Objective To explore the distributive changes of PIDD protein in HT29 cells stimulated by 5-fluorouracil(5-FU),and the influence of the PIDD protein interfered by small interference RNA(siRNA) on the drug resistance of HT29 cells in vitro.Methods siRNA was used to interfere the PIDD expression,and HT-29 cells were treated with 5-FU.Western blotting was employed to detect the PIDD expression before and after interference.The distribution of PIDD in nucleus and cytoplasm after 5-FU treatment was also detected.Changes in drug sensitivity of HT-29 cells to 5-FU were determined with MTT assay and IC50 values were evaluated.Results PIDD protein was expressed mainly in the cytoplasm before 5-FU stimulation,and it migraded into the nucleus after stimulation.Western blotting showed that the total PIDD expression and the expression both in cytoplasm and nuclei decreased significantly after RNA interference,and no increase of the total PIDD and that migrated into nucleus was found even after 5-FU stimulation.It was found that in the transfection group(cells were incubated 12h after being transfected with PIDD-360),normal group(cells without treatment) and control group(cells were incubated 12h after being transfected with negative transfection reagent),the IC50 values of cells treated with 5-FU were 0.23?0.06?g/ml,2.71?0.70?g/ml and 2.78?1.03?g/ml,respectively.The IC50 value declined significantly in transfection group compared with that of both the normal group and control group(P

Objective To evaluate the value of prenatal gene diagnosis for thalassemia. Methods 128 fetuses suspected with thalassemia were performed amniocentesis or cordocentesis for gene diagnosis. Results No severe complications occurred during all procedures. 32 fetuses had normal genotype. 38 were heterozygous and 27 were homozygous of ?- thalassemia; 18 were heterozygous, 4 were homozygous and 9 were double heterozygous of ?-thalassemia. The types and frequencis of ?-thalassemia mutation were CD 41-42(47.5%), IVS-Ⅱ-654(42.5%), 17(A-T)(7.5%) and -28 (A-G)(2.5%) in turn. Pregnancies of 40 fetuses with severe thalassemia were terminated in time. Conclusions The screening and prenatal diagnosis of high risk fetus for thalassemia is safe, effective and accurate. It should be used as an obstetrical routine examination at the region with high thalassemia occurrence.

Objective To explore the technique of implantation of double-J stent via the guide-wire track, which was established through percutaneous renal puncturing, for the treatment of ureteral stricture and obstruction, and to evaluate its therapeutic effect. Methods A total of 75 patients with ureteral stricture or obstruction, who failed to respond to cystoscopic catheterization, were enrolled in this study. The lesions included benign stricture(n=60) and malignant stricture(n=15). Ureteral guide-wire track was established through percutaneous renal puncturing, which was followed by the dilatation of the stricture with balloon catheter and subsequent implantation of double-J stent via the guide-wire track. After the double-J stent was removed, the patients were followed up for 3 months to five years. Results The success rate of the procedure was 98.7%(74/75). Technical failure occurred in one patient with benign ureteral stricture. The cure rate was 70.7%(53/75), the improvement rate was 26.7%(20/75), and no improvement was seen in one case (1.35%). The total effective rate was 97.3%(73/75). Conclusion For the treatment of ureteral stricture and obstruction, the implantation of double-J stent via the guide-wire track, which is established through percutaneous renal puncturing, is a safe and effective method.

Objective To evaluate the value of single leaflet replacement of bovine pericardium in the treatment of aortic valve insufficiency using transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods TTE and TEE examination were performed for 25 cases pre-operation,postpump intraoperative and 3-6 months after the operation,to judge the structure and the regurgitation of the aortic valve.And the inside diameter of left atrium(LA)and left ventricle(LV)in the same plane and the same phase were also been measured.Results The degree of aortic regurgitation(AR)before operation were significantly different with that postpump intraoperative(P＜0.001)evaluated by TEE.There was no difference in the degree of AR by postpump intraoperative TEE and those of AR by TTE 3-6 months after surgery(P＞0.1).The inside diameter of LA[(3.80±1.37)em]and LV[(5.75±1.32)cm]before repair were larger than those 3～6 months after surgery[LA(3.19±0.90)cm,LV(4.72±1.19)cm,P＜0.001].Conclusions The replacement of single aortic valve with bovine pericardium to treat aortic valve insufficiency is a good alternative for patients with satisfactory short-term results,but long-term results are not clear.

Objective:To study the 3D accuracy of 4 impression materials.Methods:A metal mould with a custom tray was prepared for the measurement.Impression samples of 2 alginate and 2 rubber impression materials were prepared in the metal mould(n =3)re-spectively.The length of three tagged lines,along X,Y,Z axis directions of the samples was measured with a 3D optical scanner.Re-sults:120 min after sampling the variable rates of the length along X,Y,Z axis of Zhermark alginate samples were 3.615%,3.037%and 2.836%,those of CAVEX alginate samples were 2.836%,3.358% and 4.276% respectively;8 h after sampling the variable rates of Impregum Penta polyether rubber samples were 0.039%,0.071% and 0.057%,those of ExpressXT Penta H addition-curing silicone rubber samples were 0.033%,0.088% and 0.084% respectively.Conclusion:The variable rates of the 4 impression materi-als are in accordance with ISO1563∶1990.The variable rate of alginate impression material is greater than that of rubber.

OBJECTIVE:To regulate the management of operation drug and promote medication security. METHODS:Based on the relevant principles in the standard of JCI,the practice about establishment of operation pharmacy in our hospital was intro-duced,and it were stated from two aspects which included working mode and effects. RESULTS:The working mode were format-ed by definiting the duties and working flow of pharmacist,anesthetist and liaison man. The establishment of operation pharmacy, which brought operation drugs into the unified management system of our hospital,saved manpower and improved work efficien-cy,refined the management of drugs in all aspects,improved the management of drug safety level,strengthened drug expiration date management,implemented the reporting of adverse drug reactions(event)and collecting of medication(potential)errors. The established mode conformed to the relative standard of JCI including preparation,grant,storage and collection of ADR of drug. CONCLUSIONS:The established drug management of operation pharmacy promotes standardized administration of surgery drug, which guarantees the drug use safety of patients.

Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.

Chinese Physician Declaration and Medical Professionalism in the New Millennium-Physician De-claration in the United States and European countries are two significant documents that promote and cultivate phy-sicians′professionalism. Researches showed that the two declarations were basically the same in the background and guiding ideology. However, influenced by the historical tradition, cultural characteristics, medical and health system, medical science technological development, and social psychological factors, there exists difference in terms of perceive and practice. The differences manifest in the comprehension and grasping, ethnical theory basis, the nature and the degree of standard abilityand practice guarantee of physicians′professionalism. Therefore, study on the differences between the two declarations is beneficial to the construction of physicians′professionalism in our country.

Objective To evaluate the analytical performance of Mindray BS‐820 automatic biochemical analysis system used in primary hospitals in Guangzhou area for verifying whether its performance meeting the clinical requirements .Methods Accord‐ing to the EP5‐A2 ,EP6‐A ,EP7‐A2 and EP‐17A files recommended by CLSI and the Pharmaceutical Industry Standard of the Peo‐ple′s Republic of China YY/T0654‐2008 ,the precision ,linear rang ,anti‐interference capability ,sensitivity and carry‐over rate of the Mindray BS‐820 automatic biochemical analysis system were evaluated by adopting 16 routine biochemical items .Results The pre‐cision results of all 16 analyzing items conducted by the Mindray BS‐820 automatic chemical analysis system conformed to the re‐quirements .The results of 15 items showed good linear relation during the testing range (r≥0 .997 9) .In 16 biochemical items ,the anti‐interference capability of TBIL ,TP ,TC ,TG ,LDL ,HDL ,UREA and Ca to bilirubin ,triglyceride and hemoglobin conformed to or were higher than the anti‐interference capability declared by manufacturer ,but among other 8 items ,the anti‐interference capabil‐ity of 3 items was lower than that declared by manufacturer .The limit of blank(LOB) of all 16 analyzing items was less than LOB in the kit instruction .The carry‐over rate of Glu was 0 .02% ,less than 0 .50% .Conclusion This instrument has good precision , sensitivity and low carry‐over rate(0 .02% ) ,the linear range is ideal ,r≥0 .997 9 ,the anti‐interference capability basically satisfies the clinical needs .Therefore this instrument is suitable for the use in the middle‐small scale laboratory department .