Objective To investigate the efficacy and safety of using adsorption method combined with warm saline in heparin- free dialysis for patients with high risk bleeding tendency in order to reduce blood ag-glutination in the dialyzer and pipeline. Methods 60 patients with high risk bleeding tendency who were to undergo long- term hemodialysis (HD) were divided into the experimental group and the control group with 30 eases in each group,they both adopted heparin- free dialysis.The control group used saline washing of room temperature, while the experimental group adopted adsorption method combined with warm saline during washing. The completion of dialysis as well as the agglutination in the dialyzer and pipeline were ob-served. Results Number of patients who completed the dialysis were more, the completion rate of dialysis was higher and agglutination of dialyzer and pipeline decreased in the experimental group than those in the control group. Conclusions Agglutination of dialyzer and pipeline can be reduced and the aim of safe and effective heparin- free dialysis can be reached when using adsorption method combined with warm saline.

Objective To evaluate the usefuluness of the color Doppler flow imaging(CDFI) in subclinical atrial septal defects(ASD).Methods We reviewed 122 cases of subclinical ASD in adult which were first detected with CDFI.Results We found most of the patients were women and elder people,and no more special clinical symptoms and signs can be found.Color Doppler flow imaging had characteristic abnomallities making the dosis of ASD possible and easily with a high degree of accuracy in patients in whom the clinical presentation was atypical different magnitudes of left-to-right shunt were revealed in all these patients.Conclusion CDFI is a good noninvasive technique in the diagnosis of subclinical atrial septal defects.

Objective To investigate the expression of microRNA-134 ( miR-134 ) , CREB and pCREB in the temporal lobe tissue of patients and epileptic rats and to explore their roles in pathogenesis of epilepsy.Methods Tempo-ral lobe tissue samples of 14 patients with refractory epilepsy and 10 non-epileptic patients, and hippocampus and brain tis-sue samples of 42 rats were used in this study.Forty-two healthy adult male Sprague-Dawley rats were randomly divided in-to 6 epilepsy groups (24 h, 72 h, 7 d, 14 d, 30 d, and 60 d after kindling epilepsy) and a normal control group (n=6 for all groups) .The rat model of epilepsy was generated by intraperitoneal injection of 127 mg/kg lithium chloride and 16-20 h later, 35 mg/kg pilocarpine.In the temporal lobe tissue of patients and hippocampal tissue of rats, the expression level of miR-134 was detected by real-time polymerase chain reaction.The expression levels of CREB and pCREB were de-termined by Western blot, and CREB and pCREB localization was assessed by immunohistochemistry.Results Compared with the control rats, the expression of miR-134 was significantly decreased in the temporal lobe tissue of experimental rats at 72 h,7 d,14 d, 60 d after kindling (P＜0.05),and no significant change at 24 h and 30 d after kindling (P>0.05). Expression of miR-134 in patients with refractory epilepsy was significantly lower than that of the controls ( P＜0.05 ) , while up-regulation of CREB expression was at the same time points (P＜0.05).Up-regulation of pCREB expression was at all the time points after kindling (P＜0.05).CREB and p-CREB expressions were seen in the nuclei of neurons, and significantly higher in patients with refractory epilepsy and epileptic rats.Conclusions The expression of miR-134 is sig-nificantly decreased and that of CREB and pCREB was significantly increased in the temporal lobe tissue of patients with re-fractory epilepsy and the hippocampal tissue of epileptic rats.These findings indicate that the signaling pathway of miR-134/CREB/pCREB may play an important role in the pathogenesis of epilepsy.

Objective To investigate blood plasma melatonin level in night-shift nurses and explore the relationship of blood plasma melatonin level with nervous system symptom (insomnia、anxiety、depression). Methods ELISA were used for detection of blood plasma melatonin level in 80 night-shift nurses of different age group. Results Blood plasma melatonin level of shift work nurses (36to40、41to45 yearold) were significant lower than the corresponding age group of the control group, the nervous system symptom of these age group night-shift nurses correlated to melatonin level of melatonin. Conclusions Blood plasma level of melatonin have a close relation to nervous system symptom(insomnia、anxietydepression).

Objectives To investigate the incidence of brain injuri in premature infants in ten hospitals of seven large cities in China sponsored by the Subspecialty Group of Neonatology of Pediatric Society, China Medical Association. Methods All premature infants with gestational age less than 37 weeks in ten hospitals were given routine cranial ultrasound within three days of birth, and then repeated every 3-7 days till the discharge from the hospital during January 2005 to August 2006. Results Incidence of intraventricular hemorrhage (IVH) and severe IVH were 10.8% (406/3 768) and 2.4% (92/3 768) with 22.6% (92/406) for grade 1, 54.7% (222/406) for grade 2, 17.2% (70/406) for grade 3 and 5.4% (22/406) for grade 4 in nine hospitals; incidence of periventricular leukomalacia (PVL) and cystic PVL were 2.3% (112/4 933) and 0.3% (16/4 933) with 85.7% (96/112) for grade 1, 12.5% (14/112) for grade 2, and 1.8% (2/112) for grade 3 including all ten hospitals, respectively. Risk factors associated with increased severity of IVH were vaginal delivery (OR = 1.874, 95% CI = 1.172 - 2.997, P < 0.01), perinatal asphyxia (OR = 1.598, 95% CI = 1.077 - 2.372, P < 0.05), mechanical ventilation (OR = 3.988, 95% CI= 2.448 -6.948, P< 0.01), and amniotic fluid contamination (OR = 2.192, 95% CI = 1.054 - 4.544, P< 0.05). Risk factors that might result in the development of cystic PVL were vaginal delivery (OR = 1.400, 95% CI = 1.186 - 1.652, P < 0.001) and mechanical ventilation (OR = 3.000, 95% CI = 1.015 - 8.864, P < 0.05). Conclusions These data reflect basically the prevalence of brain injuriy in premature infants in major cities of China. However, more than 60% of population lives in the rural area, further multicenter investigation including the rural area is expected to be undertaken in future.

Performance appraisal is one of the key points of hospital management. The authors introduce a comprehensive hospital performance appraisal scheme based on the concept of value transfer, including qualitative and quantitative index system, weight and appraisal method.In the pilot practice of a hospital, it is found that the appraisal scheme can effectively improve the operational efficiency, social and economic benefits, and has a strong incentive role for employees. This scheme weighs the operability and scientificity of performance appraisal, and provides a reference for clinical department performance appraisal.

Objective To investigate the effect of thymosin ?1 (T?1) on cellular immune function in gastric cancer patients through observing its treatment on the differentiation of T-lymphocyte subsets from screened peripheral blood mononuclear cells (PBMCs). Methods PBMCs were obtained by centrifugation of blood samples from 18 healthy subjects and 32 patients with gastric cancer,and then cultured in the presence of culture medium with addition of T?1 at 50,10 and 1 ?g/ml for 2 d. T lymphocyte subsets (such as CD4+,CD8+ and CD4+ CD25+ Foxp3+ T cells) and Th1/Th2 multiplex cytokines were detected by flow cytometry (FCM). Results After PBMCs isolated from healthy people and patients were incubated with or without T?1,there was no significant change in percentage of CD4+,CD8+ peripheral lymphocyte subsets and ratio of CD4+/CD8+. There was no obvious change in the percentage of CD4+ CD25+ Foxp3+ T lymphocyte subsets in the normal control,but a significant increase was observed in the cells from patients with gastric cancer after treatment (P

Objective: To evaluate the application of FISH testing of bcl-2/IgH gene translocation and IgH/L gene rearrangement in different stages of follicular lymphoma. Methods: In 32 follicular lymphoma cases, which were collected at Guangdong General Hospital from September 2014 to December 2016, the bcl-2/IgH gene ectopic state was detected by FISH while the IgH/L gene rearrangement was tested using PCR-GeneScan to analyze the relationship between bcl-2/IgH gene translocation, different stages of follicular lymphoma and clonal immunoglobulin (IgH/L) gene rearrangements. Results: From the paraffin sections of all 32 follicular lymphomas, 17 cases showed bcl-2/IgH gene translocation, and the percentages of FL1, FL2 and FL3 translocation were 12/13, 3/5 and 2/14, respectively. Among the 24 cases of IgH/L gene arrangements identified from the total sample, the occurrence rates of FL1, FL2 and FL3 gene arrangement were 7/13, 4/5 and 13/14, respectively. Spearman′s rank correlation analysis and χ² analysis showed that bcl-2/IgH gene translocation was negatively correlated with follicular lymphoma stage and the association was statistically significant. In more advanced stages of follicular lymphoma, the occurrence of bcl-2/IgH gene translocation tended to decrease with distinct FL1, FL2 and Fl3 gene expression (P<0.05). As IgH/L gene rearrangement in FL3 was higher than that in FL1 and FL2, its detection may be complimentary to FISH test for bcl-2/IgH gene translocation in diagnosing follicular lymphoma. Conclusions The combined use of FISH and PCR-GeneScan increases the positive rate of follicular lymphoma diagnosis, and this combination is more sensitive than FISH or clonal analysis only to detect the chromosomal abnormality or the gene rearrangement.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the sleep quality of patients after radical operation for esophageal cancer.Methods:A total of 150 patients of both sexes, aged 35-60 yr, of American Society of Anesthesiology physical status Ⅰ or Ⅱ, with body mass index of 18.5-25.0 kg/m 2, undergoing elective radical operation for esophageal cancer, were divided into 3 groups ( n=50 each) using a random number table method: TEAS group, non-electrical stimulation group (NS group), and transcutaneous electrical non-acupoint stimulation group (TENAS group). In group TEAS, the Neiguan (PC6) and Hegu (L14) acupoints were stimulated staring from 10 min before anesthesia until the end of operation, with a frequency 2-100 Hz, disperse-dense waves and voltage 6-10 mA.In group NS, stimulating electrodes were placed at the same acupoints before induction, but no electrical stimulation was applied.Non-acupoints were stimulated staring from 10 min before anesthesia until the end of operation in group TENAS.The Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) scores were recorded at 1 day before operation and 1, 3 and 7 days after operation.The Quality of Recovery-15 (QoR-15) scores were recorded.The duration of postanesthesia care unit stay and length of hospital stay were recorded.The development of major adverse events was recorded during hospitalization. Results:Compared with group NS and group TENAS, the total scores of PSQI and AIS and incidence of postoperative sleep disorder were significantly decreased at 1, 3 and 7 days after operation, and QoR-15 scores were increased at 1 and 2 days after operation, the incidence of pulmonary complications was reduced, and duration of postanesthesia care unit stay and length of hospital stay were shortened in group TEAS ( P<0.05). There were no significant differences in the incidence of adverse events such as respiratory depression, sinus bradycardia, sinus tachycardia, hypertension, hypotension, nausea and vomiting among the three groups ( P>0.05). Conclusion:TEAS can improve the sleep quality of patients after radical operation for esophageal cancer and promote postoperative outcomes.

Irritable bowel syndrome (IBS) is a common defecation related functional disease, presented as recurrent abdominal discomfort accompanied by a change in bowel habits. The pathogenesis of IBS is still unclear. Several factors have been identified as the etiological factors, such as altered gastrointestinal motility, visceral hypersensitivity, intestinal infection, and immunological activation, etc. Now more and more researches suggest that small intestinal bacterial overgrowth (SIBO) might be one of the pathogenic factors of IBS. This article reviewed the correlation of IBS with SIBO, the possible mechanism and treatment, so as to provide a reference for clinical diagnosis and treatment of IBS combined with SIBO.