years ago, Noma first applicated the patch\|clamp technique to CN\|treated mamammalian heart cells,evealed specific K + channels which were depressed by intracellular ATP at level greater than 1 mM.He suggested the ATP-sensitive channels are important for regulating cellular energy metabolism in the control of membrane exitability.Recent studies supported the hypothesis and suggested that ATP-sensitive channels play an important role in hypoxia,myocardial ischemia/reperfusion and is chemic preconditioning.

AIM: To determine the effects of phospholipase A 2 (PLA 2) and K ATP on rat ischemia/reperfusion(I/R)-induced arrhythmia. METHODS: Myocardial ischemia and reperfusion were produced by occlusion and reirregation of the left anterior descending artery(LAD). An inhibitor of PLA 2, 5,5-dithio-bis(2-nitrobenzoic acid) (DTNB) (16 mg /kg), a K ATP opener pinacidil (0.2 mg/kg), a K ATP blocker glibenclamide (0.3 mg/kg) was used 5 min prior to 10 min regional ischemia and 10 min reperfusion. RESULTS: DTNB (16 mg/kg) reduced the scores of arrhythmia, creatine kinase (CPK) and lactate dehydrogenase(LDH) (P

Purpose To analyze the relevance between magnetic susceptibility weighted imaging intratumoral susceptibility signal intensity (ITSS) and diffusion weighted imaging apparent diffusion coefficient (ADC) with different grade gliomas, and to explore the value of ITSS and ADC in the preoperative grading of gliomas. Materials and Methods Fifty-two cases of glioma patients underwent magnetic susceptibility weighted imaging and diffusion weighted imaging scans, all subjects were divided into low-grade glioma group (18 cases) and high-grade glioma group (34 cases) according to brain tumor grading standard, correlation between ITSS grade and ADC values with tumor grade was analyzed, and ROC curve was used to evaluate the diagnostic efficacy of ITSS and ADC values in the grading of brain glioma. Results Difference of ITSS grading was statistically significant (χ2=27.458, P<0.01) among different grade gliomas;difference of ADC values between different grade gliomas was also statistically significant (U=689.000, P<0.01); there was a significant positive correlation (r=0.727, P<0.001) between ITSS grading and pathological grading, ADC values were significantly negatively correlated (r=-0.622, P<0.001) with tumor grading, and ITSS grading was significantly negatively correlated (r=-0.617, P<0.001) with ADC values among different grade brain gliomas. With pathological grading as reference standard, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ITSS for preoperative glioma grading was 85.29%, 77.78%, 82.69%, 87.88%and 73.68%, respectively, while the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ADC values for preoperative glioma grading was 97.06%, 88.89%, 94.23%, 94.29%and 94.12%, respectively. Conclusion There is a significant correlation between ITSS grading, ADC values and pathological grading of gliomas, the combination use of ITSS and ADC values can significantly improve the preoperative grading accuracy of brain glioma.

0.05).Conclusion A silent C161 T polymorphism of PPAR? gene might not be genetic markers of osteoporosis,which might not be employed to screen the high risk population of osteoporosis in Chinese women of Han nationality.

Objective By exploring the state of residents' living condition, it is helpful to promote the living condition of residents and improve the quality of medical services. Methods A qualitative re-search was conducted on 13 residents in 4 hospitals in Beijing by depth interview during April to May 2016, and the data were collected and analyzed by using Colaizzi seven step method. Results In terms of work, the residents had specific work, and the interpersonal relationship was more harmonious. In learning, residents were able to take the initiative to learn, and hoped to get more help in scientific research. In life, residents faced multiple pressures from the economy and the family. In the subjective cognition, the cogni-tion of resident was rational and objective. Conclusion The residents' work shows a heavy workload, and while working the residents need to take the study and the life pressure into account. And the residents can rationally recognize their role. To improve the living status of the resident physician, we need to integrate multiple forces, to promote the integration of live doctors into the hospital culture, and enhance their sense of existence. We also need to improve the construction of the system and improve the protection of live training physicians to enhance their sense of security. Most important of all, the whole society should pay more attention to the living condition of the residents and enhance their sense of access.

Objective To evaluate the feasibility and safety of trans-umbilical NOTES to perform abdominal adhesion lysis using a flexible endoscope.Methods A 42-year-old female was admitted to our hospital with a complain of abdominal pain due to abdominal adhesion after hysterectomy.A gastroscope (GIF-2TQ260M,Olympus)was inserted into the peritoneal cavity through an incision(1.5 cm)of the umbilical opening.Pneumoperitoneum was established by the endoscopic air supply system using CO2 instead of air.Abdominal exploration showed that omentum and bowel were stuck to the scar of the low central peritoneum incision.Separation of the abdominal wall adhesions was performed with an IT knife and a hook knife respectively.After most of the adhesions were separated,bleeding was found from the isolated adhesion wound of the omentum and bowel.Hemorrhaged blood vessel was difficult to be found with the flexible gastroscope.Then a 5 mm Trocar was placed at the left lower abdomen and laparoscopic assistance was adopted to search the bleeding point.However,no bleeding site was found and the hemorrhage was stopped automatically.Residual adhesion lysis was conducted with laparoscopic assist.After the procedure,the umbilical incision was closed with absorbable suture,but lower left abdominal incision was left without suturing.Results The operation time was 40 minutes.The patient suffered from minus pain from the umbilical incision without need of treatment.She had normal diet and got out of bed after reconsious.She was discharged 2 days after the procedure without any complaints.Conclusion Trans-umbilical NOTES using a flexible endoscope for peritoneal adhesion lysis is safe and feasible,but the effectiveness remains to be further confirmed.

Objective To study the relationship between the stenosis content of carotid artery and the degree of homocysteine (Hcy) by analyzing the level changes of Hcy in ischemic stroke patients.Methods One hundred and thirty patients of carotid artery stenosis with ischemic stroke were divided into four groups based on the degrees of carotid artery stenosis determined by ultrasound Doppler flow imaging:the slight stenosis group (32patients),the moderate group (35 patients),the severe group (33 patients) and the total occlusion group (30 patients).Meanwhile,30 healthy people were chosen as the control group.The levels of serum homocysteine (Hcy),total cholesterol (TC),triglyceride (TG) and low density lipoprotein (LDL) of each group were measured,and the results were compared with those of the control group.Results It was found that the serum Hcy level in ischemic stroke group were significantly higher than that in the control group (P＜0.05),whereas the variations ofTC,TG,HDL and LDL levels between the ischemic stroke group and the control group could be neglected (P＞0.05).An obviously increased order of serum Hcy levels was observed as the following,the control group,the slight stenosis group,the moderate group,the severe group as well as the total occlusion group.The difference between every two groups was statistically significant (P＜0.05).The level of serum Hcy was positive correlated to the content of carotid artery stenosis (r=0.835,P＜0.05).However,no correlation was found between the carotid artery stenosis and each level of TC,TG and LDL (r=0.031,0.012,0.018,respectively,P＞0.05).Conclusions The serum Hcy level is closely related to the degree of carotid artery stenosis,and high level Hcy is suggested to be one of major risk factors for ischemic stroke.

Background The current epidemiology study had shown the prevalence of age and sex adjusted dry eye was higher in patients with diabetes than population without diabetes.Further researches demonstrated that the tear film disturbance is common after the phacoemulsification or photocoagulation in the eyes of diabetic patients.Objective The aim of this study was to characterize the clinical features of tear film instability in diabetes patients.Methods One hundred and sixty-two patients with tear-film abnormality referred to Tongren Eye Center from January 1,2010 to September 1,2010 underwent questionnaire about diabetes and other diseases,BUT,Schirmer test.Tear film instability was diagnosed as abnormality of either Schirmer test or BUT and showed as M ( Q25,Q75 ).The right eyes of 162 dry eye patients meeting with the including criteria were enrolled.The patients were assigned to two groups according to with ( 80 patients) or without ( 82 patients) diabetes mellitum.DEQ questionnaire were scored.The percentage of cases with meibomain gland abnormal score ＞ 1 was calculated.Mann-Whitney U analysis and Chisquare analysis were used to compare the difference between the two groups.Results The Schirmer test in diabetic group was 8 ( qualities:5,9 )mm and was longer than 6 ( qualities:5,7 ) mm in non-diabetic patients ( U =2452,P =0.00).The result of BUT test was 3 ( qualities:2,4 ) seconds in diabetic patients and was shorter than 4 (qualities:3,5) seconds in non-diabetic patients( U=2104,P＜0.01 ).The DEQ score of diabetic patients was 15 ( qualities:1 0,19,which was less than21 ( qualities:19,23.25 ) in non-diabetic patients.51.2 ％ ( 41/80 ) diabetic participants and 32.9％ (27/82) nondiabetic participants appeared meibography ( grade larger than 1 ) (x2 =16.07,P=0.00).The percentages of dry eyes were 51.2％ (41/80) and 93.9％ (77/82) respectively in diabetes and nondiabetes groups(x2 =37.24,P＜0.01 ).No significant correlation was found between the diabetes course and DEQ score or meibography( r =0.16,P =0.16 ; r =0.10,P =0.36 ).Conclusions Diabetes patients with tear film instability have longer Schirmer test results,shorter BUT,more severe meibomain glands damage and lower DEQ scores.The dry eye symptom is lack in the diabetic patients though appearing the tear film and meibomain glands damage.Therefore,more attention should be given to ocular surface health in diabetes patients.

ObjectiveTo investigate the TCM pathogenesis of male infertility through analyzing the characteristics of the pulse of oligoathenoteratospermia patients.MethodsRetrospect analysis was performed to get the pulse characteristics of oligoathenoteratospermia patients.The relation between the regularity of pulse and oligoathenoteratospermia was studied.ResultsThe pulse of oligoathenoteratospermia patients mainly presented at the both guan pulses and the both chi pulses,especially at the left guan pulse and the right chi pulse with thready pulse,wiry pulse,slippery pulse,uneven pulse,and moderate pulse,besides there were some differences of pulse between oligospermia and asthenozoospermia.ConclusionThe liver and kidney were the main location of oligoathenoteratospermia,and the main pathogenesis was asthenia of kidney,blood stasis,and dampness-heat.

Prone position ventilation has become an important part of lung protective ventilation in acute respiratory distress syndrome (ARDS) patients. Timely and appropriate implementation can improve the mortality of such patients. The same is true for patients with critical coronavirus disease 2019 (COVID-19) patients, but safety assessment, control of implementation details and prevention of complications still need to be further standardized during the practical procedure of prone position ventilation. The purpose of this paper is to explain the specific requirements and key points of prone position ventilation in critical COVID-19 patients, in order to promote the application of prone position ventilation in the treatment of patients with critical COVID-19 and reduce the occurrence of related complications.