Deletions,insertions,duplications,and complex multi-site variants,now formally termed copy number variations(CNVs),are regions larger than 1 kb that are present with variable copy numbers in comparison with the reference genome.CNVs in humans and other mammals are associated with a series of complex genetic diseases including congenital heart disease.The studies of CNVs have become hot topics.This review mainly discusses the principle of CNVs,the detection techniques and CNVs in the pathogenesis of congenital heart

Objective To observe the effects of combined spinal-epidural anesthesia (CSEA) with small dose of ropivacaine on the circulatory and respiratory function in aged patients undergoing hip arthroplasty surgery.Methods Forty ASA Ⅱ or Ⅲ patients were randomly divided into two groups,20 cases in each group.In group A,0.25％ ropivacaine 5-7mg was given for spinal block and 0.25％ ropivacaine for epidural block.Patients in group B were given 0.5 ％ bupivacaine 8-10mg and 0.375％ bupivacaine,respectively.The anesthetic efficacy,BP,HR,SpO2,Bromage score were recorded.Results The analgesic plane was T8-T10 in group A,and that was T6-T8 in group B.The changes of BP,HR,SpO2 in group A were less than those in group B.Bromage scores of group A were 1-2 for nonoperative extremity and 0-1 for the operative extremity,which were 3-4 for two extremities in group B.Conclusion The CSEA with 0.25％ ropivacaine 5-7mg for spinal block and 0.25％ ropivacaine for epidual block is suitable for patients undergoing hip arthroplasty surgery.

15 cases of malignant tumours of gastrointestinal tract and ovary were treated by chemotherapy through intraperitoneal puncture and perfusion under B-ultrasound guidance.The results were satisfactory.The success rate of intraperitoneal puncture under B-ultrasound guidance was 100%.The method is introduced in detail and the advantage of the application of B-ultrasound guid-ance was discussed.The authors considered that it is safe,reliable,less in complication,easy to oper-ate:less in agopy and easy to be used clinically.

Velpatasvir is a new generation of NS5A inhibitors, and combined with marketed sofosbuvir, compound tablets Epclusa was obtained and approved by FDA in June, 2016, which is used for the treatment of adult patients infected with chronic hepatitis C vi-rus ( HCV) with all genotypes. The mechanism of action, pharmacodynamics, pharmacokinetics, clinical trials and safety of Epclusa were reviewed in this article.

The BRAFV600E mutation in papillary thyroid carcinoma is the most common genetic event,which is an invasive tumor clinical phenotype and a poor prognosis indicator.The BRAFV600E mutation detection has an important guiding significance for the differential diagnosis of malignant thyroid nodules on preoperative,guiding the surgical resection range of thyroid cancer,judging the patient(s) prognosis and guiding the subsequent treatment of postoperative.

Objective To explore the effects of tamoxifen on the proliferation of SHG-44 glioma cells and the currents of sodium channel. Methods The cell activity was detected by MTT. The alteration of cellular proliferation and apoptosis were dectected by flow cytometer. Whole-cell patch clamp technique was used to record the Na currents.Results After treatment with tamoxifen,the cells began aging and shedding and cell counting decreased.The cells in G2/M cell cycle were more than that in control and the apoptosis ration increased. Tamoxifen significantly decreased the amplitude of Na currents of SHG-44 cell line.This blocking effect was dose-dependent and voltage-dependent.When the holding potential was 0 mV, 8 ?mol/L tamoxifen could block this currents by 69%.The half inhibition concentration(IC50) was 5.54 ?mol/L. Conclusion Tamoxifen can inhibit SHG-44 glioma cells proliferation.The inhibion of sodium channel may be one of its mechanisms.

Objective To prospectively assess the association between cardiac resynchronization therapy (CRT )and left atrial volume .Methods Fourteen patients with chronic heart failure ,sinus rhythm and left bundle branch block were enrolled in this study and prepared for CRT implantation .Clinical and echocardiographic evaluations were performed before CRT implantation and 6 months later .Followings were parameters of the left atrial and left ventricular volume:left ventricular end-systolic volume index (LVESVi)and end-diastolic volume index(LVEDVi) ,maximal LAV index(iLAVmax) ,etc ,LAV index before atrial systole(iL-AVpre)and minimal LAV(iLAVmin) .CRT responders were defined as those whose reduction rates were more than 10% in iL-VESV in 6-month follow-up .Results Responders(71 .4% )and non-responders(28 .6% )had similar baseline ,clinical characteristics and pre-implantation LV volumes .However ,iLAVmax in the responders was remarkably lower than that in non-responders .CRT therapy significantly reduced LVESVi(P<0 .01) ,LVEDVi(P<0 .001) ,iLAVmax(P=0 .004) ,iLAVpre(P=0 .003)and iLAVpost (P<0 .01) ,but when compared with the non-responders ,iLAVmax was much lower in responders .Correlation analysis showed that there was a significant correlation of LVEDVi with iLAVmax ,iLAVpost(P<0 .05) .Conclusion CRT therapy can significant-ly improve iLAVpre and iLAVmax may be a predictor of LV reverse remodeling .

Objective To investigate the clinical efficacy of acupoint catgut embedding in treating patients with early-stage type 2 diabetes.Methods Two hundred and forty patients with early-stage type 2 diabetes were randomly allocated to treatment and control groups, 120 cases each. The control group received diet control and kinesitherapy and the treatment group, acupoint catgut embedding in addition. Fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin (GHB) and body mass index (BMI) were measured in the two groups before and after treatment and the clinical therapeutic effects were compared between the two groups.Results There were statistically significant post-treatment differences in FPG, 2hPG and GHB between the two groups (P<0.05). There was a significant difference in comparing FPG and GHB between the two groups after intervention (P<0.05).The total efficacy rate was 98.3% in the treatment group and 85.0% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusions Acupoint catgut embedding can improve glucose tolerance and reduce the incidence of diabetes in patients with early-stage type 2 diabetes.

As introduced in the paper, the average days of stay of clinical department were calculated as a management target, in view of the complexity of disease and case mix index. This method could avoid the deficiency of traditional methods and make the management of average length of stay of clinical department more conforming to the actual situation, and also more scientific and reasonable.

Epidemiological studies reveal that prenatal adverse environment could cause lower birthweight in offspring and increase the susceptibility to multiple chronic diseases (e.g. metabolic and neuropsychiatric diseases etc.) after maturity. However, the underlying mechanism remains unclarified. The hypothalamic-pituitary-adrenal (HPA) axis is a key neuroendocrine axis playing pivotal roles in systemic stress responses before and after birth. It is also an important but vulnerable fetal targeting organ. Previous studies showed that many environmental insults during pregnancy, including external environment and maternal health condition, could affect fetal development in multi-ways via maternal-placental-fetal unit, which leads to the intrauterine programming alteration of HPA axis and the in?creased susceptibility to chronic diseases in adulthood. This article reviews the latest global advances in the etiology of increased susceptibility to adult diseases induced by compromised prenatal environ?ment and the associated intrauterine programming mechanisms by incorporating our recent research findings, and proposes that the fetal over-exposure to maternal glucocorticoids (GC) could bring about the intrauterine neuroendocrine metabolic programming alteration in offspring:the core is the program?ming of GC-insulin-like growth factor 1 axis in multiple organs, and the abnormal epigenetic modification is involved in this programming.