Prognostic relevance of number and ratio of metastatic lymph nodes in resected carcinoma of the ampulla of Vater

Objectives： To explore the prognostic relevance of the number and ratio of metastatic lymph nodes in resected Carcinoma of the ampulla of Vater （CAV）. Methods： The clinical data of 155 patients who underwent pancreaticoduodenectomy （PD） for cancer of the ampulla of Vater between January 1990 and December 2010 were retrospectively analyzed. Kaplan- Meier method was used in survival analysis and Log rank method in comparison. Multivariate analysis was performed using Cox proportional hazards model. Results： Among these 155 patients, the in-hospital mortality rate was 4.5%, lymph node positive disease was 21.3%, and the 5-year survival rate was 51.6%. Patients with a lymph node ratio （LNR） 〉20% were more likely to have tumor differentiation, depth of duodenal involvement, depth of pancreatic invasion, T-stage and TNM-Stage. The number of the metastatic lymph nodes is important prognostic factors of the CAV. Univariate analysis showed that the factors associated with the prognosis included tumor size （P=0.036）, tumor differentiation （P=0.019）, LNR （P=0.032）, mtmber of metastatic lymph nodes （P=0.024）, lymph node metastasis （P=0.03）, depth of pancreatic invasion （P=0.001）, T-stage （P=0.002）, TNM stage （P=0.001）, elevated CA 19-9 （P=0.000）, and jaundice （P=0.021）. Multivariate analysis showed that the factors associated with the prognosis were the number of metastatic lymph nodes （P=0.032; RR： 1.283; 95% CI： 1.022-1.611）, tumor size （P=0.043; RR： 1.736; 95% CI： 1.017-2.963）, and elevated CA 19-9 （P=0.003; RR： 3.247; 95% CI： 1.504-7.010）. Conclusions： LNR is a useful factor for predicting the prognosis of the radical treatment for CAV,, whereas the number of metastatic lymph nodes is the most important factor. Further research on the locations, number, and LNR will be clinically meaningful to improve survival in patients with CAV.

Urinary Myeloperoxidase to Creatinine Ratio as a New Marker for Diagnosis of Urinary Tract Infection

Objective To determine whether urinary myeloperoxidase to creatinine ratio(MCR) can serve as a marker for diagnosis of urinary tract infection(UTI).Methods Patients suspected of UTI were consecutively enrolled and further divided into the culture positive and the sterile groups according to urine culture results. Subsequently, MCR, white blood cell(WBC) and bacteria in the urinary samples from patients were detected and compared between the two groups.Results Finally, 253 patients were enrolled including 157 urine culture positive patients and 96 urine culture negative patients(sterile group). After logarithmic transformation in 2 as the base, the MCR, WBC, and bacteria were separately presented as log_2^(MCR), log_2^(WBC)(quantitative), and logbacteria2. The values of log_2^(MCR)(8.6±2.5 vs. 5.4±1.5, t=-12.453, P=0.001), log_2^(WBC)(quantitative)(8.0±2.5 vs. 5.2±1.8, t=-10.332, P=0.001), logbacteria2(11.4±2.5 vs. 8.2±2.8, t=-9.297, P=0.001) and WBC(semi-quantitative) [2(interquartile range 1, 3) vs. 1(interquartile range 0.5, 1), Z=-7.580, P=0.001] showed significant difference between the urine culture positive group and the sterile group. Among the urine culture positive group, the values of log_2^(MCR) of the gram positive and gram negative subgroups were 7.2±2.5 and 9.0±2.4(t=4.016, P=0.001), respectively. The correlation between log_2^(MCR) and log_2^(WBC)(quantitative), log_2^(bacteria), WBC(semi-quantitative) was 0.708(Pearson correlation, P=0.001), 0.381(Pearson correlation, P=0.001), and 0.606(Spearman correlation, P=0.001), respectively.Conclusions MCR is positively correlated with WBC counts and could be ser ved as a promising biomarker for diagnosis of UTI. MCR could be even used for initial inference of infectious bacteria types of UTI.

Nerve coblation for treatment of trigeminal neuralgia: A case report

BACKGROUND Trigeminal neuralgia(TN) is a severe type of neuropathic pain which is often inadequately managed using conventional therapies. In this report, we present the first case of TN treated with gasserian ganglion nerve coblation(NC).CASE SUMMARY A 58-year-old man presented with right facial pain, mostly localized in the right zygomatic zone, alveolar region, and jaws. Similar to acupuncture and shock pain, the pain lasted about five seconds after each attack before resolving unaided. A diagnosis of TN was made, after which treatment with acupuncture therapy and oral carbamazepine was given. However, the pain was not satisfactorily controlled. Subsequently, gasserian ganglion NC of the right trigeminal nerve guided by computed tomography(CT) was performed on the patient. Following this procedure, the right zygomatic, alveolar, submandibular,and cheek pain disappeared completely. The right zygomatic and alveolar areas experienced mild numbness(level II). At 1-, 2-, 3-, and 6-mo follow-ups after surgery, the patient was painless and the numbness score was level I.CONCLUSION CT-guided gasserian ganglion(NC) is an effective treatment for TN and is associated with less or no postoperative numbness or hypoesthesia in comparison with current standard-of-care approaches.

Effect of ramipril on progression of nonculprit lesions in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention

Objective To investigate the effect of ramipril on progression of nonculprit lesions in patients with ST-elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(PPCI). Methods A total of 200 patients(60.1 ± 11.3 years) with STEMI who underwent successful PPCI from January 2010 to December 2013 were enrolled in this study. All patients underwent PPCI as treatment for culprit lesions. Patients were divided into two groups according to the dosage of ramipril used at hospital discharge as follows: high dosage group(2.5–10 mg, q.d.) and low dosage group(1.25–2.5 mg, q.d.). Clinical and angiographic follow-up was performed for 12 months. The primary endpoint was clinically-driven percutaneous coronary intervention(PCI) for nonculprit lesions. The clinical and angiographic features were analyzed. Results Clinical and angiographic follow-up was performed with 87 patients in the high dosage group and 113 patients in the low dosage group. The numbers of patients who underwent additional PCI were six and 20 in the high and low dosage groups, respectively. The rate of having additional PCI performed was lower in the high dosage group than in the low dosage group(6.90% vs. 17.70%, P = 0.03). Conclusions A high dosage of ramipril may prevent progression of nonculprit lesions, which could be the major cause of recurrent PCI in patients with STEMI after PPCI.

Serum Myeloperoxidase Level in Systemic Lupus Erythematosus

SYSTEMIC lupus erythematosus （SLE） is a systemicautoimmune disease. Several mechanismshave been put forward as underlying the loss ofself-tolerance and development of organdysfunction, such as genetic, environmental, hormonal andimmunoregulatory factors.

Meta-analysis of the relationship between cytotoxin-associated gene-A and ischemic stroke subtypes

OBJECTIVE： To assess the role of cytotoxin-associated gene-A （CagA） positive strains of Helicobacter pylori （Hp） in ischemic stroke （IS） subtypes. DATA SOURCES： A computer-based online search of PubMed, EMBASE, the Cochrane Collaboration database, the CNKI database and the VIP database, from January 1997 to July 2010, was performed to find relevant studies. DATA SELECTION： Case-control studies relevant to CagA with IS and IS subtypes were selected. Data regarding related factors in the case group and control group were acquired using the same approach. All patients had been diagnosed as exhibiting IS using skull CT or MRI, and were etiologically typed according to the 1993 TOAST diagnosis criteria. Two investigators independently performed the same search and study selection. Meta-analyses were then performed for the selected studies using RevMan 5.0 software （Cochrane Collaboration） after strict screening. Heterogeneity tests, sensitivity analyses and publication bias assessments were then conducted. MAIN OUTCOME MEASURES： Relationship of CagA with IS and IS subtypes. RESULTS： Eight studies were selected, involving data from 879 patients with IS, and 849 healthy controls. Five out of eight of the selected studies were related to large artery atherosclerosis （461 patients with IS and 497 health controls）. The results of our meta-analysis revealed a significant association between prior infection with CagA-positive strains and increased risk of IS （odds ratio （OR） = 2.31,95% confidence interval （C/）： 1.89-2.82, P 〈 0.01）, In addition, we found an association between infection with CagA-negative strains and IS （OR = 0.57, 95%C1：0.47 0.70, P 〈 0.01）. CagA positive and negative strains were found to correlate with large artery atherosclerosis （CagA-positive strains： OR = 2.87, 95%C/： 2.19-3.77, P 〈 0.01; CagA-negative strains： OR = 0.51, 95%CL 0.39 0.67, P 〈 0.01）. Because of the diversity of etiological factors in the case-control study, we conducted further analyses after correcting for confounding factors, and the overall effects were recalculated. The results revealed significant relationships between CagA-positive strains and IS （OR = 2.36, 95%C1： 1.84-3.02, P 〈 0.01）, and between CagA-positive strains and large artery atherosclerosis （OR = 3.10, 95%C1： 2.29-4.19, P 〈 0.01 ）. A heterogeneity test of CagA-positive strains in IS and its subtypes revealed good homogeneity （f = 0%; f = 0%） and we adopted a fixed-effects model to calculate OR. Sensitivity analysis confirmed that the results of the meta-analysis were reliable. However, the funnel plot suggested that the experimental results may be affected by bias, possibly resulting from a lack of published studies reporting negative outcomes in the meta-analysis. CONCLUSION： Infection with CagA-positive strains is a risk factor for IS, especially the large artery atherosclerosis subtype. However, the evidence from case-control studies is weak, and more prospective studies are required to conclusively determine whether infection by CagA-positive strains should be considered a novel risk factor for IS and its subtypes.

Artificial Intelligence Providing a More Optimized Assessment Tool for Comprehensive Geriatric Assessment

With the continuous development of science and technology,artificial intelligence(AI)is coming into our lives and changing our lives.Since China entered the aging society in 2000,the degree of population aging has deepened.Comprehensive geriatric assessment(CGA)is now the accepted gold standard for the care of older people in hospitals.However,some problems limit the clinical application,such as complexity and time consuming.Therefore,by analyzing previous studies,we summarize some existing AI tools in order to find a more optimized assessment tool to complete the entire CGA process.

A developed ant colony algorithm for cancer molecular subtype classification to reveal the predictive biomarker in the renal cell carcinoma

Background:Recently,researchers have been attracted in identifying the crucial genes related to cancer,which plays important role in cancer diagnosis and treatment.However,in performing the cancer molecular subtype classification task from cancer gene expression data,it is challenging to obtain those significant genes due to the high dimensionality and high noise of data.Moreover,the existing methods always suffer from some issues such as premature convergence.Methods:To address those problems,we propose a new ant colony optimization(ACO)algorithm called DACO to classify the cancer gene expression datasets,identifying the essential genes of different diseases.In DACO,first,we propose the initial pheromone concentration based on the weight ranking vector to accelerate the convergence speed;then,a dynamic pheromone volatility factor is designed to prevent the algorithm from getting stuck in the local optimal solution;finally,the pheromone update rule in the Ant Colony System is employed to update the pheromone globally and locally.To demonstrate the performance of the proposed algorithm in classification,different existing approaches are compared with the proposed algorithm on eight high-dimensional cancer gene expression datasets.Results:The experiment results show that the proposed algorithm performs better than other effective methods in terms of classification accuracy and the number of feature sets.It can be used to address the classification problem effectively.Moreover,a renal cell carcinoma dataset is employed to reveal the biological significance of the proposed algorithm from a number of biological analyses.Conclusion:The results demonstrate that CAPS may play a crucial role in the occurrence and development of renal clear cell carcinoma.

Correlation between Helicobacter pylori infection and atherothrombotic stroke

Previous studies have demonstrated that Helicobacterpylori infection is associated with coronary atherosclerotic heart disease, but the correlation between Helicobacterpylori infection and ischemic stroke remains unclear. The present study assessed the effects of Helicobacter pylori infection on atherothrombotic stroke. This study included 115 individuals with atherothrombotic stroke, all of whom were patients receiving treatment at the Department of Neurology, Aerospace Central Hospital （Aerospace Clinical Medical College Affiliated to Peking University） in China, from March 2006 to July 2009. In addition, 131 controls without the history of cardiovascular disease, cerebrovascular disease or atherothrombosis were also enrolled in the study. Results show that the Helicobacterpylori-lgG positive rate was greater in the atherothrombotic stroke patients than in the controls, but the difference was not statistically significant （67.8% vs. 61.8%, OR = 1.301,95%C/： 0.769-2.203, P = 0.327）. After correction for potential risk factors for Helicobacter pylori infection and known risk factors for ischemic stroke, no significant difference was detected between them （OR = 1.278, 95%C1： 0.667-2.449, P = 0.459）. These results indicate that there is no specific correlation between Helicobacterpylori infection and atherothrombotic stroke. This finding requires further verification in large-sample prospective studies.

Correlation of serum trace element changes with inflammatory cytokines and oxidative stress indexes in patients with urinary tract infection

Objective: To study the correlation of serum trace element changes with inflammatory cytokines and oxidative stress indexes in patients with urinary tract infection (UTI). Methods: The patients who were diagnosed with lower urinary tract infection in our hospital between March 2013 and December 2017 were selected as the UTI group and the healthy volunteers who received physical examination were selected as the control group. Serum was collected to measure the contents of trace elements and inflammatory cytokines, and urine was collected to measure the contents of oxidative stress indexes. Results: The content of Zinc (Zn) in serum of the UTI group was significantly lower than that of the control group (P<0.05) while the contents of Copper (Cu), Selenium (Se), Calcium (Ca) and Magnesium (Mg) were not significantly different from those of the control group (P>0.05);the contents of C-reactive protein (CRP), amyloid protein A (SAA), procalcitonin (PCT), intercellular adhesion molecule-1 (ICAM-1), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-5(IL-5), interleukin-17(IL-17) and transforming growth factor-β1 (TGF-β1) in serum as well as the contents of malondialdehyde (MDA) and advanced oxidation protein product (AOPP) in urine of the UTI group were significantly higher than those of the control group and negatively correlated with the content of Zn in serum (r=-0.514, -0.573, -0.475, -0.636, -0.612, -0.585,-0.492, -0.537, -0.611, -0.476 and -0.542, p=0.015, 0.011, 0.024, 0.007, 0.009, 0.010, 0.020, 0.014, 0.009, 0.024 and 0.013) while the contents of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) in urine were significantly lower than those of the control group and positively correlated with the content of Zn in serum (r=0.592, 0.657 and 0.610, p=0.010, 0.002 and 0.009). Conclusion: Serum trace element Zn significantly decreases in patients with urinary tract infection and it is closely related to the occurrence of disease as well as the abnormality of inflammation, immune response and oxidative stress in the course of the disease.

Changes of cerebral blood flow in rats with acute cerebral ischemia and the effect of nitric oxide donor S-nitroso-N-acetyl-penicillamine

BACKGROUND ： Previous studies show that nitric oxide donor can increase cerebral blood flow and improve the function of neurons in cerebral ischemia, but the change does not happen in all the models of cerebral ischemia. OBJECTIVE ： To observe the effects of nitric oxide donor S-nitroso-N-acetyl-penicillamine （SNAP） on the cerebral blood flow, cyclic guanosine monophosphate （cGMP） content in cerebral cortex, infarct volume and blood pressure in acute ischemic rat brain.DESIGN ： A randomized and control animal experiment SEI-FING ： Department of Neurosurgery, Aerospace Central Hospital, Peking University.MATERIALS： Twenty-eight male Wistar rats of SPF grade, weighing 250-300 g, aged 10-12 weeks were randomly divided into control group （n =14） and SNAP-treated group （n =14）. SNAP （5 mg/bottle） was provided by Beijing Chemical Reagent Company. Laser Doppler Flowmeter （FLO C1; Omegawave Inc., Tokyo, Japan） and immunoassay kit （Amersham Pharmacia Biotech, UK） were applied. METHODS： ① Model establishment： In the control group, models of cerebral ischemia were induced by ligating right common, internal and external carotid arteries; In the SNAP-treated group, models of cerebral ischemia were induced by ligating right common and external carotid arteries, followed by occluding middle cerebral artery and ligating internal carotid artery. ②Administration： In the SNAP-treated group, SNAP （100 μg/kg） was intravenously infused within 2 minutes, whereas in the control group, phosphate buffered saline （PBS, 1 mL） was intravenously infused （0.5 mL per minute）. Six rats were used to measure the volume of cerebral infarction, and the other 8 rats were used to determine other indexes in each group respectively. ③ Determination of indexes： Regional cerebral blood flow （rCBF） was continuously measured by laser-Doppler flowmetry in the ischemic penumbra and contralateral cortex under the continuous monitoring of blood pressure, cGMP concentrations in brain tissue were determined using the enzyme immunoassay 20 minutes after administration. SNAP and PBS were infused in the SNAP-treated group and control group respectively at 10 minutes and 2 hours after ischemia, and the infarct volumes were estimated by 2,3,5-triphenyltetrazolium chloride staining. The differences of the measurement data were compared with the ttest. MAIN OUTCOME MEASURES ： The change of the cGMP and rCBF in acute ischemic rat brain were investigated and recorded after SNAP intravenous infusion. RESULTS ： All the 28 rats were involved in the final analysis of results. ① rCBF： The rCBF in the ischemic side at the median part of the right frontoparietal cortex decreased to a similar extent between the control group and SNAP-treated group [（58.5±15.5）%, （53.0±11.2）%,t =1.345,P =0.10], which suggested that the severity of ischemia was comparative between the two groups. No significant change was observed in rCBF after the administration of PBS, and there was no obvious difference between the left and right cortices （t =0.896, P 〉 0.05）. The rCBF in cortex of the ischemic side decreased at 15 and 20 minutes after administration of SNAP, and it was significantly different in the ischemic （right） and the contralateral （left） cortices （t =2.298, P =0.01 ; t =3.499, P〈 0.01）. ② cGMP levels in bilateral cortices： The cGMP levels in the ischemic and contralateral cortices in the SNAP-treated group were not significantly different [（163.02±40.7） and （162.47±43.98） pmol/g, P 〉 0.05], but were obviously higher than those in the control group [（ 105.86 ±29.4）, （112.21 ±20.64） pmol/g, t =2.977, 2.560, P 〈 0.01]. ③ Volume of cerebral infarction： The infarction lesions were found mainly focused in the caudate nucleus and cerebral cortices in the right middle cerebral artery distribution field after 4 hours. The infarct volume in the control group was close to that in the SNAP-treated group [（123.35 ±55.08）, （130.25±68.32） mm3, t =1.998, P 〈 0.05]. ④ Changes of blood pressure： The mean arterial blood pressure in the SNAP-treated group 5 minutes after SNAP infusion was obviously lower than that in the control group （t =1.985, P 〈 0.05）. CONCLUSION： The intravenous infusion of SNAP therapy for cerebral ischemia can cause cGMP increase through acting in the upstream of the nitric oxide-cGMP reaction chain. SNAP did not decrease the volume of the cerebral infarction, and it did not protect the brain. However, SNAP can play a role in vasodilation and de- compression.

Effect of Gardenia extract ZG on the adsorption quantity of herpes simplex virus type 1 (HSV-1)

To observe the effect of Gardenia extract ZG on the adsorption quantity of herpes simplex virus type 1 （HSV-1） so as to explore the mechanism of its antiviral activity, fluorescein isothiocyanate （FITC） was used as the fluorescent probe to label viruses and heparin sodium was used as control. Meanwhile, the effect of Gardenia extract ZG on the adsorption quantity on the surface of Hep-2 cells was determined by flow cytometry. It was demonstrated that adsorption of HSV-1 on the surface of Hep-2 cells exhibited the character of saturation and specificity and heparin sodium could prevent attachment of viruses on these ceils. These results are in accord with those reported previously. It was also proved that the manner of drug-use prior to adsorption or simultaneous use of drug and adsorption was better than adsorption prior to drug-use, and the inhibition rates of the former and latter manner were 84.76% and 82.92% respectively. Three manners of drug-use with Gardenia extract ZG were all effective to reduce the adsorption quantity of viruses, especially the manner of simultaneous use of drug and adsorption with an adsorption inhibition rate of 68.46%. From the above observation, it is apparent that the mechanism of anti-viral activity of Gardenia extract ZG may be via several steps involved in the HSV-1 adsorption.

Lovastatin changes activities of lactate dehydrogenase A and B genes in rat myocardial cells

Background Lactate dehydrogenase （LDH） is a crucial regulator of energy metabolism in many organs including the heart. Lovastatin is widely used in prevention and treatment of coronary heart disease and is a drug with substantial metabolic influences. Our study aimed to determine the activities of the lactate dehydrogenase A and B （LDHA and LDHB）genes following lovastatin treatment.Methods The rat myocardial cell line H9c2（2-1） in culture was exposed to 100 nmol/L lovastatin for 24 hours or for five days. The functions of the LDHA and LDHB genes were examined at the transcriptional （mRNA） level with quantitative real-time polymerase chain reaction （Q-RT-PCR）, and at the translational （protein） level with immunoblotting.Results When compared with control levels, the LDHA mRNA went up by （151.65±16.72）% （P=0.0132） after 24 hours and by （175.28±56.54）% （P=0.0366） after five days of lovastatin treatment. Although 24 hours of lovastatin treatment had no significant effects on LDHB mRNA levels, when the treatment was extended to five days, LDHB mRNA levels were significantly down-regulated to （63.65±15.21）% of control levels （P=0.0117）. After 24 hours of treatment with lovastatin,there were no significant changes in protein levels of either LDHA or LDHB. When treatment time was extended to five days, the protein levels of LDHA were up-regulated by （148.65±11.81）% （P=0.00969）, while the protein levels of LDHB were down-regulated to （64.91±5.47）% of control levels （P=0.0192）.Conclusions Lovastatin affects gene activities of LDHA and LDHB differently, which may reveal novel pharmacological effects of lovastatin.

Gut microbiota from end-stage renal disease patients disrupt gut barrier function by excessive production of phenol

End stage renal disease (ESRD), an advanced stage of chronic kidney disease, has received increasing attention as a leading public health problem (Webster et al., 2017). Chronic kidney disease (CKD) and ESRD are invariably accompanied by chronic systemic inflammation which plays central roles in CKD progression (Cachofeiro et al., 2008) and the increased mortality due to cardiovascular disease (Landray et al., 2004).

Regulation of lovastatin on a key inflammation-related microRNA in myocardial cells

Background Advances in the understanding of cardiovascular pathogenesis have highlighted that inflammation plays a central role in athemsclemtic coronary heart disease.Therefore,exploring pharmacologically based anti-inflammatory treatments to be used in cardiovascular therapeutics is worthwhile to promote the discovery of novel ways of treating cardiovascular disorders.Methods The myocardial cell line H9c2（2-1） was exposed to lipopolysacchadde （LPS） in culture and resulted in a cellular pro-inflammation status,miR-21 microRNA levels were detected using quantitative real-time polymerase chain reaction （Q-RT-PCR）.The influence of Iovastatin on miR-21 under normal and pro-inflammatory conditions was tested after being added to the cell culture mixture for 24 hours.Conditional gene function of two predicted cardiovascular system relevant downstream targets of miR-21,protein phosphatase 1 regulatory subunit 3A （PPP1R3A） and signal transducer and activator of transcription 3 （STAT3）,were analyzed with immunoblotting.Results Forty-eight hours of LPS treatment significantly increased the miR-21 to 170.71%±34.32% of control levels （P=0.002）.Co-treatment with Iovastatin for 24 hours before harvesting attenuated the up-regulation of miR-21 （P=0.013）.Twenty-four hours of Iovastatin exposure up-regulated PPP1R3A to 143.85%±21.89% of control levels in cardiomyocytes （P=0.023）.Lovastatin up-regulated the phosphorylation level of STAT3 compared to the background LPS pretreatment （P=0.0077）,this effect was significantly （P=0.018） blunted when miR-21 was functionally inhibited.Conclusions miR-21 plays a major role in the regulation of the cellular anti-inflammation effects of Iovastatin.

Four-year dynamic observation and study on standardized management of elderly patients with type 2 diabetes in Beijing Yongding Road Community

Purpose:This study aimed to understand the joint standard of blood glucose,blood li-pids,and blood pressure in elderly patients>60 years of age with type 2 diabetes in the Beijing Yongding Road Community.Methods:One hundred ninety-two elderly patients>60 years of age who were diagnosed with type 2 diabetes in Yongding Road Community served as the investigation subjects,under-went standard management,and the dynamic changes in blood glucose,blood lipids,and blood pressure were monitored for 48 months.Results:At the end of the observation period,the standard rates of fasting blood glucose and postprandial blood glucose were 72.55%and 80.00%,respectively,which were increased compared with 55.73%and 56.08%at baseline(P<0.01).The standard rate of HbA1c was 59.81%,which was increased compared with 53.44%at baseline(P>0.05).The standard rates of TG and LDL-C were 76.71%and 60.38%,respectively,which were increased compared with 54.69%and 34.74%at base-line,and the standard rate of HDL-C was 13.64%,which was decreased compared with 40.10%at baseline(P<0.01).The standard rate of BP was 58.33%,which was increased compared with 38.54%at baseline(P<0.01).The optimal control rate of blood glucose for 48 months(the standard times of the total measurement times in 48 months≥75%)was higher;the fasting blood glucose was 52.17%,the 2-h postprandial blood glucose was 60.22%,and the HbA1c was 46.45%.The optimal control rate of blood lipids was lower;LDL-C was 17.49%and HDL-C was 13.59%.The optimal control rate of BP was 9.13%.At the end of the observation period,the levels of fasting blood glucose and postprandial blood glucose were decreased by 0.7 mmol/L and 1.48 mmol/L,respectively,compared with the base-line(P<0.01).The level of HbA1c was decreased by 0.18%compared with the baseline(P<0.05).The levels of LDL-C and HDL-C were decreased by 0.4 mmol/L and 0.23 mmol/L,respectively,compared with the baseline(P<0.01).The levels of SBP and DBP were decreased by 4 mmHg compared with the baseline(P<0.01).At the end of the observation period,the joint standard rate of the three indices of HbA1c,LDL-C,and BP was 24.72%,which was increased compared with 6.25%at baseline(P<0.01).Conclusion:Standardized management of elderly patients with diabetes in the Community can improve the joint standard rate of blood glucose,blood lipids,and blood pressure.The op-timal control rate and joint standard rate are the important indices for evaluating the quality of diabetes management.

A high-precision multi-dimensional microspectroscopic technique for morphological and properties analysis of cancer cell

Raman and Brillouin scattering are sensitive approaches to detect chemical composition and mechanical elasticity pathology of cells in cancer development and their medical treatment researches.The application is,however,suffering from the lack of ability to synchronously acquire the scattering signals following three-dimensional(3D)cell morphology with reasonable spatial resolution and signal-to-noise ratio.Herein,we propose a divided-aperture laser differential confocal 3D Geometry-Raman-Brillouin microscopic detection technology,by which reflection,Raman,and Brillouin scattering signals are simultaneously in situ collected in real time with an axial focusing accuracy up to 1 nm,in the height range of 200μm.The divided aperture improves the anti-noise capability of the system,and the noise influence depth of Raman detection reduces by 35.4%,and the Brillouin extinction ratio increases by 22 dB.A high-precision multichannel microspectroscopic system containing these functions is developed,which is utilized to study gastric cancer tissue.As a result,a 25%reduction of collagen concentration,42%increase of DNA substances,17%and 9%decrease in viscosity and elasticity are finely resolved from the 3D mappings.These findings indicate that our system can be a powerful tool to study cancer development new therapies at the sub-cell level.

Drug-resistant genes carried by Acinetobacter baumanii isolated from patients with lower respiratory tract infection

Background Acinetobacter baumanii （A. baumanii ） remains an important microbial pathogen resulting in nosocomialacquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A. baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple 13-1actamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections （LRTIs）. Methods Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system. Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods. Results Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanfi strains to ampicillin and first- and second-generation cephalosporins （94.87%, 100% and 97.44%, respectively）, but also to the third-generation cephalosporins （ceftriaxone at 92.31%, ceftazidine at 51.28%） and imipenem （43.59%） as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains. Aminoglycoside-modifying enzyme gene aac-3-1a was found in 23 strains, and the aac-6＂lb gene in 19 strains, aac-3-1a and aac-6＂lb genes hibernated in three A. baumanfi strains that showed no drug-resistant phenotype. Conclusions A. baumanii can carry multiple drug-resistant genes at the same time and result in multi-drug resistance. Aminoglycoside-modifying enzyme genes could be hibernating in aminoglycoside sensitive strains without expressing their phenotype.

Two Cases of Intrauterine Adhesions with Rare Hysteroscopic Findings

An intrauterine adhesion （IUA） is a form of disease that causes the uterine muscle walls to become adhered to each other due to the basal layers of the endometrium being damaged by various factors, thus resulting in partial or complete occlusion of the uterine cavity.

Polarographic immunoassay coupled with catalysis of non-radioactive multiple iodine label

A now polarographic immunoassay was developed In this assay,human serum albumin (HSA) as the model antigen was covalently labeled with organic compound erythrosin B(EB) containing four non-radioactive iodides through Ⅰ step chemical reaction The labeling procedure is simple and the conditions needed are moderate.The molar labeling ratio of KB HSA was 12 Ⅰ The content of iodine in the conjugate obtained by the proposed procedure is ninth higher than that by the other existing methods.A heterogeneous competitive immunoassay was established by compling the catalysis of the conjugate to substrate As(Ⅲ)-Ce(Ⅳ) reaction with the linear-sweep polarographic detec-tion of As(Ⅲ) amount HSA can be determined in the HSA concentration range from 1 to 200μg/mL,with the de-tection hum of 0 66μg/ml.