Objective To compare the effectiveness of the forced-air warming system and the conventional warming care practice in preventing hypothermia in patients undergoing major surgeries.Methods A total of 62 patients were enrolled in this study. Patients of both sexes,aged≥18 years,and with an ASA physical status Ⅰ-Ⅲ were included and allocated randomly into intervention group(n=30)or control group(n=32). Patients in the intervention group were provided forced-air warming,either prior to induction or during the surgery procedure depending on core temperature monitoring results. In the control group,patients were warmed with conventional warming care without any intervention. Core temperature was measured by Spot-On sensor and tympanic membrane thermometer,blood pressure,the electrocardiogram,heart rate,pulse oxygen staturation,and partial pressure of end-tidal COwere also monitored continuously in the two groups.Crystalloid,colloid,and allogeneic blood were also recorded by strict protocol. Results Intraoperative hypothermia monitored with tympanic thermometer was observed in 23 patients(71.87%)in the control group,which was significantly higher than that (0) in the intervention group(P=0.00). In addition,the incidence of hypothermia monitored by Spot-On sensor was 81.25%(n=26)in control group and 13.33%(n=4)in intervention group(P=0.00). Conclusion Compared with the conventional warming care,forced-air warming system is more effective in preventing hypothermia during major surgeries.

Cone-bine CT(CBCT)images of 2 130 maxillary third molars were divided into 3 groups according to the impaction position. The relationship between the floor of maxillary sinus and the roots of maxillary third molar was analyzed and compared.In low,median and high impaction groups the probability of the root tip of maxillary third molar higher than the floor of maxillary sinus was 4.5%,10.3% and 14.6% respectively.

Covered in the paper are reform efforts made by the hospital on the HIS system amid the pilot programs total prepaid and mcdicine-drug separation trials in Beijing.Findings of the programs revealed defects of the HIS system,for example measures for refusal of payment of non-compliance items,and real-time reimbursement for patients.In view of these setbacks,the hospital made further attempts to the system in such aspects of the fundamental maintenance,rational drug usage and new problems,for the purpose of successful completion of the pilot programs at the hospital.Discussions were also made as to how to adapt the HIS system to total prepaid and the separation reforms,aiming at helping those not yet initiated with the reforms,and the information sharing of patient diagnosis/treatment records and social insurance payment at all hospitals in Beijing.

Tuberous sclerosis complex (TSC) is a genetic multisystem disorder that has an impact on many organ systems.It is a common neurocutaneous syndrome in children, the main clinical manifestations characterized by impairment of skin and nervous system.The most frequent neurological symptoms are seizures,which occur in up to 90％ of patients and often are intractable,followed by autism spectrum disorders, intellectual disability, attention deficit-hyperactivity disorder, and sleep, et al.Conventional treatment has frequently proven insufficient for neurological and behavioral symptoms, particularly seizure control.Currently, there are many studies focus on the mechanism-based treatment in TSC.Therefore, this review will focus on the genetic mechanism of TSC, further exploring personalized medicine and prognosis for TSC shows good prospects.

OBJECTIVE:To provide reference for small interfering ribonucleic acid (SiRNA) R&D and registration in China. METHODS:The situation of SiRNA R&D at home and abroad were introduced,and problems encountered in the evaluation and approval process were summed up to put forward suggestions. RESULTS & CONCLUSIONS:SiRNA has developed slowly in Chi-na,with a gap of 5-10 years at least compared with foreign developed countries. The registration category of SiRNA is not clear;applicants lack of guidance documents;production workshop which meet requirement is in shortage;the efficiency of drug registra-tion allows of no optimism. It is recommended that pharmaceutical registration departments carry out the pilot reform for SiRNA registration,publish SiRNA registration guide,relax regulations for IND gradually,encourage applicants to participate in the inter-national multicenter clinical trials in order to improve the efficiency of SiRNA evaluation and approval efficiency.

Diagnostic Errors ; Humans ; Myoclonus ; diagnosis ; Tics ; diagnosis

Objective To longitudinally analyze the unit costs and technical efficiency of the model of male circumcision in the different kinds of persons .Methods Unit costs were calculated by the person and period using longitudinal data from 3 kinds of persons ,and then technical efficiency and Malmquist indices were measured with an approach to data envelopment analysis . Results Theunit costs for changing the willingness to accept surgery changed dramatically ,decreasing from 7 166 .67 yuan(mean) to 737 .31 yuan ,while the costs for changing the ratio of the surgery increased from 666 .64 yuan (mean) to 744 .58 yuan ,and its technical efficiency was averaging between 0 .95-0 .96 .Conclusion The time series of unit costs for changing the willingness to ac-cept surgery dramatically dropped ,while changing the ratio of the surgery formed a U-shape curve with an inflection point before which unit costs dramatically dropped and another inflection point beyond which unit costs went up .These findings can inform pro-gram managers of the changing unit costs when extending or expanding the program .

Objective To investigate the expression of T cell factor-4 (TCF4) gene in dermal papilla cells of hair follicles.Methods The expression of TCF4 gene was examined by in situ hybridization in scalp tissues of patients with alopecia areata and normal human controls,The protein and mRNA exprcssions of TCF4 were detected by immunochemistry and RT-PCR method,respectively,in aggregated and non-aggregated human dermal papilla cells.ResultsAs shown by in situ hybridization,TCF4 gene was expressed in the dermal papilla cells from healthy controls,but not in those from patients with alopecia areata.Both cell immunochemistry and RT-PCR showed that TCF4 gene expressed in aggregated dermal papilla cells,but not in non-aggregated dermal papilla cells.ConclusionsTCF4 gene is expressed in dermal papilla cells.The growth cycle Of follicles may be related to wnt signal.

p53 gene mutation (exon4 , 5 , 6 . 7 . 8 and intron6) in gastric cancer and precancerous le- sions and p53 gene (exon4 and intron6) .APC gene deletion in gastric carcinomas were studied by PCR/ SSCP and PCR/RFLP. Results showed: mutation rate of p53 in intestinal metaplasia ,dysplasia and gas- tric carcinoma was 37. 5% (3/8) ,42. 1 % (8/19) , 53. 3% (16/30) ,respectively. There was significant dif- ference between groups of metaplasia、dysplasia、cancer and that of normal control. We found there were no exon8 mutation in metaplasia and dysplasia , but 4 cases in cancer group. lt is suggestted that exon8 mutation occurs at the late stage of gastric cancer , but exon 5 , 6 , 7 mutation occur in the course of pre- cancerous lesions to cancer. Loss of heterozygosity (LOH) of exon4 . intron6 . APC was 47. 4 % ( 9/19) . 8. 7%C2/23).16. 7%(3/18) ,respectively. There are some relationship between LOH of exon4 and poor- ly differentiation , lymph node metastas , depth of invasion. LOH of exon4 may be one of prognostic marker of gastric cancer. We concluded that p53 gene mutation is an early event and perhaps has syner- gism with ras oncogene in gastric carcinogenesis

Objective To describe a new surgical approach to treatment of scapular neck and body fractures and evaluate the clinical outcomes. Methods From December 2002 to October 2004, 13 cases of the scapular neck and body fractures including 9 males and 4 females with age range of 22-48 years (mean 31 years) were admitted into our hospital. There were seven cases with neck fractures, two with associated clavicle fractures, six with mere body fractures, seven with associated subluxation of humeral head and three with associated rib fractures. Internal fixation and open reduction reconstruction using titanium plate and screws were for treatment of scapular neck and body fractures in all 13 cases by making straight incision along lateral border of the scapula. Results The operation lasted for 40-80 minutes, with intraoperative blood loss for 30-80 ml. The follow up for 4-24 months showed average fracture healing time for 6-8 weeks and satisfactory results in 10 cases. Conclusion The surgical approach with straight incision along the lateral border of the scapula can attain perfect reduction and internal fixation of scapular neck and body fractures as well as satisfactory functional recovery with minor (trauma.)