Atrioventricular node is responsible for conducting impulse from atria to ventricles.Connexin within atri-oventricular junction play a key role in conducting function of atrioventricular junction;because it presents diversi-fied expression,so its conducting junction is diversified in different areas of atrioventricular junction.Knowing ex-pression type of connexins can approximately determine conductive function in atrioventricular junction area.

ObjectiveTo assess the relationship between central obesity and metabolic syndrome (MS) in community population.MethodsOne thousand and fifty-three individuals aged≥18 (mean,45.6),including 542 men and 511 women,were recruited for questionnaire survey and medical exarmnation from 4 communities of Hangzhou during March and November 2007.Their blood pressure,waist circumference,serum glucose,lipid profile,and other biochemical markers were measured.All data were used for variance analysis.ResultsThe prevalence of MS,central obesity,hypertension,and diabetes mellitus (DM) was 11.2%,23.6%,30.5%,and 8.5%,respectlvely.The prevalence of MS,DM,and hypertension was increased with waist circumference(P<0.05).Waist circumference was positively correlated to body mass index (BMI).systolic blood pressure(SBP),diastolic blood pressure(DSP),fasting blood sugar,total cholesterol,and triglyceride (r=0.812,0.649,0.712,0.657,0.598,and 0.676,respectively),although negativelv with high-density lipoprotein cholesterol(r=-0.578).Waist circumference also showed positive rclationship with the number of lipid metabolism abnormity(r=0.658,P<0.01).CondusionFor Hangzhou community population.central obesity might be one of the risk factors of MS.

Objective\ To introduce the clinical application of the osteocutaneous flap pedicled with the lateral superior genicular artery or the lateral most superior genicular artery in reconstruction of defect of the soft tissue, bone or compound tissue defect on the hand or distal of the forearm.Methods\ The origin course distribution and an astomosis of the lateral superior genicular artery and the lateral most superior genicular artery were observed on the lower limbs of 30 adult cadavers perfused with pink plastics. The osteocutaneous flap based on the lateral superior genicular artery or the lateral most superior genicular artery were designed according to anatomic study. Results\ One cutaneneous flap, 1 osteo flap and 3 osteocutaneous flaps pedicled with lateral superior genicular artery were used; the area of the cutaneous or osteo flap were 7.5 cm?5.0 cm-14.5 cm?6.5 cm and 5.0 cm?1.5 cm?1.2 cm-6.5 cm?2.0 cm?1.6 cm respectively; all the flap and osteocutaneous flap survived. Bone union occurred 3-5 months after the operation. Conclusion\ The lateral supragenual osteocutaneous flap can be used to reconstruct the defect of soft tissue, bone or compound tissue defect on the hand and distal of the forearm.

Objective To study The effect of a early systemic psycho-rehabilitation intervention on patients with post-stroke depression.Methods 80 patients with post-stroke depression were randomly divided into test group (n=40) and control group (n=40) by Hamilton's Depression Scale (HAMD).They were treated conventionally by neurologist. The patients in test group were added systemic psychological intervention administered by psychologist and movement training administered by professional physiatrician. And then the scores to HAMD and CNFDS (clinical neurological functional defect scoring) between two groups were evaluated until 2 weeks or 4 weeks later. Results Nerve function of the both groups was improved,and score to HAMD in the test group was less than that in control group (P

Objective: To investigate the expression of α-B crystalline in triple-negative breast cancer (TNBC) and discuss its role in the prognosis and targeted therapy of TNBC by analyzing the correlation amongα-B crystalline and the clinico-pathological indi-ces of breast cancer. Methods:Immunohistochemistry SP assay was used to determineα-B crystalline expression in paraffin-embedded specimens of 30 cases of TNBC and 50 cases of non-TNBC tissues. The differences in protein expressions among tissues were com-pared, and correlation analysis was performed to determine the relationship between protein expression and clinico-pathological indi-ces. Results:The positive expression rate ofα-B crystalline was 66.67%in TNBC (20/30) and 42.00%in non-TNBC (21/50), which in-dicates that the expression is significantly higher in TNBC than in the non-TNBC tissues (χ2=4.566, P<0.05). The expression ofα-B crystalline in breast cancer has no significant difference in terms of age, tumor diameter, and cancer stage (P>0.05), but exhibits a differ-ence in terms of lymph node metastasis and the number of metastasized lymph nodes [P53, Ki67 (P<0.05)], which presents a positive correlation (r=0.251). Theα-B crystalline expression in TNBC has no significant difference among indices such as age, tumor diameter, nodal metastasis, number of metastasis, P53, cancer stage, and Ki67 (P>0.05). Conclusion:Significant differences were found inα-B crystalline expression between TNBC and non-TNBC.α-B crystalline is highly expressed in TNBC tissues, and the expression is signif-icantly higher in TNBC tissues than that in non-TNBC tissues.α-B crystalline is associated with poor prognosis of breast cancer. Conse-quently, the overexpression ofα-B crystalline in TNBC may be a reason for unfavorable TNBC prognosis.

Objective To explore a safe and effective hyperthermia interventional therapy temperature for hepatic carcinoma. Methods Eight swines were divided into four groups according to trans-arterial hyperthermic perfusion temperature, 45 ?C , 50 ?C ,55 ?C , and 60 ?C (catheter flowing temperature) groups. The hepatic and renal functions and blood coagulation function were examined before and after the procedur and then all swines were sacrificed and the livers were pathologically analysed,simultoneously with the evaluation of the safe hyperthermic temperature 35 hepatic carcinomas were carried out under this interventional hyperthermochemotherapy via the arterial catheter (80 cm, 5F) placed into the tumoral artery with the perfusion agents warmed to 60～65 ?C (catheter flowing temperature was 47.55?0.44 ?C ). Results The hyperthermic coagulation necrosis, hepatic dysfunction level and fever were found after 55 ?C and 60 ?C hyperthermic perfusion while those of 45 ?C and 50 ?C groups basically remained normal. The tumor growth rate and total efficacy rate were -(0.35?0.32) and 79.2%, respectively, and 0.5, 1, 1.5 year survival rates were 100%, 80%, 60% respectively after follow-up. The adverse effects of the interventional hyperthermochemotherapy was similar to the routine TACE. Conclusions 45 ?C and 50 ?C (catheter flowing temperature) hyperthermochemotherapy for hepatic carcinoma is safe and effective.

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

BACKGROUND:Studies have found that liver cels can synthesize insulin after giving pancreatic and duodenal homeobox 1 (PDX1) gene. Anti-CD20 monoclonal antibody can inhibit the immune reaction of insulin-producing liver cels, but the mechanism is unclear. OBJECTIVE:To observe the influence of interleukin-10 gene on liver cels and liver PDX1 expression in nonobese diabetic mice after interfered by adenovirus vector-mediated murine interleukin-10 and anti-CD20 monoclonal antibody. METHOD:Forty nonobese diabetic female mice aged 3-5 weeks were randomly divided into anti-CD20, anti-CD20 + interleukin-10, interleukin, and control groups. Mice in each group were respectively injected with anti-CD20 monoclonal antibody, anti-CD20 monoclonal antibody + adenovirus vector-mediated murine interleukin-10, adenovirus vector-mediated murine interleukin-10 and normal saline on days 1, 8, 15 and 21via tail vein. RESULTS AND CONCLUSION:At 12 weeks, the blood glucose level of mice treated with anti-CD20 monoclonal antibody and/or interleukin-10 was significantly reduced compared with the control group, while the insulin, interleukin-10 and CD20 expression levels in the serum and liver were significantly increased, the liver PDX1 expression was also upregulated. Anti-CD20 monoclonal antibody with interleukin-10 had more obvious effects than the single use. No matter the combined intervention or single use, anti-CD20 monoclonal antibody and interleukin-10 show no impact on the inflammation of liver cels. Anti-CD20 monoclonal antibody and/or interleukin-10 increases PDX1 expression in nonobese diabetic mice.

Objective To establish and evaluate the review criteria of blood routine detection by the Sysmex XE‐5000 hematolo‐gy analyzer in our hospital for improving the effectiveness of the measurement results .Methods 606 blood samples were collected from the outpatients and inpatients during 2014 and performed the microscopic examination by 2 technologists‐in‐charge with the double‐blind method .The average value of these results was used as the judging criteria .According to the 41 items of rule formula‐ted by the international expert group and combining with the patients characteristics of infectious disease hospital and instrument features in this hospital ,20 items of review criteria for blood routine test of our hospital was formulated .Results With the micro‐scopic examination results as the criteria ,among 606 detected samples ,116 samples were in line with the rules and the review rate was 19 .14(116/606) ,in which the true positive rate was 6 .93% (42/606) ,the false positive rate was 12 .21% (74/606) ,the false negative rate was 2 .64% (16/606) ,the true negative rate was 78 .22% (474/606) ,the sensitivity was 72 .41% and the specificity was 86 .5% .The expected values of positive and negative results were 36 .21% and 96 .73% respectively .The total effective rate was 85 .15% .Conclusion The review criteria formulated by this laboratory are reasonable and effective ,which has an important significance in the clinical application for increasing the detection speed of blood routine ,improving the laboratory reports quality , without missed true blood patients and accurately providing the valuable information for clinicians .

Objective To investigate the cognition and attitude towards the elderly family nursing among nurses and college students in Chengde, and analyze its influencing factors. Methods A total of 1000 college students and nurses in Chengde were investigated by self-designed questionnaire about their cognition and attitude to elderly family nursing. Results Nurses' cognition and attitude towards the elderly family nursing was better than nursing college students, medical students were better than non-medical students; and there was no statistical significance about their expectation for government's senior citizen service among different groups. Conclusions More attention should be paid to family members' attitudetowards the elderly home care, and should strengthen the elderly family care through various way.