0 05) for inducible VT; Utility of QTD≥70ms combined with positive VLP had a more satisfied outcome than using either of these abnormalities in predicting inducible VT. Conclusion QTD is an easily measurable electrocardiographic index for predicting coronary heart disease.

Objective To investigate the influence of remote care management on the diet compliance and disease recurrence of patients with pancreatitis. Methods Seventy-four simple pancreatitis patients in our hospital from January 2013 to March 2014 were involved and numbered according to the administration order and divided into the observation group and the control group according to the random number table with 37 cases in each group. The two groups accepted conventional health education during hospitalization time. The control group was given intensive classes after discharge, while the observation group received remote care management. Twelve months later, the rate of disease recurrence and diet compliance of the two groups were observed and compared. Results After the management, the observation group was superior to the control group in diet compliance. The rate of disease recurrence was significantly lower in the observation group than that of the control group (all P<0.05). Conclusion The remote care management can effectively improve the diet compliance of pancreatic patients, lower the recurrence rate, and have positive effect on prognosis.

Objective According to the theoretic framework of successful ageing,this study developed a multidimensional Successful Ageing Assessment Scale and tested its reliability and validity.Methods Through literature review,the study determined evaluative dimension,structure and scoring method.Then,the Successful Ageing Multidimensional Assessment Scale(SAMAS) was developed and was optimized by the expert consultation,semi-structured interview and twice tests.The predicted sample was conducted with item analysis,and testing of reliability and validity; the formal tested sample was conducted with item analysis,conformance testing and testing of reliability and validity.Then the formal tested sample was tested and retested two weeks later.The intestine emendatory Activities of Daily Living Scale (ADL),Mini Mental State Examination Scale (MMSE),Social Disability Screening Schedule (SDSS) and Memorial University of Newfoundland Scale of Happiness(MUNSH) were used to test its criteri-on validity.Results SAMAS consisted of 5 dimensions,including chronic disease state,physical perfor-mance,cognitive function,social function,subjective well-being.Item analysis showed the dimensions of scale and total scale scores had positive correlation.In conformance testing,the Kappa value was 0.65～0.86,test-retest reliability was 0.66～0.85 and the internal consistency reliability was 0.88.The correl-ative coefficient of the physical performance and social function scores were negatively correlated with ADL scores and SSDS scores,the correlative coefficient of the cognitive function and subjective well-being scores were positively correlated with MMSE scores and MUNSH scores.Conclusions SAMAS suggested good reliability,validity and could well evaluate comprehensive health for the elderly,at the same time could distinguish between SA and non SA group.

Objective To study the expressions of the tumor suppressor gene TSH receptor( TSHR),P16, and RAS in papillary thyroid carcinoma ( PTC ) , and the correlation between the occurrence of tumor and the aberrant promoter hypermethylation of three tumor suppressor genes. Methods RT-PCR was used to detect the mRNA expression of three tumor suppressor genes in tissues of 50 cases of PTC ,20 cases of nodular goiter,and 12 cases of thyroid adenoma. The promoter methylation status of three tumor suppressor genes was examined by methylation-specific PCR technique( MSP). Gene sequencing was used to test if the hypermethylation existed in the promoter of three tumor suppressor genes. Results In 68.0% (34/50) TSHR gene, 54.0% (27/50) P16 gene, and 60.0% ( 30/50 ) RAS gene in PTCs, hypermethylation in promoter region was detected, the respective results 21.9% (7/32) , 15. 6% (5/32) ,and 31. 3% (10/32) were found in control tissues. The rates of the three genes with promoter hypermethylation in PTC were significantly higher than those in control tissues ( all P<0. 05). The mRNA expressions of TSHR,P16,and RAS were significantly lower in PTC than those in control tissues (0. 41 ± 0.11 vs 0.63±0. 08,0. 51±0. 17 vs 0. 72±0. 22,0. 56±0. 10 vs 0. 67±0. 16, all P<0. 05). The sequencing confirmed that there was CC to TC transmission in the promoters of three tumor suppressor genes. Conclusions The methylation of three tumor suppressor genes in promoter region is a common molecule event and may be involved in the genesis and development of human PTC.

Objective: To learn the interaction of serum direct bilirubin and blood lipids on the risk of carotid atherosclerosis and carotid plaque. Methods : The subjects were selected from Hangzhou Wuyunshan Sanatorium from March 2016 to December 2018. Demographic information,laboratory testing results and carotid intima-media thickness（IMT）were collected. The logistic regression model was employed for the association of direct bilirubin,blood lipids and their interaction with the risk of carotid atherosclerosis and carotid plaque. Results: Totally 8 308 subjects were recruited. Among them,616（7.41%） subjects had carotid atherosclerosis,and 2 409（29.00%）subjects had plaques. The results of multivariate and multinomial logistic regression analysis showed that high level of direct bilirubin was associated with decreased risks of carotid atherosclerosis（OR=0.701,95%CI：0.537-0.916）and carotid plaque（OR=0.647,95%CI：0.527-0.795）;high TC level（OR=1.335,95% CI：1.106-1.611）, high LDL-C level（OR=1.338,95%CI：1.098-1.629）and low HDL-C level（OR=1.431,95%CI：1.148-1.783）were associated with increased risks of carotid atherosclerosis;high TC level（OR=1.325,95% CI：1.151-1.525）and high LDL-C（OR=1.311,95%CI：1.130-1.520）were associated with increased risks of carotid plaque. There were interactions between direct bilirubin and TC or LDL-C on the risk of carotid plaque（P<0.05）. Compared with the subjects with high level of direct bilirubin and normal level of TC,the subjects with normal level of direct bilirubin and high level of TC had significantly higher risk of carotid plaque（OR=1.831,95%CI：1.438-2.333）;compared with the subjects with high level of direct bilirubin and normal level of LDL-C,the subjects with normal level of direct bilirubin and high level of LDL-C had significantly higher risk of carotid plaque（OR=1.814,95%CI：1.427-2.306）. Conclusion The interactions between direct bilirubin and TC or LDL-C increase the risk of carotid plaque. It is important to strengthen blood lipid control in the patients with normal level of direct bilirubin and hyperlipidemia.

Objective To study the clinical features and follow-up of newborns with severe hypoxic-ischemic encephalopathy ( HIE) , and to provide the basis for rational diagnosis, treatment and follow-up.Methods Clinical data of cases of HIE from the Neonatal Department of our Hospital from January 2011 to October 2014 were studied retrospectively. The data of general information, laboratory examination, treatment, outcome, follow-up and prognosis of the patients were collected. Multivariate logistic regression analysis was used to study the influential factors of the prognosis of HIE.Results A total of 123 infants with sever HIE were enrolled in our study. In addition to general therapy, 6 cases were treated with mild hypothermia, and 21 cases were treated with high pressure oxygen. 60 cases improved our treatment, 55 cases had withdrawal treatment with parental consent, and 8 cases died. Single factor analysis showed that 5 minutes Apgar score, convulsions, coma, pH, BE, organ injury, and mild hypothermia treatment were the risk factors that affect the prognosis of severe HIE. Multiple factors analysis showed that 5 min Apgar score <3 points ( OR=4. 071 ,95℅CI 1. 309-15. 613 ) and BE≤-10 mmol/L ( OR=36. 810, 95℅CI 5. 913-41. 119) were independent risk factors of prognosis of severe HIE ( P<0. 05). Hospitalization within the first 72 hours of life ( OR=0. 096, 95℅CI 0. 096-0. 353) was a protective factor of severe HIE. Multiorgan injury ( mainly the injury of brain, lung and heart) and electrolyte imbalance ( mainly hypocalcemia and hyponatremia ) were common complications of serve HIE. In the follow-up of these patients, 33 cases were loss in follow up, and 49 cases died (8 cases died during hospitalization, 41 cases died after withdrawal of treatment). The top five causes of death were abandonment of treatment due to financial reasons and the fear of adverse outcome (n=20), multiple organ dysfunction ( n =16 ) , and pneumothorax ( n =4 ) , diffuse intravascular coagulation (n=6), and shock (n=3). 41 cases survived were followed up for 9~54 months. The critical clinical conditions observed among these infants included cerebral palsy ( n = 5 ) , epilepsy ( n = 3 ) and developmental retardation(n=26).Conclusions There are many complications of severe HIE.The mortality of severe HIE is high, and the incidence of poor outcome of survivors is also high. Timely detection of risk factors is the key to the prevention of severe HIE. Long-term prognosis of severe HIE requires proper organization of neonatal follow up.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.