The treatment for chronic heart failure has been changed significantly in recent 20 years.Therapeutic target in heart failure not only improves symptoms and quality of life,more important is for the mechanism of myocardial remodeling,prevent and delay the development of myocardial remodeling.Angiotensin converting enzyme inhibitor/angiotensin receptor blockers,beta blockers,and aldosterone inhibitors are used as the golden triangle drug therapy for chronic heart failure.In recent years,it has been or is about to carry out some clinical new drugs for the treatment of chronic heart failure.

Objective: China Heart Failure Registry Study (China-HF) is aimed to understand the etiology, clinical features and treatment of in-hospital heart failure (HF) patients in China. Methods: Based on geographic region and economic condition, we prospectively recruited the in-hospital patients with primarily diagnosed HF, and the demographic information, etiology, clinical features and treatment condition were collected by electronic case report form in all patients. Results: A total of 8516 HF patients from 88 participating hospitals between 2012-01 and 2014-12 were analyzed. The average age of patients was at 66 years with 54.5% male. There were 6777/7997 (84.7%) patients with NYHA functional classiifcation at III-IV, 4207/8516 (49.4%) with coronary artery disease (CAD), 4649 (54.6%) with hypertension, 2109/7102 (29.7%) with chronic kidney disease and 2478/6608 (37.5%) with left ventricular ejection fraction (LVEF) < 40%. The patients with infection 3909/8516 (45.9%) and exertion or stress 2214 (26.0%) and myocardial ischemia 1967 (23.1%) were the major cause of HF worsening. There were 6165/8516 (72.4%) patients treated by intravenous diuretics during hospitalization, and after discharge, 5722 (67.2%) patients received oral loop diuretics, 2563 (30.1%) received angiotensin converting enzyme inhibitor, 2095 (24.6%) received angiotensin II receptor antagonist. The median length of in-hospital stay was 11 days and the in-hospital mortality was 5.3% (451/8516). Conclusion: China-HF provides a comprehensive insight of clinical features for the in-hospital HF patients in China. There is still a gap for medications between our current condition and the guideline, it is important to educate both patients and physicians in clinical practice.

Objective To investigate the effect of pretend play training based on Learn to Play program on pretend play capabilities of children with autism. Methods The researchers referred some training strategies in Learn to Play program, and designed a pretend play train-ing which adapted to autistic children's level of development. And then they conducted the pretend play training on three autistic children for four weeks. After that they used Child-Initiated Pretend Play Assessment to assess the effect of the intervention before, after and two weeks after training. Results The percentage of pretend play actions, the number of object substitutions and the number of imitated actions in-creased in some degrees in the children. Conclusion The pretend play training based on Learn to Play program can promote the pretend play capabilities of children with autism.

The aim of this review is to detect the difference in outcome of cardiac resynchronization therapy (CRT) between ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM).By reviewing some clinical trials of large scale,we found that restore of heart structure and function in NICM was more significant than ICM.However,there were no significant differences in clinical outcome of improving cardiac function and quality of life,decreasing heart failure re-hospitalization and mortality.

Objective:To research the application value of coronary CT angiography(CTA) detection for epicardial adipose tissue(EAT) and pericardial adipose tissue(PAT) in the diagnosis of coronary stent restenosis.Method:Selected 68 cases coronary atherosclerotic stenosis patients who were treated by coronary stent from June 2012 to June 2013 in hospital. All patients were detected after the operation of CTA within 3 years and they were divided into two groups (coronary stent restenosis positive group included 29 cases, negative group included 39 cases). To analyze the relationship between EAT and PAT through the statistical method and analyze the application value of EAT and PAT in the diagnosis of coronary stent restenosis based on calcification score image measurement of EAT and PAT volume.Results: Correlation analysis results showed there was correlation between EAT volume and PAT volume (r=0.859,P<0.05); through compared CAG and the diagnostic results of coronary artery stent restenosis by EAT and PAT, the sensitivity was 82.87%, specificity was 84.62%, CCTA positive predictive value was 80.00%, negative predictive value was 86.84% and diagnostic accuracy was 83.82% of the stent patency which was evaluated by CAG. The consistency evaluation marker Kappa was 0.554. The analysis of patients with coronary stent restenosis showed that there was significant correlation between Gensini score of coronary stent restenosis and EAT and PAT(P<0.05).Conclusion:There was significant correlation between EAT volume and PAT volume, and they can be used to evaluate the sensitivity and specificity of coronary stent operation restenosis and the results were higher. Besides, its clinical diagnostic value was similar with CAG.

Teacher portfolio is originally used for teacher assessment.The role of a teacher portfolio includes strengthening teaching ethics for improving faculty's quality of professional ethics,finding faculty's disadvantages and problems,enhancing faculty's training,providing the basis for faculty assessment,promotion and the appointment,and developing clinical teachers' teaching and research capacity.

Using the prime b(special to M. tuberculosis) to amplify 21 mycobacterium and 13 nonmycobacterium, the products amplified were detected by agarose gel electrophoresis. The sensitivity was 50fg at annealing temperature 61℃,and only M. tuberculosis, M. gastri were amplified, those results showed: the clinical isolated mycobacterium can be differentiated and detected quickly and efficiently by using the prime b(using the prime a when necessary) to amplify 16S～23S rDNA spacer sequence of mycobacterium.

BACKGROUND: Small conductance,Ca2+-activated potassium(SK)channel,presents in various cell types and plays a crucial role in action potential profile.However,coupling and modulation of calcium and associated molecules to SK2 channel remains unclear.OBJECTIVE: To construct the recombinants of pGBAT7 and target fragments of SK2 gene,so as to observe the coupling and regulation of SK2 channel gene to calcium and other molecules.METHODS: Three pairs of primers of the target fragments of SK2 gene were designed and synthesized based on the full-length sequences of SK2.After being identified,they were individually sub-cloned into the yeast expressive plasmid pGBKT7 to construct pGBKT7-SK2 vectors.The recombinant pGBKT7-SK2 vectors were transformed into yeast AH109 by electroporation,and their activation was tested.The recombinants were extracted from yeast AH109 and verified by electrophoresis and sequencing.RESULTS AND CONCLUSION: The target fragments of SK2 gene by PCR were 411,546 and 729 bp,respectively.Three sub-clones of pGBKT7-SK2 were successfully constructed.Electrophoresis and sequencing showed that the constructed sub-clones of pGBKT7-SK2 met the expected requirements.The recombinant pGBKT7-SK2 vectors transformed into the yeast could be activated.The successful construction of the sub-clones of SK2 gene provides an important material basis for further study in the SK2 channel and function-associated molecules.

Objective To evaluate the prospects of recombinant 38000 protein of Mycobacterium tuberculosis in tuberculosis epidemic investigation and subunit vaccine preparation.Methods Physicochemical characteristics of recombinant 38000 protein was detected by P I, peptide-mapping analysis and circular dichroism,guinea pig skin test,MTT stain,and peripheral blood macrophage phagocytosis were used to investigate the roles of recombinant 38000 protein in the cell immunity.Results Recombinant 38000 protein was acidic protein,its P I, was 4 67.The number of alkaline amino acid correspond with theoretic number;The secondary structure of recombinant 38000 protein was composed of ?-helix(32 6%),?-turn(31 6%) and random coil(35 8%) Recombinant 38000 protein could induce DTH in guinea pig sensitized by Mycobacterium tuberculosis Recombinant 38000 protein enhanced phagocytosis of macrophage in mice . PBMC from 30 8% healthy donors and 25% tuberculosis patients were stimulated by the recombinant 38000 protein.Conclusion Recombinant 38000 protein may be used as diagnostic reagent and as an candidate in development of subunit vaccine.

Objective:To explore the application of Allostatic Load (AL) in evaluation the effect of management for patients with type 2 diabetes.Methods:According to the control objectives of each indicator in the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China, the P75 and P80 of the subjects before intervention, AL was calculated, which were AL1-1, AL1-2 and AL1-3 respectively. On the basis of the above three indicators, the number of complications was taken as the numerical sum to obtain AL2-1, AL2-2 and AL2-3. Study participants were from a one-year randomized controlled intervention trial in patients with type 2 diabetes. Patients in the control group were treated with the integrated diabetes management mode used bg the tier-three medical institutions, while the intervention group added the intervention based on " Your Doctor" App on the basis of the above strategy. The changes of 6 types of AL and HbA 1C in the two groups before and after intervention were compared. Two groups of patients were treated with propensity score matching method to ensure the balanced distribution of covariates between groups. Multiple regression analysis was used to explore the factors influencing the effect of AL intervention. Two independent samples t-test, paired t-test and chi-square test were used to analyze the efficacy of the intervention. Results:After propensity score matching, the control group and the intervention group each included 483 patients. Among the six types of AL, the score of AL2-1 was the highest, while the score of AL1-3 was the lowest. Compared with baseline, all other indicators in the two groups decreased after intervention except ALL-3 in control group ( P<0.05).Patients who were residing in rural areas, having less co-habitants and more diabetic complications, and lower annual household income, shown higher AL ( P<0.05). The number of complications and the situation of urban or rural areas were the factors influencing the effect of AL intervention. Conclusions:More research is needed on AL as an early evaluation index of the effect of comprehensive management of diabetes.