Objective:To investigate the changes of strains based on feature tracking in patients with hypertrophic obstructive cardiomyopathy (HOCM) after surgical myectomy and the potential factors that influenced post-myectomy global strains.Methods:A total of 27 patients with HOCM who underwent septal myectomy in Fuwai Hospital from June 2014 to July 2017 were retrospectively collected. They all received cardiac MR (CMR) cine acquisitions before and after surgery. Their preoperative and postoperative strain parameters, including radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle, septum, and lateral wall, were assessed by feature tracking. Comparisons of pre-myectomy and post-myectomy imaging parameters were performed using paired-samples t-test or Wilcoxon matched-pairs signed-ranks test. Pearson or Spearman correlation analysis and linear regression analysis were utilized to find the correlated factors of postoperative global strains. Results:Compared with preoperative strains, postoperative global LS, septal LS, lateral RS, lateral CS, and lateral LS increased statistically (all P<0.05); postoperative global RS, global CS, and septal CS decreased (all P<0.05); no statistically significant difference was observed in septal RS ( P=0.165). Age at surgery ( r=0.428, P=0.026) and preoperative myocardial maximum ventricular wall thickness ( r=-0.587, P=0.001) were both linearly related to postoperative global RS; the further multivariate stepwise linear regressions showed that only preoperative myocardial maximum ventricular wall thickness might be correlated with postoperative global RS (adjusted R 2=0.287, P=0.002). Only myocardial maximum ventricular wall thickness was linearly related to global CS ( r=0.679, P<0.001) and global LS ( r=0.588, P=0.001), respectively; univariate linear regression revealed that preoperative myocardial maximum ventricular wall thickness might be correlated postoperative global CS (adjusted R 2=0.337, P=0.001) and postoperative global LS (adjusted R 2=0.281, P=0.003), respectively. Conclusions:Cardiac surgery definitely relieves left ventricular outflow tract obstruction and generally improves longitudinal and lateral strains, but a negative impact may occur in global and septal CS and RS. Preoperative maximum ventricular wall thickness may affect postoperative global strains.

Objective To analyze the clinical characteristics of urinary tract infection after kidney transplantation and to analyze the distribution of pathogenic virulence factors.Methods From January 2014 to June 2016,a total of 255 cases were subjected to DCD renal transplantation in our center,and 45 cases of urinary tract infection occurred after operation.Among them,urinary tract E.coli infection occurred in 32 cases.The virulence factors gene aer,hly,irp2 and iucD in the 32 strains of E.coli isolated from urine were tested using PCR and multiple PCR.Results Thirty-two cases (71.1％) of urinary tract infection after renal transplantation was caused by E.coli,and divided into 9 cases of nosocomial infection group,and 23 cases of community-acquired group.The positive rate for aer,hly,irp2 and iucD in Nosocomial infection group was 66.7％,33.3％,88.9％ and 77.8％,and that in community-acquired group was 30.4％,8.70％,39.1％ and 34.7％,respectively.There were statistically significant differences among four kinds of virulence factors between two groups (P＜0.05).The positive rate of virulence factors was significantly higher in nosocomial infection group than in community-acquired groups.The total resistance rate was 84.38％,and there was significarit difference in multi-drug resistance rate between two groups (P＜0.01).Conclusion E.coli is the main pathogenic bacteria of urinary tract infection after renal transplantation,especially nosocomial infections.The detection rate of virulence factor is high,and the multiple drug resistance is outstanding,so the attention should be paid clinically.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.

Objective To investigate the clinical efficacy of Tianshu capsule in the treatment of migraine and its influence on vascular endothelial function,hemodynamics.Methods 80 patients with migraine from October 2014 to October 2015 in our hospital were selected as the research subjects,and according to the different treatment methods, they were divided into control group and observation group.The control group was treated with oral flunarizine hydrochloride capsules,the observation group was given Tianshu capsule on the basis of the treatment of the control group.The blood dynamics of the two groups before and after treatment and the clinical curative effect of the patients [the middle cerebral artery (MCA),anterior cerebral artery (ACA),Fu (PCA)after artery peak systolic velocity (Vs)and diastolic peak flow velocity (Vd)index,endothelin (ET)index]were observed.Results The curative effect of two groups was significantly improved compared with before treatment,the total effective rate of observation group (97.50%)was significantly higher than the control group (75.00%)(χ2 =8.54,P<0.05).The related indices of hemodynamics and endothelium were lower than before treatment,and after treatment,Vs of MCA,ACA,PCA in the observation group were (105.02 ±1.12)cm/s,(80.22 ±1.10)cm/s,(60.34 ±1.20)cm/s,Vd of MCA,ACA,PCA in the observation group were (35.22 ±1.13)cm/s,(40.33 ±1.21)cm/s,(21.23 ±1.12)cm/s,which were signifi-cantly lower than those in the control group[Vs of MCA,ACA,PCA:(120.10 ±1.13)cm/s,(95.33 ±1.12)cm/s, (80.21 ±1.13)cm/s;Vd of MCA,ACA,PCA:(42.33 ±1.10)cm/s,(50.23 ±1.10)cm/s,(30.21 ±1.10)cm/s] (t=25.46,25.76,33.38,12.30,17.04,15.55,all P<0.05).Conclusion The curative effect of Tianshu capsule in the treatment of migraine was improved in patients with cerebral blood flow velocity and vascular diastolic function, and is worthy of promotion.

Objective To investigate the median effective plasma target concentration of propo-fol (Cp50 )needed for lumbar surgery during inhalation-intravenous balanced anesthesia when BIS is 50.Methods Patients aged 40-56 years,scheduled for vertebral pulp ectomy were included.Anesthe-sia were maintained by TCI of propofol,sevoflurane 0.5 MAC,remifentanyl 0.2 μg·kg-1 ·min-1 , and vecuronium 0.08 mg·kg-1 ·h-1 .The target plasma concentration of propofol was initially set at 1.8 μg/ml,and adjusted by the sequential up-and-down methods,based on BIS index.The Cp50 of propofol and its 95% confidence interval (CI)were calculated.Results Twenty-six patients were en-rolled in this study.The median effective plasma target concentration of propofol was 1.61 μg/ml (95%CI 1.52-1.70)μg/ml.Conclusion The Cp50 of propofol needed for maintaining the BIS index of 50 is 1.61 μg/ml during the anesthesia with 0.5 MAC of sevoflurane combined with remifentanyl in lumbar surgery.

Two γ-glutamyl-cysteine peptides (γ-GCPs ) , ( SC2 RC7 )-γ-L-glutamyl-S-allyl-L-cysteine ( 1 ) and ( SC2 RC7 )-γ-L-glutamyl-S-propyl-L-cysteine ( 2 ) have been isolated from fresh garlic scales using ion-exchange chromatography and pre-HPLC. Their molecular structures were identified by HPLC-MS, CD, 1 H NMR, 13 C NMR, specific rotation and confirmed by the corresponding standard compounds. The influence of exogenously adding 1 and 2 on the bioavailability of iron and zinc from food legume was examined with soybean and mung bean, in the level of 0. 01 mmol/5 g of legume respectively. The enhancing effect of the two γ-GCPs of compound 1 and 2 on bioaccessibility of iron was generally evidenced in the case of soybean ( from 1 . 88% to 6 . 73% and 4 . 42%) and mung bean ( from 2 . 52% to 12 . 04% and 9 . 38%) . The two γ-GCPs similarly enhanced the bioaccessibility of zinc from the food legume, in soybean ranging from 13. 37% to 23. 95% and 20. 58%, and in mung bean from 15. 98% to 28. 44% and 27. 05%. Thus, both compounds 1 and 2 obviously had a promoting influence on the bioavailability of iron and zinc from food legumes. These findings are of practical value in a food-based strategy to enhance the bioavailability of trace minerals for human health.

Objective To investigate the changes of peripheral blood Foxp3+ regulatory T cell (Treg cell) in patients with ovarian cancer (OC).Methods In 46 patients with OC and 46 normal controls,the percentage of peripheral blood CD4+ Foxp3+ Treg cell was assessed by flow cytometry and Foxp3 mRNA level was detected by real-time quantitative reverse transcription polymerase chain reaction.The level of plasma.transforming growth factor β1 (TGF-ββ 1) was measured by enzyme linked immunosorbent assay.Results The percentages of CD4+ Foxp3+ Treg cell,Foxp3 mRNA and level of plasma TGF-β1 in patients with OC were statistically higher than those in normal controls [(11.42 ± 2.67)％ vs.(8.94 ± 1.98)％,0.59 ± 0.21 vs.0.37 ±0.14,(35 580 ±7274) ng/L vs.(28 610 ±5631) ng/L,P=0.0000].Conclusion The number and/or function of CD4+ Foxp3+ Treg cell in peripheral blood of patients with OC are abnormal,CD4+ Foxp3+Treg cell may participate in the occurrence of OC.

The present study visualized the knowledge map of research hotspots and changes of keywords by importing literatures from The American Journal of Clinical Nutrition (2000 ～ 2011) into CiteSpace.Analysis of the research hotspots (keywords),evolution of clinical nutrition,and front-line research based on tf-idf algorithm was then performed.

Objective To evaluate the clinical effect of clitoroplasty with preservation of the glans clitoris and the dorsal neurovascular pedicle in patients with clitoral hypertrophy. Methods From July 2003 to June 2009, cunnus feminization operations with preservation of the glans clitoris and the dorsal neurovascular pedicle and labioplasty were performed on 8 patients with female pseudohermaphroditism. Results All 8 cases were primary healing. The shaping glans of clitoris was completely viable with satisfactory size, location, contour and touching sensitivity, and the cunnuses presented the appearances of female external genital organs. Conclusions Clitoroplasty with preservation of the glans clitoris and the dorsal neurovascular can improve the appearance of clitoris and labia, preserving the functions of sensation and erection, reconstruting a new clitoris which is aesthetically appealing and functional, and it is suitable for various kinds of cunnus feminization operations.

Objective To investigate the correlation of the type of hypospadias and external genital system malformations. Methods From Jan 2000 to Oct 2009, the data of 632 patients diagnosed with hypospadias was analyzed retrospectively. The proportion of all types of hypospadias and the frequency of external genital system malformations were statistically analyzed. Results Among all cases, 12.6% exhibited mild hypospadias, 22. 8% moderate, 43. 2% severe and 21.4% had extremely severe hypospadias. One hundred and eighty-four cases with external genital system malformations were classified into penoscrotal transposition, cryptorchidism, hydrocele of tunica vaginalis,concealed penis and pseudovagina. The probability was about 24.8% (157 cases) of 632 patients with hypospadias. There was significant difference and a positive correlation among the type of hypospadias with total malformations, penoscrotal transposition, cryptorchidism. Conclusions In this patient cohort, moderate and severe hypospadias accounted for the majority of hypospadias. Penoscrotal transposition was the most frequent external genital system malformation in hypospadias, followed by cryptorchidism and hydrocele of tunics vaginalis. More severe hypospadias is accompanied with a higher probability of the external genital system malformations, penoscrotal transposition and cryptorchidism.