Objective To investigate the relationship between morning blood pressure surge (MBPS) and urinary albumin/creatinine (UmAlb/Cr) ratio in elderly patients with dipper essential hypertension.Methods Totally 273 elderly patients with dipper essential hypertension were divided into MBPS group (observation group,n =106) and non MBPS group (control group,n=167)according to the presence or absence of MBPS.The urinary UmAlb/Cr ratio,blood urea nitrogen (BUN),creatinine (Cr),blood glucose (Glu),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG) and cholesterol (TCH) were detected.The differences in UmAlb/Cr ratio between the two groups were analyzed.Results There were no statistical significances in sex ratio,age,course of hypertension,BUN,Cr,blood Glu,HDL-C,LDL-C,TG and TCH between the two groups (P＞0.05).The amplitude of variation in morning systolic pressure peak was higher in MBPS group than in non-MBPS group [(32.8±8.2) mmHg vs.(12.0±7.2) mm Hg,P＜0.001].UmAlb/Cr ratio was higher in MBPS group than in non-MBPS group [(4.93±2.17) vs.(4.23±2.42),P＜0.05].There were significant differences in UmAlb/Cr ratio between MBPS group and non-MBPS group in different genders [male:(4.95± 1.96) vs.(2.98 ±2.05),female:(5.89±2.24) vs.(5.03±2.37),both P＜0.05].Conclusions MBPS has a great influence on UmAlb/Cr ratio and tends to cause early impairment of renal function in elderly patients with dipper essential hypertension.

To compare the difference in tumor immunity and autoimmunity elicited by adenovirus (Ad) encoding human or murine tyrosinase-related protein 2 (AdhTRP2 or AdmTRP2), and to find the most effective way to induce immunity by AdhTRP2 or AdmTRP2, C57BL/6 mice were immunized with AdhTRP2 or AdmTRP2 intramuscularly at different doses of 10(5), 10(6), 10(7) and 10(8) separately (10 mice for each dose). Two weeks after the immunization, in vivo CTL assay and intracellular staining (ICS) of IFN-gamma were carried out to analyze the dose-effect relationship. Tumor growth and vitiligo (as an sign of autoimmunity) were observed until 3 months after challenge with 10(5) B16F10 tumor cells. The results showed that Ad encoding AdmTrp2 induced weak tumor immune response. Similar immunization with AdhTrp-2 elicited stronger protective immunity. CTL activity and IFN-gamma-produced CD8+T cells were directly proportional to dose of AdhTrp2 or AdmTrp2. Moreover, AdhTrp2 group showed tumor rejection in 100% of challenged mice till the end of 3rd month while 60% of mice immunized with AdmTrp2 were protected against tumor. In the whole process of this experiment, no vitiligo was observed in mice immunized either with AdhTrp2 or AdmTrp2. It is concluded that anti-melanoma responses induced by genetic vaccination expressing xenoantigens breaks immune tolerance effectively and is able to elicit strong antigen-specific cytotoxic T cell response without vitiligo.
Adenoviridae/metabolism ; Antineoplastic Agents/*pharmacology ; Cell Line, Tumor ; Cytokines/metabolism ; Immune System ; Immune Tolerance ; Interferon-gamma/metabolism ; Intramolecular Oxidoreductases/*biosynthesis ; Intramolecular Oxidoreductases/*genetics ; Mice, Inbred C57BL ; T-Lymphocytes, Cytotoxic/*metabolism ; Vitiligo/*metabolism

Objective To study the correlation between time of fever onset in the course of patients'illness and etiologies of fever of unknown origin (FUO).Methods A total of 1 570 patients with FUO admitted from January 2013 to December 2014 were retrospectively analyzed, and clinical data ( sex, age, time of fever onset) of 348 patients meeting FUO diagnosis criteria with definite etiology diagnosis and time of fever onset were collected for multivariate logistic regression analysis after bias check.Results No statistically significant bias was found between 348 selected cases and 1 570 overall cases in gender (χ2 =0.029, P=0.903) and age (t=-1.040, P=0.299), and multivariate logistic regression analysis showed positive correlation between fever onset during 13: 00-18: 00 and infection (P=0.044, B=1.275), 18:00-24: 00 and connective tissue diseases ( P =0.029, B =0.838 ) , and showed negative correlation between age and miscellaneous (P =0.010, B =-0.042).Conclusions Characteristics of fever onset time may have significant value in preliminary diagnosis and guiding the correct direction of final definite diagnosis by means of targeted examinations or diagnostic treatments.It is worth to be further studied and discussed.

Objective To investigate the intervention of ciliary enurotrophic factors(CNTF)on weightlessness-induced muscle atrophy and its myofiber phenotype transition.Methods Tail-suspended (hindlimb unloading)of adult male Wistar rats were used to create the mode J of weightlessness-induced muscle atrophy.The effect of CNTF treatment on weightlessness-induced muscle atrophy and its myofiber phenotype transition was determined by analyzing the expression changes of MHCI/IIb and p130 or Myf5 with RT-PCR and Western blot.Results CNTF treatment in vivo markedly reversed weightlessness-induced muscle weight IOSS selectively in the slow-twitch muscle soleus.Moreover,during tail suspension,soleus weight loss and myofiber phenotype transition indicated that CNTF treatment could sigificantly attenuate the weight loss and slow to fast myofiber phenotrype transition in soleus compared with control(CNTF untreated and tail suspended).Furthermore,it was showed that the CNTF-induced intervention effect was associated with the protein level upregulation of muscle satellite cell-specific markers,P130 and Myf5.The satellite cell pool in CNTFtreated soleus was increased.Conclusion It iS firstly demonstrated that CNTF can attenuate weightlessness-induced muscle atrophy and its myofiber phenotype transition to be through the increase of satellite cell pool in soleus.

Objective To construct the risk model for healthcare-associated infection (HAI)with multidrug-re-sistant organisms(MDROs)in intensive care unit (ICU).Methods 836 patients who were admitted to ICU for more than 48 hours between October 2012 and September 2015 were analyzed retrospectively,logistic regression model of HAI was constructed,the model was conducted goodness of fit tests and the area under ROC curve analysis. Results Among 836 patients,incidence of HAI with MDROs was 14.23%(n=119).15 variables that were statis-tically significant in univariate analysis were included in logistic multivariate analysis,the results showed that the following variables entered into logistic regression equation:length of ICU stay (OR,2.493 [95%CI ,1 .816 -3.494]),underlying diseases (OR,1 .536 [95%CI ,1 .243 - 1 .898 ]),hypoproteinemia (OR,87.211 [95%CI , 36.165-210.304]),ventilator days (OR,1 .723 [95%CI ,1 .399-2.121 ]),fever(OR,20.639 [95%CI ,3.462 -123.043]),and primary pulmonary infection (OR,0.295 [95%CI ,0.133 -0.664]).Evaluation of model effect:sensitivity 95%,specificity 87.9%,the area under ROC curve 0.973.Conclusion Logistic regression model has a high goodness of fit in predicting HAI among ICU patients.

Objective: To evaluate the clinical value of echocardiography in aortic valvuloplasty (AVP) in the low-age pediatric patients with congenital aortic valve stenosis. Methods: We retrospectively studied 39 low-age (at median of 23 months) patients with congenital aortic valve stenosis who received aortic valve repair in our hospital for their echocardiography information, and statistically analyzed the main indicator changes by 4 time points as pre-operation and 1 week, 1-3 months, 6-12 months after the operation respectively. Results: In our study, the bicuspid to tricuspid valve ratio was approximately at 5.5/1 and 2 patients died during peri-operative period. Compared with pre-operative time point, Doppler aortic valve peak velocity (Vmax ) and the mean aortic transvalvular pressure gradient (MPG) were reduced accordingly, for Vmax: (4.30 ± 0.73) m/s vs (2.65 ± 0.78) m/s, (2.93 ± 0.63) m/s, (3.01 ± 0.83) m/s,P<0.01, for MPG: (45.78 ± 15.19) mmHg vs (18.24 ± 10.08) mmHg, (21.01 ± 10.08) mmHg, (22.31 ± 13.41) mmHg. Compared with pre-operative time point, left ventricular ejection fractions (LVEF) were similar in 3 post-operative time points. Compared with 1 week post operative time point, left ventricular end-diastolic anteroposterior diameter (LVEDD) was increased at 6-12 months post-operative time point, the relative wall thickness (RWT) was decreased, bothP<0.05, and aorta valve regurgitation (AR) was increasedP<0.01. Pearson correlation analysis showed that aortic annulus (AA) inner diameter was positively related to LVEDD (r= 0.648,P<0.01), negatively related to Vmax (r= -0.205,P<0.05) and RWT was positively related to Vmax (r= 0.196,P<0.05). There were 6 patients with pre-operatively decreased LVEF, 1 of them died and the rest 5 with elevated LVEF at 6-12 months post-operative period,P<0.05. Conclusion: Echocardiograghy could be used as the ifrst choice of imaging method for diagnosing congenital aortic valve stenosis, it has the important role for in-operative monitoring and post-operative evaluation of AVP in relevant patients.

ObjectiveTo explore the effects of comprehensive geriatric assessment(CGA)on nursing safety management in general geriatric wards.Methods The safety problems existing before CGA,including falls, pressure sores,falling down from bed,catheter slippage and aspiration,were analyzed retrospectively. CGA was performed for each patient. Individualized intervention and integrated safety management was given to the patients on the basis of assessment results,after which,safety data were collected and analyzed again.Results Based on the CGA for the incidence of adverse nursing safety events within 2 years before and after the intervention,the incidence of falls dropped from 2.46% to 0.56%,the incidence of pressure sores from 1.23% to 0,the incidence of falling down from bed from 0.92% to 0,the incidence of catheter slippage from 3.08% to 0.56%,and the incidence of aspiration from 1.54% to 0.56%. The incidence of adverse events after the CGA,including falls,falling down from bed and catheter slippage,was lower than that before the CGA(P<0.05).Conclusions Early general assessment and intervention as well as ward safety management and assessment on the basis of CGA can reduce or eliminate adverse events in hospital,and enhance the effects of ward safety management.

In order to investigate the immunity of unloaded dendritic cells (DCs) derived from murine bone marrow to preexisting lung melanoma metastases of mice, MO5 were intravenously injected to induce lung metastases in syngeneic C57BL/6 mice. Unloaded GM-CSF DCs, PBS and DCs+SIINFEKEL were subcutaneously injected into the mice, which were divided as experimental group, negative control group and positive control group respectively. Monoclonal antibody was used to deplete NK or T cells separately. The immunity-inhibitory effects on the lung melanoma were observed and the corresponding effector cells were examined. It was found that in the experimental and positive groups, the regression was induced in metastatic nodules in the lungs of tumor-bearing mice,but abrogated by treatment with anti-asialo-GM1 but not anti-CD8. It was concluded that the unloaded DCs could suppress the lung melanoma metastases to some extent, which was mediated by NK cells, and could be used as a potent therapeutic agents for lung tumor.

Extra-nodal malignant lymphoma is often characterized by a lack of typical symptoms and positive results of auxiliary examinations, which make diagnosis difficult. In some cases, fever can be the only clinical manifestation. For the lymphoma patients presenting with persistent fever with a duration over 3 weeks, characteristics of fever including time of fever attack, fever type and effects of drugs may have significant value in the diagnosis, especially in the early stage of the disease or in rare cases.

Objective To investigate the correlation between the frailty and nutritional status of the elderly hospitalized patients.Methods A total of 244 hospitalized patients were enrolled in this investigation. By using comprehensive geriatric assessment (CGA),patients answered these questions together with experts (questionnaire assessment by professional instructions). Researchers input the result into computer at same time. Results Compared with normal patients,frailty patients were older (P<0.001),and had lower ability to take care of themselves (P<0.001),in other words,they had more demands from their families and carers in terms of medical care (P<0.01). In addition, frailty patients had higher risks of having depressive symptom (P=0.016),cognitive impairment (P<0.001), living function disability (P<0.001),as well as malnutrition (P<0.001). Regression analysis result showed a negative correlation between frailty and nutrition (P=0.005).Conclusions Malnutrition is closely related to frailty,and malnutrition patients and patients with risks of malnutrition were easily to acquire frailty.