ABSTRACT:Norovirus infection in human and animals can cause acute viral gastroenteritis .With molecular biology ,cell culture and animal models of development ,the different groups of norovirus genome sequenced ,the virus capsid protein ex‐pressed in vitro in eukaryotic ,prokaryotic and plant systems ,and thus the characteristics of the virus with some new under‐standing and perspective .Recently ,an increasing number of studies were focused on the norovirus and related topics along with the research progress all around the world .Here we systematically expound the latest advances in norovirus research from dif‐ferent aspects ,such as genome structure and function ,cell culture ,tissue tropism ,epidemiology ,virus infection mechanism , detection methods and vaccine development .Furthermore ,different viewpoints for norovirus molecular evolution ,detection technology and transmission route will be discussed as well .

0.05). Serum glutamate pyruvate transaminase activity significantly decreased in the injured liver BMSCs group (P

OBJECTIVE:To investigate the current situation and trend of clinical application of calcium channel blockers METHODS:The kinds and sum of money of calcium channel blockers,consumed in our hospital during the period 1999～2001,were collected and the prospects of clinical application of the drugs were analyzed with consulting the relevant literature RESULTS:The consumption of calcium channel blockers remained stable during the period 1999～2001,and the most commonly-used drugs were dihydrocollidines Domestic and joint ventrue products held a leading post in clinical application CONCLUSION:Sustained and controlled release preparations of calcium channel blockers have broad prospects in clinical application

Objective: To observe changes of variation of red blood cell distribution width-coefficient (RDW-CV), levels of matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinases (TIMP)-1 in patients with essential hypertension (EH) of different risk stratification.Methods: A total of 105 EH patients treated in our department from Oct 2015 to Sep 2016 were regarded as EH group.According to hypertension risk stratification, they were divided into low risk group (n=34), medium risk group (n=38) and high-and extremely high risk group (n=33).Another 105 subjects with corresponding age and gender were selected as healthy control group during the same period.RDW-CV, serum levels of MMP-2, MMP-9 and TIMP-1 were measured and compared among all groups.Multivariate Logistic regression analysis was used to analyze relationship among above indexes and hypertension.Results: Compared with healthy control group, there were significant rise in RDW-CV [(12.57±1.46) vs.(14.54±1.82)], serum levels of MMP-2 [(121.71±18.86)ng/ml vs.(155.43±40.81)ng/ml], MMP-9 [(109.72±21.80)ng/ml vs.(191.23±53.05)ng/ml] and TIMP-1 [(59.42±9.41)ng/ml vs.(83.64±15.82)ng/ml] in EH group, P<0.05 or <0.01.Compared with low risk group, there were significant rise in RDW-CV [(13.35±1.54) vs.(14.43±1.17) vs.(15.90±1.81)], serum levels of MMP-2 [(131.21±35.24) ng/ml vs.(152.16±33.15)ng/ml vs.(184.16±37.14)ng/ml], MMP-9 [(163.95±38.61) ng/ml vs.(198.70±43.52)ng/ml vs.(232.83±54.12)ng/ml] and TIMP-1 [(73.15±13.12)ng/ml vs.(83.78±10.22) ng/ml vs.(94.27±16.77)ng/ml] in medium risk group, high-and extremely high risk group, and those of high-and extremely high risk group were significantly higher than those of medium risk group, P<0.05 or <0.01.Multivariate Logistic regression analysis indicated that RDW-CV, MMP-2, MMP-9 and TIMP-1 were independent risk factors for hypertension (OR=2.248~2.725, P<0.05 or <0.01).Conclusion: RDW-CV,MMP-2,MMP-9 and TIMP-1 are independent risk factors for hypertension, active monitoring and intervention should be given for these risk factors.

Objective The sensitivity and specificity of 18 FDG PET/CT are poor in the diagnosis of gastric cancer .Gastric signet ring cell carcinoma and Mucinous gastric carcinoma is known to have low fluorodeoxyglucose (18FDG) uptake,but not known for poorly differentiated gastric adenocarcinoma .This study was to investigate the value of 18 FDG PET/CT in the diagnosis of poorly differ-entiated gastric adenocarcinoma . Methods We retrospectively analyzed the results of 18 FDG PET/CT of 34 cases of histologically confirmed poorly differentiated gastric adenocarcinoma .We recorded the volume , location , and gastric wall invasion depth , and maxi-mum standardized uptake value ( SUVmax) of the tumors and analyzed the relationship of 18 FDG uptake with the clinicopathologic pa-rameters. Results By 18 FDG-PET/CT, poorly differentiated gastric adenocarcinoma was diagnosed in only 67.6% of the patients (23/34).SUVmax was found to be significantly correlated with age , gastric wall invasion, and tumor size (P<0.05), but not with gender , tumor location , tumor pathologic subtype , lymph node metastasis , and distant metastasis ( P>0 .05 ) .Logistic regression a-nalysis showed the tumor size to be the sole factor influencing the 18 FDG uptake of poorly differentiated gastric adenocarcinoma ( OR=0.37, 95%CI 0.154-0.920, P=0.03). Conclusion The di-agnostic value of 18 FDG-PET/CT is but limited for poorly differentia-ted gastric adenocarcinoma , and attention should be paid to its false-negative results .

Objective To investigate the value of serum IgG4 in diagnosis of IgG4-RD and in differentiation from rheumatic diseases.Methods Total of 23 patients with IgG4-RD and 502 patients with rheumatic diseases were enrolled,who presented at Changhai Hospital in 2010 to 2011.In the study,rheumatic diseases were categorized into groups of Sj(o)gren syndrome (n =26),ankylosing spondylitis (n-50),systemic sclerosis (n =3),rhcumatoid arthritis (RA,n =125),mixed connective tissue disease (n =15),systemic lupus erythematosus (SLE,n =212),adult onset still disease (n =20),Behcet syndrome (n =17),polymyositis (n =12),dermatomyositis (n =12),polymyalgiarheumatica (n =10).Serum IgG and IgG4 levels were measured by a rate nephelometer assay.The ROC curves were constructed to identify the optimal serum IgG4 cutoff value for diagnosing IgG4-RD and evaluate its sensitivity and specificity.Results The mean levels of serum lgG4 in the group with IgG4-RD were 11.4(5.0-14.8) g/L.In about 95.6％ IgG4-RD patients,the serum IgG4 level was higher than ＞ 1.4 g/L and other rheumatic diseases (U values were 6.0,21.0,0,58.5,0,9.0,3.0,4.0,0,3.0,3.5,P ＜0.01).The levels of serum IgG4 with RA was 0.6(0.3-1.2) g/L,the levels of serum IgG4 with SLE was 0.2 (0.1-0.4) g/L.There were statistical differences between RA and SLE (U value was 5847,P ＜ 0.01).At the same time,some patients with other rheumatic diseases were found serum IgG4 level higher than ＞ 1.4 g/L,which was about 10％ in the patients whith RA,ankylosing spondylitis,adult onset still disease and polymyalgiarheumatica.According to the ROC constructed the cut off value in present study was 2.2 g/L,and sensitivity and specificity were 95.7％ and 97.4％,respectively.Area under the cerve (AUC) was 0.995.There were no significant differences between the sensitivity and specificity values obtained with a cutoff value of 2.2 g/L.In patients with other rheumatic diseases,the ratio of high serum IgG4 level (＞ 2.2 g/L) were declined obviously,except polymyalgiarheumatica,it was less than 10％.For differentiation from rheumatic diseases specificity values were higher.Conclusions The cut off value of 2.2 g/L is useful for diagnosing IgG4-RD,and in differentiation from rheumatic diseases.The high serum IgG4 concentrations are not specific to IgG4-RD.The cut off value of 2.2 g/L is better to diagnose IgG4-RD,and contributes to the differential diagnosis of IgG4-RD and other rheumatic diseases,but it needs to be further confirmed in clinical practice.

Objective To investigate the correlation between HLA-DRB71 allele and primary biliary cirrhosis(PBC)of Han pop-ulation in Qinghai plateau.Methods 95 PBC patients from March 2011 to March 2013 in the hospital were enrolled in the study (PBC group),203 cases of healthy individuals were recruited as control group.By using a sequence specific primer PCR method,the HLA-DRB71 alleles in the two groups were analyzed.Results HLA-DRB71*07 gene frequencies in PBC group and control group were 36.84% and 13.79% respectively,the difference was statistically significant(P <0.05).In PBC group,the other HLA-DRB71 alleles′frequency were lower than that in control group(P <0.05).There was a higher positive rate of HLA-DRB71 * 07 in PBC group than control group,and the OR value is 2.67(P <0.05).All the PCB patients carring HLA-DRB71 *07 alleles were HLA-DRB71*0701,but other subtypes such as HLA-DRB71 *0703,HLA-DRB71 *0704,HLA-DRB71 *0705,HLA-DRB71 *0706 were not found.Conclusion PBC Susceptibility might associated with HLA-DRB71 *0701 alleles,but is not an independent risk factor.

Objective To detect the expression of SSX and to correlate it with clinical indicators of primary hepatocellular carcinoma (HCC).Methods The expression of SSX1-5 mRNA and SSX1 protein were respectively detected by RT-PCR and Western blot and immunohistochemistry staining.The relation between the expression of SSX mRNA and SSX1 protein with clinical indicators were analysed.Results SSX1,SSX2,and SSX3 mRNA were expressed in hepatocellular carcinoma cell lines BEL-7404,Hep G2,and SMMC-7721.In 26 HCC samples,SSX1-SSX5 mRNA was detectable in 53.8％,42.3％,50.0％,46.2％ and 26.9％.The expression of SSX1 mRNA was not related to serum AFP levels (P ＞0.05).Specific expression was both found in the normal group and the high value group.The expression rate of SSX1 mRNA was 85.7％ in the older group,which was higher than in the younger group (16.7％,P ＜ 0.05).The expression rate of SSX1 protein was 50％ in HCC tissues,which was not seen in the caner-adjacent or cirrhosis tissues.In 49 HCC paraffin tissue section samples,the expression rate of SSX1 protein was higher than that in caner-adjacent tissues (46.9％ vs 18.4％,P ＜ 0.05).The expression rate of SSX1 protein was 68.3％ in the large hepatocellular carcinoma group,which was higher than in the small hepatocellular carcinoma group (29.6％),(P ＜ 0.05).Conclusions SSX1 mRNA is expressed with a high percentage and specificity in HCC and their products are new potential promising targets for antigen-specific immunotherapy of HCC.The detection of SSX1 expression has the potential value for auxiliary diagnosis of HCC.

Objective The aim of this study was to investigate the impact of constructing national key clinical specialty on high quality nursing service.Methods Using the Colaizzi 7-step analysis method to analyze the information,which through using the phenomenology research methods by making interviews with 14 clinicians,nurses and nursing administrators.Results The clinical medical staffs experienced the construction of key clinical specialist,to some extent,that would promote the development of nursing discipline,enhancing the environment and equipment in hospital,having improvement on the ability of nursing service and quality simultaneously,and then the cooperation between medical staffs and patients were more closely,while nurses bearing increased work pressure,with obviously job burnout.Conclusions The national key clinical specialist construction would effectively launching nursing quality care in depth and improving patient satisfaction with medical care,while the working pressure of nurses and the imperfection of post performance management restricted the development of nursing discipline.

Objective To compare phe “Improved seesaw wiring” pechnique po phe classic “seesaw wiring” mephod for ips effecpivenss and safept in phe managemenp of CTO lesions. Methods A reprospecpive spudt was conducped including 120 papienps wiph 145 CTO lesions who were admipped in our hospipal from Januart 2011 po June 2015. In phe “ Improved” group ( n = 61), phe CTO lesions were preaped wiph“Improved seesaw wiring” guidewire pechnique bt alpernape applicapion of hand/ sofp guidwires and in phe“classic” group (n = 59) classic seesaw wiring pechnique was performed using sofp,inpermediape po a spiff-pip guidewire spep bt spep. Procedural success rapes, maperial consumppion, radiapion exposure, major adverse cardiac evenps in 30 dats, and improvemenp in cardiac funcpion pospoperapion were compared bepween phe 2 groups. Results The procedural success rapes bt firsp appempp was 93. 4% in phe ″Improved″ group and 77. 9% in phe “ Classic ” group and phe overall procedural success rapes were 95. 1% and 96. 6%respecpivelt. Guidewire consumppion [(3. 0 (2. 0, 4. 0) guidewires vs. 5. 0 (3. 0, 7. 0) guiderwires], X-rat exposure [(110 ± 65)min vs. (175 ± 73)min], conprasp media used [(210 ± 137)ml vs. (305 ± 148) ml] were all fewer or less in phe “Improved group” (all P < 0. 05). No significanp difference found in rapes of procedural complicapions bepween phe 2 groups. MACE rapes were lower in phe “ Improved” pechnique group (16. 4% vs. 30. 5% , P = 0. 045). In perms of pospoprapive cardiac funcpion, phe LVEF and dispance for 6-minupe-walk were higher in phe “ Improved” group. Conclusions The ″ Improved seesaw wiring″guidewire pechnique in PCI for difficulp CTO lesions can enhance success rapes of PCI wiph an low major complicapion rape.