Objective:To investigate the dynamic changes of coagulation system following radiofrequency catheter ablation(RFCA) and effect of molecular weight heparin. Methods:Blood samples were collected at 6 different times to measure the thrombin-antithrombinⅢcomplex (TAT) and hepatocyte growth factor (HGF) in 60 RFCA candidates and 22 controls undergoing electrophysiological study (EPS).Patients were randomly divided into 2 groups.Low molecular weight heparin was given to 31 pationts (subgroup B) after RFCA,but not to the others (subgroup A). Results:①Plasma TAT exhibited a double peaked pattern in the subgroup A.The first peak occurred instantly after RFCA (42.8?15.7 ng/ml),and the second 3 days later (20.1?19.4 ng/ml).The second peak was significantly higher than that of the control group (2.7?1.5 ng/ml) and the subgroup B(4.3?5.2 ng/ml)(P

Objective To assess the changes in the effect compartment concentration (Ce) and bispectral index (BIS) during a step-by-step TCI of propofol in the elderly.Methods Ten ASA Ⅰ -Ⅱ patients (6 male, 4 female) aged 67-77yr and weighing 51-78kg, undergoing elective surgery were studied. Patients with severe cardiovascular disease were excluded. The patients were unpremedicated. Anesthesia was induced with propofol administered by a TCI system (Diprifusor) . The target concentration (Ct) of propofol was increased step-by-step from 1?g?ml-1 to 4?g?ml-1 in 6 steps. At each step Ct increased by 0.5?g?ml-1 and the interval between the two steps was 2min. The changes in Ce (calculated and displayed by Diprifusor) and BIS were recorded. Modified OAA/S sedation score were measured. Blood samples were taken from artery for determination of blood concentration of propofol (Cb) before TCI (T0 ) and when Ct was 1, 2, 3, and 4?g*******ml-1 (T1-4) in 5 randomly selected patients.Results (1) Ce consistently increased with the increase in Ct and there was a delay between Ct and Ce. When Ct was increased to 4?g*******ml-1, it took (14.4 ? 0.5) min to achieve the balance between Ct and Ce. (2) Cb of propofol was higher than Ct of propofol at each step. MDPE and MDAPE was 9.7% and 11.2% respectively. (3) There was a close correlation between BIS and Ct, Ce and OAA/S score( r = - 0.878, - 0.888 and 0.913 respectively , P

Objective To investigate the relationship between CD40,Ki-67,and CD34 expressions and clinical significance of gastric cancer.Methods The expressions of CD40,Ki-67,and CD34 were detected by immunohistochemistry in 80 cases of gastric carcinomas and adjacent mucosas.Results The high expression of CD40 was detected in 36.3％ (29/80) cases of gastric cancer tissues,and Ki-67 was 53.8％ (43/80).The high expression of CD40 was related to lymph node metastasis,depth of invasion,and the patient's prognosis.The high expression of Ki-67 was related to histological differentiation,depth of invasion,vascular invasion,and lymph node metastasis (P ＜ 0.05).Expression of CD40 was positively related to Ki-67 and CD34 in gastric carcinomas (P ＜ 0.05).Conclusions The high expressions of CD40,Ki-67,and CD34 in gastric cancers are related to the tumor proliferation,tumor angiogenesis,and the prognosis of patients.

To reflect specialty teaching characteristics and levels in clinical standardized training of medical professional degree postgraduates and highlight the thinking of evidence-based medicine culture,in urology rotation training practice,we conducted clinical pathway teaching according to picot principle (PICOT-CP teaching).According to the requirements of the teaching syllabus,the six kinds of major diseases were brought into PICOT-CP teaching.After the screening of pre teacher training,teaching tools and teaching cases,and based on the form of PICOT-CP,we standardized the implementation of clinical teaching of Urology,fully used subject website platform to discuss the interaction between teachers and students,and assessed the effect in combination with the departmental rotation examination and the teaching questionnaire survey of the students and the training teachers.Preliminary practice shows that PICOT-CP teaching helps to stimulate students' interest in learning,improve their overall quality,expand their clinical thinking,and establish their concept of evidence-based medicine.In addition,PICOT-CP teaching is beneficial to the teaching norms of teachers' teaching and can improve teaching level.

Objective To investigate the current situation and influencing factors of overweight and obesity in the elderly from Changsha city.Methods Using stratified sampling,2500 elderly in Changsha were included for the investigation by questionnaire and physical examination.The influencing factors were analyzed with univariate analysis and two-level models.Results Among 2500 persons,the valid questionnaires were 2254,the effective rate was 90.16％.About 39.71％ (895/2254) of Changsha's elderly were in overweight and obesity (BMI≥ 24 kg/m2).Univariate analysis showed that there were significant differences in BMI among different area,education degree,income,marital status,drinking wine,drinking tea,physical exercises and occupation (x2＝ 304.17,18.39,19.35,12.93,13.29,11.77,12.87,12.84,all P＜0.05).The results of two-level models indicated that the independent influencing factors were income,physical exercises,drinking wine,age and occupation.Conclusions It is necessary to take interventional measures against elderly obesity and to encourage the elderly taking physical exercises and keeping reasonable diets.

Objective To evaluate the changes of left ventricular regional function in normal subjects with aging and the influencing factors by Doppler tissue imaging. Methods One hundred and twelve normal subjects were divided into four groups according to age: I group with age≤18 years old ; II group with 18 60 years old. Using a quantitative tissue velocity analysis system and tissue tracking, the peak velocities of different ventricular segments at systole, early and late diastole (Vs, Ve,Va) , the Ve/Va ratios were obtained and the effects of age, gender, heart rate and STd were analyzed. Results (1) Peak velocities of different segments of each wall were decreased one by one from mitral annulus, the basal, middle segment to the apical portion. (2) Peak velocities of different ventricular walls were significantly different, with the antero- and posterio-inter-ventricular septum being the lowest CVe (6. 89?2. 60) ,(7. 94?2. 64)cm/s]and with the latero-,posterio-,antero, and inferior walls of the left ventricle being higherCVe (9. 85?3. 02) , (9. 80?3. 09), (8. 86?3. 16), (8. 23?2. 48) cm/s] . (3) Peak velocities of different segments were associated with age, STd, BMI, heart rate and not associated with gender. (4) The Ve/Va ratios were increased one by one from mitral annulus, basal, middle segment to apical portion, and were significantly lower in III group and IV group than in I group and II group. Conclusions Peak velocities of different segments at different walls change regularly and age is the most important influencing factor to the diastolic velocities.

Objective To study the effect of sub-chronic exposure to dehamethrin(DM) on the behavior of mice in learning and memory.Methods 60 Female SPF Kunming mice were randomly divided into 4 groups and given DM by gavaging for 60 days.Morris water maze (MWM) was used to evaluate spatial memory in mice.Results After exposure to DM,the escape latency of the solvent control group and the treatment groups were (12.20±6.5)s,(14.99±5.4) s,(15.64±8.3)s,(22.71±6.2)s on the fifth day.The escape latency of the high-dose group was higher than those of the low-dose group (P=0.0041) and the solvent control group (P=0.019) in the navigation test.The number of crossing position of the platform in the high-dose group ((2.93± 1.53)times) and the middle-dose group ((3.40± 1.12) times) were lower than that in the solvent control group ((5.87 ± 1.55) times) and the low-dose group ((4.90± 1.41)times)(P＜0.05).Conclusion Sub-chronic exposure to DM can damage the spatial learning and memory of mice.

Objective To evaluate the POSSUM scoring system as preoperative risk assessment approaches for lower extremity arteriosclerosis obliterans (LEASO).Methods A retrospective study was undertaken in 108 patients ( 120 limbs) diagnosed as long segment LEASO from January 2008 to October 2010,in which,67 patients (74 limbs) receiving percutaneous transluminal stent (PTS) treatment were included into PTS group,and 41 patients (46 limbs) undergoing femoral artery to popliteal artery bypass treatment into bypass group.Rutherford classification was used to evaluate degree of chronic ischemia for lower limb and ankle/brachial index (ABI) for the treatment results in these two groups.The score of POSSUM,physiological score and physiological score without age interference were calculated respectively to estimate the risks for operations in two groups.Results The chronic ischemia conditions for two groups were similar (P =0.543 ).Postoperative follow-up was done for 9 - 15 months,there were no difference between two groups for limb salvage ( P =0.556 ) and patency rate ( P =0.632 ).Risk evaluation for patients: POSSUM score for the PTS group (33 ± 7 ) was similar with that of bypass group ( 32 ± 6 ) ( P =0.369 ) ; Physiological score of POSSUM for PTS group ( 24 ± 7 ) was more than that of bypass group ( 22 ±7) (P =0.033) ; Physiological score without age interference in PTS group (22 ±6)was higher than that of bypass group ( 19 ± 6) (P =0.035).Condusious The physiological score of POSSUM could assess the health status of patients with LEASO,which is more useful for pre-vascular surgery evaluations.

Aim To clone and express the 1.2kb cDNA fragment (1/753-2 934bp) of human integrin α 4 subunit. Methods The 1.2 kb cDNA fragment of human integrin α 4 subunit was amplified from HL-60 total RNA by RT-PCR, then it was subcloned into expression vector pGEX-3X and induced with IPTG. Results The 1.2 kb cDNA fragment of human integrin α 4 subunit was cloned. The sequencing indicated that there was only one missense mutation (Arg→ Gln) among the fragment, and this mutation won't affect antigenicity after analysed by GOLDKEY. Then the 1.2 kb cDNA was subcloned into expression vector pGEX-3X. The α 4 fragment was highexpressed in E.coli after induced with IPTG. Conclusion The 1.2kb cDNA fragment of α 4 subunit was obtained, and it was highexpressed in E.coli, it might be important for study on the function of α 4 integrins.

Objective To analyse the effect of holmium laser incision through ureteroscopy and simple ureteroscopy treatment for refrac-tory hemospermia. Methods From December 2003 to April 2013,the data of 67 cases with refractory hemospermia were retrospectively ana-lyzed. All the patients underwent semen analysis,transrectal ultrasonography,seminal vesicle ultrasonography,some patients underwent pelvic CT or MRI. Results Simple ureteroscopy were done for 24 cases,holmium laser incision through ureteroscopy were done for 43 cases. Var-ying degrees of ejaculatory duct stenosis or obstruction were observed. Postoperative follow-up was from 6 months to 8 years,in 24 cases of simple ureteroscopy,2 cases experienced recurrence 6 or 8 months later. The ejaculatory duct narrow were found when they received reopera-tion,with holmium laser incision,hemospermia disappeared. No complications such as retrograde ejaculation,urinary incontinence or rectal injury occurred postoperatively. Conclusion The effect of holmium laser incision through ureteroscopy for refractory hemospermia is better than simple ureteroscopy,which is worthy of clinical application needs further observation and summary.