Williams syndrome is a rare disease caused by 1.5 ～ 1.8 Mb gene deletion in the chromosome 7q1 1.23 region,with autosomal dominant inheritance.The incidence is about 1/10 000.It involves the cardiovascular system,nervous system,endocrine system and so on,and is most likely to cause damage to the cardiovascular system.The mortality of sudden cardiac death in patients with Williams syndrome is higher than that in healthy population.At present,suspected patients were screened by Lowery score and the American pediatrics score,then were evaluated by imaging examination and were diagnosed by gene detection.The main therapy is symptomatic treatment.Therefore,it is important to ensure an accurate diagnosis and prompt treatment.In the article,the research progress of the clinical diagnosis,gene diagnosis,gene therapy and prognosis is reviewed.

Objective:To discuss the relationship between serum advanced oxidation protein products (AOPP)and cystatin C with the early preeclampsia pregnancy outcome.Methods:Clinical data of 75 patients received treatment and labor at our hospital from 2011 to 2013 was retrospectively analyzed.The control group included 60 normal pregnant women who received prenatal examination in our hospital at the same time.The difference in cystatin C and AOPP level of the patients with preeclampsia and the normal group was compared.The clinical data and the adverse pregnancy outcome of the patients with preeclampsia in different severity and different outcome of pregnancy were compared.Results:A total of 135 patients were retrospective analyzed ,including 75 in observe group and 60 in control group.The SBP level in the patients with preeclampsia is obviously higher than in the normal group .The level of SB,UA,Cr and AOPP in the patients of mild group is obviously lower than in the severe group.The incidence of oligohydramnios , placental abruption,fetal growth restriction and HELLP syndrome in the patients of mild group was obviously lower than in the severe group .The differences were statistically significant.The level of cystatin C,UA,Cr and AOPP in the patients of adverse pregnancy outcome were obviously higher than in the group of good outcome of pregnancy.Conclusion:The cystatin C and AOPP level of the early preeclampsia patients is obviously increased and it has significant correlation with the pregnancy outcome in patients .

Objective To study the current situation of diagnosis and treatment of rudimentary uterine horn pregnancy through 4-cases report. Methods We made a clinical study of 4 cases of rudimentary uterine horn pregnancy admitted to our hospital between 1995 and 2005. Results Three patients had been undergone artificial abortion before they were admitted to our hospital. All the patients were asymptomatic. Ultrasonography was made in 3 cases. Two cases were diagnosed as rudimentary uterine horn pregnancy. Three patients were cured with surgery. Conclusions Rudimentary uterine horn pregnancy is rare and with atypical clinical manifestation in the first trimester. Although diagnosis before surgery is difficult, ultrasonography and MRI make a great role. Surgery is the most important therapeutic method.

Objective:To test Jiang Guangrong's(2005)three-dimension model on the depth of counseling process.Methods:In this process-outcome research,28 sessions in a university counseling center were videotaped and coded in terms of the model.Structure Equation Model(SEM)was used to examine the relations between the coding and counselors and clients' evaluation of the session depth.Results:(1)Clients and counselors evaluated differently on the session depth,and clients' evaluation was more positive than counselors' [(4.95±1.12)vs.(4.23±0.94),P<0.05];(2)The model was significantly correlated with counselors' session depth evaluation(path coefficient = 0.55,P<0.01),but not with the clients';(3)The session curves describing each dimension changing over time had different patterns in sessions of different depth level,through which more about the counseling process could be known.Conclusion:The three-dimension model on the depth of counseling process has got some empirical evidences.

BACKGROUND: Animal models of peripheral partial epiphyseal plate closure are commonly used in related trials.OBJECTIVE: To modify the original animal models of distal femoral partial epiphyseal plate closure.DESIGN, TIME AND SETTING: A self-controlled trial was performed at the Experimental Animal Center of General Hospital of Chinese PLA from March to October 2007.MATERIALS: Twenty healthy New Zealand rabbits of 4-6 weeks old weighing 1.0-1.5 kg were selected.METHODS: A straight incision about 2 cm was made in lateral knee of 20 rabbits. The subcutaneous tissues and knee capsule were cut open to expose distal femoral condyle. The condylar plate line was clear. Two holes were drilled in the fight lateral condyle, about 3.0-4.0 mm deep, and partial normal epiphyseal plate (about 33%-44% of the total growth plate) was removed. An incision deep to periosteum was created in the left side and regarded as self-control.MAIN OUTCOME MEASURES: Femoral length, valgus angle of the distal femur, and femoral deformity were detected by X-ray photograph, and gross observation. Bone bridge formation of bilateral femora was observed by histological examination.RESULTS: One rabbit died of diarrhea 31 days after surgery, and 19 were included in final analysis. ①Radiographs showed that the mean length of left femur (control side) was significantly longer but valgus angle was significantly smaller than the right side (experimental side) 4 months after surgery (P ＜ 0.01). The left distal femur averagely grew for 2.27 cm,accounted for 57.6% of the overall femoral growth, and the right side averagely grew for 0.45 cm, accounted for 21.4% of the overall femoral growth.②Four months after surgery, femoral appearance of the control side was normal, with smooth and complete condylar and facies articularis patellae. While, the experimental side femur was significantly shortened, and severe vaigus deformity was observed in the distal femur. ③Five weeks after surgery, layer cells of the epiphyseal plate arranged regularly in the control side. Bone trabecula with many fibers was found in bone defect cavity of the experimental side, and the cell layer of the remnant epiphyseal plate was decreased. The epiphyseal plate was closed in the control side,and bone trabecula of the experimental side was thickened 10 weeks postoperatively.CONCLUSION: This modeling method is simple, efficient, and easy to manipulate; in addition, the bone bridge area is controllable. The models can meet the study demands for peripheral partial epiphyseal plate closure, and are significant for filling material selection during treatment.

Hypoxia-induciole factor-1 (HIF-1) is an important transcription factor.It participates in the body's response to the hypoxic environment mainly through its active subunit HIF-1α.During cerebral ischemia and hypoxia,the expression of HIF-1α is upregulated and may activate the expressions of multiple downstream target genes involving glycolysis,vascular growth,cell survival and apoptosis.It has an important significance for the improvement of energy metabolism and the establishment of microcirculation after cerebral ischemia.HIF-1α can not only promote the neuronal survival,but also mediate delayed neuronal death.A variety of preconditioning and postconditioning methods may regulate the survival and death of neuronal cells by activating HIF-1α.

p38 mitogen-activated protein kinase (MAPK) is an important intracellular signaling transduction pathway.Its major role is involved in inflammatory regulation and apoptosis.p38 MAPK is activated during the cerebral ischemia.Its expression level and the upstream and downstream protein phosphorylation levels will change.Ischemic preconditioning may mediate the survival or death of neuronal cells after cerebral ischemia through signaling transduction pathway.

〔Abstract〕 The paper retrieves different difinitions of Electronic Medical Records ( EHR) through PubMed database, domestic and international standards, analyzes the terms and definitions of EMR using concept analysis method.The definitions are divided into 3 at-tributes namely, noun, characteristics and objective, providing ideas for developing EMR system at various levels in China.

Professional competence is the inevitable requirement of medical students toward jobs.At present, the cultivation of professional competence of clinical internship has many problems and this requires higher medical colleges and universities should take the the cultivation of professional competence of clinical internship as an im-portant task.Cultivate goodness and moral self-discipline ability, demonstration and practice of medical knowl-edge ability and colleagues cooperation and doctor-patient communication ability.To this end, should optimize the path of the cultivation of professional competence:perfect the education contents and courses of professional compe-tency;organize professional competence training and simulation contest;encourage clinical interns to learning and self-improvement;build the assessment mechanism of professional competence of clinical internship.

Objective To confirm the most effectively screening conditions by comparing the ARR values of different posi‐tions after saline load test .Methods After exclusion the other secondary hypertension ,the completion of saline dressing test ,84 ca‐ses diagnosed hypertensive patients under saline load test results were divided into primary aldosteronism group (pH ,52 cases) and primary hypertension group (32 cases) .Analyzed plasma aldosterone (PAC) ,renin (PRA) values of upright and decumbent body positions ,their ARR values were calculated and the urine aldosterone was tested .Results Those whose upright position ARR rati‐os higher than 240(pg/mL)/(ng · mL -1 · h-1 ) were accounted for 80 .77% (42/52) and 43 .75% (14/32) ,respectively in the both PA group and PH group;Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL were accounted for 65 .39% (34/52) and 3 .13% (1/32) ,respectively in the both PA group and ph group;The specificity of this method for PA was 96 .88% .Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h ,The specificity of this method for PA was 100 .00% .Conclusion It is an effective screening method for primary aldosteronism when ARR values of upright position higher than 240(pg/mL)/(ng · mL -1 · h-1 ) ,PAC of decumbent position higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h .