Objective To analyze the characteristics of pulse pressure index(PPI) and its value in predicting the risk for cerebral and cardiac vascular events in old males with hypertension. Meth-ods The 24-hours ambulatory blood pressure monitoring was performed in a total of 265 elderly men with essential hypertension(EH). The patients were classified into 3 groups based on the lev-el of PPI.PPI≤0.400(103) ,0. 401-0. 500(124) ,and≥0.501(38). Results There was significant difference in PP between day-time and night-time in hypertensive patients. The change of PPI was less than that of PP. With the increase in PPI, SBP(24 h, day-time, night-time), PP(24 h, day-time, night-time), the load of SBP(night-time), systolic blood pressure variation(BPV, 24 h, day-time) were raised significantly (P<0.01); while DBP(24 h, day-time, night-time), nocturnal de-cline in BP and the load of DBP(day-time) declined with the decrease in PPI (P<0.01). High PPI would increase the incidence of cardiac-cerebral vascular events (P < 0.01). Conclusion PPI is a useful parameter in clinical evaluation of arteriosclerosis. It may also have prognostic value for cardiac-cerebral vascular events in elderly men with EH.

The experiment was conducted to examine the effect of zinc toxicity on the peripheral blood T-lymphocyte by the method of flow cytometry(FCM) and ANAE.200 one-day-old Avian broilers were divided into four groups,and fed with the diets as follows:①control group(Zn 100 mg/kg diet) and ② zinc toxic groups(Zn 1 500 mg/kg diet,zinc toxic group Ⅰ;Zn 2 000 mg/kg diet,zinc toxic group Ⅱ;Zn 2 500 mg/kg diet,zinc toxic group Ⅲ) for seven weeks.The ANAE positive ratios of the peripheral blood T-lymphocytes were much lower in the three zinc toxic groups than that in control group at 7 weeks of age.CD4+ T cell numbers were reduced from 2 to 7 weekds of age in zinc toxic group Ⅲ and from 6 to 7 weeks of age in zinc toxic group Ⅱ,as compared with that of control group.The numbers of CD8+ T cell decreased at 2 and 4 weeks of age in zinc toxic groups Ⅱ and Ⅲ,and at 7 weeks of age in zinc grups Ⅰ and Ⅲ.CD4+/CD8+ ratio was higher at 2 and 4 weeks age,and lower at 6 and 7 weeks of age in zinc toxic groups Ⅰ,Ⅱ and Ⅲ than in control group.The results showed that zinc toxicity would suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations.Potential mechanism underlying these observations are also discussed.

The nursing risk event is a hospital nurse on patient care, a series of unsafe events may occur, it is very im-portant to enhance clinical nursing risk management in hospital. This paper carried on the research analysis on the re-lated factors of clinical nursing risk events of the hospital, and puts forward relevant management measures and solu-tions.

Objective To evaluate the effect of temporal resolution of breast dynamic contrast-enhancing (DCE)-MRI on pharmacokinetic parameters and diagnostic performance in benign and malignant breast lesions.Methods Retrospective review was performed on 26 benign and 29 malignant breast lesions which were proven pathologically by surgery or biopsy.Dynamic contrast enhanced breast MRI using a new volume-interpolated-breath-hold examination sequence combining parallel acquisition, Dixon fat separation and time-resolved imaging with interleaved stochastic trajectories (CDT-VIBE) was performed in all patients.The original time resolution of this sequence was 12 s and based on which, dynamic sequences with different temporal resolutions of 24 s, 36 s, 48 s and 60 s were simulated by a sample-removing method and were used for the calculation of pharmacokinetic parameters, including volume transfer constant (Ktrans), constant flux rate (Kep), volume of extravascular extracellular space (Ve) and area under the curve at initial 60 s (iAUC), to observe their changes with different temporal resolution.The repeated measurement of analysis of variance was used to explore significant changes in pharmacokinetics parameters with different temporal resolution.To evaluate the diagnostic efficiency of parameters with different temporal resolution, ROC analysis was performed in accordance with pathological findings.Results With decrease of temporal resolution from 12 to 60 s, there was a significant increase in Ktrans and Kep of benign lesions [Ktrans: (0.147±0.084)/min to (0.170 ± 0.085)/min, Kep: (0.321± 0.176)/min to (0.433± 0.175)/min] and steady decrease in Ktrans and Kep of malignant lesions [Ktrans: (0.373±0.210)/min to (0.259± 0.122)/min, Kep: (0.929 ±0.402)/min to (0.581 ± 0.143)/min];the changes of Ve were less significant and irregular;the values of iAUC decreased both in benign [(9.192± 4.660) to (7.388± 3.065)] and malignant [(20.221±9.876) to (12.850±5.194)] lesions.The changes in all parameters with different time resolution were statistically significant in benign and malignant lesions (all P＜0.05).By pair-wise comparison between different time resolution, the changes of K among 12 s, 24 s and 36 s (all P＜0.05), the changes of Kep between 12 s and others (all P＜0.01), the changes of Ve between 24 s and others (all P＜0.01), and the changes among all pairs of iAUC were significant (all P＜0.05) except for 12 s and 24 s (P=1.000).The best AUC value of Ktrans and Kep between benign and malignant lesions were achieved with 12 s dynamic sequences (0.887, 0.939), and the best AUC value of iAUC was with 24 s sequences (0.877).The AUC values of Ve were between 0.511 to 0.601, which was lower than that of other three parameters.Conclusion A 24 s or higher temporal resolution of DCE-MRI should be able to provide consistent differentiation of pharmacokinetic parameters in benign and malignant breast lesions.

Objective To explore the effects of Chinese herbal compound Tangbikang on the expressions of p38 MAPK of sciatic nerve and plasma TNF-α in diabetic rats. Methods Ten of the sixty male SD rats were selected randomly as normal group, and the rest were fed with high-fat diet and low-dosage STZ was used to induce type Ⅱdiabetic rat models. Model rats were randomly divided into model group, mecobalamine group and Tangbikang low-, medium-, and high-dosage groups, 10 rats in each group. Each medication group was intervened with relevant medicine. Rat unilaterals sciatic nerves were taken after 16 weeks. The content of TNF-α in plasma was determined by radioimmunoassay. Western blot method was used to detect the expressions of p38 and p-p38 MAPK protein of sciatic nerve. Results Compared with normal group, the expressions of p38 and p-p38 protein and content of TNF-αin model group significantly increase (P<0.05, P<0.01). Compared with the model group, the expressions of p-p38 protein and the content of TNF-α significantly decreased after medicine intervention in different doses Tangbikang groups and mecobalamin group (P<0.05, P<0.01). The expression of p38 protein in Tangbikang high-dose group significantly decreased (P<0.05), with statistical significance (P<0.05). Conclusion Tangbikang can reduce the expression of p38 and p-p38 MAPK protein of the rat sciatic nerve, and reduce the content of TNF-α protein in rat plasma, which may be one of the effective targets of neuroprotection and abirritation of diabetic peripheral neuropathy.

Objective:To establish an HPLC method for the determination of four kinds of isoflavone compounds including daid-zin, tectoridin, daidzein and tectorigenin in the extracts of Pueraria lobata flowers. Methods:The separation was performed on an Agi-lent C18 column(250 mm × 4. 6 mm, 5 μm) using a mobile phase of methanol-acetonitrile-water(2∶1∶2). The flow rate was 1. 0 ml· min-1 ,and the detection wavelength was 264nm. The column temperature was 25℃ and the sample size was 20 μl. Results:The de-tection could be accomplished within 10 minutes with good separation and specificity of four isoflavone compounds with the retention timeof3.4,3.8,5.7and7.2min,respectively. Thelinearrangewas0.784-78.440 μg·ml-1(daidzin),2.000-200.000 μg· ml-1(tectoridin) and 0.800-80.020 μg·ml-1 (daidzein and tectorigenin),and the relative coefficient was 0.999 9, 0.999 8, 0. 999 7 and 0. 999 9, respectively. The average recovery was 100. 54%(RSD=1. 66%,n=6),100. 03%(RSD=1. 00%, n=6), 99. 48%(RSD=1. 76%, n=6) and 100. 92%(RSD=2. 26%, n=6), respectively. Conclusion: The method is simple, rapid and accurate with good repeatability, which can be used in the rapid determination of isoflavone compounds in the flowers of Pueraria loba-ta.

Objective To optimize the extraction technology of flos Puerariae lobata isoflavone .Methods The flos Pu-erariae lobata isoflavone was distilled by ethanol circumfluence .Total flavonoids ,tectoridin and tectorigenin extracted from Puerariae using the UV and HPLC spectromertry methods were taken as evaluation indexes .Extraction technology was opti-mized with L9 (34 ) orthogonal test on the base of single observation of ethanol concentration ,solvent dosage and distilling time . Results The best extraction technology of flos Puerariae lobata isoflavone was :to add 12 times the amount of 70% ethanol for 90 minutes for the first time ,and 10 times the amount of 70% ethanol for 60 minutes for the second time .Conclusion The op-timized extraction process of flos Puerariae lobata isoflavone is reasonable and feasible ,and it can offer reference to actual pro-duction .

The primary importance of magnetic resonance (MR) imaging in evaluating anal fistulas lies in its ability to demonstrate hidden areas of sepsis and secondary extensions in patients with fistula in ano. MR imaging is relatively expensive, so there are many healthcare systems worldwide where access to MR imaging remains restricted. Until recently, computed tomography (CT) has played a limited role in imaging fistula in ano, largely owing to its poor resolution of soft tissue. In this article, the different imaging features of the CT and MRI are compared to demonstrate the relative accuracy of CT fistulography for the preoperative assessment of fistula in ano. CT fistulography and MR imaging have their own advantages for preoperative evaluation of perianal fistula, and can be applied to complement one another when necessary.
Adult ; Anal Canal/anatomy & histology ; Female ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Rectal Fistula/diagnosis/*radiography/surgery ; Tomography, X-Ray Computed ; Young Adult

Pulmonary mucinous adenocarcinoma is a subtype of lung adenocarcinoma, among which invasive mucinous adenocarcinoma (IMA) is the most common subtype and is easily misdiagnosed as pneumonia. Its etiology and pathogenesis are unclear and may be related to gene mutations and other factors. Due to its relative rarity and few related studies, guidelines do not provide advices on its treatment. KRAS mutations are common in IMA patients, and Sotorasib may be effective against KRAS G12C mutated IMA. NRG1 fusion is considered to be an important driver of IMA, and afatinib may be effective in treating IMA with NRG1 fusion/rearrangement. PD-L1 expression is very low in IMA patients, while B7-H3 expression is high, so B7-H3 may be a potential immunotherapeutic target.

Objective To evaluate the clinical effects of the treatment on chronic kidney disease 3 with dampness-heat type. Methods A retrospective cohort study recruited 103 patients with qi deficiency and dampness-heat type of CKD3. Among them,51 cases in the control group were treated with western medicine therapy. The 52 cases in the treatment group received Qingbudigui Decoction. SCr ,eGFR and 24hU-Prowere were observed after 12 months and 24 months for evaluating the clinical effects of Qingbudigui Decoction. Results After 12 and 24 months treatment,the treatment group had a significantly lower SCr and U-Pro(P < 0.01),but a higher eGFR (P<0.01,P<0.05). After 12 months and 24 months,there was no significant change in SCr,U-Pro or eGFR in the control group (P > 0.05). Conclusions Combination therapy of the Qingbudigui Decoction of the patients with qi deficiency and dampness-heat type of CKD3 could delay the kidney disease,which is superior to simple western medicine group. The mechanism may be related to the reduction of urinary protein excretion.