Objective To investigate the effect of old myocardial infarction on the heart rate variability.Methods Totally 86 patients with old myocardial infarction and 78 healthy people were enrolled in the study.Twenty-four-hour heart rate variability in the time domains including NN,SDNN,SDANN,RMSSD,and PNN50 and the frequency domains including VLF,LF,HF,and LF/HF were analyzed.Results Both the time domain and frequency domain indexes of the heart rate variability in patients with old myocardial infarction significantly decreased than those in the healthy peolple（P 0.05）.Conclusion There might be autonomic nervous system dysfunction in the patients with old myocardial infarction.

Many complications occur in the early stage of post-orthotopic liver transplantation, six patients with or the ptopic liver transplantation, mainly contract hemorrhage,renal insufficience,acute host-vs-graftreaction,palmonary infectin,thoracic fluid and oral ulcer.We conclude in order to improver the postoperation survival of the patients it is very important to closely obere the change of patients and early recognize and deal with various complications on the basis of observing and nursing these patients

Objective To investigate the clinical features of anterior pituitary hypofunction.Methods A retrospective analysis was carried out on the data of 117 patients with anterior pituitary hypofunction during 1994-2010.Results There were 60.68％ male and 39.32％ female patients respectively.The onset age was from 13 to 79 years,with 79.12％ of the patients more than 40 years old.There were 57 cases with sellar tumors ( 40.17％ ),in which 55 cases( 96.49％ )were operated and (or) treated with radiotherapy.35 cases were operated via the frontal approaches( 66.04％ ) and 18 cases underwent transsphenoidal surgery ( 33.96％ ).There were 108 cases with hyponatremia with the first symptoms of weakness,anorexia,nausea,and vomiting induced by ACTH deficiency (92.31％ ).There were 23 cases accompanied with central diabetes insipidus( 19.66％ )and 82 cases with coronary heart disease( 70.09％ ).Conclusion Owing to the difference in etiological factors,the incidence,early symptoms,and the hormones involved are greatly different.The main cause is pituitary tumor,which occured more in aged person,more in males than females.

AIM: To observe the effect of Xiaoyu Huatan Decoction on the nonalchoholic fatty liver tissue peroxisome preliferator-activated receptor?(PPAR?) expression. METHODS: The nonalchoholic fatty liver disease rat model was fed by high fat forage and the rats were divided into five groups: normal control group,model control group,high-dose of Xiaoyu Huatan Decoction group,low-dose of Xiaoyu Huatan Decoction group,Dongbao Gantai control group.Total RNA of liver was extracted,and the expression of PPAR?mRNA was analyzed by semi-quantitative RT-PCR method.We determined the contents of total cholesterol(TC),triglyceride(TG),free ratty acid(FFA) in serum and the TC,TG in liver tissue homogenate of each group,and the degree of hepatocytic steatosis. RESULTS: Expression of liver tissue PPAR? mRNA in the model group decreased significantly,lipid in blood serum and hepatic tissues increased significantly,liver fat cell greatly denaturalized.After the intervention of medicine,expression of liver tissue PPAR? mRNA of each treatment group increased significantly,lipid in blood serum and hepatic tissues decreased significantly,liver fat cell denaturation was improved. CONCLUSION: Xiaoyu Huatan Decoction can increase the expression of liver tissue PPAR?mRNA of rats,It is likely to be one of the important mechanism for treating fatty liver.

Objective By observing the effect of Xiaoyuhuatan decoction on insulin resistance in rar with nonalchoholic fatty liver,the author made a reasearch into this herb'S machanism on cambating on nonalchoholic fatty liver.Methods The insulin resistance rat model was fed by high fat forage and Dongbaogantai control group was set up for the sake of comparion.We determined the contents of total cholesterol(TC),triglyceride(TG),free fatty acid(FFA),fasting plasma glucose(FBG),fasting serum insulin(INS)in serum and the contents of TC,TG of liver tissue homogenate of each group,and the degree of hepatocytic steatosis.Results Xiaoyuhuatan decoction could obviously decrease the index of insulin resistance and improve insulin insensitive index.Lipid in blood serum and hepatic tissues were significantly decreased,liver fat cell denaturation was improved.Conclusion The thrapentic eftect of Xiaoyuhuatan Decoction on fatty liver is probably contribute tO this herb's mechanism of improving insulin resistance and increasing insulin insensitive.

Objective To analyze the epidemiological characteristics of pituitary apoplexy and investigate the changes and features of endocrine hormones caused by pituitary apoplexy.Methods A retrospective analysis of the clinical and laboratory data of pituitary tumor and pituitary apoplexy was carried out.Results (1) The incidence of pituitary apoplexy was 31.78％,patients were 15-75 (47.5 ± 11.7) year old,most patients were female.(2)Diabetes,coronary heart disease,menopausal hormone therapy,radiotherapy,surgery,and bromocriptine administration may be related to pituitary apoplexy.(3) There was high incidence of apoplexy in nonfunctioning adenoma.(4) According to the relationship between apoplexy and pituitary tumor,cases with pituitary apoplexy were divided into 5 types.(5) Pituitary apoplexy was associated with low serum creatinine,hypernatremia,hyperchloremia,hypoeosinophilia,and hypobasophilia.(6) 61.61％ of the patients had pituitary hormone deficiency,especially the GnH deficiency.(7)98.10％ of the patients were treated by surgery.Conclusion Pituitary apoplexy has its own clinical characteristics,and more attention should be paid in clinical practice.

Objective: To detect the protein expression and relationship between integrin-linked kinase (ILK) and E-cadherin (E-cad) in primary gallbladder cancer (PGC), as well as to evaluate their clinical significance. Methods:ILK and E-cad were examined in 48 cases with PGC, 25 with gallbladder adenoma and 25 with chronic cholecystitis tissues by immunohistochemistry. Then, the corre-lation between clinical and pathological features, as well as their relationship, was investigated. Results:The positive rate of ILK was significantly higher in the gallbladder cancer group (66.7%;32/48) than in the gallbladder adenoma (36.0%;9/25) and chronic cholecys-titis groups (24.0%;6/25) (P<0.05). However, the positive rate of E-cad, namely, 45.8%(22/48), was significantly lower than those of the benign groups (P<0.05). When the depth of invasion was aggravated and lymph node metastasis had occurred, the ILK expression level became significantly higher. Nevertheless, negative E-cad results were produced (P<0.05). A negative correlation between the ex-pression of ILK and E-cad in gallbladder cancer existed (r=-0.411, P<0.05). Conclusion:The expression of ILK and E-cad is signifi-cantly correlated with tumor invasion and metastasis. A negative correlation exists between these expressions. Detection of these two in-dexes is useful in predicting tumor progression and prognosis.

ObjectiveTo explore the regulation of claudin-4 expression in endometrial adenocarcinoma cell lines by progesterone.Methods Ishikawa cells were treated with various concentrations of megestrol acetate (MA:2,5,10,15,20 mg/L).After cultured for 24,48 and 72 hours,cells growth were measured by methyl thiazolyl tetrazolium (MTT).The group of Ishikawa cells incubated with MA at the 50％ inhibitory concentration ( IC50 ) was selected for cell apoptosis assay by using transmission electron microscopy and flow cytometry method.Real-time PCR and western blot were used for detecting the mRNA and protein expression levels of claudin-4.The localization of claudin-4 was examined by immunofluorescent staining.Results The inhibitory effects of megestrol acetate on the growth of Ishikawa cells were dosedependent and time-dependent.IC50 of MA on Ishikawa cells was 15 mg/L after incubated for 72 hours.After MA treatment,Ishikawa cells showed shrinkage,nuclear chromatin condensation,fractures of nuclear membrane and endoplasmic reticulum expansion,even round apoptotic bodies were found.The apoptosis rate of cells before MA treatment was (0.076 ±0.024)％,and the rate was (3.934 ±0.816)％ by MA treated for 72 hours,in which there were signicant difference( P ＜ 0.05 ).The relative quantification of claudin-4 mRNA and protein of the cells before MA treatment were 0.64 ± 0.20 and 0.94 ± 0.18,while they were 0.47 -0.15 and 0.62 ±0.15 after MA treated.The expression of claudin-4 was significantly decreased after MA treatment ( P ＜ 0.05 ).The localization of claudin-4 transferred from cytomembrane to cytoplasm and nucleus after MA treatment.Conclusions MA could inhibite the growth of Ishikawa cells,in which the mechanism may be decrease the expression of claudin-4 and the apoptosis of cells.The distribution change of claudin-4 may be related to the anti-cancer effect of progesterone.

Objective To investigate the effect of bibliotherapy in soothing the postoperative pain in children and relieving the perioperative anxiety of children and their care givers. Methods Hospitalized children and their care givers from August 2007 to March 2009 were studied. 153 cases from August 2007 to May 2008 were assigned to the control group and the other 153 cases to the intervention group. Routine surgical nursing were applicated in the control group by introduction of perioperative nursing procedures.Bibliotherapy were applicated in the intervention group on the basis of the control group-using "bibliotherapy materials for hospitalized children" which was designed by ourselves and correspond with the theory of bibliotherapy to interfere in the 153 cases in the intervention group. The variance of preoperative anxiety of care givers and perceptions of postoperative pain of children between the two groups were compared with scales of mYPAS, STAI and FLACC and Wong- Baker Facial Scale. Results The scores of mYPAS in children of the intervention group and the control group was (35.875+4.441)and(46.796+8.606 )respectively and the variance was significant. The scores of STAI in care givers of the two groups was(38.125+4.371 )and (49.901 +7.420) respectively and revealed significant variance. The scores of Wong-Baker and FLACC in children of both groups 1 hour after operation were compared and revealed no statistical significance. The scores of Wong-Baker and FLACC in children at 6 hours and 24 hours postoperative were compared subjectively and objectively and revealed statistic significance. Conclusions Bibliotherapy can ameliorate the anxiety level of both children and their care givers, relieve the perception of postoperative pain in children and improve their comforts. Bibliotherapy thus conduces to the recovery of postoperative children.

Principles of medical equipment course were explored of formative evaluation as the center examination,constructed an examination reform scheme as” One center (formative evaluation as the center),three systems (content system,operation system,monitoring system).” Made students to learn from the center of focus scores change to autonomous learning and culture analysis,solves the question ability and practical ability.At the same time,strengthen the teaching process of teaching and learning to communicate and exchange,Get the students learning feedback information to improve teaching and learning in time,Strengthen the students′ ability of autonomous learning and lifelong learning ability.