Objective To explore the value of using the characteristic P wave of the intracavitary electrocardiogram (ECG) in positioning the tips of the peripherally inserted central catheters (PICC).Methods Totally 201 patients with PICC from December 1,2015 to February 29,2016 were enrolled in this study.The characteristic P wave of the intracavitary ECG was applied to locate the PICC tips.The pre-determined depth of catheter insertion (Y),highest P wave (L),and actual insertion depth (Z) were recorded.Chest radiography was performed after a successful insertion of PICC.The optimal depth (H) was recorded.Then we observed the sensitivity of P wave in positioning PICC tips,the operative time of positioning PICC tip with intracavitary ECG,and the difference in the predicted depth and the actual depth of PICC insertion.Results The sensitivity of the intracavitary ECG in positioning PICC tips was 100％.The operation time of the intracavitary ECG in guiding PICC tip was significantly shorter than the that of ultrasonic diagnosis of ectopic PICC [(3.4 ± 2.4) min vs.(5.6 ± 3.4) min] (P =0.006 9).The actual depth of ECG-guided positioning was significantly more accurate than the predicted depth [(0.4 ± 0.1) cm vs.(3.9 ± 0.8) cm] (P =0.007 2).L minused Z averaged (4.3 ± 1.6) cm.Conclusion Positioning PICC tips with ECG is simple,accurate,and easy to learn,and it is worth to be widely used in clinical settings.

AIM: To optimize the extraction process of the total flavonoids of Pollen typhae. METHODS: The optimum extraction process was selected with the orthogonal design (L 27 (3 13 )), using the contents of typhaneoside and isorhamnetin 3 O neohesperidoside as the evaluating criteria. RESULTS: The significant effects of alcohol concentration, extraction time and extraction times on the extraction of the total flavonoids of Pollen typhae were discovered. CONCLUSION: The optimum extraction process was as follows: Pollen typhae was extracted with 40% alcohol for two times, each with the solvent volume 14 times of the weight of the raw materials and extraction time for 3 h.

Objective:To find the discrepancies caused by HLA B gene variants in HLA B antigen homozygotes which were typed again by DNA method.Methods:75 blood samples assigned HLA B homozygotes by serology were typed and detected HLA B expression variants by PCR SSP.Results:The 12 samples had been assigned the second alleles by DNA method in 75 HLA B homozygotes by serology.One out of 12 samples was identified expression variant by PCR SSP.The null allele was caused by the insertion of an extra cytosine at the beginning of exon 4.Conclusion:HLA B gene typing by PCR SSP will be the use of supplement to serology.The expression variant detection by PCR SSP will improve accuracy for tissue typing and benefit clinical application.

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

[ ABSTRACT] AIM:To investigate the cardiac AMP-activated protein kinase ( AMPK) activity and the effects of AMPK activator on cardiac structure and function in the mice with different β-adrenoceptor (β-AR) stimulation patterns . METHODS:Male BALB/c mice were subcutaneously injected with AMPK activator ( AICAR, 250 mg· kg -1 · d-1 ) or saline, and infused with β-AR agonist isoproterenol (ISO, 5 mg· kg-1· d-1) for 14 d.The cardiac functions were evalu-ated by echocardiography or hemodynamic method , and the hearts were harvested after infusion cessation immediately or 3 d later.Phosphorylated AMPK ( p-AMPK) was measured by Western blot .RESULTS:Sustained ISO infusion increased p-AMPK level.AICAR did not further increase p-AMPK but attenuated ISO-induced increase in heart weight .Sustained ISO infusion increased cardiac systolic function as indicated by left ventricular fractional shortening ( FS) and maximum rate of pressure rise (+dp/dtmax).The cardiac systolic function was not further increased by AICAR .The cardiac diastolic func-tion as indicated by left ventricular end-diastolic pressure (LVEDP) was not different in each group .In contrast, cardiac p-AMPK level was similar between the control mice and the mice with sustained ISO infusion and ceased infusion for 3 d. In this model, AICAR improved the cardiac systolic and diastolic functions , which were impaired by ISO.Moreover, the increased pattern of p-AMPK level was similar with that of heart rate upon ISO stimulation .CONCLUSION: Sustained ISO infusion increases p-AMPK.After ISO infusion cessation for 3 d, p-AMPK is decreased to the basal level .β-AR-in-duced inotropic effects should be avoided to investigate the cardioprotective role of AMPK activation in the β-AR stimulation models.

Objective To make sure whether Bcrp1 is the marker of cervical cancer stem-like cells or not by studying the characterization of Bcrp1+ HeLa cells.Methods Immunofluorescence stained flow cytometry and electron microacope were used to sort and observe uhrastructures of Bctp1+ and Bcrp1- HeLa cells.Flow cytometry wag used to identify the cycle and the rate of apoptosis with annexin V in two group cells.The expression of proliferating cell nuclear antigen (PCNA)and caspase-3 were tested using western blot methed.Results (1)There were 7.1% Bcrp1+ cells and 92.9% Bcrol- cells in HeLa cells.Bcrp1+ HeLa cells were large in size of nuclear and nucleoli are clear.and there were rich of cytomicrosome and rough endoplasmic reticulum.After sorted and cultured for 24,48,72 hours,the adhesion in Bcrp1+ cells were 72.8%,81.1%,80.4%,respectively.While,they were 3.3%,18.7%,12.6%at each time for Bcrpl- cells(all P<0. 05 ). (2) There are more S phase cells in Bcrp1+ cells than that in Bcrp1- cells (54. 1% vs 21.1%, P <0. 05) ,while the percentage of G0/G1 and G2/M in Bcrp1 - cells were highter than those in Bcrp1 + cells (53.0% vs 44. 4% ,25.9% vs 1.5% ; all P <0. 05 ). The rate of apoptosis in Bcrp1+ cells was lower than that in Bcrp1 - cells (0. 2% vs 5.3%, P < 0. 05 ). ( 3 ) The expression of PCNA in Bcrp1 + cells was higher than that in Bcrp1- cells (3140 vs 2255, P< 0. 05 ), while the expression of caspase-3 of Bcrpl + cells was lower than that in Bcrp1 - cells ( 1970 vs 3551, P < 0. 05 ). Conclusion There are more vigor and ability of proliferation and lower rate of apeptosis in Bcrp1 + HeLa cells than those in Bcrp1 - cells ,which may be some characters of cervical cancer stem cells.

OBJECTIVE　To study the bioequivalence of methylprednisolone (MP) tablets in healthy volunteers.METHOD　A rapid and sensitive RP-HPLC assay was modified for the determination of the drug levels in plasma. In a randomized two-way crossover design, 40 mg single dose po domestic (B) and imported (A, MedrolTM) MP tablets, respectively, were given to 18 male healthy volunteers. The parameters were estimated by non-compartment model with a statistic analysis of ANOVA and two one-side t-test.RESULTS　The tmax,cmax,t1/2 and AUC0～∞ of tablet-B and-A were (1.9±0.5) h and (2.1±0.5) h, (597.6±119.8 ) ng*mL-1 and (572.6±121.7) ng*mL-1,(2.2±0.4) h and (2.3±0.4) h,(2528.4±558.8) h*ng*mL-1 and (2571.2±647.4) h*ng*mL-1,respectively.The mean relative bioavailability of the tablet-B vs A was 99.62%. There was no significant difference between the two products.CONCLUSION　The results suggested that these two products were bioequivalent.

BACKGROUND:Porous tantalum rods, possessing high porosity and highly similar elastic modulus to the trabecular bone, not only can provide effective mechanical support for the femoral head, but also can enhance revascularization in the areas of necrosis, reduce stress shielding, and provide guarantee for bone ingrowth in necrotic area.
OBJECTIVE:To investigate the attachment and proliferation of bone marrow mesenchymal stem cells on the surface of porous tantalum rod.
METHODS:The purified bone marrow mesenchymal stem cells which were separated from canines were seeded on the surface of porous tantalum rod by the celldensity of 1.5×109/L. cellattachment and proliferation was observed under phase microscope and scanning electron microscope at 5, 10 and 15 days under co-cultured condition.
RESULTS AND CONCLUSION:(1) Inverted microscope:Within 1-5 days after co-culture, the cells began to proliferate, and less cells were found near the tantalum rod, but more cells far from the rod. At 6-10 days after co-culture, the cells increased significantly and gradual y migrated to the rod, and even some cells attached to the edges of the rod. After 14 days, the cells were interconnected to form a film, packing the surrounding and dents of the tantalum rod. cells were visible to agglomerate and cellcalcification occurred. (2) Scanning electron microscope:At 5 days after co-culture, no celladhesion appeared on the the tantalum rod surface. At 10 days after co-culture, the cells scattered on the surface of tantalum rod, but there was no interconnection between them. After 15 days, cells were polygon shaped and connected into pieces. It could be seen that the cells secreted large amounts of col agen fibers, and the cells that were fusiform and polygon shaped were surrounded by a great amount of extracellular matrice. Bone marrow mesenchymal stem cells appear to have good adhesion and proliferation capability on the surface of tantalum rod.

Background Graft rejection is a primary cause of corneal transplantation failure,especially in high-risk keratoplasty.How to extend the survival time of graft is a problem to be solved.Objective This study was to investigate the influence of immune tolerance on high-risk rat keratoplasty induced by donor bone marrowderived immature dendritic cells (imDCs) transfected by chemokine receptor 7 (CCR7) recombinant adenovirus (Ad).Methods Bone marrow-derived imDCs were isolated and cultured from femur marrow of one male Wistar donor rat.The cells were transfected using recombinant Ad vector with rat CCR7 gene and resuspended in 500 μl PBS containing 1％ fetal bovine serum with the cells 1 × 107.High-risk corneal transplantaion models were established using monolateral corneal alkali-burn method in 60 SD rat recipients, and then allograft keratoplasty was performed with the 30 Wistar rats as donors.The models were randomized into the PBS group,imDCs group,imDCs with blank Ad vector group and imDCs with Ad-CCR7 group following the corresponding solution injection via caudal vein on preoperative day 7 and postoperative day 3 respectively.The survival time of graft was evaluated under the slit lamp microscope once per day.On the 14th day after operation, corneal sections were prepared from 6 eyes of each group for the pathological examination,and the relative expression levels of T helper cell 1 (Th1)-related factors,interleukin-2 (IL-2) mRNA and interferon-γ(IFN-γ) mRNA,as well as Th2-related factors, IL-4 mRNA and IL-10 mRNA, were detected by reverse transcription PCR (RT-PCR).The use and care of animals complied with the ARVO statement Results The mean survival time of grafts was (10.44±1.88) , (16.00±2.18) , (15.11±2.03) and(23.67±2.83) days in the PBS group,imDCs group,imDCs with blank Ad group and imDCs with Ad-CCR7 group, respectively, with a significant difference among the 4 groups (F =53.005, P =0.000).Compared with the PBS group, the mean survival time of grafts was considerably extended in the imDCs group,imDCs with blank Ad group and imDCs with Ad-CCR7 group (t=5.220,4.385,12.423 ,all at P=0.000) ,and a remarkble prolongation of graft survival duration was seen in the imDCs with Ad-CCR7 group in comparison with the imDCs group and the imDCs with blank Ad group (t =7.204,8.039,both at P=0.000).The relative expression levels of IFN-γ mRNA and IL-2 mRNA in the grafts were significantly lower,but the relative expression levels of IL-4 mRNA and IL-10 mRNA were significantly higher in the imDCs group,imDCs with blank Ad group and the imDCs with Ad-CCR7 group than those in the PBS group (all at P＜0.05).Compared with the imDCs group and the imDCs with blank Ad group, the relative expression levels of IFN-γ mRNA and IL-2 mRNA in the grafts were remarkably delined,but the relative expression levels of IL-4 mRNA and IL-10 mRNA were remarkably elevated in the imDCs with Ad-CCR7 group (all at P =0.000).Conclusions Application of imDCs transfected with CCR7 recombinant Ad via vena caudalis can prolong the survival time of grafts after keratoplasty of SD rats probably by affecting the balance of Th1/Th2 cytokines.

Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia (MTD) .Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD .All the patients were divided into two groups ac‐cording to the different remedies:the surgery group (n=57) ,and the combination group (n=60) .The Xion acous‐tic analysis was carried out on the two groups before and after therapy .We compared the results in each group ,the results of post-therapy between two groups ,and that of post-therapy with the control group(n=50) .The acous‐tic parameters were jitter percent (jitter) ,shimmer percent (shimmer) ,dysphonia severity index (DSI) .Results The results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group(P<0 .05) .Jitter and shimmer in post -therapeutic out‐come of the combination group were lower than those of in surgery group ,and DSI was even higher(P<0 .05) .Jit‐ter and shimmer in post-therapeutic outcome of surgery group were higher than those of in normal group ,and DSI was lower than those of in normal group(P<0 .05) .But there were no clinically significant differences in post -therapeutic outcomes of combination group compared with control group(P>0 .05) .Conclusion As for vocal polyps accompanied with M TD ,successful phonosurgical treatment and voice therapy can improve patients’ voice quality .