Objective To evaluate atrial septal defect (ASD) occlusion employing a small right anterior thoracotomy approach. Methods A total of 21 patients with ASD underwent general anesthesia and 2 -3 cm incision was made in the fourth right intercostal space. Utilizing transesophageal or transthoracic echocardiography, the occluder was released using a monotube unit. Results All patients were occluded successfully. No patient required open surgery utilizing extracorporeal circulation. There were no major complications and no evidence of residual atrial shunt. Conclusion ASD occlusion via a minimal surgical incision is safe, less invasive, and has excellent outcomes.

Objective To evaluate the clinical efficacy and adverse effects of CAG regimen in treatment of primary, refractory and relapsed acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS), and analyse the factors influencing long-term survival. Methods Sixty-one patients with AML ( primary, n = 27; refractory, n = 18; relapsed, n = 16) and 9 patients with MDS were treated with CAG regimen. Examinations on liver and renal function, electrocardiogram and bone marrow cytology were performed before and after treatment, and adverse effects of CAG were observed. Short-term efficacy was evaluated based on clinical manifestation, peripheral blood and bone marrow cytologic examinations. Patients were followed up, overall survival ( OS) and disease free survival ( DFS) were analysed, and long-term efficacy of CAG regimen was evaluated. The factors influencing long-term survival were analysed by Log-rank test of survival curve. Results After a course of treatment by CAG regimen, the total effective rate was 71% , and 34 patients (49%) experienced complete remission. The median time of follow up was 45 months, the median OS was 28 months, and the median DFS was 23 months. Age, level of lactate dehydrogenase (LDH), remission condition after a course of treatment by CAG regimen and adoption of HD-Ara-C regimen as consolidation treatment were influencing factors for OS and DFS. The dominant clinical adverse effects were bone marrow depression, with 13 d as the median duration of agranulocytosis ( neutrophil <0.5 ×10~9/L) and 9 d as the median duration of thrombocytopenia (platelet <20 ×10~9/L). Conclusion CAG regimen may lead to favourable therapeutic effects in treatment of primary, refractory and relapsed AML and high risk MDS, and may yield less adverse effects and better long-term therapeutic effects. Age, level of LDH, remission condition after a course of treatment and adoption of HD-Ara-C regimen as consolidation treatment are dominant influencing factors for survival.

Objective To explore the features and neural generators of the events related potentials ( ERP) component N400, elicited by congruent and incongruent ending sentences, in first episode schizophrenia patients. Methods N400 was elicited by 76 congruent (31) or incongruent (45) ending Chinese sentences paradigm, and recorded by WJ-1 ERP instruments in 56 first episode schizophrenia. The neural generators of N400 different wave in 105 -615 ms time windows were analyzed by Brain Electrical Activity Mapping software. Results① The N400 latencies were significantly longer and amplitudes significantly higher in incongruent conditions than in congruent conditions in first episode schizophrenia (P < 0.05 or P <0.01).② N400 elicited by Chinese sentences distributed on frontal, parietal, occipital and temporal regions, and had a clear waveform. ③ The main brain areas activated by N400 were frontal areas in 345 -405 ms time windows, and central areas in 420 - 570 ms time windows. Conclusion N400 elicited by Chinese sentences are multi-generated in first episode schizophrenia, especially in frontal area.

Objective To investigate the gene expression pattern of metabotropic glutamate receptor- Ⅰ ( mGluR-Ⅰ ), D-p-hydroxyphenylglycine (DHPG) -induced rat hippocampal slice epileptic seizure model. Methods In vitro rat hippocampal sclice was continously perfused with artificial cerebrospinal fluid containing 50 μmol DHPG, and epileptic seizure model was established (DHPG group, n = 3). cDNA microarray chip was applied to explore the gene expression pattern in DHPG group, the differentially expressed genes were screened in comparison with control group ( n = 3), and functional classification analysis was conducted. Results There were 206 up-regulated genes and 489 down-regulated genes, among which 67 up-regulated genes and 86 down-regulated genes differentially expressed by 1.5 fold, 6 up-regulated genes differentially expressed by more than 2.0 folds, and 25 down-regulated genes differentially expressed by less than 0.5 fold. Functional classification analysis revealed that differentially expressed gene function involved in protein binding (19 genes), molecular function, calcium ion binding and nucleotide binding. Conclusion Epileptic seizure and roles of mGluR-Ⅰ agonist may be related to various genes, which is a complicated process. This experiment provides evidences for further researches.

Recurrent spontaneous abortion (RSA), which affects 1% to 5% of women of reproductive age, is difficult to treat in the clinical setting. In the investigations of iramunopathogenesis, diagnosis and treatment of RSA since the late 1980s, it was found that RSA was associated with abnormal maternal local or systemic immune response, the pathogenesis of autoimmune RSA was mainly associated with antiphosphlipid antibody (APA), while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance. Systemic etiological screening process and diagnosis systems of RSA with immune type were developed, and anticardiolipin (ACL) + β_2-GP1 combining multiple assay for effective diagnosis of RSA with immune type was initially established. According to dynamic monitoring clinical parameters before and during gestation, low-dose, short-course and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA. With immune type were initiated. The outcomes of the offsprings of patients with RSA were followed up, and the safety and validity of the therapies were confirmed. The research achievement leads to great progress in the diagnosis and treatment of RSA in China.

Helicobacter pylori (H. Pylori) infection has been an established risk factor for gastric cancer identified by World Health Organization. H. Pylori triggers chronic inflammation of gastric mucosa and induces host cells to release various cytokines, some of which might lead normal epithelial cells to transfer to gastric cancer. Expression of interleukins in gastric mucosa experiences significant changes after H. Pylori infection. Interleukins play different roles in carcinogenesis and development of gastric cancer. This article briefly reviews the research advances of roles of interleukins in carcinogenesis and development of gastric cancer.

Protein post-translational modifications are important ways to regulate protein function and cell behavior, and oxidative stress directly influences protein post-translational modifications. P53 protein has various post-translational modifications, which can be quickly regulated under stress conditions to activate a series of downstream target genes and facilitate the p53 function diversity. The effects of oxidative stress on p53 post-translational modifications of phosphorylation, ubiquitination, sumoylation, acetylation and methylation are introduced in this paper.

Objective To identify the determinants of average length of stay of 16 upper first-class general hospitals from 2000 to 2007.Methods Relative data of 16 upper first-class general hospitals from 2000 to 2007 were collected, and descriptive analysis and multiple linear regression analysis were employed to explore the determinants of average length of stay. Results Operation ratio and days before operation of inpatients, ratio of salary to medical income, ratio of doctors to nurses, successful rescue rate in emergency, number of operation tables and staff had impact on average length of stay. Conclusion Resource allocation should be optimized, health care quality be enhanced, reasonable salary scheme be designed, and rational medical insurance policies be implemented in hospitals to shorten average length of stay.

Objective To explore the diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease ( CAD). Methods Eighty-six patients suspected of CAD were divided into low risk group, intermediate risk group and high risk group according to estimated pretest probabilities of CAD. All patients underwent coronary angiography, 64-slice spiral CT and exercise treadmill test. With coronary artery stenosis rate >50% as positive findings, the sensitivity, specificity, positive predictive value ( PPV), negative predictive value ( NPV) and accuracy of 64-slice spiral CT and 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were calculated. Results With coronary angiography as the "golden criteria", the sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT in diagnosis of CAD were 95.2% , 88.6% , 88.9% , 95.1% and 91.9% , respectively. The sensitivity of low risk group, intermediate risk group and high risk group was 100% , 100% and 92.6%, specificity was 94.4% , 94.1% and 66.7%, PPV was 80.0%, 91.7% and 89.3%, NPV was 100% , 100% and 75.0%, and accuracy was 95.5% , 96.4% and 86.1%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were 97.6%, 97.7%, 97.6%, 97.7% and 97.7%, respectively. Conclusion 64-slice spiral CT combined with exercise treadmill test works well in screening CAD, especially for those with a low or intermediate estimated pretest probability.

Objective To study the levels of soluble endoglin (sEng) in peripheral blood and intervillous space blood of patients with preeclampsia, and analyse the correlation between levels of sEng and clinical performance. Methods Levels of sEng in peripheral blood and intervillous space blood of 22 patients with preeclampsia (preeclampsia group, 12 cases of severe preeclampsia and 10 cases of mild preeclampsia) were detected by ELISA, and the correlation between levels of sEng and blood pressure, 24 h urine protein and fetal birth weight was analysed. Twenty-two normal pregnant women were served as control group. Results The sEng levels in peripheral blood and intervillous space blood of preeclampsia group were significantly higher than those of control group [ (31.89 ± 8.80) ng/mL vs (5.24 ± 1.60) ng/mL, P < 0.01; ( 37.74 ± 7.12) ng/mL vs (6.63 ±1.76) ng/mL, P < 0.01]. In preeclampsia group, the sEng levels in peripheral blood and intervillous space blood of severe preeclampsia were significantly higher than those of mild preeclampsia (P <0.01). In preeclampsia group, the sEng level in peripheral blood was significantly correlated with that in intervillous space blood of preeclampsia group (r = 0.876, P < 0.01) , neither was significantly correlated with blood pressure (P > 0.05), both were significantly correlated with 24 h urine protein (r = 0.729, P < 0.01; r = 0.743, P < 0.01) , and both were significantly correlated with fetal birth weight (r = - 0.736, P < 0.01; r = - 0.707, P < 0.01). Conclusion Levels of sEng in peripheral blood and intervillous space blood of patients with preeclampsia are significantly higher than those of normal pregnant women, and the levels of sEng are significantly correlated with the clinical performance of preeclampsia.