The conception of evidence-based medicine (EMB) has a strong influence on the medical world since it built up.This concept has been widely used in all sorts of clinic and basic medical research,however,it is little reported to be practised in our fundamental medical education.As for it,this article will briefly analyze the importance of introducing the idea into fundamental medical education,and for one thing,suggest some more reform measures for medical teaching staff.

Anemia, Hemolytic, Congenital ; etiology ; Female ; Hepatitis ; complications ; Humans ; Infant ; Syndrome

Objective To evaluate the effect of nitrous oxide(N2O) on the cuff pressure of ProSeal laryngeal mask airway(PLMA) in pediatric anesthesia. Methods Thirty-two pediatic patients were enrolled and divided into two groups randomly.PLMA cuffs were inflated with air(Group A) or 50% N2O/oxyen(Group N) to 20 mmHg as initial pressure.The intracuff pressure was monitored during anesthesia with 50% N2O in oxygen. Results Intracuff pressure increased to(40.6?9.3) mmHg in Group A and slightly decreased in Group N.Deflation volume in Group A was much more than that in Group N[(4.4?2.3) mL vs(2.6?1.0) mL,P

Objective To investigate the expression of human macrophage metalloelastase(HME) both in gastric cancer cell lines and gastric cancer tissues,and to find the role of HME in gastric carcino genesis.Methods Fifty eight patients who were operated in our hospital during April to Aug.2003 were enrolled.The samples taken from cancer,paracancer or normal tissues of these patients and cancer cell lines(MGC-803,SGC-7901,AGS)were detected for HME protein and HME mRNA expressions by Western blot and immunohistochemistry,RT-PCR and fluorescence quantitative PCR,respectively. Results Both HME mRNA and HME protein expressions were found in all three gastric cancer cell lines.The expressions of HME mRNA and HME protein in gastric cancer tissues was increased signifi- cantly compared with that in normal tissues(P0.05).Conclusions The increased HME expression in gastric cancer tissures compared with normal tissue indicate that HME may be a potential tumor marker for gastric cancer.

Objective The aim of this study is to evaluate the early and midterm results of reconstructive new tricuspid valvar annulus technique and prosthetic ring in the anatomic correction of Ebstein's anomaly.Methods 60 operations for Ebstein's anomaly were performed by the reconstructive new tricuspid valvar annulus technique,prosthetic ring was used to reinforce the new tricuspid valvar annulus,the plastic effect of tricuspid valve was observed real-time by trans-esophagus echocardiography during operation.The follow-up results of the plastic effect of tricuspid valve were studied after operation.Results Mean operation time was (3.1 ± 2.3) h,mean cardiopulmonary bypass time was (148.8 ± 44.6) min,mean aortic cross-clamp time was(112.6 ± 34.1) min.3 patients had tricuspid valve replacement because of bad plastic effect;1 patient had bidirectional shunt Glenn procedure because of right sided heart failure.Hospital mortality was 1.When the patients were discharged,tricuspid regurgitation severe 1,medium 5,mild or no 50;53 being of heart functional class Ⅰ and class Ⅱ,3 of classⅢ.45 patients (80.3 ％) were followed-up out-hospital from 6 months to 7 years,mean (24.4 ± 21.4) months.Tricuspid regurgitation severe 1,medium 6,mild or no 38.And the nice stability of tricuspid valve was found during the follow-up period,41 patients being of heart functional class Ⅰ or Ⅱ (NYHA),4 of class Ⅲ.1 need reoperation.Conclusion The reconstructive new tricuspid valvar annulus technique can maintain farthest the dimension and geometric configuration of functional right ventricle,longitudinal plication of the atrialized right ventricle can restore a large ventricular cavity,improve it's pump function,and make valvuloplasty perfect,which widen obviously the indication of tricuspid valvuloplasty for Ebstein's anomaly.The research concluded that this technique can correct anatomically Ebstein's anomaly effectively,and it can get the stable effect of tricuspid valvuloplasty obviously if use prosthetic ring to reinforce the new tricuspid valvar annulus.

Aim To discuss the influence of endosome/ lysosome transport proteins SNX10 on macrophage, providing new potential targets for the treatment of variety of related immune diseases . Methods The genotype of mice was identified by PCR. The role of SNX10 in phagocytosis of bacterial components and sterilization by macrophages were assessed. The levels of TNF-α、IL-12 / 23 p40 and IL-6 were measured by q-PCR and ELISA assay. Finally, the NF-κB signaling pathway was evaluated by Western blot and immuno-fluorescence staining. Results Ex vivo experiments showed that SNX10 knockout could enhance bactericid-al ability and inhibit the expression and production of TNF-α, IL-12 / 23 p40 and IL-6 of macrophages.These effects might attribute to the inhibition of NF-κB signaling pathway activation. Conclusion SNX10 knockout could enhance bactericidal ability and inhibit the inflammatory response of macrophages, and its mechanism may be achieved through the NF-κB signa-ling pathway.

Plasma ghrelin level was measured by RIA in 49 grids with idiopathic central precocious puberty(ICPP)and 35 girls with simple premature thelarche(PT).The results showed that the plasma ghrelin level was negatively correlated with Tanner stage,bone age,Lid at 15,30 and 60 min after GnRH activation, uterus and ovary volumes.The plasma ghrelin level in the ICPP group was remarkably lower than that in the PT and control groups(both P

Objective To investigate the changes of the serum sex steroids levels in prepuberal children with autism,and analyze the possible clinical implications.Methods The serum sex steroids,including folliclestimulating hormone(FSH),luteotropic hormone(LH),testosterone(T),estradiol(E2),progesterone(P),dehydroepiandrosterone sulfate(DHEA-S) and androstenedione were measured in 44 autistic children(35 boys and 9girls,47.5 ± 18.9 months) and 44 normal children(35 boys and 9 girls,45.0 ± 18.7 months),using chemiluminescence immunoassay.Results ①The progesterone levels in autism group were significantly lower than control group((＜ 0.48,2.08) nmoL/L vs (＜ 0.48,6.95) nmol/L,Z =-3.564,P ＜ 0.01),but no statistical differences were observed in other sex steroids levels(P＞ 0.05).②The progesterone levels in ＜ 48 months autism group showed no significant differences from ≥48 months autism group (Z =0.150,P ＞ 0.05).There were no statistical differences in progesterone level between the boys and girls of the autism group(Z=1.972,P＞0.05).Conclusion The progesterone levels are lower in autistic children,and they are not associated with the children's age or gender.This study indicates that the progesterone levels are closely associated with autism.

Objective To investigate the value of myocardial contrast echocardiography(MCE)combined with high-dose dobutamine stress echocardiography(DSE)in the early diagnosis of coronary artery disease(CAD).Methods The dobutamine stress MCE and SonoVue contrast infusion were performed before an elective percutaneous coronary intervention in 38 patients with suspected CAD.The total and regional perfusion were scored as normal or abnormal and attributed to the three main epicardial coronary arteries using a 16-segment left ventricular model.Results An intermediate stress level was obtained in 22(58%)patients,and 9(24%)patients were obtained with peak stress.Twenty seven of 38 patients were diagnosed as CAD by quantitative coronary angiography.A perfusion defect was detected in 89% of the patients at peak stress,compared to 37% at baseline,there was significant difference(χ2=15.565,P<0.01).ConclusionsThe MCE combined with DSE can increase the sensitivity of myocardial ischemia detection.As a new non-invasive method,MCE combined with DSE could be used in the early diagnosis of CAD.

Objective Analyse the change of left ventricular (LV) longitudinal and radial strain in patients with aortic regurgitation (AR) and discuss the relationship between the 2D strain parameter and the filling and ejection of LV. Methods Thirty healthy controls and 45 patients with AR (24 patients with moderate AR and 21 with severe AR) were enrolled in this study, LV systolic global peak radial strain(GRS), systolic global peak longitudinal strain(GLS) and systolic peak longitudinal strain(S), systolic peak longitudinal strain rate(SRs), early diastolic peak longitudinal strain rate(SRe) of every segment were measured or calculated using 2D-STE, early and late diastolic transmitral flow velocity (E, A) were recorded by pulsed Doppler echocardiography and early diastolic mitral annular velocity (Ea) were assessed by tissue Doppler imaging,the E/A and E/Ea ratio were calculated. Discuss the relationship of GLS and LV ejection fraction (LVEF), GLS and E/Ea using the Pearson correlation analysis. Results The GLS were (-20.09±1.47)%, (-18.68±1.52)%, (-12.56±3.25)%and the GRS were (46.71±7.65)%, (43.01±5.95)%, (28.52±6.13)% in control group, patients with moderate and severe AR (MAR group and SAR group) respectively. There were significant differences among the groups (F =82.08,47.69, both P < 0.01) as following:SAR group with control group and MAR group [ q=17.56,13.60 (GLS), q=13.44, 10.20 (GRS), all P<0.01),MAR group and control group [ q=3.42 (GLS), P<0.01]. The SRs of the apical segment were (-1.24±0.22)s-1, (-1.19±0.25)s-1, (-1.04±0.28)s-1 in control group,MAR group and SAR group respectively. There were significant differences among the groups (F=4.47, P < 0.05) as following:SAR group with control group and MAR group ( q=4.02,3.28, both P<0.01). The S, SRe of apical segment and the S,SRs,SRe of basal and midventricular in MAR group were all lower than the control group ( q=4.42, 5.01, 3.48, 3.24, 4.78, 4.12, 3.61, 6.72, all P < 0.01). Pearson correlation analysis revealed the GLS had a relationship with LVEF and E/Ea ( r=-0.73, 0.64, both P<0.01). Conclusion The reduced longitudinal strain and strain rate could detect LV dysfunction in patients with AR in early stage and the GLS had the ability to reflect the diastolic filling and systolic ejecting of the LV.