The operating principle of pulse blood oxygen saturation monitor is introduced. The usage and maintenance are discussed. Notice in using the instrument is suggested. The problem that the SPO2 detector is easy to damage is solved.

Dysentery is one of the digestive system diseases, which has a higher incidence rate. The aim of present study was to further explore the incidence of dysentery and get the better prevention of this disease. The data were collected and statistically analyzed from Shaanxi Province for the monthly incidence of dysentery in 22 years. In addition, according to the Yunqi theory and related incidence of diseases, the correlation between the incidences of dysentery and Suiyun, Sitian, Zaiquan and Six-qi were summarized systematically. This study provides a reference for the incidence of dysentery.

ObjectiveTo compare the efficacy and health economics between open choledocholithotomy and endoscopic sphincterotomy (EST) these two operations on patients with choledocholithiasis. Methods177 patients (aged 20-75 yrs, with simple choledocholithiasis on medical imaging,who had not been treated with either biliary tract surgery or EST, and had no severe complications)were treated electively at the Beijing Friendly Hospital and Beijing Jishuitan Hospital from 2002 to 2009. These patients were divided into two groups according to the treatment they received: open operation (n=62), or EST (n=115). There was no significant difference in sex, age, ASA class,symptoms before operation, and complications before operation between the 2 groups. The following data were compared: operation time, blood loss, size and number of stone, duration of postoperative ileus, duration of abdominal pain, incidence of postoperative complications, duration of hospitalization, cost of hospitalization and operation, and incidence of residual stones. ResultsFor the open operation group, the operation time was 50-300 min (M=110), the blood loss was 10-300 ml (M=60), the duration of post-operative ileus was 24-96 h(M=48), the duration of abdominal pain was 0-96 h(M=48), the duration of hospitalization was 8-70 d(M=21), the duration of hyperamylasemia after operation was 8.1％ and the cost for operation was 546-2498 yuan (M=1503. 2). For the EST group, the operation time was 10-120 min (M=25), the blood loss was 2-40 ml (M=10),the duration of post-operative ileus was 1-48 h (M=3), the duration of abdominal pain was 0-144 h (M-0), the period of hospitalization was 5-56 d (M=17), the duration of hyperamylasemia after operation was 40％ and the cost for operation was 2028-5728 yuan (M=2028). There were significant differences in every aspect between these 2 groups of patients. Conclusions EST has a significantly shorter operation time, less blood loss, shorter duration of postoperative ileus, shorter duration of abdominal pain, shorter duration of hospitalization. However, EST had a significantly higher incidence of hyperamylasemia after operation and the cost was higher than open operation.

Objective To investigate the polymorphism of the vitamin D receptor(VDR)gene in relation to primary hyperparathyroidism(PHPT). Method Polymerase chain reaction and restriction analysis were used to determine VDR genotypes in 30 patients with PHPT and in normal subjects.ResultsThe frequency distribution of VDR genotypes in PHPT patients was 0 in BB,1(3.3%) in Bb, 29(96.7%) in bb; and in normal persons was 2(3.3%) in BB, 11(18.4%) in Bb, and 47(78.3%) in bb. There was a significant difference between PHPT patients and normal persons in distribution of BB, Bb, bb genotypes (P≤0.05).ConclusionsThere is some distribution alterations of VDR gene polymorphism in PHPT patients.

[Objective]To recommend the detailed operative skill of lower cervical transpedicle screw and peri-operative experience.[Method]From July 2004 to April 2006,based on anatomical research of cadaver,15 cases involved lower cervical had been treated by transpedicle screws and plate or rod,which assisted in fluoroscopic moniter.Lateral mass needed be revealed completely,thus basilar part of superior articular process could be recognized.The central point of screw inserted were laid on the surface of lateral mass: 5mm inner to the outside border of lateral mass;3mm below to the inferior of superior articular process.Ball-like burr was used to de-cortical.Made a pathway with 2 mm hand-drill paralleled with the upper end-plate cartilage of the vertebra and maintain abduction angle about 40?～45? with middle line of the vertebra,self-designed pedicle probe was used to ensure safety tunnel of cancellated bone.3.5 mm cortical screws were adoption and thread was not recommend.[Result]Eightysix lower cervical pedicle screws had been inserted successfully in C3～7 vertebra,exclude a failed C4 screw.Average screws length was(26 + 1.6)mm and abduction angle based on postoperative CT scan was 37.9??5.4?.Abundant bleeding was occurred while built the pedicel pathway in 2 screws,and there were 6 screws showed perforation of the pedical wall refer to postoperative CT scan. No evidence indicated the complication about injury of vessel or nerve structure.[Conclusion] The technique of lower cervical transpedicle screw are relatively safet.Successful screw insertion depends on subtile sense of operation doctor's hand.

Objective To develop electronic touch-screen inpatient satisfaction questionnaires so as to improve the real-fimeness and accuracy of data processing in patient satisfaction surveys and evaluations. Methods 266 inpatients from 20 clinical departments of a certain hospital in Zhangjiakou were asked to make satisfaction evaluations via a touch screen and the reliability and validity of the questionnaires were assessed by statistical and psychological means. Results The item response rate was 98.72％, the effective rate was 98.1％, and the a reliability coefficient for internal consistency was 0.9474; the composition of the questionnaires, which matched the reality of management, supported contents validity; a factor analysis showed that the factor load and structure, which matched the structure of the questionnaires, supported structure validity; intra-factor correlations, which were stronger than interfactor correlations, supported aggregation and discrimination validity. Conclusion The questionnaires, reliable andvalid, interface friendly and easy to operate, facilitate their use by patients with different backgrounds. The real-time occurrence and antomatic pooling of survey data render possible the automation of data collection in patient satisfaction surveys and evaluations.

Objective To summarize the experience on diagnosis and treatment of primary hyperparathyroidism(PHPT).Methods Clinical data of 91 PHPT patients treated in Beijing Jishuitan Hospital from November 1992 to December 2008 were analyzed retrospectively.Results Among 91 PHPT cases,88 were diagnosed as parathyroid adenoma(96.7%),3 were diagnosed as parathyroid carcinoma (3.3%).Serum calcium and PTH levels increased in all cases.Main clinical manifestations were osteodynia and kidney stones.The accuracy rate of preoperative B-ultrasound.CT and ECT~(99m)Tc-MIBI on location was 83.5%(76/91),60.9%(14/23)and 98.6%(69/70)respectively.Parathyroidectomy was performed in all but one cases,in which parathyroid carcinoma was managed by ipsilateral hemithyroidectomy and modified neck dissection.The cure rate of primary operation was 97.8%(89/91).Ninety cases were followed-up from 8 months to 14 years postoperatively,87 cases with parathyroid adenoma achieved complete remission,2 with parathyroid carcinoma suffered from tumor recurrence and 1 died.Conclusion Patients with chronic bone diseases,repeatedly recurrent nephrolithiasis,peptic ulcer disease should be a suspect of PHPT.The routine examinations of serum calcium and phosphorus are to be conducted.UItrasonography and ECT~(99m)Tc-MIBI should be considered as the methods of first choice for preoperative localization.

[Objective]The oxidative injury of retinal pigment epithelium(RPE)plays a key role in the pathogenesis of age-related macular degeneration(ARMD). This study is to investigate the effects of endoplasmic reticulum stress and the vital transcriptional factor X-box binding protein 1(XBP1)in acrolein-induced oxidative damage of RPE.[Methods]RPE cells were treated with acrolein (75μmol/L)for 2~24 h,expression of glucose regulated protein 78(GRP78)and XBP1 was determined by Western blot analysis. After being transfected with XBP1 siRNA with 24 h,the expression of XBP1 was knocked-down in RPE cells. Protein level of Nrf2 and SOD2 was then determined by Western blot analysis and intracellular Reactive Oxygen Species(ROS)generation was determined by DCF staining. Acrolein was added for 8 h after being transfected with XBP1 siRNA or control siRNA for 24 h. Apoptosis was detected by TUNEL assay before and after the treatment. Subretinal injection of Cre or GFP adenovirus was performed in XBP 1flox mice. After 1 week the mice were sacrificed. Total RNA was extracted from mice eyecups using TRIzol and real-time RT-PCR was performed to determine the two XBP1 down-stream genes,ERdj4 and p58IPK. Cryosectioning and immunofluorescent staining were performed to look at the expression of XBP1,Nrf2 and SOD2 in mice RPE.[Results]Protein level of GRP78 was significantly un-regulated after exposure to acrolein for 2 and 4 h. XBP1 was activated after acrolein treatment for 6 h. Knock-down of XBP1 by siRNA down-regu?lates anti-oxidant genes expression and increased ROS generation in RPE cells. Loss of XBP1 exacerbates acrolein-induced cell apoptosis. XBP1 was knocked-down in the RPE of XBP1flox mice after subretinal injection of Cre adenovirus. Decreased mRNA level of ERdj4 and p58IPK,and decreased Nrf2 and SOD2 expression were seen in the Cre-injected group.[Conclusions]Acrolein induces ER stress and activates XBP1 in RPE cells. Knock-down of XBP1 down-regulates anti-oxidant genes expression ,increases ROS generation,and exacerbates acrolein-induced cell apoptosis. XBP1 plays a role in the anti-oxidant defense in the RPE cells.

Objective To investigate the effect of p15~(INK4B)(p15)gene transfection on the proliferation of pancreatic cancer cell line BxPC3.Methods In p15 transfection group.pCDNA3.1(+)p15 was transfected into BxPC3 cell by the vector of Lipofectamine2000.In empty plasmid transfection group, pCDNA3.1(+)neo was transfected into BxPC3 cell with the sa/ne method as a blank control group.In non-transfection group.the BxPC3 cell was not transfected as a negative control group.The p15 mRNA expressions were assayed by RT-PCR,and p15 protein expressions were assayed by Western blot.The proliferation was determined by MTY assay,ultra-structure changes were measured by transmission electron microscope.Cell cycle and apoptosis were measured by flow cytometry.Results In the pCDNA3.1(+)p15 transfeetion group,the expression of p15 mRNA and protein were resumed.Since the 2nd day of culture,the growth of pCDNA3.1(+)p15 transfeetion group was inhibited,till the 7th day,the inhibitory rate was 47.9%,G_0/G_1 Dhase cell accounted for(61.56±3.96)% of all the cells,which was significantly higher than(47.44±6.35)%ofthe black control groups and(49.22±7.23)%0f tlle negative control group(P<0.05).G_1apoptosis peak occurred and the apoptosis rate was(5.27±1.04)%in pCDNA3.1(+)p15 transfection group,which was significantly higher than(0.11±0.06)% of the black control groups and(0.09±0.07)% of the negative control group(P<0.05).Apoptosis was also observed by transmission electron microscope in the pCDNA3.1(+)-p15 transfection group cells.Conclusions After p15 gene transfection,BLPC3 cell proliferation could be significantly inhibited and apoptosis could be induced.

Objective To investigate the structural changes during the early stage of spinal cord injury,and the relationships between these structural changes and patients' motor recovery.Methods The clinical data of 25 patients with spinal cord injury collected from 2012 October to 2014 March were analyzed retrospectively.The spinal cord injury patients were split into two groups (Good recoverers group and Poor recoverers group) according to the clinical outcome of motor recovery at 6 months follow-up,and there were 10 Good recoverers (ASIA grade:1 A,4 B,3 C,and 2 D) and 15 Poor recoverers (ASIA grade:7 A,3 B,3 C,and 2 D).The study also recruited 25 matched healthy controls.The mean age of Good recoverers,Poor recoverers and healthy controls were 37.9± 13.9,35.8± 11.5 and 36.5±9.3,respectively.Structural MRI was used to investigate the regions with brain structural changes among the three groups.Pearson correlation analysis was used to explore the relationships between these structural changes and patients' motor recovery.Results Compared to healthy controls group,both poor recoverers and good recoverers had significantly decreased cortical thickness in the bilateral primary motor cortex.Poor recoverers exhibited more serious and widespread structural damages,in addition to reduced cortical thickness in the primary motor cortex,poor recoverers also showed decreased cortical thickness in the right SMA and premotor cortex when compared to healthy controls.Compared to the healthy controls group,poor recoverers showed reduced white matter volume in the right primary motor cortex and posterior limb of the internal capsule;good recoverers showed no significant difference in white matter microstructure.Furthermore,these structural changes at the internal capsule and primary motor cortex were associated with the motor recovery rate at 6 months follow-up (r=0.75,P＜ 0.001;r=0.76,P＜ 0.001,respectively).Conclusion These findings suggest that spinal cord injury causes significant anatomical changes in the human sensorimotor system in the early phase,and these structural changes directly affect the motor recovery of spinal cord injury.Future treatment aimed at promoting neural function recovery of spinal cord injury patients should pay close attention to the injured brain.