Objective:To investigate the similarities and differences of Doppler echocardiographic parameters in healthy adults among Chinese (EMINCA study), Japanese (JAMP study) and Europeans (NORRE study).Methods:Based on the published Doppler echocardiographic data of JAMP and NORRE studies, the corresponding Doppler parameters were selected from the original database of EMINCA study and stratified by sex and age groups accordingly. Independent-samples t-test, summary t-test, and one-way analysis of variance (ANOVA) were used to test the differences between groups. Results:①Common Doppler parameters in three studies included: peak velocities of early diastolic (E) and late diastolic waves (A) of mitral valve inflow, E/A ratio, deceleration time (DT) of E wave, tissue velocities of early diastole (e′ ) and late diastole (a′ ) at both septal and lateral sites of the mitral annulus and the average value of e′ at both sites (average-e′), ratios of E to septal e′ (septal-E/e′), E to lateral e′ (lateral-E/e′), and E to average e′ (average-E/e′). ②Differences between genders: There existed significant gender differences for 5/10 of parameters in EMINCA study, 8/10 in JAMP study and 3/12 in NORRE study (all P<0.05). ③Stratification by sex and age groups: Except for DT for men in EMINCA study, significant differences were found in all 12 Doppler parameters both for men and women in all three studies (all P<0.05). ④Comparison between EMINCA and JAMP studies: There were statistically significant differences in 8/10 and 9/10 of parameters for men and women, respectively (all P<0.05). ⑤Comparison between EMINCA and NORRE studies: 7/12 of parameters both in men and women were significantly different between the two studies (all P<0.05). ⑥For the three studies, 6/10 of parameters both in men and women correlated positively with age ( r=0.12-0.66, all P<0.001), while 4/10 correlated negatively with age ( r=-0.27--0.72, all P<0.001). Conclusions:Doppler echocardiographic measurements in healthy adults are significantly different with genders, ages and races/nationalities. Therefore, gender, age and race/nationality-specific reference values of Doppler echocardiography parameters should be encouraged in clinical practice.

Objective: Hepatocyte nuclear factor 1 homeobox b (HNF1B) -associated disease is an autosomal dominant inherited disorder with a variable, multi-systemic phenotype. In China, five adult probands and one child proband with HNF1B-associated disease had been reported, whereas few fetuses are described. The aims of this retrospective study were to understand about the clinical manifestations of HNF1B-associated disease and to further improve the recognition of this disorder. Method: Four patients (3 males, 1 female) and three fetuses with HNF1B mutations were included in this study. They were admitted to our hospital from January 2013 to March 2017. HNF1B mutations were detected using targeted next generation sequencing and quantitative real-time PCR or Sanger sequencing. HNF1B heterozygous deletion of exons 1-9 was found in 4 patients and 2 fetuses, and HNF1B heterozygous missense mutation in 1 fetus. These two mutations had been reported. Two patients and 1 fetus had de novo mutations. Results of renal ultrasonography with or without magnetic resonance imaging, biochemical investigations, urine routine examination and other necessary investigations in 7 cases were analyzed. Result: Three patients were Han Chinese ethnicity, and one patient was Mongolian. In patients 1 and 4, abnormal fetal kidneys were discovered by routine ultrasonography, and the age at first feature identified in Patients 2 and 3 were 13 years and 28 years. Patient 3 had normal renal function and the remainder had reduced glomerular filtration rate. In addition, patient 4 presented with nephrotic syndrome and glycosuria, patient 2 with early onset hyperparathyroidism and renal osteodystrophy, and patient 3 with diabetes mellitus. All the 4 patients had renal structural abnormalities including bilateral multiple renal cysts, dysplasia and hyperechogenic kidneys. Only patient 3 had a positive family history of renal diseases, the remainder had a negative family history of renal diseases. In 3 fetuses, prenatal ultrasound anomalies were detected during the second trimester. These 3 fetuses had hyperechogenic kidneys with or without renal cysts. Polyhydramnios was detected in only one of the 3 fetuses. Two of the 3 fetuses had a positive family history of renal diseases. Conclusion Clinical phenotypes of HNF1B-related disease are heterogeneous, renal malformations clearly appear to be the most common manifestation, multiple renal cysts are characteristic, and patients can progress to impaired kidney function during childhood; HNF1B mutation is a differential diagnosis of fetal hyperechogenic kidneys or multiple renal cysts.

Objective Analyzing epidemiological characteristics and etiology of hand,foot and mouth disease outbreaks from 2011 to 2012 in Shenzhen to provide the basis for prevention and control of hand,foot and mouth disease.Methods The data about epidemiology of hand,foot and mouth disease outbreaks was analyzed and Viral RNA was used for enterovirus type 71 (EV71),coxsackie virus type A16 (CA16) and Pan-enterovirus (PE) detection by real-time RT-PCR.Results A total of 501 specimens from 160 hand,foot and mouth disease outbreaks were collected and detected between 2011 and 2012.EV71 was responsible for 36 outbreaks (22.50％),CA16 was responsible for 52 outbreaks (32.50％) and other enteroviruses were responsible for 40 outbreaks (25％).84 outbreaks (52.50％) occurred in Nanshan District in Shenzhen and 36 outbreaks (22.50％) occurred in Luohu District in Shenzhen.Outbreaks occurred throughout the year except August between 2011 and 2012.There were two peak periods from March to July and September to November,respectively.The positive rates of male and female are 72.3％ and 73.4％,respectively.Conclusion There was variation in hand,foot and mouth disease outbreaks in different regions and months.There was no significant difference between gender.CA16 was the main causative agent of hand,foot and mouth disease in 2011,while non-EV71and non-CA16 human enterovirus were main pathogens of hand,foot and mouth disease outbreaks in 2012.

Objective To compare diagnosis value and the clinical application of enzyme linked immunosorbent assay (ELISA) method and the immune turbidimetric method detecting serum anti cyclic citrullinated peptide (CCP)antibody in patients with RA.Methods Collected fresh serum specimen of 267 inpatients with RA in Rrheumatism Department of Xi’an Institu-te of Rheumatism from December 2014 to February 2015,and fresh serum specimen of 50 healthy blood donors from the Blood Center of Shaanxi Province respectively.Anti CCP antibody was detected by enzyme-linked immunosorbent assay (ELISA)method and the latex immunoturbidimetry assay.Evaluated the correlation of the results and clinical application to RA diagnosis.Results Sensitivity,specificity and diagnostic consistency of ELISA and latex immunoturbidimetry assay were 77.3%,86.8%,94.3% and 76.2%,80.2%,77.9% respectively.Compared two kinds of methods,the value of Kappa was 0.756,for having consistency.Throughχ2 test (χ2 =1.85,P >0.05),there was no significant difference between two meth-ods.Area of ELISA and lateximmunoturbidimetry under the ROC curve were 0.876 and 0.832 respectively.Conclusion De-tection of serum anti CCP antibody has diagnostic value in RA patients.The ELISA method and the latex immunoturbidime-try assay for detection of anti CCP antibodies had consistency.Two methods had no statistical difference,and the latex turbi-dimetric method is suitable for grassroots medical institutions.

Encephalomyocarditis virus (EMCV) ,named JZ1202 ,was isolated from domesticated boar in Henan ,China . We performed the full-length genome sequencing and molecular characteristic analysis of the isolated strain .Results showed that the full-genome sequence of EMCV JZ1202 generated a sequence of 7 735 bp in length ,and had 81 .2%-99 .9% nucleotide identity with other reference strains from different animals ,but 99 .4% with Chinese reference from pig .The phylogenetic tree was constructed based on the full-length genome;ORF and VP1 gene sequences identified EMCV was divided into G1 ,G2 and G3 groups ;the strain JZ1202 belongs to G1 with other Chinese reference strains .Results identified that the EMCV infection could cause severe clinical symptoms in domesticated boar .Big regional differences exist in EMCV and the transmission is limit-ed in a range of area .However ,cross infection and prevalence of EMCV disease between domesticated boar and mice might ex-ist .Mutation of some amino acid may occurred in EMCV infected domesticated boar .

Objective To evaluate the accuracy of realtime polymerase chain reaction (PCR) assay in the detection of group B Streptococcus (GBS) in pregnant women. Methods Samples were collected from 1 395 women at 35-37 weeks of gestation from March 1 to December 31, 2009 at three hospitals in Beijing. Samples were obtained from the lower one third vaginal wall and perianal area and tested for GBS using standard culture and PCR. Standard culture and gene analysis for GBS were applied as the gold standard, and the sensitivity and specificity of the rapid assay were determined. Results Of the 1 395 women qualified for PCR testing, 40(2.9%) were identified as GBS positive on the basis of the results of specimen culture, compared to 114 (8.2%) on the basis of PCR assay. The culture was negative and the PCR positive in 77 patients. The results which were not in agreement using the two tests were evaluated by the gene analysis for GBS. Among the 77 samples which were GBS positive by PCR, 66 samples were determined as GBS positive by gene analysis. The sensitivity of the PCR assay was 97.2%(103/106) and specificity was 99.1%(1 278/1 289), the maternal GBS colonization was 7.6%(106/1 395). Conclusions Realtime PCR assay allows rapid and reliable detection of GBS in last trimester with high sensitivity and specificity.

Objective To investigate the knowledge about risk factors for stroke in stroke patients. Methods 1043 stroke patients in 10 hospitals were investigated with self-designed questionnaire. Results The rate of awareness of risk factors for stroke was: hypertension 61.55%, hyperlipidemia 40.27%, drinking 32.21%, smoking 30.11%, diabetes mellitus 28.67%, heart disease 23.11%. 6.42% knew all the 6 risk factors, and 20.13% did not know any risk factor. The rate of awareness of diabetes mellitus was different among various aged groups (P<0.01), and the rate of awareness of hypertension, hyperlipidemia, and diabetes mellitus increased with the years of education. Conclusion The stroke patients know less about the common risk factors for stroke, who need more health education.

Objective To investigate the knowledge of stroke risk factors in the families of patients with stroke. Methods 1100 family members of stroke patients hospitalized in 10 hospitals of various levels in Gansu were investigated with self-designed questionnaire. Results Most families knew that the hypertension was a risk factor for stroke, and there was no significant difference among ages. 7.32% of the families knew all the 6 common risk factors for stroke, and 14.23% knew none of them. Hypertension, hyperlipidemia, diabetes as the risk factors for stroke was known most in the families finished higher education, and different with the education levels. Heart disease, smoking, consumption of alcohol as risk factors for stroke was known poorly whatever the careers of the families. Conclusion The families of patients with stroke know less about common risk factors for stroke in Gansu.

Objective To investigate the knowledge of stroke risk factors, early symptoms, and rehabilitation in stroke patients. Methods 1043 cases with stroke were stratified randomly sampled from 10 hospitals at different levels in Gansu, and were surveyed with self-designed questionnaire. Results For risk factors for stroke, hypertension was the most aware (61.55%), 6.42% knew all the factors. For the prevention and treatment, reasonable diet was the most aware (56.18%), followed with giving up smoking and drinking (52.92%). For the early symptoms, dysaesthesia of one side body was the most aware (53.88%), and then the headache and dizzy (50.14%). It was less than 30% to know the blurring, nausea and vomiting, and stiff tongue, etc. as the early symptoms. 60% of the patients did not know any about the rehabilitation, 22% did not know if rehabilitation be needed. 80% of the patients with stroke chose medication regardless of family income, and rehabilitation was chosen less than 30%. Conclusion It is important to popularize the knowledge of risk factors, early symptoms, and rehabilitation of stroke.

Objective To understand the awareness of early symptoms of stroke patients in Gansu. Methods 1100 stroke patients in neurology and neurosurgery departments in 10 hospitals of different levels in Gansu in 2010 were surveyed by questionnaire. Results The awareness rate of early symptoms of stroke was generally low in all age groups. Conclusion Stroke patients were lack of awareness of early symptoms in Gansu, we should step up publicity efforts to enable more patients to receive early treatment and reduce morbidity and mortality.