Objective To evaluate the predictive value of electrocardiogram in localizing the occlusion site in the left anterior descending coronary artery(LAD) in acute anterior myocardial infarction(AMI).Methods According to the coronary angiogram,all patients with AMI were divided into two groups:one(the PS group) was a collection of patients(n=61) whose occlusion sites were proximal to the first septal branch(S1) and the other(the DS group) was a collection of patients(n=40) whose occlusion site were distal to S1.Diagnostic sensitivity and specificity in prediction of the occlusion site in LAD were calculated based on the measurements and incidence of ST segments deviation on electrocardiogram(ECG).Results The sensitivity and specificity for prediction of occlusion site being proximal to S1 in LAD using ECG were as follow:43% and 85%(P=0.004) for ST elevation in lead aVR,16% and 97%(P=0.031) for ST elevation≥1.5 mm in lead aVL,39% and 85%(P=0.009) for ST depression≥1.0 mm in lead Ⅱ,23% and 98%(P=0.005)for ST depression ≥2.0 mm in lead Ⅲ,38% and 88%(P=0.006) for ST depression ≥1.0 mm in lead aVF,20% and 86%(P=0.037) for ST depression in lead V5,18% and 100%(P=0.005) for ST elevation in lead aVR together with ST depression in leads V5,30% and 93%(P=0.008) for ST elevation in lead aVR together with ST depression in leads V6.The sensitivity and specificity for diagnosis of occlusion site being distal to S1 were 53% and 90%(P=0.000)ST elevation or unchanged in lead Ⅲ,50% and 82%(P=0.001) for ST elevation in lead V5.There were no significant difference in infarction size and left ventricle ejection fraction between the two groups.Conclusion(1) ST elevation in lead aVR together with ST depression in leads V5 and V6,obvious ST depression in the inferior leads,and ST elevation in leads I and aVL were all indication of occlusion in LAD proximal to S1.(2) ST elevation or unchanged in inferior leads(especially in lead Ⅲ),and marked ST elevation in lead V5 indicated that the occlusion site in LAD was distal to S1.

Objective To explore the prognosis of children under different modes of delivery in the oli?gohydramnios patients,in order to reduce unnecessary cesarean section rate. Methods One hundred and forty?eight cases of oligohydramnios from September 2013 to October 2015 in the First Affiliated Hospital of Tsinghua University were reviewed,including 74 cases of vaginal delivery,54 cases of vaginal delivery group,20 cases for fetal heart abnormalities in the induction of labor or labor in the process or abortion failure emergency caesarean birth operation( pilot transfer of emergency cesarean section delivery group);direct line selective cesarean section in 74 cases. The delivery surround unripe ending of three kinds of delivery mode was compared,and gestational weeks,estate, cervical score, maximal amniotic fluid dark area vertical depth ( AFV), amniotic fluid index ( AFI) ,fetal size,water treatment and abortion case of the vaginal delivery and emergency caesarean birth were statistically compared. Results Both fetal heart abnormality and amniotic fluid of third degree incidence of trial production of emergency cesarean section group was 80. 00%( 16/20) ,of vaginal delivery group was respectively 11. 11%( 6/54) ,29. 63 ( 16/54) ,and of selective cesarean section delivery group was 0 and 9. 50%( 7/74) re?spectively,the difference between the 3 groups was statistically significant( P<0. 05) . The gestational age of vagi?nal trial production successfully delivery group and transfer of emergency cesarean section production group was respectively (39. 33+0. 13),(40. 20+0. 2) weeks, the parity was 0 were 45 cases,20 cases respectively,the parity was 1 were 9 cases,0 case respectively;AFV was ( 2. 14+0. 06) cm,( 1. 86+0. 08) cm respectively;the water treatment rates were 66. 67%( 36/74) and 30%( 6/20) respectively;the difference between the two groups was statistically significant(P<0. 05). Induction:in vaginal delivery group,there were 24 cases of spontaneous labor without induction,12 cases treated with misoprostol for cervical mature after vaginal delivery,12 cases of contraction oxytocin induction of labor with vaginal delivery,6 cases of misoprostol for cervical ripening after va?ginal delivery;in emergency cesarean section group,there were 2 cases of natural labor,8 cases of oxytocin,miso?prostol after oxytocin in 10 cases. There was significant difference between the two groups ( P<0. 001 ) . Conclusion Low risk pregnancy, fetal reserve ability of oligohydramnios in vaginal delivery is feasible. Water treatment,gestational age < 40 weeks, the parity more than 1 times,AFV>2 cm,the high rate of abortion sensi?tive pregnant women with high rate of vaginal delivery.

Objective To systematically review the effect of ω-polyunsaturated fatty acids-supplemented nutrition support on the immune function and nutritional status of patients with gastrointestinal malignancies.Methods Databases of MEDLINE,EMBASE,Cochrance Central register of controlled trials,China National Knowledge Infrastructure (CNKI),China Biology Medicine disc (CBM) were searched.The search words were omega-3 polyunsaturated fatty acids,fish oil,cancer,turmor,neoplasms in English or Chinese.All the high quality randomized controlled trials were included after assessed with Jadad scale.RevMan 5.2 was used for statistical analysis.Results Altogether 12 studies were included.Meta-analysis results showed that CD4+％ (I2 =0％,95％ CI=3.44～6.93,Z=5.82,P＜0.00001),CD8+％ (I2 =0％,95％ CI=2.44～7.13,Z=4.00,P＜0.000 1),CD4+％/CD8+％ (I2 =74％,95％ CI=0.16～0.83,Z=2.87,P=0.004),IgA (I2=14％,95％ CI=0.21 ～0.43,Z=5.84,P＜0.00001),prealbumin (I2 =0％,95％CI =0.02 ～ 0.05,Z =3.94,P ＜ 0.000 1) in the treatment group were higher than in the control group,C-reactive protein (I2 =76％,95％ CI =-21.33 ～-5.03,Z =3.17,P =0.002) in the treatment group was lower than in the control group,the differences were all statistically significant.But there were no statistically significant differences in CD3 + ％ (I2 =0％,95％ CI =-3.50 ～ 2.56,Z =0.31,P =0.76),IgG (I2 =92％,95％ CI=-0.32 ～5.54,Z=1.74,P=0.08),IgM (I2 =99％,95％ CI=-0.52～1.89,Z=1.11,P=0.27),total protein (I2 =0％,95％CI=-4.08 ～1.77,Z=0.78,P=0.44),albumin (I2 =29％,95％ CI=-0.87 ～1.45,Z=0.49,P=0.63),transferrin (I2 =0％,95％ CI=-0.23～0.19,Z =0.19,P =0.85) between treatment and control groups.Conclusion Omega-3 polyunsaturated fatty acids can improve the perioperative immune function of patients with gastrointestinal malignant tumor,reduce inflammatory and stress reactions,but have no obvious effect on the improvement of the nutritional status.

Objective To analyze the genetic difference of biological characters on germplasm resources of fenugreek(Trigonella foenumgraecum) and to study the genetic diversity of them.Methods Thirty-two fenugreek germplasm resources from Ningxia, other provinces in China,and abroad were used to investigate the biological characters on plant height,pod formation height,nodes per main stem,branches number,effective pod per plant and so on.The tested materials were planted in the farm of Ningxia University.The genetic diversity based on the phenotype was analyzed by Word′s minimum variance method.Results The variance analyses of ten biological characters were of significance or the most significance except pod length.The branches number and effective pod per plant possessed the largest coefficient of variance(CV). The pairwise Euclidean distance of the tested materials ranged from 1.11 to 9.49,averaged 4.01.Mean Euclidean distance of single tested material ranged from 2.94 to 6.54.The tested germplasm resources could be divided into three groups in D=6.86,which coincided with the district of collecting germplasm resources on the whole.Conclusion There is a little genetic difference in various fenugreek germplasm resources.Compared with Euclidean distance of germplasm resources from Ningxia,the Euclidean distance of most from abroad is far away from that of other provinces in China.

Objective To investigate the diagnostic value of hysteroscopy in patients with abnormal uterine bleeding.Methods The clinical data of 547 cases of abnormal uterine bleeding were analyzed retrospectively.The diagnostic curettage was conducted after hysteroscopy,the specimens were examined by histopathology,the detection result of hysteroscopy and histopathological were compared.Results The sensitivity of hysteroscopy in diagnosed abnormal uterine cavity lesions was 95.83％ (161/168),the specificity was 97.63％ (370/379),the false positive rate was 2.37％ (9/379),the false negative rate was 4.17％ (7/168),the positive predictive value was 94.71％ (161/170),the negative predictive value was 98.14％ (370/377),the Jorden index was 0.934.Hysteroscopy diagnosis showed that the endometrial polyps was 54 cases,the pathological diagnosis coincidence rate was 79.63％ (43/54);93 cases of simple hyperplasia,the pathological diagnosis coincidence rate was 90.32％ (84/93);16 cases of atypical hyperplasia,the pathological diagnosis coincidence rate was 87.50％ (14/16);4 cases of differentiated endometrial adenocarcinoma,the pathological diagnosis coincidence rate was 100.00％ (4/4);2 cases of uterine papillary serous carcinoma,the pathological diagnosis coincidence rate was 100.00％ (2/2);1 case of transitional cell carcinoma of endometrium,the pathological diagnosis coincidence rate was 100.00％ (1/1).Conclusion Hysteroscopy can visually observe the morphology of cervical canal and uterine cavity,the diagnostic rate of endometrial polyps,simple hyperplasia,atypical hyperplasia and endometrial carcinoma are higher,so it has important clinical value in the diagnosis of abnormal uterine bleeding.

Background and purpose: As one of the important epigenetic phenomena, DNA methylation plays an important regulatory function for the expression of genes. Study shows that abnormal changes of DNA methy-lation patterns of normal tumor cell genome leads to dysfunction of cancer related gene, and this may be associated with tumor occurrence and development. The study investigated the promoter methylation and expression of caveolin-1 (CAV-1) gene in esophageal squamous cell carcinoma (ESCC), and to elucidate its role in ESCC. Methods:We used MSP approach, RT-PCR, and immunohistochemistry method respectively to examine the methylation status of the 5’CpG island of CAV-1 gene and its expression at mRNA and protein levels in tumors and corresponding normal tissues. Results: CAV-1 mRNA expression in tumor tissues (0.86±0.56) was signiifcantly higher than that in corresponding normal tissues (0.40±0.36, P<0.05). The mRNA expression of CAV-1 was correlated with status of lymphatic metastasis and TNM stage of ESCC patients (P<0.05). The protein expression of CAV-1 in tumor specimens (66.7%, 34/51) was signiifcantly higher than that in corresponding normal tissues (15.7%, 8/51, P<0.01). The protein expression of CAV-1 was signiifcantly associated with lymphatic metastasis of ESCC (P<0.05), however, it was not associated with differen-tiation and TNM stage (P>0.05). The promoter methylation frequency of CAV-1 in tumor specimens was 2.0%(1/51), and the methylation phenomenon has not been found in corresponding normal tissues. The promoter methylation fre-quency of CAV-1 in tumor specimens showed no signiifcant difference compared with the corresponding normal tissues (P>0.05). Conclusion:The mRNA and protein expression of CAV-1 in tumor specimens was signiifcantly higher than that in corresponding normal tissues. Aberrant high expression of CAV-1 has played a certain role in promoting tumori-genesis and lymph node metastasis. The expression both in ESCC and corresponding normal tissues has no correlation with the promoter methylation status.

Objective To investigate the influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.Methods Twenty epilepsy patients with cerebral hemispheric atrophy,admitted to Second Department of Neurosurgery of Hebei Provincial People's Hospital from March 2012 to December 2014 were selected by convenience sampling method,and divided into the intervention group (12 cases) and control group (8 cases),Patients in the control group were given routine guidance discharge,and intervention group were given continuing nursing intervention.The influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients were compared between two groups.Results Twelve months after discharge,QOL in the control group and the intervention group scored 58.8±20.9 and 77.2±14.3,t=2.37,P ＜ 0.05.The ADL scored 49.42±8.14 and 62.72±7.06,t=2.39,P ＜0.05.Conclusions Diversification continuing nursing intervention is helpful to improve quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.

OBJECTIVE:To ensure the stability of electronic data capture(EDC)system in drug clinical trials and to improve the quality of drug clinical trials. METHODS:The quality control system for EDC system was established and introduced from the formulation of quality control process,establishment of data standard,trial project management,daily management,trial project design,system operation,system function,etc. RESULTS & CONCLUSIONS:Data standard have been achieved through estab-lishing EDC quality control system by our hospital based on attributable,legible,contemporaneous,original and accurate principle. The management of trial project and daily management are conducted through data registration,staff training,the formulation of da-ta management plan,fault emergency treatment,database backup;multiple verification of support data,data lock and export,trial report autogeneration and other functions have been realized by formulating related standard operation instruction,program file,op-eration manual and quality record. Those aspects improve facticity,accuracy and integrality of data in clinical trials,and lay a foun-dation for further data mining.

Objective To test the Footscan system for guiding the postoperative rehabilitation of calcaneus fractures.Methods Sixty patients with unilateral calcaneus fracture were divided randomly into a rehabilitation group and a control group.Patients in both groups began a routine of functional rehabilitation training 24 h after a reduction and fixation operation.The patients in the rehabilitation group received individualized rehabilitation protocols based on regular dynamic evaluation of their plantar pressure using the Footscan system.Those in the control group were administered routine rehabilitation training without the personal modifications.At the 2nd and 7th month postoperation,the dynamic plantar pressure of both groups was evaluated and the functioning of their feet Was scored.Results At the 2nd month post-operation,there was no significant difference between the two groups in terms of subtalar ioint range of motion,the lateral deviation of pressure center,the time of heel touch with the ground,the maximum pressure at the lateral aspect of the calcaneus and impulsive force during walking.The functional evaluation scores were also not significantly different.At the 7th month post-operation,all the indices in both groups had improved significantly over the 2nd month,bulthe improvement in the rehabilitation group Was greater(except the time of heel touch with the ground).Conclusion The Footscan system can be a valuable tool for evaluating patients with calcaneus fracture and serve as a reference for planning rehabilitation interventions for such patients.

AIM: To investigate the application of microemulsion TLC to separation and identification of(Z)-and(E)-resveratrol and piceid in Polygonum cuspidatum based on polyamide film as stationary phase.METH-ODS: SDS-n-butane-n-heptane-aqueous microemulsion as the development in combination with aminic acid and methonal as the modifier,the influence of the change in components of microemulsion on the resolution was exam-ined to search for the optimal separation condition of Polygonm cuspidatum extract collected from 6 production places.RESULTS: The best mobile phase was the microemulsion containing 4% SDS,80% water-methyl acid-methanol(1.0 ∶ 2.0 ∶ 1.0).As compared with conventional TLC,resolution of microemulsion TLC for resveratrol and piceid were improved markedly.CONCLUSION: Microemulsion TLC is an efficient,simple and new method for separating and identifing(Z)-and(E)-diastereomers of resveratrol and piceid in Polygonum cuspidatum.