The two pore domain K + Channel is a new superfamily of potassium channel subunits expressing the background potassium current on the cell membrane. Its functions are closely related with the physiological and pathological changes. This article reviews five groups of the two pore domain K + Channel on the gene and protein structure, current characteristics and pharmacological properties.

Objective To evaluate the efficacy and safety of morphine by supersound atomizer for the management of postoperative pain in gynecology and obstetrics patients.Methods Eighty ASA class III patients scheduled for elective mixed gynecology and obstetrics surgeries were randomly and single-blindly located into 4 groups.Patients in each group received different analgesia therapy 30 rain before the end of the surgeries,as inhaling morphine 15 nag in group MI,inhaling morphine 20 nag in group M2,inhaling normal saline 10 ml in group N and intravenous patient-controlled analgesia (PCA) in group PCA.Open-label rescue analgesia of intramuscular injection pethidine 50 mg or intravenous PCA was also available as needed.Pain scores were measured at baseline,15 min,30 min,1 h,2 h,3 h,4 h,6 h,8 h and 24 h after the extubation using visual analng score ( VAS ),vital signs,adverse events,and the uses of rescue analgesia were also recorded.Results The VAS of group M2 were significantly lower than that of group N and group M1.The VAS at 15 min,1 h,6 h,8 h,24 h of group M2 were significantly lower than that of group PCA(P ＜ 0.05 or ＜0.01 ).The VAS at 15 min,30 min,1 h,2 h,4 h,6 h of group M1 were significantly lower than that of group N (P ＜ 0.05 or ＜ 0.01 ) postoperatively,which were significantly higher than that of group PCA except for 30 min.The morbidity of postoperative,nausea and vomiting in group M1 and group M2 were significantly higher than those in group N and group PCA.The rescue analgesia was more performed in group M 1 and group N than that in group M2 and group PCA.Conelusions Inhalation of morphine by supersound atomizer via intratracheal tube may produce safe and satisfying analgesic effect in postoperative pain model of gynecology and obstetrics patients.More studies are needed to determine what,if any,the optimum dose of morphine is for postoperative pain relieving and the possible mechanism.

In order to improve the clinical outcomes and promote the development of enhanced recovery after surgery(ERAS),a full-time specialized role of nurse navigator(NN) was established in Department of Surgery in February,2016. Clinical pathway for ERAS was designed,and role functions,core competencies and responsibilities of NN were formulated. According to the functions and the working frame,NN connected and coordinated teamwork activities,monitored the implementation of ERAS during the overall process. After implementation,the NN had dealt with 10 unusual incidents,the execution efficiency of the 14(82.4%) measurements were 100%,1 measurement was 97%,2 measurements were 94.1%,and 33 patients and 42 medical staff thought highly of the NN. This practice effectively promoted the development of ERAS team and specialist nurse role in our hospital.

OBJECTIVE:To provide reference for safe application of antibiotic drugs in single or inter-medical institution ser-vices. METHODS:An antibiotic drug safety evaluation index system was established by reference to literatures. Medical records tracing method was adopted to obtain the medical records of children with respiratory infectious diseases under the medical consor-tium model. The medical records were matched and evaluated by experts to analysis the safety of antibiotic drug use in single medi-cal institution and the connection between two medical institutions with respect to the safety of antibiotic drug use. RESULTS:248 effective medical records had been obtained. Under the medical consortium model,the rate of the combination of antibiotic drugs in large hospitals was 86.29%,higher than the community hospitals of 77.02%(χ2=5.49,P<0.05). The error rate of antibiotic drug use by children in large hospitals was 14.52%,lower than the community hospitals of 25.81%(χ2=9.733,P<0.05). There were many contradictions in antibiotic drug use between the medical institution where children received treatment initially and the medi-cal institution which the children were referred to and hospitalized in. There were totally 128 cases of unsafe antibiotic drug use, with the overall incidence of 51.61%. CONCLUSIONS:Under the medical consortium model,the safety of antibiotic drug use by the hospitalized children in single medical institution is worrying,and the connection between two medical institutions with respect to the safety of antibiotic drug use by children who are referred and hospitalized is less reliable.

Objective To explore the application of nutritional management leaded by nurses in hospitalized phthisical patients.Methods We set up a safe,effective nutritional management model by establishing united nutritional management group,making nutritional management system and process and organizing nutritional management knowledge training,and this model was carried out in 50 hospitalized phthisical patients.Results The total satisfaction rate for nutritional management was 97.56％.The screening risk rate for nutrition by nurses was 100％.Dietitians were asked to assess 22 cases for nutrition risk and 12 cases received nutritional support.The supporting rate was 54.55％,and the patients' condition was improved.Conclusion The application of the nutrition management leaded by nurses in hospitalized phthisical patients improved patients' nutritional condition,increased satisfaction of patients,enforced the screening function of nurses during the process of nutrition management and promoted the process of nursing expertise.

Objective To explore the image quality and radiation dose for coronary angiography using DSCT (dual-source computed tomography) under lower tube voltage and lower contrast agent concentration ('double low').Methods A total of 160 patients with suspected coronary artery disease underwent dual-source CCTA.80 patients (BMI ＜ 25 kg/m2) were randomly assigned to group A (270 mg I/ml-80 kV) and B (350 mg I/ml-120 kV).The other 80 patients (25 ≤ BMI ＜30 kg/m2) were randomly assigned to group C (270 mg I/ml-100 kV) and D (350 mg I/ml-120 kV),sonogram affirmed iterative reconstruction technology and 270 mg I/ml contrast agent were applied to group A and C ; FBP technology and 350 mg I/ml contrast agent were applied to group B and D.Adaptive cardio-sequence prospective ECG-gated technology was applied in all patients,while the acquisition phase was 65％-75％ RR interval (when heart rate ＜ 75 beats / min) or 40％-50％ RR interval at when heart rate ≥ 75 beats/min.Volume CT dose index (CTDIvol),dose length product (DLP),effective dose (E),size specific dose estimates (SSDE),image noise,CT value,signal-to-noise ratio (SNR),and contrast-to-noise ratio(CNR) were all evaluated for each patient.Results There was not statistical difference in scan length among groups A and B,C and D.There was statistical difference in tube current between group A and B (t =8.932,P ＜0.05).There was not statistical difference in tube current between group C and D (tCD =-1.212,P ＞ 0.05).There was statistical difference in CTDIvol,DLP,E and SSDE between group A and B,C and D (tCTDIvol =-16.141,-11.440 ; tDLP =-17.454,-10.521 ; t =-17.444,-10.523 ;tSSDE =-13.032,-9.119,P ＜0.05).Compared to group B,the SSDE in group A decreased by 64.4％.Compared to group D,the SSDE in group C decreased by 39.3％.There was no statistical difference in image noise between group A and B,C and D (P ＞ 0.05).There was statistical difference in CT value,SNR and CNR between group A and B (t =0.436,4.623,3.272,P ＜ 0.05).There was no statistical difference in CT value and CNR between group C and D,while there was statistical difference in SNR between group C and D (t =2.981,P ＜0.05).There was no statistical difference in image quality scores between group A and B,C and D (P ＞ 0.05).Conclusion Compared with conventional DSCT coronary angiography,'double low' DSCT coronary scanning solution can significantly reduce the radiation dose and contrast agent,and could provide the effective coronary images which meet the clinical diagnostic needs.

Objective To study the expression feature and clinical significance of plasma Protein C(PC) in pre‐PICC placement and post‐PICC placement in patients with cancer .Methods The levels in plasma of PC was tested by ELISA in patients with cancer in one day before PICC placement ,in one day ,30 day ,and 90 day after PICC placement ,the change of feature and clinical signifi‐cance was analyzed .Results The levels of PC in one day after PICC placement were 3 .74 ± 1 .99 μg/L ,the levels was lower than the levels of in one day before ,and in 30 ,90 day after PICC placement ,which were 5 .00 ± 2 .40 ,4 .78 ± 2 .41 and 5 .35 ± 2 .71 μg/L (q=3 .74 ,2 .85 and 4 .58 respectively ,P<0 .05);There were no statistical significance both in D‐D levels and PLT count among pre‐PICC and post‐PICC placement(P>0 .05);There were no correlation both PC levels and D‐D levels ,and both PC levels and PLT count(r= -0 .024 1 and 0 .111 0 ,all P>0 .05) .Conclusion The PC levels in one day after PICC placement were lower ,but there were no correlation both PC and D‐D ,and PLT .PICC catheter were safety .

Objective To studiy the surgical outcomes of children with congenital aortic stenosis (AS),and summarized the experience of surgical procedures.Methods From February 2006 to November 2011,a total of 49 consecutive children with AS underwent surgical treatments.Twenty-nine patients were male and 20 patients were female.The median age was 17 months (1 month to 14 years),and median weight was 15.6 kg (3.2-47.0 kg).Peak AS gradients was (74.9 ±20.4)mmHg (45-123 mm Hg) before surgery.Fourteen patients had isolated congenital AS,4 had combined moderate-to-severe aortic insufficiency (AI).Thirty-Three patients had associated cardiac anomalies,including ventricular septal defect,atrial septal defect,patent ductus ateriosus,coarctation of aorta,subaortic stenosis,and supravalvular mitral stenosis.Thirty-one patients underwent aortic valvotomy,9 valvuloplasty,2 Aortic valve replacement (AVR),1 Ross procedure,2 Ross-Konno procedure,and 4 Konno/AVR.Median follow-up was 20 months (2-55 months).Clinical and echocardiographic follow-up data were analyzed.Results There was 1 postoperative death who died of heart failure due to severe mitral valve insuffciency.Latest follow-up data showed that the survivals performed in satisfactory cardiac function.Left ventricular ejection fraction (LVEF)was 0.69 ±0.10,and fraction shortening (FS) was 0.38 ±0.09.Peak AS gradients decreased significantly after surgery to (38.6 ± 15.8) mm Hg (20-73 mm Hg),P ＜ 0.001.One patient needed reintervention because of severe recurrence of adhesion in the commissure 3 months after the previous surgery.Totally 31 patients underwent simple valvotomy procedure.Postoperative AI was none or trace in 5,mild in 20,and moderate in 6.Two surgical techniques were used to repair the aortic valve according to the anatomy of the valve and the cause of insufficiency,including commissuroplasty in 6 and pericarial casp extension in 3.Nine patients underwent valvuloplasty procedure,post-operative AI was none or trace in 3,mild in 5,and moderate in 1.We put more attention to the 7 patients who had moderate AI valvotomy or valvuloplasty,and the latest follow-up showed that these patients were in good condition and there was no deterioration the degree of AI.Conclusion Long-term outcomes show that aortic valvotomy and valvuloplasty are reliable and effective approaches for congenital AS in children.When moderate-to-severe AI exists,other procedures such as Ross,Ross-Konno,AVR,or Konno/AVR are preferred.

Objective To investigate the correlation between serum tumor necrosis factor (TNF)-α,neuron-specific enolase (NSE)and the degree of hypoxic-ischemic encephalopathy (HIE).Methods Forty-six HIE patients in acute and convalescent stage and 30 full-term newborn infant were enrolled in this study.The level of serum of TNF-α and NSE were detected.The relationship between TNF-α,NSE level and severity of HIE was analyzed.Results The level of serum TNF-α and NSE in acute stage of HIE group were (156.3 ± 28.8) ng/L and (21.5 ± 3.6) μg/L,in convalescent stage of HIE group were (80.7 ± 26.1) ng/L and (10.6 ± 1.7) μ g/L,and in control group were (76.3 ± 24.4) ng/L and (9.4 ± 1.6) μ g/L.The level of serum TNF-α and NSE in acute stage of HIE group were significantly higher than those in convalescent stage of HIE group and control group (P ＜ 0.05).The level of serum TNF-α and NSE in convalescent stage of HIE group had no significant difference compared with those in control group (P ＞ 0.05).The level of serum TNF-α and NSE in mild HIE group were (88.5 ± 25.6) ng/L and (9.7 ± 2.4) μ g/L,in moderate HIE group were (150.1 ± 16.5) ng/L and (17.8 ± 3.6) μ g/L,and in severe HIE group were (197.3 ± 30.2) ng/L and (23.6 ±4.3) μg/L.The level of TNF-αand NSE were increased with the aggravation of HIE and there had significant difference among different degree of HIE(P ＜ 0.05).The level of serum TNF-α and NSE in mild HIE group and control group had no significant difference (P ＞ 0.05),and there had significant difference between moderate HIE group,severe HIE group and control group (P ＜ 0.05).Spearman rank correlation analysis showed that the level of TNF-α and NSE had positive correlation with the degree of HIE (r =0.54,0.57,P ＜ 0.01 or ＜ 0.05).Pearson correlation analysis showed that the level of TNF-α had positive correlation with the level of NSE (r =0.46,P ＜ 0.05).Conclusions The variation of TNF-α and NSE level in HIE newborn infant is parallel to the severity of the disease,which can sensitively reflect the severity of HIE.Therefore,TNF-α and NSE may be used as vital indexes for the evaluation of the severity of HIE.

Objective To study the effects of up-regulated gene-4 (URG-4) on colon cancer cellproliferation.MethodsColon cancer cell line with high expression of URG-4 was selected.The recombinant URG-4 siRNA retroviral vector was constructed and packaged by PT67 cell,then retroviral particles which can express URG-4 siRNA in mammal cell and its negative control were obtained.Expressions of URG-4 in MKN45,SW480,LoVo,HCT116,HT29 were detected by RT-PCR and Western blot,respectively.Recombinant virus (interference group),original virus (negative control group) and the same amount of PBS (blank group) were used to transfect LoVo cells respectively.Stably transfected cell lines were screened.The growth condition of cell lines in each group was assayed by MTT.All data were analyzed by the one-way analysis of variance and the t test.Results Sequencing results confirmed the successful construction of retroviral which expressed siRNA,the relative expression levels of URG-4 mRNA in MKN45,SW480,LoVo,HCT116,HT29 were 0.58 +0.02,0.63 ±0.03,0.81 ± 0.01,1.01 ± 0.02,0.91 ± 0.04 and the expression levels of URG-4 protein in the 5 cell lines were 0.73 ±0.02,0.85 ± 0.03,1.42 ± 0.01,0.80 ± 0.30,0.80 ± 0.04,respectively.High expression of URG-4 was observed in the LoVo cells.The expression of URG-4 mRNA in the LoVo cells in the interference group was 0.55 ±0.03,which was significantly lower than 1.15 ±0.02 of the negative control group and 1.15 ±0.01 of the blank group ( t =- 5.179,- 9.285,P ＜ 0.05 ).The inhibition rate of URG-4 mRNA in the interference group was 52.6％.The expression of URG-4 protein in the interference group was 0.82 ± 0.05,which was significantly lower than 1.46 ± 0.07 of the negative control group and 1.54 ± 0.04 of the blank group (t =-4.239,-3.704,P＜0.05).The inhibition rate of URG-4 protein in the interference group was 43.6％.The LoVo cells in each group grew exponentially.Compared with the negative control group,the cell growth of the interference group was inhibited during day 3 to day 6,which had statistical significant difference ( t =- 6.436,-6.045,-6.434,-4.285,P＜0.05).ConclusionInterference of the expression of URG-4 can inhibit the growth of LoVo cells.