BACKGROUND: There are about 20 millions people suffering from mental retardation in China and about 200 thousands newborns of mental retardation are born every year. Mental retardation in children is a result of multiple factors.OBJECTIVE: To explore the popular causes of mental retardation in order to provide scientific evidence for effectively preventing mental retardation.DESIGN: An observational case study taking children with mental retardation as the subjects.SETTING: Population and family plan institute of a hospital.PARTICIPANTS: Totally 1 336 disabled children in 6 counties of Tai' an city diagnosed by family planning authority from January 1998 to December 2001 were selected. Inclusive criteria: intelligence quotient(IQ) < 55 and met the condition of disabled children, aged over 4 years old, those whose parents requested to give birth to the second baby due to mental retardation of the first children. Exclusive criteria: Disabled children with diseases of other systems. A total of 613 disabled kids met the above standards, aged from 4 to 14 years old, including 509 boys and 104 girls with the ratio of boy to girl of 4.9 to 1.INTERVENTIONS: All the children with mental retardation were examined by professional pediatrists and experts of family planning medical appraisal and conducted IQ test by using Chinese Wechsler Intelligence Scale for Children(C-WISC). Uniform survey was made according to all the data and processed by SPSS10. 0.MAIN OUTCOME MEASURES: The main factors caused mental retardation in kids.RESULTS: Among the 1 336 disabled kids in Tai' an city, the incidence rate of mental retardation was 45.88%. There were 112 mild cases and 501 severe cases with mental retardation among the 613 disabled kids. The component ratio of etiological classification on prenatal, perinatal and postnatal factors was 36.7%, 29.85% and 13.21% respectively, and 20. 23% of them were caused by unclear reasons.CONCLUSION: It is the key mean to prevent the occurrence of mental retardation by reinforcing maternal health, improving obstetric quality, preventing acquired disease and paying attention to early education.

Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes (one had chronic cholangitis with choledochal lithiasis), another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.

Objective To study the drug resistance situation of Mycobacterium tuberculosis strains isolated from the patients with HIV/AIDS complicating tuberculosis (TB).Methods One hundred and ninety-six inpatients with AIDS complicating TB in our hospital from January 2012 to December 2015 were collected.The drug resistance situation of Mycobacterium tuberculosis strains cultured from sputum/tissue fluid/fiber liquid and pathological tissue submitted samples in the patients with AIDS complicating active TB was analyzed.The BACTEC MGIT960 systems was adopted to perform the bacterial identification.The drug sensitivity test was conducted by using 960 culture testing system.Results One hundred and ninety-six strains of Mycobacterium tuberculosis were cultured,the total drug resistance rate of Mycobacterium tuberculosis was 26.02％.These cases were divided into the ＞100/μL and ≤100/μL groups according to different CD4+ T cells count.The drug resistance situation of Mycobacterium tuberculosis to 4 kinds of first line anti-TB drugs were compared between these two groups.The comparison results found that the resistance rate of Mycobacterium tuberculosis strains to the first line anti-TB drugs had no statistical difference between the two groups (P＞0.05).The resistance rates of first line anti-TB drugs from high to low were isoniazid,rifampicin,streptomycin and ethambutol.The drug resistance rate of Mycobacterium tuberculosis strains to 5 types of drug resistant TB had no statistical difference(P＞0.05).Conclusion The drug resistance rate in the initial patients with HIV complicating TB is consistent with the average initial drugresistance level of TB patients in our country.The TB drug resistance rate in the patients with HIV complicating TB has no correlation with CD4+ T cells count.

Aim To investigate whether liver X recep- tors attenuate high glucose-induced apoptosis in H9C2 cells through inhibiting nuclear factor-NF-κB.Methods The lentiviral vector of LXRs was constructed and H9C2 cells cultured in high glucose were infected.The H9C2 cells were divided into 6 groups:control group (5.5 mmol·L -1 glucose),mannitol group(5.5 mmol ·L -1 glucose +27.5 mmol·L -1 mannitol),high glu-cose group(33 mmol·L -1 glucose),green fluorescent protein(GFP)group LXRαgroup,and LXRβgroup. The inhibition rate of H9C2 cells,the mRNA of Bax, Bcl-2,the protein content of NF-κB,Bax,Bcl-2, cleaved caspase-3,and the cell apoptosis were com-pared among these groups.Results LXRs overexpres-sion significantly attenuated high glucose-induced in-crease in Bax NF-κB,cleaved caspase-3 and cell ap-optosis(P <0.05),and increased high glucose-induced decrease in Bcl-2.Conclusion Liver X receptors at-tenuate high glucose-induced apoptosis in H9C2 cells through NF-κB signaling pathway.

Electronic case report forms (eCRFs) instead of the traditional paper case report forms (pCRFs) are increasingly used by investigators and sponsors of clinical research. We include a total of 14 phase III studies (8 pCRF, 6 eCRF) to compare paper and electronic data documentation both quantitatively and qualitatively in clinical studies. The result suggests that adaptions of electronic data capture (EDC) in clinical trials have the advantages in optimization of data capture process, improvement of data quality and earlier clinical decision compared to paper-based methods. Furthermore, the successful implementation of EDC requires accouplements with corresponding data management processes and reallocation of resources.

Objective To improve the cleaning quality of reusable medical instruments continuously through root cause analysis,reduce healthcare-associated infection(HAI)and the wear and tear of instruments.Methods The major factors influencing the cleaning quality of instruments were analyzed and clarified by fishbone diagram,contin-uous quality improvement was carried out based on 5 terminal factors,the rate of rusting,stain,repeated cleaning, damage,and clinical department satisfaction before and after the implementation of continuous improvement were compared.Results The qualified rate of instrument clean increased from 94.24% before implementing measures to 97.60% after implementing measures,the rate of rusting,stain,repeated cleaning,damage decreased from 3.39%, 2.37%,5.76%,and 2.08% to 1 .55%,0.85%,2.40%,and 0.48% respectively,there were significant difference among different groups(all P <0.001 );the score of satisfaction rate to central sterile supply department elevated from(93.87±3.87)before implementing measures to (98.08 ±0.59)after implementing measures(t =6.80,P <0.001).Conclusion Root cause analysis is important in improving cleaning quality of reusable instruments continu-ously,as well as reducing HAI and the wear and tear of instrument,it can save medical cost.

Objective To explore gene polymorphism of the C/T genotype of rs 16 944 in the promoter of IL-1β gene in male population living in the coastal area of Shandong,and thus to investigate the relationship between the gene polymorphism of IL-1β and gout.Methods A total of 276 gout patients and 268 healthy controls were enrolled.The possible association between the polymorphism of IL-1β-511 C/T and gout in Chinese was investigated and gcnotype frequencies and allelic frequencies were calculated by polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) method.Hardy-Weinberg was used to verify the representativeness of the sample.Comparisons between the groups were performed with x2 test and t-test.Results There was no statistically difference in IL-1β-511 C/T genotype frequencies between gout patients and controls(x2=3.251,P=0.197,df=2).The allele frequencies of C and T in gout cases were not different from those in the controls (x2=2.941,P=0.086,OR=1.232,95％CI:0.971-1.563).Moreover,no association between IL-1β-511C/T genotypes and risk factors for gout were observed in gout cases by x2 test.Conclusion Results of the present study suggest that the C/T genotype of rs 16944 in the promoter of IL-1β gene is not associated with gout in male population living in the coastal area of Shandong.

ObjectiveTo explore the expression of CD3+ CD8+ human leukocyte antigen (HLA)-A2+T lymphocytes with specificity to the different hepatitis B virus (HBV) peptides in the peripheral blood mononuclear cells (PBMC)from the patients with hepatitis B associated hepatocellular carcinoma (HCC).MethodsThe HLA-A2+ PBMC from four patients with hepatitis B associated HCC were incubated with five HBV/HLA-A2 pentamers respectively,which were HBV sAg (FLLTRILTI),HBV sAg (GLSPTVWLSV),HBV sAg (WLSLLVPFV),HBV core (FLPSDFFPSV),and HBV pol (FLLSLGIHL),as well as anti-CD3-pacific blue and anti-CD8-fluorescein isothiocyanate (FITC).Then,HBV/HLA-A2-CD3-CD8 positive cells were detected by flow cytometry. The monoclonal HBV/HLA-A2-CD3-CD8+ cells were acquired by fluorescenceactivated cell sorter,and cultured and identified by flow cytometry.The anti-HBV specific T lymphocytes were then cultured with HepG2 (HLA-A2+ ) cells and the release of interferon γ (IFN-γ)were determined by enzyme-linked immunosorbent assay (ELISA),Res(a)ltsThe percentage of antiHBV T lymphoeytes with specificity to GLSPTVWLSV in total CD8+ T lymphoeytes from four patients with hepatitis B associated HCC was 1.44％±0.04％,which was higher than those to other four HBV antigen peptides (0.68％±0.08％ of FLLTRILTI,1.06％±0.09％ of FLPSDFFPSV,0.56％ ±0.04％ of FLLSLGIHL,and 0.46％ ±0.08％ of WLSLLVPFV) (t=0.001,P＜0.05).The two lines of monoclonal cell with specificity to GLSPTVWLSV both exhibited high level of IFN-γ expression after incubated with hepatic carcinoma cell line HepG2 (HLA-A2+)with HBV GLSPTVWLSV peptide.ConclusionsCD3+ CD8+ HLA-A2+ cells with specificity to the different HBV peptides exist in PBMC of patients with hepatitis B associated HCC.The expression level depends on HBV antigen peptide sequences and genomic sites.

Objective To explore the value of coronary CT angiography (CCTA) in prediction of major adverse cardiac events (MACE) in patients with coronary plaques.Methods Totally 256 coronary atherosclerotic plaque patients underwent CCTA.The degree of coronary stenosis was assessed quantitatively,and the plaque components were analyzed and classified.The occurrence of MACE was followed up.Three models were established for predicting MACE,including model 1 (classification of CCTA stenosis),model 2 (classification of CCTA stenosis combined with plaque typing) and model 3 (CCTA combined with plaque typing and clinical risk factors).The ability of the three models to predict MACE was evaluated.Results Follow-up was completed in 209 patients.Forty-six patients had experienced MACE.Classification of CCTA stenosis and plaque typing were used to assess the risk of MACE,and the hazard ratio (HR) was 4.47 and 3.43,respectively,both higher than those of clinical risk factors.The predictive ability of MACE by model 2 and model 3 was significantly superior to that of model 1 (P＜0.05),and there was no significant difference between model 2 and model 3 (P=0.076).Conclusion CCTA can assess the risk of MACE from both coronary stenosis and plaque typing.The new modality of CCTA stenosis classification combined with plaque typing could promote the ability of CCTA to predict the risk of MACE.

OBJECTIVE: To investigate the relationship between immune status of adenoids and secretory otitis media (SOM). METHOD: The adenoid tissue samples of 72 cases with SOM and 30 cases with adenoid hypertrophy without SOM were studied by immunohistochemical method. RESULT: The PCNA, BCL-2, CD4+, CD8+ and CD4+ / CD8+ in SOM tissue samples were 30.85 +/- 1.73, 21.27 +/- 1.25, 41.90 +/- 9.07, 20.45 +/- 7.08 and 2.10 +/- 0.17, respectively, which were much more than that of tissue samples without SOM (25.25 +/- 1.75, 14.05 +/- 1.02, 16.30 +/- 8.21, 11.15 +/- 5.71, 1.39 +/- 0.15 respectively) (P < 0.01). The expression of CD4+ in T-lymphocyte was obviously higher than that of CD8+. CONCLUSION In adenoid tissues of SOM patients, the activity of T-lymphocyte subsets are increased,the adenoids are enlarged and local immunity are enhanced. Therefore,adenoidectomy should be applied in SOM patients as early as possible.
Adenoids ; immunology ; metabolism ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Otitis Media with Effusion ; immunology ; metabolism ; Proliferating Cell Nuclear Antigen ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism