Objective To evaluate the detection rate of congenital heart defect (CHD) during the first trimester screening for chromosomal abnormalities,the role of ultrasound soft markers including increased nuchal translucency (NT),tricuspid regurgitation (TR) and abnormal ductus venosus (DV) flow in the screening for cardiac anomalies was also investigated.Methods From January 2009 to January 2012,4 673 fetuses were scanned at 11-14 weeks at Department of Fetal Medicine,the First Affiliated Hospital of Jinan University.The ultrasound findings and follow up outcomes were recorded,False-positive rate of different first-trimester ultrasound markers for the detection of CHD was calculated,sensitivity of the markers for all major CHD was calculated as well.Results There was a significant association between major CHD and first trimester ultrasound markers.(1) Overall findings:among the 4 673 fetuses,31 fetuses were diagnosed CHD prenatally,17,12 and 2 of which were detected in the first,second and third trimester,respectively.In 22 of the 31 CHD cases,invasive procedure was performed,fetal karyotype was abnormal in 12 cases,including triosmy 21 (5 cases),trisomy 18 (2 cases),trisomy 13 (2 cases),Turner syndrome (2 cases) and pericentric inversion of chromosome 9 (1 cases).(2) NT measurement and prenatal detected CHD:in 4 673 cases,NT measurement between 95th-99th percentile were present in 206 (4.41％),5 cases were diagnosed CHD prenatally,in 4 of 5 cases were detected in first trimester; NT measurement ＜ 95th percentile were present in 4 430(94.80％),16 cases were diagnosed CHD prenatally,in 5 of 16 cases were detected in first trimester; NT measurement ＞ 99th percentile (＞ 3.5 mm) were present in 37 (0.79％,37/4 673),10 cases were diagnosed CHD prenatally,in 8 of 10 cases were detected in first trimester.(3) TR and inverted a-wave at the DV and prenatal detected CHD:among 4 673 cases,TR or inverted a-wave at the DV were present in 51 (1.09％),98 (2.10％) respectively.TR was present in 8 of 31 CHD cases,inverted a-wave at the DV was present in 7 of 31 CHD cases.(4)Sensitivity of different first trimester ultrasound markers for detection of major CHD cases:in 31 CHD cases diagnosed prenatally,23 eased were defined as major CHD.Sensitivity of at least one of the ultrasound narkers,NT measurement between 95th-99th percentile,＞ 99th percentile(＞ 3.5 mm),TR or inverted a-wave at the DV for detection of major CHD eases was 74％ (17/23),22％ (5/23),39％ (9/23),35％ (8/23),30％ (7/23),respectively.(5) Specificity of different first trimester ultrasound markers for detection of CHD cases:specificity of NT measurement between 95th-99th percentile,＞ 99th percentile(＞ 3.5 mm),TR or inverted a-wave at the DV for detection of major CHD cases was 4.30％ (201/4 673),0.58％ (27/4 673),0.92％ (43/4 673),1.94％ (91/4 673).Conclusions Routine first trimester soft markers for chromosomal abnormalities screening combined with cardiac assessment can detect quite a number of major heart defects.Increased NT,TR and abnormal DV flow can be important indicators for echocardiography,which is favorable to early prenatal diagnosis of CHD.

Cultivating clinical comprehensive ability is one of the core and main purposes for surgical clinical education.According to the characteristics in clinical teaching of hepatobiliary surgery,we combined basic theory with clinical practice and discussed on the problems of how to improve medical students' clinical comprehensive abilities including clinical operational ability,logical thinking ability,scientific research innovative ability and the doctor-patient communication ability and how to cultivate medical ethics and professional competence from aspects of basic clinical skills training,translational medicine concept,etc.

A high performance liquid chromatography-tandem mass spectrometric method ( HPLC-MS/MS ) was developed for the simultaneous determination of 31 kinds of triazine herbicides in farmland soils. Samples were extracted by accelerated solvent extraction ( ASE ) and purified by Oasis MCX solid phase extraction ( SPE) cartridges, and then analyzed by HPLC-MS/MS in multiple reaction monitoring ( MRM) mode with positive electrospray ionization. The analytical column was Phenomenex Luna C18 ( 150 mm í 2. 0 mm í3 μm) and the mobile phases were acetonitrile and water containing 0. 1% (V/V) formic acid. The limits of detection (S/N≥3) were 0. 008-0. 440 μg/L. All of the triazine herbicides had good linear responses with r≥0 . 996 and the average recoveries in the spiked levels of 0 . 40-40 . 0 μg/kg ranged from 76 . 9%-102 . 0%with the RSDs of 3 . 4%-10 . 3%. The HPLC-MS/MS method had been applied for the detection of the triazine herbicide residues in farmland soils from Shenyang region and the results showed that atrazine, simazine, prometryne and atrazine-desethyl were the main triazine herbicides in the region.

Objective To investigate risk factors of Alzheimer's patients with aspiration pneumonia and inter-vention,to provide a reference for clinical treatment.Methods From January 2013 to June 2014,322 patients with Alzheimer's disease were selected,the incidence of aspiration pneumonia was analyzed,and the age,gender,depression Tian water test grading,underlying diseases,aspiration and other potential factors were analyzed to get risk factors of aspiration pneumonia,and summarized countermeasures.Results Multivariate analysis showed that underlying disea-ses (95%CI =1.694 -5.319,P =0.011),invasive procedures(95%CI =1.884 -6.362,P =0.001),depression Tian water test grade(95%CI =2.184 -9.636,P =0.000),malnutrition(95%CI =2.501 -11.114,P =0.000), Glasgow Coma Scale(95%CI =1.271 -3.569,P =0.011),were risk factors for Alzheimer patients with aspiration pneumonia(P <0.05).Conclusion Alzheimer's patients with inhalation pneumonia have multiple risk factors,more expectoration should be done for caring,e.g.oral care,in order to reduce the probability of pneumonia.

BACKGROUND:Many studies concerning influence of traditional Chinese medicine on animal movement capacity have been conducted.However,studies on the improvement of exercise capacity by traditional Chinese medicine are few,especially comparisons among traditional Chinese medicineOBJECTIVE:To explore the influence of different traditional Chinese medicine preparations on the exercise capacity in mice to screen compound preparations with precise effects.METHOD:A total of 80 8-week-old pure male Kunming mice were randomly assigned to 8 groups(n=10):control and compound 1-7 groups.There were no significant differences in body mass of all groups The compound 1 comprised Xuejie and Shexiang;compound 2 comprised Qingui,Baizhu and Baishao;compound 3 comprised Baizhu,Baizhi and Sanqi;compound 4 comprised Baizhi,Ruxiang,Danggui and Radix glycryrrhizae;compound 5 comprised Guiwei;compound 6 comprised Sichuan Honghua and Danshen;compound 7 comprised Danggui and Shexiang.Of the 7 prescriptions,compound 1-5 were empirical formula,compound 6 was common medicine used during training,and compound 7 was prescription of traditional Chinese medicine The 7 compound groupswere respectivelytreatedwith 1.17,0.78,0.78,1.17,7.02,5.53,and 11.70 g/kg per day for 4 weeks,and control group was intragastrically infused with normal saline.From day 4 to 6,load-free swimming training was performed 20 minutes a day for 3 days,followed by swimming for 6 days a week after 1 day of rest.The intensity was gradually increased frOm 30 minutes per day by 10 minutes per day for 2 hours,followed by loading swimming with load of 2%of the body mass,increased by 1%per day until the final experiment.During the entire procedure,a great intensity swimming training was performed every week to make the mice exhausted.Mice training and serum creatine kinase and lactate dehydrogenase 4 weeks following treatment were observed.RESULTS AND CONCLUSION:A total of 80 mice were included in the final analysis The compounds showed little influence on mice body mass;the compound 2 and compound 6 groups had longest exhaustive time All compounds inhibited serum creatine kinase activity following exercise,in particular compound 6 and 2(P＜0.05).Compared with control group,the serum lactate dehydrogenase activity of each compound group was decreased,in particular,compound 2 and 6 groups showed significant differences(P＜0.05).Compound 2 and 6 significantly enhanced the exercise capacity of mice and delayed injury of body.The mechanism may highly relate to components in the compounds,Danggui,Sichuan Honghua and Danshen.

Twenty-four patients with parapharyngeal space tumors were treated from 1964 to 1999.There were 11 males and 13 females,ranging in age from 10 to 71 years old.Among 24 patients, benign tumors were 17(70.8%),malignant tumors 7(29.2%).The diagnosis of these tumors were biopsy and CT scaning .Pathologic results showed that the original tumors were salivary gland tissue in 11(45.8%),cranial nerve in 7(29.2%),vascular tissue in 2(8.3%)and the unidentified in 4(16.7%).The surgical approaches for these tumors were neck side incision in 19,through mouth in 5.Results showed that 4 malignant tumors were died in one year,3 cases did not clear;the prognosis of 17 benign tumors were well.

Objective To study the clinical feature and treatment of lung benign metastasizing leiomyoma. Methods A retrospective analysis was performed on 2 cases of lung benign metastasizing leiomyoma. Results Two cases were asymptomatic who also had previously undergone hysterectomy, but imageology revealed multiple pulmonary nodules bilaterally of various sizes. And one of them had a pelvic mass. Conclusion Lung benign metastasizing leiomyoma is a rare disease. Hysterectomy, bilateral salpingo-oophorectomy and hormonal therapy may be helpful to improve the prognosis.

Objective To research the status of health literacy among a vocational high school in Guizhou province ,and provide the evidence for health education for the students in this school .Methods Independent design a health literacy questionnaire based on Chinese citizens′health literacy questionnaire in 2008 ,and random sampling 380 students from freshman to senior of this school to investigation in November ,2012 .Results 78 .35% of the students in this school had a basic health knowledge ,39 .57% students had a healthy lifestyle and behaviors ,and 66 .61% students had a sense of the basic literacy skills .The difference was statistically significant among the three items(F=651 .710 ,P<0 .01) .From the overall condition of the health literacy ,the students form high-er household income have higher health quotient ,but with no statistically significant (P>0 .05) ,meanwhile ,there was no difference in health quotient on household registration and gender students .With the increase of school age ,student health literacy level was reduced ,the difference was statistically significant (F=3 .657 ,P<0 .05) .Conclusion The health literacy of lifestyle and behavior of students in this school is poor .Education should be targeted to develop healthy habits .As for the junior and senior students ,the school should enhance the health education intensity to improve the health literacy .

Objective To systematically study solvatomorphism of indomethacin and provide a scientific basis for the quality control of the solvated impurities in this drug. Methods By changing the recrystallization solvent, solvent volume, recrystallization temperature, time and pressure, nine solvates and four non-solvated forms were discovered and prepared. The differential scanning calorimetry (DSC), thermogravimetric analysis ( TGA), X-ray powder diffraction ( PXRD) and infrared spectrometry (IR) were introduced for characterization analysis. Furthermore, the test of influencing factors was used to explore the stability of solvate crystal form and the crystal transformation rules among them. Results Nine solvates were prepared, which including two solvates reported for the first time in this work. Results showed that crystal forms of the 9 solvates have different types or proportions of crystal solvents according to the various results of DSC, TGA, PXRD and IR. Moreover, the nine solvates prepared in this work were metastable crystal forms which could be transformed to non-medicinal forms. Conclusion The composition, thermodynamic property and transformation rule of all the solvates are elucidated in this work. In addition, an effective method for qualitative or quantitative analysis of these solvates was established. The standard graphs and data were used as basic data and scientific basis for the solvate control in the manufacturing of indomethacin.

Objective To study the expression and clinical significance of the SALL4 in human gastric carcinoma tissues. Methods The expression of SALL4 in 91 samples of gastric carcinoma and 37 samples of normal gastric tissues was detected by RT-PCR,Western blot and immunohistochemistry,and its relationship with the clinical data were analyzed statistically.Results The positive expression rate of SALL4 in gastric carcinoma(74.7%)was significantly higher than that(18.9%)in normal gastric mucosa tissues(P <0.05).Moreover,with the decreased with the differentiation of gastric carcinoma,the positive expression rate of SALL4 was increased.The expression of SALL4 mRNA and protein in gastric carcinoma tissues were significantly higher than that in normal gastric tissues(P <0.050).The expression levels of SALL4 were relevant to lymph node metastasis(P =0.001),infiltra-tion depth(P =0.029)and the differentiation degree of gastric carcinoma(P =0.050).Conclusion SALL4 was highly expressed in gastric cancer tissues and relevant to lymph node metastasis,infiltration depth and the differentiation degree,which may have play an important role in the development of gastric cancer.