Objectives To grasp the situation and fluctuation tendency of Keshan disease in Qujing City,and to scientifically evaluate the control effect of Keshan disease.To provide scientific basis for elimination of Keshan disease in the 12th Five-Year Plan.Methods Cardiomyopathy cases of the past three years were searched,screening suspected cases of Keshan disease.And according to the National Surveillance Program of Keshan Disease (Trial),In Qujing City,2 Keshan disease counties (Huize,Qilin) were selected to carried out focused monitoring,1-2 endemic townships with more patients were selected based on total numbers of cases in each county,1 village with more patients was selected in each township as a monitoring site,the residents of the monitoring sites were examined clinically and electrocardiographic (ECG) tracings recorded and suspicious patients were taken chest radiograph and color Doppler ultrasound echocardiography.Diagnosis was based on the Diagnostic Standard for Keshan Disease.Results Totally 300 cases of cardiomyopathy were found,10 cases were suspected Keshan disease,0 cases of Keshan disease was diagnosed in 2009-2012.In the three villages of the two counties monitored,3 cases of potential Keshan disease were detected of the 1 505 villagers,the detection rate was 0.20％;62 abnormal ECG were found,the abnormal rate was 4.12％.Chest X-ray examination was done in 3 people,cardiothoracic ratio of 0.50 or less were 2 people,and 0.51-0.55 was 1 person.Conclusion The prevalence of Keshan disease in Qujing City is low,but the pathogenesis of Keshan disease remains,therefore,monitoring and intervention of children Keshan disease should be strengthened.

Objective To investigate the effects of paeonol on renin-angiotensin system (RAS) occurred on the development of ventricular remodeling after acute myocardial infarction (AMI) in rats. Methods The left anterior descending coronary artery was ligated to establish the model of AMI in male SD rats. Six groups were set up:sham-operation group, AMI model group, captopril control group, paeonol low dose group (6 mg/kg), paeonol middle dose group (9 mg/kg) and paeonol high dose group (12 mg/kg). Rats were given treatment for 4 weeks after the AMI model was established. HE staining was used to observe changes of myocardial tissue. Real-time PCR was used to detect the mRNA levels of angiotensinogen (AGT), angiotensin Ⅱ receptor type1(AGTR1) and endothelin (ET)-1 of six groups. Western blot assay was used to detect the protein levels of peptidyl-dipeptidase A (ACE), angiotensin Ⅱ(Ang)-Ⅱand AGTR1 in six groups. Results The transcription of AGT, AGTR1, ET-1mRNA and the expressions of ACE, Ang-Ⅱ and AGTR1 protein were significantly higher in myocardial tissue of AMI rats than those of sham-operation rats (P＜0.05). Compared with model group, the expressions of AGT, AGTR1, ET-1mRNA and ACE, Ang-Ⅱ, AGTR1 protein were significantly decreased in paeonol high dose group and captopril control group (P＜0.05). Paeonol reduced the expressions of those mRNA and protein levels in a significant dose dependent manner. Conclusion Paeonol can slow down the deterioration of the ventricular remodeling after AMI in rats, which may be related to the inhibition of over-activation of RAS.

Hypoxic-ischemic encephalopathy (HIE) is the main reason of causing neonatal death and poor prognosis of the nervous system.The treatment of HIE has gone into the era of therapeutic hypothermia,the early,continuous,specification amplitude integrated electroencephalography(aEEG) monitoring for therapeutic hypothermia to screen appropriate cases,assess early the severity of HIE,provide early nerve protection treatment and evaluate the therapeutic efficiency,early intervention and improve the prognosis of the long-term HIE.This paper review the application of aEEG in the therapeutic hypothermia of HIE.

Objective To explore the relationship between the plasma membrane glycoprotein ( PC-1 ) gene and obesity, type 2 diabetes mellitus, insulin resistance in Chinese population. Methods 53 norma1 subjects, 105 simple obesity subjects, 63 type 2 diabetic patients and 114 obesity type 2 diabetics have been genotyped with PCR-RFLP. Results The frequency of PC-1 gene Q allele was 3%, 18%, 4% and 30% in control, obesity subjects, diabetic patients and obesity diabetic individuals, respectively. Compared with control group, the relative risk (RR) in OB group, OBH grop, OBI group, OBL group and OBHIL group was 4. 26,4. 12,7. 36,5. 15 and 9. 70, respectively. Compared with diabetes group, the RR in diabetes with DMOB, diabetes with OBH group, diabetes with OBI group, diabetes with OBL group and diabetes with OBHIL group was 5.23,7. 37,12. 07,8. 53 and 13. 50, respectively. Concluision The frequency of PC-1 gene Q allele were significantly associated with obesity, obesity diabetics and insulin resistance in Chinese. The results suggested that the PC-1 gene Q allele was a potential genetic marker for obesity, type 2 diabetes and insulin resistance.

Objective To investigate the effects of CBL in teaching human embryology for medical students.Methods After having seminar with clinical case, scoring rate of questions discussed and not discussed in final exam were compared in recent 3 years.Embryological knowledge were evaluated in 1, 2, 3 years after embryology class by online test.Results There is no difference of total scoring rate among 3 grades in final exam, while the score of questions discussion was significantly higher than that of non-dissaution course(P<0.01).Scoring rate of objective questions discussed was significantly higher.Scoring rate of online test decreased with years after embryology class, while questions discussed were better than not discussed.Conclusions Seminar with clinical case as CBL could improve the learning outcomes of embryology in short and long term memory.

Objective To carry out a taxonomic identification of a strain of claviform bacteria iso-lated from prostatic fluid of a patient who suffered from chronic prostatitis, and to approach its phylogenic and biologic position. Methods We undertaked an initial identification by phenotypic characters such as morphologecal, physiological and biochemical characteristics to ascertain its phylogeny by chemical composi-tion analysis of cell wall and 16S rRNA gene sequencing and alignment. Results A club-shaped gram posi-tive rod bacillus was isolated in pure culture state. Its biochemical reactions were not active. The diamino-acid of cell wall was meso-diaminopimelic acid (meso-DAP) and it had wall chemotype Ⅳ ( contained arabi-nose, galactose and maltose ). Sequence searches of the GenBank database revealed that this strain had a highest level of 16S rDNA sequence similarity (99.4%) to C. tuberculostearicurn strain ATCC35692 with only 8 nucleotides difference. Conclusion On the basis of phenotypic and phylngenetie analysis, it is rea-sonable to assign this strain to the species C. tuberculostearicum, and this is the first isolation of C. tubercu-lostearicum from prostatic fluid home and abroad.

Objective To study the characteristics and clinical significance of the coronary plaques in patients with benign prostatic hyperplasia (BPH).Methods A total of 91 patients undergoing coronary artery angiography (CAG) were selected and divided into two groups according to with or without BPH,56 cases in BPH group,46 cases in control group.The qualitative and quantitative characteristics of 102 lesions area were analyzed by intravascular ultrosound (IVUS),including external elastic membrane-cross-sectional area (EEM-CSA),minimal lumen area (MLA),plaques area (PA),plaques burden (PB),reference external elastic membrane-cross-sectional area (REEM-CSA),reference minimal lumen area (RMAL),reference plaques area (RPA) and reference plaques burden (RPB).Results IVUS showed a higher rate of area stenosis than did the CAG [(58.2± 7.1)％ vs.(55.9 ± 5.2)％,P＜0.01].BPH group had more soft plaques,eccentric plaques,positive remodeling and less calcified than did the control group (P＜0.05).The MLA and RMAL of BPH group were smaller than those of control group:MAL [(5.61±0.96) mm2 vs.(6.06±0.75) mm2,P＜0.05],RMAL[(9.26±1.05) mm2 vs.(10.02±1.10) mm2,P＜0.05]； while the EEM-CSA,PA,PB,RPA,RPB were larger than those of control group:EEM-CSA[(14.51±1.10)mm2 vs.(13.37±1.02)mm2],PA[(8.90±1.24) mm2 vs.(7.31±1.04) mm2],PB[(61.26±6.53)％ vs.(54.53±5.69)％],RPA[(4.26±1.15) mm2 vs.(3.73±1.33) mm2],RPB [(31.30±8.37) ％ vs.(26.81±8.75) ％,P＜0.05].Conclusions IVUS has a higher value on evaluation of mild to moderate coronary artery stenosis.Evidence of myocardial ischemia in patients with BPH needs further excludeing coronary heart disease.

Objective To explore the clinical characteristics of tuberous sclerosis complex (TSC). Methods The clinical data of one child with TSC were collected. The clinical features and gene mutation were analyzed. Results A 36-day-old girl had abnormal nodules found by echocardiography, which was considered multiple cardiac rhabdomyomas. There were multiple hypomelanotic macules distributed over the skin surface of the trunk and legs. Cranial MRI showed cortical nodules, subependymal nodules and cerebral white matter radial migration line. A mutation in the TSC2 gene (c.4541-4544delCAAA) was found by second generation high-throughput sequencing technology and tuberous sclerosis complex was confirmed. Conclusion Gene detection is helpful in the early diagnosis of tuberous sclerosis complex.

Lifitegrast is a novel inhibitor of integrin,which can take effect by blocking the binding of intercellular adhesion molecule 1 and integrin lymphocyte function associated antigen 1.In July 2016,the U.S.Food and Drug Administration (FDA) officially approved the application of lifitegrast ophthalmic solution 5％ (commodity name XiidraTM).Clinical trials of the drug include a 12-week phase II clinical trial and three 12-week phase III clinical trials for dry eye disease patients.The results of clinical trials have demonstrated the efficacy and safety of the drug.Lifitegrast is the first FDA approved drug to improve and treat dry eye symptoms,and other similar drug is only cyclosporine.It is believed that in the near future clinical application of lifitegrast will be more extensive.

Objective To investigate the risk factors of surgical site infection ( SSI) in adult patients undergoing major heart surgery, and to provide the reference of controlling the development of SSI. Methods A case-control study was conducted with 54 SSI patients underwent major heart surgery from January 2001 to December 2009 in the case group and 162 controls in the control group. Univariate and multivariate conditional logistic regression analysis were used to analyse the risk factors of SSI development Results Univariate conditional logistic regression showed the risk factors for the development of SSI were left ventricular ejection fraction ( LVEF) < 50% (odds ratio ( OR) = 2.134,95% C/: 1.095 - 4. 159, P = 0. 026) , heart function New York Heart Association classification (NYHA) ≥Ⅲ grade, (OR =2. 390,95% CI: 1. 218 -4. 690; P = 0. 011) .diabetes (OR=3.275, 95% CI: 1.391 - 7. 708; P = 0.007), chronic obstructive pulmonary disease (COPD) ( OR = 5. 408,95% CI: 1.248- 23.445,P = 0.024),extracorporeal circulation time>90 mins ( OR =3. 045,95% CI: 1.540 - 6.024, P = 0. 001 ) , operation time > 4 h ( OR = 3. 281, 95% CI: 1. 610 - 6. 685, P = 0.001 ) , blood product consumption >2 u ( OR = 1. 929,95% CI; 1. 018 -3. 675;P =0. 044) .incision continuous suture close ( OR = 2.344,95%CI: 1.221 -4.498;P =0.010) exploration for bleeding (OR =6. 625,95%CI: 1.597-27.491 ;P =0. 009) , postoperative hyperglycemia (OR = 3. 510,95%CI:l. 5% -7. 718;P =0. 002) ,the stay in intensive care units (ICU) > 72 h ( OR = 3. 281,95% CI: 1. 505 - 7. 150;P = 0. 003). Multivariate analysis showed 3 variables increased with the risk of SSI: operation time >4h (OR = 3. 100,95% CI: 1.470 - 6. 537,P = 0.003 ) , incision continuous suture close (OR =2. 340,95% CI: 1. 183 - 4. 692, P = 0. 015 ) , and postoperative hyperglycemia (OR = 3. 272,95% CI:1.427 -7. 505,P=0. 005 ). Conclusions This study shows that the operation time >4 h, incision continuous suture close and postoperative hyperglycemia are risk factors most likely associated with SSI development in major heart surgery.