Objective To observe the influence of post-operative swallowing painwith Disposcope endoscope or Macintosh laryngoscope in patients with difficult visible glottis. Methods Thirty-six patients scheduled for elective surgery under general anesthesia whose glottis was not visible underMacintosh laryngoscope (according to Cormach-Lehane Grading of laryngoscopic view) were randomized into 2 groups (n = 18 each):Disposcope endoscope group (group D) and Macintosh laryngoscope group (group M). The rate of glottis exposure and successful intubation, swallowing pain at 30 min, 1, 3 d after extubation were observed. Results Compared with group M , the successful rate of glottis exposure and first intubation was significantly higher than thatin group D (P < 0.05). Swallowing pain VAS was higher in group M than in group D at 1d afterextubation (P < 0.05). Conclusions Compared with Macintosh laryngoscope , Disposcope endoscope in patients with difficult visible glottis could induce higher successful rate of glottis exposure and first intubation , shorter time of intubation and lower VAS of swallowing pain at 1d after extubation.

Objective To explore the relationship between methylene tetrahydrofolate reductase (MTHFR) gene polymorphism and homocysteine (Hcy),and further to investigate their correlation to coronary heart disease (CHD) in females.Methods This study involved 29 premenopausal women with CHD,57 postmenopausal women with CHD,50 men with CHD and 46 postmenopausal women with non-CHD.All patients underwent coronary angiography.The patients' gender,age,history of hypertension,diabetes and smoking were recorded.The plasma Hcy level,blood lipids and MTHFR gene polymorphism were examined.Results The level of Hcy in postmenopausal women with CHD was (18.11±7.21)μmol/L,which was significantly higher than (15.01±6.53)μmol/L in premenopausal women with CHD,(12.98±5.46)μmol/L in postmenopausal women with non-CHD group and (14.32±6.01)μmol/L in men with CHD group (t=5.23,3.65,5.08,all P<0.05).The frequency of the MTHFR TT genotype in postmenopausal women with CHD was 28.1% which was significantly higher than postmenopausal women with non-CHD(17.4%)(χ2=5.13,P<0.05),but there was no statistically significant difference with the other two groups.The plasma Hcy level in patients with TT genotype was significantly higher than that with CT or CC genotype in all groups.Multivariate logistic regression analysis showed a significant positive correlation in Hcy and TT genotype.Multivariate logistic regression analysis showed that smoking,Hcy,hypertension and diabetes were independent risk factors for CHD.The odds ratios(OR) of Hcy for CHD was 2.601 (95% confidence interval,1.326 to 5.745).Conclusion Hcy may be an independent risk factor for CHD in females.MTHFR C677T genotype is significantly associated with hyperhomocysteinemia,and its mutation frequency increases significantly in patients with CHD,but MTHFR mutation is not related with the incidence of CHD.

AIM　To find new anticancer drug based on the structure of podophyllotoxin. METHODS AND RESULTS　4-Deoxy-4β-arylmethylenesulfonylamido-4′-demethylpodophyllotoxins were (1-15) synthesized and their antitumour activities against KB cells and L1210 leukemia cells were tested. CONCLUSION　These compounds are new compounds. Among them, compounds 2, 3, 8, 9, 11 and 12 showed antitumour activities. When halides exist on the aryl ring of substituted sulfonyl group, the corresponding compound has relatively higher activities. The stereo factor is important for the activities.

Objective:To develop a Q-TRAP LC-MS/MS method for the content determination of militarine, protocatechuic acid and caffeic acid in Bletilla Striata. Methods:A Supelco Discovery C-18 (150 mm × 2. 1 mm, 3 μm) column was used and the mobile phase was acetonitrile-water containing 0. 1% formic acid (v/v) with gradient elution. The flow rate was 0. 25 ml·min-1. Bletilla Striata contrast medicinal materials and Bletilla Striata samples were detected by AB Sciex 4000 Q-MRM scan mode. Results: The content of militarine, protocatechuic acid and caffeic acid in the control herb of Bletilla Striata was 1. 167 5, 0. 062 6 mg·g-1 and 0. 001 0 mg·g-1 , respectively, and that in Bletilla Striata samples was 0. 708 8, 0. 001 1 mg·g-1 and 0. 000 4 mg·g-1 , respec-tively(n=3). Conclusion:The method is simple, accurate and reproducible. It can be used to quantitatively analyze militarine, pro-tocatechuic acid and caffeic acid in Bletilla Striata.

In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.

Objective To analyze the differentially expressed genes between the NCAM + c-Kit +RBE and NCAM-c-Kit-RBE of intrahepatic cholangiocarcinoma (ICC) cell lines,and to screen out the differentially expressed genes that are related to the stem cell signaling pathways.Methods Magnetic activated cell sorting was used to isolate the NCAM + c-Kit +/NCAM-c-Kit-subset cells,and then Agilent Whole Human Genome Microarray Kit was used to test the difference in gene expressions between the NCAM + cKit + and NCAM-c-Kit-subset cells.The difference in gene expressions related to the stem cell signaling pathways was analyzed by the SAS system.The result of the microarray was further confirmed by RT-PCR.Results The total differentially expressed genes which could be found through gene microarray were 7270 [foldchange(fc) ≥2 or fc ≤0.5].Compared with the NCAM-c-Kit-RBE,3572 genes were upregulated while 3698 genes were downregulated.The differences in gene expressions related to the stem cell signaling pathways were 421 (fc ≥2 or fc ≤ 0.5),among which 231 genes were upregulated while 190 genes were downregulated.Conclusions High-flux microarray could be used to screen out lots of differentially expressed genes between the NCAM + c-Kit + and NCAM-c-Kit-RBE cells.The differences in gene expression in the stem cell signaling pathways could also be further analyzed using the SAS system.

One patient confirmed as pituitary carcinoma by histopathology was retrospectively analyzed according to the great changes of tumor invasive growth in imaging examine and clinical characters. Clinically,pituitary carcinoma quickly grows,and the growth character of tumor is helpful in the diagnosis. Moreover,the treatment for pituitary carcinoma is different from pituitary adenoma.The rapid progress of pituitary adenoma indicates the possibility of primary carcinoma.More experience should be accumulated for the diagnosis and treatment of the disease.

Purpose:To evaluate the role of multi - detector row CT(MDCT) using reconstruction techniques in the assessment of patients with obstructed diseases of biliary tract.Materials and Methods: 47 Patients with obstructed diseases of biliary tract confirmed clinically underwent MDCT and their reconstructed images of biliary tract including multi-planar reconstruction (MPR) images and curved planar reconstruction(CPR) images were compared with those of 50 patients without obstruction and dilatation of biliary tract.The display effect of biliary duct structure and biliary duct wall and the display ability of biliary tract by MPR and CPR images between the 2 groups were compared and analysed.The reconstruction images of biliary tract were analysed retrospectively to evaluate the location and possible causes of biliary obstruction.Results: The display effect of biliary duct structure and biliary duct wall in MPR and CPR images of the group with biliary obstruction is better than that of control group,and the display ability of biliary tract in CPR images of the group with biliary obstruction is also better than that of control group.The accuracy of localization and cause evaluation of obstruction by MPR and CPR images is 100% and 89.4% respectively.Conclusions: The MPR and CPR images of MDCT provide a good display of biliary duct structure,biliary duct wall and an accurate evaluation of obstruction localization.The reconstruction technique of MDCT such as MPR and CPR should be widely applied in the evaluation of biliary obstruction.

Objective To investigate the survival data and acute toxicities in patients with locoregionally advanced nasopharyngeal carcinoma who receive intensity-modulated radiotherapy (IMRT)with concurrent chemotherapy using nedaplatin plus 5-fluorouracil (PF) or taxol plus nedaplatin (TP).Methods A retrospective analysis was performed on the clinical data of 152 patients with stage Ⅲ or Ⅳa nasopharyngeal carcinoma who were admitted to our hospital in 2009-2010.Of the 152 patients,80 received IMRT with concurrent PF chemotherapy,and 72 received IMRT with concurrent TP chemotherapy;there were at least 2 cycles of concurrent chemotherapy in both groups.The Kaplan-Meier method was used to calculate the survival rates,and the log-rank test was used to analyze the survival difference ; the chisquare test was used to compare the acute toxicities in the two groups.Results The follow-up rate was 100％.The 2-year relapse-free survival rate,distant metastasis-free survival rate,progression-free survival rate,and disease-specific death rate for the IMRT/PF group were 95％,82％,81％,and 13％,respectively,versus 97％,83％,79％,and 12％ for the IMRT/TP group (x2 =0.03,0.02,0.62,and 0.22,P=0.861,0.881,0.431,and 0.638).The incidence rates of leukopenia (grade ≥3),neutropenia (grade ≥ 3),thrombocytopenia (grade ≥ 3),ALT elevation (grade ≥ 2),and oral mucositis (grade ≥3) for the IMRT/PF group were 33％,23％,14％,8％,and 12％,respectively,versus 60％,47％,28％,18％,and 25％ for the IMRT/TP group (x2 =11.33,10.29,4.59,3.94,and 3.94,P =0.001,0.001,0.032,0.047,and 0.047).Conclusions Compared with IMRT with concurrent PF chemotherapy,IMRT with concurrent TP chemotherapy does not lead to significantly better survival and results in more acute toxicities in the patients with locoregionally advanced nasopharyngeal carcinoma.

Objective To determine if the cardiac index (CI) measured with arterial pressure-based cardiac output (APCO) agrees with that measured with pulmonary artery catheter (PAC) during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension.Methods Thirty parturients with congenital heart disease and severe pulmonary hypertension,scheduled for elective cesarean section,were enrolled in the study.APCO and PAC were used for cardiac output and other parameters of hemodynamics monitoring during operation in all patients.Continuous epidural anesthesia was performed.CI was recorded immediately before epidural administration (T1),at 5 and 10 min after epidural administration (T2-3),immediately before delivery (T4),and at 2 and 5 min after delivery (T5-6).The correlation was tested by Pearsone correlation analysis.CI derived from APCO and PAC was compared by Bland-Altman analysis for agreement.Results CI measured with PAC was significantly higher than that measured with APCO (P ＜ 0.05).Compared with the baseline value at T1,no significant difference in CI measured with PAC and APCO was found at T11-T4 and T6 (P ＞ 0.05),and CI measured with PAC and APCO was significantly increased at T5 (P ＜ 0.05).Bland-Ahman analysis showed poor agreement between CI measured with the two methods.The correlation analysis showed that there was positive correlation between CI derived from the two methods at T1-6 (the correlation coefficient was 0.93,0.95,0.94,0.89,0.96 and 0.91 at T1-6,respectively,P ＜ 0.05).Conclusion CI value obtained with APCO agrees poorly with that obtained with PAC during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension,but agrees well in monitoring the changing trend of CI.