Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic ; genetics ; Humans ; Mutation

OBJECTIVE:To provide reference for improving the national essential medicine system and satisfy the needs of ra-tional use from the public METHODS:The current situation and existing problems in the national essential system were described by literature research and comparative analysis,and recommendations were presented. RESULTS:The implementation of essential medicine system has certain effects in China,but there still remains some problems,involving too much variety of essential medi-cines,high price and others,and limitation of the use of medicine and distribution in primary medical institutions. CONCLU-SIONS:Government should further simplify the essential medicine lists,reduce prices,strengthen policy support for primary medi-cal institutions,deepen the national essential medicine system and protect the public's rational drug use.

Objective To evaluate the performance of enzyme linked immunosorbent assay (ELISA) kit in detection of Hepatitis B virus(HBV) markers by using improved and optimized method ,so as to provide a practical and feasible method and reagents for clinical laboratory .Methods ELISA test was used for the detection of HBV markers .The gradient dilution method was used to e‐valuate the lower limit .The verifiation of cut off value was carried out based on clinical and laboratory standards institute (CLSI) EP12‐A2 document .Samples with cut off values were collected to evaluate the precision ,including repeatability and intermediate precision .The coincidence rates were counted through comparing the results of ELISA with those of external quality assessment and those detected by using Abbott i4000SR chemiluminescence instrument .Results The lower detection limit of HBsAg ,HBsAb , HBeAg ,HBeAb and HBcAb were 0 .2 IU/mL ,20 mIU/mL ,1 NCU/mL ,0 .75 NCU/mL and 0 .05 NCU/mL respectively .The cut‐off value(C50 )± 20% concentration included the concentration range between C5 and C95 .The within‐run coefficient of variation (CV)≤15% ,in sandwich method the between‐run CV≤25% ,in competition method the between‐run CV≤35% .The positive and negative coincidence rates in accuracy and comparing with i 4000SR all were more than 95% and all κ>0 .75 .Conclusion ELISA tests for HBV markers in our laboratory could meet the requirements of the detection performance and clinical needs .

Objective To evaluate the clinical effects of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) on lumbar spondylolisthesis and lumbar instability in Chinese patients.Methods Literatures about clinical effects of TLIF and PLIT on lumbar spondylolisthesis and lumbar instability were collected from Chinese academic literature database (CNKI),Chinese biomedical literature database (CMBdisc),Wanfang database and Chinese journals of orthopedics.Data from those literatures including operation time,bleeding volume,surgical complications,postoperative interspace height,visual analog scale (VAS) score,Oswestry Disability Index (ODI) and improvement rate of Japanese Orthopedic Association (JOA) score were analyzed by Stata SE 11.2 software.Results A total of 12 literatures met the inclusion criteria and 1041 cases were included (PLIF group,n=520; PLIF group,n=521).The operation time was longer in PLIF group than in TLIF group [standardized mean difference (SMD)=1.26,95％CI:0.58-1.94,P＜0.001].The bleeding volume was more in PLIF group than in TLIF group SMD=1.70,95％CI:0.94 2.46,P＜0.001).The surgical complications were more in PLIF group than in TLIF group (SMD=4.50,95％CI:2.65-7.64,P＜0.001).There were no statistical differences in postoperative interspace height,VAS score,ODI score,improvement rate of JOA score and fusion rate between the two groups [SMD=-0.07,-0.07,0.15,1.43,95％CI:-0.44-0.30,-0.27-0.13,-0.06-0.35,0.75-2.73,0.63-2.15,respectively,all P＞0.05].Conclusions TLIF has significant advantages on decreasing operation time,bleeding volume and risk of surgical complications as compared with PLIF.TLIF and PLIF have the same clinical efficacy on restoring and maintaining postoperative interspace height.

The effect of acute ischemia on the electrophysiological characteristics of the three layers myocardium of canine in vivo was investigated. Twelve canines were divided into two groups randomly: acute ischemia (AI) group and sham operation (SO) group. By using the monophasic action potential (MAP) technique, MAP and effective refractory period (ERP) of the three layers myocardium were measured by specially designed plunge needle electrodes and the transmural dispersion of repolarization (TDR) and transmural dispersion of ERP (TDE) were analyzed. The results showed that in the AI group, MAP duration (MAPD) was shortened from 201.67 +/- 21.42 ms to 169.50 +/- 13.81 ms (P < 0.05), but ERP prolonged to varying degrees and TDE increased during ischemia. In the SO group, MAPD and ERP did not change almost. Among of the three layers myocardium of canine, MAPD was coincident in two groups. It was concluded that during acute ischemia, MAPD was shortened sharply, but there was no significant difference among of the three layers myocardium. The prolonged ERP was concomitant with increased TDE during acute ischemia, which may play an important role in the occurrence of arrhythmias induced by acute ischemia. These findings may have important implications in arrhythmogenesis.
Action Potentials/*physiology ; Electrodes ; Heart/physiopathology ; Myocardial Ischemia/*physiopathology ; Myocardium/*metabolism ; Random Allocation ; Refractory Period, Electrophysiological/*physiology

Objective To investigate the clinical value of velocity vector imaging (VVI) in the assessment of cardiac torsion in fetuses with gestational diabetes mellitus(GDM).Methods Digital dynamic four-chamber views of 98 fetuses with gestational diabetes mellitus and 135 normal fetuses were collected and analyzed using VVI.Left ventricular(LV) peak apical rotation of endocardium and epicardium at basal and apical level were measured,LV peak torsion was calculated.Results 140 of 233 cases were analyzed successfully.Direction of LV peak apical and basal rotation of endocardium and epicardium in fetus could be clockwise or counter clockwise,however apical and basal level was opposite.LV peak apical and basal rotation of endocardium and epicardium in fetus were stable throughout gestation ( P ＞ 0.05).LV peak rotation of endocardium was higher than that of epicardium in both apical and basal level.The peak rotation　in apical level of endocardium and epicardium was higher than that in basal level( P ＜0.05).LV peak　torsion of endocardium was significantly higher than that of epicardium( P ＜0.05).Compared with normal　group,LV peak rotation of endocardium and LV peak torsion in fetus with GDM were higher( P ＜0.05).　Conclusions VVI can measure the LV rotation and torsion parameters,and evaluate the cardiac function of　GDM fetus.

Objective To establish the normative data of the 2D and 3D ultrasound (US)measurements of the developing fetal thymus and comparing the 2DUS and 3DUS measurements of the fetal thymus. Methods The normal fetuses' thymus of 567 cases were assessed, and maximum transverse diameter(MTD),antero posterior diameter (APD), suprainferior diameter (SID), maximum transverse area (MTA) were measured by 2DUS,and thymic volume(TV) was measured by 3DUS. Results 2DUS,3DUS assessments of the fetal thymic MTD, APD, SID, MTA and TV were possible in 541 of 567 normal singletons. The fetal thymic 2D diameters/area and 3D volume grow with the gestational age(GA) in linear correlation. The 3D-US TV measurements and GA was significantly higher than that of any individual 2DUS measurements and GA ( P ＜0.05). Conclusions This study presents the normative data of the 2DUS and 3DUS measurements of the developing fetal thymus. 3DUS fetal thymus volume is more significantly correlated to GA than the other 2DUS measurements, which indicates 3DUS measurement of the fetal thymus is more accurate than that of 2DUS.

Objective To study MRI findings of pancreatic ducts of piglets with chronic pancreatitis (CP) induced by pancreatic duct ligation and analyze the relationship between pancreatic duct changes in piglets with CP and the pathological severity of CP. Methods Thirty healthy piglets were included in this study. Five piglets were randomly selected as normal control group, and the remaining 25 piglets were served as the experimental group. The duct ligation operations were performed on experimental group. After 2 to 18 weeks, pancreas and pancreatic ducts were observed on MRI. Then the pancreas was removed and graded into three types by histopathology. The relationship between the diameter of pancreatic duct or the pancreatic branch displaying rate and the severity of CP was analyzed by Spearman correlation coefficient. Results CP was found in 21 piglets( 84. 0% ) in the experimental group including mild ( n = 7 ), moderate ( n = 8 ) and severe( n = 6) pancreatitis. Pancreatic ducts were shown in mild CP and the edge of pancreatic ducts was irregular in three cases. The dilated RPD, LPD and MPD constituted the "person" form in moderate and severe CP. The diameter of pancreatic ducts was(0. 9 ±0. 3)mm, (2. 9 ± 1.4)mm and (4. 8 ± 1.2)mm in mild, moderate, and severe CP respectively. The expansion extent of pancreatic ducts was correlated with the severity of CP of piglets (r = 0. 837, P ＜ 0. 05). The pancreatic branch displaying rate increased with the increase of the severity of CP ( r = 0. 990, P ＜ 0. 05 ); the displaying rate was 0/7 for mild, 3/8 for moderate, and 5/6 for severe CP. Conclusions The dilated pancreatic ducts with "person" form in piglets with obstructive CP created by pancreatic duct ligation. The pancreatic duct changes on MRI reflect the severity of CP of piglets.

AIM: To construct a recombinant hEGF-hbFGF(78-154aa)fusion protein, which not only has the heparin-binding ability, but also promotes the growth of the cells, and to express the fusion protein in E. coli expression system with high expression level.METHODS: hEGF gene was joined with 231 bp fragment coding hbFGF(78-154aa) and expressed in E. coli. The fusion protein was purified using affinity chromatography of heparin-Hyper D and analyzed with western blot. The pI value and the biological activity were both assayed.RESULTS: The fusion protein was expressed in a high expression level of about 30% of the total cell protein, as estimated by SDS-PAGE. Western analysis results showed that the antigenicity of fusion protein was similar to hEGF. Fusion protein could not only bind heparin but also promote the growth of 3T3 cell. The pI value of fusion protein was 5.2.CONCLUSION: The recombinant hEGF-hbFGF(78-154aa) fusion protein possessed the characteristics of both hEGF and hbFGF. This new-designed protein would become a good object for the research on the relationship between the structure and the function of the growth factor.

Objective To explore the prevention and treament of the complications for laparoscopic cholecys- teetomy(LC).Methods Clinical datas of 600 eases undergoing LC were collected and analyzed retrospectively.Re- suits Among all the cases,249 cases were diagnosed as cholecystolithiasis,284 cases as gallbladder and 67 cases as chronic cholecystitis.The mean duration of operation was 42min.Conversions to open cholecystectomy were needed in 18 cases(3%).Complications took place in 6 cases(0.5%),involving 2 cases of abdominal bleeding and 1 case of bile leakage.There was no bile duct injury and death.Conclusion Strictly-controlled indications,skilled performance and timely open exploration are very important to prevent and reduce the complications.