Objective:To evaluate the performance of paramagnetic particles chemiluminescence microparticle immunoassay ( CMIA) for detection of serum Vitamin B12 ( VitB12 ).Methods: Analysed CMIA system precision, accuracy, anti-interference, analytical measuring range( AMR) ,clinical reportable range ( CRR) and biological reference interval were evaluated,according to the clinical and laboratory standards institude ( CLSI) EP5-A2,EP15-A2,EP7-A2,EP6-A,C28-A3c guidelines.To assess the accuracy,we used the reference material SRM 1955 from national institute of standards and technology ( NIST ) and external quality assessment ( EQA) samples ( LN5-B and K-C) from CAP.Results:The precisions of within-run and between-run were less than standard of manu-facturer when the concentration of VitB12 was 108.84-874.43 pmol/L.The results of SRM1955 met the allowable range of the target val-ue.The results of EQA samples( K-C and LN5-B) also up to the CAP calibration and validation/linear evaluation error limits stipulated standards,and the results through linear verification when the concentration of VitB12 was 89-1 057 pmol/L.The 95% verification interval contains the specified value also.The relative deviation was less than external quality assessment standard from national center for clinical laboratory ( TEa:target value ±25%).Anti-interference evaluation showed without significant interferenc when TG ≤20 mmol/L,Bil ≤300 μmol/L VitC≤1.5 g/L to the VitB12 detection system ( CMIA).AMR validation showed determines the best fit equation was linear equation polynomial.There was the linear relationship when the concentration of VitB12 was 0-1 107 pmol/L.The upper limit of CRR was 110 700 pmol/L,the maximum dilution was 100 times.Biological reference interval validation showed that the overall level of VitB12 in this study reference individuals conform to the standard of manufacturer statement for the population,the overall level of VitB12 in female little higher than male,but no significant differences.Conclusion:Performance of CMIA for detection of serum VitB12 basically met needs of laboratory,which can provide reliable results of VitB12 for laboratory,provide information for the VitB12 status of population in the laboratory evaluation.

We investigated the baseline brain activity level in patients with major depressive disorder (MDD) by am plitude of low-frequency fluctuation (ALFF) based on resting-state functional MRI (fMRI). We examined 13 patients in the MDD group and 14 healthy volunteers in the control group by resting-state fMRI on GE Signa 3.0T. We calculated and compared the ALFF values of the two groups. In the MDD group, ALFF values in the right medial prefrontal were higher than those in control group, with statistically significant differences (P < 0.001). ALFF values in the left parietal in the MDD group were lower than those in control group with statistically significant differences (P < 0.001). This resting-state fMRI study suggested that the alteration brain activity in the right medial prefrontal and left parietal ALFF contributed to the understanding of the pathophysiological mechanism of MDD patients.
Brain ; physiopathology ; Brain Mapping ; Case-Control Studies ; Depressive Disorder, Major ; physiopathology ; Humans ; Magnetic Resonance Imaging

A total of 118 patients with type 2 diabetes mellitus were divided into acarbose treatment group ( A group,n =58 ) and no acarbose treatment group ( B group,n =60),and 57 healthy subjects were used as control group (C group).The quantification of fecal bifidobacteria and enterococcus faecalis in these subjects was made by realtime PCR.The results showed that fecal bifidobacteria contents in A and B groups were lower and enterococcus faecalis contents were higher compared with C group.After four weeks of intervention,fecal bifidobacteria contents in A and B groups increased ( P＜0.01 ),especially in A group,while enterococcus faecalis contents decreased ( P＜0.05 )compared with the baseline.Univariate correlation analysis showed that bifidobacteria content was negatively associated with lipopolysaccharides(LPS),advanced glycation index,high sensitive C reactive protein ( hs-CRP),and body mass index ( BMI ) at baseline ( P＜0.05 or P＜0.01 ).The enterococcus faecalis content was positively associated with levels of monocyte chemoattractant protein-1,LPS,tumor necrosis factor-α,hs-CRP,plasminogen activator inhibitor-1,BMI,and HbA1c (P ＜0.01 ).After four weeks of intervention,the above associations disappeared.Stepwise multivariate regression showed that basal BMI,HbA1c,and age contributed to the increase in the number of enterococcus faecalis,and BMI negatively contributed to the decrease in number of bifidobacteria.

Objective To investigate the mechanism of hearing loss after focal cerebral ischemia-reperfusion injury in rats.Methods A total of 60 healthy male adult SD rats were included in this study and randomly divided into 2 groups, ischemia-reperfusion(I/R) group and sham operated control, with 30 rats in each group.The rats in I/R group were operated for suture-occluded method to establish middle cerebral artery occlusion(MCAO)model, with ischemia for 60 mins followed by reperfusion for 24 hrs.The control group was only to be isolated cervical vessels, with no thread embolism inserted.The auditory brainstem response (ABR) was tested before operation and at 24 hrs post-operation respectively.At 24 hrs post-operation, we scored neurological functions, measured the changes of water content in the brain using the dry-wet weight method, and determined the infarct volume through TTC method.We also evaluated the integrity of blood-brain barrier(BBB) by viewing the exudation of Evans blue and observed the apoptosis of neurocyte by TUNEL method to conclude apoptotic index(AI).The expression of MMP-9,Claudin-5,Occludin and CX-43 were detected by Western blot.Results Compared with the sham group,the neurological function scores,the infarct volume and water content of the brain increased, with the elevated thresholds of ABR significantly and AI went up in I/R group.The expression levels of MMP-9 and CX-43 were significantly up-regulated,but the expressions of Claudin-5 and Occludin were obviously down-regulated.All of the differences above had statistical significances.Conclusion The mechanism of hearing loss after focal cerebral ischemia-reperfusion injury in rats is possibly related to MMPs activation,neurocyte apoptosis,BBB breakage and gap junction damage.

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Objective To investigate and evaluate the correlation between brain natriuretic peptide (BNP) and gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy (HDCP).Methods Fifty cases with HDCP and 46 cases with mild and 83 cases with sever stage preeclampsia were selected as our subjects.And 33 cases with regular pregnancy and 31 with irregular pregnancy were served as control group.Plasma brain natriuretic peptide,urinary protein quantity(UBQ),24-hour urinary protein assay (UPA) were measured.The correlations of brain natriuretic peptide and UBQ,UPA,systolic pressure (SP),diastolic pressure (DP) were analyzed.Results The levels of brain natriuretic peptide in the group with gestational hypertension and mild,severe preeclampsia groups were (48.54± 18.27),(79.46± 32.18) and (292.24±213.08) ng/L,higher than that in normal pregnancy and non pregnant group ((27.84± 14.58) and (20.63± 8.28) n/L;F =49.583,P＜0.05).While no significant difference exists between normal pregnancy group and non pregnant group.Grouped on the median values (199) of brain natriuretic peptide of the severe preeclampsia group,the levels of 24-hour UPA,systolic pressure and diastolic pressure were (5.46±2.68) g,(174.55± 13.58) mmHg,(113.74±9.91) mmHg in patients with brain natriuretic peptide ≥ 199 ng/L(n=42),significant higher than those in patients with brain natriuretic peptide ＜ 199 ng/L(n =41;(4.34± 1.95)g,(165.31±11.12) mmHg,(106.05±8.02) mmHg;t=2.603,3.396,2.308;P=＞0.010,0.001,0.024).The levels of 24-hour UPA,systolic pressure and diastolic pressure of patients with brain natriuretic peptide ≥ 86ng/L(n=20) in mild preeclampsia were (1.68±0.27) g,(163.69±8.29) mmHg,(105.45±6.71) mmHg,significant higher than those in patients with brain natriuretic peptide ＜ 86 ng/L (n =26;(1.16 ± 0.31) g,(152.90±7.32) mmHg,(99.19 ± 5.25) mmHg;t =3.180,2.508,2.32;P =0.010,0.016,0.025).Brain natriuretic peptide was closely correlated with UPA,systolic pressure and diastolic pressure in hypertensive disorder complicating pregnancy (HDCP) (r =0.29,0.30;P ＜ 0.01).Brain natriuretic peptide was closely correlated with UPA systolic pressure and diastolic pressure in mild preeclampsia (r =0.39,0.37,0.40;P ＜0.01).And correlation efficacy of brain natriuretic peptide with UPA,systolic pressure and diastolic pressure were 0.44,0.42 and 0.53 (P＜0.01).Conclusion The level of brain natriuretic peptide is closely associated with the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.Correlation of brain natriuretic peptide to the severity of gestational hypertension and preeclampsia is independent of urinary protein and hypertension.Brain natriuretic peptide is an important indicator for the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.

Objective To evaluate the clinical application of CT perfusion in predicting the status of axillary lymph nodes in patients with breast cancer.Methods Fony-five patients with infiltrating breast cancers and 46 clinically palpable axillary lymph nodes underwent dynamic mtdti-slice spiral CT(MSCT).Semi-automatic calculation of perfusion parameters including blood flow(BF),blood volume(BV),mean transit time(MTT)and permeability surface(PS)of "target" lymph nodes and muscles in the same scan level were respectively meagured and analyzed.Nonparametric Mann-Whitney U test was used for the statistics.Results Forty-six "target" lymph nodes examined by CTP were metastasis in 32 cases and reactive hyperplastic lymph node inflammation in 14 cases at pathology.22 of 32 metastatic "target" nodes (68%)were sentinel lymph nodes(SLN).BF of CIP for inflammation and metastatic "target" nodes were (76.18±31.53)and(161.60±40.94)ml·100 mg-1·min-1,BV were(5.81±2.50)and(9.15±3.02)ml／100 mg.MTT were(6.80±1.55)and(5.50±1.84)s,PS were(25.82±4.62)and (25.96±7.47)ml·100 mg-1·min-1.There were significant correlations between the BF value of inflammation and metastatic "target" nodes(r=0.14,P<0.05)and there were no significant correlations among the BV,MTT and PS values of inflammation and metastatic "target" nodes(r=-0.03,0.05,0.07.P>0.05).Conelusion CTP can provide useful informafion for evaluating lymph node status.

Objective To evaluate the effect of acarbose on the circulating concentration of inflammatory factors in patients with type 2 diabetes mellitus(T2DM). Methods Total 118 patients with T2DM who did not take acarbose before enrollment within 4 weeks were recruited by a randomizing formula into 2 groups ( group A and B). 57 healthy subjects were included into group C as control. After excluding those of inadequate samples, 57 patients with T2DM were enrolled into group A in which acarbose was prescribed 50 mg three times a day, 59 patients with T2DM were enrolled into group B in which acarbose was not given and other hypoglycemic approaches were similar to group A. Serum samples at the time of enrollment and at the end of 4 weeks intervention were collected and stored in refrigerator at -80℃ until analysis. Analysis of biochemical indexes was performed in central lab of the institution,inflammatory factors were determined with commercial ELISA kits. Results (1) The metabolic indexes were significantly decreased after intervention in two diabetic groups. (2) The baseline levels of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α( TNF-α), prothrombin activator inhibitor-1 (PAI-1), lipopolysaccharide (LPS), high sensitive C reactive protein ( hs-CRP), and advanced glycation index (AGI) in diabetic patients were significantly higher than in group C MCP-1 [( 463.4± 187.1 vs 267.1 ± 158.3 ) pg/ml, TNF-α( 12.07 ± 19.59 vs 4.18 ±3.03 ) pg/ml, PAI-1 ( 2.47 ± 1.87 vs 1.38 ± 2.37 )ng/ ml, LPS ( 130.6 ± 128.5 vs 29.39 ± 17.93 ) pg/ml, hsCRP(4.25 ±2.29 vs 2.11 ± 1.07 ) μg/ml, AGI (3.78 ± 2.61 vs 0. 74 ± 0. 15 ) AU, all P ＜ 0. 05]. (3) Repeated measurement ANOVA analysis showed that after four weeks of intervention, MCP-1 [F( 1,106 ) = 19. 830, P＜0.001],LPS[F(1,106)=7.815, P＜0.01], PAI-1 [F(1,106)= 7.792, P＜0.01], TNF-α[F(1,106=24. 656, P=0.001 )] ,AGI[F( 1,106)= 12. 971 ,P=0. 01] decreased significantly in group A than in group B. Although hsCRP decreased in both group A and group B, but the trend was not different [F( 1,102 )= 0. 915, P = 0. 342].Conclusion The levels of inflammatory factors were elevated in patients with type 2 diabetes mellitus, which could be mostly reduced by acarbose.

Objective To investigate clinical characteristics and medium-term prognosis of the advanced elderly patients with mild ischemic stroke,and to evaluate the risk factors for poor clinical outcome.Methods The 574 elderly patients with mild acute ischemic stroke admitted in neurology department of our hospital were retrospectively studied from January 2016 to December 2017.All cases were divided into the advanced elderly group(n=276,≥80 years old)and elderly patient group(n=298,60-79 years old).Clinical characteristics were analyzed.After 12-month follow-up,the mid-term prognosis and risk factors for poor clinical outcome(mRS≥ 3)were analyzed in the two groups.Results Compared with the elderly patients,the advanced elderly patients were more often complicated with history of atrial fibrillation,diabetes and stroke(P ＜0.05).The scores of National Institute of Health stroke scale(NIHSS)and Modified Rankin Scale(mRS)were higher in the advanced elderly patients than in the elderly patients(1.37± 1.03 vs.0.94 ±0.43,2.79± 1.27 vs.1.92 ± 0.66,P＜0.001).The proportion of patients receiving anticoagulation treatment were lower in the advanced elderly patients than in the elderly patients,with no significant difference(P ＞0.05).After an average follow-up of(11.3 ± 1.5) months,the proportions of poor clinical outcome and mortality were higher in the advanced elderly patients than in the elderly patients(63.4％ or 175/276 vs.48.0％ or 143/298,25.7％ or 71/276 vs.16.1％ or 48/298,P＜0.05).Cox proportional hazard model analysis showed that age,baseline NIHSS score and mRS score,diabetes and stroke history were the risk factors for poor clinical outcome in elderly patients with mild ischemic stroke(all P＜0.05).Conclusions The advanced elderly patients with mild ischemic stroke have a severe clinical condition,higher rates of atrial fibrillation,diabetes and stroke history,and poor mid-term prognosis.Age,baseline scores of NIHSS and mRS,diabetes and stroke history are the risk factors for poor clinical outcome in elderly patients with mild ischemic stroke.

Objective:To explore the effect of mini-clinical evaluation exercise (Mini-CEX) combined with simulation teaching + case-based learning (CBL) in pediatric clinical teaching.Methods:A total of 60 medical students who practiced in Department of Pediatrics, Affiliated Hospital of Jining Medical College from August 2019 to August 2020 were selected as the research objects. According to different teaching methods, they were divided into control group ( n=30) and observation group ( n=30). The control group received traditional teaching, and the observation group received Mini-CEX combined with simulated teaching + CBL. The assessment results, comprehensive ability of medical interview, critical thinking ability and teaching satisfaction of the two groups were compared. SPSS 20.0 was performed for t-test and Chi-square test. Results:The test scores and total scores of the observation group were significantly higher than those of the control group ( P<0.05). After teaching, the Mini-CEX scores, the CTDI-CV (critical thinking disposition inventory Chinese version) scores and the total scores of the two groups increased significantly, and the above scores were significantly higher in the observation group than the control group ( P<0.05). The scores of the teaching program satisfaction questionnaire in the observation group were significantly higher than those in the control group ( P<0.05). Conclusion:The application of Mini-CEX combined with simulation teaching + CBL in pediatric clinical teaching can help to cultivate the medical interview ability, clinical practice ability and critical thinking ability of interns, improve the examination results, and improve the teaching satisfaction.