Objective To assess the value of implanting remedial or prophylactic cardioverter defibrillator in patients with Brugada syndrome for protecting from malignant ventricular arrhythmias and to estimate the initial outcomes in one-month follow-up. Methods Implantable cardioverter defibrillators (ICDs) were implanted in 21 consecutive patients (9 symptomatic and 12 asymptomatic) with Brugada syndrome using standard procedure under general anesthesia. Patients presented the typical ECG changes of Brugada syndrome with or without sodium channel blockers but without structural heart disease in all the cases. Electrophysiological examinations were performed in all patients. Eight asymptomatic patients had spontaneous or induced malignant ventricular arrhythmias and 4 asymptomatic patients had single positive family history. Results Sixteen single chamber ICDs (VVI) and 5 double chamber ICDs (DDD or DDDR) were implanted. The DDD- or DDDR-ICDs were applied for patients with sinus node dysfunction and/or atrioventricular conduction disturbances. Battery/lead status measurements of ICDs were good and met with standards of implantation during the procedure. No complications occurred after ICD implantation and also no changes of various electrophysiological parameters during re-hospitalization in one-month follow-up. There were no events' record of anti-tachycardia pacing or cardiovertion or defibrillation for ventricular arrhythmias in the memory of treatment by ICDs. Conclusions ICDs were implanted successfully with safety in patients with Brugada syndrome showing good function for the initial outcomes in one-month follow-up.

Objective To construct the multi-epitope antigen(mea) gene of G2 glycoprotein of Hantavirus SEO type L99 strain.Methods The B cell epitopes was chosen and connected by three-peptide GPG after the amino acid sequence of G2 protein was analyzed and predicted by bioinformatical soft wares.The corresponding gene mea was constructed by overlap PCR,and cloned into the prokaryotic expression plasmid pET32a(+).Results The mea gene was successfully constructed by the five epitopes being chosen.The recombinant plasmid pET32a-mea was acquired by directional cloning.Conclusion The mea and its expression system E.coli BL21/pET32a-mea were constructed for the first time.The foundation was laid for the expression of the mea and its immunological applications.

Objective To study the effect of low-dose dexamethasone after acute and subacute cerebral infarct.Methods One hundred and forty patients with acute ischemic stroke were randomly divided into acute ischemic stroke group (acute stage group),subacute ischemic stroke group (subacute stage group),placebo and control groups.Subjects in acute stage groups received conventional therapy and 1 mL (5 mg) dexamethasone injection from 1 day to 3 day after admission and in subacute stage group,received the same treatment as acute stage group from 4 day to 6 day after admission.In control and placebo groups,subjects received conventional therapy and conventional therapy + 1 mL normal saline for injection respectively.One week after treatments,complete blood count and erythrocyte sedimentation rate were tested.One month and three month after treatments,neurological function were evaluated by Barthel Index and modified Rankin Scale (mRS).Results The valuate of erythrocyte sedimentation rate in acute stage group were significantly different from it of placebo and control groups (P ＜ 0.05).Moreover,neurological function of subjects in acute stage group was significantly improved than that in placebo and control groups in by Barthel Index and mRS (P ＜ 0.05).However that in subacute stage group was not different from that placebo and control groups (P ＞ 0.05).Conclusion Low-dose dexamethasone plays a neuroprotection role after acutc cerebral ischemia.

Objective To investigate the preventive effect of clinical nursing pathway of health education on partum urinary retention.Methods Two hundred and forty primiparas hospitalized in our hospital from September 2012 to February 2013 were randomized equally into the observation group and the control group.The former received health education by clinical nursing pathway and the control group conventional health education.The two groups were compared in terms of incidence of postpartum urinary retention.Results The incidences of postpartum urinary retention in the observation group and the control one were 3.33% and 11.67%,respectively.The difference in the incidence between the groups were statistically significant(P<0.05).Conclusion The clinical nursing pathway of health education may effectively prevent the occurrence of postpartum urinary retention.

OBJECTIVE To investigate the antimicrobial susceptibility of Streptococcus pneumoniae isolated in Yantai and their mechanisms of resistance to macrolides.METHODS Antimicrobial susceptibility of S.pneumoniae was determined by agar dilution method.Phenotypes of macrolide-resistant S.pneumoniae were determined using double disk test with erythromycin and clindamycin disks.ermB And mefE genes were amplified by PCR.RESULTS Among 42 strains of S.pneumoniae,65.0% were intermediate to and no strain was resistant to penicillin.The resistance rates to erythromycin and clindamycin were 93.0%,respectively.Of 41 erythromycin resistantstrains,93.0% were constitutive resistant.ermB Was detected in 40 strains and mefE in 1 strain,both ermB and mefE genes were found in 9 strains.CONCLUSIONS The resistance rate of S.pneumoniae to penicillin is high in Yantai area,the resistance rates to erythromycin and clindamycin are very high.Target modification by ermB methylase is the predominant mechanism in macrolide-resistant S.pneumoniae in Yantai.

Objective To establish RT-PCR-RFLP method for studying the genotype of wild mea-sles virus strains isolated from Tianjin area from 2002 to 2008. Methods Isolations of measles virus were carried out by tissue culture method from urine and throat swab specimens collected from suspected cases. RNA were extracted from the virus specimens. The 594 bp fragment of C terminal of the N (nucleoprotein) gene was amplified by one-step RT-PCR, then the PCR products were digested with Bcn I , separated on agarose gel electrophoresis and then analyzed by the method of RFLP (restriction fragment length polymor-phism). In addition, above results were compared with DNA sequencing. Phylogenetic tree was plotted based on the results for the genetic relationship and distance analysis. Results Sixty-nine measles virus strains were isolated from 189 specimens from 2002 to 2008, of which the C terminals of N gene were all de-tected positive. Among the 69 strains of measles virus isolates, 98.55% (68/69) belonged to Hla sub-geno-type which was the predominant sub-genotype, and only one strain (1.45%) belonged to H1b sub-genotype by RFLP analysis which was in accordance with the results by DNA sequencing method. Phylogenetic tree analysis indicated the H1a sub-genotype measles virus strains should be further divided into 2 clades, and the variation fluctuated between 0.2% and 3.8%. There were transmission chains caused by different virus strains co-cireulation. Conclusion A genotype, H1a and H1b sub-genotype can be identified by RT-PCR-RFLP assay specically based on the restriction enzyme Bcn I .The RT-PCR-RFLP assay can be a rapid, simple, accurate and efficient method for large-scale surveillance of measles virus strains in China.

Objective To investigate the clinical manifestation of hMPV in infants and young chil-dren presented with acute respiratory tract infection and to identify the molecular character. Methods Na-sopharyngeal aspirates were taken from 310 hospitalized pediatric patients from February to May in 2006, March to April in 2008, and September 2008 to February 2009, and the N gene fragments of hMPV were de-tected by nested PCR amplification. Phylogenetic analysis of 17 strains hMPV N genes was performed. The clinical materials of patients were collected and analyzed. All hMPV-positive samples were examined by multi-PCR for other respiratory viruses. Results Of 310 pediatric patients, 20 (6.5%) were positive for hMPV. The median age of hMPV infected children was 15.0 months(from 16 days to 9 years old), 90% (18/20)of the cases were under 2 years, and 60% were male. Phylogenetic analysis of 17 N gene fragments showed that 11 hMPV strains were A2b subtype. 20 hMPV-positive children were subjected to pneumonia, accounting for 7.1% (20/282) among all pneumonia subjects in this study. The common clinical manifesta-tions of hMPV infected patients were cough, wheezing, shortness of breath and fever. 35% (7/20) needed intensive care, 15% (3/20) were given oxygen therapy. The median length of hospital stay was (11.9 ±4.8) d. No significant seasonal distribution of hMPV was displayed. Two patients were coinfected with ade-novirus and rhinovirus respectively. Conclusion hMPV was an important respiratory pathogen in young children subjected to pneumonia in Tianjin. Three subtypes(A2a/A2b, B1, B2) were prevalent in Tianjin, and A2b was the predominant subtype. No significant difference of clinical characters was observed between A and B type hMPV infected patients.

Chinese medicinal materials are the basis for the inheritance and development of traditional Chinese medicine,as well as strategic resources related to the national economy and people's livelihood.In 2015,12 departments,including the Ministry of Industry and Information Technology,and the State Administration of Traditional Chinese Medicine,jointly formulated the Plan for the Protection and Development of Traditional Chinese Medicine(2015-2020)(hereinafter referred to as the Plan),focusing on seven major construction tasks for the protection and development of traditional Chinese medicine.Through the summary and evaluation of the Plan,it can be seen that the overall development goals and 7 specific indicators have been achieved by 2020.It has been focused on solving the problems of the loss and depletion of some wild Chinese medicinal materials resources and the shortage of Chinese medicinal materials supply.Promoting to alleviate the problems,including the abuse of chemical fertilizers,pesticides,and growth regulators.The extensive production and management of Chinese medicinal materials,as well as the poor exchange of supply and demand information were effectively improved.On the whole,the development and protection of Chinese medicinal materials were promoted.Moreover,the dependence on wild Chinese medicinal materials was reduced through scientific development of Chinese medicinal materials production.And the sustainable development of the Chinese medicinal materials industry was coordinated with the protection of the ecological environment.However,there were still some problems and deficiencies,such as a lack of accurate information guidance,an incomplete price formation mechanism,and an incomplete whole-process traceability system of Chinese medicinal materials.It is suggested that during the 14th Five-Year Plan period,we should continuously strengthen the protection and sustainable development of traditional Chinese medicine resources,and build a new development pattern for traditional Chinese medicine industry based on the new development concept and requirement.

Psoriatic arthritis is a chronic systemic autoimmune disease, characterized by psoriasis skin lesions and inflammation of the spine and joint. It has complicated clinical manifestations and individual variations. Nearly half of the patients will have joints erosion in two years, which is crippling. The severity of the skin and joint disease frequently do not correlate with each other. Currently, the understanding of the disease is insufficient in China with the lack of standardized diagnosis and treatment. Therefore, researchers from the Chinese Rheumatology Association formulated this specification based on the diagnosis and management experience together with guidelines at home and abroad. The specification summarizes the present situation of domestic diagnosis and treatment, aiming to standardize the diagnosis process and treatment protocols of psoriatic arthritis. Furthermore, it can reduce misdiagnosis and missed diagnosis, as well as improve the prognosis.

Objective To understand the relationship between perinatal factors and congenital hypothyroidism(CH)and provide scientific evidence for the prevention of CH. Methods A case-control study was conducted among 125 neonates with CH (case group) and 375 neonates without CH(control group)in Fujian Neonatal Screening Center from January in 2012 to December in 2013. Univariate and multivariate logistic regression analysis were performed to identify the risk factors to CH during perinatal period. Results Univariate logistic regression analysis indicated that compared with control group,gestational hypertension,gestational diabetes mellitus,gestational thyroid disease and older age of mother were the risk factors to CH,the difference was statistically significant (P<0.05) and the risk of CH was higher in female babies,preterm babies,post-term babies low birth weight babies,macrosomia,twins,babies with birth defects and infection in cases group than those in control group,the difference was statistically significant (P<0.05). Multivariate logistic analysis showed that older age of mother(OR=2.518,95%CI:1.186-5.347), gestational diabetes mellitus(OR=1.904,95%CI:1.190-3.045),gestational hypothyroidism or hyperthyroidism(OR=12.883 and 30.797,95%CI:2.055-80.751 and 3.309-286.594),preterm birth (OR=4.238,95%CI:1.269-14.155),and post-term birth(OR=12.799,95%CI:1.257-130.327),low birth weight(OR=3.505,95%CI:1.059-11.601),macrosomia(OR=3.733,95%CI:1.415-9.851), twin or multiparous delivery(OR=5.493,95%CI:1.701-17.735),birth defects(OR=3.665,95%CI:1.604-8.371)and fetal distress(OR=3.130,95%CI:1.317-7.440)were the high risk factors to CH (P<0.05). Conclusion CH was correlated with mother’s age,gestational diabetes,gestational thyroid disease as well as neonate’s birth weight and gestational age,foetus number,fetal distress and other complicated birth defects at certain degree. More attention should be paid to perinatal care to reduce risk factors and the incidence of CH.