Objective To study the relationship between insulin resistance with cardiac function and cardiovascular events in the patients with obstructive sleep apnea syndrome(OSAS).Methods Eithy-eight cases of SHAS in our hospital from August 2015 to August 2016 were selected as the research subjects,and contemporaneous 20 persons undergoing healthy physical examination served as the control group.The blood glucose metabolism indicators were detected for evaluiating the level of insulin resistance.The insulin resistance and glucose metabolism indexes were compared between the two groups.The relatioship between insulin resistance with cardiac function and cardiovascular events in the OSAS was investigated.Results BMI,HOMA-IR,FPG and FINS in the observation group were (28.1± 3.9),(4.7 ±1.9),(4.8± 0.9) and (19.8± 3.7) respectively,which were significantly higher than those in the healthy control group,LVEF in the observation group was (58.7±5.6)%,which was significantly lower than that in the control group,LVEDP,RVEDP and mPAP in the observation group were 8.6±1.8,5.4±0.9 and 25.4±1.9 respectively,which were significantly higher than those in the control group,the multivariate analysis results indicated that LVEF<55%(P=0.014) and HOMA-IR>4.5(P=0.04) were the independent risk factors for cardiovascular events in OSAS patients.Conclusion The insulin resistance has obvious correlation with the cardiac function in OSAS patients.

Cardiac neurosis is a syndrome caused by dysfunction of CNS,which influences autonomic function and then disordered cardiac-vascular function.The author sums up a set of firm-soft differentiation treatment to the disease under his years of clinical experience,which has marked clinical cure effect.

Objective To investigate the climacteric symptoms and depressive related factors of climacteric females in gynecology outpatients and inpatients,to provide evidence for effective health promotion.Methods 416 climacteric women were investigated by using improved menopause Kuppermen Scales and Center for Epidemiological Studies Depression (CES-D).The results underwent analysis.Results There were 93.99％ of patients suffering from climacteric syndrome,49.52％ with depression symptom.The main factors of climacteric syndrome were eating breakfast according to the timetable every day,nutritionally balanced diet,controlling of salt intake,regular body exercises and to maintain a proper body weight.Factors related to depression symptoms were sore breasts,constipation,dry skin,lower abdominal pain.The correlation between climacteric syndrome and depressive symptom was significant.Conclusions The main influencing factor of climacteric syndrome was healthy lifestyle.The climacteric syndrome increases the risk of depressive symptoms.

Objective　To explore the prophylactic effect of T cell vaccination (TCV) on type 1 diabetes. Methods　6-week-old nondiabetic femele NOD mice were vaccinated intraperitoneally with the attenuated, activated T lymphocytes isolated from the spleen of 4-week-old nondiabetic NOD mice, 18-week-old newly diabetic NOD mice and 32-week-old long-term diabetic NOD mice. The incidence of cyclophosphamide-treated diabetes, inflammatory score of insulitis in NOD mice as well as T lymphocyte subset changes in spleen and thymus were determined after TCV. Results　TCV was able to reduce the incidence of cyclophosphamide-treated diabetes, to alleviate insulitis, to increase the percentage of CD8+ T lymphocyte subset in spleen and CD4- CD8+ simple-positive T lymphocyte in thymus, and to decrease the percentage of IL-2R+ T lymphocyte and CD4+/CD8+ rate in spleen. Conclusion　TCV may decrease host autoimmunity, which seems related to the changes of T lymphocyte subsets in spleen and thymus and prophylactic effect on diabetes.

Objective To explore if strand breaks of DNA in human early chorionic villus cells in uterus were induced by diagnostic ultrasound and to evaluate the method used for detection of single-stranded breaks and doublestranded breaks in human DNA. Methods 60 normal pregnant women aged 20-30, who underwent artificial abortion during 6-8 weeks of gestation, were randomly divided into 2 experimental groups: All 30 cases were exposed to diagnostic ultrasound in uterus for 10 minutes, and 24 hours later chorionic villi were extracted; the other 30 cases were taken as the control group. Single-stranded DNA and double-stranded DNA in villus cells in all cases were isolated by the alkaline unwinding combined with hydroxylapatite chromatography, and were quantitatively detected using32 P-labeled Alu probe for dot-blotting hybridization. Results There was no significant difference in quantity and percentage in single-stranded DNA and double-stranded DNA between 2 groups (P＞0.05). 32 P-Alu probe could only hybridize with human DNA, and could detect DNA isolated from as few as 2.5 × 103 chorionic villus cells and 0.45 ng DNA in human leukocytes. Conclusion The results suggested that there were no DNA strand damages in human chorionic villus cells when the uterus was exposed to diagnostic ultrasound for 10 minutes. The method, 32P-Alu probe for dot-blotting hybridization, was even more specific, sensitive and accurate than conventional approaches.

Objective To explore the significance of combined detection of urinary podocalyxin (PCX), nephrin and mono-cyte chemoattractant protein-1(MCP-1) for diabetic nephropathy in newly diagnosed type 2 diabetic patients.Methods A total of 132 newly diagnosed type 2 diabetes mellitus (T2DM) patients and 36 healthy subjects were recruited .The concentrations of urinary PCX (UPCX), nephrin (UNephrin) and MCP-1(UMCP-1) were measured with enzyme-linked immunosorbent assay (ELISA), and urina-ry UAE ( UAlb) concentration was measured with turbidimetric immunoassay method .All the results were shown by dividing the urine creatinine ( UCR) concentration in the same sample .The comparisons among UAlb/UCR, UPCX/UCR, UNephrin/UCR, and UMCP-1/UCR among groups were investigated .The correlation among UAlb/UCR, UPCX/UCR, UNephrin/UCR and UMCP-1/UCR was in-vestigated in T2DM patients.The comparison among positive rate of UMCP-1/UCR, UNephrin/UCR, UPCX/UCR and UAlb/UCR was investigated in T2DM patients.Results The levels of UPCX/UCR and UMCP-1/UCR were significantly higher in diabetes melli-tus(DM) group (37.37 ±22.83 and 47.19 ±29.98, respectively) than in healthy subjects (9.59 ±2.28 and 9.98 ±3.63, respec-tively) ( P <0.05 ) .The levels of UAlb/UCR、UPCX/UCR and UMCP-1/UCR were significantly higher in diabetic nephropathy (DN) group (90.39 ±59.35, 72.11 ±58.88, and 104.82 ±82.77, respectively) than in DM group (17.50 ±9.49, 37.37 ± 22.83 , and 47.19 ±29.98 , respectively ) and in healthy subjects ( 8.93 ±3.81 , 9.59 ±2.28 , and 9.98 ±3.63 , respectively ) ( P<0.05).The level of UNephrin/UCR was significantly higher in DN group (83.60 ±61.61) than in DM group (38.74 ±35.27) ( P <0.05).The levels of UPCX/UCR, UMCP-1/UCR, and UNephrin/UCR were positively correlated with UAlb/UCR ( r =0.619, 0.568, and 0.535, respectively) ( P <0.05) in T2DM patients.The level of UPCX/UCR was positively correlated with the levels of UMCP-1/UCR and UNephrin/UCR ( r =0.799 and 0.718 , respectively ) ( P <0.05 ) .The level of UNephrin/UCR was positively correlated with the level of UMCP-1/UCR ( r =0.635 P <0.05) in T2DM patients.The positive rate of UMCP-1/UCR, UNephrin/UCR, and UPCX/UCR was significantly higher than that of UAlb/UCR(χ2 =9.818, 6.673, and 5.395, respectively, P <0.05)in T2DM patients.Conclusions The combined detection of urinary PCX , Nephrin and MCP-1 is very important for the early renal dam-age in newly diagnosed type 2 diabetic patients .

Objective To understand the nurses' evaluation of current grading nursing system.Methods Self-questionnaire was designed and used to investigate 141 clinical nurses coming from three general hospitals sampled conveniently.Results (1)Clinical nurses lacked in-depth study of grading nursing instruction principle;(2)Doctors and nurses lacked the cooperation during the process of identifying the level of care;(3)Level of care was not consistent with the patients' condition and self-care ability;(4)Disease inspection and primary care were not consistent with patients' level of care;(5)Health guidance and mental nursing couldn't meet the actual needs of patients;(6)Senior nurses' evaluation of the implementation of grading nursing was lower than Junior nurses; (7)Clinical nurses held positive attitudes to nurses and patients participating in grading nursing.Conclusions Nurses thought poorly of grading nursing system in operation,it was necessary to improve the content of principles about grading nursing manner,health instruction and psychological nursing,and implement grading nursing system correctly.It was also important to take patients' willingness of participating in care into account.

Background and purpose:As a member of the catenin family, Delta-catenin protein could promote proliferation and invasion of tumor cells, but the accurate mechanism of Delta-catenin promoting cell proliferation is not clear. In the present study, we illustrated that Delta-catenin’s effect on cell apoptosis and their relationship with mitogen-activated protein kinase (MAPK) signaling pathway, and the possible mechanism was also explored for Delta-catenin promoting invasion and proliferation of tumor cells. Methods:The alterations of p38 and c-jun N-terminal rinasel JNK protein activity were detected in SPC and SK lung cancer cell lines with Delta-catenin overexpression or not, by Western blot method. At the same time, the apoptotic number of tumor cells was also examined by FCM method. Furthermore, the number of invasive tumor cells was examined by Matrigel invasive experiment. Results:Compared with untreated group and empty vector group, the activity of p38 protein was unchanged in lung cancer cell lines with Delta-catenin overexpressed (P>0.05), but the activity of JNK protein was decreased signiifcantly (P<0.05),meanwhile, apoptotic proportion of tumor cells were also reduced (P<0.05), and invasive ability of tumor cells was enhanced signiifcantly (P<0.05). Conclusion:Delta-catenin probably decreases apoptosis number of lung cancer cells via inhibiting the activity of JNK pathway, and then promotes invasive ability of tumor cells.

Objective To investigate the distribution,drug resistance of bile pathogenic bacteria,and the risk factors for biliary infection.Methods Clinical and laboratory data of patients hospitalized from January 2008 to October 2015 were reviewed for pathogenic bacteria and drug resistance,and the factors related to biliary tract infection were studied.Results Among all 320 cases,there were 249 cases of pathogenic bacteria in bile specimens,the positive rate was 77.81％.There were 356 strains of pathogenic bacteria of 40 species,including 244 strains of gram negative bacteria (68.54％),93 strains of gram positive bacteria (26.12％) and 19 strains of fungi (5.34％).Top three bacteria were Escherichia coli (84 strains,23.60％),Klebsiella pneumonia (60 strains,16.85％),and Enterococcus faecium (40 strains,11.24％).The Escherichia coli and Klebsiella pneumoniae had the highest drug resistance to cefazolin,and they had a lower drug resistance to cefoxitin and amikacin.The multivariate analysis showed that age ≥ 60 years (AOR =2.311,95％ CI:1.292-4.135) and the history of ERCP operation (AOR =3.475,95％ CI:1.587-7.607) were independent risk factors for biliary tract infection.Conclusion Bacteria are mainly gram negative bacteria in the bile of patients with biliary tract infection,suggesting antibiotics with low resistant rate of gram-negative is the first choice.The age ≥ 60 years and history of ERCP surgery are independent risk factors for patients with biliary tract disease.Measures to prevent biliary infections in high-risk patients should be taken.

To investigate the etiology and differential diagnoses of patients with systemic lupus erythematosus (SLE) and fever of unknown origin (FUO).From January 2012 to December 2014,a total of 928 SLE patients were admitted to Peking Union Medical College Hospital.Only 50 patients were combined with FUO (5.4％).The most common reason of fever was caused by infections (33 cases,66.0％),including bacterial infection in 17 cases with 5 tuberculosis,viral infection in 11 cases,and fungal infection in 5 cases.The second reason offever was due to poor disease control or recurrence in 17 patients (34.0％).No fever was caused by malignant tumor.When clinical data was compared between 17 non-infected patients versus 33 infected patients,C reactive protein and procalcitonin in the infected group were significantly higher than those in the non-infected group.In SLE patients combined with FUO,infection is the most common etiology which is necessary to be paid attention to.