As a nonparametric method, the Kruskal-Wallis test is widely used to compare three or more independent groups when an ordinal or interval level of data is available, especially when the assumptions of analysis of variance (ANOVA) are not met. If the Kruskal-Wallis statistic is statistically significant, Nemenyi test is an alternative method for further pairwise multiple comparisons to locate the source of significance. Unfortunately, most popular statistical packages do not integrate the Nemenyi test, which is not easy to be calculated by hand. We described the theory and applications of the Kruskal-Wallis and Nemenyi tests, and presented a flexible SAS macro to implement the two tests. The SAS macro was demonstrated by two examples from our cohort study in occupational epidemiology. It provides a useful tool for SAS users to test the differences among three or more independent groups using a nonparametric method.

Objective To inverstigate the efficiency and safety of transcatheter uterine artery embolization (TUAE) as well as the pathological changes and it′s significance after embolization. Methods 44 cases of uterine fibroids were treated by TUAE using lipiodol pingyangmycin emulsion (LPE) and Gelfoam sponge paeticles. Seven of 44 cases underwent hysterectomy or myomectomy from 1 to 6 weeks after TUAE.The specimens were studied to observe pathological changes of fibroids and myometrium. 37 of 44 patients were followed up for 1 to 6 months to observe the changes of fibroid size and uterine volume. The changes of ovarian function and myometrium after TUAE were found out by observation on mensis, test of ovarian hormone, premenstrual diagnostic curettage and pathology of the resected specimens. Results Total improvement of symptams occurred in 91.9%(34/37), including control of menorrhagia in 91.4%(32/35), disappearance of lumbago and lower abdominal pain in 85 3%(29/34),relief of freguency and urgency of micturition in 50.0%(7/14). Average decrease of fibroid and uterine volume at 6 months after TUAE was 61.3% and 50.6% respectively. No amenorrhea happened. Premenstrual diagnostic curettage showed secretory endomtrium. There was no significant difference in ovarian hormon level befor and after embolization. Pathological study showed that lipiodol was found to deposit in fibroids and was not seen in myometrium. Spotty necrosis 2 weeks occurred in fibroid and extensive patchy necrosis 3 weeks after embolization. The necrotic area became larger with elapse of time postoperative. Necrosis was not seen in myometrium. Conclusion TUAE is a new ,and effective procedure for uterine fibroid and LPE as an embolizing agent is safe without damage on myometrium.

Objective To investigate the satisfaction of clinicians on clinical research associates (CRA)and its influencing factors,for the purpose of providing rationalized proposals on education of CRAs.Methods 141 clinicians were randomly sampled from tertiary hospital for questionnaire survey,using the 5-point Likert scale.The survey covers 4 levels,i.e.,the work attitude,professional knowledge and ability,communication skills,and project management capabilities,as well as 14 dimensions.Data processing and statistics were analyzed using SPSS 15.0 software.The attribute characteristics of the investigation subjects were analyzed using x2 of the contingency table,along with analysis of its correlation with the general satisfaction on CRAs.Results The mean values of the 12 indicators range 2.28 to 3.75,with low satisfaction in general.Among these indicators,satisfaction of the service attitude of the CRA,and of their familiarity with the pilot program and CRF completion axe the highest,respectively,74.04％and 61.70％.Satisfaction of the rest 10 indicators falls below 50.00％.The chisquare analysis showed no association between satisfaction and gender,education,job titles.The satisfaction is different(P＜0.05)between those trained and those not,while there exists a significant differences(P＜0.01)between those participating in different number of tests.Conclusion Clinicians have a low satisfaction on CRAs.It is recommended to strengthen the training,establish a CRA occupation certification system,and to strengthen the clinicians' emphasis and competency of clinical trials.These actions will normalize the industry of clinical trials and improve the level of clinical trials in China.

ObjectiveTo investigate the effect of intensive dose atorvastatin on preventive contrast-induced nephropathy (CIN) in elder with coronary heart disease (CHD) after elective percutaneous coronary intervention (PCI).Methods110 subjects older than 60 who received elective PCI,were randomly divided into intensive dose atorvastatin group (the study group,n =50) and conventional treatment group (the control group,n =50).On the ba sis of the hydration therapy,the study group received atorvastatin and the control group received atorvastatin.Scr、β2- MG and liver function were checked for evidence of tubular or glomemlar damage before and after elective PCI were compared between the two groups.Ccr was calculated according to Cockcroft-Gault formula;The incidence of the major adverse cardiovascular events (MACE) and cytotoxicity and hepatotoxicity of rosuvastation were respectively recorded in 30 days follow-up period.ResultsCcr in the study group was significantly higher than that in the control group at day 1 [( 73.12 ± 16.89 ) ml/min vs ( 63.89 ± 18.42 ) ml/min,P =0.036],day 2 [( 65.32 ± 13.46 ) ml/min vs (55.63 ± 15.47 )mL/min,P =0.021] ;Blood β2-M in the study group was significantly lower than that in the control group at day 1 [( 2.44 ± 0.42 ) ml/min vs ( 2.69 ± 0.63 ) mL/min,P =0.009],day 3 ( 2.52 ± 0.46 ) mL/min vs (2.81 ±0.63) ml/min,P =0.011],day 3[(2.37 ±0.43) ml/min vs (2.54 ±0.65 ) ml/min,P =0.021].The incidence of CIN was lower in the study group than that in the control group(6％ vs 24％,P =0.012).During 30days clinical follow-up,the incidence of the MACE in the control group was more than the study group ( x2 =5.316,P =0.021).There was no significant difference between the two groups for the cytotoxicity and hepatotoxicity.ConclusionHigh dose atorvastatin may be more efficient in prevention CIN in elder before elective PCI and this higher dose may be safe to the elder.

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The influence of exercise at high temperature on adult males' routine blood indexes and biochemical indexes and the expression of HSP72 in peripheral blood lymphocytes (PBLs) was studied in order to provide theoretical ground for health supervision of adults receiving exercise at high temperature. 180 adult males were selected and divided into exercise group and control group, in which the exercise group was subdivided into subgroup 1 and subgroup 2 receiving exercise at high temperature in the afternoon and in the morning, respectively. Peripheral venous blood was phlebotomized before and after the exercise to examine routine blood indexes and blood biochemical indexes. The expression levels of HSP72 in PBLs were detected by flow cytometry. The results showed that the routine blood indexes and biochemical indexes in each group were within the range of normal values of male adults. There was no significant difference between each exercise group and control group in indexes before exercise. After exercise, the expression levels of HSP72 in PBLs in exercise groups were higher than those before exercise, and HSP72 expression levels in subgroup 1 were obviously higher than those in subgroup 2 and control group. The contents of ALT, urea, Na+, Cl-, Ca2+ and K+ in subgroups 1 and 2 were lower than those in control group, but CK level was higher than in control group (P<0.05). The contents of Na+ and Cl- in subgroup 1 were relatively lower than those in subgroup 2 (P<0.05). It was concluded that while receiving exercise at high temperature, adult males' HSP72 levels in PBLs could be increased and the biochemical indexes changed. Attention should be paid to health supervision to avoid obvious body injuries at high temperature.
Blood Chemical Analysis/*methods ; Exercise/*physiology ; HSP72 Heat-Shock Proteins/*blood ; HSP72 Heat-Shock Proteins/metabolism ; Hot Temperature ; Lymphocytes/*metabolism ; Young Adult

Objective To investigate the risk factors of electrical storm(ES) in patients with acute myocardial infarction (AMI) during perioperative period of direct percutaneous coronary intervention(PCI).Methods Forty-one AMI patients had been treated with direct PCI.The patients with perioperative ES were included in ES group and those without perioperative ES were included in conntrol group.ES was defined as the occurrence of spontaneous ventricular tachycardia or venicular fibrillation was twice or more within 24 h and unable to stop by itself and emergency treatment was needed.The difference of the clinical data between two groups were compared.Results There were 7 in 41 patients with direct PCI who had ES,the incidence was 17.07％,and 34 cases didn't have ES.Systolic pressure,diastolic pressure,white cell count,blood glucose,international normalized ratio and time duration from chest pain onset to direct PCI between two groups had no significant differences (P ＞0.05).Age,CK-MB,cardiac troponin I,the diameter of infarctrelated arleries(IRA ),incidence of reperfusion arrhythmia and mortality of ES group were all obviously higher than those of control group (P ＜ 0.05 or ＜ 0.01 ).The incidence of ES in patients whose IRA was left main artery or occlusion of middle section of two main coronary arteries,right coronary artery,left anterior descending branch and left circumflex artery was 66.67％(2/3),18.75％(3/16),11.76％(2/17) and O, respectively.Conclusions Perioperative ES during direct PCI most commonly occurrs in AMI patients with left main artery or occlusion of middle section of two main coronary artery.The diameter of IRA,TIMI flow classification after the patency of IRA and recanalization arrhythmia are the main risk factors of the occurrence of perioperative ES.

Objective To evaluate the Effect of dexmedetomidine on the stress reaction for awake nasotra-cheal intubation in patients with maxillofacial tumor. Methods Forty patients,which are ASA physical status Ⅰor Ⅱ,aged 20 ~ 62 yr ,BMI < 25 and scheduled for radical operation for maxillofacial tuomr ,were randomly divided into 2 groups (n = 20 each)using a random number table:dexmedetomidine groups(group D)and mid-azolam group(group M). MAP ,HR ,SpO2 were recorded ,and the rate of respiratory depression ,the degree of tolerance and matching and the memory to intubation were recorded. Results Compared with the baseline value at T0,MAP and HR at T1-2 and HR at T3 were increased in group M. HR were increased at T1 in group D(P<0.05). Compared with group M,MAP and HR at T1-2 and HR at T3 were decresed in group D(P<0.05). The rate of respi-ratory depression in group D was decreased compared with group M ,and the degree of tolerance and matching to intubation was better in group D. Conclusion dexmedetomidine can inhibit the stress reaction caused by nasotra-cheal intubation in patients with maxillofacial tuomr ,and improve the degree of comfort and security in the process of intubation.

Schizophyllum commune has emerged as the most promising model mushroom to study developmental stages (mycelium, primordium), which are two primary processes of fruit body development. Long non-coding RNA (lncRNA) has been proved to participate in fruit development and sex differentiation in fungi. However, potential lncRNAs have not been identified in S. commune from mycelium to primordium developmental stages. In this study, lncRNA-seq was performed in S. commune and 61.56 Gb clean data were generated from mycelium and primordium developmental stages. Furthermore, 191 lncRNAs had been obtained and a total of 49 lncRNAs were classified as differently expressed lncRNAs.Additionally, 26 up-regulated differently expressed lncRNAs and 23 down-regulated between mycelium and primordia libraries were detected. Further, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that differentially expressed lncRNAs target genes from the MAPK pathway, phosphatidylinositol signal, ubiquitin-mediated proteolysis, autophagy, and cell cycle. This study provides a new resource for further research on the relationship between lncRNA and two developmental stages (mycelium, primordium) in S. commune

To investigate the health impacts of crystalline silica mixed dust and other potential occupational hazards on workers in ceramic factories, a cohort study of 4851 workers registered in the employment records in 3 ceramic factories in Jingdezhen city of China between 1972 and 1974 was identified. The cohort mortality was traced throughout 2003 with an accumulation of 128970.2 person-years, revealed 1542 deaths. Standardized mortality ratios (SMRs) were calculated for the main causes of death by using Chinese national mortality rates as reference. The mortality from all causes in three ceramic factories was 12.0 per thousand and the cumulative mortality was 31.8%. Malignant neoplasm, cardiovascular diseases, respiratory diseases, infectious diseases were the first four illnesses that threaten workers' life, and they accounted for 73.2% of all deaths. The results of this study showed that the standardized mortality ratio for all subjects was 1.02, which is very close to that expected on the basis of the China national mortality rates. Statistically significant mortality excesses for respiratory disease (SMR=1.36), pneumoconiosis (SMR=37.34), infectious disease (SMR=5.70) and pulmonary tuberculosis (SMR=3.88) were observed. The mortality of 2938 dust-exposed workers was higher than that of 1913 non dust-exposed workers. Except for pneumoconiosis, the mortality from lung cancer, non-malignant respiratory diseases and pulmonary tuberculosis in dust-exposed workers were significantly increased as compared with that in non-exposed workers, and the relative risks (RRs) were 1.86 (1.16-2.99), 2.50 (1.84-3.40), 1.81 (1.34-2.45). The exposure-response relationships between cumulative dust exposure level and mortality from all causes, colorectal cancer, lung cancer, respiratory diseases, and pulmonary tuberculosis were also identified. The findings indicated that silica mixed dust in ceramic factories has harmful impact on the workers' health and life span in ceramic factory.