objectives To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening per-formed in normal singleton pregnancies at 14+1 to 19+6 weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1 to 23+6 weeks from 2010 to 2013. Results In 24 368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14%(35/24 368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnan-cies with an expected date of delivery higher than 35 years old. In 1 215 pregnancies, second-trimester serum screening showed high risk (cutoff>1:380), 14 were confirmed as Down syndromes ( sensitivity 40%;specificity 95.06%). In 1 142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down syndrome (sensitivity 60%;specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syn-drome (sensitivity 11.43%;specificity 99.56). Conclusions The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

Objective To explore the effects of the application of targeted surveillance in the Deparment of Neurosurgery. Methods Someone was specially assignedd to work out both process and outcome goals by means of perspective investigation, clinical groups were formed and information feedback, evaluation of effects and correction of deviation were regularly conducted. Results The process goals were obtained: from July 1996 to June 1997, the rate of hospital infection in the Department of Neurosurgery droppoed from 26.07% to 21.32% (x2 = 4.3465,P ＜0.05). The outcome goals were also obtained: from July 1997 to June 1998, the rate of infection dropped from 21. 32% to 13.40% (x2 = 16.1193,P＜0.01). Conclusion Targeted surveillance is a really effective form of surveillance and information feedback and evaluation of effects are indispensable. Application of targeted surveillance in the Department of Neurosurgery has won initial success.

BACKGROUND: Researches on the diagnosis and detection methods of diabetic autonomic neuropathy(DAN) is very weak at present.OBJECTIVE: To get the data about the degree of autonomic neuropathy by using the nonlinear heart rate variability(HRV) so as to provide clinical evidence for the early diagnosis of DAN.DESIGN: A single sample study.SETTINGS: Computer department in a university; Staff room of medical physics of department of biomedical engineering in a university.PARTICIPANTS: The experiment was completed in the Staff Room of Medical Physics, Department of Biomedical Engineering in the First Military Medical University of Chinese PLA from March to May 2002. Thirty-four diabetic patients, including 22 with DAN complications, were selected from the inpatients of Department of Endocrinology in the Affiliated Nanfang Hospital of the First Military Medical University of PLA, and other 40 normal subjects, who were from the faculty in the First Military Medical University of Chinese PLA and students in the Department of Physical Education, Chinese PLA Institute of Physical Education, were taken as the controls. The R wave to R wave intervals(RRI) time series is sampled and corrected to 512 points for analysis.INTERVENTIONS: Based on the virtual instrumental workbench-LabVIEW, 74 standard adjacent RRI signals were selected from 34 diabetic patients and 40 normal cases, and then analyzed with the method of nonlinear predictability.MAIN OUTCOME MEASURES: Collective and analytical results of the 74 standard adjacent RRI signals.RESULTS: There was no significant difference between the diabetic patients without DAN and the controls by the analysis with normalized mean square error(NMSE) NMSE ( P = 0. 075 ), but the significant difference between the DAN patients and the controls( P = 0. 001) . While significant analysis between the diabetic patients without DAN complications and the controls was significant by the analysis of mean absolute error(MAE) (P = 0. 007 and P = 0. 000), there was also significant difference between the diabetic patients with and without DAN ( P = 0. 001 ).CONCLUSION: Different impaired degree of autonomic nerve system in diabetic patients can result in nonlinear reduction in HRV analysis, but nonlinear predictability analysis can prove the nonlinear model of HRV,. and can also provide important state information of sympathetic and parasympathetic systems so that it can provide reliable evidence for the earlier diagnosis and the prognosis evaluation of DAN.

Objective To evaluate the influence of different combination of anesthetics on blood pressure (BP) and heart rate (HR) of aged patients with serious illness during operation. Methods Forty patients, aged 80～92, with physical status Ⅱ～Ⅲ as categorized according to American Society of Anesthesiologists (ASA) undergoing selective surgery, were randomly divided equally into two groups: in group A ancsthesia was induced with midazolam, fentanyl and maintained with isoflurane, and in group B anesthesia was induced and maintained with etomidate, sevoflurane and nitrous oxide. Mean arterial pressure (MAP), HR and bispectral index (BIS) were observed at the points of preinduction (T0), induction (T1), intubation (T2), incision (T3), 30 minutes after incision (T4) and extubation (T5). Results After induction, BIS decreased from 95?2 to 52?4, while MAP and HR decreased from 110?11mmHg and 73?8/min to 75?9mmHg and 59?4/min respectively, in group A. While in group B BIS decreased from 94?3 to 58?3, MAP and HR decreased from 103?8 mmHg and 76?6/min to 87?7 mmHg and 67?5/min, respectively. At the point of tracheal intubation, MAP and HR increased significantly in group A compared with group B (P

Objective To study the anti-inflammatory mechanism of the Penyankangshuan (PYKS) in treating chronic pelvic inflammation. Methods After model rats with endometritis were established successflly, 6 groups were formed which were the high, the middle and the low dosage groups of the PYKS, the KFXYS (a kind of patent medicine has a similar effect) group, the model group, the normal group. The treated rats were continuously rectal administration 3 weeks, the expression of NF-?B, Caspase-3 and MMP-2 were observed in the high, the middle dosage groups of the PYKS, the KFXYS group, the model group and the normal group with immunohistochemistry. Results The PYKS obviously raised the expression of Caspase-3 and MMP-2, but decreased the expression of NF-?B. Conclusion The anti-inflammatory mechanism of the PYKS possibly raised the expression of Caspase-3 and MMP-2 of mice endometrial cells, decreased the expression of NF-?B, so as to reduce inflammation soakage in excess and formation of inflammatory medium, accelerate apoptosis and reduce local inflammation.

Objective To analyze the problems frequently found in medical equipment bidding at public hospitals and come up with countermeasures for building a scientific and standardized bidding procedure.Methods 168 cases of medical equipment bidding of the hospital in the recent five years served as objects of study,for a full-process longitudinal study.It covered the preparation of technical parameters,compilation of bidding documentation,bid opening/evaluation process,all the way to final acceptance and after-sales service,and complaints responses.Results In the 168 cases,imported equipments accounted for 86.90%;only 16.07% of the purchases involved consumables,yet their importance deserved high attention;59.52% of the equipments involved after-sales maintenance costs,calling for regular maintenance to ensure smooth operation of the equipments.Conclusions Quality of domestic equipments should be enhanced,for optimization of the ratio between domestic and imported equipments;equipment purchase,after-sales service and consumables purchase should be taken into account in general;scientific evaluation levels and standards should be established to enhance supervision,for the purpose of scientific and rational purchase of medical equipments.

Objective To examine the role of c-Jun NH2-terminal kinase(JNK) 1 in cytolytic T lymphocyte (CTL) responses against virus infection.Methods Wild-type (WT) and JNK1-knockout (JNK1-/-) mice were infected with ectromelia virus(ECTV) through hind footpads.Survival and virus titers in the target organs (liver and spleen) were analyzed.Effector T cells in the spleen and popliteal lymph nodes were determined on day 3 and 7 post-infection.Proliferation and INF-γ production of CTL were also detected.Results JNK1 deficiency caused an increased susceptibility to ECTV infection in mice,indicated by higher case fatality and viral burden in target organs.The decrease in CTL response correlated with a defect in CTL proliferation and INF-γproduction.Conclusion The data suggest that JNK1 is involved in expansion of activated CTL during ECTV infection,and plays an important antiviral role in regulating the proliferation and effector function of CTL.

BACKGROUND:SIRT6/NF-κB is the important signal axis to cellsenescence, but the effect of SIRT6/NF-κB signal axis to hematopoietic stem and progenitor cell(HSC/HPC) senescence is unclear. OBJECTIVE:To induce (t-BHP) in vitro and to investigate the role of SIRT6/NF-κB signal axis in Sca-1+HSC/HPC senescence induced by tert-butylhydroperoxide in vitro. METHODS:Sca-1+HSC/HPC was isolated and purified by magnetic activated cellsorting. Sca-1+HSC/HPC senescence was induced by 100μmol/L tert-butylhydroperoxide in vitro. The senescence-associatedβ-Galactosidase staining, cellcycle analysis and culture of mixed hematopoietic progenitor cellwere used to investigate the biological effects of tert-butylhydroperoxide on Sca-1+HSC/HPC senescence. The expression of senescence associated SIRT6, NF-κB mRNA and protein was examined by real-time fluorescence quantitative PCR and western blot assay. RESULTS AND CONCLUSION:Compared with control group, the percentage of positive cells expressing SA-β-Gal and cells in G0/G1 phase increased and the number of forming colony of mixed hematopoietic progenitor decreased in the aging group. It showed lower expression of SIRT6 and higher expression of NF-κB in the aging group. The SIRT6/NF-κB signal axis may play a key role in the Sca-1+ HSC /HPC senescence inducted by tert-butylhydroperoxide.

Objective To investigate the pharmacokinetics ( PK ) and pharmacodynamics ( PD ) processes of rabeprazole in inhibiting gastric acid secretion with the combined PK-PD model. Methods A total of 10 healthy volunteers were given a intravenous infusion of 20 mg rabeprazole over a 30-min period. The concentration of rabeprazole in the plasma at different time points was detected by HPLC,and the PK parameters were calculated by DAS 2. 0 software. At the same time the intragastric pH was monitored over 24 hours to fit the PD parameters with indirect inhibition model. Results The main PK parameters,t1/2,Cmax,and AUC were(60. 5±17. 3)min,(1 299. 1±201. 0)ng·mL-1,and(106. 4±26. 0)mg·min·L-1, respectively.The corresponding PD parameters,Kin,Ke,IC50 and Imax were(8.200±3.362)h-1,(1.080±0.378)h-1,(0.286± 0. 129)mg·L-1 and(6. 93± 2. 15)pH,respectively. Conclusion The PK of rabeprazole in healthy volunteers conforms to one compartment model,and the PD fits the indirect response inhibition model. The equation can effectively establish the relationship between the blood drug concentration and the effect.

Objective To study the features and reasons of violent events in medical staff and the public sentiments on them based on a network analysis. Methods The data of violent events in medical staff were down-loaded from Internet. The annual and geographic distribution and reasons of violent events in medical staff, casualties of medi-cal staff and the public opinions on the major Websites were analyzed. Results The number of violent events in medical staff increased to 31 in 2012 from 1 in 2003. The violent events were distributed in 18 provinces of China, the number of casualties was 105 , and 53% of the violent events occurred due to the unsatisfactory therapeutic out-comes in patients. Conclusion The public sentiments on violent events in medical staff tend to increase on Internet and characterized by no signs and direct conflict between patients or their family members before attacking medical staff, and against general medical staff. Public sentiments on violent events in medical staff are easy to become hot events with significant negative effects on the society. Medical institutions and hospitals should prevent such events and play an active role in guiding the public sentiments.