Objective To observe heart functions of the patient with cancer receiving combined chemotherapy of paclitaxel plus cisplatin through troponin test and speckle tracking echocardiography. Methods 43 patients who had been scheduled to receive combined chemotherapy of paclitaxel plus cisplatin were recruited in the study. Ser-um cTnT and cTnI levels were measured before chemotherapy,after the first cycle of chemotherapy,middle cycle of chemotherapy and after the last cycle of chemotherapy. In all patients, the lobal longitudinal systolic strain( GSL) and strain rate(GSRs)of the LV as well as peak early-diastolic strain rate (GSRe) and peak late-diastolic strain rate ( GSRa) were measured by two-dimensional speckle tracking echocardiography at every stage. Results The patients' serum cTnT and cTnI level after chemotherapy were increased gradually(P<0.01). After the last stage of chemotherapy the GSL and GSRs decreased significantly, having made significance in statistics ( P <0.01 ) . Compared with those before chemotherapy, the patients' GSRe and GSRa in the early stage of chemotherapy had no significant difference (P>0. 05), but compared to those of the middle and last stage of chemotherapy, significant difference (P<0.01) existed. Conclusion Paclitaxel plus cisplatin induce certain subclinical myocardial injury to patient's heart. Cardiac troponin level and speckle tracking echocardiography have important value in the obser-vation of heart functions of the patients with cancer receiving chemotherapy.

Objective To assess the toxicity of anthracyclinc to left ventricle function in patients withbreast cancer,and to compare the clinical values between two-dimensional speckle tracking echocardiography (2D-STE) and 3D-STE.Methods 50 patients with breast cancer who had received surgical treatment and epirubicinbased chemotherapy were recruited to study groups.All the patients had undergone up to 6 cycles of chemotherapy.Different stages wcre identified according to accumulated doses of epirubicin reaching 0 mg/m2,120 mg/m2,240 mg/m2 and 360 mg/m2.2D-STE and 3D-STE parameters were measured before chemotherapy and after different stage of chemotherapy.The receiver operating characteristics curves (ROC) of parameters (2D-GLS,3D-GLS,3D-GCS,3DGAS) were graphed to evaluate the specificity and sensitivity of detecting dysfunction of the left ventricles.25 healthy volunteers were recruited to a control group.Results As compared with the control group and the baselines,2D-GLS and 3D-GCS was significantly declined (P ＜ 0.05),3D-GAS and 3D-GLS were significantly lowered after interim period and later period (P ＜ 0.05),while 3D-GRS was not changed significantly during the whole chemotherapy period.The ROC curves revealed the sensitivity of 2D-GLS,3D-GCS,3D-GLS and 3D-GAS for assessing dysfunction of the left ventricles was 60.7％,65.3％,62.7％,and 80.7％,while the specificity was 50.0％,54.0％,64.0％,and 82.0％,respectively.Conclusions As compared with 2D-STE,3D-STE can detect the dysfunction of left ventricles earlier and more accurately.Furthermore,the specificity and sensitivity of 3D-GAS are the highest among all parameters in detecting the early dysfunction of left ventricles.

Objective To analysis of the thyroid hormone test results of Abbott Architect ci16200 automatic biochemical-im-mune analyzer (Abbott system) and Roche Cobas e601 automated immunoassay analyzer (Roche system) .Methods The thyroid hormone(including T4 ,FT4 ,T3 ,FT3 ,TSH ) levels of 93 cases of serum samples were respectively detected by Abbott system (CMIA) and Roche system (ECLIA) ,and the results were analyzed .Results The thyroid hormone test results of the two systems had a good correlation ,and the coefficients of T4 ,FT4 ,T3 ,FT3 ,and TSH were 0 .960 ,0 .962 ,0 .976 ,0 .900 ,and 0 .999(P<0 .01) . However ,there were significant difference of the detection results of the two systems(P<0 .05) .Conclusion The thyroid hormone test results of Abbott system and Roche system are not comparable .

ObjectiveTo evaluate whether the human patient simulator-based training would improve the leadership and management skills in critical care unit physicians.MethodsThe 40 physicians was completed 1/2 day of training on the human patient simulator. Each subject participated in four scenarios in the rescue team and two experts scored emergency care skills and teamwork leadership/interpersonal skills. A multiple choice question examination and training effectiveness questionnaire were completed before and after training.ResultsThe training effectiveness had more advantages than traditional teaching.Improvement was seen in participants' scores in leadership skills ( 34.8％ ),interpersonal ability ( 36.5％ ) and self-confidence ( 29.9％ ).ConclusionHuman patient simulator training may be useful for leadership,teamwork,and self-confidence skills in critical care unit physicians.

e extra-adrenal pheochromocytoma.

Objective To explore the correlations between the social support and the quality of life to them who live in Yunnan sudden unexplained death ward,and provide a scientific basis for taking effective measures to improve the people' s quality of life in the ward.Methods Using the cross-sectional household survey to collect the information of the inhabitants on social support and quality of life by the Social Support Scale,and the WHOQOL-brief Scale.Results The total score of social support,scores of subjective support,objective support in Yunnan sudden death ward ((40.85±8.34),(9.58±3.58),(23.86±4.87)) were lower than those of the control group in the same dimension ((41.82±7.12),(10.47±3.26),(24.51±4.68)) (all P＜0.05).But the score of social support utility in Yunnan sudden death ward (7.41±2.67)was no significant difference between the two groups (6.84±2.56,P＞0.05).After using multiple linear regression to control other confounding factors,such as house-hold income per capita,scores of social support,subjective support,objective support and social support utility were positively correlated with the score of quality of life in Yunnan sudden death ward (the correlation coefficient between the scores of social support and the dimensions related to the quality of life were 0.30,0.11,0.29,0.28,0.36;the correlation coefficient between the scores of objective support and the dimensions related to the quality of life were 0.15,0.05,0.13,0.14,0.19;the correlation coefficient between the scores of subjective social support and the dimensions related to the quality of life were 0.18,0.06,0.21,0.23; the correlation coefficient between the scores of social support utility and the dimensions related to the quality of life were 0.11,0.05,0.10,0.09,0.11 (all P＜0.05).Conclusions The people who live in Yunnan sudden death ward get less social support and social support utility is low,which cause the worse quality of their life.To make this situation better,more social support is necessary to enhance the utilization.

Objective To explore the correlation between polymorphism of angiotensin converting enzyme (ACE) gene and hypertensive disorder complicating pregnancy (HDP) in Chinese people.Methods The 21 case-control studies on the correlation between polymorphism of ACE gene (genotype DD,DI,Ⅱ) and HDP in Chinese people were analyzed by meta-analysis.The analysis was performed on Review Manager 4.2 software.According to the result of test for heterogeneity,the random effects model was used to calculate the pooled OR value and 95% CI.Results Twenty-one case-control studies were enrolled in this meta-analysis,a total of 1486 HDP cases and 1758 controls were included.The pooled OR values (95% CI) of DD,DI,Ⅱ genotypes of ACE gene polymorphism for HDP risk were 2.60 (1.84-3.67),0.98 (0.76-1.27) and 0.46 (0.32-0.65) respectively.Conclusions Genotype Ⅱ of ACE is a protective gene against HDP and genotype DD is a susceptibility gene for HDP.

Objective: To establish real-time qPCR method to analyze each HLA-C allele expression level of individual.Methods:Database including exon 2&3 sequences of HLA class Ⅰalleles was built ,HLA-C allelic specific primers were designed and the real-time quantitative PCR method for analyzing HLA-C allele expression level was built .The allelic specificity of these primers were confirmed in database and 835 normal peripheral blood samples of Han population .The mRNA level of each HLA-C allele from 20 pairs of liver tumor tissues and non-tumor tissues was analyzed by the qPCR method we built .Results:20 pairs of allelic specific primers were designed to distinguish the two HLA-C alleles of each individual with frequency over 0.96%in 835 cases of Han population.Among 55%of the liver cancer tissues ,the expression levels of the two HLA-C alleles from the same tumor tissue changes differently compared to that of the relevant non-tumor tissue.Conclusion:This study provides method for HLA-C allele expression level analysis of Han population and each HLA-C allele expression level is inconsistent of liver cancer tissue .

Objective To investigate the change and clinical value of serum cystain C(CysC)level in the patients with HBeAg-negative chronic hepatitis B(CHB).Methods 212 cases of CHB in our hospital were selected and divided into the HBeAg-negative group and the HBeAg-positive group according to the HBeAg status.105 healthy individuals at the same time were enrolled as the control group.The levels of serum CysC,ALT,AST,Cr,BUN and HBV DNA in 3 groups were detected and compared.The corre-lations between serum CysC with AST,AST,Cr,Bun,HBV DNA were analyzed by the Pearson correlation analysis.Results The mean CysC level in the HBeAg-negative group was (1 .40±0.36)mg/L,which was higher than (0.93±0.12)mg/L in the control group and (0.96±0.18)mg/L in the HBeAg-positive group,the differences between them was statistically significant(P <0.05). The CysC was significantly positively correlated with serum Cr level in the HBeAg-negative group(r=0.840,P <0.01).Conclusion The CysC level might be used as an effective index for monitoring the early kidney injury in the patients with HBeAg-negative CHB,which has important significance in the prevention and treatment of HBeAg-negative CHB.

Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI)in early dectection of left ventricular myocardial dysfunction in patients with breast cancer after receiving Anthracycline.Methods A group of 63 breast cancer postoperative patients were recruited and received a six-cycle epirubicin-based chemotherapy.Electrocardiogram,conventional echocardiography and 3D-STI parameters were measured before chemotherapy and during 24-48 hours after the cumulative dose of 120 mg/m2 ,240 mg/m2 and 360 mg/m2 .The receiver operating characteristics (ROC ) curves of 3D-STl parameters,such as global area strain(GAS),global longitudinal strain(GLS),global circumferential strain (GCS),and global radial strain(GRS)were drawn to determine optimal sensitivity and specificity.Twenty-one healthy female volunteers served as control subjects.Results Compared with before chemotherapy and control subjects,GAS and GLS were significantly reduced at the cumulative dose of 240 mg/m2 ,360 mg/m2 (P <0.05).The area under ROC of GAS was 0.974,and its optimal cut-off value was -3 1 .5%,with a specificity of 87.1 % and a sensitivity of 92.9%.Moreover,correlation analysis showed GAS was significantly associated with cumulative doxorubicin dose(r = -0.834,P < 0.01 ).Conclusions During chemotherapy,GAS can detect minor LV myocardial dysfunction associated with cardiotoxicity of anthracycline.3D-STI is useful in early dectection of left ventricular myocardial dysfunction in patients with breast cancer after receiving anthracycline.