Objective To investigate the genetic polymorphism of the transmembrane region of the MICA locus in Guangdong Han population,and to protract the genetic distance in different populations.Methods DNA samples from 106 unrelated Han individuals were genotyped by PCR to analyze the frequencies of MICA alleles.The genetic distance was estimated and the phylogenetic tree was protracted by DISPAN Software.Results In total,5 alleles of MICA-TM were observed,they were A4,A5,A5.1,A6 and A9.MICA-TM A5 was the dominant allele(0.2877),whereas A4 was the least popular one(0.1321).From genetic distance and phylogenetic tree we made,the preliminary finding is that Chinese Hans may have migrated from southwest China to northern and southern China.Conclusion MICA-TM locus has high genetic polymorphism and obvious variance in different populations.Since the genetic distance could be estimated effectively through MICA-TM locus,it could serve as the genetic marker in human migration and evolution research.

Objective To study the value of emergency angiography and interventional therapy in digestive tract hemorrhage. Methods 123 cases was performed with repeated angiography after perfusing vasodilator substance in those patients without bleeding signs in the first angiography. According to with or without bleeding during angiography, these cases were divided into group A (the patients is bleeding during angiography) and group B (the patients' stool bleeding examined were negative before angiography) for analysis. The patients with bleeding demonstrated angiographically had accepted the arterial embolization and/or infusion of vasoconstrictor substance later on. Results 90.8% patients of group A was found bleeding and 47.22% patients of group B was found bleeding on angiography. Bleeding was stopped immediately in all those patients with arterial embolization and 82.7% of those patients with vasoconstrictor substance infusion. Conclusions The detective rate of bleeding in active stage is greater than that of in resting stage on emergency angiography of patients with digestive tract hemorrhage ( P

Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .

BACKGROUND: Although some studies have been done on the functional change of cochlea in chickens during prolonged administration of kanamycin,few studies on ultrastructural changes in chicken cochlea have been reported.OBJECTIVE: To observe ultrastructural changes of the chicken basilar papilla following poisoning with prolonged administration of kanamycin.DESIGN: A completely randomized design and controlled observation.SETTING: Affiliated Xinhua Hospital, Shanghai Second Medical University.MATERIALS:The experiment was conducted in Xinhua Hospital Affiliated to Medical College, Shanghai Jiao Tong University from June 2001 to August 2003. Newly born Roman chickens (n=78), of either sex, provided by Shanghai Guixing Breeding Chick Farm, were used as subjects.METHODS: 200 mg/kg kanamycin was injected into muscles daily at day 3 after birth for 10 days. Then they were divided into 3 groups randomly:①typical application group: The chickens were applied with drugs no longer, and then killed at days 1, 3,7, 10 and 15, 6 chickens in each time phase. ②prolonged application group: 200 mg/kg kanamycin per day were injected into muscles continuously, and then killed at days 13, 17, 20, 25and 30, 6 chickens in each time phase. ③control group: The chickens were not treated with any drug. They were assigned into 3, 13 and 33 days groups with 6 chickens in each time phase. When the chickens were killed they were at the same age with the experime ntal animals at days 0, 10 and 30 of kanamycin treatment. All the experimental animals were studied with auditory brain-stem response (ABR) and scanning electron microscopy in chicken basilar papilla to observe ultrastructural change of cochlea, threshold, latency and amplitude of ABR wave I.MAIN OUTCOME MEASURES: ①Ultrastructural change of the chicken basilar papilla, and ② ABR result of chicken.RESULTS: A total of 78 Roman chickens were involved in the result analysis, without dropout. ①Outcome of ABR: Loss and recovery of chicken ABR threshold value was similar between within continuous administration for 20 days and administration for 10 days plus 10 days of recovery (drug withdrawal group). Twenty days after administration, ABR threshold significantly increased again. ②Outcome of scanning electron microscopy: At the end of 10-day kanamycin administration, hair cells in 40％ proximal chicken basilar papilla were destroyedand disappeared completely. Although continuous administration was performed, the hair cells began to regenerate and repair after damage. Within the 20-day continuous administration, the regenerated hair cells of basilar papilla developed maturity, which was mostly coincident with the administration for 10 days group. At day 25, regenerated hair cells of proximal basilar papilla were injured once again. At day 30, most of the regenerated hair cells were destroyed and disappeared.CONCLUSION: Prolonged administration of kanamycin obviously prevents the full repair of chicken basilar papilla damaged by kanamycin poisoning.

Discharge planning is the basis of continuous medical service. It could shorten the length of hospital stay, improve bed occu-pancy, reduce readmission rate, save medical costs, and improve the quality of life. It's considered to be important and supplemented by rele-vant policies and regulations to promote development in the United States, the United Kingdom, Canada, Australia and other developed countries. In China, even though Hong Kong and Taiwan have issued discharge planning policies, the mainland is still at the stage of explora-tion. Discharge planning in Chinese mainland has problems like restricted objectives, imperfect content, un-optimized process, unestablished professionals and organizations and so on. Standardized discharge planning guide still needs further research. As the health service system including hospitals, public health institutions and primary health institutions coverd urban and rural gradually, and the new pattern of grad-ing diagnosis and treatment established, it's necessary to analyze the necessity, importance, obstacles and measures of discharge planning in China.

With the social development and the transformation of medical model, providing patients with continuous services and seam-less transfer between different medical institutions, namely continuity care, is inevitable. Discharge planning take patients as the center and patient's needs as the guidance. Patients and their families should actively take part in the plan. Through multi-disciplinary and multi-institu-tional cooperation, patients can continue to enjoy health services after discharge. Discharge planning is the basis of continuous medical ser-vice. This article summrized the background and situation of discharge planning in the United States, Canada, Brazil, the United Kingdom, Ireland, Australia, Japan, India, South Africa, and Hong Kong, Taiwan and mainland in China. When heavy medical burden, aging, im-balence between supply and demand occurred, discharge planning could be helpful to make rational use of medical resources, save medical costs, guarantee the quality of medical service continuity, avoid the occurrence of adverse events after discharge and improve the patients' function and quality of life. This article reviewed group members, time, institutions and process of discharge planning in order to provide ev-idence-based basis for the development of discharge planning in China.

Objective To summraize the safety and efifcacy of modiifed transcatheter closure of atrial septal defect. Methods From Dec. 2012 to Dec. 2013, 100 cases performed modiifed transcatheter closure of atrial septal defect in our center (72 were famale and 28 were male) with average age (37±16) years. The diagnosis was conifrmed by transthoracic echocardiography. All the atrial septal defect closures were completed in the modiifed way by direct delivery of the closure devices without the need of guidence wire. Results One hundred and one defects were identiifed in 100 patients, with 1 patient had 2 defects. The mean diameter of the defect was (20.3±6.6) mm. 100 devices were implanted successfully. Complete closure was revealed in all the patients after the procedure. One patient developed atrial ifbrillation during the procedure. No other serious complication occurred till the last follow-up. Conclusions The modiifed transcatheter closure of atrial septal defect is an effective procedure with high successful rate and low rate of complications.

Esophagogastric variceal bleeding is one of the most common complications of liver cirrhosis and is also one of the most critical diseases in the department of gastroenterology, with the features of acute onset and high rebleeding and mortality rates. Strengthening the understanding of related prognostic factors has great clinical significance in reducing early rebleeding rate and mortality rate. There are many factors associated with rebleeding and death in patients with esophagogastric variceal bleeding. Risk factors include advanced age, sex, Child-Turcotte-Pugh class C, low platelet count, high leukocyte count, bleeding history, portal broadening, widening of the portal vein, a positive red-color sign under an endoscope, severe varices, and infection, while the percentage of lymphocytes, serum sodium, and the use of non-selective β-blockers and antibiotics are protective factors. By analyzing these prognostic factors, we can learn more about their mechanisms and risk degree. At present, related research mainly focuses on the exploration of better individual treatment regimens and nursing strategies based on the risk assessment models established using these risk factors to reduce the risk of rebleeding and death.

Transjugular intrahepatic portosystemic shunt (TIPS), after nearly 30 years of continuous exploration and development, has been widely used in the treatment of complications of portal hypertension. TIPS has significant advantages in acute esophagogastric variceal bleeding, prevention of rebleeding, refractory peritoneal effusion, and Budd-Chiari syndrome; however, if postoperative anticoagulant measures are inappropriate, it can cause several complications, such as stent dysfunction and acute thrombosis, and lead to the recurrence of the symptoms of portal hypertension before TIPS, which greatly affects middle- and long-term clinical outcomes and survival rate. Maintenance of stent patency is the key to good postoperative treatment outcome, and therefore, anticoagulants play an important role in the prevention and treatment of post-TIPS thrombosis. At present, no consensus has been reached on post-TIPS anticoagulant therapy in China and foreign countries. This article reviews the research advances in the application of anticoagulants after TIPS.