QT dispersion(QTd,equals maximal minus minimal QT interval on a standard ECG) has been shown to reflect inhomogeneity of myocardial repolarization and cardial electrical instability, hence,been proposed to be associated with ventricular arrhythmias.But the intrinsical mechanism of QTd is incompletely understood. Contributing to QTd are differences of action potential duration(APD) in the three-dimensional structure of ventricular myocardium, which is identified to own three cell subtypes:endocardial, midmyocardial(M cells) and epicardial cells.And findings suggest that regional differences in the duration of the M cell action potential may lead transmural and spatial dispersion of repolarization. Autonomic nerves by combining receptors on the myocardial cells,especially M cells affect significantly the APD.Concordance between heterogeneity of ventricular myocardium and heterogeneity of autonomic innervation in heart provide support for the role of autonomic nerve in the generation of the QT dispersion.

OBJECTIVE:To discuss the issue of medical institution's pharmaceuticals purchase by public bidding and so as to put forward some improvement measures.METHODS:The problem in the pharmaceuticals purchase by public bidding sys?tem was analyzed by the governmental management theory.RESULTS&CONCLUSION:The pharmaceutical purchase by public bidding system was far from perfect which were highlighted in the high cost of governmental management,over-burden of bidding factories,financial loses of medical institutions,and chaos of medicine pricing management.The governmental pricing system should be regulated,the medical reform systems should be speed up,and the efficiency of governmental man?agement should be improved.

Objective By observing the incidence of postoperative hyperalgesia in patients with total intravenous anesthesia,to study the effects of different anesthesia depth on postoperative hyperalgesia.Methods Forty gynecologic patients undergoing open lower abdominal operation were randomized into two groups (n=20): group B1 with BIS 40-49 and the group B2 with BIS 50-59.Anaesthesia was induced and maintained with intravenous anesthetics.The threshold of haphalgesia and the range of mechanical hyperalgesia were measured before operation.The consumption of the intravenous anesthetics,the emergence time and the extubation time were recorded.The vital signs were recorded at eight time points: pre-aneasthesia (T0),abdominal exploration (T1),the end of operation (T2)and 1 h (T3),4 h (T4),12 h (T5),24 h (T6),48 h (T7) after extubation.The VAS scores at T3-T7 were recorded.The PCA dosage of analgesic and superaddition in postoperative 24 h and 48 h were recored.The Von Frey Hairs were used to assessed the threshold of haphalgesia and the range of mechanical hyperalgesia at T6 and T7.Results The MAP at T6 and T7 and the VAS scores at T6 of the group B1 were lower than those of the group B2 (P<0.05).The range of mechanical hyperalgesia at T7 of the group B1 was narrower than that of the group B2 (P<0.05).Conclusion Maintaining the anesthesia depth within BIS 40-49 can reduce the body′s stress reaction,decrease the incidence of postoperative hyperalgesia and accelerate the recovery time of mechanical hyperalgesia in postoperative 48 h.

Background The early diagnosis and treatment is vital for the age-related macular degeneration (AMD).Previous examining methods were fundus fluorescein angiography(FFA)and optical coherence tomography (OCT).However,a new diagnostic technique,fundus autofluorescence(FAF),is applying in ophthalmology.objective This study was to observe the FAF characteristics of atrophic AMD. Methods Thirty-nine eyes of 28 patients with atrophic AMD were diagnosed and collected in our hospital and classified based on the criteria of Chen Song.FAF was performed by a confocal scanning laser ophthalmoscope(Heidelberg Retina Angiograph 2,HRA2).Characteristics of FAF images were compared with FFA images or color fundus photographs.Written informed consent was obtained from each patient prior to the examination. Results Areas with abnormal increased or decreased FAF signals were consisted or unconsisted with funduscopically visible alterations.Seven manifestations of FAF were found in the eyes with preatrophic stage of atrophic AMD,including slight change,focal increase pattern,patchy pattern,linear pattern,lacelike pattern,reticular pattern,and speckled pattern.In atrophic stage of atrophic AMD,geographic atrophy showed a well-defined hypoautofluorescence area;while non-geographic atrophy showed a ill-defined hypoautofluorescence area.There were three abnormal FAF patterns(focal,band and diffuse)in the junctional zone of geographic atrophy and diffuse pattern in the junctional zone of non-geographic atrophy. Conclusion FAF imaging is helpful for the diagnosis of atrophic AMD as a new non-invasive technique.

Objective To assess the blood safety under the current sero-screening program and gain experience on how to implement NAT as a routine assay for blood screening in China. Methods Sera from 103,539 non-remunerated donors of Shanghai blood center were tested by Chiron's Procleix(TMA HIV-1/HCV Assay in 2 study stages with 8 and 24 sample-pool respectively. Results 5 NAT positive samples were found to be Anti-HCV EIA-2 test positive at the same time. No window period cases of HIV-1/HCV were found in this donor group. But 275 (0.27% ) anti-HCV and 107 (0. 10%) anti-HIV false positive samples were identified by the second sero-screening. Conclusion The blood quality of Shanghai city was high to be close to the level of developed countries and the window period risk of HIV-1 and HCV was less than 1:100,000. With its high sensitivity and specificity,Procleix( TMA HIV-1/HCV Assay can be used in routine blood screening in China.

Objective: To explore the myocardial protection of induction and reperfusion with warm blood cardioplegia for hypoxic immature myocardium. Methods: A hypoxic model of neonatal rabbits was established in this study. Some indexes,such as myocardial energy metabolism, water content, SOD, MDA and myocardial ultrastucture, were observed after induction and reperfusion with warm blood cardioplegia, comparing to cold crystalloid cardioplegia. Results: Hypoxic neonatal rabbits in this study presented cyanotis, hypoxemia and higher ratio of RV/(LV+S) simulating the pathophysiological changes in cyanotic congenital heart disease. It could be built and repeated easily in experimental researches of immature myocardial protection. Myocardial ATP content was (13.09?1.50) ?mol/g in studying group versus (11.53?5.40)?mol/g in control group (P

Objective:To investigate the high risk factors of pelvic lymph node metastasis in patients with type Ⅰ endometrial carcinoma in order to provide the basis for making reasonable operation scope.Methods:Risk factors of pelvic lymph node metastasis were analyzed in 136 cases of type Ⅰ endometrial carcinoma.Univariate analysis was performed with Chi square test or Fisher's exact probability method,and multivariate analysis was performed with a logistic regression mode.Results:The positive rate of pelvic lymph nodes in 136 patients with type Ⅰ endometrial carcinoma was 9.56％ (13/136).Univariate analysis showed that histological grade,size of lesion,depth of myometrial invasion and vascular invasion were related to lymph node metastasis(P ＜0.05);Multivariate Logistic analysis showed that low differentiation,deep muscular invasion,tumor diameter≥2 cm and LVSI were independent risk factors of pelvic lymph node metastasis in patients with type Ⅰ endometrial carcinoma(P ＜0.05).Conclusions:The rate of pelvic lymph node metastasis is low in type Ⅰ endometrial carcinoma.Patients with low differentiation,deep muscular invasion,tumor diameter≥2 cm and LVSI are more likely to occur pelvic lymph node metastasis in type Ⅰ endometrial carcinoma.

Objective To randomly compare the therapeutic effect and safety between Levetiracetam (LEV) and Phenobarbital (PB) in the treatment of neonatal seizures.Methods A total of 61 infants with acute convulsion were randomly divided into 2 groups:LEV group (n =30) and PB group (n =31) during January 2013 to December 2014 in Urumqi Children's Hospital.All neonates received routine management including etiology treatment and adverse drug reaction monitoring.In the LEV group,subjects received oral formulation of LEV with initial loading dose 30 mg/kg,followed by 15 mg/kg twice a day.If the seizures were not controlled completely,PB treatment was added until seizures were completed controlled.If seizures were controlled quickly,the dose of PB was gradually reduced and LEV was used as monotherapy.The subjects in PB group received intramuscular or intravenous injection of PB with 10 mg/kg as the first dose,then 5 mg/(kg · d) oral PB was administered,if seizures were not controlled,LEV treatment was added,then dose of PB was gradually reduced until seizures were controlled completely,and then patients were switched to LEV monotherapy gradually.The drug adverse reactions were observed.Results (1) After LEV or PB monotherapy,66.7％ (20/30 cases) and 54.8％ (17/31 cases) of the subjects obtained sustainable seizure free respectively.Although,there was a higher control ratio in LEV group,but no significant difference was observed between the 2 groups (P ＞0.05).(2) LEV group (16/30 cases,53.33％) had higher rapid seizure control ratio with seizure controlled within 24 h after first dosage administration than that of PB group (8/31 cases,25.80％),and there was significant difference (x2 =4.841,P =0.028).Further more,if adding the cases who had to change to use another comparative one (LEV or PB) due to their seizures failure control with the first one treated,LEV group (21/44 cases,47.72％) still had higher rapid seizure control ratio in total patients than that of PB group(10/41 cases,24.39％),and there was significant difference (x2 =4.988,P =0.026).(3) Eight cases who changed to LEV after PB as the first treatment drug failed obtained sustainable seizure free.(4) One case in PB group with transient urinary retention was observed but the symptom disappeared 36 h after PB withdrawal,and no significant drug adverse reaction was observed in LEV group.Conclusion LEV is more rapid and safe for seizure control of neonates than PB.

BACKGROUND:Proximal femoral nail antirotation and femoral head replacement could quickly recover hip function in intertrochanteric fractures in the elderly, but whose efficacy is better remains controversial. OBJECTIVE:To compare the differences in the effects of proximal femoral nail antirotation and femoral head replacement on intertrochanteric fractures in the elderly by using a meta-analysis. METHODS:The relevant literatures were searched in PubMed, Cochrane, CNKI, Wanfang database and VIP, and other relevant journal such asChinese Journal of Orthopaedicsand Orthopedic Journal of Chinafor articles published in recent five years. Randomized controled trials concerning proximal femoral nail antirotation and femoral head replacement for the treatment of intertrochanteric fractures in the Chinese elderly were colected. Baseline data, operation time, intraoperative blood loss, postoperative out-of-bed time, length of stay, Harris score, complication rate and number of death were colected and processed using RevMan 5.30 software for meta analysis. RESULTS AND CONCLUSION:Totaly 37 clinical controled trials with 3 216 patients were recruited. Meta-analysis results showed that compared with femoral head replacement, proximal femoral nail antirotation was at a disadvantage in postoperative out-of-bed time, length of stay and joint function in the early stage. No significant difference in complication and mortality was detected between proximal femoral nail antirotation and femoral head replacement. However, proximal femoral nail antirotation had some advantages such as short operation time, smal trauma, and less intraoperative blood loss, and showed good midterm and long-term outcomes of joint function.

Objective To investigate the effects of icariin, a major active component of traditional Chinese herb Epimedium on schizo-phrenia animal model. Methods MK-801, a N-methyl-D-aspartate (NMDA) receptor antagonist, was intraperitoneally injected into mice to establish a schizophrenia animal model. The open field behavior test infrared detection system was used to measure the mobility of mice in order to find the best optimal dose. 40 mice were randomly divided in to control group, model group, risperidone group and icariin group with 10 mice in each group. The risperidone group and the icariin group were given 0.1 mg/kg risperidone and 50 mg/kg icariin respectively. All groups were injected with 0.6 mg/kg MK-801 0.1 ml intraperitoneally, except the control group. The total distance and the central dis-tance within 210 minutes were tested. Results The total distance and the central distance were significantly longer in the model group than in the control group (P<0.001), and were shorter in the risperidone group than in the control group (P<0.05). The total distance was shorter in the icariin group than in the model group, but there was no significant difference (P=0.065); and the central distance was shorter (P=0.037). There was no significant difference in both total distance and the central distance between the risperidone group and the icariin group (P>0.05). Conclusion Icariin may improve the positive and negative symptoms of schizophrenia mice, which may be beneficial to schizo-phrenia therapy.