Objective To study the expression of the imprinted gene H19 and IGF-Ⅱ in newborn placenta,and to discuss its influence on the birth body mass of the neonate. Methods The fresh placental tissues from full-term newborn (without trimester of pregnancy complica-tion and placenta and funic abnormality) with normal,high and low birth body mass (12,10 and 8 samples respectively)were collected. The expression of imprinted gene H19 and IGF-Ⅱ mRNA in the placenta were estimated by reakime fluorescence quantitative PCR Results The ex-pression of H19 mRNA in the placenta was negative correlation to the birth body mass (r =-0.403,P = 0.027).The expression of of IGF-H mRNA was positive correlated to the birth body mass (r = 0.444,P = 0.014). The H19 mRNA expression level in the high birth weight neonates (0.21 0.31) was significantly lower than that in the low birth body mass neonates (1.51 2.04)(P= 0.013). But the expression level of IGF-Ⅱ mRNA in the high birth body mass neonates (2.67±3.41) was significantly higher than that in the low birth body mass neonates (0.39±0.33)(P =0.013). Conclusion The expression of H19 and IGF-Ⅱ mRNA was significantly different in the placenta of normal,high and low birth body mass newboms. These two genes may be related to the birth body mass,and there may be some realation-ship between these two genes.

AIM: To establish a HPLC method for determing naringin,rhein,emodin,chrysophanol,honokiol and magnolol in Da,Xiao-Chengqi Decoction bought from Taiwan. METHODS: The seperation was performed on Licrospher C_(18) column(150 mm?4.6 mm,5 ?m) with acetonitrile-0.5% HAc(gradient elution) as mobile phase and the detection wavelength was set at 270 nm. RESULTS: In the eight samples measured the content of naringin was from 0.54 to 44.20 mg/g;rhein from 0.51 and 2.10 mg/g;honokiol from 0.44 to 6.65 mg/g;emodin from 0.02 to 0.23 mg/g;magnolol from 1.09 to 2.29 mg/g,chrysophanol from 0.09 to 2.70 mg/g.However,honokiol and magnolol were not detected in some samples. CONCLUSION: This established method is fully validated with respect to linearity,precision,reproducibility and accuracy and successfully applied to quantifying the six constituents in eight commercial samples.The overall results demonstrate that this proposed method is simple,reliable,and suitable for the quality control of Da,Xiao-Chengqi Decoction.

Objective We compared the difference of diagnosing macrosomia using the body mass index (BMI)and body mass,so as to investigate whether BMI play an important role in the diagnosis and management of macrosomia in our clinical work.Methods We analysed 5522 newborns (without any maternal complication)delivered in Shengjing Hospital of China Medical University from Jan.2004 to Apr.2009,all of them were full term,singleton and with the birth body mass larger than 2500 g,among them 4989 were in the group with body mass <4000 g,that was 2510-4000 g.533 cases were in the group of body mass ≥4000 g.By both body mass and length,we got the BMI.According to statistical receiver operating characteristic curve(ROC),we determined the cutoff of BMI for diagnosing macrosomia,in addition the sensitivity and specificity of it. Using this newly gotten BMI cutoff as a method to diagnose macrosomia and analyse the results.Results (1)When the newborns with birth length 40-43 cm.the mean birth body mass was(3010 ±351)g,BMI was(17.0 ±2.7)kg/m2;the newborns with birth length 48-51 cm,the mean birth body mass was(3450 ±313)g,BMI was(13.2±1.4)kg/m2;newborns with birth length 56-60 cm,the mean birth body mass was(4332 ±456)g,BMI was(12.5 ±1.3)kg/m2,The longer the birth length,the larger the birth body mass,while the less BMI.(2)Determined by ROC curve,the BMI value could be used to diagnose macrosomia was 14.2 kg/m2.with sensitivity of 78.4% and specificity of 85.0%, the area of under curve was 0. 892. (3) By the BMI cutoff ( 14. 2 kg/m2 ), 111 macorsomia with birth body mass ≥4000 g were not macrosomia any more (20. 8%, 111/533 ),422 still were macrosomia (79.2% ,422/533) ; while for those birth body mass <4000 g, 728 were macrosomia determined by this BMI cutoff ( 14. 59%, 728/4989 ), 4261 were still not macrosomia ( 85.41%, 4261/4989 ). Using BMI cutoff 14. 2 kg/m2 to diagnose macrosomia, within the group of birth body mass ≥4000 g, their birth length in macrosomia and non macrosomia was (52. 2 ± 1.8) cm and ( 55.6 ± 1.3 ) cm respectively, the difference was significant (P <0. 01 ) ;while within the group with body mass <4000 g, the birth length of macrosomia and non-macrosomia was (49.0 ±2. 2) cm and (50. 8 ±2. 2) cm respectively,the difference was significant as well (P <0. 01 ). The whole incidence of macrosomia was 20. 83% (1150/5522) determined by this BMI cutoff. Conclusions Birth body mass and BMI in determining macrosomia show some bias, and birth length relates with this difference, which suggests birth length maybe play an important role in determine the macrosomia. We suggest it is very necessary to use BMI≥ 14. 2 kg/m2 in the diagnosis and management of macrosomia.

Objective To explore the influence of preferred contract-altering system on contracted nurses to provide reference for stabilizing a team of high quality nursing.Method A scale on effort-reward unfairness(ERI)was used to investigate the ERI conditions among 348 contracted nurses before and after the enforcement of preferred contract-altering system.Results The scores on satisfaction with nursing work and the security in nursing work after the enforcement of the system were higher than before the enforcement(P<0.01).The ratio between effort and reward after the enforcement was lower than before the enforcement(P<0.01). Conclusions The preferred contract-altering system may enhance the job security and sense of belonging.It may decrease the ERI condition among contracted nurses,which are beneficial for stabilizing the nurses team,retaining talents and increasing the group’s competitiveness and vigour.

Objective To investigate the diagnostic value of gluocose-6-phosphate isomerase (G6PI) detected by an enzy-me linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA). Methods The G6PI was detected by ELISA in serum samples from 106 patients with RA, 53 non-RA controls with various rheumatic diseases, and healthy individuals. The level of rheumatoid factor (RF), anti-CCP antibodies and AKA were also assessed in RA patients. The correlation analysis beween G6PI and anti-CCP, IgM-RF. G6PI, anti-CCP, IgM-RF and AKA were carried out between patients with erosion and with non-erosion diseases . Results ① G6PI serum level of patients with RA was (1.61 ±1.20) μg/ml, and was (0.11 ±0.17) in patients with other rheumatic diseases, and (0.06±0.07) μg/ml in healthy individuals. There was statistical significant difference between RA patients and patients with other rheumatic diseases (P<0.05). Receiver operator curve analysis (ROC) showed an opitium cut off level for C6PI at 0.225 μl/ml. The sensitivity of G6PI was 0.868, the specificity was 0.853 in RA. C6PI was associated with RF, but was not associated with anti -CCP. C6PI ws not associated with disease activity index by Spearman' s correlation analysis. The association between above parameters with bone erosion was not detected, however. Conclusion C6PI is abnormally increased in some RA so it may be a new diagnostic marker for RA. G6PI has a reasonable sensitivity (86.8%) and with high specificity(85.3%) to RA and it is valuable for RA diagnosis. C6PI is associated with RF, but not completely overlaps. C6PI is not associated with diseases activity. No association is found between G6PI and bone erosions.

Objective To investigate the effectiveness of the comprehensive quantitative　assessment system in the review of senior clinical titles so as to set up a comprehensive appraisal　system for clinicians.Methods A retrospective analysis was made to compare the objective parameters　for performance appraisal of the applicants for senior titles before and after the adoption of the　comprehensive quantitative assessment system,namely,between 2003 to 2006 and 2007 to 2010.Results The parameters were improved in aspects of clinical practice,education and research.And　the average age of applicants was lowered.Conclusion The new assessment system works well for　clinician appraisal,and produces a positive guiding effect of the senior title review on hospital　development.Suggestions are also made to solve the existing problems and to improve the system.

Pelvic inflammatory disease sequela (chronic pelvic inflammation) is one of the diseases that affect women's health conditions, and leads to large economic burden. Chinese Material Medica (CMM) plays an impor-tant role in treating pelvic inflammatory disease sequela (chronic pelvic inflammatory). However, due to the lack of Evidence-based Pharmacoeconomic Evaluation Technical Essentials of CMM in Treatment of Pelvic Inflamma-tory Disease Sequela (Chronic Pelvic Inflammatory), non-standard phenomenon often appears in the research liter-ature, such as the selection of research methods, viewpoint of research, determination of cost, effect and utility. Thus, the publish of Evidence-based Pharmacoeconomic Evaluation Technical Essentials of CMM in Treatment of Pelvic Inflammatory Disease Sequela (Chronic Pelvic Inflammatory) is essential for the pharmacoeconomic evalua-tion of CMM in treating pelvic inflammatory disease sequela (chronic pelvic inflammatory).

Objective To study the expression and clinical significance of thyroid transcription factor-1 (TTF-1) in stage Ⅰ non-small cell lung cancer (NSCLC) after operation and to 1 investigate the values in identification of the prognosis of stage Ⅰ NSCLC.Methods The expression of TTF-1 in 129 specimens of stage Ⅰ NSCLC was detected by immunohistochemistry.Results The positive rate of TTF-1 in stage Ⅰ NSCLC was 64.3％.There were significant differences in TTF-1 expression rate among pathological subtypes (x2 =25.231,P ＜ 0.001),different ages (x2 =4.581,P =0.032),sex (x2 =4.900,P =0.027) and differentiation degrees(x2 =11.519,P =0.019).Univariate analysis suggested that in the stage Ⅰ NSCLC patients,the median disease-free survival and overall survival of those positive for TTF-1 expression were superior to those negative:38.9 months versus 27.8 months (P =0.023) and 64.10 months versus 50.68months (P =0.013).Cox regression analysis suggested that TTF-1 expression,tumor differentiation degrees were independent factors affecting the prognosis of stage Ⅰ NSCLC.Conclusion Patients with TTF-1 positive expression often had better survival.Positive expression of TTF-1 and differentiation degree of tumor were independent prognostic factors to affect the prognosis of NSCLC.

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.