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 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 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 investigate the predictive value of neutrophil and lymphocyte ratios (NLR)for the prognosis in patients with acute cerebral infarction. Methods From January 2014 to December 2015,307 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University were enrolled retrospectively,including 80 females and 227 males. They were divided into ether a good prognosis group (n = 195)or a poor prognosis group (n = 112)according to the scoring criteria of the modified Rankin scale (mRS). The age,gender, past medical history,National Institutes of Health stroke scale (NIHSS)score were documented on admission. The NLR values were calculated according to the neutrophil and lymphocyte counts on admission. Logistic regression analysis was used to analyze the influencing factors of poor prognosis of acute cerebral infarction. The receiver operating characteristic curve (ROC)was used to evaluate the predictive effect of the NLR level on patients with acute cerebral infarction on admission. Results (1)Compared with the good prognosis group,the age,incidence of recurrent cerebral infarction,NIHSS score on admission, NLR levels on admission in the poor prognosis group were higher. There were significant differences between groups (69 ± 12 years vs. 62 ± 14 years,25. 0% [28 / 112]vs. 14. 4% [28 / 195],5. 00 [3. 00, 9. 00]vs. 3. 00 [1. 75,5. 00],and 3. 66 [2. 62,7. 91]vs. 2. 47 [1. 94,3. 40];all P < 0. 05). There were no significant differences in other baseline data and clinical characteristics between the groups (all P >0. 05). (2)Multivariate logistic regression analysis showed that the increase of the age,NLR level on admission,and increased NIHSS score on admission,were independent risk factor for poor prognosis (OR 1. 030,1. 148,and 1. 427,respectively,95% CI were 1. 007 -1. 053,1. 059 -1. 246,and 1. 247 -1. 634, respectively;all P < 0. 05). (3)The diagnostic cut-off value of the NLR level on admission for the poor prognosis in patients with acute cerebral infarction was 2. 84. Its sensitivity was 69. 6% and specificity was 64. 6% . Conclusion The increase of the NLR level on admission had certain reference function on the poor prognosis in patients with acute ischemic stroke.

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 retrospectively review long?term results of developmental dislocation of the hip patients treated with open reduction and Salter pelvic osteotomy, and to analyze the potential risk factors. Methods Sixty?eight developmental dislocation of the hip cases (81 hips) were treated with open reduction and Salter pelvic osteotomy from September 1992 to Octo?ber 2002, 45 cases (52 hips) were followed up to skeletal maturity. None had undergone other treatment before the key surgery. Some cases received skeleton traction before surgery. The radiographic and functional results were assessed at last follow?up. The possible relevant factors for unsatisfactory outcome were analyzed. The correlation between type ⅡAVN and the coverage rate of the femoral head were evaluated. Results The mean age at surgery was 2.5 years (ranged from 1.4 to 5.3 years). At last follow?up, 44 hips (84.6%) had excellent or good functional results. 23 hips (44.2%) had avascular necrosis of varying severity, of which 16 hips were typeⅡ. There was significant relevance between the AVN severity and the Severin classification result (P=0.018). Theover correctionhips, that were overcorrected during surgery, were more likely to get severe type AVN ( P=0.037). There was no correlation between TypeⅡAVN with uncoverage according to CE angle and Reimers index (P=0.457, 0.308 respectively). Con?clusion 1) Satisfactory functional and radiographic results could be expected in developmental dislocation of the hip cases with?out AVN;2) High risk of AVN existed in the late diagnosised hips that underwent open reduction and Salter pelvic osteotomy, typeⅡwas the most common type;3) TypeⅡAVN was not a predictor for progressive femoral head coverage deficiency;4)Over cor?rectionin Salter pelvic osteotomy was related with severe type AVN which should be avoided.

recurrence of half a year.Results The rate of symptom improvement in D group was significantly better than the other three groups(P <0.05).Over time,there was no statistical difference between four groups.The recurrence rate of D group (0.00%)was obviously lower than A group (11.76%),the B group (2.00%)and the C group (3.85%)(P <0.05).Conclusion Microscope with the traditional Chinese medicine is a good choice in preventing postoperative the rate of symptom and recurrence.

Objective Recent researches indicate that Eph/ephrin signaling pathway is possibly related to adult neurogenesis after cerebral injury..With brief introduction of their structures and interactions,the review focus on their possible mechanism in adult neurogenesis.Methods The literatures between 2010 and 2015 were retrieved following online databases:PUBMED,ScienceDirect,Wanfang and CNKI database.The key words used in the reasearch were Eph,ephrin,cerebral injury,adult neurogenesisand so on.Results Totally 42 related articles were enrolled.And these papers discribed how researchers performed their experiments and further explained Eph/ephrin 's vital roles in adult neurogenesis.Conclusion Eph/ephrin signaling can influence adult neurogenesis after cerebral injury.positively or negatively.And Akt may be a downstream signaling molecule of Eph/ephrin that change the progress of adult neurogenesis.However,the detailed mechanisms remain to be further study.

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.