Objective To observe the influence of post-operative swallowing painwith Disposcope endoscope or Macintosh laryngoscope in patients with difficult visible glottis. Methods Thirty-six patients scheduled for elective surgery under general anesthesia whose glottis was not visible underMacintosh laryngoscope (according to Cormach-Lehane Grading of laryngoscopic view) were randomized into 2 groups (n = 18 each):Disposcope endoscope group (group D) and Macintosh laryngoscope group (group M). The rate of glottis exposure and successful intubation, swallowing pain at 30 min, 1, 3 d after extubation were observed. Results Compared with group M , the successful rate of glottis exposure and first intubation was significantly higher than thatin group D (P < 0.05). Swallowing pain VAS was higher in group M than in group D at 1d afterextubation (P < 0.05). Conclusions Compared with Macintosh laryngoscope , Disposcope endoscope in patients with difficult visible glottis could induce higher successful rate of glottis exposure and first intubation , shorter time of intubation and lower VAS of swallowing pain at 1d after extubation.

Objective To explore the relationship between methylene tetrahydrofolate reductase (MTHFR) gene polymorphism and homocysteine (Hcy),and further to investigate their correlation to coronary heart disease (CHD) in females.Methods This study involved 29 premenopausal women with CHD,57 postmenopausal women with CHD,50 men with CHD and 46 postmenopausal women with non-CHD.All patients underwent coronary angiography.The patients' gender,age,history of hypertension,diabetes and smoking were recorded.The plasma Hcy level,blood lipids and MTHFR gene polymorphism were examined.Results The level of Hcy in postmenopausal women with CHD was (18.11±7.21)μmol/L,which was significantly higher than (15.01±6.53)μmol/L in premenopausal women with CHD,(12.98±5.46)μmol/L in postmenopausal women with non-CHD group and (14.32±6.01)μmol/L in men with CHD group (t=5.23,3.65,5.08,all P<0.05).The frequency of the MTHFR TT genotype in postmenopausal women with CHD was 28.1% which was significantly higher than postmenopausal women with non-CHD(17.4%)(χ2=5.13,P<0.05),but there was no statistically significant difference with the other two groups.The plasma Hcy level in patients with TT genotype was significantly higher than that with CT or CC genotype in all groups.Multivariate logistic regression analysis showed a significant positive correlation in Hcy and TT genotype.Multivariate logistic regression analysis showed that smoking,Hcy,hypertension and diabetes were independent risk factors for CHD.The odds ratios(OR) of Hcy for CHD was 2.601 (95% confidence interval,1.326 to 5.745).Conclusion Hcy may be an independent risk factor for CHD in females.MTHFR C677T genotype is significantly associated with hyperhomocysteinemia,and its mutation frequency increases significantly in patients with CHD,but MTHFR mutation is not related with the incidence of CHD.

Objective:To develop a Q-TRAP LC-MS/MS method for the content determination of militarine, protocatechuic acid and caffeic acid in Bletilla Striata. Methods:A Supelco Discovery C-18 (150 mm × 2. 1 mm, 3 μm) column was used and the mobile phase was acetonitrile-water containing 0. 1% formic acid (v/v) with gradient elution. The flow rate was 0. 25 ml·min-1. Bletilla Striata contrast medicinal materials and Bletilla Striata samples were detected by AB Sciex 4000 Q-MRM scan mode. Results: The content of militarine, protocatechuic acid and caffeic acid in the control herb of Bletilla Striata was 1. 167 5, 0. 062 6 mg·g-1 and 0. 001 0 mg·g-1 , respectively, and that in Bletilla Striata samples was 0. 708 8, 0. 001 1 mg·g-1 and 0. 000 4 mg·g-1 , respec-tively(n=3). Conclusion:The method is simple, accurate and reproducible. It can be used to quantitatively analyze militarine, pro-tocatechuic acid and caffeic acid in Bletilla Striata.

In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.

AIM　To find new anticancer drug based on the structure of podophyllotoxin. METHODS AND RESULTS　4-Deoxy-4β-arylmethylenesulfonylamido-4′-demethylpodophyllotoxins were (1-15) synthesized and their antitumour activities against KB cells and L1210 leukemia cells were tested. CONCLUSION　These compounds are new compounds. Among them, compounds 2, 3, 8, 9, 11 and 12 showed antitumour activities. When halides exist on the aryl ring of substituted sulfonyl group, the corresponding compound has relatively higher activities. The stereo factor is important for the activities.

Objective To analyze the differentially expressed genes between the NCAM + c-Kit +RBE and NCAM-c-Kit-RBE of intrahepatic cholangiocarcinoma (ICC) cell lines,and to screen out the differentially expressed genes that are related to the stem cell signaling pathways.Methods Magnetic activated cell sorting was used to isolate the NCAM + c-Kit +/NCAM-c-Kit-subset cells,and then Agilent Whole Human Genome Microarray Kit was used to test the difference in gene expressions between the NCAM + cKit + and NCAM-c-Kit-subset cells.The difference in gene expressions related to the stem cell signaling pathways was analyzed by the SAS system.The result of the microarray was further confirmed by RT-PCR.Results The total differentially expressed genes which could be found through gene microarray were 7270 [foldchange(fc) ≥2 or fc ≤0.5].Compared with the NCAM-c-Kit-RBE,3572 genes were upregulated while 3698 genes were downregulated.The differences in gene expressions related to the stem cell signaling pathways were 421 (fc ≥2 or fc ≤ 0.5),among which 231 genes were upregulated while 190 genes were downregulated.Conclusions High-flux microarray could be used to screen out lots of differentially expressed genes between the NCAM + c-Kit + and NCAM-c-Kit-RBE cells.The differences in gene expression in the stem cell signaling pathways could also be further analyzed using the SAS system.

Objective To evaluate the efficacy of Disposcope endoscope for tracheal intubation in patients with difficult glottis exposure.Methods Sixty adult patients of both sexes,aged 22-68 yr,scheduled for elective oro-tracheal intubation under general anesthesia,whose glottis was not visible under Macintosh laryngoscope (grade Ⅲ or according to Cormach-Lehane Grading of laryngoscopic view),were randomized into 2 groups (n =30 each) using a random number table:group Macintosh laryngoscope-assisted Disposcope endoscope (group DM) and group Disposcope endoscope (group D).The glottis exposure condition and time,intubation condition and time,assisted lifting mandible,laryngeal mucosa bleeding and postoperative sore throat and hoarseness were recorded.Results The success rate of intubation at second attempt achieved 100％ in the two groups.Compared with group DM,the incidence of assisted lifting mandible was decreased,and no significant changes were found in the success rate of glottis exposure,glottis exposure time,intubation time,success rate of intubation at first attempt,incidence of laryngeal mucosa bleeding,and postoperative sore throat and hoarseness in group D.Conclusion Disposcope endoscope can improve the condition for tracheal intubation significantly after lifting mandible in patients with difficult glottis exposure.

Objective To determine if the cardiac index (CI) measured with arterial pressure-based cardiac output (APCO) agrees with that measured with pulmonary artery catheter (PAC) during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension.Methods Thirty parturients with congenital heart disease and severe pulmonary hypertension,scheduled for elective cesarean section,were enrolled in the study.APCO and PAC were used for cardiac output and other parameters of hemodynamics monitoring during operation in all patients.Continuous epidural anesthesia was performed.CI was recorded immediately before epidural administration (T1),at 5 and 10 min after epidural administration (T2-3),immediately before delivery (T4),and at 2 and 5 min after delivery (T5-6).The correlation was tested by Pearsone correlation analysis.CI derived from APCO and PAC was compared by Bland-Altman analysis for agreement.Results CI measured with PAC was significantly higher than that measured with APCO (P ＜ 0.05).Compared with the baseline value at T1,no significant difference in CI measured with PAC and APCO was found at T11-T4 and T6 (P ＞ 0.05),and CI measured with PAC and APCO was significantly increased at T5 (P ＜ 0.05).Bland-Ahman analysis showed poor agreement between CI measured with the two methods.The correlation analysis showed that there was positive correlation between CI derived from the two methods at T1-6 (the correlation coefficient was 0.93,0.95,0.94,0.89,0.96 and 0.91 at T1-6,respectively,P ＜ 0.05).Conclusion CI value obtained with APCO agrees poorly with that obtained with PAC during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension,but agrees well in monitoring the changing trend of CI.

Objective To analyze the influential factors of healthy children′s heart rate turbulence (HRT). Methods One hundred and six healthy children with ventricular premature beat (VPB) were selected in this study and the correlation among HTR parameters as turbulence onset (TO) and turbulence lope (TS) and age, gender, basic heart rate, the number of VPBs were analyzed. Results It was observed that among three age groups, TO decreased with the age, and the difference was statistically significant (P < 0.05), but there was no significant gender difference (all P > 0.05). TS increased with the age, and intergroup difference was statistically significant (P < 0.05). In the group of children aged over seven, significantly higher TS was observed among boys (P < 0.05), while in the group of children aged 1 to 3 and the group aged 3 to 7 , there was no significant gender difference (P > 0.05). TO and TS decreased with the decline of heart rate (r = 0.494, P < 0.00; r = -0.569,P < 0.00 respectively), and the correlation between TO and HR, TS and HR was found.The number of VPBs had no significant correlation with TO or TS (r = 0.104,P = 0.290; r = 0.122,P =0.212). Conclusions The results demonstrate that influenced by age and basic heart rate, healthy children′s HRT increases with the age and the decline of heart rate. Therefore, the reference index of children′s HRT should differ from that of adults, which requires further evaluation.

Objective To investigate the significances of karyotyping analysis on umbilical cord vein blood lymphocytes in the diagnosis of abnormal karyotypes in middle to late period of pregnant fetus.Methods A volume (0.5 ～ 1 ml) of umbilical cord vein blood was extracted from pregnant women in third trimester pregnancy with prenatal detection indications,and collected in sterilized anticoagulant tube.Lymphocytes were cultured and collected for karyotyping analysis after fixed and dropped on slides.Data were analyzed statistically.Results Lymphocytes were cultured successfully in 1 211 cases out of total 1 213 cases collected.Totally 142 abnormal karyotypes were found,which includes 81 cases (detection rate 6.68 ％) of non-heteromorphic abnormal chromosomes and 61 cases (detection rate 5.03％) of heteromorphic chromosomes.Among these abnormal karyotypes,50 cases (accounting for 35.21％ in total abnormal cases) of aneuploidy include 4 cases of chimerical karyotype.Structural abnormalities were found in 31 cases (accounting for 21.83％ in total abnormal cases) samples including 11 cases of translocations,17 cases of inversion and 3 cases of deletion.Conclusions Based on our findings,karyotyping analysis on umbilical cord vein blood lymphocytes could be an effective method for detect abnormal karyotypes in middle to late period of pregnant fetus and played an important role in prenatal diagnosis.