Objective To understand the contents of residual chlorine in the wastewater of 12 hospitals in the urban districts of Jinan. Methods Wastewater samples discharged from 12 hospitals were collected from June to September in 2003. The contents of residual chlorine in the wastewater samples were determined using iodometric titration method and the fecal coliform counts of the wastewater were determined. Results The contents of residual chlorine in the wastewater of 12 hospitals were 3.7 mg/L-128 mg/L with the average level of 27.6 mg/L. The result of the fecal coliform count in the wastewater was accorded with the National Hygienic Standard. Conclusion The contents of residual chlorine in the wastewater discharged from municipal hospitals in Jinan were too high, which might cause the secondary pollution to water environment.

Objective To explore the necessities and clinical value of acute intestinal obstruction with com-puted tomography of whole abdomen in over 80 years old patients.Methods 50 patients with acute intestinal obstruc-tion were diagnosed in department of emergency surgery and underwent the abdominal CT examinations.The clinical data,CT and surgery pathology of all patients were compared and analyzed.Results All cases were verified by surgi-cal operation and pathological diagnosis,including colorectal cancer(n =21)and incarcerated abdominal external her-nia(n =21),appendicitis(n =2),adhesive intestinal obstruction(n =2),intestinal volvulus (n =2),and intestinal intussusception(n =1)and stercoral intestinal obstruction(n =1),12 cases were accompanied by bowel necrosis and perforation.12 patients were treated by laparoscope surgery,38 cases by open laparotomy,48 patients acquired good recovery,and 2 cases died from extensive bowel necrosis and multi -organ failure.Conclusion CT examination in whole abdomen could rapidly and accurately diagnose the cause of intestinal obstruction,evaluate complications and risks,so as to provide reasonable treatment choice and time,making patients acquired the effective effects as soon as possible,reducing the bad consequences.

Objective To investigate the clinical significance of serum ferritin (SF) detection in myelodysplastic syndromes (MDS).Methods A total of 42 cases of MDS without blood transfusion who were admitted to General Hospital of Huainan Eastern Hospital Group from January 2010 to July 2017 were collected.There were 27 males and 15 females,aged 46-90 years old with a median age of 72 years old.In 42 cases of MDS,10 cases had refractory anemia (RA),4 cases had refractory anemia with ring increased iron bead young cell (RARS),8 cases had refractory blood cells decreased with more dysplasia (RCMD),and 20 cases had refractory anemia with primitive cells increased (RAEB).According to the International Prognostic Scoring System,22 cases had low risk,and 20 cases had high risk.At the same time,40 healthy checkers were chosen as healthy control group.SF levels were measured and compared between the MDS patients and healthy controls.Results The SF level in the MDS group was significantly higher than that in the healthy control group [(479±267) ng/ml vs.(153±56) ng/ml],and the difference was statistically significant (t =7.379,P ＜ 0.05).The difference in SF levels among the patients with different subtypes of MDS was statistically significant (F =4.81,P =0.006).Among them,the RA group had the lowest SF level,while the RAEB group had the highest,and the difference between the two groups was statistically significant [(346±257) ng/ml vs.(818±443) ng/ml,P =0.005].The SF level in the low-risk group was lower than that in the high-risk group [(456±238) ng/ml vs.(788±467) ng/ml],and the difference was statistically significant (t =2.867,P =0.008).Conclusion Patients with MDS show a significant increase in SF level,and high-risk patients are associated with iron overload,and SF may be an auxiliary indicator for judging the prognosis of MDS.

Objective　To explore the therapeutic effects of comorbid different insomnia symptoms on continuous positive airway pressure （CPAP） in patients with obstructive sleep apnea （OSA）. Methods　A total of 202 patients with CPAP in the Department of Neurology of Tangdu Hospital of Air Force military Medical University from 2011 to 2016 were collected. Age，sex，height，weight and past history were collected，as well as the results of Epworth sleepiness scale，polysomnography of diagnostic night and CPAP titration night. The differences of the above indexes between the group of difficulty maintaining sleep and other insomnia groups were analyzed. Results　There were 101 patients co-morbid insomnia and sleep apnea （48.95±11.75 years old）. There were 101 patients with OSA only （48.39±11.23 years old）. Compared with other insomnia groups，there were significant differences in proportion of Stage No rapid eye movement 2（NREM 3），proportion of Stage NREM 3，Apnea-hypopnea index（AHI），mean pulse oxygen saturation and oxygen desaturation index in the group of difficulty maintaining sleep after treatment. Conclusion　Therapeutic efficacy of patients with comorbid OSA and different insomnia symptoms on CPAP treatment are different. Individualized therapy for insomnia symptoms combined with OSA therapy is benefit for the rehabilitation of these patients.

OBJECTIVEThis project is designed to explore the potential role of cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) in cardiac electrical remodeling induced by pacing at different ventricular positions in dogs.

METHODSAn animal model by implanting the pacemakers in beagles was established. According to the different pacing positions, the animals were divided into 4 groups:conditional control group (n=6), left ventricle pacing group (n=6), right ventricle pacing group (n=6) and bi-ventricle pacing group (n=6). Cardiac and electrical remodeling were observed by echocardiography, electrocardiogram and plasma BNP. Myocardial pathology and protein expression of extracellular regulated protein kinases1/2 (ERK1/2), P38 mitogen activated protein kinases (P38 MAPK) and CREB were examined at 4 weeks post pacing.

RESULTSCardiac structure and plasma BNP level were similar among 4 groups (all P>0.05). Electrocardiogram derived Tp-Te interval was significantly prolonged post pacing (92±11, 91±10, and 79±13 ms vs. 60±12 ms), and the Tp-Te interval in bi-ventricle pacing group was shorter than in left or right ventricle pacing group (P < 0.05). Western blot results showed that the expression of p-ERK1/2 in left ventricular myocardium of left ventricle pacing group, right ventricular myocardium of right ventricle pacing group and bi-ventricular myocardium of bi-ventricle pacing group was 2.7±0.4, 2.4±0.2, 1.7±0.1 and 1.9±0.2, respectively, the expression of p-P38 MAPK was 1.9±0.3, 1.7±0.2, 0.8±0.1 and 1.1±0.1, respectively, and the expression of p-CREB was 2.1±0.2, 2.0±0.2, 2.7±0.4 and 2.6±0.3, respectively. The p-ERK1/2 and p-P38 MAPK expression of bi-ventricle pacing group was lower,but the p-CREB expression was higher compared to the other pacing groups (P < 0.05).

CONCLUSIONSVentricular pacing could induce electrical remodeling evidenced by prolonged Tp-Te interval and increased phosphorylation of ERK1/2 and p38 MAPK and reduced phosphorylation of CREB. Compared with single ventricle pacing, bi-ventricle pacing could attenuate electrical remodeling in this model.

Adenosine Monophosphate ; metabolism ; Animals ; Atrial Remodeling ; physiology ; Blotting, Western ; Cardiac Pacing, Artificial ; Dogs ; Echocardiography ; Electrocardiography ; Heart Ventricles ; Myocardium ; Phosphorylation ; Response Elements ; Ventricular Remodeling ; p38 Mitogen-Activated Protein Kinases ; metabolism