QT dispersion(QTd,equals maximal minus minimal QT interval on a standard ECG) has been shown to reflect inhomogeneity of myocardial repolarization and cardial electrical instability, hence,been proposed to be associated with ventricular arrhythmias.But the intrinsical mechanism of QTd is incompletely understood. Contributing to QTd are differences of action potential duration(APD) in the three-dimensional structure of ventricular myocardium, which is identified to own three cell subtypes:endocardial, midmyocardial(M cells) and epicardial cells.And findings suggest that regional differences in the duration of the M cell action potential may lead transmural and spatial dispersion of repolarization. Autonomic nerves by combining receptors on the myocardial cells,especially M cells affect significantly the APD.Concordance between heterogeneity of ventricular myocardium and heterogeneity of autonomic innervation in heart provide support for the role of autonomic nerve in the generation of the QT dispersion.

Objective By observing the incidence of postoperative hyperalgesia in patients with total intravenous anesthesia,to study the effects of different anesthesia depth on postoperative hyperalgesia.Methods Forty gynecologic patients undergoing open lower abdominal operation were randomized into two groups (n=20): group B1 with BIS 40-49 and the group B2 with BIS 50-59.Anaesthesia was induced and maintained with intravenous anesthetics.The threshold of haphalgesia and the range of mechanical hyperalgesia were measured before operation.The consumption of the intravenous anesthetics,the emergence time and the extubation time were recorded.The vital signs were recorded at eight time points: pre-aneasthesia (T0),abdominal exploration (T1),the end of operation (T2)and 1 h (T3),4 h (T4),12 h (T5),24 h (T6),48 h (T7) after extubation.The VAS scores at T3-T7 were recorded.The PCA dosage of analgesic and superaddition in postoperative 24 h and 48 h were recored.The Von Frey Hairs were used to assessed the threshold of haphalgesia and the range of mechanical hyperalgesia at T6 and T7.Results The MAP at T6 and T7 and the VAS scores at T6 of the group B1 were lower than those of the group B2 (P<0.05).The range of mechanical hyperalgesia at T7 of the group B1 was narrower than that of the group B2 (P<0.05).Conclusion Maintaining the anesthesia depth within BIS 40-49 can reduce the body′s stress reaction,decrease the incidence of postoperative hyperalgesia and accelerate the recovery time of mechanical hyperalgesia in postoperative 48 h.

OBJECTIVE:To discuss the issue of medical institution's pharmaceuticals purchase by public bidding and so as to put forward some improvement measures.METHODS:The problem in the pharmaceuticals purchase by public bidding sys?tem was analyzed by the governmental management theory.RESULTS&CONCLUSION:The pharmaceutical purchase by public bidding system was far from perfect which were highlighted in the high cost of governmental management,over-burden of bidding factories,financial loses of medical institutions,and chaos of medicine pricing management.The governmental pricing system should be regulated,the medical reform systems should be speed up,and the efficiency of governmental man?agement should be improved.

Objective To assess the blood safety under the current sero-screening program and gain experience on how to implement NAT as a routine assay for blood screening in China. Methods Sera from 103,539 non-remunerated donors of Shanghai blood center were tested by Chiron's Procleix(TMA HIV-1/HCV Assay in 2 study stages with 8 and 24 sample-pool respectively. Results 5 NAT positive samples were found to be Anti-HCV EIA-2 test positive at the same time. No window period cases of HIV-1/HCV were found in this donor group. But 275 (0.27% ) anti-HCV and 107 (0. 10%) anti-HIV false positive samples were identified by the second sero-screening. Conclusion The blood quality of Shanghai city was high to be close to the level of developed countries and the window period risk of HIV-1 and HCV was less than 1:100,000. With its high sensitivity and specificity,Procleix( TMA HIV-1/HCV Assay can be used in routine blood screening in China.

Objective:To investigate the high risk factors of pelvic lymph node metastasis in patients with type Ⅰ endometrial carcinoma in order to provide the basis for making reasonable operation scope.Methods:Risk factors of pelvic lymph node metastasis were analyzed in 136 cases of type Ⅰ endometrial carcinoma.Univariate analysis was performed with Chi square test or Fisher's exact probability method,and multivariate analysis was performed with a logistic regression mode.Results:The positive rate of pelvic lymph nodes in 136 patients with type Ⅰ endometrial carcinoma was 9.56％ (13/136).Univariate analysis showed that histological grade,size of lesion,depth of myometrial invasion and vascular invasion were related to lymph node metastasis(P ＜0.05);Multivariate Logistic analysis showed that low differentiation,deep muscular invasion,tumor diameter≥2 cm and LVSI were independent risk factors of pelvic lymph node metastasis in patients with type Ⅰ endometrial carcinoma(P ＜0.05).Conclusions:The rate of pelvic lymph node metastasis is low in type Ⅰ endometrial carcinoma.Patients with low differentiation,deep muscular invasion,tumor diameter≥2 cm and LVSI are more likely to occur pelvic lymph node metastasis in type Ⅰ endometrial carcinoma.

Objective: To explore the myocardial protection of induction and reperfusion with warm blood cardioplegia for hypoxic immature myocardium. Methods: A hypoxic model of neonatal rabbits was established in this study. Some indexes,such as myocardial energy metabolism, water content, SOD, MDA and myocardial ultrastucture, were observed after induction and reperfusion with warm blood cardioplegia, comparing to cold crystalloid cardioplegia. Results: Hypoxic neonatal rabbits in this study presented cyanotis, hypoxemia and higher ratio of RV/(LV+S) simulating the pathophysiological changes in cyanotic congenital heart disease. It could be built and repeated easily in experimental researches of immature myocardial protection. Myocardial ATP content was (13.09?1.50) ?mol/g in studying group versus (11.53?5.40)?mol/g in control group (P

Background The early diagnosis and treatment is vital for the age-related macular degeneration (AMD).Previous examining methods were fundus fluorescein angiography(FFA)and optical coherence tomography (OCT).However,a new diagnostic technique,fundus autofluorescence(FAF),is applying in ophthalmology.objective This study was to observe the FAF characteristics of atrophic AMD. Methods Thirty-nine eyes of 28 patients with atrophic AMD were diagnosed and collected in our hospital and classified based on the criteria of Chen Song.FAF was performed by a confocal scanning laser ophthalmoscope(Heidelberg Retina Angiograph 2,HRA2).Characteristics of FAF images were compared with FFA images or color fundus photographs.Written informed consent was obtained from each patient prior to the examination. Results Areas with abnormal increased or decreased FAF signals were consisted or unconsisted with funduscopically visible alterations.Seven manifestations of FAF were found in the eyes with preatrophic stage of atrophic AMD,including slight change,focal increase pattern,patchy pattern,linear pattern,lacelike pattern,reticular pattern,and speckled pattern.In atrophic stage of atrophic AMD,geographic atrophy showed a well-defined hypoautofluorescence area;while non-geographic atrophy showed a ill-defined hypoautofluorescence area.There were three abnormal FAF patterns(focal,band and diffuse)in the junctional zone of geographic atrophy and diffuse pattern in the junctional zone of non-geographic atrophy. Conclusion FAF imaging is helpful for the diagnosis of atrophic AMD as a new non-invasive technique.

OBJECTIVETo investigate the exerted force in different phases of the female menstrual cycle, as well as the changes in estrogen (E2), osteocalcin (OCN), receptor activator of nuclear factor-kappa B ligand (RANKL), and osteoprotegerin (OPG) levels in the gingival crevicular fluid (GCF) during orthodontic tooth movement, to provide a theoretical basis for the selection of the best opportunity for efficient tooth movement.

METHODSTwelve women (aged 18 years to 28 years) with extracted first premolars had been selected. Six women in the group were randomly selected as the menstrual period group, whereas the remaining six were assigned to the ovulation period group. Right canines were retracted with 1.5 N NiTi close coil spring. GCF samples were collected prior to the force exertion experiments at 0 (T0), 15 (T1), 30 (T2), and 45 d (T3). The levels of E2, OCN, OPG and RANKL in GCF were measured by chemiluminescence and enzymelinked immunosorbent assay.

RESULTSThe E2 and OCN levels were significantly higher in the ovulation period group than in the menstrual period group (P < 0.05). No significant differences were found in RANKL and OPG levels between the two groups (P > 0.05). Finally, no significant difference was found in RANKL/OPG ratio between the two groups (P > 0.05).

CONCLUSIONExerted force on teeth during the menstrual period may promote rapid tooth movement.

Objective To obtain recombinant human granulysin using prokaryotic expression system. Methods Total RNA was extracted from cultured PBMC. Granulysin gene segments were obtained with granulysin-specific primers by RT-PCR and then inserted into pET32a(+) plasmid. After identification by DNA sequence, pET-GN-LY9K and pET-GNLY15K were transferred to E. Coli Rosetta (DE3). The fusion protein was identified by SDS-PAGE and Western blot. The bioactivity of granulysin fusion protein was measured by MTT assay. Results The prokaryotic expression vectors pET-GNLY9K and pET-GNLY15K were successfully constructed. The corresponding protein was highly expressed in E. Coli. Recombinant protein was specifically bound by anti-granulysin antibody. GNLY9K fusion protein significantly inhibited the growth of A549 cells in a dose-dependent manner, while GN-LY15K had little effect on the growth of A549. Conclusion Granulysins with different mw were successfully expressed using prokaryotic expression system, which might be helpful for the further study of granulysin.

Objective To randomly compare the therapeutic effect and safety between Levetiracetam (LEV) and Phenobarbital (PB) in the treatment of neonatal seizures.Methods A total of 61 infants with acute convulsion were randomly divided into 2 groups:LEV group (n =30) and PB group (n =31) during January 2013 to December 2014 in Urumqi Children's Hospital.All neonates received routine management including etiology treatment and adverse drug reaction monitoring.In the LEV group,subjects received oral formulation of LEV with initial loading dose 30 mg/kg,followed by 15 mg/kg twice a day.If the seizures were not controlled completely,PB treatment was added until seizures were completed controlled.If seizures were controlled quickly,the dose of PB was gradually reduced and LEV was used as monotherapy.The subjects in PB group received intramuscular or intravenous injection of PB with 10 mg/kg as the first dose,then 5 mg/(kg · d) oral PB was administered,if seizures were not controlled,LEV treatment was added,then dose of PB was gradually reduced until seizures were controlled completely,and then patients were switched to LEV monotherapy gradually.The drug adverse reactions were observed.Results (1) After LEV or PB monotherapy,66.7％ (20/30 cases) and 54.8％ (17/31 cases) of the subjects obtained sustainable seizure free respectively.Although,there was a higher control ratio in LEV group,but no significant difference was observed between the 2 groups (P ＞0.05).(2) LEV group (16/30 cases,53.33％) had higher rapid seizure control ratio with seizure controlled within 24 h after first dosage administration than that of PB group (8/31 cases,25.80％),and there was significant difference (x2 =4.841,P =0.028).Further more,if adding the cases who had to change to use another comparative one (LEV or PB) due to their seizures failure control with the first one treated,LEV group (21/44 cases,47.72％) still had higher rapid seizure control ratio in total patients than that of PB group(10/41 cases,24.39％),and there was significant difference (x2 =4.988,P =0.026).(3) Eight cases who changed to LEV after PB as the first treatment drug failed obtained sustainable seizure free.(4) One case in PB group with transient urinary retention was observed but the symptom disappeared 36 h after PB withdrawal,and no significant drug adverse reaction was observed in LEV group.Conclusion LEV is more rapid and safe for seizure control of neonates than PB.