Objective To ecaluatc the diagnostic value of digital subtraction angiography (DSA) and carotid artery ultrasound for transient ischemia attack (TIA). Methods Among the 74 patients with TIA, 45 had internal carotid artery (ICA)-TIA and 29 had vertebrobasilar artery (VBA)-TIA. DSA examination was performed in order to detect intracranial and extracranial arterial stenosis in the above two systems. Cervical artery ultrasound examination was used to understand the distribution of arterial plaques. Results DSA shoved that the detection rate of vascular stenosis in patients with ICA-TIA was 84. 4% (n = 38),and the patients with serious, moderate and slight stenoses were 31.1% (n = 14), 26. 7% (n = 12) and 11.1% (n =5), respectively. Of those, intracranial arterial stenosis was 44.4% (n =20), and it was significantly higher than 22.2%(n = 10) in extracranial arterial stenosis (P ＜0. 001 ); the detection rate of vascular stenosis in patients with VBA-TIA was 65.5% (n = 19), and the patients with serious, moderate and slight stcnoscs were 17. 2% (n = 5), 27. 5% (n = 8), and 20. 7% (n = 6), respcctivegly. Of those, cxtracranial arterial stenosis was 44.8% (n = 13), and it was significantly higher than 13.8% (n = 4) in intracranial stenosis (P ＜ 0. 001 ). Carotid artery ultrasound shoved that the detection rate of ICA plaque was 44.4% (n = 20), and it was higher than 24, 1% (n =7) in patients with VBA-TIA; the detection rate of the plaques in the initial segment of subclavian artery in patients with VBA-TIA was 44. 8% (n = 13), and it was significantly higher than 13.3% (n = 6) in patients with ICA-TIA (P ＜ 0.001 ). Conclusions There were differences between the intracranial and extracranial vascular lesions and the distribution of atherosclerotic plaques in patients with ICA-TIA and VBA-TIA. 1he former was more common in intracranial lesions, and the latter was more common in extracranial lesions.

Objective To compare the application value of contrast enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance angiography ( CEMRA ) in the diagnosis of carotid plaque characteristics . Methods Fourty-six patients ( 48 carotid plaques) were performed with carotid CEUS and CEMRA examination prior to carotid endarterectomy . The following characteristics of plaque including the surface of the plaque ,the presence of calcification ,the internal composition and the diameter stenosis were observed and measured ,which were compared with pathologic and digital subtraction angiography ( DSA ) results . Results There were 42 vulnerable plaques and 6 stable plaques in the 48 plaques . Fourty-seven carotid plaques had been correctly diagnosed by CEUS and CEMRA ,and one plaque had been misdiagnosed . The sensitivity ,specificity and accuracy between CEUS and CEMRA had no obvious differences in terms of the overall evaluation of plaque vulnerability ( P > 0 .05) ;CEUS and CEMRA in the diagnosion of the plaque surface situation had no statistical difference in terms of sensitivity ,specificity and accuracy compared with pathological results( P > 0 .05) ;There was no significant difference in diagnostic accuracy rate between two modalities ( P < 0 .05) ;In the diagnosis of plaque internal composition ,they had statistically differences in terms of specificity and accuracy ( P < 0 .05) ,while sensitivity had no obvious difference ( P > 0 .05) . With DSA examination results as the gold standard ,the accuracy of CEUS in the diagnosis of the diameter stenosis was 97 .92% (47/48) ,CEMRA was 100% (48/48) ,they had no significant difference between two groups ( P > 0 .05 ) . Conclusions CEUS and CEMRA in carotid plaques characteristic evaluation have respective advantages ,are highly complementary ,and combining two methods can systematically evaluate for plaque characteristics .

Objective To investigate the effects of 5-Aza-CdR (methylation transferase inhibitor) on gene expression levels of interleukin-1β (IL-1β),transforming growth factor-β (TGF-β) and nitric oxide synthase (NOS) in chondrocytes.Methods Chondrocytes from patients with osteoarthritis (OA) (n=22),rheumatoid arthritis (RA) (n=3) or trauma without rheumatic diseases (n=10) were collected and cultured.The mRNA expression levels of IL-1β,TGF-β and NOS were detected by real-time polymerase chain reaction (RT-PCR).Chondrocytes in trauma group were treated with 5-Aza-CdR(10μmol/L) for 72 h,and the mRNA and protein expression levels of IL-1β,TGF-β and NOS were detected by RT-PCR and ELISA,respectively.Results The mRNA expression levels of IL-1β,TGF-β and NOS were increased in OA and RA group as compared with trauma group (P＜0.05),while they had no differences between OA and RA groups.After treated with 5-Aza-CdR,the mRNA and protein expression levels of IL-1β,TGF-β and NOS in chondrocytes rised in trauma group as compared with pretreatment (all P＜0.05).Conclusions The mRNA expression levels of IL-1β,TGF-β and NOS in chondroytes are higher in OA and RA patients.5-Aza-CdR could increase the mRNA and protein expression levels of IL-1β,TGF-β and NOS by inducing relative gene methylation,which suggests demethylation might play a role in OA pathogenesis by influncing the inflammatory signal pathway or cell apoptosis.

Objective To observe the clinic features and serology of systemic lupus erythematosus(SLE) in elderly patients. Methods The clinic features and serology of 27 patients with late-onset SLE in our hospital from 1994 to 2003 were analyzed and compared with non-lateonset SLE. Results The average duration from disease onset to diagnosis in late-onset SLE was 56.1 months, which was significently longer than in non-lateonset SLE (mean 10.5 months, P

Objective: To explore influence of nursing health education on morning blood pressure surge (MBPS) fluctuations in aged patients with hypertension.Methods: A total of 100 outpatients and inpatients with non-dipper hypertension, who haven't been treated, were selected from Apr 2011 to Sep 2015.According to random number table method, patients were randomly and equally divided into routine treatment group and health education group (received nursing health education based on routine treatment group), both groups were treated for four weeks.MBPS, trough/peak(T/P) ratio and smoothness index (SI) were measured and compared between two groups after treatment.Results: Compared with routine treatment group after four-week treatment, there were significant reductions in systolic blood pressure (SBP) morning surge[(46.95±5.17) mmHg vs.(42.21±5.19) mmHg]and diastolic blood pressure (DBP) morning surge[(16.31±3.23) mmHg vs.(14.21±3.58) mmHg], and significant rise in SBP T/P[(59.22±6.65)% vs.(70.11±6.41)%], DBP T/P[(50.91±5.04)% vs.(56.97±5.12)%], SBP SI[(1.19±0.13) vs.(1.42±0.12)]and DBP SI[(1.11±0.09) vs.(1.29±0.08)]in health education group, P<0.05 all.Conclusion: Health education can effectively improve blood pressure fluctuations and may likely improve prognosis in patients with non-dipper hypertension, which is worth extending.

Objective To study the effects of lactate peritoneal dialysis solution(L-PDS) with different concentrations on apoptosis of human peritoneal mesothelial cells(HPMC),the expressions of bcl-2,bax and activity of caspase-3.Methods HPMC were separated using enzyme digestion and cultivated stably in vitro.After HPMC were co-cultivated with different concentrations(1.50%,2.50%,4.25%) L-PDS,flow cytometry was used to test the apoptosis of HPMC,RT-PCR was used to observe the expressions of bcl-2 and bax,fluorometric method was used to detect the activity of caspase-3.Results Compared with control group, L-PDS could induce the apoptosis of HPMC,especially in high concentration.With the increasing of L-PDS concentration,the expression of bcl-2 mRNA decreased,the expression of bax mRNA increased,the activity of caspase3 raised.There were significant differences of the indexes mentioned above between 4.25%,2.50% L-PDS groups and control group(P0.05).Conclusion L-PDS could induce HPMC apoptosis,which may be executed by alternating of the expressions of bcl-2,bax and activating of caspase3.

Objective To investigate the association of the expression level of anti-apoptosis protein p-AKT and gastric mucasal injury induced by indomethacin in mice.Methods The cytotoxicity induced by indomethacin was measured by LDH assay.The p-AKT expression levels were measured in the gastric mucosal tissues from C57BL/6 mice and rat gastric mucosal (RGM-1) cell lines treated with indomethacin lay western blotting.Results The cytotoxicity induced by indomethacin was in a dose dependent manner.Compared with the control,a typical histological appearance of gastric ulcer was observed in the gastric mucosa of in domethacin-administered mice;p-AKT protein expression in the gastric mucosa of mice and RGM-1 cell lines was decreased after treated with indomethacin.Conclusion The reduction of Anfi-apoptesis protein p-AKT expression may be a new mechanism for the gastric mucosal injury induced by indomethacin.

Objective To investigate the appropriate setting up of normal reference ranges of lymphocyte subsets in some flow cytometry laboratories and to study the effects of different flow cytometers and various reagents by different manufacturers on the analysis of peripheral blood lymphocyte subsets. Methods Three FCM labs (named A, B and C) in Beijing region were selected representing 3 commonly used flow cytometers (Beckman Coulter Epics XL, Beckman Coulter Cytomics FC500, BD FACS Calibur). 50 samples from healthy donors were distributed to 3 labs and tested according to individual lab's standard operating procedure to verify whether the normal reference ranges of peripheral blood lymphocyte subsets established were appropriate. The application of internal quality control was also investigated. Commercial blood quality control reagents were given to the 3 FCM labs and tested within 20 working days paralleled with routine samples. In addition, 20 patients' samples were prepared using 4 different combinations of reagents ( a , b , c and d). The results from combination a, which used the Beckman Coulter reagents and instrument, were compared to the results from combination b, c and d, which used reagents from different manufacturers. Then the prepared samples were tested on Beckman Coulter Epics XL to evaluate the effects of different combinations of reagents on the results of peripheral blood lymphocyte subsets analyzed by the same instrument. Furthermore, 24 patients' samples prepared by same reagents from Beckman Coulter company were tested on both Beckman Coulter Epics XL and BD FACS Calibur respectively to assess the effects of different instruments on peripheral blood lymphocyte subsets. 20 patients' samples prepared by same reagents and instruments were analyzed by Beckman Coulter Epics XL analytic system and BD FACS Calibur analytic system respectively to assess the effects of the two analytic systems on the lymphocyte subsets. Results Over 10% of the results for NK and T4/T8 in lab A as well as T4 in labs B and C fell outside of their normal reference ranges. The probabilities exceeding corresponding normal reference ranges were 16% ( 9/50 ), 24% ( 12/50 ), 22% (11/50) and 12% ( 6/50 ), respectively. The results using internal blood quality control in 3 FCM labs within 20 working days were all within the reference ranges of the quality control provided by the kit. The biases from b and c reagent combinations were substantial compared with that of reagent a combination. Among the biases from b and c reagent combinations, the lowest probability of bias exceeding 10% was T8 of combination b, which had probability of 70% (14/20). The highest probabilities of hias exceeding 10% were T3 and T4 of b and c reagent combinations, which reached 100% (20/20) . Furthermore, the biases of T3, T8 and B of d reagent combination compared with that of reagent a combination were also substantial. The probabilities of bias exceeding 10% were 35% (7/20) ,85% (17/20) and 75% (15/20), respectively. Comparing the results of samples prepared and analyzed by reagents and instruments from different manufacturers to that of samples prepared and analyzed by the same company's reagents and instruments showed that there were great discrepancies in T3, T4 , T8 , B and NK. The probabilities of bias exceeding 10% were 71% ( 17/24), 80% (19/24) ,38% (9/24), 33% (8/24) and 92% (22/24), respectively. The biases of T8, NK and B were substantial when compared the results from Beckman Coulter Epics XL analytic systems and BD FACS Calibur analytic systems. The probabilities of bias exceeding 10% were 55% (11/20 ), 70% ( 14/20 ) and 55% (11/20), respectively. Conclusions FCM labs should set up their own normal reference range for peripheral blood lymphocyte subsets. The normal reference range should be verified periodically. It is important to apply internal blood quality control regularly and accumulate the quality control results. The reagents and instrument for preparing peripheral blood samples should be from the same manufacturers.

Objective To investigate the association between the systolic/diastolic orthostatic hypotension (OH-S/OH-D) and myoeardial infarction (MI) in the elderly.Methods Health screening physical examination were carried in 1081 subjects without MI aged over 65 years in Guangzhou Military region.The orthostatic blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 minutes after standing.All the cases were divided into systolic or diastolic group on the basis of definition of orthostatic hypotension and followed up by telephone or inpatient medical records with mean period of 315.8 days.The primary endpoint was MI occurrence.Results The prevalence of OH in this cohort was 24.5％ ( OH-S/OH-D:19.3％/17.2％ ).Significant differences in the occurrence of OH and OH-S were found in the elderly and the very elderly subjects( ≥80 years) (26.1％ vs 20.1％,P=0.045; 21.0％ vs 14.6％,P =0.018),while no difference was found in OH-D.The prevalence of MI in the OH positive subjects was significantly higher than that in the OH negative subjects,as well as in OH-S or OH-D group.After adjustment of age,supine blood pressure,creatinine and cerebrovascular history by logistic regression,the association was observed between MI and OH ( HR 15.635,95 ％ CI 3.299-74.091,P=0.001),OH-S(HR 8.760,95％CI2.487-30.851,P=0.001)and OH-D(HR 3.889,95％ CI 1.097-13.790,P =0.035 ).Conclusion OH-S and OH-D hypotension are robust predictors for MI in the elderly.

Guangdong province assumes the task of pilot exploration and demonstration for building the preventive health service system of Chinese medicine. In the pilot process of preventive treatment of disease, a health pro-ject of Chinese medicine, sectoral agreements and policy studies are focusing issues. This paper explores the pre-ventive health service system building of Chinese medicine in G uangdong province , from following aspects such as access policy of service agencies, access policy of professional service staff, evaluation mechanism and verify sys-tem, the revision of existing medical subjects of medical institutions, health insurance policies and compensation policies, price policies, proactive technology policies and fiscal policies, incentive policies for the introduction of private capital .