Effects of both hypOXia and nifedipine injected during hypoxia on hemodyhamic and blood-gas parameters were studied in 18 female swine.During hypoxia(at a simtllated high altitude 0f 4,000m),puImonary arterial pressure(Ppa)and puImonary vascLllar resistance(PVR)increased significantly.Systemic arterial pressure(Psa)and total peripheral resistance(TPR)increascd at the same time.N0 significant change in cardiac output(CO)was observed.After intravenous injection 0f nifedipine(40 ?g/kg)at 4,000 m,Ppa and PVR decreased significantly,Psa and TPR als0 decreased,and CO increased significantly. Swine which had received nifedipine (two times per day, 40?g/kg/time, IM)during chtortic intermittent hypOXia(exposed to a simulated high altitude of 4,000 m, 8 hrs/day for 30 days)did not develop right ventricular hypertrophy. It is evident that nifedipine can prevent hypoxic pulmonary hypertension and right ventricular hyper trophy induced by chronic imermittent hypoxia in swine.

Objective: Combined with the metrological verification in order to strengthen the quality control of medical ultrasonic diagnostic instrument, to ensure the image quality of instruments and medical safety. Methods: Measure output sound intensity, patient leakage current, metrological verification parameters detection depth, resolution, geometric position error value, cystic focal diameter error, blind area and so on. Results: Through analyzing the data of metrological verification results, and in combination with the practical situation of hospital ultrasonic diagnostic instrument calibration, approved metrological verification instrument performance detection technology as the basis. Conclusion: The combination of metrological verification, strengthen training, maintenance, etc, to ensure the operation and safety of instruments, to achieve good quality control in the device.

Objective:To describe PACS hardware infrastructure experimental design and summary under big data environment.Methods: A real DICOM communication test of PACS hardware infrastructure experimental design.Results: Archive test figures of DICOM communication for 64 channel CT, 1.5T MRI and DR.Conclusion: Currently, an efficient, reasonable hardware infrastructure design is essential to guarantee large hospital PACS application.

Evidence-based medicine(EBM)advocates finding problems in clinical practice,searching for the best evidence,appraising and analyzing comprehensively the acquired evidence,and then applying the evidence to direct the diagnosis,therapy and prognosis of diseases.Our experiences showed that the application of EBM in clinical teaching could help the students improve their clinical intellection,clinical skills and innovation ability.

Objective To evaluate the efficacy and safety,particularly eye safety of hydroxychloro-quine(HCQ)treatment in primary Sj(o)gren's syndrome(pSS)patients.Methods Forty pSS patients were en-rolled and treated with HCQ 400 mg/day for 12 months.This is a prospective open-label study.Clinical mani-festations,clinical efficacy,biochemical and immunoserological parameters as well as ophthalmological exami-nations were investigated every three months to assess the safety and tolerability.Results There were signifi-cant decrease in the erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),immunoglobulin M (IgM)and rheumatoid factor(RF)level after 6 months treatment with HCQ(P＜0.01 or P＜0.05).No changewas detected in serum antinuclear antibody(ANA),anti-SSA/SSB antibodies after treated for 12 months.Somepatients had partial improvement in symptoms such as dry mouth,dry eyes and arthralgia.During the treat-ment,no significant effect on serum alanine aminotransferase (ALT),blood urea (BUN),serum creatinine (Cr),whole blood count(WBC)or hemoglobin(Hb)could be discovered.Central semus retinopathv(CSR)was found in one patient after 6 months treatment with HCQ.However,its association with HCQ could not be confirmed since it was not compatible with the usual HCQ retinopathy.Conclusion HCQ can improve svmp-toms of some pSS patients and can significantly decrease ESR,IgG,IgM and RF level.The safety profile of HCQ is generally good.However,ophthalmological examination before and after a 6-month interval may be necessary in long term HCQ treatment.

Objective To improve the understanding of giant hypertrophy of the gastric mucosa.Methods Giant hypertrophy of the gastric mucosa in 6 cases proved by operation or gastroscopy biopsy pathological examination were reviewed.Barium meal examination was performed in all cases,CT in 3 cases.B-type ultrasound in 2 cases.Results It was ease to be misdiagnosed giant hypertrophy of the gastric mucosa on the basis of the conventional imaging appearances.Laboratory data and gastroscopy biospsy played an important role in diagnosis and differential diagnosis.Conclusion Giant hypertrophy of the gastric mucosa is uneasily to correct diagnosed,comprehensive evaluation is necessary for it.

Tacrolimus, an immunosuppressant used after liver transplantation, has a narrow therapeutic range and its pharmacokinetic variability complicates its daily dose assessment. Therapeutic drug monitoring after liver transplantation, which is the mainstay to clinical immue suppression adjustment, still has its short- age. The development of pharmacogenomics depends on genetic polymorphism provides more reasonable di- rections to individualized immunosuppressive therapy. At present, the researches of the therapy mainly focus on the genetic polymorphism of coding gene of P450, PgP and nuclear receptor.

Objective To investigate the effect of CYP3A5 and C5 gene polymorphisms on the concentration/dose ratio of tacrolimus in Chinese liver transplant patients during the early posttransplantation period.Methods A total of 100 adult patients who underwent primary liver transplantation (LT) were enrolled.Tacrolimus dosage and trough blood concentration were detemined at first week after liver transplantation.Two single-nucleotide polymorphisms were genotyped and analyzed in both donor and recipient groups.The relationship between gene polymorphisms and tacrolimus concentration/dose ratio (C/ D ratio) was analyzed.Results The distribution of allele A in C5 rs17611 was 63.5 ％ among donors and 58.5％ among recipients.For CYP3A5,the rs776746 allele G represented the major alleles in both donors and recipients (71％ and 72％,respectively).The tacrolimus C/D ratio of recipients carrying allele AA in C5 rs17611 was significantly higher than that of recipients carrying the C5 rs17611 allele G.Both donor and recipient CYP3A5 rs776746 polymorphisms were highly correlated with the tacrolimus C/D ratio at first week after liver transplantation.No linkage disequilibrium between CYP3A5 rs776746 and C5 rs17611 polymorphisms was found (D'max =0.392,r2max =0.034).Recipient CYP3A5 rs776746 allele A,C5 rs17611 genotype AA,and donor CYP3A5 rs776746 allele A were associated with rapid tacrolimus metabolism.With increasing number of these alldes,tacrolimus C/D ratio was reduced during the one week after transplantation.Conclusion Recipient C5 rs17611 polymorphism is a new genetic locus that influences tacrolimus metabolism in patients after OLT during the early post-transplantation periocd.

Objective To summarize the experience of rapid liver and kidney graft harvesting. Methods From Jan 2001 to Sep 2003,a quick procedure for combined liver and kidney procurement were used in 138 cases. The procedure includes in situ perfusion through aorta and superior mesenteric vein(SMV) plus drainage through inferior vena cava. Liver,pancreas,spleen and kidney were harvested en bloc. Results The warm ischemia time averaged at 2 to 6 minutes for kidneys and 3 to 8 minutes for livers. The total procurement time averaged at 20 to 30 minutes. All aberrant arteries were preserved. After transplantation there was no primary non-function in all 131 liver grafts,and the peak sALT level during the first 3 post-operative days was (581?392) U/L. Acute tubular necrosis rate was 3.3%(9/274) in renal grafts. Conclusion[WT5”BZ] This rapid procurement protects the quality of liver and kidney simultaneously. It is a simple,effective,safe and reasonably standardized procedure.