Tissue distribution of Qingfei Paidu Decoction based on HPLC-MS/MS / 中国中药杂志

The tissue distribution of Qingfei Paidu Decoction was studied by HPLC-MS/MS in vivo. Hypersil GOLD C_(18) column(2.1 mm×50 mm, 1.9 μm) was used for gradient elution with acetonitrile as the mobile phase A and 0.1% formic acid solution as the mobile phase B. High-resolution liquid chromatography-mass spectrometry in both positive and negative ion scanning mode and multiple response monitoring(MRM) mode was employed to analyze the behaviors of the active components of Qingfei Paidu Decoction in diffe-rent tissues. The results showed that 19, 9, 17, 14, 22, 19, 24, and 2 compounds were detected in plasma, heart, liver, spleen, lung, kidney, large intestine, and brain, respectively. The compounds belonged to 8 groups, covering 14 herbs in the prescription. After administration with Qingfei Paidu Decoction, the compounds were rapidly distributed in various tissues, especially in the lung, liver, large intestine, and kidney. The majority of the compounds displayed secondary distribution. This study comprehensively analyzed the distribution rules of the main active components in Qingfei Paidu Decoction and provided a basis for the clinical application.

Clinical analysis of 3 cases of mucormycosis in children with acute lymphoblastic leukemia and literature review / 中华儿科杂志

Objective: To investigate the clinical features, diagnosis,treatment and prognosis of children with acute lymphoblastic leukemia complicated with mucormycosis, and to improve the understanding of the disease. Methods: The clinical data of 3 children with acute lymphoblastic leukemia (ALL) complicated with mucormycosis treated at the First Affiliated Hospital of Zhengzhou University between October 2020 and January 2021 were analyzed retrospectively. Literature search and review covered the China national knowledge infrastructure, Wanfang database and Pubmed using the keywords of "acute lymphoblastic leukemia" and "mucormycosis" up to June 2021. Results: Case 1, a 12-year-old boy, was diagnosed with ALL, developed fever and chest pain during induction therapy. The Metagenomic next-generation sequencing (mNGS) testing of alveolar perfusion fluid suggested infection with Rhizopus oryzae. Amphotericin B combined with posaconazole was applied and amphotericin B was removed after improvement. Bone destruction was indicated by CT. Amphotericin B was applied again. Case 2, a 4-year-old boy, with a history of pallor and tetter, was diagnosed with ALL. He developed cough and fever during induction therapy. mNGS of blood suggested infection with Rhizomucor pusillus. Amphotericin B combined with voriconazole was applied, but the situation was not significantly improved. The disseminated infection occurred. Amphotericin B combined with posaconazole was applied and vacuum sealing drainage was performed. Case 3, a 2-year-old girl, was diagnosed with ALL, developed fever and cough during induction therapy. Rhizomucor pusillus was indicated by mNGS. Amphotericin B combined with posaconazole was used, and posaconazole was stopped after improvement. Follow-up until June 2021, the condition of the 3 children improved. There was no recurrent Mucor infection, and the primary hematopathy was in complete remission. According to the literature, 7 reports were found in Chinese journals, while 17 reports were found in English literature, 25 cases have been reported. Among a total of 28 children, 11 cases rhino-orbito-cerebral mucormycosis, four pulmonary mucormycosis, 2 cutaneous mucormycosis, 2 gastrointestinal mucormycosis and 9 disseminated mucormycosis. There were 17 cases developed infection during induction chemotherapy, 8 cases during maintenance therapy, 3 cases after hematopoietic stem cell transplantation. Voriconazole was used in 15 cases; 19 cases were treated with combined surgery, 7 cases were treated with drugs only, 2 cases were untreated; 21 cases showed improvement after treatment. Death occurred in seven cases. Conclusions: ALL complicated with mucormycosis often occurs in the stage of induction therapy. The clinical features lacked specificity, mNGS can help find the pathogen and provide evidence for diagnosis. Surgical treatment also could be combined when necessary, which is helpful to improve the prognosis.

Incidence and risk factors of metabolic syndrome in rural community population on islands in Zhejiang province / 中华流行病学杂志

Objective: To estimate the incidence of metabolic syndrome and explore possible risk factors for metabolic syndrome in adults of rural communities in Yuhuan county, Zhejiang province, China. Methods: During June-December, 2018, a follow-up survey was conducted in participants without metabolic syndrome at baseline survey in 2012 to obtain the information collected in questionnaire survey, anthropometric data and laboratory data. The incidence of metabolic syndrome in the participants was estimated, and Logistic regression model was used to explore the risk factors, adjusted risk ratio (aRR) and 95%CI. Results: Among 3 162 participants, 522 new metabolic syndrome cases were identified. The 6-year cumulative incidence rate of metabolic syndrome was 16.5%, and the cumulative incidence rate was higher in women (20.6%) than that in men (12.3%, P<0.001). Those incidence rates were higher in those in jobless, smoking or drinking groups. Being women (aRR=1.96, 95%CI: 1.50-2.58) and family history of hypertension (aRR=1.31, 95%CI: 1.04-1.63) were independent risk factors for metabolic syndrome. Conclusion: The follow up indicated that the incidence of metabolic syndrome was relatively high in rural adults on islands in Zhejiang, and women or those with family history of hypertension were more likely to have metabolic syndrome.

Sentinel lymph Node mapping versus systematic pelvic lymphadenectomy on the prognosis for patients with intermediate-high-risk Endometrial Cancer confined to the uterus before surgery: trial protocol for a non-inferiority randomized controlled trial (SNEC trial) / 부인종양

Background@#Sentinel lymph node (SLN) mapping has been recommended as an alternative staging approach to lymphadenectomy for apparent uterine-confined endometrial cancer (EC). However, the prognostic value of SLN mapping alone instead of systematic lymphadenectomy on EC patients remains unclear. @*Methods@#A multi-center, open label, non-inferiority randomized controlled trial has been designed to identify if SLN mapping alone is not inferior to pelvic lymphadenectomy on prognosis of patients with intermediate-high-risk EC clinically confined to uterus. Eligible patients will be 1:1 randomly assigned to accept SLN mapping or pelvic lymphadenectomy. The primary endpoint is the 2-year progression-free survival (PFS). The second points are the 5-year PFS, 5-year overall survival, surgery-related adverse events and life quality. A total of 780 patients will be enrolled from 6 hospitals in China within 3-year period and followed up for 5 years.

Different methods establish a rat model of morphine drug discrimination with a fixed ratio 10 / 药学学报

In this study, a rat morphine drug discrimination model with a fixed ratio (FR) of 10 (FR10) was established using different methods to explore which methods can shorten the modeling time and test the dose-response relationship and median effective dose (ED50) value. Animal welfare and experimental procedures are in accordance with the provision of the Animal Ethics Committee of Shanghai InnoStar Bio-tech Co., Ltd. Forty rats were initially shaped to press lever under a fixed-ratio schedule of food reinforcement. The animals that were successfully trained under a FR10 schedule of food reinforcement were divided into two groups, namely the single-lever + double-lever training group 1 and the double-lever training group 2. In each group, rats were trained to discriminate morphine at 5.6 mg·kg-1 from saline by the intraperitoneal route. After training, different doses of morphine were used to substitute for training dose of morphine, the dose-response curve for morphine were identified in rats, and the ED50 value was calculated. The results showed that, in food training phase: 34 rats successfully entered the discrimination training during food training; in discrimination training phase: 14 animals in group 1 met the discrimination training standard for the first time, which took about (40.71 ± 2.93) days, and there were 13 animals in group 2 that met the discrimination training criteria for the first time, and it took about (51.15 ± 2.55) days. It can be seen that the method of single-lever + double-lever training is better than single-lever training, and the difference is significant compared with group 1 (P ˂ 0.05); in generalization test phase: there are 17 rats completed morphine generalization test, and the percentages of morphine-lever responses produced by the generalization test of different doses of morphine (0, 0.1, 0.5, 1, 3, 5.6, and 10 mg·kg-1) were (9.56 ± 3.13) %, (9.01 ± 5.83) %, (13.82 ± 7.95) %, (29.04 ± 10.13) %, (41.70 ± 10.65) %, (85.36 ± 7.16) %, (94.56 ± 2.76) %, respectively. The results showed that the discriminative stimulative effect induced by morphine dose between 0-10 mg·kg-1 increased in a dose-dependent manner, producing a good dose-response curve, and the ED50 value of morphine was 4.74 mg·kg-1 by linear fitting. The above results showed that, the FR10 morphine drug discrimination model has been successfully established using different methods; the single-lever + double-lever training method is better than the single-lever training, and can relatively shorten the discrimination training cycle.

A method for expression and activity determination of Anti-Her2 humanized monoclonal antibody / 中国药理学通报

Aim To establish a method for the stable expression of recombinant humanized Anti-her2 monoclonal antibody and to measure its bioactivity. Methods Anti-her2 heavy chain and light chain eukaryotic expression vectors were used to transfect CHO cells, and then scaled-up after screening the stably expressed cell line. Protein A affinity chromatography was utilized to purify the fusion protein. Western blot was used to identify the properties of the product, SDS-PAGE and HPLC were employed to detect its specificity, and CCK8 assay was used to detect its effect on cell viability. Results One cell line with stable expression of recombinant antibody was selected for scale-up. The supernatant was gained for the purification with protein concentration of 135.9 mg · L

Effect evaluation of public health education for on-the-job master students / 上海预防医学

Objective The shortage of health human resources highlights the necessity of high-level public health education.Master of Public Health (MPH) education is an important aspect to improve the ability of public health talents.The purpose of this study is to explore the impact of MPH project on graduates′ career and application of their learned ability in Fudan University. Methods An online questionnaire survey was conducted among Masters of Public Health who graduated from Fudan University from 2006 to 2013 to investigate the impact of MPH learning on their career and public health competency. Results The contribution of MPH project reported by graduates to the improvement of public health professional competence after graduation ranged from 74.7% to 96.5%.Over 90% graduates thought there were 9 competencies among the 23 public health professional competencies in the study of MPH had certain or greater help to their work.And 49.5% of the graduates thought that their leadership level had improved, and 33% participators thought their personal remuneration increased after graduation. Conclusion This study shows that MPH project can help graduates improve their professional ability, promote the construction of public health leadership, and enhance their self-identity.MPH education project still has room to improve in the ability development of graduates regarding community work and policy making.

Penehyclidine Hydrochloride Premedication Is Not Associated with Increased Incidence of Post-Operative Cognitive Dysfunction or Delirium:A Systemic Review and Meta-Analysis / 中国医学科学杂志(英文版)

Objective Post-operative cognitive dysfunction (POCD) and post-operative delirium (POD) are two common post-operative cerebral complications. The current meta-analysis was to systematically review the effects of penehyclidine hydrochloride (PHC) on POCD and POD in surgical patients.Methods Electronic databases were searched to identify all randomized controlled trials comparing PHC with atropine/scopolamine/placebo on POCD and POD in surgical patients. Primary outcomes of interest included the incidences of POCD and POD; the secondary outcomes of interest included peri-operative mini-mental state examination (MMSE) scores. Two authors independently extracted peri-operative data, including patients' baseline characteristics, surgical variables, and outcome data. For dichotomous data (POCD and POD occurrence), treatment effects were calculated as odds ratio () and 95% confidential interval (). Each outcome was tested for heterogeneity, and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity. For continuous variables (MMSE scores), treatment effects were calculated as weighted mean difference (WMD) and 95% . Statistical significance was defined as <0.05.Results Our search yielded 33 studies including 4017 patients. Meta-analysis showed that, the incidence of POCD in PHC group was comparable to that in saline group (=0.97; 95% : 0.58-1.64; =0.92), scopolamine group (=0.78; 95% : 0.48-1.27; =0.32) and atropine group (=1.20; 95% : 0.86-1.67; =0.29). The incidence of POD in PHC group was comparable to that in saline group (=1.53; 95% : 0.81-2.90; =0.19) and scopolamine group (=0.53; 95% : 0.06-4.56; =0.56), but higher than that in atropine group (=4.49; 95% : 1.34-15.01; =0.01).Conclusions PHC premedication was not associated with increased incidences of POCD or POD as compared to either scopolamine or placebo.

Wolffian Adnexal Tumor:Report of One Case / 中国医学科学院学报

This article reports a patient who suffered from Wolffian adnexal tumor.We also briefly elucidate the pathogenesis,clinicopathological features,diagnosis,differentiation,and treatment of Wolffian adnexal tumor,with an attempt to increase the awareness of the disease and reduce misdiagnosis.

Cloning and sequence analysis of leptin receptor overlapping transcript-like 1 gene from Dermatophagoides farinae / 中国血吸虫病防治杂志

Objective To obtain the leptin receptor overlapping transcript-like 1 encoding gene (LepROTL1 gene) from Dermatophagoides farina, investigate the molecular characteristics of the gene and construct a prokaryotic expression vector to express this gene. Methods The LepROTL1 gene-encoding sequence fragments were captured based on the transcriptome sequencing results, and the full-length gene fragments were amplified from total RNA of D. farinae using a RT-PCR assay, and used to construct the expression plasmid pET28a(+)-LepROTL1, followed by sequencing. The plasmid was transformed into E. coli BL21 (DE3) T1R for the induction of IPTG expression. The expression product was characterized by SDS-PAGE and Western blotting. Bioinformatics analyses were performed to analyze the sequence and the molecular characteristics of its encoded protein. Results The amplification products of the RT-PCR assay showed a clear band on agarose gel electrophoresis, and sequencing analysis of the pET28a(+)-LepROTL1 plasmid showed 417 bp in length of the coding gene from the start codon ATG to the termination codon TAA. Following the plasmid transformation into E. coli and induction with IPTG, a specific band was seen on SDS-PAGE, indicating successful expression. Bioinformatics analysis showed that the LepROTL1 gene-encoded protein was composed of 134 amino acids, and had a relative molecular weight of 14 378.13 Da, a hydrophilicity index of 1.149, and certain hydrophobicity. The secondary structure was composed of alpha-helix (19 aa, 14.18%), extended strand (48 aa, 35.82%) and random coil (67 aa, 50.00%). The deduced amino acid sequence was used to obtain homologous genes by BLAST, and the phylogenetic tree showed that D. farinae was clustered with D. pteronyssinus. Conclusion The full-length sequences and expression plasmid of the LepROTL1 gene are obtained, and the molecular features of the gene are demonstrated using bioinformatics analyses, which provide insights into further studies on the gene.

Correlation analysis of plasma lipid with glucose status and insulin resistance in pregnant women with gestational diabetes mellitus / 上海交通大学学报（医学版）

Objective: To investigate the correlation of plasma lipid with gestational diabetes mellitus (GDM) and insulin resistance in women with GDM, and to analyze the effect of plasma lipid on pregnancy outcome. Methods: A total of 922 pregnant women with GDM who underwent prenatal examination in Shanghai Sixth People's Hospital from January 2012 to April 2017 were selected for plasma lipid examination in the second trimester of pregnancy [(14.7±2.8) weeks]. Oral 75 g glucose tolerance test (OGTT) and islet function examination were performed during 24-28 weeks of pregnancy. According to the fasting triacylglycerol (TAG) level in the second trimester of pregnancy, they were divided into three groups: group T1 (TAG ≤ 1.3 mmol/L, n=310), group T2 (1.31.79 mmol/L could be used as an index to predict glucose status in GDM patients (P=0.001). ②Compared with group T1 and T2, group T3 showed significantly increased fasting glucose, fasting insulin, HOMA-IR, MBCI, and decreased WBSIS (all P4.19 mmol/L in the third trimester and TAG level in the second trimester to the third one increasing by 2.38 mmol/L or more, were high risk factors for macrosomia (both P=0.001). Conclusion: Increased TAG (TAG>1.79 mmol/L) in the second trimester is an independent and correlated factor of insulin resistance, which may aggravate GDM. Increased TAG levels (TAG increasing>2.38 mmol/L) from the second trimester to the third one and high TAG (TAG>4.19 mmol/L) in the third trimester are risk factors for macrosomia.

Value of contrast - enhanced ultrasonography and acoustic radiation force impulse elastography in identification of boundary range and viability of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To investigate the biologic viability and boundary range of hepatic alveolar echinococcosis (HAE) by the contrast-enhanced ultrasonography (CEUS) and acoustic radiation force impulse elastography (ARFI). Methods Totally 27 HAE patients confirmed by pathology underwent CEUS and ARFI examinations. Results Gray scale sonography of HAE showed unclear boundary, inhomogeneous, and middle hyperechoic nodules, and the maximum area was (6.08 ± 4.47) cm2 in 27 lesions. CEUS of HAE showed non-enhancement in three phases and black hole sign. Circumferential enhancement on the pe riphery of the lesion was synchronized with the liver parenchyma and showed “fast in and slow out”. The maximum area was (8.87 ± 4.83) cm2. The area of ECUS was larger than gray scale sonography in HAE (t = 2.20, P = 0.03). The mean shear wave velocities (SWVs) of the interior, the boundary range, and the surrounding liver tissues of HAE were statistically different by ARFI (F = 84.538, P < 0.001), and the interior had the highest values. Conclusions CEUS and ARFI examinations can detect the biologic viability and boundary range of migrating zone around HAE, which is valuable for guiding treatment, judging curative effect, and predicting prognosis.

Application of natural orifice transluminal endoscopic surgery in pelvic floor dysfunction / 中国实用妇科与产科杂志

In recent years,due to the coming of aging society,pelvic floor dysfunction(PFD)has gradually become one of the research hotspots in the field of obstetrics and gynecology worldwide.At present,surgery is the preferred treatment for moderate to severe PFD patients. With the development of minimally invasive surgery technology and the renewal of minimally invasive concept,PFD treatment options have been improved continuously. Natural orifice transluminal endoscopic surgery has been applied to gynecological surgery because of its fast recovery,slight pain and being without abdominal incision. Although the development of minimally invasive surgery provides more surgical options,different surgical methods have their advantages and disadvantages,and they should be controlled.Therefore,the age,symptoms,signs,medical history and general condition of the patients should be comprehensively evaluated to achieve the best therapeutic effect.

Therapeutic effects of transvaginal natural orifice transluminal endoscopic surgery sacrocolpopexy on pelvic organ prolapse / 中国实用妇科与产科杂志

OBJECTIVE: To study the efficacy of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)sacrocolpopexy in the treatment of pelvic organ prolapse(POP).METHODS: From June 2017 to September 2018,33 POP patients who underwent vNOTES sacrocolpopexy in the Third Affiliated Hospital of Guangzhou Medical University were collected.The operative time,blood loss and postoperative complications were recorded to evaluate the safety of the operation.After regular follow-up,POP-Q was used to objectively evaluate the effect of surgery,and PFIQ-7 was used to evaluate the recovery effect.RESULTS: In this group,3 of 33 cases were converted to transumbilical laparoscopy,and in the remaining 30 cases the surgery was successfully completed.The operation time was(184.97±41.91)min,and mean estimated blood loss was(28.33±18.77)mL.No complications such as exposure or infection of mesh were found after operation.The POP-Q indicators were significantly improved in 1,3,6 months after surgery(P<0.05),and the quality of life was better after operation than before(P<0.05).CONCLUSION: vNOTES is a feasible and safe approach for sacrocolpopexy with positive short-term efficacy in the treatment of POP.

Effect of Erzhiwan on Invasion and Metastasis of Human Colon Cancer Cells / 中国实验方剂学杂志

Objective: To investigate the effect of Erzhiwan (EZW) on the invasion and metastasis of human colon cancer HCT116 cells. Method: The abilities of invasion (number of transmembrane cells) and migration (relative width of 48 h scratch) were observed by Transwell assay. Western blot was used to detect vascular endothelial growth factor (VEGF) and E-cadherin protein, respectively. Result: ① Transwell results showed that compared with the blank control group, the number of model piercing cells in each drug group was decreased (PPPPPPPP-1 L-OHP combined with 10% EZW group was lower than that in L-OHP group (PP-1 L-OHP combined with 10% EZW group and L-OHP group increased the expression of E-cadherin protein significantly. Compared with L-OHP group, the expression of E-cadherin protein was the highest (PConclusion: EZW can inhibit the invasion and metastasis of colon cancer HCT116 cells, and the best effect is achieved after combined with L-OHP. This may be related to the decrease of VEGF protein expression and the increase of E-cadherin protein expression after combination with L-OHP.

The association of overweight and obesity with hypertension among residents aged 35 years or older in Yuhuan county / 中华疾病控制杂志

Objective To assess the prevalence of overweight and obesity among residents aged 35 years or older in Yuhuan county of Zhejiang Province and explore the associations of overweight and obesity with hypertension. Methods A cross-sectional study was conducted among 124 693 permanent residents aged 35 years or older, who were randomly selected using cluster sampling method from Yuhuan county. Results The prevalence of overweight and obesity was 34.53% and 10.18% among subjects, respectively. The overweight prevalence for male (35.56%) was higher than that for female (33.66%), whereas the obesity prevalence for female (11.26%) was higher than that for male (8.90%) (all P<0.05). The multivariate analysis showed that age, education, occupation, regular physical exercise, smoking, drinking and high-salt diet were possible factors for overweight and obesity (all P<0.05). After adjustment for covariates, compared to participants with normal weight, the multivariate logistic regression indicated that the adjusted odds ratio (OR) and their 95% confidential interval of overweight and obesity were 2.02 (95% CI:1.93-2.11) and 3.83 (95% CI:3.57-4.10) for hypertension in men, and were 1.94(95% CI:1.86-2.02)and 3.56(95% CI:3.35-3.77) in women, respectively. Conclusions The prevalence of overweight and obesity was high among residents aged 35 years or older in Yuhuan county, and they may relate to the increasing risk of hypertension.

Advances in research on anti-Müllerian tube hormone and male reproductive endocrine-related diseases / 基础医学与临床

Anti-Müllerian tube hormone(AMH), also known as Müllerian inhibitory substances, is a member of the transformation system. In males, AMH is secreted by immature Sertoli cell which promotes the degradation of male fetal Müllerian tubes,and participates in testicular development and spermatogenesis.AMH can regulate gona-dotropin-releasing hormone (GnRH), pituitary secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH),testicular stromal cells secrete testosterone(T) and inhibin B causes male reproductive endocrine related diseases through HPG axis.

Effects of inhibitory concentration minocycline on the proliferation, differentiation, and mineralization of osteoblasts / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the effect of the inhibitory concentration minocycline on the proliferation, differentiation, and expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and osteopontin (OPN) mRNA of osteoblasts.</p><p><b>METHODS</b>Primary osteoblasts were cultured in osteogenic induction medium containing 0, 0.1, 0.5, 1, 10 μg·mL⁻¹ minocycline. Cell counting kit-8 was used to observe cell proliferation. ALP activity assay, alizarin red S staining, and real-time quantitative polymerase chain reaction (PCR) were used to determine cell differentiation and mineralization.</p><p><b>RESULTS</b>The groups with 0.1, 0.5, 1 μg·mL⁻¹ minocycline promoted cell proliferation. The mRNA expression levels of ALP and Runx2 were up-regulated. Osteoblast-mediated mineralization was increased. The group with 1 μg·mL⁻¹ showed maximal promotion effect (P<0.05). When the concentration increased to 10 μg·mL⁻¹, the promoting effect began to decline, and the ALP activity and OPN expression were significantly inhibited (P<0.01).</p><p><b>CONCLUSIONS</b>Appropriate concentration of minocycline can promote osteoblasts proliferation, up-regulate the expression levels of Runx2, ALP and OPN, and increase the differentiation and mineralization of osteoblasts.</p>

Correlation of Enhancement Degree on Contrast-enhanced Ultrasound with Histopathology of Carotid Plaques and Serum High Sensitive C-Reactive Protein Levels in Patients Undergoing Carotid Endarterectomy / 华中科技大学学报（医学）（英德文版）

This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound (CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein (hs-CRP) levels in patients undergoing carotid endarterectomy (CEA).Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA,and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis.Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation.Additionally,the carotid plaque samples were subjected to histopathological examination postoperatively.The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry.The results showed that among the 115 patients,grade 0 plaque contrast enhancement was noted in 35 patients,grade 1 in 48 patients and grade 2 in 32 patients.The degree of plaque enhancement,the density ofneovessels,the number of macrophages,and the hs-CRP levels were highest in the grade 2 patients.Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels.It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.

The relationship between serum vitamin D and diabetic retinopathy in patients with type 2 diabetes mellitus / 复旦学报（医学版）

Objective To investigate the relationship between diabetic retinopathy(DR) and serum vitamin D in patients with type 2 diabetes mellitus (T2DM).Methods A total of 310 patients with T2DM both managed in the bio-bank and the diabetes management system of Center for Disease Control and Prevention of Minhang District during Feb.,2012 to Dec.,2014 were selected.Then 205 patients were divided into non diabetic retinopathy group (NDR) and 105 patients into DR group according to the fundus examinations.The patients' demographical information,medical history and laboratory essays were collected,serum 25 (OH)D levels were detected.Results Single factor analysis indicated that,compared with NDR group,25(OH)D level of DR group decreased(t =3.465,P＜0.001),prevalence of 25(OH)D deficiency rose (x2 =5.313,P =0.021),however,prevalence of 25 (OH) D insufficiency showed no statistical significance (x2 =0.990,P =0.320).Binary Logistic regression analyses showed the inverse correlation between 25 (OH)D level and DR (OR =0.954,95％CI:0.926-0.983,P =0.002),in addition,the risk for DR in T2DM patients who were deficient in 25 (OH)D was 2.17 times than those who were not (OR =2.171,95％ CI:1.047-4.500,P =0.037),after adjusting for a number of variables (demographics,medical history,fasting plasma glucose,postprandial blood glucose,triglyceride and uric acid).Conclusions Serum 25 (OH)D level was negatively related with DR in patients with T2DM.25 (OH)D deficiency might be relevant to the risk of type 2 diabetic retinopathy.