Objective:To investigate the correlation between serum CXCL10 level and the severity of obstructive sleep apnea syndrome(OSAS) in male patients.Methods:52 male patients and 41 control volunteers were enrolled.Polysomnography was processed to monitor the AHI scores.Serum CXCL10 level was determined by ELISA.The correlation between serum CXCL10 level and AHI scores was analyzed statistically.Results:Serum CXCL10 level(ng/ml) in the OSAS groups was significantly higher than that in the control group [99.18 (70.46-158.01) vs 64.13 (53.5-73.6),P ＜ 0.001].Multivariate logistic regression analysis demonstrated that serum CXCL10 level was the only independent predictor of OSAS(OR:1.021;95％ CI:1.009-1.035;P ＜0.001).The serum CXCL10 level was positively correlated with the severity of OSAS [CXCL10 level in mild OSAS:82.7 (56.76-145.51);in moderate:OSAS 113.28 (87.15-162.67)].Serum CXCL10 level was independently correlated with AHI scores(r =0.476,P ＜ 0.001).Conclusion:Serum CXCL10 level was independently associated with the occurrence and the severity of OSAS.Serum CXCL10 level can be used as a biomarker to diagnose the OSAS and further to assess the severity of OSAS.

Objective To analyze related factors for pacemaker pocket infection in elderly patients after implantation of permanent pacemakers and to provide a theoretical basis for preventing pacemaker pocket infection.Methods Pacemaker pocket infection and related factors were analyzed for 412 patients who received implantation of permanent pacemakers from Apr.2010 to Jun.2013 in the Department of Cardiology.Results With 5 cases of pacemaker pocket infection,the rate of infection was 1.2％.The infected patients were older than the uninfected patients [(74.5±4.2) years vs.(60.3±6.6) years,t=4.781,P＜0.01].The rate of infection was higher in patients who had undergone operations twice or more than in patients who had undergone one operation [10.0％ (3/300) vs.0.5％ (2/382),x2=10.583,P＜0.01].The rate of infection was higher in patients with the operation lasting 2 hours or longer than in patients with the operation time shorter than 2 hours [(3.8％ (4/106) vs.0.3％ (1/306),x2=7.802,P＜0.01].The rate of infection was higher in patients with pocket hematoma than in patients without pocket hematoma [16.7％ (3/18) vs.0.5％(2/394),x2=37.492,P＜0.01].Independent risk factors for pacemaker pocket infection included pocket hematoma (OR=6.193),number of operations≥2 (OR=2.594),operating time≥2 hours (OR=2.265) and age of 75 years or older (OR =2.193).Conclusions Pocket infection after implantation of permanent pacemakers is related to pocket hematoma,number of operations,operating time and age.

In order to understand the existing problems in the management of medical ethical review,this paper summed up related domestic literature published in 2001 to 2015 with the method of literature analysis.There existed several problems in the construction and management,the ability of ethical review,external supervision,and other aspects of the current medical ethics committee.It suggests that strengthening external continuous supervision,strengthening the ethics committee itself construction and management and participating in standardized certification can help medical ethics committee to solve the above problems and have important significance for the standardized development.

Problem-based learning (PBL) teaching method combined with formative evalua-tion was used in the teaching practice of pediatrics education. This method was implemented by four phases: courses designing, group-preparing, problems-organizing and teaching practice. The method was evaluated by students' feedback and survey results of patients, teachers and teaching councilors. It was showed that the teaching effects of PBL combined with formative evaluation was better than tra-ditional teaching method in pediatrics teaching.

Objective To investigate the diagnostic value of DTI anisotropy parameters in breast malignant tumors.Methods Fifty four patients,including 33 patients with malignant tumors and 21 patients with benign lesions,were retrospectively analyzed.The E1,MD and FA of lesions were measured and compared by paired t test between the malignant tumors and the contralateral healthy breast tissue.The difference between malignant tumors and benign lesions was analyzed by independent sample t test.Logistic regression analysis was made using E1,FA,MD as predictors in detecting and differentiating the malignant tumors,ROC curve analysis was performed to compare diagnostic performance based on the area under the curve (AUC).Results E1,MD and FA in malignant tumors were (0.99 ± 0.12) × 10-3mm2/s,(0.85 ±0.26) × 10-3mm2/s and 0.20 ±0.08 respectively,and those in normal breast tissues were(1.46 ± 0.55) × 10-3 mm2/s、(1.48 ± 0.44) × 10-3 mm2/s and 0.29 ± 0.17 respectively.Those parameters in benign lesions were (1.80 ±0.42) × 10-3mm2/s,(1.38 ±0.52) × 10-3mm2/s and 0.22 ± 0.10 respectively.Significant statistic differences were found between malignant tumors and normal breast tissues in E1,MD and FA (t =-4.889,-6.449,-2.842 ; P ＜ 0.01).Significant statistic differences were also found between malignant tumors and benign lesions in E1 and MD (t =-10.476,-4.394; P ＜ 0.01) with no difference found in FA (P ＞ 0.05).E1,MD and FA are independent predictors in malignant tumors' detection,and the combination of E1,MD and FA significantly improved discrimination between cancer and normal tissue over each one alone with the sensitivity 97.0％ (32/33),specificity 97.0％ (32/33),accuracy 97.0％ (64/66).Combination of E1 and MD had a similar AUC with E1 and a more AUC than MD and FA,with the sensitivity 97.0％ (32/33),specificity 100.0％ (21/21),accuracy 98.1％ (53/54).Conclusion The regression model combining E1,MD and FA is most valuable in breast cancer detection and E1 is the preferred index for the differentiation of breast cancers from benigin lesions.

Objective To explore the influence of social support and coping style on body and mind symptoms of patients with laryngeal carcinoma. Methods SCL-90, SSRS and MCMQ were used for the questionnaire survey of 168 patients with laryngeal carcinoma. Results The result of SCL-90 showed that all items were higher than those of norm in China, except the interpersonal relationship sensitivity and psychotic symptoms. The result of SSRS showed that the total score of social support was higher than that of norm, while the availability of support was obviously lower than that of norm. The result of MCMQ showed that avoidance and submissiveness were used frequently in patients, and avoidance was negatively correlat-ed with the factors of psychology. Conclusions Before the nursing plan and health consultation are set for patients with laryngeal carcinoma, the patients' social support should be used sufficiently, and the effect of coping style on patients' mental health should be evaluated.

The effects of ketamine on transient outward potassium current (I(to)) of isolated human atrial myocytes were investigated to understand the mechanism of part of its effects by whole-cell patch-clamp. Atrial myocytes were enzymatically isolated from specimens of human atrial appendage obtained from patients under going cardiac valve displacing. Ito is recorded in voltage-clamp modes using the patch-clamp technique at room temperature. Currents signals were recorded by an Axopatch 200B amplifier with the Digidata 1322A-pClamp 9.0 data acquisition system. Ketamine decreased I(to) of human atrial myocytes in a dose-dependent manner. The current-voltage curve was significantly lowered, 30, 100, 300, and 1000 micromol x L(-1) ketamine decreased respectively I(to) current density about (13.62 +/- 0.04)%, (38.92 +/- 0.05)%, (72.24 +/- 0.10)% and (83.84 +/- 0.05)% at the potential of 50 mV, with an IC50 of 121 micromol x L(-1). The I(to) activation curve, inactivation curve and the recovery curve were not altered by ketamine. So, ketamine concentration-dependently decreased I(to) of human atrial myocytes.

Objective To observe the effects of GABA on proliferation, cell cycle and expression of MMP-2, MMP-9 of pancreatic cancer cell line SW1990. Methods The effects of different concentration of GABA (0 ～ 320 μmol/L) on proliferation and cell cycle of pancreatic cancer cell line SW1990 was investigated by MTT assay and flow cytometry analysis, respectively. Expressions of MMP-2 and MMP-9 proteins were evaluated by Western blot analysis. Results GABA could promote the proliferation of SW1990 cells and influence the distribution of cell cycle, which made less cells of G0/G1 phase and more cells of S and G2/M phase. The value of A570 after GABA pretreatment at a dose of 320 μmol/L was 1. 11 ± 0.03, which was significantly higher than that in the control group (0. 56 ± 0.01, P < 0. 01 ), the cells of G0/G1 phase was (46.18 ± 1.12 )% ,which was significantly lower than (87.29 ± 1.34)% in the control group (P < 0. 01 ) ;the expressions of MMP-2 mRNA, MMP-9 mRNA and their proteins were 8.6, 6.8, 10.5, 8.4, respectively, which were significantly higher than those in the groups of the doses of 0 ～ 40 μmol/L ( P < 0. 05 ). Conclusions GABA could influence the proliferation and expression of MMP of SW1990 cells.

Background Xenotransplantation is arousing more attention of researchers because of the lack of corneal donors.Biological corneal scaffolds constructed by porcine corneal acellular stroma appears to have an acceptable biocompatibility.However,its clinical effects and the histomorphological features in the corneal tissue of receipts' are still unclear.Objective This study was to evaluate the viability of bioengineered corneas as a new material of human lamellar keratoplasty and observe the in viva biological features after human keratoplasty under the laser confocal microscope.Methods A prospective serial cases observational study was carried out.Fifteen eyes of 15 patients with infectious keratitis were enrolled in Henan Eye Hospital from February to August 2014 under the approval of Ethic Committee of Henan Eye Hospital and informed consent of each patient, including 4 eyes of fungal keratitis,1 eye of bacterial keratitis, 9 eyes of mixed infectious keratitis and 1 eye of leucoma.Corneal lamellar transplantation was performed on the eyes with the bioengineered corneas as grafts and the follow-up time was one year.The survival of grafts was assessed and scored, and the indices including corneal transparency,neovascularization, graft lysis or inflammatory recurrence and visual acuity (logMAR) were evaluated.The morphology and density of corneal epithelial cells and endothelial cells, corneal stroma and subepithelial neural fibers were examined by laser confocal microscope 3,6,9 and 12 months after surgery.Results Postoperative inflammatory response was seen 3 days and disappeared 7 days after surgery.The grafts were clear 1 month after surgery, and no corneal dissolution was found during the follow-up duration.Glaucoma occurred in 1 eye at 6 months and graft rejection occurred in another eye 12 months after surgery.The logMAR, corneal transparency scores and corneal neovascularization scores improved after surgery in comparison with before surgery,with a significant difference among various time points (x2 =92.63,59.37,10.50 ,all at P＜0.05).Complete epithelization of grafts was seen.Compared with the contralateral eyes,the morphology of epithelial cells was similar and endothelial cells were enlarged in the operated eyes.In addition,no stromal cell structure was seen in the corneal stroma in the operative eyes.Subepithelial nerve fibers appeared in 8 eyes at 6 months, but the fiber density was lower in the operated eyes than that in the contralateral eyes.Significant difference was found in epithelial cell density among different time points (F=1.48, P =0.22).The endothelial cell densities were (2 542 ± 119), (1 895 ± 129), (1 869 ± 135), (1 854 ± 101) and (1 844 ± 103)/mm2 before surgery and 3, 6, 9 and 12 months after surgery, showing significant differences between preoperation and postoperative time points (all at P＜0.05).The subepithelial nerve fibers densities were (1.26± 0.13),(3.62±0.81) and (5.98±0.44) mm/mm2 at 6,9 and 12 months after surgery,with significant differences between adjacent two time points (t'=-8.16 ,-7.24;both at P=0.00).Conclusions Bioengineered corneal grafts survive well in human eye after lamellar transplantation,which can reconstruct ocular surface and improve the visual acuity.Biological cornea can replace human corneal materials.

Objective To evaluate the feasibility of application of single and dual antiplatelet aggregation therapy in high sensitive C-reactive protein (hs-CRP) level in patients with angina pectoris. Methods Ninety-six hospitalized patients with angina 6~48 h (hs-CRP< 2 mg/L) were selected and randomly divided into single aspirin group (aspirin 100 mg/d, n=48) and aspirin plus clopidogrel combination therapy group (aspirin 100 mg/d and clopidogrel 75 mg/d, n=48). The efficacy was evaluated after 30-day treatment. Data of composite end points were analyzed by follow-up in patients within 6 months. Results The total effective rates were 85.42%for combination therapy group and 81.25%for single aspirin group. There was no significant difference in total effective rate between two groups (P>0.05). There were no significant differences in events of composite end points in patients after treatment between two groups (P > 0.05). Conclusion For angina pectoris patients with hs-CRP<2 mg/L, the risk of cardiovascular events is relatively little. There is no obvious difference in curative effect between single and dual antiplatelet aggreration therapies.