Objective To study the relationship between the inherit gene and the pharmic efficacy by observing the apolipoprotein E polymorphism and the nylestroil effect in lowering serum lipids in postmenopausal women. Methods Ninety-four postmenopausal women were divided into three groups according to their types of the apoE gene: E2, E3 and E4. Thirty-six women who received nylestroil therapy were compared with controls, 58 women who had not received the therapy, in lipids, apolipoprotein E and lipoprotein(a)〔LP(a)〕. Results Compared with the control groups, the treatment groups showed an increase in HDL-C (high-density lipoprotein) and decrease in LDL-C(low-density lipoprotein) and LP(a). Though Group E2 showed an increase in the HDL-C and TG and a decrease in the LDC-C and LP(a), no significance was shown compared with the controls. Group E3 was increased in the HDL-C(2.7?0.9)mmol/L and decreased in the LDL-C (3.2?1.0)mmol/L and Lp(a) (0.4?0.2)g/L, and the differences were significant in HDL-C(1.7?0.5)mmol/L and Lp(a) (0.5?0.3)g/L compared with the controls. Group E4 was increased in the HDL-C (2.6?1.0)mmol/L and decreased in the LDL-C(2.5?1.6)mmol/L, TC and LP (a), and the differences were statistically significant(P

A recombinant plasmid containing cathepsin B endopeptidase of Schistosoma japonicum(Sjcb2)was constructed,indentified by PCR,restrictive enzyme,digestion and DNA sequencing,and expressed into mammalian cells.Immunochemistry examination showed that the Sjcb2 gene can be expressed in the eukaryotic system,providing a basis for the development of schistosome DNA vaccine.

Obective To study the association between vertebral artery hypoplasia (VAH) and acute posterior circulation ischemic stroke (APCIS).Methods Of the 718 patients admitted to our hospital for carotid artery ultrosonography and head MRI included in this study,381 with unilateral or bilateral VAH served as an observation group and 337 without unilateral or bilateral VAH served as a control group.The incidence of APCIS in two groups was retrospectively analyzed.The risk factors for APCIS were analyzed by multivariate logistic stepwise regression analysis.Results The incidence of embryonal posterior cerebral artery hypoplasia was significantly higher in observation group than in control group (48.03％ vs 15.13％,P=0.000).No significant difference was found in the incidence of APCIS between the two groups (14.16％ vs 10.00％when the age was ≤ 55 years,7.84％ vs 11.24％ when the age was＞＞55 years,xMH2 =0.310,P=0.578).Hypertension and hyperlipidaemia were the risk factors for APCIS (OR=1.913,P=0.019;OR=1.875,P=0.015).Conclusion VAH is rather common in APCIS patients.However,its accomplanied embryonal posterior cerebral artery hypoplasia does not incease the risk of APCIS.

OBJECTIVETo determine the prevalence of loss to follow-up (PLF) and risk factors among human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients from 1989 to 2012 in Baoshan city, Yunnan province.

METHODSThe epidemic and follow-up databases of HIV/AIDS patients by the end of 2012 were downloaded from "the history card downloading site" of HIV/AIDS database in China Information System for Disease Control and Prevention and obtained the related data of patients from 1989 to 2012 who had local residence in Baoshan city. These data included demographic characteristics (genders, age at the time of HIV testing positive, and occupation, marital status, and education levels, et al), transmission routes, and disease staging, antiretroviral therapy (ART), and sources of samples, the first CD4(+)T cell counts, and status of follow-up, et al. Descriptive epidemiological study was used to describe the general characteristics of loss to follow-up. Multivariable Cox regression was used for determining risk factors associated with loss to follow-up.

RESULTSA total of 3 295 eligible HIV/AIDS patients from 1989 to 2012 were included. The accumulative study person-year was 11 416.59 years, 222 HIV/AIDS patients were lost to follow-up, and the PLF was 0.019 4/ person years (py). The highest PLF was 0.052 8/py in 2008, the lowest was 0.006 2/py in 2012. The lost patients included 56.76% (126/222) males and 43.24% (96/222) females, the PLFs were 0.020 4/py, 0.018 3/py, respectively. Baoshan city, other cities in Yunnan province, and other provinces, foreign nationality as the family register reached 53.60% (119/222) , 28.83% (64/222) , and 5.86% (13/222) , 11.71% (26/222) , respectively, and their PLFs were 0.012 5/py, 0.046 3/py, and 0.053 6/py, 0.095 6/py, respectively. Receiving ART and not receiving ART occupied 6.76% (15/222) , 93.24% (207/222) , respectively, and the PLFs were 0.001 9/py, 0.0588/py. AIDS and HIV staging standed at 8.11% (18/222) , 91.89% (204/222) , respectively, and the PLFs were 0.003 3, 0.034 5/py. The first CD4(+)T cell counts < 200, 200-350, and > 350 cells /ml accounted for 4.95% (11/222) , 73.87% (164/222) , 21.17% (47/222) , respectively, and the PLFs were 0.004 8/py, 0.024 0/py, 0.020 3/py. The results of multivariable Cox regression showed the risks of loss to follow-up (RLFs) of family register as other cities in Yunnan province (HR = 3.11, 95%CI:2.28-4.25) , other provinces (HR = 2.55, 95%CI:1.42-4.56) , and foreign nationality (HR = 2.12, 95%CI:1.35-3.33) higher than that of Baoshan city, respectively. The RLFs of not receiving ART (HR = 20.83, 95%CI:11.74-36.96) and HIV staging (HR = 3.61, 95%CI:1.82-7.16) were higher than those of receiving ART and AIDS staging, respectively, moreover, the RFLs of the first CD4(+)T cell counts between 200-350 cells/ml (HR = 0.35, 95%CI:0.15-0.82) and the first CD4(+)T cell counts > 350 cells/ml (HR = 0.29, 95%CI:0.12-0.72) were less than that of first CD4(+)T cell counts < 200 cells /ml, respectively. The RLF of transmission route as injecting drug (HR = 0.60, 95%CI:0.41-0.88) was less than that of heterosexual contact.

CONCLUSIONOverall, the prevalence of loss to follow-up among HIV/AIDS patients shows a downward trend, moreover, patients of outsiders, heterosexual contact, HIV staging, baseline CD4(+)T cell counts < 200 cells/ml are at higher risk of loss to follow-up.

Acquired Immunodeficiency Syndrome ; epidemiology ; China ; epidemiology ; Continuity of Patient Care ; statistics & numerical data ; trends ; Female ; Follow-Up Studies ; HIV Infections ; epidemiology ; Humans ; Lymphocyte Count ; Male ; Prevalence ; Risk Factors

Objective:To investigate the risk factors for ischemic stroke in patients with spontaneous extracranial vertebral artery dissection.Methods:From November 2013 to December 2019, patients with spontaneous extracranial vertebral artery dissection admitted to the Department of Neurology, Baotou Central Hospital were enrolled retrospectively. According to whether they had ischemic stroke or not, they were divided into ischemic stroke group and non-ischemic stroke group. The independent risk factors for ischemic stroke in patients with spontaneous extracranial vertebral artery dissection were identified by binary logistic regression analysis. Results:A total of 39 patients were enrolled, 25 were female (64.1%), 14 were males (35.9%), their age was 51.51±14.98 years old, 16 of them (41.0%) had ischemic stroke. The proportion of patients with double-lumen sign, intimal flap sign of occluded lumen (37% vs. 4%; P=0.013) and specific initial symptoms (56% vs. 9%; P=0.003) of the ischemic stroke group were significantly higher than those of the non-ischemic stroke group. Multivariate logistic regression analysis showed that double-lumen sign and intimal flap sign of occluded lumen (odds ratio 47.951, 95% confidence interval 26.284-87.478; P<0.001), and specific initial symptoms (odds ratio 19.232, 95% confidence interval 10.695-34.587; P<0.001) were independently associated with ischemic stroke in patients with spontaneous extracranial vertebral artery dissection. Conclusions:Double-lumen sign, intimal flap sign of occluded lumen and specific clinical symptoms are the independent risk factors for ischemic stroke in patients with spontaneous extracranial vertebral artery dissection.

Based on the requirement of the ongoing healthcare reform on the performance appraisal for public hospitals, Shanghai Tenth People′s Hospital explored the performance appraisal system oriented by clinical ability and cost control from the perspective of medical administration and finance. Performance appraisal programs were made from five aspects: clinical development ability, key efficacy indicators, clinical path, disease-entity structure, cost control, aiming to highlight the functional positioning of tertiary hospitals, change doctors′ behaviors of diagnosis and treatment, lead clinical improvement and maintain healthy economy development.