Objective To evaluate the effect of injection duration on bruising and pain after the subcutaneous injection of heparin.Methods The relevant randomized controlled trials,quasi-randomized controlled trials about subcutaneous heparin injection duration of ≥30 s and ≤ 10 s were searched in the databases of CNKI,CBM,VIP Database for Chinese Technical Periodicals,PubMed,Highwire,ScienceDirect,Chinese Cochrane Library,Wanfang database and Google.The quality of RCTs was assessed and Metaanalysis was conducted by RevMan 5.0 Software.Results Twelve RCTs involving 1 986 injections were included.The results of Meta-analysis showed that:There was significant difference between the two groups in the occurrence of bruising.The injection duration of 30 s was much better to prevent bruising.Statistical differences existed in pain intensity between the two groups.Conclusions Prolonging the injection duration to 30 s may reduce the occurrence of subcutaneous bruising.There is no enough evidence to draw a conclusion on pain intensity.Adequately,the current study is limited to a small sample,powered and high quality randomized controlled trials are still needed to be conducted.

Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.

Objective:To study the effect of Mg 2+ on glutamate and energy metabolites during focal cerebral ischemia and reperfusion in rats. Methods: Twelve male Wistar rats were divided into 2 groups(n=6):magnesium sulfate(100 mg/kg, i.p.) group and saline group.Cerebral ischemia was produced by occlusion of middle cerebral artery with a nylon thread for 60 min and followed by 60 min reperfusion.Microdialysis probes were stereotaxically implanted into the cortex; dialysates were collected every 15 min to determine the concentrations of glucose, lactic acid and glutamate. Results: There was a dynamic decrease of glucose and an increase of lactic acid and glutamate during ischemia and reperfusion in saline group.Glucose decreased slightly in magnesium sulfate group during ischemia and recovered to normal rapidly during reperfusion. The lactic acid levels in magnesium sulfate group were lower than that in saline group during early stage of ischemia(0-15 min) and reperfusion.There were significant attenuation in the elevation of glutamate during ischemia and reperfusion when magnesium sulfate was administered and recovered to normal after 30 min of reperfusion. Conclusion: The preservation of cellular energy metabolism,the decrease of lactacidosis and attenuation of glutamate level during ischemia and reperfusion may contribute to the neuroprotective effects of Mg 2+ .

Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

Modern medical staff are facing the challenge to survive in competitions and develop through cooperation.Thus it is of great importance for the future medical staff,that is,medical students to cultivate and enhance their teamwork for future demand.Cultivating approaches mainly include creating a collaborative environment,carrying out cooperative scientific research,creating teamwork in the curriculum,and launching community service activities.

Objective To investigate the correlation of serum ferritin (SF) and hypersensitive C-reactive protein (hs-CRP) with carotid intima-medium thickness (CIMT) in aged type 2 diabetes mellitus ( T2DM) patients.Methods sixty patients with T2DM, 60 with impaired glucose regulation (IGR) and 60 normal control subjects were recruited .SF, hs-CRP, fasting blood glucose (FBG), 2h postprandial blood glucose(2h PBG) along with glycosylated hemoglobin (HbA1c), fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were assayed, while CIMT of the participants were measured using B mode colorful Doppler ultrasonography .Results FBG, 2hPBG, HbA1c, FINS, homeostasis model assessment insulin resistance (HOMA-IR), TG, TC and LDL-C showed significant difference be -tween patients with T2DM and normal controls ( P <0.05).FBG, 2hPBG, HbA1c, FINS, HOMA-IR showed significant difference between patients with IGR and normal controls ( P <0.05).FBG, 2hPBG, HbA1c, FINS, HOMA-IR, TG and LDL-C showed sig-nificant difference between patients with T 2DM and IGR (P <0.05).Compared with patients with IGR and controls , SF、hs -CRP and bilateral CIMT were found significantly increased in the T 2DM group (P <0.05), the similar differences which was also found comparing IGR group and normal control group .Besides, SF had positive correlation with hs -CRP and bilateral CIMT in both T2DM group ( r =0.89, P <0.05; r =0.82, P <0.05) and IGR group ( r =0.79, P <0.05; r =0.75, P <0.05).Conclusions SF and hs -CRP might contribute to the pathogenesis of diabetic macroangiopathy ,which means they could be useful clinically as vascular risk factors.

Objective To understand the trend of drinking-tea type fluorosis in the diseased areas in Inner Mongolia Autonomous Region,and to evaluate the effect of prevention and control measures.Methods In 2009 and 2012,6 monitored counties were selected in Inner Mongolia Autonomous Region; 5 diseased villages were selected in each monitored county,and 10 families were selected in each monitored village; fluorine content of brick tea was tested,and dental fluorosis conditions of all 8 to 12-year-old students and skeletal fluorosis conditions of all 36 to 45-year-old adults were examined.In 2012,in each monitored village,1 water sample of the drinking water source was collected respectively from five positions(east,south,west,north and the central of the village),and fluoride content of drinking water wastested.Results In 2009,the mean of brick tea fluorine content was 541.48 mg/kg in the monitored villages,and the fluoride content ≤ 300 mg/kg accounted for 17.62％.(49/278).In 2012,the mean of brick tea fluorine content was 536.06 mg/kg,and the fluoride content ≤300 mg/kg accounted for 11.00％(33/300).Total exceeding standard rate of the water fluoride content was 40.00％(12/30).In 2009,the detection rate of the children's dental fluorosis was 52.39％ (274/523),very mild,mild,moderate and severe cases accounted for 9.56％(50/523),19.86％(104/523),21.03％(110/523) and 1.91％(10/523),respectively.In 2012,the detection rate of the children's dental fluorosis was 35.71％(200/560),very mild,mild,moderate and severe cases accounted for 14.11％ (79/560),11.43％ (64/560),9.64％ (54/560),and 0.54％ (3/560),respectively.Compared with 2009,the proportion of moderate and severe cases reduced in 2012(W =40 696.0,P ＜ 0.01).In 2009,the detection rate of adult skeletal fluorosis was 23.52％ (167/710),mild,moderate and severe cases accounted for 17.32％(123/710),4.51％(32/710) and 1.69％(12/710),respectively.In 2012,the detection rate of adult skeletal fluorosis was 20.12％ (103/512),mild,moderate and severe cases accounted for 17.38％ (89/512),2.54％ (13/512) and 0.20％ (1/512),respectively.Compared with 2009,the proportion of moderate and severe cases reduced in 2012(W =12 797.5,P ＜ 0.01).Conclusion The drinking-tea type fluorosis in Inner Mongolia Autonomous Region has been controlled to some degree,but still serious in some areas;prevention and control measures need to be further strengthened.

Objective To assess the value of C-reactive protein(CRP) for the prognosis of acute pulmonary embolism (PE). Methods 56 acute pulmonary embolism patients, confirmed by spiral computed tomography (sCT), magnetic resonance imaging(MRI), or pulmonary angiography (CTPA). CRP as well as electrocardiogram (ECG), echocardiography(UCG), blood gas analysis, were taken after admission. Results Among these patients,24 cases with higher CRP(≥10 mg/L),were diagnosed as massive (50.0%), sub-massive PE(45.8%), mini-massive (4.2%) or died(25.0%). 24 cases (100.0%) showed right heart dysfunction and 24 cases showed pulmonary hy-pertension on UCG, right ventricular 20 (83.8%) on ECG, 22 cases (91.7%) showed hypoxemia. 8 cases (33.3%) had syncope,and 9 cases (37.5%) had cardiogenic shock. CRP was lower than 10 mg/L in 32 patients, among whom,3 cases (9.4%) were with massive PE,6 cases (18.8%) were with sub-massive PE,23(71.8%) were with small PE,1 cases(6.3%) died. 13 (40.6%) had right heart dysfunction and 16(50.6%) had pulmona-ry hypertension on UCG, right ventricular on ECG in 15 cases (46.9%), hypoxemia in 11 cases (34.4%), syncope in 2 cases (6.3%), cardiogenic shock in 4 cases (12.5%). The occurrence of massive PE, mortality (P<0.01) and sub-massive PE (P<0.05)were statistically different between the groups with higher CRP and the groups with lower CRP. The ratio of right heart dysfunction, pulmonary hypertension, right ventricular overloading, hypoxemia had statistical significance (P<0.01). There was statistical significance in the occurrence of syncope, cardiogenic shock (P<0.05). Conclusions CRP can be used as a parameter for PE, and can be used to stratify risk levels for severi-ty and assess the effectiveness of treatment.

Measuring the innovation capacity and competitive strength of the department mainly depends on the quality and quantity of its independent intellectual property.Here we discussed intellectual property issues occurring in the different stages of the application,approval,implementation and concluding,including the theses written at the application stage,the novelty retrieval of patent documentation,periodic achievement protection during implementation,the association between the patent application and paper publication,etc.And the intellectual property ownership was expounded according to Contract Law of PR China.The strategy of intellectual property protection was put forward from the view points of the mechanism,regulation,and personnel.The helpful tips are expected to the scientific researcher and the administrative staff.

Background Corneal confocal microscopy can denamically offer the morphological image of corneal cells at cellular level.To find out the dynamic change of corneal thickness and morphology of corneal cells with aging is very important for the design of corneal refractive surgery.ObjectivePresent study is to find out the important relevance of dynamic change of corneal thickness and morphology of corneal cells with aging and the design of corneal refractive surgery and investigate the influence of age on central corneal tissue and characterize precisely the anatomy of cornea by in vivo confocal microscopy.Methods122 eyes of 122 normal subjects were enrolled in this study with the age from 18 through 80 years old.The subjects were diagnosed as emmetropia in the Center of Tianjin Medical University from August 2003 to December 2007.All eyes were examined in vivo by confocal microscopy.The cell morphology,cell density and corneal thickness were measured by confocal microscopy.The relationship of central corneal tissue change and age was evaluated.ResultsThe density of corneal superficial basement epithelial cells showed a significantly negative correlation with age (r=-0.355,P=0.017).The keratocyte density in the anterior and posterior stroma indicated a significantly negative correlation with age (r_1=-0.462,P=0.001;r_2=-0.403,P=0.016).The thickness of corneal epithelium cells had a significantly negative correlation with age (P=0.02).The mean value of total corneal thickness and stromal thickness in high myopic eyes was (523.2±26.20)μm and (468.4±20.72)μm respectively,presenting a significantly negative correlation with age (r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).A significantly negative correlation was also found in endothelial cell areas and density with age (r_1=0.417,P=0.004;r_2=-0.598,P=0.002).The percentage of polymorphological corneal endothelial cells was considerably increased(r=0.417,P=0.004)but that of pleomorphism cells was significantly decreased in >60-year-old population compared with younger subjects (r=-0.598,P=0.002).The morphology of corneal basement cell,anterior stroma cytocyte and endothelial cell were normal in younger subjects,and enlargement of the cells in size,decreases of number and density of the cells were found in >60-year-old subject.ConclusionThe anatomy and histology of the central cornea in young subjects exist discrepancy from older ones.The corneal hisological changes with aging include thinner thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased size of endothelial cells.Corneal thickness is asymmetric and seems to undergo age-related anatomic changes.