Objective To explore a practicable method for analyzing the cost losses of residents' health impact induced by environmental pollution and evaluate the cost losses of local residents' health impact in arsenic contaminative area. Methods The data on residents' health were obtained in an arsenic polluted area as the basis analysis of economic loss. Additionally, the data on the sizes of local population, GDP, the annual personal income, the annual prevalence of acute diseases, absence due to sickness and patients' nursing care, the annual prevalence of chronic diseases in 1985. Local residents' age specific death rates and sizes of population in 1985-1995 were collected also. 3 mumerable indexes were screened for estimating the cost losses of residents' a health impact in arsenic contaminative area based on the data mentioned above and combined with abridged life table. Results Based on the calculated GDP and personal average income in 1995, the cost losses of residents due to arsenic pollution consisted of 3 sections: the first included GDP losses of 50.52 yuan/(person-year) and personal income loss of 43.71 yuan/(person-year) attributed to the reduced life expretancy of the residents living in arsenic-polluted area. The second was an excess of the annual medical expenditure of 56.30 yuan/(person-year) for residents living in arsenic-polluted area compared with that of control group. The third included GDP loss of 74.14 yuan/(person-year) and income loss of 64.23 yuan/(person' year) attributed to the health life days of residents in arsenic-polluted area during the period of number of working years. The total economic loss of 3 section mentioned above make the total GDP reduction of about 180.96 yuan/(person-year) and average income loss of about 164.27 yuan/(person-year) including excessive medical costs. Conclusion The analytical method could be applied to the estimation of economic loss of environmental pollution-attributable health impact.

Objective To explore the Gram-positive bacterial drug resistance in blood culture in 2013 to 2015 from the members of Antimicrobial Resistant Investigation Net of Shaanxi province,and guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identified susceptibility date by software WHONET 5.6.Results 8 824 Gran positive bacterial isolates and their antibacterial susceptibilitydata were collected.The top five populations of Gram-positive bacterial isolates were Staphylococcus epidermidis,Staphylococcus hominis,Staphylococcus haemolyticus,Staphylococcus aureus and Enterococcus feacium.The isolating rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus(MRCNS) were 33.9 ～ 54.9％ and 72.1 ～88.6 ％ respectively.No vancomycin,Linezolid and teicoplanin resistant Staphylococcus isolates were found.There were 0.9 ～2％ E.faecium vancomycin-resistant isolates.Conclusion The composition of blood culture from 2013 to 2015 was not changed,The rate of MRSA and MRSE showed downward trend.But it was severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fully use bacterial drug resistance surveillance results for supervision and administration,and take effective measures for controlling the spread of resistant isolates.

Purpose:The aim of this study was to evaluate the changes of NK and T lymphocyte with gastric cancer and before and after operation.Methods:T lympho cyte subsets and NK cell activity of 36 cases of gastric cancer and 30 cases of normal subjects were measured by monoclonal anti human T lymphocyte antibody and MTT assay before and after operation.Results:It was found that before operation the CD3(+),CD4(+) cell and ratio of CD4(+)/CD8(+) were significantly decreased and CD8(+) cell was increased and NK activity decreased with gastric cancer as compared to control group ( P

Medical research institutions in Shanghai have been developing in at a slow pace because of problems such as out of date institution structures, unreasonable resource allocation and distribution,shortage of research resources, insufficient creativity, and unfocused effort and investment. Hence reform is the only way out. This research discussed the possible strategies for development and proposed some suggestions on the institution categorization, structure change, allocation of resource and overall arrangement.

Objective To explore the bacterial drug resistance in blood culture in 2015 from the members of Antimicrobial Re-sistant Investigation Net of Shaanxi province,and to guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identifiedsusceptibility date by software WHONET 5.6.Results 6 871 bacterial isolates and their antibacterial susceptibilitydata were collected which included 3 199 (46.56%)Gram-negative bac-terial isolates and 3 672 (53.44%)Gram-positivebacterial isolates.The top five populationsof Gram-positive bacterial iso-lates were Staphylococcus epidermidis (30.94%),Staphylococcus hominis (17.84%),Staphylococcus haemolyticus (11.74%),Staphylococcusaureus (9.69%)and Enterococcus feacium (6.29%).The top five populationsof Gram-negative bacterial isolates were E.coli (43.67%),Stenotrophomonas maltophilia (14.63%),K.pneumoniae (13.47%), P.aeruginosa (4.13%)and Acinetobacter baumannii (3.63%).Theisolating rates of methicillin-resistant Staphylococcus aureus (MRSA)and methicillin-resistant coagulase negative Staphylococcus (MRCNS)were 31.2% and 76.1%,respec-tively.No vancomycin resistant Staphylococcusisolates were found.There were 0.9% E.faecium vancomycin-resistant iso-lates.The isolates of Enterobacteriaceae were still highly susceptible to carbapenem,whosetotal resistance rate was below 4.0%.The resistance rates of A.baumannii to most surveillance drugs in cludingimipenem were above 50.0% and the iso-lates of P.aeruginosa were still highly susceptible to most surveillancedrugs.Conclusion It is severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fullyuse bacterial drug resistance surveillance results for supervision and administration,and take effective measures forcontrolling the spread of resistant isolates.

The idea of establishing Shanghai Academy of Medical Sciences was brought forward　in the background of great external changes.It was to meet the demand for resolving all kinds of　conflicts about researches arised from the long time operation of Medical Institutes in Shanghai.This　article mainly discusses about the necessity and plans for establishing Shanghai Academy of Medical　Sciences.

Objective To evaluate the advantages of TB-IGRA and protein chip to detect the Mycobacterium tuberculosis. Methods From October 2013 to March 2014,collected 78 cases of clinical diagnosis of tuberculosis and normal control’s pe-ripheral blood specimens,used TB-IGRA kits and Mycobacteriumtuberculosis IgG kit(protein chip)to detected respectively. The results were analyzed and compared.Results The sensitivity of protein chip and TB-IGRA in the detection of Mycobac-teriumtuberculosis were 34.5% and 89.7% respectively,which was statistically significant (χ2=26.95,P<0.05).The spe-cificity of protein chip and TB-IGRA were 90.0%,95.0% respectively,which were not statistically significant (χ2=1.64,P> 0.05).The positive rate of TB-IGRA and Protein chip in tuberculosis were 90.5% and 42.9%.The positive rate of TB-IGRA and Protein chipin extrapulmonary tuberculosis were 89.20% and 29.7% respectively.Conclusion Compared TB-IGRA and protein chip,either diagnose tuberculosis or extrapulmonary tuberculosis has highly positive rate and sensitivity, TB-IGRA can be widely used in the early screening of tuberculosis.

Objective To investigate the changes of the morphology,structure and biological characters of mutated Candida and through its genetic characteristics,research and reveal the mechanism of the variation at the molecular level.Methods Used different nutritional conditions,different growth conditions and different azole antifungal agents to induce mutation of the standard strains of Candida albicans.In clinical study,Candida mutant strains was isolated from vaginal secretions,pleu-ral effusion and gastric juice samples in patients of poor effect with Antifungal therapy,and studied on the morphological characteristics,and the nuclear structure,the biochemical reaction,the drug resistance,the bacterial composition and the ge-netic characteristics of above variants,etc.Results Mycelial?morphology:Candida were prone to mutation like bacteria, mutant bacteria could show G+ Aureus shape,G+ Bacillus,G+ long filamentous,G- Aureus shape,G- Bacillus and G- long filamentous;Nuclear structure:Candida mutant strains changed like prokaryotes under the electron microscope because it lost the original structure of eukaryotic cells.Biochemical reaction:there were 5 different items in 20 biochemical test ob-served.Drug sensitivity test:Candida mutated to antifungal drugs being originally sensitive was completely resistant,sensi-tive and resistant originally was completely sensitive,and the same as ordinary bacteria resistant.The cell component chan-ges:there was significantly different in Candida variant strain and the atavism of variant strain identified by mass spectrome-try.The most conservative fungalgene expression:Candida mutated had conservative gene expression of eukaryotes.It could be demonstrated that oidiomycetes mutant strains like bacterial morphology with prokaryotic cell biological characteristics was derived from Candida with eukaryotic cells.Conclusion Candida was prone to variation like bacterial morphology.The biological characteristics of mutant resembled prokaryote.There was a qualitative change among the standard strains of Can-dida albicans,mutant strains of oidiomycetes like bacterial morphology and the atavism of variant strain with clear genetic re-lationship under the electron microscope in the form of nuclear matter.The study on biological evolution,especially contact in prokaryotic cells and eukaryotic evolution has very important significance.

ObjectiveTo explore the experiences of treatment of aortic root aneurysm and mitral valve disease through the incision of aorta.MethodsFrom Mar.2009 to Dec.2010, sixteen patients with aortic root aneurysm and mitral valve disease were operated by transaortic incision.After the leaflets of aortic valve were excised, mitral valve replacement or plasty was performed.There were 13 males and 3 females.The age ranged from 18 to 75 years old with a mean of (40 ± 10) years.The operation procedures included Bentall plus mitral valve replacement in 12 patients, Bentall plus mitral valve plasty in 1,Bentall + total arch replacement + stent elephant trunk + mitral valve plasty in 1, Bentall plus mitral valve plasty and CABG in 1.In 12 patients underwent mitral valve replacement, 11 were using continuous suture and interrupt mattress suture in 1.Four patients underwent mitral valve plasty, the procedure of banding mitral valve leaflets junctions was used.All patients were followed up through telephone and out-patient service.Transthoracic echocardiogram was performed before discharge and 3-, 6-,12-months after operation.Follow-up including cardiac function, valvular and perioperative complications.Results There were 2 re-thoractomy because of bleeding.One patient with pulmonary infection was cured by antibiotics.No death occurred in hospital.Patients were followed-up for 1 to 19 months with a mean of (7 ±5) months.No death occurred during follow-up period.There were no valve-related complications (embolism, bleeding, mitral valve dysfunction).Heart function was improved in all patients and graded as class Ⅰ to Ⅱ (NYHA).Two patients had trace regurgitation after mitral valve plasty when discharged.One patient had mild mitral valve regurgitation was found after mitral valve replacement.There was no further valve exacerbation for above 3 patients during follow-up period.ConclusionTransanrtic mitral valve operation is feasible in patients with aortic root aneurysm and mitral valve disease.

OBJECTIVETo determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.

METHODSSince 1996 to 2002, 30 consecutive patients underwent ablation procedures for isthmus-dependent atrial flutter. There were 23 males and 7 females [mean age (47.85 +/- 9.35) years]. With the use of fluoroscopic view of anatomy, radiofrequency ablation was performed during coronary sinus pacing at a cycle length of 600 ms.

RESULTSBidirectional block was achieved with ablation in 29 (97%) of 30 patients. The transisthmus intervals before ablation and after complete transisthmus block were (73.82 +/- 13.01) ms and (140.47 +/- 20.48) ms, respectively, in the clockwise direction (P < 0.0001), and (77.63 +/- 8.36) ms and (138.17 +/- 15.55) ms, respectively, in the counterclockwise direction (P < 0.0001). A period of incomplete isthmus block was observed during 17 (58%) of the 29 ablation procedures. The clockwise transisthmus intervals during incomplete block [(107.65 +/- 21.33) ms] were (45.5 +/- 8.7)% longer than the baseline transisthmus intervals. An increase in the transisthmus interval by > or = 50% in both directions after ablation predicted complete bidirectional block with 100.0% sensitivity and 83.3% specificity. The positive and negative predictive values were 90.6% and 100.0%, respectively. The diagnostic accuracy of a > or = 50% prolongation in the transisthmus interval was 83.3%.

CONCLUSIONThe analysis of transisthmus interval is a valuable method for determining complete bidirectional isthmus block.