The number, funds, types, undertakers and responders of National Natural Science Foundation-sup-ported projects in health policy and management from 2005 to 2014 and the changes in their contents were analyzed by sequential analysis and co-word analysis, respectively, in order provide evidence for decision-making of health policy and management , to help selection of future research topics on health policy and management , and to apply for funds for research on health policy and management .

Objective To explore the importance of gene diagnosis and prenatal diagnosis of spinal muscular atrophy(SMA),and improve the clinical diagnosis of SMA by analyzing the electrophysiological and gene characteristics of SMA.Methods Fifteen cases with SMA including 9 male and 6 female were enrolled in this study.The age was 5 months to 12 years.The 15 cases were subdivided into 3 clinical types,5 cases of type Ⅰ including 3 male and 2 female aging 5-18 months;7 cases of type Ⅱ including 4 males and 3 females aging 5 months-3 years;3 cases of type Ⅲ including 2 male and 1 female aging 3-12 years.They were all characterized by symmetric muscle weakness(more proximal than distal)associated with atrophy,absence or marked decrease of deep tendon reflexes,loss of voluntary movement and inability to sit or stand.The clinical characteristics and changes of electromyography(EMG)and nerve conduction velocity were assessed in all cases by using Danish Medoc Keypoint myoelectricity and evoked potentials inducer.The survival of motor neuron(SMN)gene was detected by PCR and restriction endonuclease spectrum analysis in 10 cases.Results EMG analysis found 94% patients had spontaneous potential,90% patients had increased duration of motor unit,and amplitude increased in 89% patients.Motor nerve conduction velocity was determined in 78 nerves.Motor nerve compound action potential wave amplitude decreased in 52 nerves,among them,distal latent period prolonged and motor conduction velocity reduced slightly in 36 nerves.Sensory nerve conduction velocity was determined in 45 nerves and remained normal.The SMN gene detection revealed deletion of exon 7 and 8 in 9 cases,deletion exon 7 in 1 case.The SMN gene detection in 10 patients and their parents didn't find any deletion of exon 7 and 8.Conclusions The definite diagnosis of SMA will rely on the typical clinical characteristics,changes of EMG and gene deletion analysis.Gene diagnosis of SMA lays a basis for prenatal diagnosis.

Background:Blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen concentration.The purpose of this study was to investigate whether BOLD-MRI could evaluate hypoxia and angiogenesis of breast invasive ductal carcinoma (IDC).Methods:Ninety-eight female patients with IDC were retrospectively included in this research.All patients underwent breast BOLD-MRI at 3.0 T before surgery.R2* values of BOLD-MRI were measured.The expression of carbonic anhydrase IX (CA IX) and vascular endothelial growth factor (VEGF) was analyzed by immunohistochemistry.Spearman's correlation analysis was used to correlate R2* value with CA IX and VEGF levels.Results:Heterogeneous intensity on BOLD-MRI images was the main finding of IDCs.The mean R2* value was 52.8 ± 18.6 Hz.The R2* values in patients with axillary lymph node metastasis were significantly higher than the R2* values in patients without axillary lymph node metastasis (t =2.882,P =0.005).R2* values increased with CA IX level and positively correlated with the level of CA IX (r =0.616,P ＜ 0.001);however,R2* value had no significantly correlation with the level of VEGF (r =0.110,P =0.281).Conclusion:BOLD-MRI could noninvasively evaluate chronic hypoxia of IDC,but not angiogenesis.

Discussion teaching mode was carried out in the teaching of histology and embryol-ogy for clinical medical undergraduates in Chongqing Medical University from aspects of proposing questions, group learning, class discussing and summarizing. Classroom tests were accompanied to evaluate the teaching effect. It showed the discussion teaching achieved satisfactory effects. The correct answer rate of 92.36%students was≥60%. Students not only acquired knowledge but also increased their comprehensive abilities. The well-supervised topics, active participation of students and timely summary of teachers at the end of the class were the key factors in the practice of the discussion teaching mode.

To study thyroid hormone receptor β(THRβ)gene mutation in a pituitary-resistance to thyroid hormone syndrome family. The peripheral blood samples of the patient, his sister, parents, and 4 maternal relatives were collected. Then serum was isolated for detecting thyroid hormone levels with chemiluminescence immunoassay, and DNA was extracted for PCR, and 10 exons of THRβ gene were sequenced. The patient and his mother had the hyperthyroid symptom for many years and his mother with atrial fibrillation. The G→A heterozygous transition mutation was confirmed by exon sequencing at nucleotide 949 within exon 9 of THRβ gene in the patient and his mother, which was a missense mutation causing a substitution of Alanine to Threonine(A317T). No mutation was found in THRβ gene in other family members. This is the first Chinese family reported with pituitary thyroid hormone resistance syndrome caused by a A317T mutation in the thyroid hormone receptor β gene.

Objective We aim to evaluate the value of the current serum creatinine reference interval ( RI ) provided by Industry Standard WS /T 404.5 in clinical practice.Methods The first time serum creatinine levels and urinary albumin /creatinine ratio were obtained from 67 605 adult patients ( <60 years old) who were treated in the First Hospital of China Medical University between October 1, 2014 and September 30, 2015 in this cross-sectional study.Estimated glomerular filtration rate ( eGFR ) calculated by chronic kidney disease epidemiology collaboration (CKD-EPI) equation and urinary albumin /creatinine ratio (ACR) were used to evaluate the clinical practical significance of current and old serum creatinine RIs as the criteria.Results 4.3% of normal subjects based on current RI were showed decreased eGFR, 98% of abnormal subjects based on the current RI were founded to have decreased eGFR . 1378 subjects were evaluated as increased based on current RI but as normal based on old RI , and 93.5% of these subjects were showed decreased eGFR .In addition, ACR was measured in 26 cases, and 18 out of 26 cases (69.2%) were confirmed to have elevated ACR (≥30 mg/g) and proteinuria.On the other hand of analysis, screening positive rates of declined eGFR were 43.6% by old RI and 61.9% by current RI in the subjects with eGFR under 90 ml(min ×1.73 m 2 ), and the performance of the current RI was obviously improved(χ2 =212.648,P <0.001).Conclusions The current reference interval of serum creatinine is favorable for the detection of renal dysfunction in patients .It is recommended that the current reference interval can be applied in the clinical laboratories as early as possible .

AIM: To evaluate the diagnostic accuracy of macular ganglion cell - inner plexiform layer ( GCIPL ) measurements using high- definition optical coherence tomography ( Cirrus HD - OCT ) ganglion cell analysis algorithm for detecting early and moderate to severe glaucoma.
METHODS:Twenty normal control persons, 26 patients with early glaucoma and 29 patients with moderate to severe glaucoma were enrolled in this study. Macular GCIPL, optic nerve head ( ONH ) parameters and peripapillary retinal nerve fiber layer ( RNFL ) thickness were measured in each subject. Then all measured results of each parameter were calculated using SPSS17. 0. Areas under the receiver operating characteristic curves ( AUC) of each parameter were calculated to compare the diagnostic accuracy for detecting early and moderate to severe glaucoma.
RESULTS: For detecting early glaucoma, AUC of average RNFL and seven clock value of RNFL were the biggest ( 0. 871 and 0. 896 respectively ), the AUC of parameters in GCIPL were also significant, among them,
the average GCIPL showed bigger AUC(0. 847) than the minimum GCIPL (0. 812). For diagnosing moderate to severe glaucoma, the AUC of rim area was 0. 992, which was bigger than that of average RNFL ( 0. 991 ). The minimum GCIPL showed bigger AUC ( 0. 983 ) than the average GCIPL (0. 967). For early glaucoma diagnosis, the sensitivity of average RNFL was the highest (76. 9%), while the average GCIPL has the highest specificity (93. 5%).
CONCLUSION: AS a new diagnostic parameter for detecting glaucoma, GCIPL shows similar diagnostic potential compared with RNFL. For early glaucoma diagnosis, average RNFL is the most important parameter, while screening early glaucoma, average GCIPL should be paid more attention.

An analytical method of on-line injection technique including on-line dilution and on-line preconcentration with inductively coupled plasma mass spectrometry ( ICP-MS ) was established for the determination of trace metals in seawater, such as Cr, Mo, Cu, Pb, Zn, Cd, Fe, Mn, Ni, V, Co. This method could automatically make standard curves and match matrix, and by the on-line dilution and preconcentration modes, 11 trace metals could be analyzed directly. With high-level automation, CASS-5 and NASS-6 seawater standard samples were analyzed accurately by this method. The recovery of metals in seawater sample addition was between 80% and 115%. The method quantitation limits (μg/L ) of theses metals in seawater were 0. 06(Cr), 0. 06(Mo), 0. 01(Cu), 0. 005(Pb), 0. 01(Zn), 0. 006(Cd), 0. 03 (Fe), 0. 02(Mn), 0. 01(Ni), 0. 01(V), and 0. 01 (Co), respectively. This method was applied to analyze seawater samples of various salinities in Zhejiang coast, and the analysis results were consistent with results of conventional atomic absorption method.

Objective to investigate the value of diffusion-weighted echo-planar MR imaging in the diagnosis of head and neck lesions.Methods Fifty-seven patients with 85 head and neck lesions were enrolled in the study,including 22 patients with 22 malignant tumors,13 patients with 13 benign tumors, 13 patients with 17 cystic and liquefactive lesions(including 8 patients with 12 cystic lesions,4 patients with 4 tumor necrosis,1 patients with 1 abcess)and 33 lymph nodes.The lesions were all confirmed by operation and clinical follow up.Echo-planar difffusion-weighted imaging (DWI)was performed with different b values (0,500,and 1,000s?mm~(-2)),and the apparent diffusion coefficients (ADCs)were measured.Results Malignant and benign tumors had different characteristics in DWI with different b values.With the increase of b value,the signal intensity of tumor/spinal cord ratio decreased quickly in DWI in benign tumors,while the signal intensity of tumor/spinal cord ratio remained similar in DWI in malignant tumors.The mean ADC value of'malignant tumors[(0.78?0.24)?10~(-3)mm~2? s~(-1)] was significantly lower than that of benign tumors [(1.48?+0.20)?10~(-3)mm~2?s~(-1)] (t = 8.9,P

Objective To investigate the prevalence of chronic non-communicable diseases among farmers,land less peasants and urban population in a certain area of Anhui Province,to explore the relationship between the lifestyles of landless peasants and their chronic non-communicable diseases.Methods A total of 761 valid questionnaires were collected by cross-sectional epidemiological study,including 119 farmers,259 landless peasants and 383 urban groups.The enumeration data was analyzed by x2 test and the measurement data analyzed by variance.The risk of chronic non-communicable diseases in each group was analyzed by Logistic regressions.Results General demographic characteristics showed that there were differences in three groups of people in the respects of drinking,eating habits and physical activity and other lifestyles (all P ＜ 0.05).Logistic regression analysis showed that the onset risk of hypertension and overweight obesity in the famer group and the landless peasant group was lower than that in the urban group,but higher than that in the peasant group.After adjusting for confounding factors,the prevalence of hypertension in the farmer group (OR =0.20,95％ CI:0.12-0.33) and the lost land group (OR =0.65,95％ CI:0.44-0.95) was lower than that in the urban group,the overweight obesity in the farmer group (OR =0.44,95％ CI:0.27-0.74) and the lost land group(OR =0.67,95％ CI:0.47-0.96) was lower than that in the urban group.The incidence of atherosclerosis in the farmer group (OR =2.48,95 ％ CI:1.45-4.23) and the lost land group(OR =2.00,95％ CI:1.33-3.02) was higher than that in the urban group.Conclusions The living style of landless peasants is different from those of rural group and urban group,and the incidence of hypertension and overweight obesity is higher than that of farmers.We should take interventions against chronic non-communicable diseases in landless peasants.