Objective To explore the the interaction analysis of genetic and behavioral factors on the occurrence of acute coronary syndrome. Methods This study consisted of 134 subjects between June 2009 and Dec.2009 from affiliated hospital of Jining Medical University, All subjects underwented selective coronary angiography or coronary artery CT. Coronary artery disease based on the results of coronary angiography or coronary artery CT that at least one coronary artery diameter reduction of more than 50% and fulfilled the diagnostic criteria of ACC/AHA. 84 patients with acute coronary syndrome and 50 controls, and general informations, current disease history,past medical history, related be havioral factors were collected. DNA was extracted from acute coronary syndromepatients and healthy control subjects, stored in -20 ℃. The genotype of CFH Y402H was detected by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP) methods in acute coronary syndrome patients and controls. PCR amplification products was verificated by electrophoresis on agarose gel. Deviation of genotype distribution form Hardy-Weinberg equilibrium was assessed using x2 test in each group. Univariate and multivariate conditional logistic analyses were conducted in the end. Results The results showed that smoking history (P=0.000, OR =4.894,OR 95% CI:2.537 ～9.441 ), alcohol drinking history(P= 0.008,OR =2.879,OR 95% CI: 1.499 ～ 5.528 ), hypertension (P = 0.000, OR = 4.222, OR 95% CI: 2.195 ～ 8.123), sports activities (P =0.002,OR =0.333, OR 95% CI:0.188 ～ 0.589 ), salt intake (P= 0.006, OR = 0.457, OR 95% CI:0.287 ～0.727 ), character(P = 0.000, OR = 0.385, OR 95% CI :0.247 ～ 0.600 ) stress of occupations (P = 0.015, OR =2.118, OR 95% CI: 1.278 ～ 3.511 ) were associated with acute coronary syndrome of Northern Chinese Han population. Smoking history(P = 0.010, OR = 6.084, OR 95% CI: 1.543 ～ 23.988), hypertension (P= 0.024, OR =2.821, OR 95% CI: 1.143 ～ 6.595 ), sports activities (P= 0.004, OR = 0.297, OR 95% CI:0.130 ～ 0.678 ), personality(P= 0.011, OR = 0.435, OR 95% CI:0.229 ～ 0.829 ) were significantly associated with acute coronary syndrome in multivariate conditional logistic analyses after adjusting other factors. Conclusions Smoking history,hypertension, personality are risk factors of acute coronary syndrome of Northern Chinese Han population. Butsports activities is protective factors.

Cytoplast and microprotoplast are main subprotoplasts that can play an important role in plant genetic improvement.The present review highlights the advancements in isolation and fusion of plant subprotoplast,and some suggestions and prospects are proposed for the future studies.

Objective To investigate the expression levels of serum visfatin ,leptin and other indexes and their correlation and clinical significance in the patients with type 2 diabetes mellitus(T2DM ) .Methods Eighty-two age-matched and gender-matched cases of T2DM (T2DM group)and 71 cases of healthy subjects(health control group)were tested serum visfatin ,leptin ,insulin ,lipid and glycemia levels .Results The serum visfatin ,leptin ,triglycerides(TG) ,total cholesterol(TC) ,high-density lipoprotein choles-terol(HDL-C) and low density lipoprotein cholesterol(LDC-C) ,fasting plasma glucose ,fasting insulin(FINS) ,homeostasis model assessment of insulin resistance(OMA-IR) ,2 h FPG ,2 h FINS had statistically significant differences between the T 2DM group and the health control group(P< 0 .05);the stepwise regression analysis showed that visfatin were positively correlated with BMI , FINS ,HOMA-IR ,TC ,TG ,LDL-C (P<0 .05)and negatively correlated with HDL-C(P<0 .05);leptin were positively correlated with BMI ,FINS ,HOMA-IR(P<0 .05) .Conclusion Serum visfatin and leptin in the T2DM patients are hither than those in the healthy subjects and closely related with blood lipid ,blood glucose and insulin ,which may become the new diagnostic indexes of T2DM .

Objective To observe the dynamic changes of NO,NOS in serum and CSF in patients with CNS infection and lay an experimental basis for discrimination of CNS infection due to different agents.Methods The method of nitrate redutase and the method of chromometry were employed to measure NO,NOS in serum and CSF at different time.The dynamic changes of NO,NOS in serum were observed on admission,on 3,5,9,14 day after admission.The dynamic changes of NO,NOS in CSF before treatment and two weeks after treatment were ob- served,too.Results There were no difference between the the concentration of NO and the vigor of total NOS in serum and in CSF of viral meningitis,bacterial meningitis and tubercular meningitis patients due to different agents. Conclusion The changes of the concentration of NO in serum and CSF,the vigor of total NOS in serum and CSF could not he seen as laboratory basis for discrimination of CNS infection due to different agents.

Objective To investigate the distribution,epidemiologic features and antibiotic resistance of the enteric pathogens i-solated from children with diarrhea.Methods Enteric pathogens were isolated from children’s stool samples.The children with diarrhea were treated in the outpatient and inpatient of Shanghai Children’s Hospital between 2008 and 2013.Antimicrobial susceptibility testing was conducted by disk diffusion method for Salmonella and Shigella with 6 antimicrobial agents.Results A total of 545 enteric pathogens were collected.Salmonella was the dominant pathogen,accounting for 67.2%,followed by Shigella (20.7%),S.aureus (4.6%),C.jejuni (3.7%),Aeromonas (2.4%),and enteropathogenic E.coli (0.9%).The main serotypes of Salmonella were S.typhimurium and S.enteritidis.Approximately 56.3% of the patients were boys.A-bout 72.7% of the patients were infants under 2 years.The prevalence of diarrhea peaked in summer and autumn (72.9%). The susceptibility of these isolates was only tested with seven antibiotics.Shigella showed higher level of resistance to ampicil-lin and trimethoprim-sulfamethoxazole than Salmonella (P<0.05).Significantly higher percentage of S.flexneri isolates were resistant to sulbactam-ampicillin,ceftriaxone,ciprofloxacin,and chloramphenicol than S.sonnei (P<0.001).Further-more,the prevalence of multidrug resistant strains in Shigella (68.3%)was much higher than that in Salmonella (44.7%,P<0.001).Conclusions A variety of diarrhea-causing enteric pathogens are isolated from the children in Shanghai Children’s Hospital.The isolates are predominantly Salmonella and Shigella species.The epidemiological features of Salmonella and Shigella species are different in terms of gender,age,season and geographical distribution.The resistance to antibiotics is a serious problem and varies with different types of pathogens. Intensive and ongoing surveillance of enteric pathogens and their changing resistant pattern is required to control diar-rhea in children.

Objective To study the application value of preoperative medical adhesive locating in performing thoracoscopy for small pulmonary nodules (SPN).Methods The clinical data of 41 patients with solitary SPN,who received thoracoscopy with the help of preoperative locating procedure,were retrospective analyzed.The preoperative locating methods included medical adhesive locating (n=22,medical adhesive group) and Hook-wire locating (n=19,Hook-wire group).The locating effects,complications,the time of engagement stage and the time used for pulmonary wedge resection were determined,and the results were compared between the two groups.Results The locating of SPN was successfully accomplished in all patients of both groups.The incidences of pneumothorax,pulmonary hemorrhage and chest pain in the medical adhesive group were 18.2％,9.1％ and 4.5％ respectively,which were lower than those in the Hook-wire group;among them the difference in the incidence of pulmonary hemorrhage between the two groups was statistically significant (P＜0.01).No-complication rate in the medical adhesive group (63.6％) was higher than that in the Hook-wire group (21.1％),and the difference was statistically significant (P＜0.05).The time of engagement stage for patients in the medical adhesive group was (16.32±8.83) hours,which was longer than (3.29±4.21) hours in the Hook-wire group,the difference between the two groups was statistically significant (P＜0.01).The time used for puhnonary wedge resection in the medical adhesive group and in the Hook-wire group was (21.14±7.01) min and (18.58±5.22) min respectively,the difference between the two groups was not statistically significant (P＞0.05).Conclusion Preoperative medical adhesive locating for the performance of thoracoscopy for SPN is safe and effective,it carries less complications when compared with Hook-wirelocating method and can obtain a longer interwal period,therefore,this technique has high application valuein clinical practice.

OBJECTIVETo investigate the clinicopathologic feature, immunophenotype and differential diagnosis of cutaneous Rosai-Dorfman disease (CRDD).

METHODSClinical manifestation, morphologic features and immunohistochemical staining were studied in 8 cases of CRDD.

RESULTSAll 8 patients presented with multiple papules, nodules and/or coalescent patches or plaques distributing over the extremities or trunk, without lymphadenopathy or other systemic abnormalities. Microscopically, the lesions were located intradermally and/or subcutaneously. CRDD was characterized by the presence of S-100 positive histiocytic cells exhibiting emperipolesis, accompanying with infiltration of mixed inflammatory cells. Fibrosis, somewhere in vague storiform pattern due to stromal responses, with distribution of individual neutrophil microabscess was seen in cases with a long course of illness. Dilated vascular spaces in dermis containing numerous large typical histiocytes were seen in 2 cases.

CONCLUSIONSCRDD is a benign, persistent proliferative disease of histiocytes. Systemic involvement is rare, outcome favorable. It should be differentiated from other types of histiocytosis, dermatofibrosarcoma protuberans, xanthoma and lymphoproliferative disorders. Immunohistochemical staining for S-100 protein and CD68 is helpful in making a correct diagnosis.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Histiocytosis, Sinus ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Prognosis ; S100 Proteins ; metabolism ; Skin Diseases ; metabolism ; pathology ; surgery

OBJECTIVETo study the clinicopathologic features, immunophenotype and prognosis of primary cutaneous anaplastic large cell lymphoma (CALCL).

METHODSHistopathologic evaluation and immunohistochemical study by Envision method were carried out in 44 archival cases of CALCL. The clinical information and follow-up data were analyzed.

RESULTSThe patients presented with skin nodules, masses or plaques, sometimes associated with ulceration. The commonest sites of involvement were the extremities. Follow-up data were available in 39 patients. The overall survival rate was 87.2% (34/39). Disease relapses were detected in 46.2% (18/39) of the patients. Statistical analysis indicated that patients older than 50 years of age or with no less than two involved anatomic sites were more likely to have disease relapses (P < 0.05). Histologically, 31 cases were classified as common variant, 6 cases as small cell variant and 7 cases as neutrophil/eosinophil-rich variant. Immunohistochemical study showed that the rates of expression of CD30, CD45, CD45RO, CD43, CD3, cytotoxic protein and epithelial membrane antigen were 100% (44/44), 91.2% (31/34), 82.6% (19/23), 94.7% (18/19), 70.0% (28/40), 73.3% (22/30) and 31.8% (7/22), respectively. The CD4(+)/CD8(-), CD4(-)/CD8(+) and CD4(-)/CD8(-) immunophenotypes were found in 58.3% (21/36), 22.2% (8/36) and 19.4% (7/36) of the CALCL cases, respectively. Only one case (3.7%) expressed CD56.

CONCLUSIONSCALCL is a form of low-grade primary cutaneous T-cell lymphoma with a wide spectrum of clinicopathologic pattern. Special variants of CALCL should not be confused with other types of cutaneous lymphomas and inflammatory lesions. CALCL patients older than 50 years of age or with no less than two involved anatomic sites are more likely to have disease relapses.

Adult ; Age Factors ; Aged ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Immunophenotyping ; Ki-1 Antigen ; metabolism ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Proportional Hazards Models ; Skin Neoplasms ; drug therapy ; metabolism ; pathology ; Survival Rate ; Young Adult

Objective To evaluate the effect of pitavastatin on blood glucose in patients with hypercholesterolemia,and to investigate the efficacy of pitavastatin in diabetic patients combined with hypercholesterolemia.Method This study was a 12-week,multi-center,open-label,without parallel-group comparison,phase Ⅳ clinical trail.Results Contrasting to baseline,the prevalences at week 4 and 12 post-treatment of abnormal fasting plasma glucose (FPG) and glycosylated hemoglobin Alc (HbA1c)( FPG:14.2％ vs 14.1％ and 11.0％ ; HbA1c:14.3％ vs 15.1％ and 16.1％ ) in the safety set subjects without diabetes mellitus (DM),as well as in those with DM but not taking glucose-lowering drugs (FPG:7/7 vs 4/7 and 5/7; HbAlc:5/5 vs 4/4 and 5/5) had no significant changes (all P vaules ＞0.05).Contrasting to baseline,the levels of TC [ (6.51±0.94) mmol/L vs (5.12 ±0.93) mmol/L and (4.54 ±1.00) mmol/L],LDL-C [(4.11 ±0.79)mmol/L vs (3.02 ±0.81) mmol/L and (2.51 ±0.70)mmol/L] and TG [2.10(1.53,2.54) mmol/L vs 1.62(1.26,2.00) mmol/L and 1.35(1.10,1.86)mmol/L]at week 4 and 12 post-treatment in the per protocol set 55 subjects with DM were significantly reduced (all P values ＜ 0.05 ) ; 33.3％ of subjects at high risk and 10.0％ of subjects at very high risk had achieved a TC target value; 55.6％ of subjects at high risk and 40.0％ of subjects at very high risk had achieved a LDL-C target value.Conclusion Pitavastatin has a safe effect on blood glucose and it could be used to treat diabetic patients combined with hypercholesterolemia in China.

Objective To evaluate the prognostic value of serial 18F-fluorodeexyglucose (FDG) PET/CT in patients with nasopharyngeal carcinoma (NPC).Methods Thirty-seven NPC patients who had 18F-FDG PET/CT scan before and after external beam intensity-modulated radiotherapy, were studied retrospectively.All patients were followed for five years.Correlation analysis between metabolic tumor volume (MTV)/uptake volume index (UVI) and survival was performed by Kaplan-Meier analysis, Log-rank test and multivariate Cox model.Results The 5-year overall survival (OS) and disease-free survival (DFS) rates were 70.3% (26/37) and 62.2% ( 23/37 ), respectively.Patients with a lower MTV (MTV＜30 cm3) had significantly higher 5-year OS ( 82.6% ( 19/23 ) ) and DFS (73.9% ( 17/23 )) rates than those with a higher MTV (OS:50.0% (7/14),x2 =5.28, P＜0.05; DFS:42.9% (6/14),x2 =4.84, P＜0.05).Patients with a lower UV1 (UVI＜150) had significantly higher 5-year OS( 87.5%( 21/24 )) and DFS (79.2% (19/24)) rates than those with a higher UVI (OS:38.5% (5/13),x2 =10.72, P＜0.01;DFS:30.8% (4/13), x2 =11.04, P＜0.01).Multivariate analysis showed that UVI and metabolic response (MR) were independent predictors of DFS.Conclusions Tumor volume parameters, UVI and MR, are independent prognostic factors for patients with NPC.Patients with a high UVI may benefit from more aggressive treatment.