Objective To investigate the characteristics of risk factors and coronary angiography (CAG)in young patients with acute myocardial infarction(AMI).Methods A total of 36 consecutive AMI female patients (age≤44 years)who underwent coronary angiography were retrospectively retrieved from the database,and 90 AMI patients whose age >44 years who also underwent coronary angiography were enrolled as a control (elderly)group.Characteristics of risk factors and coronary angiography were com-pared between the two groups.Results The risk factors:BMI,family history of coronary heart disease and high triglycerides(TG)were major in the youth group.The percentage of single-branch lesion was lower in the young patients.The prevalence of left anterior descending (LAD)was higher in the young patients(P <0.05).Conclusions The main risk factors in young and elderly patients are significantly different.The out-comes of CAG in the young patients show the coronary lesion are mostly single vessel lesion,and early inter-vention may improve prognosis.

0.05). This study suggest that unlike other autonomic ganglia, the enteric nerve ganglia may exhibit a relatively high capacity of autonomic regulation and compensatory adaptation, and also provide some histochemical evidences for the transneuronal degeneration changes.

The large majority of elderly patients undergoing ophthalmic surgery take antiplatelet and anticoagulant drugs on a regular basis. Antithrombotic treatments predisposes to bleeding complications that may lead to retrobulbar haemorrhage, suprachoroidal haemorrhage and ultimately, to loss of vision. However, discontinuation of antithrombotic medication in such patients may lead to thromboembolic events with serious consequences. There are no guidelines on perioperative management of ophthalmic patients who are on antiplatelet and anticoagulant drugs. We reviewed traditional and newer agents in the context of cataract, vitreoretinal, glaucoma and oculoplastic surgery. Recommendations are given for continuation, cessation and recommencement of these agents in order to minimise the risk of bleeding and thrombotic complications.

Objective Investigation and analysis of intelligence and psychomotor function in children born after implementingt universal salt iodization(USI). Methods Historical serious illness areas of water iodine below 10μg/L were selected as study sites, water iodine in 50 - 100 μg/L in the historical non-endemic areas were as control points in Henan, 2008. Cluster sampling was used to select children aged 6 - 15 years as observing subjects,IQ were measured with CRT- Man Test(CRT-C2). A "Tianjin Medical psychomotor test battery" (JPB) was carry out to test psychomotor function. Results In IDD regions 230 children were surveyed post-USI and 1284 children preUSI. The IQs post and pre USI were 99.3 and 99.9, respectively, and the proportion of IQ ≤69 were 2.17%(6/230) and 2.80%(36/1284), respectively. In non-IDD regions 650 children were surveyed post-USI and 2079children pre-USI. The IQs post and pre USI were 95.3 and 93.8, respectively, and the proportion of IQ ≤ 69 were 2.31%(15/650) and 3.37%(70/2079), respectively. In IDD regions, the abnormal rate of T scores and damage index post USI were 3.6%(2/56), 5.3%(3/56), respectively, significantly lower than pre USI [18.1%(29/160),18.1%(29/160), x2 = 7.54, 6.86, all P ＜ 0.01]. Conclusions USI could increase the IQs of children and decrease the positive rate of JPB, and significantly improve the quality of whole nation and persistently eliminating IDD.

Three-dimensional syndrome differentiation is a new mode of syndrome differentiation of exopathic febrile diseases, which is based upon the six meridian syndrome differentiation initiated in Treatise on Cold Attack and defence-qi-nutrient-blood and triple-Jiao syndrome differentiation in the art of warm disease of traditional Chinese medicine. Syndromes appeared in the course of cold pathogenic diseases and warm diseases were differentiated through the survey of clinical cases and observation on syndrome features of exopathic febrile diseases, by applying means of analyzing, reasoning, concluding and deducting, from the stadium, location and nature of the disease. Three-dimensional syndrome differentiation theory explains and generalizes pathological mechanism and types of syndrome on acute exopathic febrile diseases roundly, has constructed theoretical frame and synthetical model of syndrome differentiation of exopathic febrile diseases. However, any new method of syndrome differentiation can not be leave nothing to be desired in the beginning, so it is proposed that we must develop epidemiologic investigation on syndromes of exopathic febrile diseases sequentially, make models of clinical commonly seen syndromes of exopathic febrile diseases and dispose fuzzy phenomenon of syndrome by applying mathematical method. By above measures, three-dimensional syndrome differentiation will be perfected gradually, therefore, it can provide scientific theoretical basis for the treatment of exopathic febrile diseases.

Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.

BACKGROUND:Computer-assisted navigation technique has been widely applied in spinal surgery, but there is stil lack of systematic reviews on this technique in lumbar pedicle screw fixation.
OBJECTIVE:To evaluate the application of computer-assisted navigation technique in lumbar pedicle screw fixation.
METHODS:Databases such as PubMed, Embase and China journal ful-text database CNKI were searched for articles about computer-assisted navigation in lumbar pedicle screw fixation, and related studies and literatures were hand-searched as wel , and then insertion accuracy, intraoperative blood loss, operative time consumption and rate of insertion-related complications between computer-assisted navigation technique group and conservative technique group were compared.
RESULTS AND CONCLUSION:Final y 7 studies which met the inclusion criteria were included with 784 patients and 4 101 lumbar pedicle screws in total. Meta-analysis indicated that malposition rate [relative risk (RR)=0.44, 95%confidence interval (CI):(0.27, 0.69), P=0.000 4] and intraoperative blood loss [weighted mean difference (WMD)=-172.40, 95%CI:(-246.26,-98.53), P<0.000 01] had statistical y significant differences between computer-assisted navigation technique group and conservative insertion group. However, operative time consumption [WMD=-31.45, 95%CI:(-85.56, 22.66), P=0.25] and incidence of complications [RR=0.41, 95%CI:(0.12, 1.41), P=0.16] did not show significant differences between groups. Application of computer-assisted navigation technique in lumbar pedicle screw fixation would improve insertion accuracy. However, further study is stil needed to make clear whether this technique can improve final outcome in post-operative patients.

Objective To explore the expression and clinical significance of GSK-3β,PTEN and PLK1 in pediatric AML . Methods Experiment group was bone marrows of 33 cases incipient children with AML .Control group was 10 cases normal bone marrows .GSK-3β,PTEN and PLK1 gene expressions in BMMNC of the two groups were tested using semi quantitative reverse transcriptase polymerase chain reaction(RT-PCR)technique .GSK-3βprotein and P-GSK-3βexpressions were tested by ELISA .Re-sults The expression of GSK-3βmRNA ,GSK-3βprotein ,PLK1 mRNA in BMMNC of children with AML was higher than that of control group(P=0 .012 ;P= 0 .014 ;P= 0 .040);The expression of PTEN mRNA ,P-GSK-3β was lower than the control group (P=0 .012 ;P=0 .002);GSK-3βprotein had a negative correlation with PTEN mRNA (r= -0 .415 ,P=0 .016);GSK-3βmRNA , GSK-3βprotein had a positive correlation with PLK 1 mRNA(r=0 .388 ,P=0 .026;r=0 .427 ,P=0 .013) .The expression of GSK-3βprotein was high in which had high peripheral white blood cell counts ;both the expressions of GSK-3βmRNA and GSK-3βpro-tein were high in which had high risk ;but the expression of P-GSK-3βwere low .Conclusion In pediatric AML ,GSK-3βand PLK1 may play a role of oncogene and PTEN may play a role of tumor suppressor gene .

Objective To study the etiology of severe acute pancreatitis (SAP) in Tibetan population at high altitude area.Methods Data of patients with acute pancreatitis (AP) from January 2013 to January 2016 were retrospectively collected.Tibetan and Han patients were selected.According to AP diagnosis criteria, the patients were divided into SAP and non-severe acute pancreatitis (NSAP).Chi square test and multiple Logistic regression analysis were used for data analysis.Results There were 53 Tibetan SAP patients, 98 Tibetan NSAP patients, and 47 Han SAP patients.The results of etiology analysis indicated that the ratios of biliary diseases caused pancreatitis in Tibetan SAP patients, Tibetan NSAP patients and Han SAP patients were 5.7% (3/53), 51.0% (50/98) and 6.4% (3/47), respectively;those alcohol caused pancreatitis were 39.6% (21/53), 10.2% (10/98) and 34.0% (16/47), respectively;those hyperlipidemia caused pancreatitis were 39.6% (21/53), 9.2% (9/98) and 40.4% (19/47), respectively;those drug caused pancreatitis were 1.9% (1/53), 2.0% (2/98) and 2.1% (1/47), respectively;those infection caused pancreatitis were 1.9%(1/53), 6.1%(6/98) and 2.1%(1/47), respectively;those trauma caused pancreatitis were 1.9%(1/53), 5.1%(5/98) and 2.1%(1/47), respectively;those other reasons were 3.8% (2/53), 13.3% (13/98) and 4.3% (2/47), respectively;and those unexplained pancreatitis were 5.7% (3/53), 3.1% (3/98) and 8.5% (4/47), respectively.The ratio of biliary diseases caused pancreatitis in Tibetan SAP patients was lower than that of Tibetan NSAP patients (5.7%, 3/53 vs 51.0%, 50/98), however the ratios of alcohol and hyperlipidemia higher than those of Tibetan NSAP patients (39.6%, 21/53 vs 10.2%, 10/98;39.6%,21/53 vs 9.2%, 9/98), and the differences were statistically significant (x2=31.069, 18.246 and 20.019, all P<0.01).Biliary disease was the independent etiology of NSAP in Tibetan (odd ratios (OR)=20.668, 95% confidence interval (CI) 5.072 to 59.427, P<0.01), but alcohol (OR=16.007, 95%CI 3.700 to 45.654) and hyperlipidemia disease (OR=11.590, 95%CI 2.581 to 33.859) were the independent etiologies of SAP (both P<0.01).There was no statistically significant difference in etiology of SAP between Tibetan and Han (P>0.05).Conclusion The etiology of SAP in high altitude Tibetan people is different from that of NSAP, however there is no difference in etiology of SAP between Tibetan and Han in the same area.

Objective To investigate the role and mechanism of retinoblastoma protein-associated proteins 48 (RBBP4) in HIV-1 latency.Methods CEM-Bru cells latently infected with HIV-1 were stimulated with 25 ng/ml of tumor necrosis factor alpha (TNF-α) in combination with 10 ng/ml of interleukin-2 (IL-2).Chromatin immunoprecipitation (ChIP) was performed to detect the changes in RBBP4 and in histone deacetylases 1 and 2 (HDAC1/2) binding to long terminal repeat (LTR).Binding activities of HDAC1/2 and RNA polymerase Ⅱ (RNA Pol Ⅱ) to LTR and acetylated histone H3 at LTR region were detected by ChIP after partially interfering the expression of RBBP4 in CEM-Bru cells with electroporation.Initiating and elongated transcripts were measured by RT-PCR.Results The binding activities of RBBP4 and HDAC1/2 to LTR in HIV-1 latently infected cells were enhanced significantly as compared with those in TNF-α and IL-2 co-stimulated cells.Fewer RBBP4 and HDAC1/2 bound to LTR following the interference of RBBP4 expression, which was accompanied with enhanced histone acetylation and strengthened binding activity of RNA Pol Ⅱ to LTR.Moreover, more initiating transcripts were detected in HIV-1 latently infected cells after the RBBP4 expression was interfered by electroporation.Conclusion RBBP4 contributes to the maintenance of HIV-1 latency, in which HDAC1 and HDAC2 might be involved.