Objective To adopt the method performance decision chart to evaluate the performance of the Stago R Evolution au-tomatic blood coagulation analyzer .Methods The method performance decision chart was drawn by the results of external quality assessment and internal quality control according to the requirement of the total error in the clinical laboratory improvement amend-ment (CLIA′88) .The 6 indexes of 3 items including prothrombin time(PT) ,activated partial thromboplastin time(APTT) and fi-brin (Fg) were analyzed .Results The 2 indexes of the PT normal level and APTT abnormal level in the automatic blood coagula-tion analyzer were qualified .The PT abnormal level was fine and 3 indexes of the APTT normal level ,Fg normal level and abnormal level were excellent .Conclusion Six indexes of automatic blood coagulation analyzer could be evaluated by the method evaluation decision chart and it was more directly and clearly compared with σvalue statistical table .

Objective To quickly understand whether the newly introduced XE-2100 automatic hematology analyzer meets the precision promised by the manufacturer .Methods After adjusting and calibrating the new hematology analyzer ,the anticogulated blood samples by EDTA-K2 were detected for 10 times and the main parametric precisions were calculated by the Sigma unit .Results The Sigma score of this automatic hematology analyzer labeled by the manufacturer was 39 ,the actual coefficient of variation (CV) in 8 indexes was less than that labeled by the manufacturer ,the operating Sigma score was full mark 48 .Conclusion The ac-tual precision of the XE-2100 automatic hematology analyzer is preliminarily reached the precision promised by the manufacturer , the operating Sigma score is in the high quality level and achieves the expected requirements in daily use .

OBJECTIVE To investigate the prevalence of ?-lactamases in nosocomial infections of Enterobacter cloacae,study the different genotyping of ?-lactamases,and analyze its independence in drug resistance. METHODS AmpC ?-lactamases and ESBLs were detected by three-dimensional extract tests.PCR was used to determine the genotype of ?-lactamases and their resistance to 13 kinds of antibiotics was detected by Kirby-Bauer method. RESULTS The sensitivity test showed that they were resistant to the most antibiotics.Among the 80 ESBLs strains,29 strains carried ESBLs gene,3 strains carried two different gene.Such as:TEM existed in 6,SHV-Ⅰ existed in 2,CTX-M-2 existed in 5,CTX-M-3 existed in 8 and CTX-M-9 existed in 11 strains.Twenty-six strains carried ampC.The resistant rate of SSBLs-producing E.cloacae to 12 antibiotics except merapenem was 66.7-100.0%.SSBLs strains of E.cloacae were higher than AmpC ?-lactamases in resistance to levofloxacin,cefepime,aztronem and trimethoprim sulpfamethoxazole with significant difference(P

Objective To observe the effect of rehabilitation training on fine motor in children with Down syndrome. Methods 30 children with Down syndrome accepted rehabilitation training for 3.1~4.6 months. They were assessed with fine motor function in Peabody Developmental Motor Scales (PDMS-FM) before and after treatment. Results The scores of fine motor quotients, grasping and visual-motor integration improved after treatment(P<0.05). Conclusion Rehabilitation can improve the fine motor in children with Down syndrome.

Objective To explore the telomere length (TL) in buccal cells and its possible implications for long-lived families of Zhuang nationality in Bama area of Guangxi.Methods Relative TL in buccal cells from Bama long-lived families (BLF,n=1250) was determined by real time PCR and compared between Bama non-long-lived families (BNLF,n=556) and Pingguo longlived families (PLF,n=630).All participants were Zhuang ethnic.Results The TL in buccal cells was negatively correlated with age (R=-0.215,P=0.000) and was independent of sex in all subjects (n=2436).There were no significant differences in TL between males and females in different of ages in BLF (all P＞0.05).Similar tendency was observed in most but not all age groups in the two other families.The TL was significantly longer in BLF aged over 65 years (the first offspring of the longlived individual) than in BNLF aged over 65 years (1.969 vs.1.622,P=0.004) and the TL of BLF aged over 90 years was comparable to that of BNLF aged over 65 years (1.662 vs.1.622,P=0.955),which indicating that the offspring of long-lived individuals inherited longer TL from their parental generation.Conclusions Telomere length is shorten with aging in long-lived families in Bama area.The TL of BLF has a tendency of inheritance,which may be one of the mechanisms of longevity in Bama area.

Objective To investigate the effect and long-term prognosis of patients who underwent hepatectomy for hepatolithiasis. Methods We retrospectively analyzed the medical records of 98 patients with hepatolithiasis who were treated by hepatectomy in Peking Union Medical College Hospital.Results Male/femah:1/1.7;median age:55 years old.58 cases(59.2%)had been treated before;among them.50 by surgery.In 88 cages(89.8%)hepatolithiasis involved the left lobe only,in 2(2.0%) only the right lobe involved.and in 8(8.2%)both left and right lobe were involved.51(52.0%)had extrahepatic biliary stones,30(30.6%)had biliary duct strictures,28(28.6%)had a history of biliary ascariasis.and 5(5.1%)had a concurrent biliary tract malignancy.All received partial hepatectomy according to the stone location;for the 8 bilaterally involved patients,left hepatectomy and right lithotomy were performed.Postoperative complications occurredin 14 cases(14.3%),and there were2perioperative deaths(2.0%).Seventy-eight patients(79.6%)have beenfollowedupfor over1 yearwith no tumors;the results were excellent or good in 91.0%;the stone residue and recurrence rate were both 2.0%.Conclusions Hepatectomy not only eliminates calcuci,but also removes diseased biliary tracts,with advantages of low residue stone and recurrence rate.

Objective:To investigate the clinical value of fascia orientated laparoscopic lateral lymph node dissection (LLND) in radical excision for advanced low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 100 patients with advanced low rectal cancer who were admitted to Peking University First Hospital from January 2013 to August 2021 were collected. There were 69 males and 31 females, aged 58(range, 32?85)years. Patients underwent laparoscopic total mesorectal excision and fascia oriented LLND. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) results of histopathological exa-mination; (4) follow-up. Follow-up was conducted by telephone interview, outpatient examination and medical records review to detect survival, disease progression, tumor recurrence and metastasis of patients up to August 2021. Survival time was from the surgery date to death or the last follow-up time of patients. Measurement data were represented as M(range). Count data were represented as absolute numbers. Kaplan-Meier method was used to draw survival curves and calculate survival rates. Results:(1) Surgical situations. Of the 100 patients, 44 cases underwent neoadjuvant therapy and 56 cases didn′t receive preoperative therapy. Of the 100 patients with laparoscopic radical excision for advanced low rectal cancer, 60 cases underwent low anterior resection of rectal cancer including 49 cases with unilateral LLND and 11 cases with bilateral LLND,20 cases underwent abdomin-operineal resection for rectal cancer including 16 cases with unilateral LLND and 4 cases with bilateral LLND, 12 cases underwent total pelvic exenteration including 6 cases with unilateral LLND and 6 cases with bilateral LLND, 5 cases underwent Hartmann surgery including 3 cases with unilateral LLND and 2 cases with bilateral LLND, 3 cases underwent posterior pelvic exenteration including 2 cases with unilateral LLND and 1 case with bilateral LLND. The operation time and volume of intraoperative blood loss were 258(range,200?325)minutes and 100(range, 50?200)mL. There were 19 patients with low anterior resection of rectal cancer and protective ileostomy simultaneously. Three patients encountered intraoperative lymph node invasion of the obturator nerve, causing injury of the nerve at dissection. Of the 100 patients, 12 cases with total pelvic exenteration were dissected the ureterohypogastric nerve fascia and 88 cases were preserved the complete ureterohypogastric nerve fascia. (2) Postoperative situations. There was no perioperative death in the 100 patients. The time to postoperative catheter removal and duration of hospital stay of the 100 patients were 4(range, 3?7)days and 11(range, 9?15)days, respectively. There were 26 cases with postoperative complications. (3) Results of histopathological examination. The maximum tumor diameter was 4.5(range, 3.8?5.9)cm. There were 21 patients with mass type of tumor pross and 79 cases with ulcerative type. There were 82 cases with high and moderate differentiation of tumor differentiation degree, 18 cases with low differentiation and undifferentiated adenocarcinoma (signet ring cell carcinoma). There were 14 cases in TNM stage Ⅰ, 38 cases in TNM stage Ⅱ, 48 cases in TNM stage Ⅲ. There were 16 cases in stage T0?2 and 84 cases in stage T3?4. There were 52 cases in stage N0 and 48 cases in stage N1?2. The total number of lymph node dissected was 23(range, 18?27)per person and the total number of unilateral LLND was 5(range, 3?9)per person. There were 36 of 100 patients with positive lateral lymph nodes, including 14 cases with neoadjuvant therapy. (4) Follow-up. Of the 100 patients, 97 cases were followed up for 21(range, 1?69)months. The 2-year overall survival rate was 81.6% and 2-year disease progression free survival rate was 70.6%. During the follow-up, 4 of 97 patients had presacral tumor recurrence and 1 case had tumor recurrence in the LLND region. There were 11 cases with liver metastasis, 5 cases with bone metastasis, 2 cases with the contralateral lymph node metastasis of unilateral LLND, 2 cases with paraaortic lymph node metastasis, 2 cases with transcoelomic spread. Of the 97 patients who were followed up, 76 cases survived with free disease, 4 cases survived with tumor, 15 cases died of tumor and 2 cases died of other diseases.Conclusion:The fascia orientated laparoscopic LLND is safe and feasible in radical excision for advanced low rectal cancer.

Objective To study the changes of blood flow in posterior cerebral artery ( PCA ) in complete transposition of great arteries (CTGA) through the application of the pulsed Doppler . Methods Twenty CTGA fetuses ( CTGA group) and 20 healthy control fetuses ( control group) were involved ,the blood flow indexes peak systolic velocity ( Vs) ,end-diastolic velocity ( Vd) ,pulsatility index ( PI) ,resistance index ( RI) ,velocity-time integral ( VTI) of PCA-S1 ,PCA-S2 and MCA of the fetuses in the two groups were detected by pulsed Doppler . The differences in blood flow indexes between CTGA fetuses and healthy controls were analyzed by independent t -test . The rates of abnormal resistance in PCA-S1 and MCA in CTGA fetuses were compared through Chi-square test ( χ2 test) . Results Compared with control group ,the MCA-PI ,MCA-RI ,PCA-S1-PI and PCA-S1-RI of CTGA group decreased significantly( all P < 0 .05) ,MCA-VTI ,PCA-S1-VTI ,PCA-S2-VTI increased significantly ( all P < 0 .05) ,but no significant difference was found in PCA-S2-PI ,PCA-S2-RI ,Vs and Vd of the MCA and the PCA ( all P > 0 .05 ) . The rate of abnormal resistance in the MCA was significantly lower than that in the PCA-S1 in CTGA group ( P <0 .05) . Conclusions The pulsed Doppler can be used to study the changes of blood flow in PCA of CTGA fetuses and the differences of specific hemodynamic alterations may occured in different segments of the PCA in CTGA fetuses ,indicating a tendency to protect the PCA-supplying areas of the brain when ischemia and hypoxia .

Objective To evaluate the effect of sevoflurane on the electrophysiological stability of i-solated rat hearts subjected to hypothermic perfusion. Methods Clean-grade healthy adult male Sprague-Dawley rats, weighing 280-360 g, were heparinized and anesthetized with pentobarbital sodium. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％CO2 at 37℃. Twenty-four Langendorff-perfused hearts were divided into 4 groups ( n=6 each) using a ran-dom number table method: control group ( C group ) , sevoflurane group ( S group ) , 32 ℃ hypothermia group ( H group) and 32℃ hypothermia plus sevoflurane group ( HS group) . After 15 min of equilibration, the isolated hearts were continuously perfused for 30 min with K-H solution at 37℃, with K-H solution con-taining 2. 3％ sevoflurane at 37 ℃, with K-H solution at 32 ℃, and with K-H solution containing 2. 3％sevoflurane at 32℃ in C, S, H and HS groups, respectively. Heart rate and monophasic action potential in three layers of the left ventricular anterior wall were recorded at 15 min of equilibration ( T0 ) and 30 of con-tinuous perfusion ( T2 ) , the transmural dispersion of repolarization ( TDR) were calculated, and the occur-rence of arrhythmia was observed. Results Compared with C and S groups, the heart rate was significantly decreased and TDR was enlarged at T1 , and the incidence of arrhythmia was increased in H and HS groups ( P<0. 05) . Compared with H group, TDR was significantly reduced at T1 , and the incidence of arrhythmia was decreased in HS group ( P<0. 05) . Conclusion Sevoflurane can improve the electrophysiological in-stability of isolated rat hearts subjected to hypothermic perfusion, and thus decrease the development of ar-rhythmia.

Objective: To construct the Z-score models for normal fetal brain fissures. Methods: Four hundred and eighty-seven pregnant woman who underwent prenatal ultrasonography from January to August 2018 in the Second Xiangya Hospital of Central South University were collected randomly for analysis, and all the fetuses(18-38 weeks) were healthy. The calacarine fissure, pariet-ooccipital fissure, sylvian fissure of the fetuses were measured and they were chosed as the dependent variables, while the independent variable were the gestational age and biparietal diamete, as well as femur length. The regression analyses of the mean(M) and the standard deviation(SD) for each parameter were performed separately. Two observers randomly measured the brain fissures depth two hours apart to evaluate the interobserver repeatability. Results: The brain fissure depth in normal fetuses during geatational age between 18 to 38 weeks can be evaluated by Z-score model.Positive correlations were found between the depth of calacarine fissure, pariet-ooccipital fissure, sylvian fissure and gestational age, biparietal diameter and femur length. Conclusions Z-score can intuitively reflect the development of brain fissure more accurate, and is valuable, and can be used as a powerful supplement to the traditional method.