Objective To explore the diagnostic value and optimal cut-off point of symptom index (SI) in gastroesophageal reflux-induced chronic cough (GERC).Methods The recordings of multichannel intraluminal esophageal impedance and pH monitoring were retrospectively analyzed in 118 patients with suspicious GERC.SI for all the refluxes,acid reflux and non-acid reflux was calculated respectively by analyzing the temporal association between detected reflux and cough recorded on diary card.Based on the favorable response to the anti-reflux therapy,the diagnostic value for GERC of SI was evaluated and compared with that of the symptom association probability (SAP).Results GERC was definitely determined in 100 patients (84.7％).When SI for all the refluxes was used for the diagnosis of GERC,the cut-off point of ≥45％ had the highest diagnostic efficacy,with the sensitivity of 56.0％,the specificity of 83.3％and Youden index of 0.393.SI for acid or non-acid reflux had the same optimal cut-off point of ≥30％ and presented with the similar efficacy in the diagnosis of acid or non-acid GERC.Compared with SAP of ≥75％,SIforall the refluxes of ≥45％ had a lower sensitivity (56.0％ vs 75.0％,x2 =7.988,P=0.005),a higher specificity (83.3％ vs 44.4％,x2 =5.900,P =0.015) and the comparable positive or negative predictive value in the diagnosis of GERC.The diagnostic accuracy for GERC was further improved when combining SI for all the refluxes with SAP.Conclusion SI for all the refluxes has a diagnostic value similar to SAP and its optimal cut-off point for GERC may be ≥45％.

Objective To discuss the important points of rescue strategies in saving patients and related administration to minimize the medical risk of county or district hospitals. Methods The analytic method to minimize the medical risk of district and county hospitals was from clinical practice and via induction,summary and reorganization. Results and Conclusions The reasonable and effective clinical medical operative process includes,timely necessary emergency initial examinations,immediately organizing group consultation after mastering the emergency rescue procedures in various critical situations,following the newest modern treatment guidelines or professional expert consensus,treating patients with correct motivation to maximize the therapeutic effect,carrying out treatment while the diagnosis confirmed,properly communicating between doctor and patient,timely recording the medical record,improving the diagnosis and treatment capacity in cases with critical and difficult diseases step by step,correcting the errors and mistakes,immediately and effectively proceeding to crisis public relations in time.

Objective This study evaluated the effects of combined procedure of surgical treatment and cell transplantation on dilated cardiomyopathy. Methods Eight patients (5 men and 3 women) with moderate to severe mitral regurgitation from end-stage dilated cardiomyopathy underwent surgery. Four patients were in functional class (FC) Ⅳ, six were in FC Ⅲ. There age ranged from 15 to 56 years. The preoperative ejection fraction (EF) ranged from 0.15 to 0.32 (mean 0.26 ± 0.08). Mitral valve replacement was performed in 5 patients and mitral valve repair in 3. Auto-bone marrow monenuclear cells were harvested, isolated, washed, and resuspended for direct injection after surgical procedure. Results All patients survived and were discharged from the hospital. After a mean follow-up period of 18 months ( 12 - 42 months). Echocardiography showed postoperative ejection fraction and wall movement velocity increased after 6 months. Radionuclide ventriculography showed myocardial perfusion improved significantly. Conclusion Combined procedure of surgical treatment and cell transplantation led to significant improvement in cardiac function in patients with dilated cardiomyopathy.

Objective To explore the expression of vascular endothelial growth factor(VEGF) and Survivin in nasopharyngeal carcinoma.Methods Immunohistochemical method staining for the paraffin sections(SP method) were used to assess the expression of VECF and Survivin expression in 80 cases of nasopharyngeal carcinoma tissues and 24 cases of nasopharyngeal chronic inflammation tissues.Results The overexpression rate of VEGF protein was 75.76% (61/80) in nasopharyngeal carcinoma tissues,and 25.00% (6/80) in nasopharyngeal chronic inflammation tissues(P<0.01) ;The overexpression rate of Survivin protein was 67.50% (54/80) in nasopharyngeal carcinoma tissues,and 16.67% (4/80) in nasopharyngeal chronic inflammation tissues(P<0.01).The expression of VEGF was related to TNM stage,T stage,lymph node metastasis and distant metastasis (P<0.05) ,and there was a close relation between the expression of Survivin and TNM stage,T stage,lymph node metastasis and distant metastasis (P<0.05).Conclusion Detecting the expression levels of VEGF and Survivin proteins simultaneously in nasopharyngeal carcinoma had certain reference value for judging biological behavior and evaluating prognosis of patients with nasopharyngeal carcinoma.

Objective To evaluate the hemolysis and fatigue resistance self suspension ventricular assist device (NIVAD) in vitro.Methods Resettled NIVAD which is filled with 2 500 ml fresh anticoagulant blood from pig in vitro loop system.The speed of blood pump was adjusted to 8 000 rpm.The afterload and the flow of pump were set as 100 mmHg and 3.5 L/min respectively.Keep the temperature at around 37 degree centigrade which is equal to average internal temperature in pig.Then harvest and measure the free hemoglobin(FHB) of blood samples at different time points before and after working.Then calculated the normalized index of hemoylsis(NIH) by comparing to control group, the unused pig blood at the same period.In fatigue test, conditions remained unchanged, except the blood was replaced by pure water.The blood pump had operated for 90 d continuously and recorded its performance.Results The FHB of experimental blood is higher than that of the control.The normal index of hemolysis NIVAD is(0.0052 ±0.0019)mg/L.Fatigue test , the blood pump operated smoothly, and every parameters was stable.Conclusion The blood pump of NIVAD does a certain degree of destruction to blood, but the NIH is in criterion range of hemolysis, it has certain advantages compared to similar products in china and aboard.At the same time it has good resistance and stable property to fatigue.

Objective To study the function of the nano-molecular polyamide-amine (PAMAM) as microRNA(miR) carrier targeting gastric adenocarcinoma, and the foundation of developing an efficient delivery of small molecule drugs tar-geting gastric cancer thereof. Methods The folic acid (FA)/PAMAM comoles compound was prepared by dialysis method. After transfection of miR-7 or liposomes into SGC-7901 cell line, fluorescence microscope was used to detect the gene trans-fect efficiency. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the miR-7 level. The immu-nocytochemistry assay was used to test the protein expressions of epidermal growth factor receptor (EGFR), protein kinase B (PKB) and proliferating cell nuclearantigen (PCNA). The transwell system was utilized to explore the migration ability of tu-mor cells. Results Compared with liposme, FA/PAMAN complex compound can significantly improve the level of miR-7 in SGC-7901 cells,reduce the protein levels of EGFR, PKB and PCNA in SGC-7901 cells, and also reduce the percentage of cancer cell migration (P<0.05). Conclusion PAMAM can effectively transfect miR into gastric cancer cells, which is expected to become an efficient delivery of small molecule drugs.

OBJECTIVE:To study the feasibility of overflow dissolution method for evaluating the drug in vitro sustained re-lease performance. METHODS:Overflow dissolution method was established by simulating the drugs elimination in vivo. Using Nifedipine sustained-elease tablets(Ⅰ)from 2 different manufacturers as model drug A,B,concentration-time curve,cumulative release rate- time curve,release velocity-time curve of model drugs in release pool at 3 different overflow speed (0,1.50,3.00 mL/min)were investigated. RESULTS:When overflow speed was 0,the cumulative dissolution was consistent with that of the con-ventional dissolution method. As the overflow speed increased,cmax of drug A,B was decreased [A:(8.89±0.20),(5.21±0.04), (3.51±0.03)μg/mL;B:(7.62±0.05),(4.80±0.09),(2.89±0.04)μg/mL];cumulative release rate was increased [A:(85.47± 2.45)%,(94.29 ± 2.44)%,(96.04 ± 2.56)%;B:(73.28 ± 1.13)%,(78.46 ± 1.94)%,(82.50 ± 1.69)%] ;tmax was ahead (A:1.5,1.0,0.5 h;B:2.0,1.0,0.5 h). CONCLUSIONS:Overflow dissolution method has avoided the inhibition of too large drug concentration on drug release,making complete drug release and more accurate evaluation of in vivo sustained release performance of the preparation.

Objective To study the effects of improving elderly patients with bowel dysfunction after cardiopulmonary bypass.Methods Choose 54 elderly patients with CPB were randomly divided into tree groups:the control group and the Gln group and the Combination group,every group has 18 patients.Glutamine(Gln) at 0.4 g/kg was administrated to the patients in the Gln group and the combination group during the beginning at CPB and two days after the operation.Based on the Gln group,the patients of The Combination group were given the different oral Chinese medicine before and after operation,according to syndrome differentiation classification.Plasma endotoxin,IL-6 and DAO were measured before operation and at the endof operation and 24 h,48 h after operation.At the same time,we used German Siemens Company's X3000 Color Doppler machine to test every group of patients superior mesenteric artery.We tested before surgery,and one to two days after operation,from the starting point within 2cmof the superior mesenteric artery and the angle between the ultrasound beam flow was less than 60 °,the probe frequency was 3.5 MHz.The detection of hemodynamic indexes were EDV and PI.Results After the test,the plasma endotoxin and IL-6 levels and DAO levels of the Gln group were reduced than the Control group after cardiopulmonary bypass.The plasma endotoxin and IL-6 levels and DAO levels of the Combined gnup were decreased than the Gln group after cardiopulmonary bypass and one day after operation.Analyze superior mesenteric artery diastolic velocity (EDV)and pulsatility index (PI) by the Color Doppler.After operation,the EDV in the Gln group and the Combined grup were significantly higher than the control group,the Pl were lower than the control group.The parameters levels have significant difference after cardiopulmonary bypass and one day after operation(P ＜ 0.05 ).The Combined group was improved than the Gln group after cardiopulmonary bypass and one day after operation.According to the traditional Chinese medicine diagnosis,there were eighteen patients in the Combined group,including fifteen patients in type of deficiency of both qi and yin and three patients in type of fu-viscera syndnome.All of the patients have defecated within tree days after operation.In the type of deficiency of both qi and yin nine patients were cured and six were shown to be effective after operation.All the patients in type of fuviscera syndrome were cured.Conclusion N(2)-L-Alanyle-L-Glutmaine have protective effect on the intestinal mucosal barrier after CPB.Combined traditional Chinese Medicine preparation was more conducive to the intestinal function recovery of elderly patients after cartiopulmonary bypass.

With the aid of scientific research management information system, we established an in-formation management for the scientific research funds. The structure,function and application of the system were introduced in this paper.

Objective To establish an animal model for implantable ventricular assist device. Methods Seven male calves, body weight 120 to 180 kg, were anesthetized and underwent surgical implantation through a left thoracotomy at the 4th intercostal space. The domestic-made implantable ventricular assist device (DIVAD) was implanted after cardiopulmonary bypass and induction of ventricular fibrillation. The major indexes of mechanical properties of the DIVAD are similar to those of imported devices. The DIVAD was 29.5 mm × 72 mm, with a total weight of 158 g. The maximal pump speed was 9000 rpm and the maximal pump flow was 8 L/min in in vitro experiment. A flow meter was incorporated into the pump. The DIVAD was constructed with an external controller, and the pump can be monitored and adjusted through it. The inflow cannula was positioned into the left ventricle and the outflow cannula was sutured to the descending aorta. The pump was run at 3,500 to 8,000 rpm. The cardiopulmonary bypass was weaned. The pump output and animal condition was continuously monitored. Heparin was administered to maintain the activated clotting time at 1.5 to 2 times its baseline value. Results All the seven calves weaned from cardiopulmonary bypass. The mean survival time is 20.28 hours with a range from 0.5 to more than 93 hours. Conclusion Calf is the right animal model for NIVAD implantation and there are some characteristics in its perioperative treatment. The establishment of this animal model may play important role for further improvement of NIVAD.