Type 2 spondyloepimetaphyseal dysplasia with joint laxity caused by KIF22 gene mutation: a case report and literature review / 中华骨科杂志

A male patient aged 1 year and 8 months with type 2 spondyloepimetaphyseal dysplasia with joint laxity (SEMDJL2) was reported. The clinical characteristics included short stature, flat middle face, hypotonia, limb joint relaxation, hyperextension of metacarpophalangeal articulation, etc. In addition, the patient had a history of congenital laryngeal stridor. Thus, SEMDJL2 was determined according to the above symptoms and medical history. Sanger sequencing showed that the child carried a c.443C>T missense mutation in the KIF22 gene, which resulted in an amino acid variation namely p.Pro148Leu. This phenotype was preliminarily determined as a pathogenic mutation. Therefore, it is suggested that next-generation sequencing genetic testing could be helpful for genetic diagnosis in children with congenital laryngeal stridor, systemic joint relaxation, and excessive joint extension.

Preliminary Study on China ’s Insurance Model for ADR Injury Compensation under MAH System / 中国药房

OBJECTIVE：To construct China ’s Insurance Mode for ADR injury compensation model under marketing authorization holder （MAH）system，and to provide reference for reducing the medical disputes caused by ADR damage and protecting the rights and interests of patients. METHODS ：Using the methods of recommendation and “snowball”，the interviewers were invited to conduct semi-structured interviews to obtain qualitative data ，and the results were analyzed by thematic analysis. According to the results of subject analysis ，the ADR injury compensation model was designed from three aspects of insurance type setting，insurance level division and compulsory insurance protection objects ，and the Fuzzy comprehensive evaluation method based on AHP was used to evaluate the model ；questionnaire and multiple factor Logistic regression analysis was adopted to analyze the influential factors of whether drug related institutions were willing to establish ADR injury compensation system. RESULTS：A total of 40 experts were invited and 34 of them completed the interview ，with a response rate of 85.0％. At present ， the problems of ADR injury compensation in China mainly included the difficulties of third-party identification and adducing evidence of ADR injury ，the difficulty of timely and fair settlement of medical disputes caused by ADR injury ，the high cost and long time of handling ADR injury disputes ，and the uncertainty of compensation mode. More than half of the experts interviewed agreed with the compensation mode of insurance . The overall score of established model was 89.50. A total of 640 questionnaires were distributed and 559 valid questionnaires were recovered （204 drug manufacturers ，172 drug distributors and 183 medical institutions）. The effective rate of the questionnaire was 87.3％. Multiple Logistic regression analysis showed that the factors positively correlated with the approval of establishing ADR injury compensation system after the implementation of MAH system in China included the familiarity of ADR staff in drug manufacturing enterprises with ADR related policies （β＝1.697，P＜0.05），the types of drugs operated by pharmaceutical companies （β＝2.987， P＜0.05），the cognitionlevel of medical staff on ADR （β＝ 2.800，P＜0.05）. The working years of medical staff were negatively correlated with the approval of establishing ADR injury compensation system after the implementation of MAH system （ β ＝－ 2.544，P＜0.05）. CONCLUSIONS ：ADR injury compensation model designed in this study is feasible. It has reference value for reducing the economic burden of ADR patients ， treating patients ’health problems caused by ADR injury in time ，and promoting the development of China ’s drug insurance. Main influential factors for the establishment of ADR injury compensation model under MAH system contain the familiarity of ADR staff in drug manufacturing enterprises with ADR related policies ，the types of drugs operated by pharmaceutical companies ，the cognitionlevel of medical staff on ADR ，the types of drugs operated by pharmaceutical companies ，the cognitionlevel of medical staff on ADR.

3D digital image microscope system-assisted vasovasostomy and vasoepididymostomy in rats / 亚洲男科学杂志(英文版)

Optimal vision and ergonomics are essential factors contributing to the achievement of good results during microsurgery. The three-dimensional (3D) digital image microscope system with a better 3D depth of field can release strain on the surgeon's neck and back, which can improve outcomes in microsurgery. We report a randomized prospective study of vasoepididymostomy and vasovasostomy using a 3D digital image microscope system (3D-DIM) in rats. A total of 16 adult male rats were randomly divided into two groups of 8 each: the standard operating microscope (SOM) group and the 3D-DIM group. The outcomes measured included the operative time, real-time postoperative mechanical patency, and anastomosis leakage. Furthermore, a user-friendly microscope score was designed to evaluate the ergonomic design and equipment characteristics of the microscope. There were no differences in operative time between the two groups. The real-time postoperative mechanical patency rates were 100.0% for both groups. The percentage of vasoepididymostomy anastomosis leakage was 16.7% in the SOM group and 25.0% in the 3D-DIM group; however, no vasovasostomy anastomosis leakage was found in either group. In terms of the ergonomic design, the 3D-DIM group obtained better scores based on the surgeon's feelings; in terms of the equipment characteristics, the 3D-DIM group had lower scores for clarity and higher scores for flexibility and adaptivity. Based on our randomized prospective study in a rat model, we believe that the 3D-DIM can improve surgeon comfort without compromising outcomes in male infertility reconstructive microsurgery, so the 3D-DIM might be widely used in the future.

An analysis of 4 cases with Gitelman syndrome caused by SLC12A3 gene mutation in children / 中华实用儿科临床杂志

Objective:To study the clinical and genetic characteristics of Gitelman syndrome in children.Methods:Four children diagnosed with Gitelman syndrome in the Baoding Children′s Hospital from January 2017 to October 2018 were enrolled, and their clinical data and pathogenic gene carrying status were analyzed.Results:There were 2 males and 2 females in the enrolled patients.Two children complained of short stature and 2 children were diagnosed as hypokalemia by accident.All the 4 children showed constipation, short stature, repeated hypokalemia, hyponatremia, hypochloremia, normal urinary calcium/creatinine ratio, elevated renin and angiotensin Ⅱ levels in supine position, and normal aldosterone.Three children had hypomagnesemia and 1 child had a normal blood magnesium level.All of the 4 children had a compound heterozygous mutation of SLC12A3 gene.The mutations of c. 1670-7G>A and c. 1698C>A were not reported in the literature. Conclusions:Constipation and short stature are common clinical manifestations of Gitelman syndrome in children.Typical cases show hypokalemia, hypomagnesemia, hyponatremia and hypochloremia, etc.The blood magnesium level can be normal in few children.Most children with Gitelman syndrome carry SLC12A3 compound heterozygous mutations.

Effects of intraperitoneal injection of insulin on the regulation of abnormal blood glucose and blood lipid in obese type 2 diabetic KKAy mice / 国际生物医学工程杂志

Objective:To study the effect of insulin intraperitoneal injection on abnormal blood lipid intype 2 diabetic KKAy mice.Methods:Type 2 diabetic mice model was established by feeding high fat and high sugar diet. KKAy model mice were randomly divided into intraperitoneal injection group ( n=6), subcutaneous injection group ( n=6) and no-treatment group ( n=3). At the same time, healthy C57BL/6J mice were selected as normal group ( n=6), and healthy KKAy mice as disease-free group ( n=6). The treatment process was divided into two stages. The first stage consists of 6 weeks, in which the mice in the intraperitoneal and subcutaneous groups were treated with insulin intraperitoneally and subcutaneously respectively. The second stage consists of 4 weeks, in which the mice in intraperitoneal and subcutaneous groups were subcutaneously injected with insulin. The mice in the remaining 3 groups were not treated. The changes of related indicators were detected every two weeks, including body weight, fasting blood sugar, 2 hours after meal blood sugar, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C). Results:Changing the injection solution in the medium term of the treatment had no effect on the body mass and blood sugar of KKAy mice with type 2 diabetes. Under this condition, the effect of intraperitoneal injection of insulin on HDL-C and LDL-C is significantly better than that of subcutaneous injection. Besides, both injection solutions are effective in regulating TG, but the effect of reducing total cholesterol is not obvious.Conclusions:The intraperitoneal injection of insulin has a certain effect on the blood lipid abnormality of type 2 diabetic KKAy mice. It can promote the increase of HDL-C, the decrease of LDL-C, and the decrease of TG.

Relationships between intracranial compartment volumes and clinical symptoms in patients with idiopathic normal pressure hydrocephalus before and after cerebrospinal fluid shunt surgery / 中华老年医学杂志

Objective@#To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH).@*Methods@#Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume.@*Results@#The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P<0.05). There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait, cognitive function and urinary function before surgery, and with the degree of symptom improvement one year after surgery in iNPH patients(all P>0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05).@*Conclusions@#Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.

High-throughput sequencing analysis of intestinal flora diversity of two freshwater snails (Radix auricularia and Planorbella trivolvis) / 生物工程学报

Freshwater snail is an important biological group in aquatic ecosystem and an intermediate host of many parasites. Intestinal flora plays an important role in animal energy metabolism and resistance to pathogens. We analyzed the intestinal microbiota diversity of Radix auricularia (RA) and Planorbella trivolvis (PL) by 16S rRNA high-throughput sequencing. At the phylum level, RA had 23 phyla, including Proteobacteria (33.63%), Cyanobacteria (15.33%), Chloroflexi (13.95%), and Actinomycetes (12.99%). PL had 13 phyla, including Proteobacteria (54.88%), Bacteroidetes (28.49%), and Actinomycetes (7.65%). At the genus level, there were 445 genera in RA, including Pleurocapsa, Thiodictyon, Leptotrichia, and Nocardioides. There were 238 genera in PL, including Cloacibacterium, OM60NOR5_clade, Pseudomonas, and Rhodobacter. Ninety-three genera were the common core flora of the two snail species (all the samples were present), and 27 genera had an abundance greater than 0.5%. The structure of intestinal microbiota was significantly different between the two groups (P=0.027). We performed the functional prediction of intestinal microbiota using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt), and the results show that the KEGG functional composition of the intestinal flora of the two snails was similar, and the abundance of the amino acid metabolism, carbohydrate metabolism and membrane transport were large. In summary, the intestinal microbiota of the two snails was high in diversity and significantly different, but there were a large number of common core flora.

Relationships between intracranial compartment volumes and clinical symptoms in patients with idiopathic normal pressure hydrocephalus before and after cerebrospinal fluid shunt surgery / 中华老年医学杂志

Objective To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery,and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).Methods Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery,and were evaluated by using 3-meter timed up and go test(TUG),minimum mental state examination(MMSE),idiopathic normal pressure hydrocephalus grading scale (iNPHGS) and modified Rankin scale (mRS) before and one year after CSF shunt procedures.The ventricular volume,brain volume,pericerebral CSF volume,total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated:the relative ventricular volume,brain volume ratio,pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume.Results The scores of gait,cognitive function and urinary function were improved after surgery in iNPH patients (all P ＜ 0.05).There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume,brain volume ratio,pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait,cognitive function and urinary function before surgery,and with the degree of symptom improvement one year after surgery in iNPH patients (all P ＞ 0.05).There was no significant difference in intracranial compartment volumes between patients having improvement in mRS,TUG,MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P＞0.05).Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait,cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume,brain volume ratio,pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery,and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason,preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.

Study on the effects of different humidifying liquids applied to non-invasive mechanical ventilation airway humidification / 药学实践杂志

Objective To study the effects of different airway humidification fluid applied to non-invasive mechanical ventilation.Methods 121cases of non-invasive mechanical ventilation admitted to the hospital from May 2016to May 2017were randomly divided into three groups.40cases in group A received sterile water for injection as humidifying liquid.40cases in group B received normal saline and 41cases in group C received 1.25％sodium bicarbonate water solution.The viscosity of sputum and the comfort of humidification for the three groups were compared.Results On day 1, there was no significant difference in the sputum viscosity among the three groups. (F=0.230, P=0.795).On day 2, group A had the highest sputum viscosity, followed by group B and group C.The difference was statistically significant (F=4.416, P＜0.05).The same results were obtained on day 3with statistically significant difference (F=11.388, P＜0.001).Group C had the highest comfort score among the three groups with statistically significant difference (F=37.901, P＜0.001).Conclusion 1.25％sodium bicarbonate water solution makes sputum more diluted and gives patients with better comfort.It can be considered as the fluid of choice for patients with high sputum amount.

Floating-Harbor syndrome: a case report and literature review / 中国当代儿科杂志

Floating-Harbor syndrome (FHS) is an autosomal dominant genetic disease caused by SRCAP mutation. This article reports the clinical features of a boy with FHS. The boy, aged 11 years and 7 months, attended the hospital due to short stature for more than 8 years and had the clinical manifestations of unusual facial features (triangularly shaped face, thin lips and long eyelashes), skeletal dysplasia (curvature finger), expressive language disorder, and retardation of bone age. Genetic detection revealed a novel heterozygous mutation, c.7330 C>T(p.R2444X), in the SRCAP gene. The boy was diagnosed with FHS based on these clinical manifestations and gene detection results. FHS is rare in clinical practice, which may lead to missed diagnosis and misdiagnosis, and gene detection may help with the clinical diagnosis of FHS in children.

Research status of HIV pre-exposure prophylaxis / 上海预防医学

The efficacy, safety and adherence of HIV pre-exposure prophylaxis (PrEP) are reviewed in this article. Oral daily tenofovir/emtricitabine can significantly decrease the incidence of HIV infection among people at high risk, with no severe adverse effects. PrEP effectiveness is closely associated with medication adherence. To reduce the transmission of HIV, it is suggested that pilot tests should be carried out in high risk population; universal education offered on AIDS prevention and control; drug prices lowered; comprehensive prevention strategy adopted; marketing of PrEP drugs promoted; and the risk of HIV infection reduced.

Weak Iaser effects on the biocompatibiIity of chitosan and Nafion as impIantabIe gIucose sensor outer materiaIs / 中国组织工程研究

BACKGROUND: The biocompatibility of chitosan and Nafion can be improved by external factors. OBJECTIVE: To explore the effect of different weak laser irradiations (red, blue, green) on biocompatibility of porous chitosan membrane and the Nafion membrane. METHODS: (1) Porous chitosan membrane test: Forty-eight Sprague-Dawley rats were randomized into red, green, blue light groups (n=16 per group). Porous chitosan membranes (two membranes at each side) were implanted into the bilateral subcutaneous tissue of the rat back with the spine as the axis of symmetry, and then the four implanted membranes in each rat were irradiated by red light for 0, 2, 4, 6 minutes respectively. The irradiation lasted until sample collection at 7, 14, 28 and 56 days after implantation, and the samples were used for histological analysis. The same procedures were done in the blue and green light groups. (2) Nafion membrane test: Twenty-four Sprague-Dawley rats were randomized into red, blue and green light groups (n=8 per group). Nafion membranes (two membranes at each side) were implanted into the bilateral subcutaneous tissue of the rat back with the spine as the axis of symmetry, and then the four implanted membranes in each rat were irradiated by red light for 0, 2, 4, 6 minutes respectively. The irradiation lasted until sample collection at 7 and 14 days after implantation, and the samples were used for histological analysis. The same procedures were done in the blue and green light groups. RESULTS AND CONCLUSION: The content of red blood cells in blood vessels and vascular density around the membrane materials (porous chitosan membranes and Nafion membranes) increased after irradiated by red light (especially at 7 days after implantation); the red light had less influence on the inflammatory response and fibrous capsule thickness around the two kinds of membranes. The inflammatory cells percentage around the membrane materials irradiated by green light for 4 minutes was significantly reduced, and the blue light had less influence on inflammatory responses; blue and green lights showed effects on the fibrous capsule thickness and vascular density around the membrane materials, but the effect was not obvious. Thus, to a certain extent, weak lasers can improve the biocompatibility of PCSM and Nafion membrane.

Research on design optimization of helicopter pilot helmet with mounted display / 医疗卫生装备

Objective To optimize the helicopter pilot helmet with mounted display in order to enhance wearing comfort.Methods The problems of the helmet were analyzed,and the trends of the helmet were discussed in foreign countries and China,and then optimization was carried out from the aspects of function,structure,design,material and etc.Results Optimization measures were proposed from the aspects of safety protection,ergonomics,platform display,night vision,tracking and positioning,material and industrial art to improve the designs of all functional modules of the helmet.Theoretical references were provided for the design of lightweight and tailored helmet.Conclusion Aviation ergonomics has to be considered to enhance wearing comfort and reliability when designing new-type helicopter pilot helmet with mounted display.

Relationship of social capital with anxiety and depression in urban elderly population in China / 中国心理卫生杂志

Objectives:To examine the relationship of social capital with anxiety and depression symptoms among urban elderly in China.Methods:A household survey by using self-administered questionnaires was conducted in 3 communities in Jinan,Shandong Province and the data of 925 people aged 60 years or over were collected.The social capital indicators according to its operational definition and Zung's Self-rating Depression Scale (SAS) and Zung's Self-rating Depression Scale were used.The social capital factors were extracted by using exploratory factor analysis and were dichotomized to conduct logistic regression analysis.Results:The average standard scores of SAS and SDS were (35.8 ±6.9) and (41.9 ±8.7),respectively.The proportion of anxiety symptom was 4.4％ and that of depression symptom was 19.0％.Logistic regression analysis showed that perceived social support,perceived trust,reciprocity and safety and social participation were associated with self-rating depression(Ps＜ 0.05).Perceived social support (OR ＝ 0.29,95 ％ CI:0.20-0.44),perceived trust,reciprocity and safety (OR ＝0.49,95％ CI:0.33-0.72) and social participation (OR ＝ 0.66,95％ CI:0.45-0.98) were protective factors of depression.No significant association between social capital factors and anxiety was found.Conclusion:It suggests that social capital could be a target for elderly people's mental health promotion in China.Additional efforts should be taken on enhancing the elderly people's perceived support,trust and safety from their families and communities,as well as providing more opportunities of social activities in the neighborhoods.

Effect of miRNA from Glycyrrhiza uralensis decoction on gene expression of human immune cells / 中国中药杂志

MicroRNAs(miRNA) are small non-coding RNAs that regulate the expression of protein coding genes by repressing translation of protein coding mRNA or enhancing mRNA degradation. Its functions have attracted more and more attention from the public. In recent years, the cross-border regulation of miRNA has become a new research direction, and provides a new perspective for people to comprehensively understand the functions of miRNA. Plant miRNA is usually methylated and not easy to degrade. According to our previous researches, there were abundant small RNAs in the decoction of dried liquorice, which provides a new way to study the mechanism of action of licorice. In this study, small RNAs extracted from Glycyrrhiza uralensis decoction and synthesized miRNA mimics were used to treat peripheral blood mononuclear cells(PBMC) isolated from healthy volunteers. The gene expression of toll-like receptors(TLRs), some transcription factors, signal molecules and cytokines were analyzed by RT-PCR. The results showed that glycyrrhiza miRNA could significantly regulate PBMC by inhibiting the expression of genes involved in T cell differentiation, inflammation and apoptosis. The study brought new ideas to us in comprehensively studying the mechanism of licorice and developing the traditional Chinese medicine.

Clinical Features With In-hospital and Long-term Prognosis of Acute Myocardial Infarction in Patients Younger Than 40 Years by Different Genders / 中国循环杂志

Objective: To evaluate clinical features with in-hospital and long-term prognosis of acute myocardial infarction (AMI) in patients ≤40 years of age by different genders and to analyze the predictors for major adverse cardiovascular event (MACE) occurrence. Methods: A total of 685 AMI patients ≤40 years treated in our hospital from 2012-01-01 to 2015-08-31 were consecutively enrolled. The patients were divided into 2 groups by gender: Male group,n=650 and Female group,n=35. The baseline data, clinical features, in-hospital MACE incidence were collected by telephone communication and compared between 2 groups; the long-term risk factors for MACE occurrence were analyzed. Results: The AMI ratio in male patients was 94.89%, in female was 5.11% and the onset age in Male group was higher than Female group (35.53±4.21) years vs (34.05±4.98) years,P=0.046. Compared with Female group, Male group showed the lower rates of coronary left main diseases (3.2% vs 11.4%,P=0.012) and in-hospital heart failure (8.3% vs 25.7%,P=0.001). The median follow-up time was of 727.0 (411.5, 1102.0) days and during that period, MACE occurrence rates in Male group was 46 (7.1%) cases and in Female group was 2 (5.7%) cases,P=0.758. Increased level of hs-TnI, (OR=1.003, 95% CI 1.001-1.006,P=0.020) and multi coronary artery disease (OR=1.964, 95% CI 1.018-3.790,P=0.044) were the independent predictors for long- term adverse event occurrence; while PCI (OR=0.475, 95% CI 0.241-0.936,P=0.031) was the protector for long-term prognosis in young male AMI patients. Conclusion: AMI patients≤40 years were mainly in male gender, the mean onset age in male was elder than female. Increased hs-TnI level and multi coronary artery disease were the predictors for MACE occurrence, while PCI was the protective factor for long-term prognosis in young male AMI patients.

Clinical characteristics and prognosis of patients with acute myocardial infarction complicated with different parts of heart rupture / 中华危重病急救医学

Objective To analyze the clinical features and prognosis of patients with acute myocardial infarction (AMI) complicated with different parts of heart rupture. Methods Patients diagnosed for AMI complicated with cardiac rupture from January 2010 to December 2015 in Beijing Anzhen Hospital were collected. All of them were divided into free wall rupture group and ventricular septal perforation group according to the rupture site. Clinical features, hospital related examination results, treatment and prognosis of these two groups were analyzed statistically. Results A total of 120 patients with AMI complicated with cardiac rupture were included in the study, including 64 patients with free wall rupture, and 56 patients with ventricular septal perforation. Compared with the ventricular septal perforation group by the single factor analysis, the patients in free wall rupture group had higher age (year: 68.88±9.31 vs. 63.86±8.68, t = 3.039, P = 0.003), lower body mass index [BMI (kg/m2): 22.74±2.07 vs. 25.21±2.99, t = -5.203, P = 0.000], higher rate of history of renal insufficiency (12.5% vs. 1.8%, χ2 = 4.942, P = 0.026), higher level of aspartate transaminase [AST (U/L): 76.00 (38.33, 197.50) vs. 33.50 (19.00, 137.50), Z = -2.788, P = 0.005], triglyceride [TG (mmol/L): 1.68±0.50 vs. 1.36±0.70, t = 2.903, P = 0.005], total cholesterol [TC (mmol/L): 4.21±0.74 vs. 3.87±1.01, t = 2.081, P = 0.040], high density lipoprotein cholesterol [HDL-C (mmol/L): 1.12±0.91 vs. 0.91±0.32, t = 2.910, P = 0.004] and cardiac troponin I [cTnI (μg/L): 18.83 (4.48, 81.68) vs. 0.82 (0.08, 8.50), Z =-5.011, P = 0.000], lower level of blood urea nitrogen [BUN (mmol/L): 7.11±3.11 vs. 10.14±6.97, t = -2.999, P = 0.004], brain natriuretic peptide [BNP (ng/L): 169.00 (98.50, 485.75) vs. 793.00 (478.75, 1 426.25), Z = -5.739, P = 0.000], and D-dimer [μg/L: 219.00 (141.00, 315.75) vs. 310.50 (188.75, 532.00), Z = -2.607, P = 0.009], smaller left ventricular end diastolic diameter [LVEDD (mm): 48.58±5.17 vs. 53.65±6.63, t = -4.631, P = 0.000] and left ventricular end systolic diameter [LVESD (mm): 33.54±5.40 vs. 37.24±6.53, t = -3.397, P = 0.001], lower proportion of left ventricular aneurysm formation [14.1% (9/64) vs. 76.8% (43/56), χ2 = 47.851, P = 0.000] and pulmonary arterial hypertension [20.3% (13/64) vs. 53.6% (30/56), χ2 = 14.368, P = 0.000], higher usage rate of aspirin [100% (64/64) vs. 75.0% (42/56), χ2 = 18.113, P = 0.000], clopidogrel usage rate [82.8% (53/6) vs. 46.4% (26/56), χ2 = 17.578, P = 0.000], ticagrelor usage rate [12.5% (8/64) vs. 1.8% (1/56), χ2 = 4.924, P = 0.026], and common heparin usage rate [53.1% (34/64) vs. 10.7% (6/56), χ2 = 24.174, P = 0.000], lower usage rate of nitrates [70.3% (45/64) vs. 85.7% (48/56), χ2 = 4.063, P = 0.044], higher percutaneous coronary intervention (PCI) operation rate [42.9% (27/64) vs. 12.5% (7/56), χ2 = 13.388, P = 0.000], lower coronary artery bypass graft (CABG) surgery rate [7.8% (5/64) vs. 48.2% (27/56), χ2 = 24.930, P = 0.000], success rate of CABG surgery [60.0% (3/5) vs. 100% (27/27), χ2 = 8.233, P = 0.004], and incidence rate of cerebral infarction in hospital [1.6% (1/64) vs. 10.7% (6/56), χ2 = 4.554, P = 0.033], higher hospital all-cause mortality [85.9% (55/64) vs. 23.2% (13/56), χ2 = 47.851, P = 0.000]. The differences of other indicators were not statistically sig nificant. Conclusions Patients with AMI complicated with free wall rupture usually have more risk factors and worse prognosis. These two types of patients should be treated with target.

Effect of Zhizhu Pill on Gastric Smooth Muscle Contractile Response and Protein Expression of Growth Hormone Secretagogue Receptor in Functional Dyspepsia Rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the therapeutic mechanism of Zhizhu Pill (ZP) for treating functional dyspepsia (FD) rats.</p><p><b>METHODS</b>Totally 30 ten-day-old male rats were randomly divided into the normal control group (n =10) and the model group (n = 20). The FD rat model was induced using gastric administration of 0.1% iodoacetamide (IA) combined tail clamping. The model was evaluated when rats were 8-week old. Successfully modeled rats were randomly divided into the model group (n = 10) and the ZP group (n = 10). Rats in the normal group and the model group were administered with normal saline by gastrogavage, while those in the ZP group were administered with ZP Decoction (2 mL/100 g) by gastrogavage. All medication lasted for 7 successive days. The contractile activity in in vitro longitudinal gastric muscle was recorded using Power Lab biological signal collecting system. The expression of growth hormone secretagogue receptor (GHSR) in stomach of FD rats was detected using Western blot and immunohistochemistry (IHC).</p><p><b>RESULTS</b>Compared with the normal group, average frequencies of gastric contraction and changing rates of amplitude obviously decreased in the model group (P < 0.05). Results of Western blot and IHC showed that the expression of GHSR decreased in the model group (P < 0.01). Compared with the model group, average frequencies of gastric contraction and changing rates of amplitude obviously increased in the ZP group (P < 0.05). Results of Western blot and IHC showed that the expression of GHSR increased in the ZP group (P < 0.01).</p><p><b>CONCLUSION</b>ZP could promote the gastric motility in FD rats induced by gastric administration of IA combined tail clamping, and its mechanism might be related to up-regulating GHSR protein level.</p>

Awareness evaluation of National Essential Medicine System among pharmacists from seconda-ry public hospitals in Shaanxi province:Based on KAP questionnaire survey / 中国卫生政策研究

Objective:To evaluate the knowledge, attitudes and practices ( KAP) on National Essential Medi-cine System among pharmacists from secondary public hospitals in Shaanxi province. Methods: The quantitative re-search of KAP questionnaire is used, and the content of questionnaire includes personal information, knowledge, atti-tudes and practices. Results: A total of 520 copies of questionnaires were distributed and 82. 3% were effective. Respondents’ overall knowledge and attitudes are at the middle level;the main way to obtain knowledge is via training and meeting;respondents’ education level and frequency of participating in training have a significant impact on their level of knowledge;the degree of attention paid by hospitals has yet to be strengthened; and respondents are mostly concerned about the supply and distribution of essential drugs. Conclusion: In order to improve the awareness and recognition levels of pharmacists on the implementation of National Essential Medicine System in secondary public hospitals, the government should take the relevant measures, including introducing the high educated persons into secondary public hospitals, organizing related training programs and standardizing the daily monitoring of essential drugs in secondary public hospitals, etc.