Objective In order to analyze the variation of HA genes of influenza viruses (H1N1) by being compared with the vaccine strain A/California/07/2009(H1N1) recommended by WHO ,influenza viruses (H1N1) isolated from 2009 to 2014 were selected to do this study .Methods According to the different isolating time and place ,47 strains of H1N1 collected from 2011 to 2014 were selected .Then the 47 strains′ nucleotide sequence of HA genes which were sequenced in the study and other 25 se‐quences of HA genes which were sequenced in 2009 were collected .Nucleotide and amino acid sequences were analyzed by using molecular biology software ,and the phylogenetic trees were drawn .Results A total of 72 strains isolated from 2009 to 2014 were closely related to the vaccine strain A/California/07/2009(H1N1) ,the nucleotide variance and amino acid variance between the 72 strains were 0-2 .7% and 0-3 .1% respectively .Compared with the vaccine strain A/California/07/2009(H1N1) ,the nucleotide variance and amino acid sequence variance were 0 .4% -2 .4% and 0 .9% -3 .1% respectively .The amino acids sequence indicated that ,although the variance was increased by years ,the H1N1 viruses were still showed characteristics of low pathogenic influenza viruses .It was also found that there were 9 strains lost their potential glycosylation site at HA protein site 481 in 2009 ,while in 2013 there were 6 strains got new potential glycosylation sites at HA protein site 162 .Conclusion The vaccines (H1N1) recom‐mended by WHO was still protective to people in Chongqing .But as time goes by ,antigen drift may occur in some new antigenic drift strains and the routine monitoring of influenza viruses should be continued .

Coronary Sinus ; abnormalities ; Humans ; Male ; Middle Aged ; Subclavian Vein ; Vena Cava, Superior

We are reporting in this article some analyzed data obtained from inspection and related information on current situations medical devices in use. Some ideas and suggestions are also proposed here on how to systematically and legally inspecting and monitoring medical devices in use.
Equipment Safety ; Materials Management, Hospital

BACKGROUND:At present,autogenous periosteum and artificial dura mater are usually applied as the substitute grafts for the dural defect by neurological surgery.However they do not accord with the developing trend of modern medicine,due to the limitations of material size and shape,operational complex and additional wound.OBJECTIVE:To observe and compare the evolution of a new type bio-artificial dura and autogenous periosteum in replacing orthotopic duraDESIGN:Controlled observation and trial.SETTING:Animal Testing Center in the 157 Hospital of Guangzhou City.MATERIALS:Nine New Zealand rabbits.aged 6 months and weighed 2-3 kg,either gender was selected.Twelve hybrid healthy dogs of both genders,aged 2 years and weighed 15-20 kg.New type dura mater(No.2006.3460627).METHODS:The experiment was carried out at the Animal Testing Center in the 157 Hospital of Guangzhou City from October 2003 to October 2005.After the general anesthesia and bilateral craniotomy,the bilateral dural defect and pia mater injury were induced partly,then dural neoplasty was performed using new type artificial dura and autogenous periosteum.MAIN OUTCOME MEASURES:At months 1,6,12 of modeling,each three rabbits were selected to isolate and expose the implanted materials,while each four dogs were selected at months 6,12,24 of modeling,died of disease or prior to death.General observation and microscopic assessment of samples were compared to analyze the development of implanted materials at difference stages.RESULTS:Except one experimental dog died during the anesthesia,9 rabbits and 11 dogs were involved in the final presented the extemal surface of adherence and separation with pedcranium,grew well with surrounding orthotopic dura.For the internal surface of materials,the new type artificial dura was more likely the orthotopic dura and did no adhere to pericranium, and filament-shaped adherence appeared occasionally, while there were filament-shaped even month 12 of grafting new type artificial dura into the experimental rabbits.inflammatory cellular reactions such as neutrophil and lymphocyte were not found,additionally no capsule wall formation occurred.The internal surface of artificial dura was covered with epithelial cells,which appeared fibroplasia,fibroblast proliferation,degradation of implants and obvious reduction of total cell amount.Moreover the blood capillary was also found.CONCLUSION:New type artificial dura can achieve the dural reconstruction through producing epithelial cells and being nibbled.degraded and substituted by autogenous tissue.And no adherence to cerebral tissues is found.New type artificial dura is superior to autogenous periosteum for repairing the dural defects.

ObjectiveThe purpose of the study was to observe and analysis the actual dosage of patients with breast cancer using metal oxide semiconductor field effect transistor (MOSFET) detector.MethodsFirst, Phantom measurements were performed to investigate dose distribution in the area of the junction in a half-field matching method and the influence of factors related to the accelerator. In vivo dose measurements were performed for patients with breast cancer to investigate the skin dose and the junction of supraclavicular-axillary field and tangential field in 6 MV X-ray beams. ResultsPhantom measurements showed that the relative deviation in the junction were within + 3％, and the dose distributions in the junction area depended on the matching field direction (x or y). In vivo measurement of tangential region for patients showed that, the maximum dose deviation between measurement and calculation was -30. 39％,the minimum deviation was - 18. 85％, the average dose deviation was -24. 76％. The dose deviation of tangential fields for patients with breast-conserving surgery was larger than that patients with radical surgery (t =2. 40 ,P＜0. 05), while dose deviation of supraclavicular-axillary fields was not significantly different. The average values of 15 fraction in the junction area showed more stable than one individual measurement.ConclusionsIt is important to real-time, in vivo measurement of radiation dose during radiotherapy in patients with breast cancer, and change treatment plan in time, to ensure the accuracy of target dose.

AIM:To study the effect of posterior sub - Tenon's capsule injection of triamcinolone acetonide ( TA ) in treatment of patients with diffuse diabetic macular edema ( DME) before panretinal photocoagulation ( PRP) .
METHODS:Retrospective analysis of the clinical data of 96 cases (96 eyes) with DME treated in our hospital from October 2008 to May 2012, and the patients were divided into the study group and control group, each group with 48 cases ( 48 eyes ) , the control group were only treated with PRP, and for the study group, TA was injected one week before PRP. At 6mo after treatment, best-corrected visual acuity ( BCVA) and retinal thickness changes of two groups were compared, the changes of intraocular pressure in two groups was analyzed.
RESULTS:After treatment, two groups were followed up for 6mo, compared with before treatment, the expression of BCVA in control group was reduced, and rise in the study group, with significant difference between the two groups (P<0. 05), and during the follow-up period, IOP change was in the normal range for the two groups, with no the difference (P>0. 05), the study group had foveal thickness reduction of 9. 6μm, the control group was increased by 31. 9μm, with significant difference (P<0. 05), parafoveal thickness in the study group decreased 5μm, significantly increased 22. 1μm in the study group, centre concave surrounding thickness increased 0. 4μm in study group and 19. 4μm for the control group, with no significant difference (P>0. 05).CONCLUSION:TA injection in patients with diffuse DME before PRP is safe and effective, and it is superior to simple PRP therapy, and it can be applied in primary hospital.

Objective To investigate the influence of esmolol infusion on QT dispersity(QTd)in elderly patients with coronary heart disease during perioperafive period.Methods Fifty ASA Ⅱ or Ⅲ patients with coronary heart disease aged 65-80 yr undegoing non-cardiac surgery under general anesthesia were randomly divided into 2 groups(n=25 each):control group(group C)and esmolol group(group E).Anesthesia was induced with midazolam,fentanyl and vecuronium and maintained with continuous iv infusion of propofol andvecuronium and intermittent iv boluses of fentanyl.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 25-35 mm Hg.In group E a loading dose of esmolol 0.5 mg/kg was given iv over 1 min at 2 min before skin incision and was followed by esmolol infusion at 25 μg·kg-1·min-1 maintained until the end of operation.Radial artery was caunulated.MAP,HR,SpO2 and PETCO2 were continuously momtored.ECG composed of 12 leads was momtored before operation,at 30 min after skin incision,immediately after operation,and at postsurgery days 1 and 2.The longest and shortest QT intervals were measured and detected by a cardiologist not involved in the study.The QTd was calculated.The ventricular arrhythmia was also recorded.Results QTd,the incidences of QTd abnormality and ventricular arrbythmia were significantly lower in group E than in group C.Conclusion The use ofesmolol during operation may decrease QTd and prevent the occurrence ofventricular arrhythmia.

BACKGROUND:The output of computed tomography (CT) is Digital Imaging and Communications in Medicine (DICOM), whereas the input of three-dimensional (3D) printing is an object Standard Template Library model represented by a triangular mesh. The process of data handing and forrmat conversion are keys to the combination of these two techniques. OBJECTIVE:To explore how to convert CT data into a stereoscopic 3D model efficiently. METHODS:The DICOM in Medicine format data of the patients with femoral fractures were edited and produced by Mimics. We made a 3D model by adjusting the parameters of the 3D printer slicing software, and discussed the significance of 3D model in medical field, especially orthopedics. RESULTS AND CONCLUSION:Mimics software is the bridge to connect two-dimensional CT scan images and 3D images, to create a 3D model by editing the data of DICOM which comes from the CT scanner, with a 3D printing technology. The 3D Model can help doctors for routine clinical diagnosis and treatment, to improve the communication between doctors and patients and the quality of clinical medical teaching. 3D printing also makes medicine more personalized, remote, minimally invasive, and promote the development of medicine to the direction of digital medicine.

Objective To analyze the clinical characteristics of two patients with 3β-hydroxysteroid dehydrogenase deficiency and to explore their molecular genetic defects.Methods The clinical features and laboratory data of two patients were collected.The exons of HSD3B2 gene were amplified by PCR and sequenced by Sanger sequencing.Results Patient 1, aged 5 yrs old, was raised as a girl with 46, XY karyotype, presented with hyperpigmentation, female infant vulva, clitoral hypertrophy, and bilateral cryptorchidism;Patient 2, aged 11 yrs old, was raised as a girl at birth but as a boy after 1 yr old for known 46, XY karyotype, presented with hyperpigmentation, micropenis and severe hypospadias.Both patients had markedly elevated adrenocorticotropin and decreased cortisol.Two homozygous missense mutations in HSD3B2 gene were identified:conversions of codon Pro155 toLeu(p.P155L)inpatient1,andcodonAla82toThr(p.A82T)inpatient2,bothofwhichwerereportedforthe first time in China.Conclusion The patients with 3β-hydroxysteroid dehydrogenase deficiency in 46,XY karyotype mainly present with male pseudohermaphroditism and adrenocortical deficiency, and the diagnosis should rely on the steroids detection and HSD3B2 gene screening.

Objective To refine the technique and improve the efficacy of seminal vesiculoscopy in the diagnosis and treatment of seminal vesicle disease.Methods The refined techniques of seminal vesculoscopy,using a patent catheter into the slit-like ejaculatory duct orifice through the verumontanum and another patent catheter introduced into seminal vesicle lumen,were performed in 58 cases,including intractable hematospermia in 42 cases and azoospermia in 16 cases.Results Seminal vesiculoscopy was successfully entered into the seminal vesicular lumen in 46 patients (79％) within 2-3 min.There was no obvious ejaculatory duct orifice in 12 of 16 azoopermia cases,and transurethral resection of verumontanum was performed,then seminal vesiculoscope was directly entered into seminal vesicle lumen.Symptoms of hematospermia were disappeared in 25 cases (60％),improved in 11 cases (26％),and azoospermia were cured in 6 cases (37％),improved in 5 (31％),unchanged in 5 (31％) during the follow-up period of 6-36 months (average 18 months).There were no major or minor complications in this series,and no urine reflux into ejaculatory duct in 19 cases demonstrated by contrast medium.Conclusion Refined seminal vesiculoscopy was technically safe,efficient,simple,and potentially widely used in the cases of hematospermia and ejaculatory duct obstructions.