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.

Objective To study the influence of carbamazepine on the neuromuscular block induced by rocuronium. Methods Thirty-two ASA Ⅰ- Ⅱ patients scheduled for neurosurgical operations were studied: 16 cases suffered from epilepsy were treated with carbamazepine for 24 to 180 months (carbamazepine group); the others suffered from intracranial tumors without antiepileptic treatment (noncarbamazepine group). Anesthesia was induced and maintained with target controlled with propofol 5 μ g/ml was monitored using train-of-four (TOF) stimulation. The onset time and times of muscle relaxation recovery 25%,50%,75% was recorded. Results The onset time was no difference between two groups (P＞0.05),but the times of muscle relaxation recovery 25%, 50%, 75% in carbamazepine group [(23.9±3.8 ), ( 29.2 ±4.5 ), ( 36.0 ± 5.4 ) min] were shorter than those in non-carbamazepine group [( 34.0 ± 2.8 ), (40.5 ± 4.6),( 49.9 ± 5.3 ) min] ( P ＜ 0.01 ). The recovery index in carbamazepine group [( 12.1 ± 2.9 ) min] was shorter than that in non-carbamazepine group [(15.8 ± 3.1) min](P＜0.05 ). Conclusion The duration of the rocuronium-induced neuromuscular block is significantly shortened by preceding chronic carbamazepine therapy.

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.

Alzheimer disease(AD) is the most common cau se of dementia today. Th e characteristic histopathologic changes include neurofibrillary tangles, neurit ic plaques, neuronal loss, and amyloid angiopathy. The noted Alzheimer symptom is the dysfunction of learning a nd memory. Potassium channels play a key role in it. A 113-pS tetraethylammoniu m-sensitive potassium channel was consistently absent from AD fibroblasts and o lfactory neuroblasts. Cp20, a memory-associated protein, amyloid precuror prote in and presenilin which are all tightly associated with genetic Alzheimer diseas e can regulate the activities of potassium channels. The changes of potassium ch annels subtype need further study. Potassium channels are maybe the important dr ug targets in the treatment of Alzheimer disease.

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 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 To explore CT and MRI appearances of intracranial germinoma.Methods 19 patients with intracranial germinoma confirmed histologically and radiotherapy were selected as the object of this study.CT and MR findings of germinoma were analysed retrospectively.Results Of 19 cases,the tumors were located at pineal region in 12,the basal ganglia and thalamus in 3 and the sellar in 4.Germinoma of pineal region showed low signal intensity on T1WI,iso or hyper-signal intensity on T2WI,isointensity or slightly hyperintensity on CT with definite margin,the pineal calculus were embedded frequently by tumors.After administration of contrast material,the tumors showed marked and uniformity enhancement.Thickness of pituitary stalk and absence of the hyperintensity of the posterior pituitary on T1WI were found in sellar germinoma.Tumors showed iso-signal intensity on T1WI,but variable signal intensity was exhibited on T2WI.Calcification was absent in all cases,but the solid components of tumors were hyperdense on plain CT,and they were obvious enhancement on contrast-enhanced CT scan.Germinoma located at basal ganglia and thalamus showed diffuse growth,larger volum of tumors,inhomogeneous signal intensity and density with indefinite margin,hemorrhage seen in most of case.After administration of contrast material,the tumors showed patch or chaplet-like enhancement.Conclusion It is possible to make the preoperative diagnosis for intracranial germinoma according to sex,age and CT,MR imaging characteristics.