Objective To evaluate the value of prenatal gene diagnosis for thalassemia. Methods 128 fetuses suspected with thalassemia were performed amniocentesis or cordocentesis for gene diagnosis. Results No severe complications occurred during all procedures. 32 fetuses had normal genotype. 38 were heterozygous and 27 were homozygous of ?- thalassemia; 18 were heterozygous, 4 were homozygous and 9 were double heterozygous of ?-thalassemia. The types and frequencis of ?-thalassemia mutation were CD 41-42(47.5%), IVS-Ⅱ-654(42.5%), 17(A-T)(7.5%) and -28 (A-G)(2.5%) in turn. Pregnancies of 40 fetuses with severe thalassemia were terminated in time. Conclusions The screening and prenatal diagnosis of high risk fetus for thalassemia is safe, effective and accurate. It should be used as an obstetrical routine examination at the region with high thalassemia occurrence.

Objective To explore the distributive changes of PIDD protein in HT29 cells stimulated by 5-fluorouracil(5-FU),and the influence of the PIDD protein interfered by small interference RNA(siRNA) on the drug resistance of HT29 cells in vitro.Methods siRNA was used to interfere the PIDD expression,and HT-29 cells were treated with 5-FU.Western blotting was employed to detect the PIDD expression before and after interference.The distribution of PIDD in nucleus and cytoplasm after 5-FU treatment was also detected.Changes in drug sensitivity of HT-29 cells to 5-FU were determined with MTT assay and IC50 values were evaluated.Results PIDD protein was expressed mainly in the cytoplasm before 5-FU stimulation,and it migraded into the nucleus after stimulation.Western blotting showed that the total PIDD expression and the expression both in cytoplasm and nuclei decreased significantly after RNA interference,and no increase of the total PIDD and that migrated into nucleus was found even after 5-FU stimulation.It was found that in the transfection group(cells were incubated 12h after being transfected with PIDD-360),normal group(cells without treatment) and control group(cells were incubated 12h after being transfected with negative transfection reagent),the IC50 values of cells treated with 5-FU were 0.23?0.06?g/ml,2.71?0.70?g/ml and 2.78?1.03?g/ml,respectively.The IC50 value declined significantly in transfection group compared with that of both the normal group and control group(P

Objective To evaluate the value of single leaflet replacement of bovine pericardium in the treatment of aortic valve insufficiency using transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods TTE and TEE examination were performed for 25 cases pre-operation,postpump intraoperative and 3-6 months after the operation,to judge the structure and the regurgitation of the aortic valve.And the inside diameter of left atrium(LA)and left ventricle(LV)in the same plane and the same phase were also been measured.Results The degree of aortic regurgitation(AR)before operation were significantly different with that postpump intraoperative(P＜0.001)evaluated by TEE.There was no difference in the degree of AR by postpump intraoperative TEE and those of AR by TTE 3-6 months after surgery(P＞0.1).The inside diameter of LA[(3.80±1.37)em]and LV[(5.75±1.32)cm]before repair were larger than those 3～6 months after surgery[LA(3.19±0.90)cm,LV(4.72±1.19)cm,P＜0.001].Conclusions The replacement of single aortic valve with bovine pericardium to treat aortic valve insufficiency is a good alternative for patients with satisfactory short-term results,but long-term results are not clear.

AIM: To improve the prevent efficacy of peptide p277 in autoimmune diabetes. METHODS: The recombinant expression plasmid pET28-Hsp65-6×p277 was constructed by inserting 6×p277 which were amplified by PCR into the vector pET28-Hsp65. The plasmid pET28-Hsp65-6×p277 was transformed into E.coli BL21 (DE3) and the fusion protein (Hsp65-6×p277) was expressed effectively as soluble protein after inducing by lactose. The fusion protein was purified and then used to immunize 4-week old female NOD mice with three times of i.n. inoculations in the absence of adjuvants. Serum samples from the immunized mice were collected at monthly interval. The concentrations of blood glucose and antibodies were measured by automatic analyzer. RESULTS: Administration with the Hsp65-6×p277 to NOD mice could prevent the development of diabetes. CONCLUSION: The fusion protein Hsp65-6×p277 might be further developed to a vaccine against insulin-dependent diabetes mellitus.

Objective To investigate the effect of comprehensive psychological intervention on cooperation degree with intravenous infusion of preschool children. Methods 240 children patients with intravenous infusion were divided into the observation group and the control group with 120 cases in each group.Children patients in two groups were all given venipuncture by two nurses who had more than 5 years of working experience,skilled venipuncture technique and were good at doing mental work for children.The control group was given intravenous infusion directly after venipuncture without giving any psychological intervention.The observation group was given comprehensive psychological intervention before venipuncture.The different psychological behavioral reactions during the venipuncture were evaluated.The cooperation degree and the first-time success rate of venipuncture for the two groups were taken for statistics. Results The psychological behavioral reactions of the observation group were as followed:the active type was 51.67％,the tension type was 30.83％,and 7.50％ for the type of fear,the compulsive type was 10.00％.Compared with the control group,the difference was significant.The cooperation degree with intravenous infusion was 82.50％,the difference was significant compared with the control group.The first-time success rate in the observation group was 86.67％,higher than 75.83％ in the control group. Conclusions Psychological interventions according to the behavior and psychological reaction of preschool children with intravenous infusion can alleviate the negative emotions and improve the cooperation degree of preschool children.

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.

Chinese Physician Declaration and Medical Professionalism in the New Millennium-Physician De-claration in the United States and European countries are two significant documents that promote and cultivate phy-sicians′professionalism. Researches showed that the two declarations were basically the same in the background and guiding ideology. However, influenced by the historical tradition, cultural characteristics, medical and health system, medical science technological development, and social psychological factors, there exists difference in terms of perceive and practice. The differences manifest in the comprehension and grasping, ethnical theory basis, the nature and the degree of standard abilityand practice guarantee of physicians′professionalism. Therefore, study on the differences between the two declarations is beneficial to the construction of physicians′professionalism in our country.

OBJECTIVE:To regulate the management of operation drug and promote medication security. METHODS:Based on the relevant principles in the standard of JCI,the practice about establishment of operation pharmacy in our hospital was intro-duced,and it were stated from two aspects which included working mode and effects. RESULTS:The working mode were format-ed by definiting the duties and working flow of pharmacist,anesthetist and liaison man. The establishment of operation pharmacy, which brought operation drugs into the unified management system of our hospital,saved manpower and improved work efficien-cy,refined the management of drugs in all aspects,improved the management of drug safety level,strengthened drug expiration date management,implemented the reporting of adverse drug reactions(event)and collecting of medication(potential)errors. The established mode conformed to the relative standard of JCI including preparation,grant,storage and collection of ADR of drug. CONCLUSIONS:The established drug management of operation pharmacy promotes standardized administration of surgery drug, which guarantees the drug use safety of patients.

Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.

Objective:To study the 3D accuracy of 4 impression materials.Methods:A metal mould with a custom tray was prepared for the measurement.Impression samples of 2 alginate and 2 rubber impression materials were prepared in the metal mould(n =3)re-spectively.The length of three tagged lines,along X,Y,Z axis directions of the samples was measured with a 3D optical scanner.Re-sults:120 min after sampling the variable rates of the length along X,Y,Z axis of Zhermark alginate samples were 3.615%,3.037%and 2.836%,those of CAVEX alginate samples were 2.836%,3.358% and 4.276% respectively;8 h after sampling the variable rates of Impregum Penta polyether rubber samples were 0.039%,0.071% and 0.057%,those of ExpressXT Penta H addition-curing silicone rubber samples were 0.033%,0.088% and 0.084% respectively.Conclusion:The variable rates of the 4 impression materi-als are in accordance with ISO1563∶1990.The variable rate of alginate impression material is greater than that of rubber.