Williams syndrome is a rare disease caused by 1.5 ～ 1.8 Mb gene deletion in the chromosome 7q1 1.23 region,with autosomal dominant inheritance.The incidence is about 1/10 000.It involves the cardiovascular system,nervous system,endocrine system and so on,and is most likely to cause damage to the cardiovascular system.The mortality of sudden cardiac death in patients with Williams syndrome is higher than that in healthy population.At present,suspected patients were screened by Lowery score and the American pediatrics score,then were evaluated by imaging examination and were diagnosed by gene detection.The main therapy is symptomatic treatment.Therefore,it is important to ensure an accurate diagnosis and prompt treatment.In the article,the research progress of the clinical diagnosis,gene diagnosis,gene therapy and prognosis is reviewed.

Objective:To discuss the relationship between serum advanced oxidation protein products (AOPP)and cystatin C with the early preeclampsia pregnancy outcome.Methods:Clinical data of 75 patients received treatment and labor at our hospital from 2011 to 2013 was retrospectively analyzed.The control group included 60 normal pregnant women who received prenatal examination in our hospital at the same time.The difference in cystatin C and AOPP level of the patients with preeclampsia and the normal group was compared.The clinical data and the adverse pregnancy outcome of the patients with preeclampsia in different severity and different outcome of pregnancy were compared.Results:A total of 135 patients were retrospective analyzed ,including 75 in observe group and 60 in control group.The SBP level in the patients with preeclampsia is obviously higher than in the normal group .The level of SB,UA,Cr and AOPP in the patients of mild group is obviously lower than in the severe group.The incidence of oligohydramnios , placental abruption,fetal growth restriction and HELLP syndrome in the patients of mild group was obviously lower than in the severe group .The differences were statistically significant.The level of cystatin C,UA,Cr and AOPP in the patients of adverse pregnancy outcome were obviously higher than in the group of good outcome of pregnancy.Conclusion:The cystatin C and AOPP level of the early preeclampsia patients is obviously increased and it has significant correlation with the pregnancy outcome in patients .

Objective To discuss the application and effect of sufentanil combined with propofol on painless gastroscopy anesthesia.Methods In the fourth people's hospital of Zhejiang in April 2014-June 2016,94 cases treated with painless gastroscopy I were randomly divided into two equal groups.Anesthesia group A were anaesthetized with fentanyl and propofol,sufentanil and propofol for anesthesia group B.The anesthetic effect,the time of consciousness disappearance,eye opening time,recovery time of orientation,the dosage of propofol in the two groups were compared.The mean arterial pressure,heart rate and adverse reaction rate in the two groups were compared.Results The anesthetic effect in the anesthesia groupB is significant better than that in the anesthesia group A(P<0.05).Compared with the anesthesia groupA,the time of consciousness disappearance,eye opening and orientation recovery is shorter in the anesthesia groupB(P<0.05),The difference of the mean arterial drug Pressure and heart rate is not significant in the two groups before medication.After medication and wake up,compared with the anesthesia group A,the mean arterial pressure,heart rate fluctuation is smaller,and the adverse reaction rate is lower in the anesthesia group B,(P<0.05).Conclusion It is effective which sufentanil combined with propofol used in anesthesia in painless gastroscopy,It can stable vital signs of patients during operation,,work quickly,restore consciousness rapidly,and contribute to reduce complications,and is worthy of promotion.

Objective To confirm the most effectively screening conditions by comparing the ARR values of different posi‐tions after saline load test .Methods After exclusion the other secondary hypertension ,the completion of saline dressing test ,84 ca‐ses diagnosed hypertensive patients under saline load test results were divided into primary aldosteronism group (pH ,52 cases) and primary hypertension group (32 cases) .Analyzed plasma aldosterone (PAC) ,renin (PRA) values of upright and decumbent body positions ,their ARR values were calculated and the urine aldosterone was tested .Results Those whose upright position ARR rati‐os higher than 240(pg/mL)/(ng · mL -1 · h-1 ) were accounted for 80 .77% (42/52) and 43 .75% (14/32) ,respectively in the both PA group and PH group;Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL were accounted for 65 .39% (34/52) and 3 .13% (1/32) ,respectively in the both PA group and ph group;The specificity of this method for PA was 96 .88% .Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h ,The specificity of this method for PA was 100 .00% .Conclusion It is an effective screening method for primary aldosteronism when ARR values of upright position higher than 240(pg/mL)/(ng · mL -1 · h-1 ) ,PAC of decumbent position higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h .

BACKGROUND:Periodontal ligament stem cels are one of the ideal seed cels in periodontal tissue regeneration. Sources, biological characteristics and influential factors of periodontal ligament stem cels have been an issue of concern. OBJECTIVE:To review the biological characteristics and functional factors of periodontal ligament stem cels as wel as relevant research status and progress in regenerative medicine, and to discuss the relevant application prospect and existing problems, thereby providing theoretical and experimental basis. METHODS:PubMed and Wanfang databases were searched by the first author for articles related to differentiation and proliferation of periodontal ligament stem cels published from 2002 to 2015. The key words were “periodontal ligament stem cel, periodontal tissue, proliferation, differentiation” in English and Chinese, respectively. Finaly, 47 articles were included in result analysis. RESULTS AND CONCLUSION:Periodontal ligament stem cels have the ability of differentiating into fibroblasts, adipocytes, chondrocytes and cementum. Cel growth factors play an important role in the proliferation and differentiation of periodontal ligament stem cels. Fibroblast growth factor, vascular endothelial growth factor and insulin-like growth factor can promote the proliferation of periodontal ligament stem cels. Application of stem cel biofilm as a carrier material can effectively guide periodontal tissue regeneration. Isolation, culture and influential factors of periodontal ligament stem cels should be further improved. Combined application of stem cels, biofilms and growth factors is expected to achieve the desired periodontal tissue regeneration, which is the focus of future research.

Objective To evaluate the therapeutic effect of new oral care method for the treatment of swallowing disturbance after cerebral apoplexy. Methods A total of 50 post-apoplexy patients with swallowing disturbance were evenly randomized into treatment group and control group, 25 in each group. Both groups were given routine rehabilitation training for recovering swallowing function, and the rehabilitation training covered fundamental training, swallowing training, and food in-take training. And additionally, the control group was given routine oral care, and the treatment group was given new oral care method which included the stimulation on K point, cold Yin He gargle stimulation and focal application of herbal medicine buccal droplets. Two weeks later, water swallow test results were grading for evaluation of the therapeutic effect of the two groups. Results (1) After treatment for 2 continuous weeks, the water swallow test results were classified into grades 1 and 2 in 23 cases of the treatment group and in 17 of the control group, indicating that the treatment group had better effect on improving swallowing function ( P<0.01). ( 2) The total effective rate was 92.0% in the treatment group, higher than 68.0% in the control group ( P<0.01). Conclusion New oral care method has better effect on relieving swallowing disturbance than routine oral care for the treatment of swallowing disturbance after cerebral apoplexy.

Objective To establish an HPLC method for evaluating deoxyschizandrin in rat plasma; To explore deoxyschizandrin metabolic processes in blood.Methods The blood microdialysis probe was implanted into the right atrial enlargement through right jugular vein to detect the concentration of deoxyschizandrin in blood. Chromatographic conditions for detecting of dialysis fluid were as follows: mobile phase was methanol-acetonitrile- water (40:35:25); flow rate was 1 mL/min; column temperature was 30℃; UV detection wavelength was 254 nm. The data obtained after being calculated by the recovery rate of the probe in vivo were dealt with DAS 2.0 software. Pharmacokinetic parameters were calculated, and the concentration-time related curves were plotted.Results The deoxyschizandrin curve was linear (r=0.999 5) within the range of 2–500μg/mL. The RSD of intra-day pecision and inter-day pecision were both <3%. The stability of the solution was good in 12 hours at roomtemperature. ke was (0.364±0.047)/h; t1/2 was (1.637±0.302)h; Tmax was (0.612±0.194)h; Cmax was (165.92±28.830)μg/mL; AUC0-t was (240.793±25.540)μg?h/mL; AUC0-∞ was (282.710±30.727)μg?h/mL.Conclusion The method is convenient to perform, and the retention time of HPLC is short. This method is suitable for detecting the content of deoxyschizandrin in dialysis fluid, which can also be used to investigate the metabolic processes of deoxyschizandrin in the rat blood.

Professional competence is the inevitable requirement of medical students toward jobs.At present, the cultivation of professional competence of clinical internship has many problems and this requires higher medical colleges and universities should take the the cultivation of professional competence of clinical internship as an im-portant task.Cultivate goodness and moral self-discipline ability, demonstration and practice of medical knowl-edge ability and colleagues cooperation and doctor-patient communication ability.To this end, should optimize the path of the cultivation of professional competence:perfect the education contents and courses of professional compe-tency;organize professional competence training and simulation contest;encourage clinical interns to learning and self-improvement;build the assessment mechanism of professional competence of clinical internship.

Recent discoveries about the effects of drugs of abuse on the brain and the mechanisms of their addictions, and new actions of available medications are offering many opportunities for the discovery and development of novel medications to treat addictive disorders.This article reviews the current medications that have shown promising results for treating opioid, cocaine, methamphetamine, cannabis, alcohol and nicotine addictions.

Objective To study the current situation of diagnosis and treatment of rudimentary uterine horn pregnancy through 4-cases report. Methods We made a clinical study of 4 cases of rudimentary uterine horn pregnancy admitted to our hospital between 1995 and 2005. Results Three patients had been undergone artificial abortion before they were admitted to our hospital. All the patients were asymptomatic. Ultrasonography was made in 3 cases. Two cases were diagnosed as rudimentary uterine horn pregnancy. Three patients were cured with surgery. Conclusions Rudimentary uterine horn pregnancy is rare and with atypical clinical manifestation in the first trimester. Although diagnosis before surgery is difficult, ultrasonography and MRI make a great role. Surgery is the most important therapeutic method.