Objective To explore the changes of coagulation factors in Xinjiang Uygur and Han patients with diabetic mellitus in order to provide reference for the prevention and treatment of diabetic mellitus patients.Methods 2 100 patients with diabetic mel-litus were taken as the patient group which were diagnosed in our hospital between February 2014 and April 2015,another 446 healthy people were collected as the control group.The difference of coagulation between diabetic mellitus group and control group was compared.Coagulation between Uygur and Han was compared for 2 100 diabetic mellitus patients.Results The APTT of dia-betic mellitus group were significantly less than that in control group(P <0.05).FIB of diabetic mellitus group were significantly higher than that in control group(P <0.05).The difference of PT between diabetic mellitus group and control group were not sig-nificant(P >0.05).The APTT of Uygur group were significantly less than Han group(P <0.05).FIB of Uygur group were signifi-cantly higher than Han group(P <0.05).PT between Uygur group and Han group was not significant(P >0.05).Conclusion Fac-tors were difference of diabetic mellitus patients and healthy people,coagulation factors in diabetic mellitus patients of Xinjang Uygur and Han.

Objective To evaluate the prognostic value of combining postprocedural fibrinogen with high-sensitivity C-reactive protein (hs-CRP) in first time ST elevated myocardial infarction (STEMI) patients who had underwent successful primary percutaneous coronary intervention (PCI).Methods A total of 183 consecutive patients who had their first acute STEMI attack and underwent successful primary PCI were enrolled. Fibrinogen and hs-CRP levels were measured within 12 hours after PCI. All patients were followed up for 2 years. The primary end point was death of any cause. The secondary end point was a combined end point of death, non-fatal MI, heart failure (NYHA Ⅲ~Ⅳ),myocardial ischemia confirmed by stress test and revascularization. Results Postprocedural fibrinogen level correlated with hs-CRP level linearly (r=0.452, P

AIM: To observe the direct effects of peripheral blood monocytes/macrophages (MO/MAC) on renal tubular epithelial cells (RTEC),and further probe into the possible mechanisms. METHODS: Conditioned medium(M-CM) of human peripheral blood MO/MAC was collected and added to HK-2,a human renal proximal tubular cell line.After incubation with M-CM for 24 hours,HK-2 cells were detected for DNA synthesis by -TdR incorporation,osteopontin (OPN) and ?-smooth muscle actin (?-SMA) expression by Western blot,and fibronectin(FN) secretion by ELISA.Furthermore,anti-TGF?_1 neutralizing antibody and interlukin-10(IL-10) were used separately to antagonize the effects of M-CM on HK-2 cells. RESULTS: ①DNA synthesis,?-SMA expression and FN secretion were all increased in HK-2 cells when incubated with M-CM.②When adding with anti-TGF?_1 neutralizing antibody (5 mg/L) in the M-CM,the degree of upregulation of ?-SMA and FN in HK-2 cells was much lower than that stimulated by M-CM alone.③M-CM added with IL-10 (20 ?g/L) had a weaker ability to induce the increasing in ?-SMA expression and FN excretion in HK-2 cells, compared with M-CM itself alone.M-CM from MO/MAC preincubated with IL-10 caused a lower upregulation of ?-SMA expression in HK-2 cells than M-CM from non-preincubated MO/MAC. CONCLUSION: MO/MAC can directly induce proliferation,transdifferentiation and extracellular matrix secretion in RTEC.TGF?_1 and proinflammatory cytokines secreted by MO/MAC might be involved in the aboveeffects.

AIM A&A treated PAN rats, and to observe the effects of A&A on MAPK signaling pathway. METHODS Rats were divided into control, PAN, A&A treated PAN (A&A) and enapril treated PAN (ACEI) groups. The pathological lesion was observed under a light microscope. Immunohistochemistry combined with semi quantitive method was used to investigate the following parameters: cell number, ? SMA expression and extracellular matrix deposition. Expression and phosphorylation of protein kinases ERK, JNK and p38 were assayed. RESULTS In PAN rats, A&A suppressed ? SMA expression, which was closely correlated to cell proliferation, and extracellular matrix accumulation in glomerular mesangium. A&A significantly attenuated ? SMA expression in the tubulo interstitial area which was also parallel to the renal interstitial fibrosis.In this study, expression of all subtypes of MAPK had no difference between control and PAN groups. Compared with the inactivation of ERK and p38, phosphorylation of JNK was observed in glomeruli, renal tubules and interstitial cells in PAN rats, which was also inhibited by A&A treatment. CONCLUSION The inhibitory effect of A&A on phenotypic changes of renal resident cells, especially glomerular mesangial cell, may participate in its renal protective mechanisms. This effect, at least partially, was mediated by down regulated JNK activation.

Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and red blood cell distribution width in discriminating disease activity of rheumatoid athritis.Methods Eighty-nine rheumatoid arthritis out-patients of the Affiliated Hospital of Jiangsu University from Jan.2012 to Mar.2013 were recruited into this study.The disease activity index,such as swollen joint count and tender joint count were made by rheumatologists,and laboratory parameters（blood cell analysis,erythrocyte sedimentation rate and C-reactive protein) were measured as well.The enrolled patients were divided into the active RA group and remission RA group based on the DAS28 definition.Differences of NLR,PLR and RDW among groups were analyzed by t test and relations between variables were assessed by Spearman correlation analysis.The t test,non-parametric test and Spearman analysis were used for statistical analysis.Results The levels of NLR (3.2±2.0,2.4±0.9,respectively) and PLR (167±70,133±43,respectively) in active RA group were higher than that of the RA remission group (t=2.28 and 2.50,P=0.02 and 0.01).The level of RDW [(13.9±2.5)％,(13.9±2.4)％,respectively] was not significantly different between the active RA group and the RA remission group (t=0.14,P=0.89).However,compared with healthy controls,the level of RDW [(13.9±2.5)％,(13.2±0.2)％,respectively] was significantly increased in RA patients (t=2.74,P=0.006 9).NLR and PLR were positively correlated with DAS28 (r=0.23,P=0.03;r=0.26,P=0.04,respectively),ESR (r=0.28,P=0.03;r=0.43,P＜0.01,respectively) and CRP (r=0.33,P=0.006;r=0.41,P＜0.01,respectively).However,there was no association between RDW and DAS28 (r=0.01,P=0.93),ESR (r=0.20,P=0.15) and CRP (r=0.05,P=0.71).Areas under curve of receiver operating characteristic (ROC) for assessing disease activity of rheumatoid athritis by NLR and PLR were 0.802 and 0.753 respectively.The cut-off values for discriminating active/remission RA were 2.86 and 143.05,with the sensitivity as 0.66 and 0.63,specificity as 0.72 and 0.65.Conclusion NLR and PLR are significantly associated with the disease activity of RA and can be useful to understand the activity state of the illness.

Objective To investigate the clinical value and the feasibility of strain-blood pressure index(SBPI) in assessing the elasticity of brachial artery and anterior tibial artery in patients with type 2 diabetes mellitus. Methods Forty-six type 2 diabetic patients and 50 healthy volunteers were involved. Maxmum of circumferential strain (CSmax) of brachial artery and anterior tibial artery were acquired through strain and strain rate imaging(Xstrain). Local systolic blood pressure(LSBP) and local diastolic blood pressure(LDBP) of brachial artery and anterior tibial artery were measured at the same time. SBPI,tibial-brachial index (TBI), and ankle-brachial index(ABI) were calculated, SBPI = CSmax/[(LSBP-LDBP) /LDBP]×100%,TBI = SBPI of anterior tibial artery/SBPI of brachial artery, ABI = LSBP of anterior tibial artery/LSBP of brachial artery. Parameters were compared between the case group and the control group. Results SBPI of anterior tibial artery and TBI had significant difference between the case group and the control group( P < 0.05), while SBPI of brachial and ABI had no significant difference( P >0. 05).Conclusions SBPI might be a new index for evaluating the elasticity of medium-sized arteries in patients with type 2 diabetes, and different changes caused by type 2 diabetes between brachial artery and anterior tibial artery could be reflected by TBI.

Objective To evaluate application of recombinant human luteinizing hormone (r-hLH)used in ovarian stimulation of assisted reproductive technique and impact on outcome of pregnancy. Methods From Apr. To Jul. 2009, 123 patients with low LH level ( < 1 U/L) at day 3 of menstruation and downregulation of pituitary function undergoing in vitro fertilization-embryo transfer (IVF-ET) in Reproductive Medical Center, Provincial Hospital Affiliated to Shandong University were enrolled in this study, whom were classified into 66 cases treated by r-hLH in r-hLH group and 57 cases without r-hLH treatment in non-r-hLH group. In the mean time, 145 patients with normal level of serum LH ( 1-2 U/L) not given by r-hLH treatment and undergoing IVF-ET were matched as control group. Total amount of gonadotropin, estradiol levels and LH levels on the administration of human chorionic gonadotropin ( hCG), number of oocytes retrieved, number of 2PN zygotes, rate of high quality embryos, the rates of implantation and clinical pregnancy were compared among these three groups. Results The level of serum LH on the day of hCG administration were ( 1.59 ± 0.77 ) U/L in r-hLH group, (0.54 ± 0.25 ) U/L in non-r-hLH group and (2.39 ± 1.01 ) U/L in control group, which reached tatistical difference between every two groups (P < 0.05). The rates of high quality embryo were 59.36％ in r-hLH group, 57.79％ in non-r-hLH group,which were significantly lower than 65.94％ in control group, respectively (P < 0. 05 ). The rates of 2PN were 67.62％ in r-hLH group and 68. 32％ in control group, which were significantly higher than 62. 84％ in non-r-hLH group, respectively ( P < 0.05 ). The rates of implantation of 29.77％ in r-hLH group were significantly higher than 18.26％ in non-r-hLH group ( P < 0.05 ). The total amount of gonadotropin,estradiol level on the day of hCG administration, the number of oocytes retrieved, and clinical pregnancy rate were not significantly different among those three groups ( P > 0.05 ). Conclusion The administration of recombinant human uteinizing hormone in patients who are profoundly suppressed after down-regulation with long protocol can get more quality embryos, the higher rates of 2PN and implantation.

Objective To explore characteristics of sleep structure and the correlation with cognitive function in cerebral infarction combined with obstructive sleep apnea hypopnea syndrome (CI-OSAHS).Methods The patients with CI-OSAHS and OSAHS in Department of Neurology and Breathing Sleep Monitoring Room of Tianjin Medical University General Hospital from December 2009 till March 2011 were collected All the patients completed polysomography(PSG).Sixty patients were selected and divided into 3 groups based on PSG.These 3 groups were combined group 20 persons (CI-OSAHS),OSAHS group 20persons (OSAHS) and control group 20 persons (without cerebral infarction obstructive sleep apnea hypopnea syndrome).All the patients completed image examinations ( CT and MRI ) evaluation of the cognitive function by Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA).Results Sleep structure:the awake time,non-rapid eye movement sleep (NREM) 1,NREM 2 and NREM periods in combined group and OSAHS group were significantly longer,the NREM3 + 4 and rapid eye movement(REM) periods were shorter than the control group.The NREM and NREM 1 periods in combined group were longer,the NREM 3 +4 and REM periods were shorter than the OSAHS group.The correlation analysis of cognitive function and breathing disorders and low oxygen related index:there was negative correlation between the total scores of cognitive function (MMSE and MoCA)and apnea hyponea index,oxygen desaturation index (ODI) ( MMSE r =-0.450,-0.671,MoCA r =-0.486,- 0.494,all P ＜0.05) while,was positive correlation between them and noctumal average hypoxemia and minimum hypoxemia ( MMSE r =0.477,0.485,MoCA r =0.507,0.482,all P ＜0.05) in the OSAHS group.There was negative correlation between ODI,arousal index and the total scores of MoCA in the combined group (MoCA r=-0.463,0.480,both P＜0.05),there was correlation between the total scores of MMSE and the other sleep parameters,but,there was no difference in statistics.The correlation analysis of cognitive function and sleep stages:There was positive correlation between the total scores of cognitive function ( MMSE and MoCA) and the NREM 3 + 4 periods ( r =0.521,0.474,both P ＜ 0.05 ) while,there was negative correlation between the total scores of MMSE and the N REM 1 + 2 periods (r =-0.458,P ＜ 0.05 )in the OSAHS group.There was positive correlation between the REM period and the total scores of MoCA (r =0.472,P ＜ 0.05 ).There was correlation between the total scores of MMSE and the sleep structure,but,there was no difference in statistics in combined group.Conclusions Patients with OSAHS have obvious sleep structure disorder.The awake time and light sleep periods are significantly longer than the control group,while,the deep sleep and REM periods are significantly shorter than the control group.The NREM 1 of the patients with CI-OSAHS is longer than the patients with OSAHS.The higher the AHI,the lower the night blood oxygen,the more obvious cognitive dysfunction The longer the awake time,the longer the light sleep,the shorter the deep sleep and REM periods,the more serious cognitive dysfunction.The correlation between the cognitive impairment and low oxygen is more apparent than sleep structure.There is apparent correlation among the total scores of MoCA,the degree of hypoxia and sleep structure in the patients with CI-OSAHS.The total scores of MoCA are more sensitivity than MMSE in mild vascular cognitive impairment.

Objective To evaluate whether small endoscopic sphincterotomy (EST) plus balloon dilation (EPBD) can replace endoscopic sphincterotomy (EST) alone for patients with common bile duct (CBD) stones.Methods From May 2008 to April 2011,462 patients with CBD stones were randomly divided into two groups.The success rate of complete stone removal after the first session,the rate of using mechanical lithotripsy (ML),the short-term complications,the procedure time and fluo roscopy time were compared between the two groups.Results Overall ductal clearance did not differ between the two groups (96.5％ vs 93.5％,P＞0.05).The complication rates at 24 hours were 6.9％ for the small EST plus EPBD group and 11.7％ for the EST group (P＞0.05).However,the rate of complete stone removal after the first session using small EST plus EPBD was significantly higher than EST alone (86.2％ vs 70.4％,P＜0.05).ML was required significantly more often in the EST group when compared with the small EST plus EPBD group (34.8％ vs 12.1％,P＜0.05).The total procedure time and total fluoroscopy time in the small EST plus EPBD group were significantly shorter than the EST group [(38.6±15.5) min vs (47.1±20.2) min,P＜0.05 and (17.3± 7.0) min vs (26.5±10.8) min,P＜0.05].Conclusions Compared with EST,small EST plus EPBD was safe and more efficacious for bile duct stones.In the future,small EST plus EPBD probably can replace EST to be the first treatment of choice for bile duct stones.

Objective To evaluate the efficacy and safety of small endoscopic sphincterotomy (EST) plus large balloon dilataion (EPLBD) for removal of common bile duct (CBD) stones larger than 12mm.Methods From June 2009 to December 2011,a total of 198 patients with CBD stones were randomly divided into two groups to receive EPLBD (n =100) or EST only (n =98).The rate of complete stone removal after the first session,the overall success rate of stone removal,the rate of using mechanical lithotripsy (ML),the rate of post procedure complication,procedure time and fluoroscopy time were compared between the two groups.Results The rate of complete stone removal after the first session in EPLBD group (89.0％) was significantly higher than that in EST group (71.4％,P ＜ 0.05).ML was required significantly more often in EST group (35.7％) compared to EPLBD group (12.0％,P ＜0.05).Total procedure time and total fluoroscopy time in EPLBD group (39.3 ± 15.8 min and 14.2 ±5.2 min) were significantly shorter than those of EST group (48.4 ± 19.3 min and 24.2 ±9.4 min,P ＜0.05).There was no significant difference between two groups in overall success rate of stone removal (97.0％ in EPLBD vs.93.9％in EST group,P ＞ 0.05) and the complications rate (8.0％ in EPLBD vs.13.3％ in ESTgroup,P ＞0.05).Conclusion EPLBD is as safe and effective as EST for common bile duct stones,larger than 12mm,and is more efficient in terms of procedure time,use of ML and success rate of stone removal.