A novel strategy employing dendrimer to multi-label the template molecule to improve the sensitivity of molecularly imprinted electrochemical sensor was proposed. The determination relies on a competition reaction between poly ( diethylene-triaminepenta-acetic acid )-glycol ester ( PDTPA )-ferrocene-carboxylic acid ( FcA ) labeled gibberellins acid 3 ( GA3 ) and GA3 in the sample. Since one cavity corresponds with multiple FcA, instead of only one FcA, the intensity of the detecting signal was greatly enhanced, so was the sensitivity of the sensor. Experimental results showed that the molecularly imprinted electrochemical sensor was sensitive to GA3 detection at a concentration from 2. 0í10-9 to 1. 0í10-7 mol/L, with a detection limit of 9. 3í10-10 mol/L. In addition, the sensor had good reproducibility and its feasibility was verified in the analysis of series of real beer samples.

Hilar cholangiocarcinoma (HCCA) or Klatskin tumor is a scirrhous adenocarcinoma that arises from the conjunction of bile duct and hepatic ducts.Hepatic magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) are important methods for the diagnosis of HCCA.In this article,the clinical data of 42 patients in the Changhai Hospital and 18 patients in the Eastern Hepatobiliary Surgery Hospital who received MRI and MRCP examination from October 2010 to October 2012 were retrospectively analyzed.According to the pathological features,HCCA could be divided into mass-forming type,infiltrating type and intraductal type.Based on the results of imaging examination and intra-and postoperative pathological examination,Bismuth-Corlette types were decided pre-and postoperatively.The coincidence rate of pre-and postoperative Bismuth-Corlette types was 89.7％ (35/39).Infiltration of liver parenchyma was both detected pre-and postoperatively in 19 patients (16 patients were detected by MRI preoperatively),and the sensitivity of MRI was 84.2％ ; vascular invasion was both detected pre-and postoperatively in 10 patients (12 patients were detected by MRI preoperatively),and the sensitivity of MRI was 83.3％ ; hilar and retroperitoneal lymph node metastasis was both detected pre-and postoperatively in 6 patients (4 patients were detected by MRI preoperatively),and the sensitivity of MRI was 66.7％.Combined application of different sequences and techniques of MRI is helpful in the diagnosis,staging and treatment of HCCA.

Objective To evaluate the safety of temporary cardiac pacemaker during perioperative period of laparoscopic cholecystectomy (LC) in patients with bradyarrhythmia. Methods Temporary cardiac pacemakers were installed preoperatively in 34 elderly patients with bradyarrhythmia for LC. On operation the ultrasonic harmonic scalpel, instead of electrotome, was used to perform dissection and coagulation. Results LC was completed successfully in all the 34 patients without surgery-related complications or perioperative serious cardiovascular diseases. Conclusions Utilization of temporary cardiac pacemaker and ultrasonic harmonic scalpel may considerably enhance the perioperative safety and reduce the incidence of cardiovascular complications in elderly patients with bradyarrhythmia.

Objective To study the upper airway structure characteristics of children with obstructive sleep apnea hypopnea syndrome (OSAHS) using electronic pharyngorhinoscopy.Methods Seventy-eight children with OSAHS (34 cases mild group,44 cases moderate and severe group) and 52 children with chronic pharyngitis in the same period (control group) were selected.Each group was examined by electronic pharyngorhinoscopy.The adenoid-nasopharynx ratio (ANR),degree of palatopharyngeal anteroposterior diameter collapse,degree of palatopharyngeal right-and-left diameter collapse,degree of palatopharyngeal cavity collapse,degree of glossopharyngeal anteroposterior diameter collapse,degree of glossopharyngeal right-and-left diameter collapse,degree of glossopharyngeal cavity collapse were compared,and the relevance between thegn were analyzed.Results The ANR in mild group,moderately and severe group was significantly higher than that in control group (0.84 ± 0.21 and 0.69 ± 0.25 vs.0.34 ± 0.12),and the ANR in moderate and severe group was significantly higher than that in mild group.There were statistical differences (P ＜ 0.05).The degree of palatopharyngeal anteroposterior diameter collapse,degree of palatopharyngeal right-and-left diameter collapse,degree of palatopharyngeal cavity collapse,degree of glossopharyngeal anteroposterior diameter collapse,degree of glossopharyngeal right-and-left diameter collapse,degree of glossopharyngeal cavity collapse in moderately and severe group were significantly higher than those in control group and mild group (0.81 ± 0.25 vs.0.41 ± 0.17 and 0.54 ± 0.20,0.66 ± 0.23 vs.0.31 ±0.08 and 0.43 ±0.14,0.51 ±0.18 vs.0.14 ±0.04 and 0.23 ±0.11,0.55 ±0.21 vs.0.29 ±0.14 and 0.32 ± 0.13,0.69 ± 0.28 vs.0.42 ± 0.12 and 0.43 ± 0.11,0.33 ± 0.12 vs.0.10 ± 0.03 and 0.14 ± 0.05),and there were statistical differences (P ＜ 0.05).There were no statistical difference in the indexes between mild group and control group (P ＞ 0.05).In children with OSAHS,the ANR,degree of palatopharyngeal anteroposterior diameter collapse,degree of palatopharyngeal cavity collapse,degree of glossopharyngeal right-and-left diameter collapse,degree of palatopharyngeal cavity collapse were positively correlated with AHI (P ＜ 0.05),while there was no correlation between the degree of palatopharyngeal right-and-left diameter collapse,degree of glossopharyngeal anteroposterior diameter collapse and AHI (P ＞ 0.05).Conclusions Upper airway structural changes in children with OSAHS have certain correlation with the severity of sleep apnea.And there is clinical value by using electronic pharyngorhinoscopy in children with OSAHS to research airway morphology.

Objective:To utilize MRI and plain films to observe the changes of soft tissue structures in patients with developmental dysplasia of the hip (DDH) after closed reduction, and explore the concentric reduction rate, the "docking" rate and the femoral head necrosis rate after reduction.Methods:Retrospective analysis of unilateral completely dislocated DDH patients with closed reduction and spica casting in our hospital from October 2012 to July 2018. MRI was performed on the day of closed reduction and every 2-3 months after operation. Pelvic plain films were performed before operation and follow-up. The labro-chondral complex (LCC) of the hip was divided into 4 types on MRI images, and the reliability and repeatability of LCC classification were evaluated by intra-class correlation coefficient. Trend chi-square test or Fisher exact probability method was used to analyze the variation of thickening rate of ligamentum teres, transverse ligaments and pulvinar during MRI follow-up, and the difference of cartilaginous acetabular head index was evaluated by analysis of variance of repeated measurements or Mann-Whitney U test. The concentric reduction rate of the femoral head after performing closed reduction, the "docking" rate of the femoral headwhen the cast was changed for the last time were analyzed, and the necrosis rate of the femoral head were followed up for 18 months or more after reduction.Results:A total of 63 DDH patients (63 hips) with closed reduction were included. Intra-class correlation coefficient of LCC classification was 0.84 between observers (95%CI: 0.74-0.91) and 0.94 within observers (95%CI: 0.90-0.97) . Most LCC classifications were type 4 on the day of CR (93.7%, 59/63) , and return to normal (type 1 classifications) at the second follow-up (50.9%, 28/55). ligamentum teres, transverse ligaments and pulvinar were hypertrophic (94.5%-100%) on the day of CR, and decreased to 10.9%-12.7% at the second follow-up, which had statistically differences ( χ2=88.6; χ2=86.4; χ2=97.9, P<0.05). The cartilaginous acetabular head index was 68.1±12.1 on the day of CR, and increased to 84.4±7.0 at the second follow-up, which had statistically difference ( Z=-3.15, P=0.002). 58.7% femoral heads were "docking", 8.6% femoral head had necrosis. Conclusion:The abnormal soft tissue structures in the hip joint mostly recovered gradually after closed reduction, and 60% femoral heads could be docked, the short-term risk of the femoral head necrosis was low.

AIMTo investigate the role of serine/threonine protein phosphatases in regulation of cell signal transduction on voltage-dependent sodium channels in rat trigeminal ganglion (TRG) neurons. METHODSWhole-cell patch clamp techniques were used to record the total sodium current (INa-T) and the tetrodotoxin-resistant sodium current (INa-TTX-R) before and after okadaic acid, a potent inhibitor of the serine/threonine protein phosphatases 1 and 2A, perfusion on adult rat TRG neurons. RESULTS1μmol*L-1 okadaic acid inhibited INa-T by (20±13)% (n=9, P<0.05) and INa-TTX-R by (4±3)% (n=6, P<0.05), respectively. The inhibition on INa-T was significantly greater than that on INa-TTX-R (P<0.05). Furthermore, 1μmol*L-1 okadaic acid produced significant 3-4 mV hyperpolarizing shifts in the conductance-voltage curves of INa-T, while it had no effect on that of INa-TTX-R. CONCLUSIONThe serine/threonine protein phosphatases take part in the regulation of total and TTX-R sodium channels on rat TRG neurons. In addition, small-diameter TRG neurons express various voltage-gated sodium channel with different sensitivity to okadaic acid.

Objective To analyze the natural development of the residual subluxation after early close reduction for developmental dislocation of the hip,and to seek the early surgical timing and indication.Methods The research included 36 patients (48 hips) born before January 2000 who showed residual subluxation after close reduction in one year.All of patients had serial X-ray radiographs at every follow-up point.The radiographs were assessed using acetabular index (AI),Reimers index,center edge (CE) angle and the orientation of the sourcil of the acetabulum.The last follow-up results were evaluated according to the Severin classification,and Severin grade Ⅰ and Ⅱ were defined as satisfactory group and Severin grade Ⅲ and Ⅳ as unsatisfactory group.Then we compared and analyzed the serial radiological parameters between satisfactory and unsatisfactory groups.Results The mean age at close reduction was 1.6 years.At the last follow-up,the mean age was 13.8 years.The satisfactory group comprised 18 hips (37％),whereas the unsatisfactory group comprised 30 hips (63％).At the age of three to four years,there was a significant difference between the two groups in the Reimers index (34.4％±4.5％ vs.43.0％±4.6％,P ＜ 0.05).And at four to five years old,there were significant differences for both Reimers index and CE angle (29.3％ ±7.2％ vs.40.0％±6.2％,P ＜ 0.05; 21.0°±5.5° vs.10.6°±5.2°,P ＜ 0.05).When the Reimers index ＞38％ at the age of three to four years,18 of 18 hips fell into the unsatisfactory group.And when Reimers index ＞33％ at the age of four to five years,26 of 30 hips had unsatisfactory result,and in addition to that the sourcil orientation was upward,26 of 26 hips fell into the unsatisfactory group.Conclusion To avoid early osteoarthritis,surgical correction for residual subluxation was recommended if the Reimers index ＞38％ at the age of three to four years or the Reimers index ＞33％ with the sourcil upward at the age of four to five years.

Objective To analyze the status of supply and the affected factors of the home care of the elderly in community of Shenzhen.Methods The investigation was carried out in 78 community health ser-vice centers and 216 elderly from 6 communities using self-designed questionnaire.Results 84% of the el-derly had the demand of home care, 38.1% of them had even received home care services.In 32 demand items of home care, the top 6 were in turn the blood pressure monitoring, the blood sugar monitoring, the health consults, the caregivers guidance, the psychological care, medication instruction.48 of 78 commu-nity health service center provided door-to-door services, 44% of them(home care service center)provided more than 10 projects, 67% of the center provided more than 5 projects, 17% of them provided 2 projects, 30 community health service center did not provide door-to-door service.The main reasons that influenced home care delivery in community were the shortage of nursing staff of home medical care, the risk factors, the medical environment, and the limited health care facilities.Conclusions The elderly has large de-mand to the home care service, home care which the community health center provided is lagging and in short supply.It is imperative to increase the number of community nurses, improve the community home care profession standard and promote stable development of home care.

OBJECTIVE:To summarize the experience of pharmaceutical care provided by pharmacists of Chinese medicine for AIDS sufferers in our hospital.METHODS:The practical experience of pharmacists of Chinese medicine in providing pharmaceutical care for AIDS sufferers in our hospital was analyzed to achieve rational knowledge from perceptual knowledge.RESULT:To carry out pharmaceutical care for AIDS patients by applying expertise achieved satisfactory effect.CONCLUS-ION:Pharmacists of Chinese medicine should strive to establish a new open pharmaceutical care model,attach great importance to the communication with patients,integrating psychotherapy and humanistic care into the pharmaceutical care all along so as to assure patient's compliance.

Objective To observe the natural outcomes of Graf type Ⅱ a hip dysplasia aged 6 weeks to 3 months,and to explore the indications of treatment.Methods A prospective study was conducted to collect children aged from 6 to 12 weeks with Graf type Ⅱ a dysplasia (50°≤α angle＜60°) but clinically stable hips according to the Early Screening of Developmental Dysplasia of the Hip in Tianjin project from July 2012 to July 2014.Those hips with history of treatment or neuromuscular disorders were excluded.All infants had no treatment initially following with ultrasound surveillance each 2 weeks and radiograph evaluation each at 3,4.5 and 6 months of age.Patients received Pavlik harness or abduction brace treatment if hip dysplasia turned to be type Graf Ⅱ c or worse,or clinical unstable before 6 months;also if hip dysplasia was persistent in radiograph at 6 months.All infants were routinely followed up at 12 and 24 months of age to detect the late cases.The difference of initial α angle,hip abduction,acetabulum index and acetabulum margin morphology (sharp,round or defect) in the pelvic radiograph at 3 month were compared between the treated and untreated groups.Results A total of 238 children (285 hips) were enrolled in the present study,of which there were 25 males and 213 females,193 left and 92 right hips.The average age was 9 weeks (range 6 to 12 weeks).No hip turned to be type Ⅱ c or worse,or clinically unstable.One hundred patients (120 hips) received treatment for persistent dysplasia at 6 months.There had statistically significant difference in initial α angle between the treated and untreated groups (respectively 54.5°±3.3° and 55.6°±2.9°,t=-2.749,P=0.004).In the treated group,there were 47 hips (39.2％,47/120) with limited abduction initially,and 52 hips (43.3％,52/120) with poor acetabular morphology at 3 months.The differences were statistically significant comparing with the untreated group (x2=4.010,P=0.045;x2=14.143,P=0.000).Logistic multivariate regression analysis showed that patients with Graf Ⅱ a-hips (OR=2.908) and poor acetabular morphology hips (OR=2.822) were more likely to receive treatment.Thirty-eight patients (47 hips) received treatment among Graf Ⅱ a+ hips (α angle ≥55°),of which 21 hips (44.7％,21/47)had limited abduction and 31 hips (66.0％,31/47) poor acetabular morphology.The differences were statistically significant comparing with untreated cases (x2=12.073,P=0.001;x2=35.879,P=0.000).Logistic multivariate regression analysis showed that Graf Ⅱ a+ hips with limited hip abduction (OR=4.145) and poor acetabular morphology (OR=10.117) were more likely to receive treatment.Conclusion Graf Ⅱ a dysplasia with clinically stable hips should be treated if α angle ＜55° at 6 weeks or if α angle ≥55° with limited hip abduction or poor acetabular morphology (round or defect) at 3 months.