To investigate the effect of calcium concentration in dialysate on the QT interval (QT) and QT interval dispersion (QTd) during hemodialysis(HD) in patients with end stage renal disease (ESRD), Ca 2+ concentrations of 1 25mmol/L (dCa 2+ 1 25), 1 5mmol/L (dCa 2+ 1 5) and 1 75mmol/L (dCa 2+ 1 75) in dialysate were given to 15 ESRD patients for five times. The QT and QTd were measured before and after the five HD sessions. The results showed: With the dCa 2+ 1 25 HD, serum Ca 2+ and plasma calcium were decreased (1 22?0 08 vs 1 17?0 07 mmol/L and 2 43?0 34 vs 2 28?0 16mmol/L, P 0 05). The changes in the QT correlated inversely with the changes in serum Ca 2+ and plasma calcium ( P

Objective To evaluate the effects of morphine preconditioning-postconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts. Methods Male SD rats weighing 180-200 g were killed after intraperitoneal injection of heparin 500 U/kg. The hearts were immediately removed and perfused in a Langendorff apparatus with K-H solution gassed with 95%O2-5%CO2 .HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. Forty isolated rat hearts were randomly divided into 5 groups (n = 8 each): group 1 (I/R); group II morphine preconditioning (M1 ); group Ⅲ morphine postconditioning (M2); group IV M1 + M2; group V 5-hydroxydecanoate (5-HD) + M2. Group M1 was perfused with K-H solution containing morphine 3.0 μmol/L for 20 min 30 min before ischemia followed by 10 min normal K-H solution perfusion. Group M2 was perfused with K-H solution containing morphine 3.0 μmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Group 5-HD + M2 was perfused with K-H solution containing morphine 3.0 μmol/L+ 5-HD 10-4 mmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) detennined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion. Results The preconditioning, postconditioning and combination of preconditioning and postconditioning with morphine 3.0 μmol/L perfusion for 10 min all provided cardio-protective effects in terms of IS/AAR and myocardial activation of CK-MB. Conclusion Although the combination of morphine preconditioning and postconditioning can protect the heart against I/R injury, the effects are similar to those of either of them alone, and the reason may be that either of them alone protects the heart against I/R injury via activating mitoKATP .

Objective To determine whether morphine postconditioning (MP) could protect the heart against ischemia reperfusion (I/R) injury and which specific type(s) of the opioid receptor is involved in the cardioprotective effect produced by hiP. Methods Male SD rots weighing 180-200 g were killed after intraperitoneal heparin 500 U/kg. The hearts were immediately removed and passively perfused in a Langendorff apparatus with K-H solution gassed with 95% O2-5% CO2. HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. The experiment was performed in 3 parts. In Part Ⅰ 32 isolated rat hearts were randomly divided into 4 groups (n = 8 each): group Ⅰ control received no treatment; group Ⅱ ,Ⅲ,Ⅳ were first perfused with K-H solution containing morphine 0.3, 3.0 and 30 μmol/L respectively for 10 min immediately after the end of ischemia followed by 50 min normal K-H solution perfusion. In part Ⅱ,the concentration of morphine in K-H solution which provided the best cardio-protective effects was chosen according to the result of Part Ⅰ , 32 isolated rat hearts were randomly divided into 4 groups ( n = 8 each) : group Ⅰ received no treatment; gvoup Ⅱ,ⅢⅣ were first perfused with K-H solution containing morphine for 5, 10, 20 min respectively immediately after ischemia followed by 50 min peffusion with normal K-H solution. In part Ⅲ,the MP method which provided the best cardio-protective effects was chosen according to the result of Part Ⅱ , 37 isolated rat hearts were randomly divided into 5 groups: group Ⅰ control (n=8);group Ⅱ-Ⅴ were first perfused for 10 min with K-H solution containing morphine (Ⅱ,n = 8)/morphine + naloxone 10 μmol/L(Ⅲ, n = 7)/morphine + nor-binaltorphimine 5 μmol/L (specific κ receptor antagonist, n = 7)/morphine + nalu'indole 5 μmol/L (specific δ receptor antagonist, n = 7) followed by 50 min reperfusion with normal K-H solution. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) determined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion.Results The postconditioning with morphine 3.0 μmol/L perfusion for 10 min provided the best cardio-protective effects in terms of IS/AAR and myocardial release of CK-MB. Nuloxone completely abolished the cardio-protective effects of MP. Nor-binaltorphimine partly reversed the protective effect of MP, while naltrindole had no effects on MP. Conclusion MP protects the heart against I/R injury via activating κ receptor.

By means of literature review,the authors initiated the behavior expression system of hospitals' social responsibilities,which is further refined and revised with questionnaires and Delphi method.13 expressions of such behavior expressions were determined,namely “providing quality of care to patients”,“undertaking rescue assignment for emergencies”,and “fulfilling government-assigned tasks”.All of the 13 expressions were supported by 75％ of the experts during the second round of experts consultation.

Objective To investigate the induced-factors levels of venous thrombosis associated with the placement of peripherally inserted central catheters (PICC) in patients with malignant tumor,and establish intervention model accordingly. Methods 40 patients complicated with venous thrombosis after PICC were set as the thrombosis group, 40 patients without venous thrombosis were selected as the no-thrombosis group, 30 healthy cases were selected as the control group. All cases' serum samples were ob-tained to measure the levels of molecular biomarkers of the coagulation system, platelet parameters and molecular biomarkers of the fibrinolysis system. The results of the three groups were assessed. Results Patients in the thrombosis group were reported significantly higher levels of vWF, GMP140,TAT than those in both two other groups, but lower levels of ATⅢ. Higher levels of MPV and PCT were found in the throm-bosis group than those in both two other groups.Tthe data also showed higher PLG and PAI levels and lower levels of PLM in the thrombosis group. Conclusions From this study it shows that patients with malig-nant tumors during the placement of PICC have evident hypercoagnlahility, high- activated platelet and se-vere pre- thrombosis state caused by PICC. In treatment of malignant tumor patients with PICC, the level of coag-ulation system molecular markers, platelet parameters,fibrinolysis molecular markers shoud be used as a clinical routine and as the index of early intervention and evaluation of the PICC.

Objective To explore the influence of carbamazepine on the plasma homocysteine (Hcy),folic acid and vitamin B12 levels in the treatment of epilepsy.Methods The clinical medical history and medication com-pliance of 80 epilepsy patients were retrospectively analyzed.40 cases treated with carbamazepine were set as group A,another 40 cases without taking antiepileptic drug therapy were set as group B.And 40 cases in the same period in hospital physical examination were selected as control group.The levels of blood Hcy,folate and vitamin B12 were detected by using the fluorescent quantitative method,the electrochemical luminescence immunoassay,and the differ-ences of three groups of the levels were compared.Results The Hcy level of group A was significantly higher than the control group and group B(F =7.16,P =0.00),and the folic acid level of group A was significantly lower than the control group and group B(F =9.67,P =0.00).The Vit B12 concentration of group A was lower than the control group and group B,but among the three groups,the difference was not statistically significant(F =1.05,P =0.15). Loss of appetite and body weight decreased in 4 cases,2 cases of dizziness,fatigue,but symptoms were mild,did not affect the findings.Control in 13 cases,12 cases were markedly effective,effective in 8 cases,ineffective in 7 cases,the total effective rate was 82.5%.Conclusion Carbamazepine treatment can cause epilepsy patients blood Hcy level rise,and folic acid level drop,has no significant effects on the Vit B12 concentration,so in patients with epilepsy should pay attention to monitor blood Hcy and folic acid level during the treatment,in order to avoid adverse events such as thrombosis and influence the prognosis.

Objective: To replace esophageal defects with artificially composed biodegradable materials and non-biodegradable materials. Met hods: A two-layered tube consisting of a collagen-chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defect s in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of es ophageal epithelia was observed in 5 dogs at week 2, and progressing constricti on occurred and the dogs became unable to swallow within 1 month. In the 10 dog s that the polyurethane stent was removed at week 4, regenerated esophageal tiss ue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, inc luding mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis i n reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen-chitosan sponge provides a three-dimensi onal structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.

Objective To investigate the effects of the point-injection combined with neuromuscular facilitation rehabilitation techniques on post-stroke shoulder-hand syndrome. Methods A treatment group, 36 cases, was treated with the point-injection combined with neural facilitation of rehabilitation techniques. And a control group, 30 cases, was treated with massage therapy. Observed the clinical manifestations and used Fugl-Meyer to assess the joint activities, pain degree and motion function of upper limbs before and after therapy. Results Compared with the control group, the treatment group showed better improvement of joint activity scope and degree, and alleviation of pain (P<0.05). Conclusion Point injection and neuromuscular rehabilitation treatment has a better effect ain treating sequelare of brain stroke and it is worth applying.

Objective To investigate the radiological features of granulomatous mastitis (GM) in dynamic contrast enhanced MRI (DCE-MRI) and DWI and to differentiate it from the breast cancer in diagnose.Methods Forty five cases of GM and 64 cases of breast cancer confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study.All of the patients were examined preoperatively by DCE-MRI and DWI.Including lesion type,location,enhancement pattern,nipple retraction,supplying arteries,skin thickening and axillary adenopathy in the two groups were evaluated and analyzed by using x2 test.One-way ANOVA was employed to compare the ADC values between the abscess area of GM and non-abscess area,and the difference among the breast cancer lesion area.Dynamic enhancement MR pharmacokinetic parameters were used to measure including early-phase enhancement rate (EER),peak enhancement ratio(Emax),and time to peak ehhancement(Tmax).The statistical differences of EER,Emax and Tmax between the two groups were calculated by using Wilcoxon test.Results In 45 cases of GM,DCE MR images showed nonmass-like lesions (43 patients) and mass-like lesions (2 patients); the nipple involved(16 patients) and segment involved (29 patients);rim-like with heterogeneous enhancement (40 patients) and heterogeneous enhancement (5 patients); nipple retraction (24 patients) supplying arteries dilatation (42 patients),skin thickening (29 patients),and axillary adenopathy (17 patients).Corresponding to the radiological features above,in the 64 breast cancer cases,it showed 54,10,5,59,30,34,16,51,12 and 20,respectively.There were statistical significance between GM and breast cancer in lesion type,location,enhancement pattern,and nipple retraction (x2=67.574,13.075,20.297,20.398 and 23.510,respectively,all P＜0.01).But no differences were existed between 2 groups in supplying arteries and axillary adenopathy(x2=3.928 and 0.502,P＞0.05).EER,Emax and Tmaxin GM were 146.58％,191.13％,195.00 s in GM and 118.13％,159.43％,183.33 s in breast cancer,respectively.Significant statistic differences between GM and breast cancer were found in EER and Emax(Z values were-2.271 and-2.948,P＜0.01).But it did not show significant difference in Tmax (Z =-0.548,P＞0.05).The ADC values of GM on abscess area,non-abscess area,and breast cancer lesion area were (8.0±2.6) × 10-3,(11.3± 1.7) × 10-3 and (8.2± 1.1) × 10-3mm2/s,respectively.There were significant differences in the groups (F=52.167,P＜0.01).Conclusions The characteristic of radiological findings can be found in GM by using advanced MR imaging techniques.DCE-MRI combined with DWI is useful in the differential diagnosis between GM and breast cancer.

Rectal cancer is one of the common digestive tract malignant tumors in China. In particular, middle and low rectal cancers are the most common. The treatment goal is to preserve anal function as much as possible through tumor radical resection. Owing to anatomical and biological explorations and the widespread application of new surgical equipment, the possibility of anal function-preserving anastomosis in low rectal cancer has gradually increased. This article reviews the research progress on anastomosis for low rectal cancer surgery and discusses its characteristics and operational difficulties.