Objective To detect the mutation of A379,we develop a TaqMan fluorogenic probe based amplification refractory mutation system (TaqMan-ARMS) and investigate whether the A379V variant and activity of Lp-PLA2 are the risk factors for CAD.Methods According to the amplification refractory mutation system(ARMS-PCR)combined with a TaqMan fluorogenic probe,we established and evaluated the assay teehnique of TaqMan-ARMS for measuring the genotype of variant.At the same time,we tested the aetivity of Lp-PLA2 in 395 patients with coronary heartdisease and 396 controls,whose clinical information [ages,CHO,GLU,TG,HDL,LDL,Hs-CRP,Lp (a)] were collected.Date was analyzed by using Independent-samples t test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results CAD group had significantly higher Lp-PLA2 activity than the controls(31.51 nmol · ml-1 · min-1 ＞21.31 nmol ·ml-1 · min-1,F =16.40,P ＜ 0.001).Comparing the highest quartile of Lp-PLA2 activitv to the bottom quartile,OR was 7.50 (95％ CI:2.34-24.05) after adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp (a) and GLU; the genotype VV of A379V was associated with higher risk of CAD (OR =2.95; 95％ CI:1.22-7.15,P ＜ 0.05).Conclusions The TaqMan-ARMS real time PCR technique is established to analyze A379V genotype.Lp-PLA2 activity is significantly higher in CAD group and is a risk factor for CAD; the genotype VV of A379V is also a risk factor for CAD.

OBJECTIVE:To evaluate the economics of azithromycin vs. amocillin clavulante in the treatment of lower respirato-ry tract infections. METHODS:System evaluation was adopted to retrieve the randomized controlled trials(RCT)about azithromy-cin(test group)vs. amoxicillin clavulanate(control group)in the treatment of lower respiratory tract infections. Information was col-lected and Meta-analyses were performed. On this basis and short-term decision tree model,cost factors were added to conduct the pharmacoeconomics by the principle of PICO of Treeage Pro 2011 edition software. RESULTS:Totally 18 RCT were enrolled,in-volving 3 365 patients. Results of Meta-analysis showed that there were no significant differences in the effective rate [RR=0.93, 95%CI(0.55,1.55),P=0.77] and incidence of adverse reactions [RR=0.79,95%CI(0.62,1.0),P=0.05] between 2 groups. The av-erage treatment cost in test group and control group was respectively 790.4 yuan and 884.4 yuan,and cost-effectiveness ratio was respectively 216.0 and 245.7,and the incremental cost-effectiveness ratio(ICER)was -1 392.59. CONCLUSIONS:Azithromycin has similar efficacy and safety to amoxicillin clavulanate in the treatment of lower respiratory tract infection,however,azithromy-cin has better cost-effectiveness.

Type 2 diabete, caused by inadequate secretion of insulin and insulin resistance in tissues and organs, is also called non insulin dependent diabete. At present, over 90% diabetes is type 2 diabete which is seriously harmful to human health, however, the current clinical application of chemical synthetic medicines have different degrees of side effects. Therefore, the study of components with antidiabetic activity acting on different targets from the natural products with low toxicity has become a focus of current research. The new targets, such as PTP1B, DPP-IV, PPAR, and AMPK, were discovered in recent years. In this paper, active components in natural products on new targets for diabetes are reviewed, so as to provide the reference for the further research of diabetes.

ObjectiveBy analyzing the epidemiological characteristics and trends of brucellosis in Hebei province,provide a scientific basis for the formulation of strategies for effective prevention and control of the disease.MethodsUsing the descriptive epidemiological method,data of the “China information system for disease control and prevention” from 2006 to 2010 were statistically analyzed.ResultsThere were 13 632 reported cases from 2006 to 2010 in Hebei province,no death,the annual incidence rates reported were 3.4068/10 million,3.4851/10 million,4.5701/10 million,4.6045/10 million,and 3.5582/10 million,respectively.Eleven counties throughout the province had reported cases.The cases were found intensively in Zhangjiakou,Chengde,Baoding,Handan and Shijiazhuang,which accounting for 90.02％ (12 271/13 632) of the total cases.The disease was found each month throughout the year,and showed a seasonal cycle with peak period in spring and summer.The disease was most commonly found in 25 - 65 age people,which accounting for 84.57％(11 529/13 632).The incidence in male was higher than that of female,and male to female ratio was about 3.56:1.00.Vocational high risk population was farmers,accounting for 91.15％ of the total cases(12 425/13 632).ConclusionsBrucellosis epidemic in Hebei province is relatively serious,and the epidemic range has expand each year,even highly active in some particular areas.To control the outbreak of brucellosis,departments cooperation between health and animal husbandry should be strengthened; management of source of infection should be strengthened; health education and behavior intervention should be carried out thoroughly and deeply for high-risk groups.

Objective To evaluate the performance of serum small dense low-density lipoprotein cholesterol(sdLDL-C) kit using enzymic method and investigate the clinical value in coronary heart disease (CHD).Methods According to the standard of Clinical and Laboratory Standards Institute (CLSI),evaluae the precision,linearity ranges,reportable range and accuracy of sdLDL-C kit.The 683 patients with coronary heart disease (CHD,423 men and 260 women,age 35-79 years) who were diagnosed at the people's hospital of Peking university from October 2015 to October 2016 were divided into two groups.The treated group include 571 patients(CHD1,342 men and 229 women,age 40-79 years) which taking lipidlowering drugs and the other include 112 cases (CHD2,81 men and 31 women,age 35-70 years)without Lipid-lowing treatment.Besides,the Control group contains 472 healthy persons (274 men and 198 women,age 41-75 years),were collected from the people's hospital of Peking university between April and August 2016.The liver function,renal function,blood glucose and blood lipid in CHD group(CHD1,CHD2) and healthy control group were detected.The new enzyme assay kit was used for the determination of sdLDL-C.The data of normal distribution were compared by independent t test between the two groups.The Mann-Whitney U nonparametric test was used for comparison between two groups.Results The precision of sdLDL-C kit examination was in compliance with manufacturer'statement.The linearity was good in 0.11-2.42 mmol/L(Y =1.008 9X + 0.024 8,R2 =0.998 2),the scope of the report is 0.11-4.84 mmol/L.The level of sdLDL-C in CHD group was significantly higher than that in healthy control group,it has a statistical significance[0.824 (0.443) mmol/L,0.609 (0.361) mmol/L;Z =-5.603,P ＜ 0.001].The level of sdLDL-C in (CHD 1) was lower than (CHD 2) [0.761 (0.479) mmol/L,0.888(0.426) mmol/L;Z=-2.304,P＜ 0.021].After additional adjustment for various tradition cardiovascular risk factor,including ages,sex,CHO,TG,Hs-CRP,Lp(a),and GLU,the highest quartile of sdLDL-C comparison to the bottom quartile,the OR was 3.02,(95％ CI,1.15-9.05) for CHD.Conclusions Experiment data demonstrated that sdLDL-C kit using enzymic method has good performance in the precision,linearity ranges,reportable range and accuracy,sdLDL-C serum level was significantly higher in CHD group.

OBJECTIVETo investigate the feasibility of continuous intraspinal ceftazidime administration for treatment of purulent meningitis due to Achromobacter infection.

METHODSA patient with established diagnosis of purulent meningitis due to Achromobacter infection was admitted, who failed to respond favorably to a 3-day ceftazidime treatment administered intravenously. Continuous intraspinal ceftazidime administration at the dose of 0.2 g/d was then attempted through a catheter placed in the cisterna magna in addition to intravenous ceftazidime for 3 days, which resulted in obvious relief of the symptoms. The catheter was subsequently withdrawn, and the patient received further treatment with additional intravenous ceftazidime for a week.

RESULTSThe symptoms of purulent meningitis was significantly improved after a 3-day continuous intraspinal ceftazidime administration, and the patient was eventually cured after completion of the treatment course. Intrathecal ceftazidime was also attempted previously but failed due to intolerance of pains in the legs. No relapse was observed in this case 3 months after the discharge.

CONCLUSIONContinuous intraspinal ceftazidime administration can be effective and safe for treatment of purulent meningitis.

Achromobacter ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Catheters, Indwelling ; Ceftazidime ; therapeutic use ; Humans ; Injections, Spinal ; Male ; Meningitis, Bacterial ; drug therapy ; Treatment Outcome

OBJECTIVEHepatitis B e antigen (HBeAg) seroconversion and/or hepatitis B surface antigen (HBsAg) clearance are considered as good prognostic indicators of treatment outcome in HBeAg-positive chronic hepatitis B (CHB) patients. While a sustained virological response (SVR) can be achieved by a finite 48-week course of pegylated-interferon alfa-2a (Peg-IFNalpha-2a), it has been suggested that longer-term treatment can improve the rate of SVR. Therefore, the aim of this study was to compare the effects of prolonged and routine Peg-IFNa-2a therapy in patients with HBeAg-positive CHB.

METHODSEighty-six consecutive patients diagnosed with HBeAg-positive CHB at our hospital between September 2006 and October 2009 were enrolled in the study. The patients were randomly assigned to receive Peg-IFNa-2a (180 mug once weekly) for either 48 weeks (routine therapy group, n = 53) or 72 weeks (prolonged therapy group, n = 33). Serum samples were collected from each patient every three months until the end of the 24-week follow-up, and standard viral and biochemical tests were carried out. Relapse was defined as HBV DNA concentrations more than 105 copies/mL or an HBeAg-positive test at the end of the 24-week follow-up. Chi-squared test and the t-test were used to determine the significance of intergroup differences. Logistic regression analysis was employed to determine the correlation of outcome parameters to treatment duration, expressed as odds ratio (OR) with 95% confidence interval (CI).

RESULTSThe two treatment groups were similar at baseline (pre-treatment) in demographic data, sex ratio, age, alanine aminotransferase (ALT) level, HBV DNA load, and semi-quantitative level of HBeAg (s/co) (all, P more than 0.05). At the end of the 24-week follow-up, there were significant differences between the 48-week treatment group and the 72-week treatment group in patients with HBV DNA negativity (62.3% vs. 97.0%, x2 = 13.273, P = 0.000), HBeAg seroconversion (39.6% vs. 57.6%, x2 = 6.765, P = 0.009), HBsAg clearance (15.1% vs. 36.4%, x2 = 5.155, P = 0.023), and relapse (58.5% vs. 33.3%, x2 = 6.713, P = 0.010). Logistic regression analysis indicated that therapy duration was correlated to HBeAg clearance (OR = 3.702, 95% CI: 1.225 to 11.188) and male sex (OR = 3.005, 95% CI: 1.038 to 8.696) but not to HBeAg level at baseline (OR = 0.999, 95% CI: 0.998 to 1.000) or age (OR = 0.902, 95% CI: 0.839 to 0.970).

CONCLUSIONIn this single-center cohort study, superior therapeutic benefit was achieved by extending the Peg-IFNa-2a therapy out to 72 weeks for patients with HBeAg-positive CHB. The prolonged duration therapy produced a higher HBsAg loss ratio, HBeAg seroconversion ratio, HBV DNA negativity ratio, and a lower relapse ratio. Furthermore, HBeAg clearance was positively correlated with duration and male sex.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the bonding properties and interface characterization of a domestic 3mol yttrium-stabilized tetragonal zirconium polycrystal (3Y-TZP) framework fired on with 4 different veneering ceramics for zirconia.

METHODS4 different commercial veneering ceramics for zirconia (VITA VM9, SHOFU VINTAGE ZR, IPS e.max Ceram, Cercon ceram kiss) were sintered on 3Y-TZP rectangulars (15 mmx5 mmx5 mm) according to the manufacturers' instructions for shear bond strength test, a metal-ceramic system(Ni-Cr alloy/VITA VMK95) was fabricated in the same type as a control group. Two bilayered specimens (3Y-TZP/VITA VM9, Ni-Cr/VMK95) were prepared for scanning electron microscope (SEM) and energy distribution spectrum (EDS).

RESULTSThe values of shear bond strength test were (18.83 +/- 1.77) MPa for 3Y-TZP/VITA VM9, (23.83 +/- 7.05) MPa for 3Y-TZP/SHOFU VINTAGE ZR, (17.87 +/- 2.30) MPa for 3Y-TZP/IPS e.max Ceram, (22.26 +/- 7.45) MPa for 3Y-TZP/Cercon ceram kiss, (20.55 +/- 5.13) MPa for Ni-Cr alloy/VITA VMK95. There was no statistically significant between all-ceramic groups and the control group (P > 0.05). The failure modes in all-ceramic groups showed predominately adhesive at the interface. SEM showed the 3Y-TZP/VITA VM9 contacted tightly at the interface, while EDS detected Si element diffused into 3Y-TZP material.

CONCLUSIONThe results indicate that domestic 3Y-TZP has a good interface compatibility with 4 commercial veneering ceramics, as a dental framework material, it can satisfy the clinical requirements.

Ceramics ; Dental Bonding ; Dental Porcelain ; Dental Stress Analysis ; Dental Veneers ; Materials Testing ; Yttrium ; Zirconium

Objective To analyze the clinical and genetic characteristics of 10 Chinese patients with 17? hydroxylase/17,20 lyase deficiency (17OHD). Methods Clinical features and laboratory data were collected from 7 kindreds with 17OHD. PCR products and subclone sequencing were performed to screen the mutation of CYP17A1 gene. Results All patients had typical clinical presentation of sexual infantilism, hypertension and hypokalemia. The laboratory examinations indicated decreased plasma cortisol, 17-hydroxy progesterone, estradiol and testosterone, and elevated blood adrenocorticotrophic hormone(ACTH), follcie-stimulating hormone(FSH) and luteinizing hormone(LH). CT scan showed bilateral adrenal hyperplasia. 5 CYP17A1 mutations were identified, 4 of which are novel types D487_F489del, the most frequent mutation, was identified in 4 families and 45% alleles. Conclusion Our study indicates that 17OHD should be considered in the diagnosis of patients with sexual infantilism. D487_F489del is the most frequent mutation in Chinese 17OHD patients.

Objective To investigate the internal quality control ( IQC ) on clinical chemistry , clinical immunology and clinical hematology in mutual recognition laboratories in medical institutions in Beijing.Methods By means of questionnaire survey and on -site investigation, fresh frozen serum and whole blood samples with assigned values by reference method were measured to investigate the status of IQC on clinical chemistry , clinical immunology and clinical hematology in 142 mutual recognition laboratories in medical institutions of Beijing,and results were analyzed.Results 142 copies of questionnaireson clinical chemistry, clinical immunology and clinical hematology were send out and 120, 97, and 101 laboratories returned the questionnaires respectively .The information feedback rate was 84.5%, 68.3% and 71.1%respectively .All the questionnaires were effective .Questionnaires survey results showed that more than 50%laboratories set up quality control goals and the most of the goals were probability for error detection ( Ped) 95%, probability for false rejection(Pfr)5%;About 70% laboratories usecd the same quality control plan for different tests ;The most frequently used quality control rules are 12s/13s/22s.On-site investigation showed that ,take the results of clinical chemistry for example , based on the desirable biological variation and WS/T 403 -2012 , most of the tests can't meet the quality control goalsunder the existing quality controlcondition.Conclusion Clinical laboratories should consider their actual situations , assess their own qualitylevels that they can reach , set reasonable quality standards for themselves , and make appropriateindividualized quality control plan.