Objective To summarize the clinical experience of laparoscopic repair of esophageal hiatal hernia.Methods A total of 15 cases of esophageal hiatal hernia underwent laparoscopic hernia repair and fundoplication from May 2004 to April 2005 in this division.There were 4 cases of type Ⅰ hernia(all of which presented severe gastroesophageal reflux disease),10 cases of type Ⅱ hernia,and 1 case of type Ⅲ.Surgical procedures included laparoscopic Nissen total fundoplication in 9 cases,Toupet partial fundoplicatin in 4 cases,and Dor partial fundoplication in 2.Symptoms of gastroesophageal reflux disease,including heart burn,dysphagia,regurgitation,chest pain,and belching,were evaluated by using the Visual Analogue Scales(VAS) at preoperative period,1 postoperative month,and 6 postoperative months,respectively.Results No conversion to open surgery was required in this study.The operative time ranged 100~187 min(mean,125 min).The postoperative hospital stay was 2~5 days(mean,2.8 days).All the patients were followed for 1~12 months(mean,8.5 months).No hernia recurrence was found.The VAS scores decreased from 5.0?3.9 preoperatively to 0.9?1.3 at 1 month postoperatively(t=3.823,P

Objective To update files in local area network automatically.Methods According to the files which has to update in data-base,the order'net' in DOS was used to copy the shared files.Results Files were updated automatically.Conclusion The workload of the staff is reduced and the programs are updated rapidly and correctly Avoiding the error,ensuring the automatic update simaltaneity.[Chinese Medical Equipment Journal,2008,29(2):50]

Objective To investigate the changes in morphology and senescence-associated markers of the marrow-derived cardiac stem cells (MCSCs) from rats at different ages and to explore the impacts of age on proliferation, survival and differentiation of MCSCs. Methods With single-cell cloning culture, MCSCs were selected from the bone marrow of young, adult and aged male SD rats respectively. Ultrastructural changes of the cells were viewed under a transmission electron microscope.The senescence-associated changes were examined with SA-β-galactosidase staining and reactive oxygen species(ROS) staining. Distribution of cell cycle of MCSCs from different age groups was evaluated with flow cytometric analysis. Rates of the survived and apoptotic cells were determined by Annexin V/PI double-labeled flow cytometric analysis and Hochest33342 staining. Differentiation of the MCSCs toward cardiomyocytes was induced with BMP-2. Expression of cardiac transcription factors and cardiac specific genes of the cells after induction were examined with RT-PCR. CTnT expression of the cells also be examined with immunocytochemistry. Results The nucleus/plasma ratio of the cells from aged rats decrease and there are some myelin bodies in the cells of aged group. With increasing of age, the MCSCs in S+G2/M phase reduce, while β-galactosidase-positive cells and ROS-positive cells increase. Survival rate of the cells from aged rats is lower than that of the cells from young rats. At four week after induction with BMP-2, expression of Nkx2.5, GATA-4, cTnT mRNA and Cx-43 mRNA of the cells of young group increase significantly. In adult and aged group, expression of the cardiac transcription factors and cardiac specific genes is lower than that of the cells in young group. In immunocytochemical staining, cTnT expression of the cells in young group is stronger after induction with BMP-2. As compared with that of the cells in young group, cTnT expression of the cells in aged group is weak after induction. Conclusion With increasing of age, MCSCs show senescent changes, including their abilities of proliferation, survival and differentiation toward cardiomyocytes decrease.

Objective:To investigate the mRNA level of adiponectin in patients with gallstone of Hui and Han nationality in Qinghai Province and its clinical significance.Methods:From August 2017 to August 2018, 108 patients with gallbladder cholelithiasis and 91 patients with other benign diseases who were hospitalized in the Affiliated Hospital of Qinghai University from August 2017 to August 2018 were selected as the research objects. According to gallbladder cholesterol stone and the classification criteria of adult obesity, they were divided into gallstone-obesity group (56 cases), gallstone non-obesity group (52 cases), non gallstone obesity group (48 cases) and non gallstone non obesity group (43 cases). The levels of serum lipid (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood glucose (GLU), uric acid and high-sensitivity C protein (hs-CRP) were measured. Meanwhile, the adiponectin mRNA levels in omental adipose tissue and abdominal subcutaneous adipose tissue were detected by real time fluorescent quantitative polymerase chain reaction (qRT-PCR).Results:Compared with non gallstone and non obesity group, the serum TC [(4.57±0.49)mmol/L vs (5.63±0.53)mmol/L, (6.12±0.51)mmol/L, (6.85±0.43)mmol/L], TG [(1.50±0.32)mmol/L vs (2.06±0.33)mmol/L, (2.53±0.39)mmol/L, (2.96±0.34)mmol/L], LDL-C [(2.14±0.35)mmol/L vs (2.65±0.33)mmol/L, (3.05±0.37)mmol/L, (3.54±0.38)mmol/L], uric acid [(188.63±13.52)mmol/L vs (257.69±14.63)mmol/L, (306.96±18.96)mmol/L, (359.96±16.58)mmol/L], hs-CRP [(228.32±18.96)μmol/L vs (298.96±19.96)μmol/L, (354.96±19.96)μmol/L, (405.98±19.47)μmol/L] were increased in gallstone-obesity group, gallstone non-obesity group, non gallstone obesity group ( P<0.05), while the adiponectin mRNA [subcutaneous adipose tissue: (1.76±0.25) vs (1.43±0.23), (0.98±0.23), (0.68±0.29); omental adipose tissue: (2.15±0.29) vs (1.88±0.28), (1.56±0.27), (1.12±0.25)] and HDL-C levels [(2.15±0.11)mmol/L vs (1.79±0.15)mmol/L, (1.42±0.12)mmol/L, (1.15±0.09)mmol/L] were decreased ( P<0.05). Compared with the non gallstone obesity group, the serum levels of TC, TG, LDL-C, GLU, uric acid were increased in the gallstone non obesity group, gallstone obesity group, while the adiponectin mRNA and HDL-C levels were decreased ( P<0.05). Compared with the gallstone non obese group, the serum levels of TC, TG, LDL-C, GLU, uric acid and hs-CRP were increased in gallstone obese group, while the levels of adiponectin mRNA and HDL-C were decreased ( P<0.05). Adiponectin in omental adipose tissue and abdominal subcutaneous adipose tissue was positively correlated with HDL-C and negatively correlated with TC, TG, LDL-C, uric acid and hs-CRP ( P<0.05). Logistic regression analysis showed that low level of subcutaneous adiponectin, omental adiponectin and high level of TG were risk factors for gallstone in non obese population ( OR=2.340, 1.931, 2.784, P<0.05), while low level of subcutaneous adiponectin, omental adiponectin and high level of LDL-C were risk factors for gallstone in obese population ( OR=2.358, 2.596, 2.115, P<0.05). Conclusions:The adiponectin mRNA is decreased in the patients with gallstone of Hui/Han nationality in Qinghai Province. The low level of subcutaneous adiponectin and omental adiponectin are the risk factors for gallstone in obese or non obese people of Hui/Han nationality in Qinghai Province.

OBJECTIVETo achieve early diagnosis for inheritable hearing loss and determine carrier rate of deafness causing gene mutations in order to provide information for premarital, prenatal and postnatal genetic counseling.

METHODSA total of 17 000 dried heel blood spots of normal newborns in Chengdu were collected with informed consent obtained from their parents. Genomic DNA was extracted from dried blood spots using Qiagen DNA extraction kits. Microarrays with 9 common mutation loci of 4 deafness-associated genes in Chinese population were used. Nine hot mutations including GJB2 (35delG, 176del16, 235delC and 299delAT), GJB3 (538C> T), SLC26A4 (IVS 7-2A> G, 2168A> G), and mitochondrial DNA 12S rRNA (1555A> G, 1494C> T) were detected by PCR amplification and microarray hybridization. Mutations detected by microarray were verified by Sanger DNA sequencing.

RESULTSOf the 17 000 new-borns, 542 neonates had mutations of the 4 genes. Heterozygous mutations of GJB2, at 235delC, 299delAT, and 176del16 were identified in 254, 55, and 15 newborns, respectively. Two newborns had homozygous mutation of GJB2, 235delC. Heterozygous mutations at 538C> T of GJB3, 2168A> G and IVS 7-2A> G of SLC26A4 were found in 23, 17 and 128 newborns, respectively. For mutation analysis of mitochondrial DNA 12S rRNA, 1494C> T and 1555A> G were homogeneous mutations in 4 and 42 neonates, respectively. In addition, 6 complexity mutations were detected, which demonstrated that one newborn had heterozygous mutations at GJB2 235delC and SLC26A4, IVS7-2A> G, one had heterozygous mutation GJB2 235delC and 12S rRNA homogeneous mutation, 1555 A> G, one heterozygous mutations at GJB2, 299delAT, and GJB3, 538C> T, one at GJB2, 299delAT and 12S rRNA, 1555 A> G, two at GJB2, 299delAT, and SLC26A4, IVS7-2A> G. All mutations as above were confirmed by DNA sequencing.

CONCLUSIONThe total mutation carrier rate of the 4 deafness genes is 3.19% in healthy newborns at Chengdu. Mutations of GJB2 and SLAC26A4 are major ones (86.5% of total). The mutation rate of mitochondrial DNA 12S rRNA is 2.71‰, which may have deafness induced by aminoglycoside antibiotics. Newborn screening for mutation of genes related to hereditary deafness plays an important role in the early detection and proper management for neonatal deafness as well as genetic counseling for premarital, prenatal and postnatal diagnosis.

Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; DNA, Mitochondrial ; chemistry ; genetics ; Deafness ; diagnosis ; ethnology ; genetics ; Dried Blood Spot Testing ; Genetic Predisposition to Disease ; ethnology ; genetics ; Genetic Testing ; methods ; Humans ; Infant, Newborn ; Membrane Transport Proteins ; genetics ; Microarray Analysis ; methods ; Mutation ; Neonatal Screening ; methods ; RNA, Ribosomal ; genetics

Objective:To explore the role of comprehensive first aid skills training in improving medical students' comprehensive first aid ability.Methods:Eighty-seven medical students were enrolled in this study, and received the training of comprehensive first aid skills developed by the emergency medicine teaching and research section of our hospital. The scores of individual first aid ability, emergency handling ability, team cooperation ability, organization and coordination ability and communication ability before and after the training were analyzed. At the same time, a questionnaire survey was conducted among students to understand their evaluation and recognition of the training. SPSS 10.0 was used for t test. Results:After the training, the total score of comprehensive first aid ability was increased significantly [(73.55±3.89) vs. (63.53±3.06)], and the scores of emergency handling ability [(10.11±1.43) vs. (8.01±1.16)], team cooperation ability [(11.38±1.21) vs. (8.15±0.99)], organization and coordination ability [(10.68±1.17) vs. (8.15±0.99)] and communication ability [(9.64±1.31) vs. (7.55±1.08)] were also significantly increased ( P<0.05). However, there was no significant difference in the scores of individual first aid ability mastery before and after training. In all, 80.46%-96.55% of the students think that the training of comprehensive first aid skills is conducive to the improvement of their comprehensive first aid ability, and all of the students are willing to use this training in the future. Conclusion:Comprehensive first aid skill training is beneficial to improve medical students' comprehensive first aid ability.