High resolution melting ( HRM) analysis is a real-time PCR based technique which can detect DNA sequence polymorphism .Immediately after routine PCR with saturated fluorescent dye , melting transition of the amplicon was monitored and fluorescence was collected .According to the different melting curve, single base differences can be distinguished .HRM is a low -cost, single -step, closed -tube, accurate and rapid method , which has aroused general concern .Rapid and sensitive detection of the clinical pathogens is critical to diagnosis of infectious diseases .However , clinical research on application of HRM in infectious disease pathogen identification and drug resistance , especially melting curve analysis based bedside technology integration will provide strong support for the diagnosis and treatment of infectious diseases.

Patent ductus venous is a kind of the congenital portosystemic shunts (CPSS). In recent years, the related case report increased gradually, but the domestic research is rare. In this article, we review the current diagnosis and treatment of neonatal patent ductus venous based on literature available.

Objective To investigate the clinical application of alpha lipoic acid on early diabetic nephropathy(DN).Methods Seventy patients with early diabetic nephropathy were randomly divided into two groups.Patients in control group were treated with regular glycemic control methods,while patients in treatment group were received alpha lipoic acid 300 mg static drop treatment for two weeks beside regular treatment.High sensitivity C reaction protein,microalbuminuria and urine creatinine were measured before and after the treatment.Microalbuminuria and urine creatinine were re-measured three months later.Results At the end of two weeks treatment,the levels of high sensitivity C reaction protein in the treatment group decreased from (3.92 ± 4.56) mg/L to (2.24 ± 2.49) mg/L,and there was significant difference (t =2.803,P ＜ 0.05).Microalbuminuria decreased from (127.18 ± 76.91) mg/L to (84.50 ± 122.87) mg/L,and there was significant difference (t =2.501,P ＜ 0.05).The ratio of microalbuminuria and urine creatinine in treatment group decreased from(28.95 ± 30.49) mg/mmol to(13.76 ± 20.83) mg/mmol,and there was significant difference (t =3.616,P ＜ 0.05).While there was no significant difference in the control group before and after regular waglycemic control.At three months after treatment,there were no significant difference regarding of microalbuminuria,the ratio of microalbuminuria and urine creatinine between treatment and control groups (P ＞ 0.05).Conclusion Alpha lipoic acid might be with ability of decreasing the levels of microalbuminuria of diabetic nephropathy in the short term,but further study is needed to verify whether alpha lipoic acid can decrease the level of microalbuminuria in the long term.

Objective To study the safety,efficiency and feasibility of increase the aminotic fluid volume by transabdominal amnioinfusion(AI). Methods Thirty-three patients were selected according to the following criteria: oligohydramnios or borderline oligohydramnios found by B ultrasound ,indications of vaginal delivery and with cephalic presentation,and who is ready to receive AI. After located by puncture bougie,at most 380 ml saline solution at 37℃ were infused into the amniotic cavity. Results AI was accomplished in 32 of 33 cases (96.97%). Premature rupture of membrane occurred in one case (3 03%). No placental abruption and infection or other complications happened. Twety-five patients (75.76%)successed in vaginal delivery. Cesarean sections were performed in 8 cases (24 24%) because of encephalopelvic disproportion,cord prolapse and fetal distress. No neonatal asphyxia happened. Conclusion Amnioinfusion can effectively increase amniotic fluid volume,create favorable conditions of vaginal delivevy for oligohydramnios and decrease the incidence of cesarean section as well as improve perinatal outcome.

Objective To compare the efficacy of balloon dilation and YAG laser endouretertomy in treatment of secondary ureteric stricture . Methods 32 patients with secondary ureteral stricture were randomly divided into balloon dilatation group and holmium laser cut group, 16 cases in each, respectively. The two kinds of treatment efficacy was compared after two years postoperative follow-up. Results The clinical results of the two groups showed no statistical differences at the third, sixth and twelfth month follow-up (P > 0.05), and there were no statistical differences in the overall effective rates (P > 0.05). The clinical results of the two groups showed no statistical difference at the twenty-fourth month follow-up (P < 0.05), and the overall effective rates had statistical difference (P < 0.05). Conclusions Balloon dilation and YAG laser endouretertomy in treatment of secondary ureteral stricture have the same short-term clinical effects. But the middle-term efficacy of YAG laser endouretertomy is superior to that of balloon dilation.

Objective To evaluate the effect of emulsified isoflurane post-conditioning on the mitochondrial function during lung ischemia-reperfusion (I/R) in rats in an in vitro experiment.Methods Twenty-four SPF healthy male Sprague-Dawley rats,weighing 250-300 g,were used in the study.After the animals were anesthetized,the lungs were removed,connected to the perfusion system and then divided into 4 groups (n=6 each) using a random number table:control group (group C),group I/R,emulsified isoflurane post-conditioning group (group EI) and intralipid post-conditioning group (group IL).After 20 min of equilibration,the lungs were continuously perfused for 105 min in group C,and the lungs were subjected to 45 min ischemia followed by 60 min reperfusion to establish the model of lung I/R injury in the other three groups.During the reperfusion period,the common perfusate was used in group I/R,the perfusate containing 1.68 mmol/L emulsified isoflurane was used in group EI,and the equal volume of perfusate containing 30％ intralipid was used in group IL.At the end of the equilibration (T0),immediately after beginning of reperfusion (T1) and at 30 and 60 min of reperfusion (T2.3),the arterial oxygen partial pressure (PaO2),airway resistance,pulmonary compliance and tidal volume (VT) were recorded.The right upper lobe of the lung was removed at T3 for determination of wet to dry weight ratio (W/D ratio).The right middle lobe of the lung was removed at T3 for pathologic examination with light microscope.The contents of reactive oxygen species (ROS),NAD+ and ATP in lung tissues were detected.Results Compared with group C,the PaO2,pulmonary compliance and Vr were significantly decreased,and the airway resistance was increased at T1-3,and the W/D ratio and ROS content were increased,and NAD+ and ATP contents were decreased at T3 in I/R,EI and IL groups (P＜0.05).Compared with I/R and IL groups,the PaO2,pulmonary compliance and VT were significantly increased,and the airway resistance was decreased at T2.3,and the W/D ratio and ROS content were decreased,and NAD+ and ATP contents were increased at T3 in group EI (P＜0.05).The pathologic changes of lungs were significantly attenuated in group EI as compared with group I/R.Conclusion The mechanism by which emulsified isoflurane post-conditioning attenuates lung I/R injury is related to decrease in mitochondrial dysfunction in rats in an in vitro experiment.

Objective To discuss the appropriate timing of providing enteral nutrition through nasojejunal tube for patients with severe craniocerebral injury.Methods 126 cases of patients were divided into 3 groups randomly,providing enteral nutrition through naso-jejunal tube for the first group,the second group and the third group within 12～24 hours,48 hours later and 72 hours later after injury respectively.The nutrition situation of 3 groups was recorded 6 hours later,48 hours later,on the 5th day and the 10th day,including indicators such as total serum protein,blood albumin,serum creatinine,etc and complication cases of diarrhea,hemorrhage of digestive tract,palirrhea,aspiration,inhalation pneumonia and so on within 2 weeks after injury.Results In terms of indicators of albumin,creatinine 48 hours after injury and total protein,albumin and creatinine on the 5th day and 10th day,the first group were better than the second and third group,there were statistic differences between the three groups.Complication comparison within 2 weeks after injury:the difference of palirrhea cases among the three groups was significant,the third group had a higher ratio than the first and second group.And there was no statistic difference in the other indicators like diarrhea,hemorrhage of digestive tract,aspiration and inhalation pneumonia.Conclusions It is high time that patients with simple severe craniocerebral injury are provided with enteral nutrition through naso-jejunal tube within 12 to 24 hours,which can improve patients nutrition situation without the increase of the complications.

Objective To identify a suspected Klebsiella variicola strain isolated from a patient with severe septic shock. Methods Sequences of rpoB, gyrA, mdh, infB, phoE and nifH genes were obtained from the clinical isolated suspected Klebsiella variicola strain, and used for constructing phylogenectic trees. Characteristics of phylogenetic trees were used to distinguish Klebsiella variicola from Klebsiella pneumoniae. Results All target gene sequences from this clinical isolated strain constantly formed a cluster with their counterparts from other Klebsiella variicola strains. These clusters were readily differentiated from Klebsiella pneumoniae clusters. Conclusions The clinical isolated strain belongs to Klebsiella variicola class and can cause septic shock. From genetic perspective, Klebsiella variicola is distinctly different from Klebsiella pneumoniae, most of which can be isolated from normal healthy people.

Purpose To explore the value of hydroxyapatite (HAP) in the measurement of bone mineral density (BMD) based on the quantitative material decomposition images of spectral CT on healthy adult females.Materials and Methods A total of 128 healthy females who underwent upper abdominal CT examination with spectral CT at the Second Hospital of Lanzhou University from September 2013 to February 2016 were enrolled as the research group.Those patients with trauma,surgery,tumor or other diseases affecting BMD were excluded.The patients (ages ranged from 18 to 87 years) were divided into 6 groups according to their ages:＜30 years (n=23),30-39 years (n=20),40-49 years (n=22),50-59 years (n=24),60-69 years (n=19) and ≥ 70 years (n=20).The HAP and calcium concentration at central part of L2 centrum of spongy bone were measured.Meanwhile,119 healthy females who underwent dual energy X-ray absorption (DEXA) examination were selected as the controls and also divided into groups according to the same criteria as the research group.The BMD of the controls was also measured at L2 centrum and showed as areal density (g/cm2).The measurements of the research group were analyzed.The correlation analysis was done between hydroxyapatite,calcium concentration and age.The correlations between hydroxyapatite,calcium concentration and BMD obtained by DEXA were also analyzed.Results There were significant differences in the HAP and calcium concentration among different age groups (P＜0.05).The results of spectral CT and the DEXA showed correlations.Both HAP and calcium concentration showed positive relationship with BMD obtained by DEXA (r=0.874 and 0.796,respectively,both P＜0.05).The HAP and calcium concentration showed positive relationship with age in the groups (ages ranged from 18-39 years) (r=0.538 and 0.416,P＜0.05) and negative relationship with age in the groups (ages over 40 years) (r=-0.629 and-0.562,P＜0.05).Conclusion Material decomposition images of spectral CT can reflect bone changes,and HAP is a new base material for BMD measurement.

Objective:To observe influence of enhanced external counterpulsation (EECP) on plasma levels of lipo‐protein-associated phospholipase A2 (Lp‐PLA2) and hsCRP in patients with coronary heart disease (CHD) ,and preliminarily explore anti -inflammatory mechanism of EECP in prevention and treatment of CHD .Methods :A to‐tal of 85 CHD patients were selected from our hospital ,randomly divided into routine treatment group (n=42) and EECP group [n=43 ,received EECP based on routine treatment ,once/d ,60min each time ,continuous five weeks were regarded as one course (35 times)] .Plasma concentrations of Lp‐PLA2 and hsCRP were measured in all sub‐jects at the enrollment day and after five -week treatment .Results:Compared with before treatment ,after five-week treatment ,there were significant reductions in plasma levels of Lp‐PLA2 [(58.46 ± 40.04)μg/L vs .(33.94 ± 23.22)μg/L] and hsCRP [ (3.54 ± 2.22)μg/ml vs .(2.19 ± 1.16)μg/ml] in EECP group (P<0.01 both) ,and there were no significant difference in routine treatment group between before and after treatment .Compared with routine treatment group ,after five-week treatment ,there were significant reductions in plasma levels of Lp‐PLA2 [ (56.87 ± 33.69)μg/L vs .(33.94 ± 23.22)μg/L] and hsCRP [ (3.63 ± 1.60)μg/ml vs .(2.19 ± 1.16)μg/ml] in EECP group , P<0.01 both .Conclusion:1. EECP of one course can significantly reduce plasma concentrations of Lp‐PLA2 and hsCRP in CHD patients , indicating that anti - inflammatory may be one of its mechanism in preven‐tion and treatment of CHD .