Objective To establish children's independent normal reference intervals of five coagulation indexes in Chongqing,in order to better provide references for clinic.Methods The plasma samples of 5 119 healthy children were collected and used to detecting prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen (FIB),thrombin time (TT) and D-Dimer (D-D) via Sysmex CS5100 and Sysmex CSA2000.According to ages,the children were divided into 6 groups:newborn (at 0 to less than 15 days of age),newborn (at 15 days to less than 1 month of age),infant (at 1 to less than 7 months of age),children (at 7 months to less than 3 years of age),children (at 3 to less than 7 years of age),children (at 7 to 15 years of age),and comparatively analysed.For normal distribution data,(x)± 1.96s was used to calculate the reference intervals;while for skewness distribution data,the reference intervals was calculated by 95 ％ reference interval according to the percentile of P2.5 and P97.5.Results The normal reference intervals of five coagulation indexes in this clinical laboratory were as follows:PT 11.1-20.2 s (at 0 to less than 15 days of age),10.7-15.8 s (at 15 days to less than 1 month of age),9.9-13.5 s (at 1 month to 15 years of age);APTT 28.8-91.6 s (at 0 to less than 15 days of age),33.3-64.2 s (at 15 days to less tha 1 month of age),24.0-53.2 s (at 1 to less than 7 months of age),21.2-39.2 s (at 7 months to less tha 15 years of age);FIB 1.45-3.52 g/L (at 0 to less than 3 years of age),1.50-3.52 g/L (at 3 to 15 years of age);TT 15.4-26.3 s (at 0 to less than 15 days of age),14.9-21.4 s (at 15 days to less than 7 months of age),14.7-20.1 s (at 7 months to less than 3 years of age),14.9-19.3 s (at 3 to 15 years of age);D-D 0.1-5.1 mg/L (at 0 to less than 15 days of age),0.2-2.2 mg/L (at 15 days to less than 1 month of age),0.1-1.1 mg/L (at 1 to less tha 7 months of age),0.1-1.4 mg/L (at 7 months to less than 3 years of age),0.1-1.3 mg/L (at 3 to less than 7 years of age),0-1.0 mg/L (at 7 to 15 years of age).Conclusion The normal reference intervals of five coagulation indexes,including PT,APTT,FIB,TT and D-D,are established,which provide more accurate references for the diagnosis of related diseases in infants and children in this area.

Objective To establish the platelet antigen panel for identifying the specificity of platelet antibodies which cause platelet transfusion refractoriness and neonatal alloimmune thrombocytopenia and provide evidence for clinical therapy and platelet genotyping research.Methods Based on the frequency distribution of human platelet alloantigen (HPA)-1 to HPA-16 gene in China, the frequencies of HPA-1 to HPA-6,HPA-15 alleles in blood group O donors were genotyped by the polymerase chain reaction with sequence-specific primers (PCR-SSP) method, and suitable donors were chosen to establish platelet-specific antigen panel.Using the established platelet-specific antigen panel, the specificity of platelet antibodies caused by alloimmune reaction was identified by using simplified sensitized erythrocyte platelet serology assay (SEPSA).Results Eleven ptatelet donors with blood group O were chosen to establish platelet-specific antigen panel which can identify specificity of HPA-1 to HPA-6, HPA-15 antibodies.One case of HPA-4b (Penb) and two cases of HPA-15a (Govb) platelet specific antibodies were detected in 1 120 samples.Conclusion Identifying the specific platelet antibodies using platelet specific antigen panel has profound significance on increasing the safety and effectiveness of clinical platelet transfusion and prevention of neonatal alloimmune thrombocytopenia.

Objective To establish a rat model of middle cerebral artery occlusion (MCAO)by blockage or obstruction of middle cerebral artery. NO precursor L-Arginine (L-ARG) and NO donator Nitroglycerine (NG)are administrated from intraearotid arteries. DWI and PWI are applied to evaluate blood circulation and brain damage of the effected region to elucidate the piotective function of L-ARG and NG in the early stage of brain ischemia. Methods The middle cerebral artery was occluded by insertion of a suture through the internal carotid artery of SD male rats to duplicate ischemia-reperfusion model. Reperfusion was established by suture withdrawal. After 2 hours of blockage, reperfusion and administrate L-ARG,NG by interventional therapy through the internal carotid artery simultaneously. Image indexes such as T1WI, T2WI, DWI and PWI are utilized to assess the changes in different time points. These indexes, Longa score and TTC stain were compared. Results There were obvious decrease in DWI high signal region and Trc pale region in drugs groups, compared with MCAO group(P＜0.01).ADC and rADC values in DWI high signal region increased gradually from 2 hours after ischemia to 24 hours after reperfusion in each group. ADC and rADC values in DWI high signal region of the drugs groups increased obviously(P＜0.01).Conclusion Interventional therapy with NO precursor/donator showed significant protective function in the early stage of brain ischemia.

Objective To compare the biomechanical properties of mono-segTnent pedicle instru-mentation and its combination with bone cement fixation in treatment of thoracolumbar fractures. Meth-ods Eight fresh specimens of calf spines ( T11 -L3 ) were used for development of incomplete burst frac-ture models at the vertebral body of L1. Mono-segment pedicle instrumentation and its combination with vertebroplasty were respectively applied in each specimen subsequently to restore spinal stability. A cyclic loading with pure moment of 4 Nm was applied to specimens, with load frequency of 0.5 Hz for 2 000 cy-cles. Range of motion (ROM) at flexion/extension, left/right lateral bending and left/right axial rotation of the fixated segment at different status of intact, injury, fixation and cyclic loading was determined by spinal three-dimensional instability test system. Results ROM after treatment with two fixation tech-niques and that at different directions after cyclic loading were distinctly smaller than that of intact and fractured models (P <0.05 ). Under mono-segment pedicle instrumentation combined with bone cement fixation, ROM at flexion, extension, lateral bending and axial rotation was 0.40°, 0. 53°, 0.86° and 0.55° respectively and that after cyclic loading was 0.10°, 0.07°, 0.19° and 0.08°respectively, which were all lower than those of monosegmental fixation, especially at flexion and axial rotation, with statisti-cal difference (P <0.05 ). Conclusions Both fixation techniques can provide instant stabihty of the fractured spine and have good fatigue resistance effect. However, mono-segment pedicle instrumentation is inferior to mono-segment pedicle instrumentation plus bone cement fixation in treatment of fractured verte-bral body at flexion and axial rotation.

Objective To investigate the clinical value of liver transplantation for intrahepatic cholangiocarcinoma (ICC).Methods A retrospective analysis was performed on 68 patients with ICC who underwent hepatic resection or liver transplantation between January 2007 and September 2013.In the surgical treatment of ICC,overall survival and prognostic risk factors were analyzed to determine the clinical value of liver transplantation for ICC compared with hepatic resection.Results Of the patients with ICC,55 underwent hepatic resection and 13 were given liver transplantation.The 1 and 3-year survival rate was significantly higher in the liver transplantation group than in the hepatic resection group (76.9％ versus 52.7％,and 61.5％ versus 27.3％,P＜0.05).In addition,liver transplantation resulted in higher tumor recurrence-free survival rate than hepatic resection (69.2％ versus 41.8％,and 61.5％ versus 20.0％,P＜0.05).The multivariate analysis showed that tumor size larger than 5 cm was an independent risk factor and HBV infection was an independent protective factor of ICC.Conclusion The prognosis of patients who underwent liver transplantation was better than hepatic resection,suggesting that liver transplantation is perhaps a prior treatment in strictly selected and unresectable patients with ICC.

Objective To examine the complement component 1 Q subcomponent-binding protein (C1QBP) gene expression in human resistance choriocarcinoma cell lines and its parental cell line JeG-3,and to investigate whether silence C 1QBP by small interference RNA could reverse the resistance of human resistance choriocarcinoma cell lines to its relevant chemotherapy drugs.Methods Expression of C1QBP mRNA and protein in cells were detected by real-time fluorogenic quantitative PCR and western blot,respectively.The difference of C 1QBP expression was compared between human resistance choriocarcinoma cell lines and its parental cell line JeG-3.Sub-cellular location was proved by confocal immunofluorescence microscopy.A lentiviral vector containing short hairpin RNA (shRNA) targeting C 1QBP was constructed and cotransfected with the packaging plasmid mixture into 293T cells by lipofectamine 2000.The human resistance choriocarcinoma cell lines were infected with the packaged lentivirus.Real-time fluorogenic quantitative PCR and western blot were used to validate whether the C 1QBP gene expression was silenced.The cell counting kit 8(CCK8)was used to determine the drug sensitivity.Results (1)The C1QBP mRNA expression levels among four human resistance choriocarcinoma cell lines[JeG-3/floxuridiuum (FUDR),JeG-3/methotrexate (MTX),JeG-3/etoposide (VP),JeG-3/dactinomycin (KSM)] were 2.520±0.680,1.770±0.230,1.940±0.090 and 1.740±0.350 folds compared to that in JeG-3 cells.The C1QBP protein was higher expression level in human resistance choriocarcinoma cell lines than that in JeG-3.The immunofluorescence methods and confocal analysis showed that C1QBP localized predominantly in the mitochondrial matrix.(2)The C1QBP mRNA expression in JeG-3/FUDR cells after infected with lentiviral vector were decreased by 93.1％ (P＜0.01).The protein expression of C 1QBP in JeG-3/FUDR cells after infected with lentiviral vector were almost completely suppressed.The resistance indexes of four human resistance choriocarcinoma cell lines(JeG-3/FUDR,JeG-3/MTX,JeG-3/VP,JeG-3/KSM) were respectively 86.3％,93.9％,92.8％ and 89.9％,which were decreased remarkably by knockdown the C 1QBP expression (P＜0.05).Conclusions C1QBP is overexpressed in human resistance choriocarcinoma cell lines compared with parental cell line JeG-3.Inhibition of C 1QBP by lentivirus-mediated small interference RNA could effectively reverses the resistance of human resistance choriocarcinoma cell lines to its relevant chemotherapy drugs.

Objective The purpose of the present study is to compare the pharmacokinetic and biodistribution properties of 99Tcm N-mercaptopyridine-N-oxide (99 Tcm N-MPO) with 99 Tcm-sestamibi (99 Tcm-MIBI) in normal dogs, and to investigate the potential of 99TcmN-MPO as a myocardial perfusion agent in canines with acute myocardial infarction. Methods Twelve healthy mongrel dogs were injected intravenously with 99TcmN-MPO (n = 6) or 99Tcm-MIBI (n = 6). Tracer kinetics in body fluids were determined by collecting blood of 1 ml via a femoral vein catheter at 30 s, 1,2,3,4,5, 10, 20, 30, 40, 60and 90 min post-injection (p. i.). The collected blood samples were weighed and counted for radioactivity in a γ-counter. Anterior and posterior planar γ-camera images were collected at 10, 20, 30, 60, 90, and 120 min after injection, with organ uptake quantified by region-of-interest (ROIs) analysis. For comparison, 99Tcm-MIBI was also evaluated in the same twelve dogs. Canine infarct models were set up by micro-invasive interventional embolization. SPECT images in the canine infarct model were collected 24 hours after myocardial infarction at 30 min and 60 min after the administration of 99Tcm N-MPO (n = 5) or 99Tcm-MIBI (n = 5). Results Both of 99Tcm N-MPO and 99Tcm-M1BI had a rapid blood clearance with less than 50% of initial radioactivity remaining at 1 min [99TcmN-MPO: (35. 77 ± 6. 31)% ID/mg ,99Tcm-MIBI (34. 46 ± 6. 83) % ID/mg] and less than 5% at 30 min p. i. [99Tcm N-MPO(3. 11 ± 1.44) % ID/mg,99Tcm-MIBI (2.93 ±0. 39)% ID/mg] . After injection, 99TcmN-MPO showed significant accumulation in the myocardium and prolonged retention. This rapid liver clearance of 99TcmN-MPO led to favorable heart-to-liver ratios, reaching values of 0. 54 ±0. 06 at 10 min, 1.02 ±0. 06 at 30 min, and 1.38 ±0. 06 at 60 min p. i.In contrast, the heart/liver ratio of 99Tcm-MIBI remained low at all time points (0. 46 ± 0. 03 at 10 min,0. 63 ±0. 03 at 30 min, and 0. 62 ± 0. 12 at 60 min p. i.). SPECT imaging studies in canines with acute myocardial infarction indicated that good visualization of the left ventricular wall and perfusion defects could be achieved at 30 min after administration of 99TcmN-MPO, but not 99Tcm-MIBI. Conclusion The combination of high heart uptake and rapid liver clearance makes 99TcmN-MPO a promising new radiotracer for myocardial perfusion imaging.

Objective: To deepen the understanding of Duchenne/Becker muscular dystrophy by investigating dystrophin (DMD) gene variants in 2 Chinese Han families with this disease. Methods: Retrospective analysis of the clinical characteristics of the probands in two families with Duchnne/ Becker muscular dystrophy and the results of multiplex ligation-dependent probe amplification (MLPA) for the probands and their relatives was performed. Results: Three probands were identified by significantly-elevated creatine kinase levels. Two probands in family one are fraternal twin brothers with the same deletions of exons 8-9, while their mother has no abnormality at this site. The proband in family two is the little brother in a pair of fraternal twins with duplication of exons 48-51, and his mother has heterozygous duplication of exons 48-51. Conclusion: ① The presence of the same DMD gene mutation in the fraternal twins suggests that the mother may be a gonad chimera with this mutation if her gene detection of peripheral blood is normal. The mother must undergo prenatal gene diagnosis to reduce the risk of Duchenne/Becker muscular dystrophy in her offsprings. ② The exons 48-51 duplication of DMD gene is pathogenic mutation.

Objective To find out the general status about the traditional Chinese medicine therapies that were included into medicare among the selected hospitals in the country's public hospital reform project, and to investigate the reasons for those not included and make recommendations.Methods Collecting relevant information through questionnaires, experts interviews and discussions.Results There are still some TCM therapies not included into the range of reimbursement.Most Of them are external treatment of traditional Chinese medicine, acupuncture, massage, special treatments of traditional Chinese medicine and comprehensive therapies of TCM.Conclusions The establishment of negotiations department about medicare in the field of traditional Chinese medicine was needed.Medicare should be in favor of TCM therapies, and traditional Chinese medicine hospitals should strengthen training of personnel and hiring.At the same time, a reasonable increase of the proportion of TCM experts involved in the making health insurance directory was needed.

To explore the status of the job satisfaction of the authorized and contract staff in a university affiliated hospital in the dilution situation of the hospital staffing management, and to discuss the key factors and reasons affecting the satisfaction difference. The questionnaire was developed based on Minnesota Satisfaction short form with extra items covering “the comprehensive satisfaction evaluation”. According to the hospital population of staff, the cluster random sampling method was used, and survey was conducted on the spot. Both authorized staff and the contract staff showed high degree of satisfaction. But the contract staff showed higher degree of satisfaction of leadership and their own responsibility sense than the authorized staff. The contract female staff showed higher degree of overall satisfaction than the authorized female staff. The discussion based on the results showed that new human resource management mode, new mechanism of flexible management of staff, targeted staff with targeted management.