Objective This present study explores and evaluates the effect of preliminary implementation in the clinical therapy programs for patients with chronic Keshan disease (CKD) in the disease seriously-affected endemic areas.Methods In 2010,seventy-six CKD patients with heart failure were chosen from Huangling and Xunyi Counties in Shaanxi Province,where incidences of CKD were high.Besides taking sodium selenite,all patients were given treatment with fixed prescription,which included angiotensin-converting enzyme inhibitor (captopril),β-blocker (propranolol),diuretics (hydrochlorothiazide,spironolactone) and cardiac (digoxin) for 4 months.The changes before and after treatment were analyzed,which included the changes of heart function by the United States of America New York Heart Association(NYHA) fractionation,cardiothoracic ratio,electrocardiogram,left ventricular ejection fraction(EF) and fractional shortening(FS).The therapeutic effect was subsequently evaluated.Results Seventy-four cases of the seventy-six CKD patients completed the treatment observation.The improvement rate of heart function was 81.1％ (60/74) after treatment.The elimination rates of ectopic rhythm,conduction block and ST-T changes were 37.5％ (9/24),2.7％ (1/36) and 26.9％ (7/26),respectively.The cardiothoracic ratios of heart function NYHA Ⅱ,Ⅲ and Ⅳ were 0.504 ± 0.051,0.572 ± 0.054 and 0.632 ± 0.063 before treatment.After treatment,the cardiothoracic ratios were 0.486 ± 0.048,0.538 ± 0.046 and 0.607 ± 0.048,which were reduced in all groups (t =2.643,6.641,3.005,all P ＜ 0.05),while the D-value of cardiothoracic ratio changes before and after treatment was not significantly different(F =3.005,P ＞ 0.05).Both the mild reduction group(35％≤EF ＜ 50％) and the moderate-severe group(EF ＜ 35％) EF were (43.62 ± 4.58)％,(27.57 ± 3.69)％ before treatment and were (48.21 ± 10.01)％,(36.57 ± 6.60)％ after treatment,EF were increased in the two groups,while the changes before and after treatment were significantly different(t =-2.911,-3.334,all P＜ 0.05).The EF D-value of the two groups was (4.59 ± 8.48)％ before treatment and was (9.00 ± 7.14)％ after treatment,which were not significantly different(P ＞ 0.05).FS was higher compared with pre-treatment in FS reduction group(FS ＜ 25％) and the changes before and after treatment[(19.75 ± 2.88)％,(21.92 ± 5.67)％] were significantly different(t =-2.297,P ＜ 0.05).Conclusions This study shows that the feasibility of clinical treatment of patients with CKD is very promising.The treatment of fixed prescription is effective.

To cultivate medical postgraduates with scientific research quality is an important task of medical education. It is of significance for excellent medical postgraduates. Cultivation of scientific research quality in scientific research thinking training,scientific research items selection and implementation was expounded in the paper to provide suggestions for better medical postgraduate education.

Objective To investigate clinical efficacy and safety of carboprost tromethamine injection combined with low B -Lynch suture for intractable postpartum hemorrhage placenta previa.Methods 125 cases of intractable postpartum hemorrhage placenta previa were divided into two groups according to treatment(n =62)with the observation group(n =63),the control group was administered oxytocin,and the line in the placental separation surface 8 interrupted suture;the observation group was used carboprost tromethamine injection combined with low B -Lynch suture.Clinical efficacy,blood loss,bleeding,postoperative bleeding 2h,24h after blood loss,transfusion rate and index sex hormone levels were compared before and after treatment.Results (1)After treatment,total effec-tive rate of the control group and observation group was 77.42%(48 /62)and 95.24%(60 /63)respectively.There was a statistically significant difference between the two groups(P <0.05);(2)Blood loss,bleeding time,2h after blood loss,blood loss and transfusion rate after 24h in the observation group were (1 608.37 ±43.01)mL,(8.89 ± 1.09)min,(101.18 ±8.73)mL,(221.17 ±20.58)mL and 4.76%,respectively,which were significantly lower than those of the control group [(1 992.28 ±55.62)mL,(12.83 ±1.77)min,(145.49 ±12.19)mL,(255.54 ± 23.30)mL and 16.13%](t =4.559,5.128,3.928,3.382,χ2 =5.559,all P <0.05);(3)before and after treatment indicator hormone(E2 ,FSH and LH)levels were not significantly different(P >0.05),and after treatment,the index level differences were not statistically significant(P >0.05);(4)the two groups during treatment,liver and kidney functions were normal,three cases of the control group and two cases of the observation group occured nausea and vomiting.Conclusion Carboprost tromethamine injection combined with low B -Lynch suture has significant effect, a small amount of bleeding,high security for intractable postpartum hemorrhage placenta previa,which should be promoted.

Objective To explore the essentiality of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) examination before breast-conserving surgery (BCS) in breast cancer patients with young women.Methods The data of DCE-MRI and mammography X-ray in 30 breast cancer patients with young women (＜ 40 years old) who received surgery with pathology-proven were retrospectively analyzed.The detection rate of breast lesion,number,size,extent of invasive and lymph node metastasis of preoperative were observed.The DCE-MRI was assessed accuracy of BCS in accordance with indications for BCS and histopathology results.Results The breast cancer detection rate of DCE-MRI was significantly higher than mammography X-ray [100.00％(30/30) vs.73.33％(22/30),P =0.002].The maximum tumor diameter of DCE-MRI was (3.55 ± 1.50) cm,mammography X-ray was (3.38 ± 1.70) cm,postoperative pathology was (3.51 ± 1.20) cm,and DCE-MRI was closer to postoperative pathology than mammography X-ray.The discovery of additional lesions of DCE-MRI was more than mammography X-ray (P ＜ 0.05).The surrounding tissue invasion of DCE-MRI was detected in 22 cases,mammography X-ray was in 9 cases,postoperative pathology was in 19 cases,there was no significant difference between DCE-MRI and postoperative pathology (P =0.598),there was significant difference between mammography X-ray and postoperative pathology (P =0.010).The number of axillary fossa lymph node metastasis of DCE-MRI was in 127,mammography X-ray was in 48,compared with postoperative pathology (91),there was significant difference (P =0.026,0.034).The detection of microcalcification of mammography X-ray was better than DCE-MRI (7 cases vs.0 case,P =0.001).The number of BCS of postoperative pathology was in 12 cases,DCE-MRI was in 11 cases,mammography X-ray was in 8 cases,DCE-MRI was higher than mammography X-ray,but there was no significant difference (P=0.132).Conclusion DCE-MRI provides comprehensive and accurate information for breast cancer patients with young women for BCS,and it is feasible to assess them using DCE-MRI preoperative for BCS.

Objective To investigate the antimicrobial resistance of Haemophilus influenzae in Peking Union Medical College Hospital for rational clinical treatment.Methods A total of 223 strains of H .influenzae were collected from patients from Jan-uary 2008 to December 2011.The antimicrobial susceptibility was tested by Kirby-Bauer method.Production of beta-lactamase was detected using nitrocefin disks.WHONET 5.6 software was used to analyze the data of susceptibility testing.Results Tri-methoprim-sulfamethoxazole and tetracycline were the two antimicrobial agents to which the H .influenzae strains were most resistant.Theβ-lactamase positive ampicillin resistant strains accounted for 15.9 %,andβ-lactamase negative ampicillin resist-ant strains accounted for 8.9%.Conclusions H .influenzae is mainly isolated from respiratory specimens.Majority of the anti-microbial agents still show good antibacterial activity against H .influenzae strains.However,H .influenzae isolates are highly resistant to trimethoprim-sulfamethoxazole and tetracycline.

Objective To derermine the affinity of site-specific labeled annexin V with ~(99m)Tc to phosphatidylserine (PS)exposed erythrocytes.Methods The annexin V fused with a metal chelating binding site was obtained from Pichia Pastoris culture and methanol induction expression.The annexin V was purified from the culture supernatant crude product by uhrafihration.The annexin V was conjugated with ~(99m)Tc site-specifically through sodium glucoheptonic acid and SnCl_2.The radioactive annexin V was added to determine its affinity to PS exposed erythrocytes.Results The calcium concentration at which half of the protein is bound to cells(EC50)is changed with varying ratio of protein to cells.The affinity was determined at a low protein/cell ratio as 33.4.Conclusion The annexin V recombinantly expressed in Pichia Pastoris shows high affinity to PS exposed erythrocytes.

Objective To observe the evaluation of early chemoradiotherapy efficacy in uterine cervical cancer by different b-value combination.Methods Thirty uterine cervical cancer patients who were treated with chemoradiotherapy received conventional MRI and diffusion weighted imaging (DWI) before treatment,after 2 weeks treatment and after treatment.The patients were divided into complete remission (CR) group (15 cases),partial remission (PR) group (9 cases),stable disease (SD) group (6 cases) according to the changes in tumor size after 9 months of treatment.The tumor size and apparent diffusion coefficient (ADC) of uterine cervical cancer were measured at each examination among the 3 groups.All ADC were calculated with b =0,600 s/mm2 and b =0,1000 s/mm2.According the receiver operating characteristic (ROC) curve,chemoradiotherapy efficacy and prognosis value of different b-value of ADC chart in uterine cervical cancer were compared.Results There were no significant differences in ADC of b =0,600 s/mm2 ADC chart and b =0,1000 s/mm2 ADC chart before treatment and after 2 weeks treatment in the 3 groups (P＞ 0.05).ADC increase rate after 2 weeks treatment in CR group was significantly higher than that in PR group and SD group (0.35 ± 0.10 vs.0.22 ± 0.10 and 0.21 ± 0.08,0.28 ± 0.08 vs.0.14 ±0.04 and 0.16 ± 0.02,P ＜ 0.05).There was no significant difference between PR group and SD group (P ＞0.05).The decrease rates of tumor diameter after 2 weeks treatment in CR,PR and SD group were 0.36 ±0.18,0.33 ± 0.17 and 0.24 ± 0.09,there were no significant differences (F=1.151,P ＞ 0.05).After 2 weeks treatment,at b =0,600 s/mm2 ADC chart,when liminal value of ADC was 0.211 × 10-3 mm2/s,ROC area under curve was 0.976,sensitivity was 85.6％,specificity was 100.0％; at b =0,1000 s/mm2 ADC chart,when liminal value of ADC was 0.181 × 10-3 mm2/s,ROC area under curve was 0.979,sensitivity was 85.6％,specificity was 100.0％.The accuracy of two kinds of ADC chart evaluation of uterine cervical cancer early chemoradiotherapy efficacy was higher,and the effect was similar.Conclusion The ADC increase rate after 2 weeks treatment can be used to predict the early chemoradiotherapy efficacy of uterine cervical cancer,and the value of two kinds of ADC chart of different b-value is similar.

Objective To set up the methods of establishing rat primary benign prostatic hyperplasic glandular epithelial cell line.Methods Male spontaneously hypertensive rats were raised to 29 weeks,and then evaluated the situation of BPH with HE staining.The prostate tissue from ventral prostate lobe was aseptically removed,dissected,minced,and then dissociated in collagenase type Ⅰ.Isolated cells were collected,seeded in WAJC-404 and PrEGM medium separately,then cultured and passaged.Specificity of primitive cultured prostatic epithelial cells was identified by cell immunochemistry with CK8/18,and the cell growth curves were drawn.Then the situation of growth of the two prostatic hyperplasic glandular epithelial cell lines were analysed and compared.Results The prostatic hyperplasic glandular epithelial cell lines of the spontaneously hypertensive rats in WAJC-404 and PrEGM medium were successfully primarily cultured,purified and passaged in vitro.Cell immunochemistry proved that the cell lines specifically express cytokeratin 8/18.Cell growth curve showed that prostatic epithelial cells in PrEGM,compared with prostatic epithelial cells in WAJC-404,possessed better cell morphology,more exuberant cell vitality,faster growth rate to enter the logarithmic growth period(4 d vs.7 d)and higher peak of cell growth curve(15.3× 104/ml vs.12.8×104/ml).Conclusions Rat primary benign prostatic hyperplasic glandular epithelial cell line can be established conventionally in vitro.PrEGM medium is more suitable for primary culture of the rat benign prostatic hyperplasic glandular epithelial cell line than WAJC-404 medium.

The purpose of this study was to reveal the current situation of health technology transfer in Shanghai hospitals,and to analyze the problems and needs.Questionnaire and interview were adopted for the study.We found that in the past 3 years,the transformation rate of patent technologies at Shanghai Tertiary Hospitals was 5.88％.The transfer routes mainly involves proactive enlist of enterprises by project leader,technology brokerage,exhibitions of patents achievements,friends' recommendation,etc..The main factors impacted the transfer included poorer quality of patent,lacking efficient management,and lacking channels for transfer.In order to improve the transfer of patents,hospitals need to provide information service,technology assessment,project packaging,patents application,consultant,and relevant trainings etc.Other things that could promote health technology transfer are to improve scientific research system,to enhance the quality of scientific achievements,and to develop technology brokerage.

Objective To explore the clinical.significance of serum anti-lysosomal associated membrane protein-2 (LAMP-2) antibody in the pathogenesis of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AASV) by investigating the relationship of its levels and AASV.Methods Sera from twenty patients with AASV and twenty healthy controls were collected.Serum anti-LAMP-2 antibody was detected using commercial enzyme linked immunosorbent assay (ELISA) kits.Anti-LAMP-2 antibody levels between the two groups were assessed using the t test,the correlation between anti-LAMP-2 antibody levels and erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) was assessed by Spearman's rank correlation test,the correlation between anti-LAMP-2 antibody levels and the Birmingham vasculitis activity score(BVAS),hemoglobin (Hb),albumin (Alb) was assessed by Pearson's rank correlation test.Results ① The serum level of anti-LAMP-2 antibody in patients with AASV [(3714±1446) pg/ml] was higher than that in the healthy controls [(174±43) pg/ml] (t=10.94,P＜0.05).The serum level of Hb [(99±30) g/L] and Alb [(27±5) g/L]in patients with AASV was lower than that in healthy controls [(138±14) g/L,(44±3) g/L] (t=5.27,t=13.04,P＞0.05).② The level of anti-LAMP-2 antibody in AASV was positively correlated with BVAS (r=0.669 9,P＜0.05),and was not found elevated compared with ESR,CRP,Hb and Alb (P＞0.05).Conclusion ① AntiLAMP-2 antibody is involved in the pathogenesis of AASV.② Anti-LAMP-2 antibody is correlated with the activity of AASV,it may be an indicator of AASV disease activity.