Objective In this paper,major issues for all those who have been selected in China national treatment program for patients with chronic Keshan disease (CNTP-CKD) were uncovered through evaluation of the annually reported data from participating provinces,in order to improve the performance quality of the program.Methods The datasets 2005-2012 were merged after cleaning them,and the composition of the treated patients was statistically analyzed,including gender and age distribution,diagnosis evidence for chronic Keshan disease (ECG,cardiothoracic ratio by X-ray,heart function grade of NYHA),and proportion of cases who had received treatment more than once.Results ①A total of 2 649 patients participated in the treatment,of them 1 115 patients were males accounting for 42.1％ (1 115/2 649),1 534 patients were females accounting for 57.9％ (1 534/2 649).Age of the patients were mainly distributed in 41 to 70 years old,and 24 CKD patients under 10 years accounting for 0.9％ (24/2 649).②2 313 cases of the involved patients were diagnosed with sufficient evidence,accounting for 81.9％ (2 313/2 823) and 121 cases with full misdiagnosis,accounting for 18.1％ (121/2 823).③There were 881 patients been treated for more than once,accounting for 38.3％ (881/2 301) of the number of treatment.Conclusions ① Diagnosis for CKD remains a key problem,suggesting that medical record for each patient diagnosed by province-level doctors' needs to be built up as early as possible.The rate of patient treatment for more than once is low which is not beneficial to the patients.② Treatment period for CKD patients is highly recommended to expand to at least one year,and the disease should be enrolled in the free cost list of the new rural cooperative medical system (NCMS).

Objective To investigate the clinicopathologic features of sclerosing polycystic adenosis(SPA)of salivary gland.Methods The clinical and pathologic profiles of 2 SPA cases were evaluated.Immunohistochemical study was performed on fixed tissues.The biologic behavior was analyzed with follow-up data.Results The main clinical manifestation of patients was parotid painless nodules.Histological features were embedded cystic dilatation of ducts and alveoli as hyaline sclerosis collagen tissue background,catheter see apocrine metaplasia,focal areas of ductal epithelial hyperplasia and dysplasia.Immunohistochemical staining for calponin and SMA staining showed that the catheter had a layer of myoepithelial cells.Conclusion Sclerosing polycystic sialadenopathy of parotid is a rare disease,the cause and course of the disease are not very clear,but the literature reports are atypical ductal epithelial remarkable phenomenon,thus strengthen the follow-up to patients.

Objective To evaluate the efficacy and side effects of whole body γ/-knife in patients with limited pancreatic carcinoma. Methods 111 patients with limited pancreatic carcinoma treated with the Stereotactie Gamma Ray Whole-Body Therapeutic System (Whole Body T-knife) were retrospectively an-alyzed. Patients were supine, fixed with a stereotactic body frame and vacuum bag, and then simulated by low-speed computed tomography. GTV, CTV and PTV were defined on the contrast-enhanced CT scans. It was required that 50% isedose line covered 100% of PTV and 70% isedose line covered more than 80% of GTV. The prescription dose was defined as 50% isodose. All patients were treated 5 fractions per week. The fractionated dose was 3-4 Gy for pancreatic head carcinoma, and 4-5 Gy for pancreatic body/tail carcino-ma. Irradiation of 40-51 Gy and 60-70 Gy were delivered to PTV and GTV margins, respectively. Re-suits The complete response rate, partial response rate and overall response rate of the primary tumors were 29.7%, 42.3% and 72.1%, respectively. The follow-up rate was 95.5%. The number of patients fol-lowed-up at 1-,2- and 3-year was 105,89 and 60. The 1-, 2- and 3-year overall survival rates were 49.3%,24.5% and 18.1%. For patients with stage Ⅰ/Ⅱ disease,the number of patients followed-up at 1-,2-,3-,4-and 5-year was 55,44,29,16 and 11 ;The 1-, 2-, 3-,4- and 5-year overall survival rates were 68%,34%, 30%, 21% and 17%, respectively. For patients with stage Ⅲ disease,the number of patients fol-lowed-up at 1-,2- and 3-year was 50,45 and 31 ;The 1-, 2- and 3-year overall survival rates were 28%,14% and 4%, respectively (χ~2=16.67, P=0.000). The acute side effects including nausea, vomiting and diarrhea were 71.2% of RTOG grade 1 -2 and 3.6% of RTOG grade 3. No treatment delay occurred.Conclusions With fractionated dose of 3-5 Gy,5 fractions per week and 40-51 Gy as total dose to PTV,whole body γ-knife is safe and effective to treat limited pancreatic carcinoma. The local control and overall survival could be improved.

Objective To investigate the clinicopathological features and diagnosis of intestinal neu-ronal dysplasia type B.Methods Between January 2004 and August 2014 , 9 patients ( 5 males and 4 females) were treated for constipation and abdominal distention,and in all of them an intestinal neuronal dys-plasia type B was confirmed histopta holoig cally.The age of 9 patients ranged from 3 months to 1 year old ( mean 7.8 months) .The specimen of 9 patients was routinely takne by paraffin-embedded full-circumference sections of lesional bowel,hematoxylin and eosin and immunohits ochemical stainign were carried out on the specimen.The patholgo ical morphology and quantitative of inet stinal en urons and ganglia were retrospectively analyzed.Results Total of the 9 patients,the number and density of myenteric ganglia increased significant-ly increased in the lesional bowel,the pathological findings included giant nerve plexus,isolated and ectopic ganglia.In the proximal bowel,the number and density of myenteric ganglia were observed abnormal on giant nerev plexus, isoal ted and ectopci ganglia was osb erved.Combinated these pathological findings and symp-toms,intestinal neuronal dysplasia type B was diagnosed.Conclusion The diagnosis of ni testinal neuronal dysplasia type B relies on typical presentations of allied disorders of Hirschsprung′s disease,giant ganglia, isolated and ectopic ganglia,and increasing the density of giant submucosal ganglia of pathologic morpholo-gy,meanwhile,excludingo thers prima ry etiologies.

Objective To investigate the safety and effectiveness of intravenous thrombolysis bridging intra-arterial thrombectomy for opening the acute occlusion of intracranial large artery.Methods Theclinical data of 63 patients with acute intracranial large artery occlusion treated with intravenous thrombolysis bridging intra-arterial thrombectomy in Beijing Xuanwu Hospital,Capital Medical University from January to September 2016 were analyzed retrospectively. The initiation time of intravenous thrombolysis was within 4. 5 h after onset. The initiation time of endovascular therapy (femoral artery puncture)was within 6 h after onset. They were divided into either a simple stent mechanical thrombectomy group (n=41)or a stent mechanical thrombectomy combined with catheter suction group (n=22)according to the ways of thrombectomy. There were no significant differences in the gender composition,average age,occlusion site and National Institutes of Health Stroke Scale (NIHSS)score on admission between the two groups of patients (all P <0. 05). The modified Thrombolysis in Cerebral Infarction (mTICI)was used evaluate the effect of vascular patency. The vascular recanalization time,number of thrombectomy,NIHSS scores on admission,at 72 h after procedure and at day 90,and intraoperative and postoperative complications treated with two kinds of intra-arterial treatment under the intravenous thrombolysis bridging were analyzed. Results (1)In the simple stent mechanical thrombectomy group,there were 37 patients with anterior circulation occlusion (90. 2%)and 4 with posterior circulation occlusion (9. 8%). In the stent mechanical thrombectomy combined with catheter suction group, there are 20 patients with anterior circulation occlusion (90. 9%)and 2 with posterior circulation occlusion (9. 1%). There were no significant differences between the two groups of patients (P<0. 05). After treatment, the large vessels achieved good recanaliazation (mTICI grade:Ⅱb-Ⅲ). (2)The mean recanalization time of the simple stent mechanical thrombectomy group was 86 ± 11 min and the mean number of arterial embolectomy was 2. 8 ± 0. 9 times. The complication rate after procedure was 14. 6%(5 symptomatic intracranial hemorrhages and 1 cardiac death). The patients of mRS 0-2 accounted for 51. 2%(21/41)at 90 days of follow-up. The mean recanalization time of the stent mechanical thrombectomy combined with catheter suction group was 83 ± 11 min and the mean number of arterial embolectomy was 2. 2 ± 0. 8 times. The compli-cation rate after procedure was 13. 6%(2 symptomatic intracranial hemorrhages and 1 cardiac death). The patients of mRS 0-2 accounted for 59. 1%(13/22)at 90 days of follow-up. There were significant differ-ences in the above indices between the two groups(all P<0.05).Conclusion Both intravenous throm-bolysis bridging simple stent mechanical thrombectomy and stent mechanical thrombectomy combined with catheter suction can quickly make the recanalization of intracranial occlusion of large artery,and the stent mechanical thrombectomy combined with catheter suction has a better recanalization rate. However, both techniques need to be further studied in improving the clinical prognosis of patients.

Objective To isolate and identify viruses from fecal samples of tree shrew with diarrhea.Methods Fecal sample supernatant of tree shrew with diarrhea was inoculated to three cell lines ( Vero, LLC-MK2 and KMB17 ) , and the cytopathic effects on the cells were observed.The infectious particles in the culture supernatant were further ana-lyzed by transmission electron microscopy ( TEM) , genomic RNA-PAGE, rotavirus detection kit, amplification of S1 com-plete segment and bioinformatics analysis.Results Constant cytopathic effects were induced in Vero, LLC-MK2 and KMB17 cell lines after three passages of culture.The results from TEM, RNA-PAGE and rotavirus analysis indicated that they belong to reoviruses.Analysis of the S1 segments revealed that the S1 sequence from KMB17 cell culture had the high-est homology with that of prototype isolate T1L (85%nucleotide homology and 90%amino acid homology), therefore this isolate was named as type I reovirus.The other two S1 sequences from LLC-MK2 and Vero cell culture were identical to have 85%nucleotide homology and 92%amino acid homology with the prototype isolate T3D, named as type III reovirus. Phylogenetic analysis indicated that the isolates in this study are evolutionally adapted to tree shrews.Conclusions It is the first report here that 2 genotypes of Tupaia orthoreovirus are isolated and identified from one fecal sample via three cell lines and viral S1-specific primers, which provides useful guidelines for the isolation and identification of other reoviruses from tree shrew or other hosts.

Objective To discuss the technical essentials of microsurgery using suboccipital muscle stratification for the treatment of complex vertebrobasilar aneurysms via far lateral approach.Methods The clinical data of 8 patients with vertebrobasilar aneurysm underwent suboccipital muscle stratification via far lateral approach at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively,including 5 patients with subarachnoid hemorrhage (Hunt-Hess grade Ⅱ 3 cases;grade Ⅲ 1 case;grade Ⅳ 1 case),and 3 with symptomatic dissecting aneurysm.Six patients underwent occipital artery-posterior inferior cerebellar artery and anterior inferior cerebellar artery bypass grafting,and aneurysm trapping,and the aneurysms of the other 2 cases were clipped directly in the operation.The modified Rankin scale (mRS) was used to evaluate the clinical efficacy.Results Postoperative digital subtraction angiography (DSA) revealed that all the bridge vessels were patent.The obtained length of occipital artery in the actual measurement of the operation was 12.5±1.1 cm.The distance between the anastomosis site and the skin incision in 6 cases was 50±6 mm.They were followed up for 4-21 months after procedure.The mRs score in 7 cases was 0-1.Two patients had new-onset hoarseness and recovered completely within 3 months after procedure.Another patient had postoperative cerebellar hemisphere dominant regional cerebral infarction and the mRs score was 4.None of them had poor wound healing,infection and cerebrospinal fluid leakage after procedure.Conclusion Suboccipital muscle stratification via far lateral approach can effectively obtain a longer occipital artery,reduce the occupation effect of muscle and depth of field.It is beneficial to expose lesions and operation of deep anastomosis.It is a more safe and practical technique in neurosurgery for the treatment of vertebrobasilar artery aneurysms.

To investigate the effects of Yupingfeng granule (YPF) on immune factors of the rats with allergic rhinitis (AR) induced by ovalbumin(OVA). OVA 0.3 mg, Al(OH)3 30 mg and saline 1 mL were mixed and intraperitoneally injected for the initial immunization, 4% OVA 200 μg (50 μL) was given to the nose on the 15th day for the second immunization to establish the allergic rhinitis model. Sixty male SD rats were randomly divided into allergic rhinitis(AR) model group, Yupingfeng granule three dose (2.7,1.35,0.68 g•kg⁻¹) groups, control drug Biyankang (0.4 g•kg⁻¹) and normal control group. After 14 days, efforts were made to collect blood from abdominal aorta, and take nasopharynx tissues and fasten them into 10% formaldehyde for a pathological examination. The levels of HIS, IgE, IL-4 and TNF-α in serum were examined by radioimmunoassay, and nasal mucosa tissues were examined by HE staining. According to the results, the levels of HIS, IgE, IL-4 and TNF-α in serum of Yupingfeng granule groups were significantly lower than that of AR model group (P<0.05, P<0.01). Nasal mucosa tissues showed slight morphological changes and inflammatory cell infiltration, with unobvious necrosis. Yupingfeng granule can improve the pathological changes of nasal mucosa tissues, and reduce the production and release of immune factors during allergic rhinitis (AR) process in vivo by OVA, which may be the important curative mechanism of allergic rhinitis.

Both of Zuogui Wan(ZGW) and Liuwei Dihuang Wan(LWDHW) contain ingredients of Sanbufang(SBF), which have been proven to have antiasthmatic effects. In order to study the antiasthmatic effects of the three tonifying kidney-Yin formulas and their mechanisms, BALB/c mice were randomly divided into 5 groups. Chronic asthma was induced by ovalbumin. Mice in treated groups were respectively given 49.0 g•kg⁻¹ZGW, 35.0 g•kg⁻¹LWDHW and 22.4 g•kg⁻¹SBF by gavage. Those in normal and model group were given normal saline. After treatment, sneeze and nose scratching times of mice were observed. Histological lung sections were prepared to determine the basement membrane thickness(BMT), smooth muscle thickness(SMT), collagen area(CA) and numbers of goblet cells(GCN). Western blotting and RT-PCR were used to determine the expression levels of MMP-9, TGF-β1, Smad2, Smad3 and Smad7. The results showed that sneeze and nose scratching times of ZGW group were significantly lower than those of SBF group. Its inhibition degree on airway remodeling was significantly higher than SBF group. Sneeze and nose scratching times of LWDHW group were significantly lower than SBF group. Its CA and GCN were significantly lower than SBF group. Regarding the four airway remodeling related factors, MMP-9, TGF-β1, Smad2 and Smad3 of ZGW group were significantly lower than those of SBF group, and its Smad7 was significantly higher than SBF. Smad7 of LWDHW group was significantly higher than SBF. There was no significant difference in MMP-9 between model group and SBF group. The results indicate that there are significant differences in the antiasthma effect of these tonifying kidney-Yin formulas. The regulatory effects of ZGW and LWDHW on MMP-9 and Smad7 may be correlated with the differences in the inhibitory effect of airway remodeling of the three formulas.

Avian influenza virus is a new recombinant virus , which can cause severe respiratory symptoms ,such as short course,acute disease,and a high mortality rate.The purpose of this paper was to summarize the current status of this virus in terms of its epidemiology ,genetic evolution and virulence .By introducing the advancement in the research of this subtype virus, we hope to provide data and evidence ,for effective surveillance and prevention of this virus .