Xi Jinping,Secretary General has recently called on scientists mastering knowledge and proving in practice,to write papers in the motherland and in the realization of modernization.Up to the beginning of this century,ancestors and predecessors in Keshan disease prevention and control have made great achievements,including therapeutic methods,prevention of Keshan disease by supplementing selenium and compiling health standards,and these achievements have played an important technical supporting role in effectively controlling the epidemic of Keshan disease and guiding the practice of national wide control of Keshan disease.In the past 10 years,we have continued improving the technical norms to guide the work of national prevention and control of Keshan disease,and conducting translational research in response to the challenges of national Keshan disease prevention and control emerged in the new era.To realize the China dream of Keshan disease prevention and control,we must strive to achieve fully and sustainable elimination of Keshan disease,and to summarize the experiences in Keshan disease elimination for generalizing in other disease control and elimination,to continue to write the big article of the China dream of Keshan disease prevention and control.

BACKGROUND: Fms-like tyrosine kinase-3 (FLT3) gene is one of the receptors for growth factors in early hematogenesis. By binding to its ligand (FL), FLT3 regulates the proliferation and differentiation of hematopoietic stem/pregenitor cells via cell signal transduction pathway. FLT3 juxtamembrane internal tandem duplication (ITD)mutation is correlated with leukemia onset, development and act as an independent factor for poor prognosis.OBJECTIVE: To explore the relationship between Flt-3/ITD mutation and acute leukemia (AL), and analyze its clinical implication.DESIGN: A repetitive measurement.SETTING: Department of Biochemistry and Molecular Biology, Shenyang Medical College.PARTICIPANTS: Totally 147 samples of leukemia patients were diagnosed by morphological bone marrow biopsy in Shenyang Central Hospitals affiliated to Shenyang Medical College from January 1999 to October 2004. They were 95 males and 52 females with the mean age of 14.5 years old (5-23 years old). According to FAB standard, there were 62 patients with acute leukemia [including 33 cases of acute myelocytic leukemia (AMLs, M1, M2), 3 cases of acute myelo-monocytic leukemia (AMMOLs, M4), 18 cases of acute monocytic leukemia (AMOLs, M5), 8 cases of acute megakaryocytic leukemia (AMKLs, M7)], 43 patients with acute lymphoblastic leukemia (ALLs), 13 patietns with juvenile chronic myelocytic leukemia (JCMLs) and 29 patients with myelodysplastic syndrome (MDSs). Informed contents were obtained from all the participants.METHOD: Flt-3/ITD was detected with polymerase chain reaction (PCR) sequence in the 147 leukemia patients.MArN OUTCOME MEASURES: The clinical manifestations and prognosis were observed in the ALL patients with Flt-3/ITD;The Flt-3 gene expression, Flt-3/ITD positive rate, duplication region and length were detected in all kinds of leukemia.to Flt-3 gene products, including 3 cases of AMLs (M1, M2), 1 case of AMMOL (M4), and 1 case of AMOL (M5). DNA sequencing and blast alignment revealed that ITDs existed in all samples with unusual products within exon 11, in various region and length (33-72 bp). Expression of Flt-3 in different levels was found in 43 cases of ALL, 29 cases of Flt-3/ITD all died short after the diagnosis, and the mean life span of was only 10.8 months.

With regard to the nature of meridians, the authors have presented the hypothesis of dual reflex in 1977. This means that acupunture can invoke some effects not only through CNS (long reflex), but through the connection of peripheral nerve terminals to transmit messages (short reflex). In this experiment, rats were anaesthetized by rethane. The superficial peroneal nerve (SPN) and the deep peroneal nerve (DPN) were found out and cut off in order to break off their connection to CNS. With electrical stimulation of SPN, the action potential (AP) on the DPN was recorded at the same time. AP was induced only in a few cases (5.7%). But, after electroacupuncture was reapplied to Zusanli (ST-39) point for 30 rain, we stimulated SPN with electricity. This showed that APs were recorded on DPN in 17 among 27 rats (58.6%). Since some tissues around Zusanli point involve both SPN and DPN, the results suggest that messages are transmitted between nerve terminals under certain condition and that impluses on a nerve stem may stimulate another nerve terminal. This might be the essence of propagated sensation along the channels.

BACKGROUND:Internal fixation has become the first choice for the treatment of intertrochanteric fractures. However, the methods and materials for internal fixation are various. Which one has the best clinical efficacy?
OBJECTIVE:To compare the effects of proximal femoral nail and total hip arthroplasty for the treatment of intertrochanteric fractures.
METHODS:A total of 46 patients with intertrochanteric fractures were voluntarily divided into two groups:proximal femoral nail and total hip arthroplasty. Operation time, intraoperative blood loss, and Harris scores were compared between the two groups, and X-ray examination was used for assessment of clinical efficacy in the two groups.
RESULTS AND CONCLUSION:Total y 46 patients were fol owed-up for 3 to 12 months. Fractures in al the patients were healed. As compared with the total hip arthroplasty group, in the proximal femoral nail group, approach incision was smal er, blood loss was higher, operation time and fracture healing time were longer, and Harris score was lower (P<0.05). These findings indicate that the total hip arthroplasty is better than proximal femoral nail for intertrochanteric fractures, with less invasion and blood loss. However, the long-term effects need further studies.

BACKGROUND:Tumor markers are of great significance in early diagnosis of cancer, screening of high risk
group with cancer, differential diagnosis between benign and malignant tumors, judgment of cancer progression, evaluation of cancer therapeutic effect and prediction of cancer recurrence and prognosis.
OBJECTIVE:To realize the importance of tumor marker for cancer early diagnosis by introducing the working principle and clinical application of silicon nanowires biosensor in detecting tumor markers.
METHODS:The first author searched PubMed, CNKI and Google Scholar Databases to retrieve relevant articles about tumor marker, working principle and application of silicon nanowires biosensor published from 2003 to 2013. RESULTS AND CONCLUSION:Silicon nanowires biosensors with high sensitivity and without secondary marks show a good application prospect in detecting tumor markers. They have been used to detect tumor markers for prostate cancer, breast cancer, tumor markers of colorectal cancer, and primary liver cancer, and achieved an ideal limit of detection. However, due to the influence of debye length, most of detections can only be performed in the standard solution. There is a lack of the serum data of cancer patients.

Today,more and more patients with diabetes are requiring surgical intervention.Not only the metabolic disturbance of carbohydrate will be aggravated by surgical stress,but also the risk of perioperative complications and mortality have been greatly increased in patients with diabetes.Therefore,a complete preoperative assessment and blood glucose management of preoperative,intraoperative,and postoperative periods are needed to get full assurance for diabetic patients to undergo surgery and to pass through the perioperative period smoothly.

OBJECTIVE:To compare the efficacy and safety of tamsulosin or nifedipine or racanisodamine in the treatment of lower ureteral calculi. METHODS:160 patients with lower ureteral calculi were randomly divided into group A(40 cases),group B(40 cases),group C(40 cases)and group D(40 cases). All patients drank plenty of water to make daily urine output more than 2 000 ml. Based on it,group A orally received 0.4 mg Tamsulosin hydrochloride sustained release capsule,once a day. Group B orally received 10 mg Nifedipine tablet,3 times a day. Group C orally received 10 mg racanisodamine tablet,3 times a day. Group D received no other drugs except for increasing drinking. The treatment course for all groups was 2 weeks. Clinical efficacy,litha-gogue time,lithagogue size,residual calculi size and the incidence of adverse reactions in all groups were observed. RESULTS:The total effective rate in group A was higher than group C,which was higher than group B and group D,the differences were sta-tistically significant(P<0.05). Lithagogue time in group A was shorter than group B and group C,which was shorter than group D,the differences were statistically significant(P<0.05),while there was no significant difference between group B and group C (P>0.05). Lithagogue size in group A was more than group C,which was more than group B and group D,the differences were statistically significant(P<0.05),while there was no significant difference between group B and group D(P>0.05). Residual cal-culi size in group A was less than group B,which was less than group C and group D,the differences were statistically significant (P<0.05). And there were no severe adverse reactions in all groups. CONCLUSIONS:The efficacy of tamsulosin is superior to nifedipine and racanisodamine in the treatment of lower ureteral calculi,while nifedipine and racanisodamine show similar effica-cy,with better safety.

Objective To observe the therapeutic effect of the integration of Longji-Huoluo pill and mild manipulations Tuina therapy for the teenagers with lumbar intervertebral disc protrusion. Methods Eligible teenager patients with lumber intervertebral disc protrusion were randomly classified into two groups according to the single blind method and the treating sequence, 69 patients in the treatment group and 58 patients in the control group. The Longji-Huoluo pill and mild Tuina manipulations were adopted on the basis of the convertional treatment in the treatment group. While ibuprofen sustained release capsules and mecobalamin were given to the control group beside the convertional treatment. Both groups were treated for 4 weeks. The CT examinations were applied before and after the treatments to observe the absorption of the prolapsed lumber intervertebral disc. The Visual Analogue Scale (VAS) was used to test the pain degree and to estimate the clinical effect. Results The VAS scores in the treatment group (4.03 ± 1.67 vs. 5.41 ± 1.55, t=10.121) and the control group (3.61 ± 1.34 vs. 5.96 ± 1.71, t=11.086) after treatment were significantly lower than those before treatment (P<0.05). The sagittal diameters of the prominence in the treatment group (2.12 ± 1.89 mm vs. 4.62 ± 0.34 mm, t=2.281) after treatmentwas significantly lower than that before treatment (P<0.05). The total effective rate of the treatment group was 87.0%(60/69), and the control group was 72.4%(42/58). Statistical significance was detected on the difference of the two groups (U=1.913, P=0.043). Conclusions The integration of manipulations can effectively relieve the pain and can return the prominent disc. The therapeutic effect is considered equivalent to western medicine.

Objective To understand the prevalence condition of occupational musculoskeletal disorders in nurses,so as to supply scientific evidence for reducing and preventing nurses′occupational injuries.Methods 582 nurses from three level three class -A hospital in Wenzhou were investigated,which were selected by convenience sampling method.Results The prevalence of musculoskeletal disorders was 76.3%.The prevalence of low back pain was highest,which was 58.9%.Among the nurses who had lower back pain,in the past 1 year,43.4%of them had a total duration of illness more than 30 days,18.7% of them reduced daily activities time for more than 30 days,and 22.6% of them had received examination and treatment.The main factors which related to low back pain among nurses were age (OR =2.18,95% CI:1.36 -3.67 ),stoop time (OR =2.24,95% CI:1.08 ~4.36 ), occupational stress(OR =1.82,95%CI:1.14 ~2.89),work fatigue(OR =2.45,95%CI:1.27 ~3.15)and physical exercise(OR =0.63,95%CI:0.44 ~0.89).Conclusion The condition of occupational musculoskeletal disorders is serious,especially low back pain.Interventions related to influencing factors can be taken to reduce the incidence of low back pain.

OBJECTIVE:Inhaled glucocorticoids(GC) are the first-line medicine for bronchial asthma during relieve phase, thereby this study was designed to explore if patient tends to suffer osteoporosis due to long term inhalation of glucocorticoids. DATA SOURCES:Literatures about GC and osteoporosis were computer-searched in Medline and Embase from January 1980 to December 2003, with the key word of " asthma, bone density, bone metabolism and inhaled glucocorticoids" and language limited to English.Meanwhile it was also computer-searched in CBM, CBM disc and manually searched in Chinese Journal of Clinical Rehabilitation between January 1990 and April 2004 with language limited to Chinese. DATA SELECTION: Literatures about the comparison of bone density and bone metabolic change between inhaled GC group and control group were consorted deleting randomized controlled trial(RCT) so as to look up the whole content of healthy controls;While patients in the treatment group received GC inhalation.Exclusive standards:obvious non-RCT. Quality assessment is mainly focused on the reality of data,the strictness of design and implementation,and the rationality of statistical management. DATA EXTRACTION:Totally 30 randomized and nonrandomized studies about the influence of inhaled GC on the bone density and bone metabolism of patients with asthma were referred to amongst which 18 studies were admitted with the other 12 excluded for similarity in content in 8 and Meta-analysis in 4. DATA SYNTHESIS:A total of 1 153 asthmatic patients in 18 studies were divided into GC inhalation group and non-inhalation control group for comparing the difference of bone density and/or bone metabolism between them. CONCLUSION:Although the results of studies on the influence of long-term inhaled GC on bone quantity were different, but there was still not enough evidence to demonstrate that osteoporosis was due to long-term GC inhalation.