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 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 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 investigate the differences of clinical features,pulmonary function tests,chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema.Methods A total of 43 patients with IPF and with pulmonary fibrosis and emphysema (CPFE) were selected as observation group,and 40 patients with IPF and without emphysema were selected as control group.The clinical data of two groups of patients,including pulmonary function,partial pressure of oxygen,cellular components of bronchoalveolar lavage fluid (BALF),survival time were retrospectively analyzed and compared between two groups.Results The smoking index was (29 ± 17) pack years in observation group,much higher than that in control group (17 ± 15) pack years,the difference was statistically significant (P ＜ 0.05).The percentage of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was (70 ± 6)％ in observation group,significantly lower than that in control group (84 ± 9)％,the difference was statistically significant (P ＜ 0.05).The percentage of diffusion capacity of carbon monoxide (DLCO) in observation group was (43 ± 11)％,significantly lower than that in control group (55 ± 17)％,the difference was statistically significant (P ＜ 0.05).The percentage of lung volume in observation group was (78 ± 12)％,significantly higher than that in control group (63 ± 11)％,the difference was statistically significant (P ＜0.05).The vital capacity was expected to account for partial pressure had no significant difference in percentage and resting arterial oxygen value between two groups (P ＞ 0.05).The total number of BALF cells,macrophages,neutrophils,lymphoeytes and eosinophils ratio had no significant difference between two groups (P ＞ 0.05).Conclusion Smoking is an important risk factor of IPF with emphysema,emphysema does not affect the prognosis of patients with IPF.

Objective To reform experimental course teaching methods of clinical bio-chemistry and elevate students interesting and ability. Methods The reformed teaching methods was taken in clinical laboratory techniques and start case-guide comprehensive experiment of clinical biochemistry. Results The innovation of teaching methods of clinical biochemistry obtained satisfactory achievement,improved students thinking skills and overall quality. Conclusion It accorded with the trend of teaching innovation and was advantageous to increasing the comprehensive predisposition.

Objective:To explore the relationship among plasma level of lipoprotein‐associated phospholipase A2 (Lp‐PLA2) ,ankle brachial index (ABI) ,brachial‐ankle pulse wave velocity (baPWV) and coronary heart disease (CHD) .Methods :According to results of coronary angiography ,a total of 120 patients with suspected or diagnosed CHD were divided into CHD group (n=90) and non‐CHD group (n=30) .CHD group was further divided into sin‐gle vessel coronary disease group (single vessel group ,n=30) ,double‐vessel coronary disease group (double‐vessel group ,n=30) and multi‐vessel coronary disease group (multi‐vessel group ,n= 30) .Plasma Lp‐PLA2 level ,ABI and baPWV were measured and compared among all groups .Results:Compared with non‐CHD group ,there were significant rise in plasma Lp‐PLA2 level [ (23.60 ± 13.33)μg/L vs .(36.65 ± 17.24)μg/L] and baPWV [ (1244.27 ± 127.85) cm/s vs .(1753.08 ± 284.32) cm/s] in CHD group ,P<0.01 both .In CHD group ,compared with single vessel group ,plasma Lp‐PLA2 level significantly rose [ (25.81 ± 8.97)μg/L vs .(35.03 ± 9.80)μg/L vs .(49.13 ± 21.22)μg/L] in double‐vessel group and multi‐vessel group ,and that of multi‐vessel group was significantly higher than that of double‐vessel group ( P<0.05 or <0.01 );baPWV significantly rose [ (1579.77 ± 178.05 ) cm/s vs . (1808.07 ± 272.11) cm/s ,(1871.40 ± 306.03) cm/s] in double‐vessel group and multi‐vessel group , P<0.01 both . ABI of single vessel group and double‐vessel group were significantly higher than that of multi‐vessle group [ (1.19 ± 0.08) ,(1.17 ± 0.07) vs .(1.11 ± 0.15)] ,P<0.01 or <0.05 .Conclusion:Plasma Lp‐PLA2 level ,ABI and baP‐WV are related to CHD and its lesion degree ,combined measurement of these three indexes can predict CHD and its severity more accurately ,then preventing and treating CHD should be more effective .

Objective To summarize the experience of harvesting and using the lungs from donation after citizens death.Method From November 2007 to December 2013,19 cases of potential donation after brain death (DBD) and donation after cardiac death (DCD) were evaluated,including 9 cases of DCD and 10 cases of DBD.All the patients received the tests of sputum culture,bedside bronchoscopes,chest X rays,and blood gas analysis.After clear evaluation,3 cases of DCD and 3 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and the rest one case of DCD was precluded due to long warm ischemic time (＞60 min).The donor lungs from remaining 12 cases were harvested successfully after the declaration of brain death or cardiac death.The donors suitable for the transplant procedure were transported to our transplant center.Result Twelve lung transplants were performed successfully,including 10 cases of bilateral lung transplantation and 2 cases of right single lung transplantation.Two patients was complicated with severe infection and died of sepsis postoperatively,and the remaining 10 patients all recovered uneventfully with dramatic improvement of pulmonary function.During the follow-up period,all the patients lived an active life style with high quality of life.The mean survival time was 34.7 months (4-60 months).Conclusion Lung transplantation using DCD and DBD can be successfully performed after adequate preoperative evaluation of donor lung and abundant preparation for donor harvesting.