Unadjusted and adjusted fracture risk assessment tool and the hip fracture risk in patients with type 2 diabetes / 中华内分泌代谢杂志

Objective:To evaluate and compare the clinical value of unadjusted fracture risk assessment tool(FRAX) and adjusted FRAX in predicting the risk of hip fracture in patients with type 2 diabetes(T2DM).Methods:In this 10-year retrospective cohort study, 1 730 patients with T2DM were collected from August 2009 to July 2013. The 10-year risk of hip fracture was calculated using the China FRAX model. Hip fracture events during the follow-up period were collected through electronic medical records and telephone interviews. The value of FRAX and adjusted FRAX in predicting the risk of hip fracture in T2DM patients was evaluated from two aspects of discrimination and calibration. Cox regression model was used to investigate the relationship between diabetes related factors and hip fracture.Results:A total of 39 participants(2.3%) experienced hip fracture during a median follow-up of 10 years. The area under the curve of unadjusted FRAX was 0.760, but the calibration ability was poor [calibration χ2: 75.78, P<0.001; calibration ratio(observation/prediction): 3.97(95% CI 2.76~5.17)]. There was no significant improvement in calibration ability of adjusted FRAX. After adjustment for unadjusted or adjusted hip fracture probability calculated by FRAX(FRAX-HF), duration, estimated glomerular filtration rate, insulin use, cerebrovascular diseases, and diabetic peripheral neuropathy were significantly associated with an increased risk of hip fracture( P<0.05). Conclusion:The FRAX tool significantly underestimated the risk of hip fracture in T2DM patients, and there was still significantly underestimation after adjustment due to the failure to eliminate the influence of diabetes-related factors such as disease duration and peripheral neuropathy.

Evaluation of therapeutic efficacy of radiofrequency ablation on hepatic cancer: a preliminary study using superb microvascular imaging / 中华肝胆外科杂志

Objective:To study the predictive value of superb microvascular imaging(SMI) in evaluating therapeutic efficacy of hepatic cancer treated by percutaneous radiofrequency ablation(PRFA).Methods:From Feb 2017 to Feb 2018, 55 patients (male: 31, female: 24, age range: 37-68 years, mean age: 56years) with 72 hepatic carcinoma lesions (length: 21.3-45.6 mm, average: 31.2 mm) were detected by SMI and contrast-enhanced CT(CECT)before PRFA. One month after treatment, more than two imaging examinations (CECT, CEMR, ultrasonic imaging) were used as the "gold standard" to evaluate the complete ablation rates. Consistency between the SMI grading and the arterial phase enhancement of CECT was analyzed by the Kappa-test.Results:Before PRFA, SMI showed 12 lesions (16.7%) to be in grade Ⅰ, 28 lesions (38.9%) in grade Ⅱ and 32 lesions (44.4%) in grade Ⅲ. The arterial phase of CECT showed 37 lesions (51.4%) to have no obvious enhancement and 35 lesions (48.6%) to have obvious enhancement. Consistency analysis showed that there was a high consistency between SMI and CECT(Kappa=0.861, P<0.001). The higher the SMI grading, the more obvious the enhancement on CECT. The complete ablation rates of the grade Ⅰ, grade Ⅱ and grade Ⅲ lesions were 100%(12/12), 92.9%(26/28) and 71.9%(23/32), respectively. The complete ablation rate of the lesions in grade Ⅲ was significantly lower than that in grade Ⅰ and grade Ⅱ (both P<0.05). Conclusion:SMI showed a good consistency with CECT in evaluating the blood flow signals of hepatic cancer, SMI grading could be used in predicting the therapeutic efficacy of hepatic cancer treated by PRFA.

Interventional effect of Chinese herbal preparation Xi Fu Pai Chen in rats with silicosis / 中国职业医学

OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.

Comparison of the effects of insulin aspart 30 and insulin glargine combined with repaglinide in the treatment of newly diagnosed type 2 diabetes in the elderly / 中国基层医药

Objective:To compare the efficacy and safety between biphasic insulin aspart 30 injection and insulin glargine combined with repaglinide in the newly diagnosed type 2 diabetes in the elderly patients.Methods:A total of 60 elderly patients with type 2 diabetes who were newly diagnosed in the First Hospital Affiliated to Hebei Medical University were selected as study objects, and they were divided into group A and group B according to the random digital table method, with 30 cases in each group.Group A was treated with aspart 30 injection, and group B was treated with glargine combined with repaglinide tablets for 2 weeks.The BMI, FPG, 2hPG, HbA1c, 1, 5-AG were detected after treatment for 1 and 2 weeks, and the FCP, PCP were detected before and after treatment.Results:The FPG and 2hPG of the two groups decreased significantly after treatment for 1 week and 2 weeks, and the blood glucose of group A decreased significantly after 1 week of treatment compared with group B, and the difference was statistically significant(FPG t=2.58, 2hPG t=2.46, all P<0.05).1, 5-AG increased significantly at 1 week and 2 weeks after treatment.At 1 weekafter treatment, the increase was more significant in group A than group B, and the difference was statistically significant( t=8.93, P<0.05). After 2 weeks of treatment, the levels of FCP and 2hCP of both two groups were increased compared with before treatment, and the differences were statistically significant(FCP t=3.72, 3.45, 2hCP t=4.14, 3.54, all P<0.05). The time of blood glucose reaching the standard in group A was(10.35±4.10)d, which was shorter than that in group B [(12.38±4.22)d], and the difference was statistically significant( t=8.32, P<0.05). The dosage of insulin required by the patients in group A was(45.14±8.42) U·kg -1·d -1, which was higher than that in group B [(24.88±7.36)U·kg -1·d -1], and the difference was statistically significant( t=9.06, P<0.01). Conclusion:Both BIAsp30 and IG combined with repaglinide can effectively reduce FPG and 2hPG of patients with type 2 diabetes newly diagnosed in the elderly.Besides, the occurrence of hypoglycemia in the glargine group is lighter than that in the BIAsp30 group, and the time of blood glucose reaching the standard is longer than that in the aspart 30 injection group.Monitoring 1, 5-AG can be used as a reference for timely adjustment of hypoglycemia programs.

Effects of Nicorandil on Vascular Endothelial Function and Angina Pectoris Recurrence in Patients with Unstable Angina Pe- ctoris after Percutaneous Coronary Intervention / 中国药房

OBJECTIVE： To observe the effects of nicorandil on vascular endothelial function and angina pectoris recurrence in patients with unstable angina pectoris after percutaneous coronary intervention （PCI）. METHODS： Totally 195 patients with unstable angina pectoris were collected from Sichuan Provincial People’s Hospital during Jan. 2016-Mar. 2018， and then divided into control group （97 cases） and observation group （98 cases） according to random number table. Both groups received PCI， and then given basic treatment as Enoxaparin sodium injection， Isosorbide mononitrate sustained-release tablets， Aspirin enteric-coated tablets， Clopidogrel sulfate tablets and Atorvastatin calcium tablets after PCI. Observation group additional received Nicorandil tablet 5 mg， tid， on the basis of control group. Both groups were treated for 6 months. The levels of vascular endothelial function related indexes （FMD， ET-1， NO）， myocardial injury markers （cTnⅠ， CK-MB） and inflammatory factors （hs-CRP） were observed before and after PCI. The recurrent angina pectoris， the occurrence of MACE and ADR were recorded. RESULTS： 6 patients of control group and 4 patients of observation group withdrew from the study. One day before operation， there was no significant difference in the levels of vascular endothelial function， myocardial injury markers or inflammatory factors between 2 groups （P＞0.05）. One day after operation， the levels of FMD and NO in both groups decreased significantly， while the levels of ET-1， cTnⅠ and CK-MB increased significantly （P＜0.05）. The levels of FMD and NO were increased significantly in the 1st and 6th months after surgery， and the observation group was significantly higher than the control group； the levels of ET-1， cTnⅠ， CK-MB and hs-CRP were decreased significantly， and the observation group was significantly lower than the control group （P＜0.05）. The incidence and times of recurrent angina pectoris， duration， the proportion of grade Ⅲ angina pectoris and total incidence of MACE in observation group were significantly lower， less or shorter than control group （P＜0.05）. There was no statistical significance in total incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Additional use of nicorandil can improve vascular endothelial function， relieve the myocardial injury and inflammatory response， reduce the occurrence of recurrent angina pectoris and MACE after PCI and doesn’t influence the safety of routine treatment.

Immunoregulatory effects of Tripterygium wilfordii Hook F and its extracts in clinical practice / 医学前沿

Tripterygium wilfordii Hook F (TwHF) and its extracts have long been used for the treatment of rheumatoid arthritis, autoimmune diseases, and kidney disease due to their anti-inflammatory, immunoregulatory, and other pharmacological effects. However, the clinical immunoregulatory effects of TwHF and its extracts remain unclear, so we reviewed their effects for use in clinical practice. This review provides a comprehensive summary of the recent literature on the immunoregulatory effects of TwHF and its extracts in clinical studies. TwHF and its extracts affect the proliferation and activation of Tand B cells; ratio of Tcell subsets; inflammatory response of monocytes, macrophages, and immunoglobulins; and secretion of many cytokines. Together, these effects dictate immune function in a variety of diseases. TwHF and its extracts can be used alone or in combination with existing therapies against many immune disorders through immunomodulation.

Epidemiological characteristics of Brucella species isolated from different regions of the world using the MLVA genotyping / 中华流行病学杂志

Objective@#To study the molecular-epidemiological characteristics of Brucella species isolated from different countries, using the multiple locus tandem-repeat (MLVA) analysis.@*Methods@#Eleven variable-number tandem-repeat (VNTR) loci were selected. VNTR strains of Brucella isolated from 48 different countries in 1953-2013, were analyzed by using the BioNumerics software. Unweighted Paired Arithmetic Average method was used to cluster and draw phylogenetic tree as well as the minimum spannin.@*Results@#The evolutionary relationship of Brucella phylogenetic tree was consistent with the classical biological typing method. However, the Brucella suis biovar 5 strains were different from the other Brucella suis biovars 1, 2, 3 and 4. Brucella ceti strains were divided into two parts and different from each other. Worldwide epidemics of brucellosis were emerged from 2005 to 2008 under the MLVA11 Orsay analysis. China has been a brucellosis-prone regions, with Brucella melitensis as the main epidemic Brucella species, followed by Brucella abortus. Brucella suis was mainly identified in the southern provinces, but Brucella canis was mainly found in dogs. No human cases were found.@*Conclusion@#Molecular-epidemiological characteristics of the Brucella strains were related to factors as time, region and hosts of isolation, which are important to setting up prevention and control programs on brucellosis.

Influence of the ultrasound examination duration using supine position on umbilical artery blood flow parameters and fetal heart rate in the third?trimester pregnant women / 中国综合临床

Objective To investigate the influence of the length of time of supine ultrasound examination on the parameters of umbilical artery blood flow in the late pregnant fetus. Methods From February 2019 to June 2019,the ultrasound data of 93 pregnant women with the third-trimester pregnant were analyzed retrospectively. Fetal umbilical artery systolic／diastolic ( S／D ) ratio, resistance index ( RI ), pulsatility index ( PI ) and fetal heart rate ( HR ) were acquired at the beginning of the ultrasound examination and those after the routine ultrasound examination ( the examination of fetal, placenta and amniotic fluid). Forty-seven pregnant women from 29 to 31 weeks of gestation were assigned to around 30-week gestation group,while 46 pregnant women from 35 to 37 weeks of gestation were assigned to around 36-week gestation group. Sixty-five pregnant women with normal S／D ratio at the beginning were assigned to the initial normal group,while 28 pregnant women with abnormal S／D ratio at the beginning were assigned to the initial abnormal group. Fetal umbilical artery S／D ratio,RI,PI and HR at the beginning of the ultrasound and after the routine ultrasound examination were compared using paired sample test within around 30-week gestation group, around 36-week gestation group, initial normal and initial abnormal group, respectively. Results There was no significant difference in fetal umbilical artery S／D,RI PI and HR in the pregnant women at around 30-week gestation(all P＞0. 05). RI before the 36 week pregnant group was 0. 56 ±0. 05,and increased to 0. 58±0. 05 after the routine examination (t＝－2. 190,P＝0. 034). The S／D,RI and Pi of umbilical artery increased from 2. 36±0. 31,0. 57±0. 06,and 0. 84±0. 11 to 2. 50±0. 42,0. 59±0. 06, and 0. 88±0. 14 in the initial normal group ( t＝－3. 087,－3. 002,－2. 287,respectively; P＝0. 003,0. 004, 0. 025,respectively),of which 16 S／D increased to abnormal; the RI of umbilical artery increased from 0. 67 in the initial abnormal group ( 28 women ) after routine examination ) . The difference was statistically significant (t＝2. 616,P＝0. 014) . The ratio of S／D decreased to normal after routine examination in the initial abnormal group ( 14／28), which was higher than that in the initial normal group ( 16 ／ 65) . The difference was statistically significant ( χ2 ＝5. 771, P＜0. 05) . Conclusion Umbilical artery blood flow parameters should be measured at the beginning of the ultrasound examination in the third-trimester pregnant women. Umbilical artery Doppler ultrasound should be performed repeatedly if the pregnant woman has abnormal S／D ratio at the beginning of the examination.

Drug sensitivity test of human derived Brucella / 中华地方病学杂志

Objective To screen the most suitable medium for Brucella drug susceptibility test, and observe the resistance of human derived Brucella to different antibiotics. Methods Totally 180 strains of Brucella isolated from 25 provinces (municipalities, autonomous regions) in recent years were taken as observation objects. Mueller-Hinton ( MH ) agar , MH blood agar and Brinell agar were used to carried out the drug susceptibility test in vitro, and to compare the results of drug susceptibility test of different medium; the most suitable Brucella drug susceptibility test medium was used to detect the resistance of human derived Brucella to Doxycycline, Rifampicin, Streptomycin, Levofloxacin, Moxifloxacin, Ceftriaxone sodium, Co-trimoxazole and Amoxicillin/Clavulanic acid by K-B drug sensitive paper, and to observe the formation of antibacterial ring around the drug sensitive paper. Results The growth of Brucella on the MH agar and MH blood agar were slower than that on the Brinell agar, and the antibacterial rings were not obvious. All the 180 strains of Brucella were sensitive to seven antibiotics such as Doxycycline, Rifampicin, Streptomycin, Levofloxacin, Moxifloxacin, Ceftriaxone sodium, and Amoxicillin/Clavulanic acid; and 70 strains of Brucella were resistant to Co-trimoxazole, accounting for 39％ (70/180); Brucella strains resistant to Co-trimoxazole were found in 21 provinces. Conclusions Brinell agar is the most suitable medium for Brucella susceptibility test. The human derived Brucella is resistant to Co-trimoxazole; the resistant strains are distributed in 21 provinces ( municipalities , autonomous regions ) . It is recommended that relevant departm ents of the province ( municipalities , autonomous regions ) carry out epidemiological investigations on the resistance of Brucella, and strengthen the monitoring of drug resistance in clinical drugs of brucellosis patients.

Etiological characteristics of the first human derived Brucella melitensis type 3 in Gansu Province / 中华地方病学杂志

Objective To analyze the etiological characteristics of human Brucella strains isolated, and to improve the precision in control and prevention of brucellosis. Methods In 2016, blood samples were collected from patients in Jingyuan County Gansu Province, and tested via the Rose-Bengal Plate Agglutination Test (RBPT) and the tube agglutination test methods,and serological positive blood samples were inoculated to bidirectional blood culture bottle for culturing, and further identified by traditional biological classification method and the Brucella abortus, Brucella melitensis, Brucella ovis, and Brucella suis species-specific PCR (AMOS-PCR). Multiple-locus variable number tandem repeat sequence analysis (MLVA) -16 was used to detect molecular typing and do cluster analysis. Results The isolated strain was identified by the traditional biological classification method, bacteria could grow in thionine and reddened dye, A and M factors agglutination tests were positive, Bk2phage treatment of bacterial strain cracking, but Tb, Wb phages were not cracked. AMOS-PCR amplification result showed a 731 bp band, which was a strain of Brucella melitensis. The results of MLVA-16 showed that there was a difference in the number of repeats on some Variaable Number of Tandem Repeat(VNTR)sites of the isolated strain. Clustering analysis showed that, the isolated strain was clusted into the same clade with the clustering of Brucella melitensis type 3 from GS-201605 in Gansu. And the clustering was similar compared with that of Zhejiang, Guangdong, Fujian and Yunnan. Conclusion Human brucellosis is a inputting transmission in Gansu Province, there is a genetic variation of genotype 3 sheep Brucella between Gansu Province and other domestic provinces.

Comparison of the two different systems for contrast injection in coronary angiography / 中国介入心脏病学杂志

Objective To study whether the contrast volume and radiation dose can be reduced by automated contrast injection system(ACIS) in coronary angiography compared with manual contrast injection system(MCIS).Methods 200 patients undergoing coronary angiography with transradial approach in the People′s Hospital of Liaoning Province were enrolled in the study from January 2016 to June 2016.They were divided into the ACIS group (n=100) and the MCIS group (n=100).The clinical data, the net amount of contrast the total amount of contrast media consumed, number of angiographic views performed, fluoroscopy time, air kerma (AK) and dose area product (DAP) of the two groups were statistically analyzed.Results There were no statistical differences in the clinical data, the net amount of contrast used, number of angiographic views performed and fluoroscopy time between the two groups (all P>0.05).The total amount of contrast media used, AK, and DAP were less in the ACIS group than in the MCIS group (all P<0.05).Conclusions The volume of contrast consumption and radiation dose can be reduced by ACIS during coronary angiography with transradial approach compared to MCIS.

Study on Formulation of Xiqingguo Buccal Tablet / 中国药房

OBJECTIVE:To study the formulation of Xiqingguo buccal tablet,optimize the proportion and quantity of main materials. METHODS:Using appearance,hardness,dissolution and taste as investigation indexes,orthogonal design was adopted to optimize the proportion and quantity of main thinner(lactose,mannitol),wetting agent(ethanol),lubricant(magnesium stea-rate),flavoring agent(aspartame),and critical relative humidity was detected. RESULTS:By wet granulation,the optimal formu-lation were as follows as the ratio of lactose and mannitol was 1:3,ethanol volume fraction was 60%,the dosage of menthol, magnesium stearate,aspartame and orange essence was 0.4%,0.9%,2.0%,0.4%;it was proven that the total score of 3 batches of samples were 2.67,2.67,2.70 (RSD=0.65%,n=3),respectively. The critical relative humidity of granule was 60%. CON-CLUSIONS:The Xiqingguo buccal tablet prepared by optimal prescription meets the requirements.

Clinical analysis on safety of primary suture in laparoscopic choledocholithotomy / 重庆医学

Objective To explore the feasibility and safety of primary suture in laparoscopic common bile duct exploration(LCBDE) for treating choledocholithiasis.Methods The clinical data in 185 cases of choledocholithiasis underwent LCBDE in Sun Yat-sen Memorial Hospital from March 2010 to October 2015 were retrospectively analyzed.The patients were divided into 1aparoscopic common bile duct exploration and primary suture(LBEPS) group(117 cases) and T tube drainage group(68 cases) according to different processing modes of common bile duct incision.The operative time,intra-operative blood loss amount and postoperative complications were observed in the two groups.Results All operations were successfully performed in both two groups without converting to laparotomy.The operative time,intra-operative blood loss amounts and postoperative complications had no statistically significant differences between the LBEPS group and T tube drainage group(P>0.05).The postoperative hospital stay of the LBEPS group was significantly shorter than that of the T tube drainage group(P<0.01).There was no bile duct stricture or stone recurrence during the follow up period in the two groups.Conclusion Under strictly grasping the operation indication,selecting correct suture material and possessing practiced operating skills,primary suture of laparoscopic choledocholithiasis is safe and feasible,can avoid the risk of T tube placing related complications,has short postoperative hospitalization duration and increases postoperative living quality.

Differential expressions of ciaH, eno and pykF genes of fluoride-resistant Streptococcus mutans cultivated in fluoride environment and its significance / 吉林大学学报(医学版)

Objective:To investigate the relationship between ciaH, eno, pykF genes and fluoride resistance through determining the differential expressions of ciaH, eno and pykF genes of fluoride-resistant Streptococcus mutans cultivated in fluoride environment. Methods:The cultured Streptococcus mutans and their fluoride-resistant strains were divided into UA (Streptococcus mutans subcultured in BHI without NaF), FR (fluoride-resistant Streptococcus mutans subcultured in BHI without NaF) and FFR (fluoride-resistant Streptococcus mutans subcultured in BHI containing 1 g·L-1 NaF) groups.After 11 h (logarithmic phase) and 20 h (platform stage) cultivation, the expression levels of ciaH, eno and pykF mRNA were detected by RT-PCR method.Results:Compared with FR group, the expression levels of ciaH, eno and pykF mRNA in FFR group were increased both in the logarithmic phase and the platform stage(P0.05), but it was increased in the platform stage (P<0.01).Conclusion:Fluoride can increase the expression levels of ciaH, eno and pykF genes in fluoride-resistant Streptococcus mutans, indicating that these genes are related to the production of fluoride resistance.

Effect of Continuous Blood Purification on Inflammatory Factors and Immune Function in Patients with Sepsis / 现代生物医学进展

Objective:To investigate the effect of continuous blood purification (CBP) on inflammatory factors and immune function in patients with sepsis,in order to provide reference for clinical treatment of sepsis.Methods:A total of 76 patients with severe sepsis,who were treated in ICU of Daqing Oilfield General Hospital from June 2014 to December 2016,were selected.The patients were divided into conventional group (n=36) and CBP group (n=40) according to the received treatment method.The patients in the conventional group were treated with targeted therapy and life support,while the patients in the CBP group were treated with CBP on the basis of targeted therapy.The levels of interleukin-6 (IL-6),interleukin-10 (IL-10),tumor necrosis factor-α (TNF-α) and C reactive protein (CRP) of the patients in the two groups were detected and compared before treatment and after 3d of treatment.The CD3+,CD4+,CD8+T cell and the CD4+/CD8+ ratio before treatment and after 3 d of treatment were calculated and compared between the two groups.Results:There was no significant difference in the level of serum inflammatory factors between the two groups before treatment (P＞0.05).The levels of serum inflammatory factors in the two groups were significantly decreased after 3 d of treatment,and the levels of IL-6,TNF-α and CRP in the CBP group were significantly lower than those in the conventional group (P＜0.05).There was no significant difference in immune function indexes between the conventional group and the CBP group before treatment (P＞0.05).After 3d of treatment,CD3+,CD4+ and CD4+/CD8+ ratio were significantly increased in the two groups,and the CD4+ and CD4+/CD8+ ratio of the CBP group were sig-nificantly higher than those of the conventional group (P＜0.05).Conclusion:The application of CBP in the treatment of patients with sep-sis can obviously improve the expression of inflammatory factors of patients,and can improve the immune function and promote the re-covery of immune function.

Comparative analysis five kinds of serological detection methods about Brucella / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluation the specificity and sensitivity of 5 kinds of serological detection methods about brucellosis.</p><p><b>METHODS</b>To investigate in the 4 autonomous banner (Cha You Hou Qi, Right-Wing Central Banner of Kerqin Region, Linxi County and Siziwangqi Banner) of Inner Mongolia autonomous region from January to December, 2013. Accepting criteria: professionals of breeding cattle and sheep, and slaughter,accompanied by Bloom's disease suspected symptoms such as fever, fatigue,arthralgia, ranging in age from 25 to 55 years old. To collect suspected patients venous blood 3-5 ml in the morning, a total of 236 samples were collected. To detect the Brucella antibody by using plate agglutination test (PAT), tiger red plate agglutination test (RBPT), standard test tube agglutination test (SAT), enzyme-linked immunosorbent assay (ELISA) and immune colloidal gold method (GICA), SAT was taken as a golden standard, analyzed the sensitivity and specificity of RBPT and SAT, ELISA and GICA.</p><p><b>RESULTS</b>SAT method of positive patients: 136 cases (57.6%). PAT method positive patients: 150 cases (63.6%). RBPT positive patients: 159 cases (67.4%), and 143 patients with ELISA method: positive (60.6%), 147 patients with positive GICA method (62.3%). The detection rate of Brucella antibody positive was different by different testing methods.There was no significant difference (χ(2)=0.52,P=0.264). To take the SAT method as the gold standard, PAT, RBPT, ELISA and GICA method of the sensitivity were 97.7% (133/136), 98.5% (134/136), 94.8% (129/136) and 94.1% (128/136), respectively. The specificity was lower,the rate were 70.0% (70/100), 75.0% (75/100), 86.0% (86/100) and 81.0% (81/100), respectively. The total coincidence rate were 86.0% (203/236), 88.5% (209/236), 91.1% (215/236) and 88.5% (209/236), respectively.</p><p><b>CONCLUSION</b>The specificity and sensitivity of ELISA and GICA method is higher in the diagnosis of disease. The two methods are rapid, GICA method can be used on-site testing, large sample test is suitable for using ELISA.</p>

Hypercalcemia in pregnancy:One case report / 中华内分泌代谢杂志

[Summary] Hypercalcemia in pregnancy is a rare condition which brings considerable risks to mother and fetus. The most common cause is primary hyperparathyroidism(PHPT). The untypical symptoms and biochemical tests results add obstacles in the diagnosis of PHPT during pregnancy. The management is difficult, due to restrictions in choices of treatments and lack of clinical guidelines. Severity evaluation which takes consideration of calcium homeostasis during pregnancy is crucial for appropriate management. Parathyroidectomy during the second trimester is recommended for those with high serum calcium levels.

Clinical study of modified ESD and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors originating from the muscularis propria layer / 天津医药

Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.

Improving effects of ginsenoside Rb1 on glucose metabolism in cardio-myocytes under hypoxia by hypoxia-inducible factor 1α / 中国病理生理杂志

AIM: To elucidate the effect of ginsenoside Rb1 (Gs-Rb1) on the glucose metabolism to improve the viability of the cardiomyocytes under hypoxia, and whether hypoxia-inducible factor 1α(HIF-1α) and/or AMPKαare involved in the process.METHODS: The neonatal rat cardiomyocytes were cultured, and randomly divided into control group, hypoxia (1% O2 , 94% N2 and 5% CO2 ) group, Gs-Rb1 (200 μmol/L) group, Ara-A (500 μmol/L) group, Gs-Rb1 +Ara-A group, YC-1 (5 μmol/L) group, Gs-Rb1 +YC-1 group, Ara-A +YC-1 group and Gs-Rb1 +YC-1 +Ara-A group.After the intervention for 8 h, the cell viability was analyzed by MTT assay.The protein levels of AMPK, HIF-1αand glucose transporter-4 (GLUT-4) were determined by Western blot.The activities of heterophosphatase (HK), phos-phofructokinase (PFK) and lactic dehydrogenase (LDH) were measured by ELISA.RESULTS: Gs-Rb1 significantly im-proved the viability of hypoxic cardiomyocytes, which was significantly inhibited by YC-1 and Ara-A.In addition, YC-1 and Ara-A had a synergistic effect.Gs-Rb1 increased the protein levels of AMPK and HIF-1αin the hypoxic cardiomyo-cytes, which was significantly inhibited by Ara-A and YC-1.Gs-Rb1 significantly increased the expression of GLUT-4 on the cytomembrane of hypoxic cardiomyocytes, which was significantly inhibited by YC-1 or Ara-A, especially Ara-A +YC-1.Gs-Rb1 significantly increased the activities of HK, PFK and LDH, all those were significantly inhibited by YC-1 or Ara-A.Besides, YC-1 and Ara-A had a synergistic effect.CONCLUSION: Gs-Rb1 improves the viability of hypoxic car-diomyocytes, which may be related to the regulation of glucose uptake and enhancement of glycolysis by synergy of both HIF-1αand AMPK.

Palpitation, tremble, sweaty, and weight gain---Localization of insulinoma / 中华内分泌代谢杂志

[Summary] A 47 years old female presented with palpitation, tremble, sweaty, and weight gain. Insulinoma was suspended and confirmed with hypoglycemia caused by endogenous hyperinsulinemia. The CT scan was failed to localize the tumor. MRI and ASVS showed inconsistent results. A nutrient arterial was found by arterial angiography and explained the different results. Robert assistant surgery successfully removed the tumor and the patient was well recovered.