Objective To study the efficiency of oral ferric ammonium citrate solution as a negative gastrointestinal contrast agent on magnetic resonance cholangiopancreatography (MRCP). Methods Sixty subjects were divided into two groups at random. Routine MRCP were performed directly for one group, and routine MRCP were performed after oral ferric ammonium citrate solution for another gruop. Contrast effect was evaluated on the basis of signal intensity in the stomach and duodenum at MRCP. Results The mean Raddit score of control group (without oral ferric ammonium citrate solution) was 0.275, and that of oral ferric ammonium citrate group was 0.725 (P

Objective:To study the effect of leuprolide preoperative used in the patients with uterine fibroids .Methods:Totally 70 patients with uterine fibroids were divided into the observation group and the control group with 35 ones in each.The 35 patients in the control group were with laparoscopic myomectomy , and those in the observation group was given leuprolide , 3.75 mg per time, once in a month for 3 months, and then undergone laparoscopic myomectomy .The serum hormone levels , menstruation situation and fi-broids and uterus volume changes in the observation group were observed and compared before the treatment and after the 3-month leu-prolide treatment .The situation during the operation and after the operation , and the recurrence rate of uterine fibroids between the two groups were compared .Results:After the pretreatment of leuprolide , the levels of luteinizing hormone ( LH) , follicle-stimulating hor-mone (FSH) and serum estradiol (E2) in the observation group were significantly lower than those before the treatment (P<0.05), and the menstrual blood volume , uterine volume and fibroid volume were significantly lower than those before the treatment , and the differences were statistically significant (P<0.05).The blood loss during the operation and pelvic drainage of the observation group were significantly lower than those of the control group , and the ambulation time and length of hospital stay of the observation group were significantly shorter than those of the control group with statistically significant differences (P<0.05).Conclusion:Leuprolide preoperative used in the patients with uterine fibroids can significantly reduce serum hormone levels and fibroid volume , which are ben-eficial to myomectomy with smaller surgery invasion and better prognosis .

0.99. The recovery rates were 72.25% -109.0% with the relative standard deviation (RSD) of 1.82% -11.61% . Conclusion The method is fast,simple,sensitive and needs no organic solvent and it is applicable to the determination of organochlorine pesticides and chlorobenzene compounds in water.

Objective To investigate the clinical value of INSURE technology in very low and extremely low birth weight infants requiring respiratory support.Methods From June 2010 to August 2012,83 cases of very low and extremely low birth weight infants who had difficulty in breathing and required respiratory support were admitted into First Hospital of Tsinghua University and divided into two groups:INSURE group (n=41) and mechanical ventilation (MV) group (n=42).Infants in INSURE group accepted intubate-pulmonary surfactant-extubate to continuous positive airway pressure and those in MV group accepted intubation with or without pulmonary surfactant treatment,and mechanical ventilation without extubation.Arterial blood gases at 1 h and 12 h after treatment were compared between the two groups by t test.The incidence of respiratory distress syndrome,ventilator associated pneumonia,air leaking,chronic lung disease,intracranial hemorrhage,retinopathy,leukoencephalomalacia disease were compared with Chi-square test.Hospitalization costs,duration of ventilation,oxygen inhalation and hospital stay were compared by rank-sum test.Results (1) PO2 in INSURE group after one hour of treatment were (78.7 ±11.5) mm Hg(1 mm Hg=0.133 kPa),which were higher than those before treatment [(50.1 ±10.8) mm Hg,t=9.737,P＜0.05]; while PCO2 was lower[(48.3±8.9) mm Hg vs (54.9±11.5) mm Hg,t=-3.428,P＜0.05].PO2 in MV group after one hour of treatment were (80.2±10.0) mm Hg,which were higher than those before treatment [(51.3±9.8) mm Hg,t=10.093,P＜0.05]; while PCO2 was lower[(45.6±9.5) mm Hg vs (57.1±12.8) mm Hg,t=-4.526,P＜0.05].(2) There were no difference in PO2 and PCO2 between the two groups after one hour of treatment (P＞0.05).After 12 hours of treatment,no differences were found in PO2[(89.4±11.5) mm Hgvs (90.2±10.8) mm Hg,t=0.093] and PCO2[(44.2±5.9) mm Hg vs (39.1± 7.3) mm Hg,t=0.126] between INSURE group and MV group (P＞0.05 respectively).(3) The incidence of ventilator associated pneumonia,air leaking,intracranial hemorrhage and chronic lung disease in INSURE group were 7.3％ (3/41),4.9％ (2/41),4.9％ (2/41) and 4.9％ (2/41),which were lower than those in MV group [34.1％ (14/42),x2=27.470; 16.7％ (7/42),x2=8.651;19.0％ (8/42),x2 =8.814; 11.9％ (5/42),x2 =4.275](P＜0.05 respectively).Duration of ventilation,oxygen inhalation,neonatal intensive care unit stay in INSURE group were 5 d (3-7 d),8 d (5-11 d) and 16 d (11-25 d),which were all shorter than those of MV group [8 d (4-12 d),Z=-1.947; 12 d (8-22 d),Z=-2.013; 21 d (12-35 d),Z=-1.782](P＜0.05 respectively).Conclusions INSURE technology could be used in very low and extremely low birth weight infants because of less invasiveness,fewer complications,safety and low-cost.

Objective To evaluate the clinical feature of the aldosterone-producing adenoma(APA) and idiopathic hyperaldosteronism(IHA)in primary hyperaldosteronism.Methods Retrospectively analyzed clinical feaures of 76 patients with APA and 17 patients with IHA.Results (1)Compared with the patients with IHA,the patients with APA had higher plasma and urinary aldosterone,lower serum potassium.(2)Furosemide provocation test(FPT)in 48 patients with APA and 14 patients with IHA were carried out.It was found that the plasma aldosterone after FPT was increased or no changed in 27 patients with adenoma,and increased in the others.It was increased in all IHA patients.(3)The diagnostic accuracy rate of CT was 84.2% in 88 patients with computed tomography imaging(CT).Conclusion The anomalies of laboratory in patients with APA are more evidence than those of IHA.The results of FPT are overlapped in a considerable amount of APA and IHA.Now those with elevation of serum aldosterone after the FPT can not exclude the adenoma.The diagnostic accuracy rate can be improved according to FPT and CT.

Objective To evaluate the relationship between 5,10-Methylenetetrahydrofolate reductase(MTHFR) gene polymorphisms and colorectal cancer(CRC).Methods Studies were selected based on the criteria for inclusion.The Meta-analysis software,REVMAN 4.2,was applied for checking the heterogeneity across the studies and calculating the pooled OR.The results were evaluated by the analyses of publication bias and sensitivity.Results A total of 9 787 cases and 12 986 controls from 18 studies for C677T and a total of 4 422 cases and 5 819 controls from 9 studies for A1 298C were included.No heterogeneity among the studies was found.For codon 677,the frequencies of CC,CT and TT genotypes were 46.48%,43.81% and 9.71% in cases,and 45.03%,43.08% and 11.89% in controls,respectively.The pooled OR of TT vs.CT+CC was 0.80(95%CI 0.74～0.87).For codon 1 298,the frequencies of AA,AC and CC genotypes were 53.60%,39.39% and 7.01% in cases,and 53.31%,38.67% and 8.03% in controls,respectively.The pooled OR of CC vs.AC+AA was 0.84(95%CI 0.72～0.97).Conclusions MTHFR 677TT is at lower risk of developing CRC and 1 298CC genotypes might be associated with the decreased risk of developing CRC.

Objective To assess the feasibility and accuracy of transesophageal echocardiography (TEE) in screening patients,intraoperative guidance of occluder releasing and efficacy assessment in the patients of percutaneous left atrial appendage (LAA) occlusion with Watchman.Methods Ultrasonic instrument Philips iE33(proble model X7-3t) were used to measure the maximum diameter and the depth of LAA ostium in enrolled patients by TEE,and intraoperative guided puncture of interatial septum,positioning Watchman transmission system and instruction closure release under TEE,immediate evaluate the postoperative therapeutic effect and record the complications by TEE.At 45 days after implantation,patients should repeat TEE to assess the efficacy.Results Eighteen patients underwent device implantation.Seventeen patients implant successfully,except one patient can't implant device beacuse of the LAA morphologe was not suitable.There was one patient showing thrombus formation on the surface of device,one patient of LAA and the device axial angulation was 90 °.At 45 days after implantaion,16 patients were fullowed up,there were no major stroke at all.Conclusions TEE has important application value in screening of preoperative patients,intraoperative guidance of occluder releasing and efficacy assessment in the patients of percutaneous left atrial appendage occlusion with Watchman.

Molecularly imprinted polymers for dimethoate recognition were synthesized by the precipitation polymerization technique using methyl methacrylate (MMA) as the functional monomer and ethylene glycol dimethacrylate (EGDMA) as the cross-linker. The morphology, adsorption and recognition properties were investigated by scanning electron microscopy (SEM), static adsorption test, and competitive adsorption test. To obtain the best selectivity and binding performance, the synthesis and adsorption conditions of MIPs were optimized through single factor experiments. Under the optimized conditions, the resultant polymers exhibited uniform size, satisfactory binding capacity and significant selectivity. Furthermore, the imprinted polymers were successfully applied as a specific solid-phase extractants combined with high performance liquid chromatography (HPLC) for determination of dimethoate residues in the cucumber samples. The average recoveries of three spiked samples ranged from 78.5% to 87.9% with the relative standard deviations (RSDs) less than 4.4% and the limit of detection (LOD) obtained for dimethoate as low as 2.3μg/mL.

Objective Recent researches find that endoplasmic reticulum is a new target for the treatment of cardiovascular disease and its stress response plays an important role in the hypertension-induced cardiovascular remodeling.The study built up the apoptosis model of endoplasmic reticulum stress ( ERS) in human umbilical vein endothelial cells ( HUVECs) and investigated the im-pact of 17β-estradiol ( E2) on the ERS apoptosis of HUVECs induced by tunicamycinand(TM)/dithiothreitol(DTT). Methods HUVECs incubated for 10 h in 10μmol/L TM or 8 h in 2 mmol/L DTT were the best concentration and time for ERS apoptosis.E2 of 10-8 mol/L was prominent in protecting ERS.According to the application of TM/DTT, E2, estrogen antagonists (ICI182, 780 and G15), there were 6 groups:control group, TM/DTT group, TM/DTT+E2 group, TM/DTT+E2 +G15 group, TM/DTT+E2 +ICI+G15 group.Western blot was applied to detect the expressions of biomarkers for ERS in-duced apoptosis (GRP78, cleaved caspase-12 and CHOP).Hochest staining was used to observe the changes of the apoptosis cell number. Results Compared with control group, the expressions of GRP78, caspase-12 and CHOP significantly increased(P<0.05).In comparison with TM group, the expressions of GRP78, caspase-12 and CHOP in TM+E2 group significantly decreased (6.80 ±1.07 vs 4.01 ±0.46, 1.54 ±0.32 vs 0.88 ±0.10, 1.91 ±0.37 vs 0.91 ± 0.02, P<0.05).In comparison with TM +E2 group, the CHOP expression in TM +E2 +ICI group increased(0.91 ±0.02 vs 0.96 ±0.02, P<0.05), and the expressions of GRP78 and caspase-12 in TM+E2 +G15 group increased(4.01 ±0.46 vs 5.25 ± 0.80, 0.88 ±0.10 vs 1.02 ±0.07, P<0.05), and the expressions of GRP78, caspase-12 and CHOP in TM+E2 +ICI+G15 group increased (P<0.05).Compared with DTT group, the expressions of GRP78 and CHOP in DTT+E2 group decreased (1.81 ± 0.08 vs 1.30 ±0.14, 1.00 ±0.13 vs 0.51 ±0.01, P<0.05).In comparison with DTT+E2 group, the expressions of GRP78 and CHOP in DTT+E2 +ICI group decreased(P <0.05), and the expression of GPR78 in DTT+E2 +G15 group increased(P<0.05), and the expressions of GRP78, caspase-12 and CHOP in DTT+E2 +ICI+G15 group increased(P<0.05).The change of the apop-tosis cell number observed by hochest staining was in consistence with the result of western blot. Conclusion E2 can protect human endothelial cells from ERS induced apoptosis caused by TM and DTT.Estrogen maintains homeostasis by regulating ERS estrogen re-ceptors, thereby protecting the cardiovascular system.

Objective To investigate the distribution and antimicrobial resistance of pathogens from lower respira-tory tract in patients in intensive care unit (ICU),so as to provide reference for clinical treatment.Methods Distri-bution and antimicrobial susceptibility of pathogens isolated from ICU patients’sputum obtained through fiberbron-choscope between 2011 and 2014 were analyzed retrospectively.Results A total of 3 454 pathogenic strains were isolated between January 1 ,2011 and December 31 ,2014,the percentage of gram-negative bacteria,gram-positive bacteria,and fungi were 84.11 %,14.50%,and 1 .39% respectively.The detection rates of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella spp .in 2011 -2014 were 38.46% -73.33% and 26.95% -37.06% respectively. Enterobacteriaceae strains had low resistance rates to imipenem and meropenem (<20.00%);resistance of Acinetobacter baumannii was higher than Pseudomonas aeruginosa ,both had low resistance rates to amikacin(3.32%-37.16%);vancomycin-and linezolid-resistant strains were not found among Staphylo-coccus .In 2011 - 2014,detection rates of methicillin-resistant Staphylococcus aureus (MRSA)were 42.86% -61 .22%,methicillin-resistant coagulase-negative staphylococcus (MRCNS)were 86.96% - 91 .67%;resistance rates of Enterococcus faecium was higher than Enterococcus faecalis ,vancomycin-resistant strains were not found among Enterococcus faecalis and Enterococcus faecium ;the major fungus was Candida albicans .Conclusion Anti-microbial resistance of pathogens isolated from lower respiratory tract is getting more serious,clinicians should pay attention to non-antimicrobial infection control strategies in addition to rational use of antimicrobial agents.