Objective Influenza A(H7N9) virus causes a relatively high mortality in humans and therefore it is of great sig-nificance to know its prevalence in China .This article aimed to study the genetic characteristics and evolution of the hemagglutinin (HA) gene of the influenza A(H7N9) virus prevailing in China between 2013 and 2017. Methods We downloaded the HA se-quences of the influenza A ( H7N9) virus prevailing in China between 2013 and 2017 from The Global Initiative on Sharing All Influen-za Data and National Center for Biotechnology Information .Using the bioinformatics software , we analyzed the homology , molecular characteristics , phyletic evolution , and selective pressure of the HA gene. Results The homology of the HA gene of the influenza A ( H7N9) virus and the reference strain was decreasing each year from 2013 to 2017, 99.0%-99.9%in 2013, 98.7%-99.5%in 2014, 98.4%-99.6%in 2015, 76.8%-99.4%in 2016, and 69.9%-98.2%in 2017.Compared with the reference strain , the HA gene of the influ-enza A(H7N9) virus underwent variations in 21 antigenic sites.The variation of N285D was the highest (23%) in 2015 and that of R148K increased yearly,reaching 65%in 2016 and 78.5% in 2017. Phylogenetic analysis showed a concentrative distribution of the influenza A ( H7N9) virus strains on the phylogenetic tree in the same year from 2013 to 2017.Amino acid substitution of T 140A was observed in most of the influenza A ( H7N9) virus strains from Guang-dong in 2013, and the widest distribution of the virus strains was found in 2014.Positive selective pressure site 65 was obtained in the sequence of 2015 using the FEL and IFEL models, but not in the strains of 2016 or 2017. Conclusion Influenza A(H7N9) virus constantly undergoes variation , which has increased the difficulty in its prevention and control .More importance should be attached to observation of the virus and response to its adaptive mutations .

Objective To assess and optimize the dosage regimens of nor-vancomycin in patients with different renal functions.Methods The minimum inhibitory concentration ( MIC ) distribution was determined by agar dilution method with the target value of AUC 0-24/MIC≥638.Ten thousand cases in virtue of Monte Carlo simulation were performed in dif-ferent doses to obtain probabilities of target attainment ( PTA) and cumu-lative fractions of response ( CFR ) in patients with different renal func-tions.Results For the patients with normal renal function , when En-terococcus faecium and Enterococcus faecalis were treated with recommen-ded dose , from 0.8 to 1.6 g· d-1 , the CFR were lower than 59.77%.The CFR could reach to 83.95%and 73.10%when the dose was adjus-ted to 2.5 g· d -1.For the patients with moderate renal function insuffi-ciency , the CFR could reach to 82.81% at the dose of 0.8 g · d -1 against Enterococcus faecalis.The CFR could reach from 73.10% to 86.84%at the dose from 0.8 to 2.5 g · d-1 in the process of treating Enterococcus faecium.For the patients with severe renal function insuffi-ciency , the CFR could reach to 97.77% and 85.90% respectively a-gainst Enterococcus faecalis and Enterococcus faecium.Conclusion Monte Carlo simulation provides dosage regimens and the norvancomycin regimen is complemented and optimized.

Objective: To analyze the cerebroplacental blood flow distribution characteristics in monochorionic-diamniotic (MCDA) twin pregnancies with selective fetal growth restriction (sFGR), and investigate the relationship between co-twin cerebroplacental blood flow discordances and co-twin birth weight discordances (BW_disc). Methods: The cerebroplacental blood flow distribution characteristics and their discordances were analyzed retrospectively in 52 MCDA twin pregnancies with normal growth (control group) and 52 with sFGR (case group), including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), cerebroplacental ratio (CPR), and their discordances (UA-PI_disc, MCA-PSV_disc, MCA-PI_disc and CPR_disc). Results: Compared to the control group, UA-PI_disc, MCA-PI_disc and CPR_disc increased significantly (all P<0.01). UA-PI_disc, MCA-PI_disc and CPR_disc were related positively to BW_disc as shown by correlation analyses (r=0.488, 0.414, 0.592; all P<0.001), and they had moderate predictive accuracy for sFGR with area under the curves of 0.743, 0.662 and 0.778, with sensitivity of 48.08%, 67.31% and 71.15%, and specificity of 92.31%, 59.62% and 78.85% (all P<0.01). Multivariate Logistic regression analyses showed that only CPR_disc were independently associated with sFGR (P<0.05). Conclusions More cerebroplacental blood flow discordances are observed in MCDA twin pregnancies with sFGR. Co-twin cerebroplacental blood flow discordance is related to BW_disc.

Objective To study the changes of risk factors of cardiovascular disease in the rural community population after intervention. Methods The Beijing Fangshan cardiovascular prevention program was a community-based comprehensive intervention study which was launched from 1991 and ended in 2000 in five communities including three as intervention communities (IC) and two as control communities (CC) in Fangshan, Beijing suburb. The intervention measures were focused on health education and hypertension control. The changes of risk factors of cardiovascular disease in IC and CC were analyzed using random sample in the year 1991, 1995 and 1999, respectively. The risk factors include systolic and diastolic blood pressure(SBP and DBP), body mass index(BMI), serum total cholesterol(TC), triglyceride(TG),high-density lipoprotein cholesterol(HDL), smoking, and drinking. Results From the year 1991 to 1999, the risk factors of cardiovascular disease such as SBP, DBP, smoking rate and drinking rate were reduced in the population of IC. For male in IC, the decline of SBP, DBP, smoking rate, and drinking rate were 1.6 mmHg, 1.1 mmHg, 14. 5% ( P ＜ 0. 01) and 3.7%, respectively. For female of IC, SBP and DBP declined 4.8 mmHg ( P＜0.01) and 3.2 mmHg ( P ＜0. 01), respectively. SBP, DBP and smoking rate in the population of CC had a little reduction while BMI, TC and TG increased in both IC and CC. During the period of 1991 to 1999, most cardiovascular risk factors in the population of IC had net reduction compared to that of CC. Conclusions Except for BMI and lipids, rural community intervention, as focused on health education and hypertension control, has resulted in the reduction of most risk factors of cardiovascular disease.

Objective To investigate the bacterial distribution and resistance to antibiotic in diabetic foot infection (DFI).Methods All the stains of outpatients and inpatients were isolated from infectious tissue in 2010-2017.The stains were cultured and identified by conventional method,and their susceptibility were tested by disk diffusion,microbroth dilution or E-test according to Clinical and Laboratory Standard Institute (CLSI,2015) manual.Results A total of 304 strains were collected.The four main species were Staphylococcus aureus,Pseudomonas aeruginosa,Streptococcus agalactiae,and Proteus mirabilis,accounting for 29.3％,8.6％,5.9％ and 5.6％ respectively.There was no resistance to vancomycin for gram-positive bacteria,and no resistance to carbapenem for gram-nagetive bacteria.Conclusion Staphylococcus aureus was predominant organism in DFI.

OBJECTIVETo prepare the polyclonal anti-peptide antibody against chemokine-like factor1 (CKLF1) and apply it to the expression and functional studies of CKLF1.

METHODSCKLF1 was analyzed with bioinformatics methods. The 16 amino acids sequence peptide was selected from CKLF1 C terminal end. Antibody was raised by immunizing rabbits with the peptide conjugated to keyhole limpet hemocyanin (KLH).

RESULTSA high titer polycolonal antibody was obtained from the rabbit against the peptide. ELISA analysis proved that the titer of rabbit serum against anti-peptide of CKLF1 was up to 10(-4). Western blot analysis revealed that it could react not only with recombinant CKLF1 expressed in a cell-Free Protein Biosynthesis System and Drosophila S2 cells, but also recognize the endogenous CKLFs in the tissue array. Positive staining was detected in the normal bronchial cartilage, gastric mucosa, and gastric smooth muscle tissues. Normal rectum and well-differentiated rectal carcinoma showed strong positive staining, but the poor-differentiated rectal carcinoma samples revealed negative staining.

CONCLUSIONThe anti-peptide antibody can specifically recognize CKLFs and may be a useful reagent for the detection of CKLF1.

Animals ; Antibodies ; analysis ; genetics ; immunology ; Antibody Specificity ; immunology ; Chemokines ; analysis ; genetics ; immunology ; Cloning, Molecular ; Humans ; MARVEL Domain-Containing Proteins ; Oligonucleotide Array Sequence Analysis ; Peptide Fragments ; analysis ; biosynthesis ; genetics ; immunology ; Rabbits ; Recombinant Proteins ; analysis ; biosynthesis ; genetics ; immunology

OBJECTIVETo identify the prevalence, distribution, current status of awareness and control of hypertension in Chinese adult population.

METHODSA cross-sectional survey was conducted in mainland of China in 2000 - 2001 as a part of work coordinated with InterASIA Program. A total of 15,838 nationally representative subjects aged 35 to 74 were selected with multistage cluster sampling. Measurement of blood pressure was taken for all of them with three readings in a mercuric-column sphygmomanometer after resting for five minutes. Standard structured questionnaire was used to collect their histories and treatment and prevention for hypertension. A case of hypertension was defined as any person with systolic blood pressure equal to or greater than 140 mmHg, or with diastolic blood pressure equal to or greater than 90 mmHg, or being administered with antihypertensive agents.

RESULTSA total of 15,838 adults aged 35 - 74 years were included in this survey. Overall, the prevalence of hypertension was 27.2%, representing 130 million persons with hypertension nationwide as estimated. Age-specific prevalence of hypertension was 10.7%, 26.8%, 38.9% and 50.2% for women and 17.4%, 28.2%, 40.7% and 47.3% for men aged 35 - 44, 45 - 54, 55 - 64 and 65 - 74 years, respectively. Among hypertensive patients, 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved their blood pressure under control (< 140/90 mm Hg). All these data indicated that percentages of awareness, treatment and control of hypertension increased by 86.2%, 92.6% and 145.4%, respectively in the past ten years, as compared with the data in 1991.

CONCLUSIONSIn the past ten years, percentages of awareness, treatment and control of hypertension in Chinese adults increased significantly, who had a relatively high prevalence of hypertension, but lower awareness and much lower percentages of treatment and control of hypertension. It is urgently needed to improve prevention, detection and treatment for hypertension in adults.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Awareness ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension ; epidemiology ; prevention & control ; therapy ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Risk Reduction Behavior ; Sampling Studies ; Surveys and Questionnaires

OBJECTIVETo evaluate the results of surgical procedures for pulmonary embolism.

METHODSFifty-four patients of pulmonary embolism received surgical treatment from October 1994 to June 2007, of which 9 were acute pulmonary embolism underwent pulmonary embolectomy and 45 patients were chronic thromboembolic pulmonary hypertension (CTEPH) underwent pulmonary thromboendarterectomy.

RESULTSThe mortality rate was 44.4% in acute pulmonary embolism group and 13.3% in CTEPH group (P < 0. 05). Thirteen patients had residual pulmonary hypertension and 23 patients had severe pulmonary reperfusion injury postoperatively. The pulmonary artery systolic pressure changed from (89.4 +/- 36.3) mm Hg (1 mm Hg =0.133 kPa) preoperative to (55.6 +/- 22.4) mm Hg postoperative. The pulmonary vascular resistance changed from (89. 7 +/- 56.7) kPa L(-1) S(-1) preoperative to (38.9 +/- 31.1) kPa L(-1) S(-1) postoperative. The arterial partial pressure of oxygen changed from (52. 3 +/- 6.7 ) mm Hg preoperative to (87.6 +/- 6.5) mm Hg postoperative. The arterial oxygen saturation changed from (88.9 +/- 4.5)% preoperative to (95.3 +/- 2.8 )% postoperative (P < 0.05). With the follow-up of (41.8 +/- 36.4) months, there were 4 patients died. According to NYHA, there were 28 patients for class I , 10 patients for class II and 2 patients for class III. According to Kaplan-Meier survival curve, the 3-year, 4-year, 5-year and 8-year survival rate were (97.1 +/- 2.8 )%, (94.0 +/- 4.1)%, (90.8 +/- 5.2)% and (85.0 +/- 7.3)% respectively. Linear rate of bleeding and thromboembolic related to anticoagulation were 0. 63% patient-years and 0. 62% patient-years respectively.

CONCLUSIONSThe operational mortality of acute pulmonary embolism is significantly higher than CTEPH, and the mid-long term survival rate is agreeable and the complication rate related to anticoagulation is relatively low.

Adolescent ; Adult ; Aged ; Embolectomy ; methods ; Endarterectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pulmonary Artery ; surgery ; Pulmonary Embolism ; pathology ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the relative merits between chordal shortening and artificial chordae to repair the anterior leaflet prolapses (ALP).

METHODSThe clinic data of 50 cases underwent repair of ALP from March 1990 to March 2008 were analyzed retrospectively. There were 29 male and 21 female patients with a mean age of (42.6 +/- 11.3) years old. There were 23 patients in chordal shortening group and 27 patients in artificial chordae group.

RESULTSThere were 3 operative deaths in chordal shortening group (13.0%), and 1 death in artificial chordae group (3.7%, P = 0.199). With a mean follow-up of (5.8 +/- 4.8) years and a total follow-up of 278 patient-years, there were 3 late deaths respectively in each group. According the Kaplan-Meier survival curve, the actuarial survival rate at 5-8 years was 70.0% +/- 18.2% for chordal shortening group and 86.8% +/- 9.2% for artificial chordae group (chi(2) = 8.17, P = 0.046). There were 5 reoperations, of which 4 in chordal shortening group and 1 in artificial chordae group. According to the Kaplan-Meier freedom from reoperation curve, the freedom from reoperation at 5 years was 83.3% +/- 15.2% for chordal shortening group and 100% for artificial chordae group (chi(2) = 12.06, P = 0.007). The COX proportional hazard regressions revealed that chordal-shortening technique was the independent risk predictor for the late cardiac event after ALP surgical repair.

CONCLUSIONArtificial chordae techniques has a relative superiority to chordal shortening for repair of mitral valve ALP.

Adolescent ; Adult ; Aged ; Child ; Chordae Tendineae ; surgery ; Female ; Follow-Up Studies ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Mitral Valve Prolapse ; surgery ; Retrospective Studies ; Treatment Outcome

To investigate the composition and diversity of heat resistant microorganisms in contaminated Chinese herbal pieces. Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) protein fingerprinting and 16S rRNA high-throughput sequencing of Illumina Miseq were used to analyze the heat resistant microbial community of 9 varieties of Chinese herbal pieces. Stem pieces (Spatholobi Caulis, Tetrapanacis Medulla, Stachyuri Medulla) showed highest detection rate and most species of contaminants; However fruit pieces (Schisandrae Sphenantherae Fructus) had the lowest detection rate and least species of contaminants; among root pieces, the detection rate and number of contaminants species were lower in Tuber Dioscoreae Persimilis and Rehmanniae Radix Praeparata. The heat resistant microbial community was mainly of Bacillaceae and Paenibacillaceae, and Bacillus showed the highest detection rate among them, followed by Brevibacillus, Paenibacillus, and Solibacillus. The rest genus in high-throughput sequencing analysis included Enterobacter, Brevundimonas, Leuconostoc, Methylobacterium, Dechloromonas, Pantoea, Klebsiella, and Erwinia. There were potential risk factors in heat resistant microbial community of Chinese herbal pieces, so we shall improve the microbial limit standard, strictly control the pathogenic bacteria in the product, and strengthen the supervision and management in production and circulation of Chinese herbal pieces.