[Summary] The genomic DNA was extracted from peripheral blood leukocyte of the patient with thyroid hormone resistance syndrome and 14 members of his family.The exons 1-10 of thyroid hormone receptor β (TRβ) gene were amplified by PCR.The products of PCR were sequenced directly to detect the gene mutation.The results showed that 3 members of this family were confirmed to have the C→T transition mutation at nucleotide 1 303 site within exon 10 of TRβ gene,and the missense mutation results in the substitution of histidine to tyrosine (H435Y).The heterozygous mutation may lead to the occurrence of thyroid hormone resistance syndrome.

Objective To observe the dose-effect relationship and side effects caused by epidural ketamine for patients after surgical intervention for knee stiffness (SIKS). Methods 80 patients undergoing SIKS at one knee joint under combined spinal and epidural anesthesia were randomly divided into 4 groups. Patients in these groups would receive analgesia respectively provided by femoral nerve block (FNB)(group C, n=20), FNB combined with 0.15 mg/kg epidural ketamine (group K1, n=20), FNB combined with 0.2 mg/kg epidural ketamine(group K2, n=20), and FNB combined with 0.25 mg/kg epidural ketamine (group K3, n=20). When spinal anesthesia was finished, the corresponding dose of ketamine was injected in patients in groups K1, K2, and K3 and 0.9% sodium chloride was injected in group C via an epidural catheter. After the operation, a catheter was left in the femoral nerve sheath and the solution of 60 mg ropivacaine in 30 ml (0.2%) was injected. All patients were performed rehabilitation therapy at postoperative 8, 24, 32, and 48 h and the same ropivacaine solution was injected in the femoral nerve sheath before each rehabilitation therapy started. Visual analogue score (VAS), active range of motion (AROM) of the suffered knee joint, and side effects were observed. Results There were 73 patients enrolled in the final statistic analysis. At postoperative 8 h, the VAS scores were lower in groups K1, K2 and K3 than in group C (P<0.05). At postoperative 24 h, 32 h, and 48 h, the VAS scores were lower in groups K2 and K3 than in groups C and K1 (P<0.05). AROM was larger in groups K2 and K3 than in groups C and K1. patients appeared psychiatric symptoms in group K3. Conclusion Small dose of epidural ketamine is a feasible method for analgesia in early rehabilitation therapy and the dose of 0.2 mg/kg is effective and safe.

AIM: Recent studies showed that stem cells could replace injured cardiomyocyte and increase the number of functional cardiomyocytes. Researching the pertinent literature in China Journal Full-text Database (CJFD) published between 2005 and 2008 indicated that the researches on stem cell transplantation in the treatment of primary dilated cardiomyopathy were few. This study investigated the therapeutic efficacy and security of peripheral blood stem cell transplantation in coronary artery in treatment of dilated cardiomyopathy and its effects on left ventricular function. METHODS: Forty-two patients with dilated cardiomyopathy between December 2006 and September 2007 were enrolled at the Department of Cardiology of First People's Hospital of Yunnan, including twenty-eight males and fourteen females, averagely aged (56?3) years. Inclusive criteria: patients with less than 65 years, left ventricular enlargement, and left ventricular ejection fraction (LVEF) ≤ 45%, and without coronary artery disease after coronary arteriongraphy. Informed consents were obtained from patients. Patients were divided into stem cell transplantation group (n=15) and control group (n=27) on the basis of whether being treated by stem cell transplantation. Patients in the stem cell transplantation group were consecutively administered granulocyte colony-stimulating factor (G-CSF) by hypodermic injection to stimulate bone marrow stem cells themselves based on conventional treatment for five days. Peripheral blood stem cell suspension was disassociated on the 6th day, and the collected suspension was injected into left anterior descending branch over the wire saccule tube for autologous peripheral blood stem cell transplantation. Patients in the control group were administered by conventional treatment of dilated cardiomyopathy. Security and adverse reaction were observed during the mobilization, collection and returning injection of peripheral blood stem cell by coronary artery. Morphous, cardiac function and motion index of left ventricle wall were evaluated using ultrasoundcardiogram before and 3 months after transplantation. Survival rate and incidence rate of heart incidents were compared. RESULTS: Three months after stem cell transplantation in coronary artery, there were a significant decrease in cardiac end-systolic volume (ESV), cardiac end-diastolic volume (EDV) and motion index of left ventricle wall, but a significant increase in LVEF(P

Objective To understand the situation of iodine of Taishan nuclear power station employees,and assess the relationships between iodine nutrition and thyroid nodule of Taishan nuclear power station in Taishan,Guangdong.Methods Totally 300 people were selected from of Taishan nuclear power station through stratifiedrandom sampling method,random urine samples were collected and urinary iodine level was tested in 2014.According to 20 to 29 years old,30 to 39 years old,40 to 59 years old,3 age groups were sampled,and each age group was 100 people.Drinking water and edible salt samples of the of nuclear power station were collected and iodine level was tested.Daily dietary intake of the staff was investigated,and daily iodine intake was calculated.Result of thyroid B ultrasonic of the employees (1 091) were studied,and detection rate of thyroid nodule was calculated.Results Totally 308 urine samples were tested,and the median urinary iodine was 193 μg/L.The difference of urinary iodine between 20-year-old group (201 μg/L) and 30-year-old group (165 μg/L) was statistically significant (P ＜ 0.05).A total of 9 iodized salt samples were collected,with an average iodine value of (24.4 ± 0.5)mg/kg.A total of 9 water samples were collected,the median of water iodine was 20.5 μg/L in 3 centralized water supply samples.The daily iodine intake per capita of the staff was 274.0 μg/d,the highest contribution among all the varieties of food was iodized salt,the second was seafood,which were 45.26 percent and 41.86 percent,respectively.A total of 99 thyroid nodules and suspicious nodules were detected in 1 091,and the prevalence was 9.07 percent (99/1 091).The prevalence of people aged 40-59 [15.6％ (22/141)] was significantly higher than those of people aged 20 to 29 [8.1％ (51/633)] and aged 30 to 39 [8.2％ (26/317)],and the differences were statistically significant (P ＜ 0.05).Conclusions The iodine nutrition of Taishan nuclear power station employees is appropriate as a whole.The detection rate of thyroid nodules is higher in people aged 40 to 59.

Objective To study the clinical outcomes of robotic extended thymectomy and thoracoscopic extended thymectomy for thymoma patients with myasthenia gravis compared with conventional median sternotomy extended thymectomy.Methods The clinical data of thymoma patients with myasthenia gravis treated by extended thymectomy between June 2013 and June 2016 were retrospectively reviewed.The clinical outcome parameters were compared according to surgical approach.Results 41 thymoma patients with myasthenia gravis,8 cases underwent robotic extended thymecotmy,11 cases underwent thoracoscopic extended thymectomy and 20 underwent median sternotomy extended thymectomy.The resected extension included tumor,thymus tissue and adipose tissue in anterior mediastinum.There were no significant differences between robotic group and thoracoscopic group regarding operative time,blood loss,chest tube duration,hospital stay,postoperative complications and postoperative myasthenic crisis (P ＞ 0.05).The blood loss of robotic group and thoracoscopic group was significantly lower than that in median sternotomy group(P ＜ 0.05).The chest tube duration of thoracoscopic group was significantly shorter than that in median sternotomy group(P ＜0.05).The effective rates of MG after extended thymectomy in robotic group,thoracoscopic group and sternotomy group was 65.0％ 、69.2％ 、62.5％ respectively and there was no significant difference (P ＜ 0.05).Conclusion Robotic thymectomy and thoracoscopic thymecotomy are both minimal invasive surgery approach with less bleeding for thymoma patients with myasthenia gravis.The clinical outcomes of robotic thymectomy and thoracoscopic thymecotomy are similar.

Objective Through the investigation of the iodine content in residents drinking water in Jianjiang River Basin of Guangdong,the scope and distribution of waterborne high iodine areas in this region were grasped so as to provide a basis for taking appropriate prevention and control measures.Methods All towns (streets) covering seven counties (cities,districts) of Jianjiang River Basin were selected by cross sectional screening method in 2012 and 2013,which were divided into mainly-investigated town (street) and generally-investigated town (street) according to the direction,geographical position and other situations of all branches of Jianjiang River.In each mainly-investigated town (street),two natural villages were selected according to the river direction and terrain conditions,and one water sample was collected from each village.In each generally-investigated town (street),one administrative village was selected respectively according to the locations (east,west,south,north and middle);two natural villages were selected from each administrative village,and one water sample was collected from each natural village.The water supply types of each natural village were investigated,including centralized water supply,decentralized water supply and river (reservoir) water.If the iodine content of the water samples was higher than 100 μg/L in the natural villages,then 10％ more water samples were collected.The inductive coupling plasma mass spectroscopy (ICP-MS) was adopted for water iodine detection.Results A total of 3 583 residents drinking water samples from Jianjiang River Basin were investigated,and the median of water iodine was 15.1 μg/L;the median of water iodine in reservoirs,river,mountain spring,well water was 12.1,9.8,2.5 and 18.6 μg/L,respectively.Iodine content of 341 water samples was ＞ 100 μg/L,accounting for 9.5％;228 water samples were ＞ 150 μg/L,accounting for 6.4％;58 water samples were more than 300 μg/L,accounting for 1.6％.The water samples with iodine content higher than 100 μg/L were all from decentralized well water.There were 18 natural villages which could be determined as the waterborne high iodine areas (water iodine ＞ 150 μg/L);they were distributed in 16 administrative villages in 14 towns (streets) of 5 counties (cities,districts) and had a registered population of 23 915 in total.The difference of water iodine between the 5 counties (cities,districts) in middle and lower reaches of Jianjiang River Basin (24.7,28.6,20.5,23.2,24.0 μg/L) and the 2 counties (cities,districts) in upper reaches (12.0,10.9 μg/L) was statistically significant (Z =13.5,P ＜ 0.05);the difference of water iodine between coastal and non-coastal areas (12.5 vs.5.9 μg/L) was statistically significant (Z =6.1,P ＜ 0.05).Conclusions The iodine content in surface water of Jianjiang River Basin is generally lower;,the high water iodine phenomenon dispersedly occurs in the underground water (well water),and the iodine content is different in different areas;the iodine content of the middle and lower reaches is higher than that of the upper reach,and the iodine content of the coastal alluvial areas is higher than that of the non-coastal areas.The natural villages with waterborne high iodine are spottily distributed in the coastal areas of all backbones and branches of Jianjiang River,but not connected together basically.

Objective To evaluate the clinical effectiveness of interventional therapy in treating thoracic aortic dissection (TAD) . Methods A follow-up visit with 24 TAD patients had been operated in our hospital from November 2008 to March 2010. The clinical data, the therapeutic measures and the follow-up results were retrospectively analyzed. Including the remission of symptom, average day in hospital,complication,the long term survival rates and so on. Results All 24 patients have survived, the symptoms have improved instantly, the hospitalization days was 7.3 days,and no complication occurred. The 3 years survival rate was 95.8%. Conclusion Interventional therapy have advantages of treating thoracic aortic dissection with less complication,more secure and higher long term survival rates.

Objective To observe the Hp infection effect on blood lipid metabolism and oxidative stress through detecting acute cerebral infarction (ACI) with Helicobacter pylori (Hp) infection serum lipid and malondialdehyde (MDA) level and superoxide dismutase (SOD) activity.Methods Chose ACI 350 cases of ACI group,80 cases of control group and detected serum Hp-IgG antibody (by colloidal gold) and 14C urea breath test (by14 C-UBT).Used the American beckman coulter AU680 fullautomatic biochemical analyzer to detect the serum lipid and SOD activity (colorimetry),and used Shanghai now 752 visible spectrophotometcr (532 nm) to detect the serum MDA level (TBA).Results The Hp infection rate of ACI group (69.5 ％) was significantly higher than that in the control group (33.8％),the differences was statistically significant (x2 =18.882,P＜0.01).The differences in serum TC,TG,LDL-C and HDL-C levels were statistically significant (t=4.167 ～5.521,all P＜0.01) compared with Hp non-infection group.The serum MDA level and SOD activity of the control group and Hp infection group were statistically significant (F=34.891～46.613,all P＜0.01).Hp infection with Hp infection group to compare serum MDA level and SOD activity differences statistically significant (t=5.197,9.713,all P＜0.01),the Hp infection group and control group in comparative differences were statistically significant (t=3.173,8.228,all P＜0.01).Conclusion Acute cerebral infarction merger of HP infection,blood lipid metabolic disturbance in body increased and enhanced oxidative stress reaction,this may be intensified HP infection is one of the reasons for acute brain infarction dis ease.

The culture medium and cultural conditions of solid-state fermentation of Streptomyces Menmyco-93-63 were tested in this study. The suitable medium which contains rice, sorghum, millet bran, and rice hull with the proportion of 2:2:3:3 was developed for the spore production of Streptomyces Men-myco-93-63 using single substrate screening, mixture substrate screening and orthogonal experiments, and the sporulation was up to 2.52?109 CFU/g. And then, initial charge, initial ratio of water to solid, inoculating quantity, and culture temperature impact to sporulation of Streptomyces Men-myco-93-63 were tested. The favorite cultural conditions are developed as the following: the initial charge is 15 g in 500 mL Erlenmeyer flask; initial ratio of water to solid is 1.7:1.0 (V/W, rice hull excluding), inoculating quantity is 7 mL, culture temperature is 28℃.

Objective To assess the effectiveness of prevention program on iodine deficiency disorders and iodine nutritional status of residents in Guangdong Province.Methods Probability proportionate to size sampling(PPS) was employed in surveillance of iodine deficiency disorders.Thirty counties(cities,districts) were selected in Guangdong Province.In each county(city,district) one township(street) was selected; in each township (street) one primary school was selected and in each primary school 40 children aged 8-10 were chosen to examine their thyroid and to collect salt samples at their home for determination of salt iodine.Out of the 40 children,12 children were chosen to collect urine samples for determination of urinary iodine.From the primary schools chosen,40 grade 5 students were selected for intelligence quotient(IQ) test.In the nearby of the primary schools,3 townships(towns,street) were selected and in each township(town,street) 5 pregnant and 5 lactating women were selected to collect their urine samples for determination of urinary iodine.Type-B ultrasonic was used in measuring the thyroid volume.The iodine content of urine samples was measured by the method of arsenic and cerium catalysis spectrophotometry.The iodine content of salt was determined quantitatively with the titration method.IQ was tested by Chinese combined Raven's test.According to geographical location and the implementation of iodized salt,the effects of iodized salt on iodine deficiency disorders were analyzed in the plains and the Pearl River Delta Coastal region with mild iodine deficiency(iodized salt implementation region,referred to as the plains and the PRD),historical iodine deficiency areas (iodized implementation region) and the eastern and the western coastal areas of Guangdong(areas with non-iodized salt problem,referred to as the eastern and the western Guangdong).Results A total of 1200 children aged 8 to 10 were examined by type-B ultrasonic test,and goiter rate was 3.5％ (42/1200).The differences of goiter rate between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant (x2 =6.6,P ＜ 0.05).The goiter rate (6.1％) in the eastern and the western Guangdong was significantly higher than that of the plains and the PRD and the historical iodine deficiency areas (3.3％,2.0％,x2 =5.6,7.1,all P ＜ 0.05).A total of 1200 salt samples were examined.The median and coefficient of variation of iodine in the salt were 31.0 mg/kg and 23.2％,respectively.Coverage of iodized salt was 97.5％(1170/1200) while 96.1％(1153/1200) of consumed iodized salt was qualified.The median urinary iodine of 1200 children aged 8-10 was 186.5 μg/L,and the differences of median urinary iodine between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant(x2 =5.9,P ＜ 0.05).The median urinary iodine of the eastern and the western Guangdong(162.4 μg/L) was significantly lower than that of the plains and the PRD(207.5 μg/L,x2 =8.7,P ＜ 0.01).The difference of median urinary iodine between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong was statistically significant(x2 =58.9,P＜ 0.01).The median urinary iodine of the eastern and the western Guangdong(109.6 μg/L) was significantly lower than that of the historical iodine deficiency areas and the plains and the PRD(152.9,155.2 μg/L,x2 =18.3,20.6,all P ＜ 0.05).The mean IQ of the 1208 grade 5 students was 102.8 ± 14.3.The IQ of the plains and the PRD(104.3 ± 13.9) and the historical iodine deficiency areas(102.7 ± 14.3) was significantly higher than that of the eastern and the western Guangdong(100.3 ± 14.7,t =3.8,2.1,P＜ 0.01 orP＜ 0.05).Conclusions The goal of iodine deficiency disorders elimination is achieved as scheduled in Guangdong Province.The health level of general population has been improved significantly.Iodine nutrition is in the appropriate range (100-199 μg/L) in general population but low in pregnant women.The selling of non-iodized salt in the eastern and the western Guangdong Province should be followed closely.