, and the num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences. In long allele m utations, the decreased repeat sequences w ere significantly m ore than the increased repeat sequences. T he num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences in paternal m utation, w hile the decreased repeat sequences w ere m ore than the increased in m aternal m utation. Conclusion T here are significant differences in the m utation rate of each locus. W hen one or tw o loci do not conform to the genetic law , other detection system should be added, and PI value should be calculated com bined w ith the inform ation of the m utate ST R loci in order to further clarify the identification opinions.

6 cases of gamete intra-fallopian transfer (GIFT) were performed in cooperation with the Department of Gynaecology and Obstetrics of The Third Teaching Hospital of our university in 1987. All the six women aged less than 41 years and have failed to be pregnant as long as ten years. One fallopian tube is patent at least. Two of them were pregnant after operation of GIFT. The rate of success was 33％. We used Ham's F10 medium mixed with different concentrations of fetal cord serum or mother's serum to prepare respectively follicular flushing medium (FM), sperm washing medium (SW), growth medium (GM) and transfer medium (TM). Clomiphene citrate and human menopausal gonadotropin (HMG) were used for inducing growth of follicle. HCG was given by intramuscular injection when two or more follicles were measured 16 mm in diameter by pelvic ultrasound. 32-34 hours later, follicular aspiration were performed by abdominal operation and the oocytecorona-cumulus complexes (OCCCs) were collected and trimmed under stereo microscope. The semen samples were obtained by means of masturbation 2-3 hours before operation. After centrifuged twice, the liquified semen was mixed with SW and incubated with 5％ CO_2 in air at 37℃ until GIFT.The OCCCs and 25?l processed semen were loaded into a special catheter and transferred into one fallopian tube. Then the transfer procedure was repeated for the other fallopian tube. The level of HCG in blood was examined from day 11 after transfer in order to diagnose pregnancy.

Objective To optimize the formulation of metoprolol succinate ( MS) controlled release pellets by central composite design-response surface methodology .Methods MS sustained-release pellets were prepared using sugar pellet cores as starter beads , ethyl cellulose as coating materials and MS itself as a pore former .The formulation of MS sustained-release pellets was optimized by a central composite design with two factors at five levels .These two factors ( two independ-ent variables) were the pore former level and coating level , and the evaluated indexes ( namely dependent variables ) included the in vitro cumulative release percentages of MS at 1, 4, 8, 12 and 16 h, respectively.Results and Conclusion The results of mathematical equation fitting suggested that the second-order quadratic model was the optimal fitting equa-tion.According to the response surfaces , the optimum values at the pore former level and coating level weve ranged from 16%to 18%and 20% to 25%, respectively .The in vitro cumulative release percentage of MS from the pellets at 1 h reached 9.15%,which consequently eliminated the lag phase in the initial release period and exhibited a good sustained-release effect.Central composite design-response surface methodology can be applied to optimizing the coating formulation for MS sustained release pellets .

Objective To investigate the effect of PXR* 1B polymorphism on postoperative analgesia with fentanyl in the patients undergoing gynecological operation.Methods A total of 102 female patients from Henan province, of Han nationality, aged 20-50 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , with body mass index of 14.8-30.0 kg/m2, scheduled for elective abdominal total hysterectomy or myomectomy under general anesthesia, were enrolled in this study.PXR genetic polymorphic sites were analyzed by polymerase chain reaction (PCR)-direct DNA sequencing.PXR* 1B haplotype was analyzed by the PHASE V.2.1 software.The patients were assigned into 3 groups according to their genotypes: PXR* 1B haplotype group (group PXR* 1B), non-PXR* 1B haplotype group (group n-PXR* 1B) and PXR* 1B/PXR * 1B group (group PXR* 1B/PXR* 1B).Postoperative pain was assessed with visual analogue scale (VAS) score.When VAS ＞ 3, fentanyl 20 μg was injected intermittently until VAS ≤ 3, and then a pump was connected to perform patient-controlled intravenous analgesia (PCIA) with fentanyl.PCIA solution contained fentanyl 1.0 mg and droperidol 5 mg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose, a 5 min lockout interval and background infusion at a rate of 0.5 ml/h.The number of successfully delivered doses was set at 7 times, and the maximal amount of fentanyl was 145 μg.If exceeding the maximal dose, the VAS score was still more than 3, nonsteroidal anti-inflammatory drugs were given as rescue medication.VAS score immediately after the end of operation, and the consumption of fentanyl within 24 h after operation were recorded.Midazolam 0.1 mg/kg was injected intravenously during induction of general anesthesia, and 1 h later venous blood samples were collected for determination of plasma 1'-hydroxymidazolam and midazolam concentrations.The ratio of 1'-hydroxymidazolam concentration to midazolam concentration was calculated to reflect the activity of CYP3A4.Results No patients required rescue anesthetics in the three groups.There were 27 cases in group PXR * 1B, 53 cases in group n-PXR* 1B, and 22 cases in group PXR* 1B/PXR* 1B.PXR* 1B allele frequency was 37.2％.There was no significant difference in VAS score immediately after the end of operation, consumption of fentanyl within 24 h after operation, and activity of CYP3A4 between the three groups (P＞0.05).Conclusion PXR* 1B polymorphism has no effect on postoperative analgesia with fentanyl in the patients undergoing gynecological operation, and is not one of the genetic factors producing individual variation in postoperative analgesia.

Objective To observe the efficacy and safety of Shenqiwuweizikeli for treating chronic insomnia.Methods One hundred and ninety-six cases of subjects were randomly divided into Shenqiwuweizikeli group (n =98) and Estazolam tablets group (n =98).The pittsburg sleep quality index (PSQI) was adopted to evaluate the clinical effects and records of adverse reactions during the study period.Also the lab routine inspection(blood routine,urine routine,liver and kidney function, electrocardiogram were conducted to evaluate safety.Results The Shenqiwuweizikeli and Estazolam tablets all had significant effects for chronic insomnia.The total effective rate of Shenqiwuweizikeli group was 92.86％ (91/98), of Estazolam tablets group was 93.88％(92/98) ,and there was no significant difference (P＞0.05).There were no abnormalities in terms of each routine inspection index.After stopping take the medicine, The adverse reactions including bounce sex insomnia(60 cases), daytime sleepiness/drowsiness (55 cases), dizziness with lacking of power and light headedness(23 cases) in Estazolam tablets group were all more than Shenqiwuweizikeli group with significant difference(P＜0.01).Conclusion The Shenqiwuweizikeli has definite efficacy and safety for treated with chronic insomnia without withdrawal of recoil and dependence.

Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city.Methods Interrupted time series analysis was used to compare changes of the average days of stay,per capita hospitalization expense,outpatient expense per visit,proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform.Results Comparisons before and after the reform found the average days of stay at the original momentum,poor control in curbing the proportion of medical expense and that of drugs during hospitalization,adropping followed by rising trend in the outpatient expense per visit,and minimal drop of the abovementioned proportions.Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer,structural trend of hospitalization expense makeup,and rationality pending scrutiny.

Tripartite-sector reform (a synergistic reform in public health services,medical insurance and medicine production-circulation) in Sanming city was described in the paper which centers on medical insurance.Tapping full potentials of the medical insurance,the city achieved efficient synergy among healthcare,medical insurance and medication systems.This reform has trimmed out inflated drug pricing to some extent for rooms of maneuver of medical service pricing changes,thus curbing excessive growth of medical costs successfully.The authors proposed areas of further improvements including the relationship between achieving such objective as curbing medical expenditure,and advancement of technical/medical service capacity;that between integrative control of medical insurance expenditure and protection of people's health;the equilibrium of interests between medical insurance,healthcare and medication.All these will contribute to the goal of healthy patients flow and a hierarchical medical system.

Objective To investigate the effect of IL-1β-511 genetic polymorphism on postoperative analgesia with fentanyl. Methods Two hundred and fifty ASA Ⅰ or Ⅱ patients of Han nationality (native of Henan province) aged 20-50 yr undergoing elective abdominal total hysterectomy or myomectomy under general anesthesia were enrolled in this study. The polymorphic sites of the IL-1β-511 allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism. The patients were assigned into 3 groups according to their genotypes: group wild homozygote; group mutation hetorozygote and group mutation homozygote. Anesthesia was induced with midazolam, remifentanil, propofol and succinylcholine and maintained with propofol, remifentanil and atracurium. The patients were mechanically ventilated after tracheal intubation. The pain was assessed using VAS score after the patients recovered from anesthesia. When VAS score was ＞ 3 the patients were given fentany120 μg every 5 min until VAS score decreased to ≤ 3. PCIA with fentanyl was then started. The PCIA solution contained fentanyl 1.0 mg and droperidol 5mg in 100 ml of normal saline. The PCA pump was set to deliver a background infusion of 0.5 ml/h and a bolus dose of 2 ml at 5 min lockout interval. The VAS score was maintained at ≤3.The amount of fentanyl consumed during 24 h of PCIA was recorded. Results There was no significant difference in the amount of fentanyl consumed during the 24 h PCIA among the 3 groups. Conclusion IL-1β-511 genetic polymorphism is not the factor contributing to the individual variation in the patient' s response to postopertive analgesia with fentanyl, indicating that the pain within 24 h after operation is not related to the inflammatory factors.