Objective Dynamic observation of oxidized low density lipoprotein(Ox-LDL) and thrombus precursor protein(TpP) expressed in patients with acute cerebral infarction ,and explore its clinical significance .Methods To detect the Ox-LDL and the plasma TpP level of 44 patients with acute cerebral infarction (ACI)respectively in acute stage and recovery stage ,and the healthy 30 cases (control group)by using enzyme-linked immunosorbent assay (ELISA) method ,and all the ACI cases were scored by the national institutes of health stroke scale (NIHSS) .To analyze the expression of Ox-LDL and plasma TpP in patients with ACI ,and the relationship with the NIHSS score .Results Ox-LDL and plasma TpP in patients with ACI all increased compared with the con-trol group .Ox-LDL and TpP in acute stage were significantly higher than the corresponding recovery stage and the control group , the difference was statistically significant (P<0 .01) .The levels of plasma TpP were positively correlated with the NIHSS score (P<0 .01) ,and Ox-LDL levels were uncorrelated with the NIHSS score (P>0 .05) .The levels of Ox-LDL were positively correla-ted with TpP in ACI group (r=0 .521 ,P<0 .05) .Conclusion The expression of Ox-LDL and plasma TpP in ACI were increased , Ox-LDL and plasma TpP level in ACI varies with changes of clinical course ,and maybe involved in the coordination and the devel-opment process of ACI ;Plasma TpP may be relevant to the seriousness of cerebral infarction ,and may be arguably used as the measurement of ACI patient′s conditions as well as the prognosis estimation .

Vascular endothelial growth factor (VEGF) has drawn extensive attention from all over the world because of its promising therapeutic prospect. However, recent studies have found that VEGF may promote the occurrence and development of atherosclerosis. The article reviews the molecule characteristics, receptor, expression regulation and function of VEGF, as well as its relationship with atherosclerosis.

Objective To explore the predictive value of cholinesterase (ChE) in the prognosis of gerontal patients with systemic inflammatory response syndrome. Methods The clinical data of 124 elderly patients with systemic inflammatory response syndrome collected from September 2009 through September 2010 were retrospectively analyzed. All patients were divided into death group and survival group according to the outcome of patients. The cholinesterase ( ChE), albumin, D-Dime, lactic acid and C-reactive protein (CRP) were detected, and the APACHE Ⅱ and GCS scores were documented in the first 24 hours in the ICU. Results There were no significant differences in age, gender, APACHE Ⅱ score and GCS score of patients between death group and survival group ( all P ＞ 0. 05 ), but there were significant differences in lactic acid, D-Dime, albumin, CRP and ChE between two groups ( theP values were 0.011,0.011, 0. 007,0. 008, 0. 000, respectively) . The results of multiple factors regression analysis showed that age, gender,lactic acid, D-Dime, albumin, CRP, APACHE Ⅱ score, and GCS score were not the independent risk factors of prognosis of gerontal patients with SIRS ( the P = 0. 401, 0. 165, 0. 446, 0. 841,0. 615, 0. 120,0. 502, 0. 184, respectively) except ChE ( P = 0. 000) . The receiver operating characteristic curve (ROC) of ChE in the gerontal patients with SIRS showed the area under curve (AUC) = 0.797, SE =0.04, P=0. 000, and the ChE = 103.00 U/L could be a diagnosis point with sensitivity = 0.793, 1-specificity = 0. 258. The correlation analysis showed that the APACHE Ⅱ score, CRP, and albumin were poorly correlated with ChE ( Kendall coefficients were 0. 061, 0. 231, and -0. 090, and theP = 0. 161,0. 000, and 0. 069, respectively ) . Conclusions ChE maybe played a important role in the gerontal patients with SIRS, and could be a predictive index for the prognosis of gerontal patients with systemic inflammatory response syndrome.

ObjectiveTo explore the relationship between sleep quality and glucose level,diabetic complications in elderly type 2 diabetes mellitus.Methods A total of 130 hospitalized elderly type 2 diabetes in our hospital were included in the study. Questionnaires and other related clinical data were collected within one week after admission.Patients were divided into two groups:poor-sleeper group and good-sleeper group according to Pittsburgh Sleep Quality Index(PSQI).ResultsSixty percent (78/130) of these patients were poor sleepers. The following parameters differed in the two groups:the duration of diabetes [ (7.9 ± 1.8 ) years vs ( 7.2 ± 1.5 ) years,t =2.318 ],systolic blood pressure [ ( 148 ± 30 ) mm Hg ( 1 mm Hg =0.133 kPa) vs ( 138 ± 23 ) mm Hg,t =2.037 ],fasting plasma glucose (FPG) [ ( 10.7 ± 2.2) mmol/Lvs ( 9.8±1.9)mmol/L,t =2.410],hemoglobin A1c (HbA1c) [(8.6 ±2.2)％ vs (7.8±2.1 ) ％,t =2.068],high-sensitive C-reactive protein (hs-CRP) [ (5.27 ± 2.34) mg/L vs (4.44 ± 1.76)mg/L,t =2.179 ],ratio of diabetic complications ( 61％ vs 32％,x2 ＝ 4.257 ),percentage of depression ( 20％ vs 8％,x2 =3.722 ),score of life quality [ ( 98 ± 19 ) scores vs ( 89 ± 13 ) scores,t ＝ 2.980 ],and proportion of patients treated with insulin (32％ vs 12％,x2 =4.489). All the above parameters were significantly higher in poor-sleeper group than the good-sleeper group (all P value＜ 0.05 ). Multiple correlation analysis showed that the factors affecting sleep quality were FPG,HbA1c,duration of diabetes,diabetic complications,depression,life quality and insulin application (r =0.213,0.257,0.223,0.335,0.422,0.3451,0.231,respectively ; all P value ＜ 0.05 ).By multivariate logistic regression analysis,the followings were found:FPG (β =1.29,P ＜ 0.05 ) and PSQI (β =1.07,P ＜ 0.05 ) were found to be correlated with HbA1c.With increasing of PSQI,FPG,HbA1c,diabetic complications and life quality were changed significantly( all P value ＜ 0.05 ).The indcpcndcnt risk factors of diabetic complications were duration of diabetes ( OR ＝ 1.32,95％ CI 1.01-2.01 ),HbA1c ( OR =2.01,95％ CI 1.63-2.67 ),hs-CRP( OR =1.12,95％ CI 1.08-1.21 ) and PSQI ( OR =1.71,95％ CI 1.58-2.02).ConclusionsElderly type 2 diabetes mellitus are usually poor sleepers. Sleep quality probably affects blood glucoseregulation, and is closely correlated with the occurrence of complications.In addition,poor sleep quality results in poor life quality.

Objective To provide insight into the clinical manifestation,histopathology characteristics,diagnostic and therapeutic methods of primary histiocytic sarcoma (HS) of central nervous system.Methods The clinical,auxiliary examination and pathological data of one patient with intracranial primary histiocytic sarcoma were presented,and relevant literature were reviewed.Results A 55-year-old female had an 2-month history of hypomnesia and unsteady gait.MRI scans showed multiple mass lesions in brain.Biopsies of the brain lesion showed the tumor cells had polymorphism,and abundant cytoplasm was eosinophilic or clear,with large,pleomorphic nuclei.Immunohistochemically,the tumor cells stained positively with CD45,CD68,CD163,Ki67 and Vimentin,but negatively with pan-cytokeratin,epithelial membrane antigen,CD3,CD20,CD79 a,estrogen receptor,progesterone receptor,Melan-A and glial fibrillary acidic protein.Though she had received radiotherapy,the disease progressed and her consciousness deteriorated within 2 months.Conclusions HS should be considered if multiple or single intracranial unexplained lumps are found and the earliest pathological biopsy is required for early diagnosis.There are no effective therapeutic methods for HS and the prognosis is very poor.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

OBJECTIVE: To explore the ways of quantitative and objective evaluation for analyzing the multiple influence factors on middle ear function in the patients with primarily diagnosed NPC, and to analyze the influence factors of middle ear function in the patients with primarily diagnosed nasopharyngeal carcinoma (NPC). METHOD: Three hundred and twenty cases (320 ears) of primarily diagnosed NPC patients were examinated with electric otoscope, acoustic immittance measurement, pure tone audiometry, nasopharynx and middle ear CT or MRI scanning, eustachian tube function examination, and electronic nasopharyngoscope. A series of quantitative methods, as the influence factors including T stage, clinical stage, location, diffusion type and form of tumor, eustachian tube function, pharynx mouth shape, imaging extension (nasal, skull base, pharyngeal recess, parapharyngeal space, tensor veli palatini muscle, levator veli palatini and so on), were used to evaluate the middle ear function. SPSS 13.0 was used to anlyze the single and multiple factors in statistics. RESULT: T stage, clinical stage, location, diffusion type, and form of tumor, pharynx mouth shape, imaging extension (nasal, skull base, pharyngeal recess, parapharyngeal space, tensor veli palatini muscle, levator veli palatini) were the single influence factors on the function of middle ear in primarily diagnosed NPC patients. The gender, age, pathological types, N staging and M staging of NPC patients primarily diagnosed had no effect on middle ear function. The multple factors analysis showed that T stage, tumor location, the function of eustachian tube, tensor veli palatini muscle invasion, and skull base invasion were independent factor of affecting the middle ear function on primarily diagnosed NPC patients. CONCLUSION In this study, the influence factors of middle ear function with primarily diagnosed NPC were related to T stage, location of tumor, the function of eustachian tube, tensor veli palatini muscle invasion, skull base invasion, otitis media and quantitative criteria. The way of quantitative analysis could be used to evaluate objectively the middle ear function in patients with primarily diagnosed NPC.
Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Ear, Middle ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; diagnosis ; physiopathology ; Young Adult

OBJECTIVE: To investigate the clinical effectiveness of Toubiao Qingfei (expelling exterior evil and clearing lung) Decoction (TBQFD) on wind-warm and pulmonary heat syndrome. METHODS: Forty-six subjects were randomized into treatment group and control group. Patients in the control group were treated with Western medicines, while patients in the treatment group were treated with Western medicines and TBQFD. The therapeutic effects and improvement of symptoms in both groups were observed. RESULTS: The durations of fever, cough and absorption of pulmonary inflammatory focus in the treatment group were 1.52, 3.52 and 6.25 days respectively, which were significantly shorter than those in the control group (P<0.05). CONCLUSION: TBQFD can improve the symptoms, such as fever and cough, and can promote the absorption of infection and shorten the clinical course of wind-warm and pulmonary heat syndrome.

Objective To investigate the value of aspartate aminotransferase-to-platelet ratio index (APRI) in judging the indication for antiviral therapy [liver inflammation grade (G) ≥2 or fibrosis stage (S) ≥2] in patients with chronic HBV infection and alanine aminotransferase (ALT) ＜ 2 × upper limit of normal (ULN).Methods A retrospective analysis was performed for the clinical data of 207 patients with chronic HBV infection and ALT ＜ 2 × ULN who were admitted to Nanyang Central Hospital from January 2015 to June 2017,and according to liver inflammation grade and fibrosis stage,these patients were divided into G ＜ 2 + S ＜ 2 group with 87 patients and G ≥2 or S ≥2 group with 120 patients.The results of liver biopsy and laboratory examination were recorded,and APRI was calculated.The Spearman correlation analysis was performed to investigate the correlation of APRI with liver inflammation grade and fibrosis stage.The area under the receiver operating characteristic curve (AUC) was used to investigate the value of ALT,aspartate aminotransferase (AST),platelet count (PLT),and APRI in judging the indication for antiviral therapy in patients with ALT ＜ 2 × ULN.The t-test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.Results APRI was positively correlated with liver inflammation grade and fibrosis stage (r =0.661 and 0.597,P ＜0.001).Among ALT,AST,PLT,and APRI,APRI had the highest value in judging the indication for antiviral therapy,with AUCs of 0.913 in the G≥2 or S≥2 group,0.882 in the G≥2 group,and 0.881 in the S≥2 group.APRI had an AUC of 0.913 (95％ confidence interval:0.871-0.954) in predicting the indication in the G ≥ 2 or S ≥2 group at the optimal cut-off value of 0.5324;when APRI was ≥0.5324,the patients had marked liver histological changes,i.e.,G≥2 or S≥2,which met the indication for antiviral therapy.APRI had a sensitivity of 87.50％,a specificity of 89.66％,a positive predictive value of 92.11％,and a negative predictive value of 83.87％.Conclusion For patients with chronic HBV infection and ALT ＜ 2 × ULN,APRI has a good value in evaluating liver pathological changes and judging the timing of antiviral therapy and can reduce the frequency of invasive assessment of histological changes via liver biopsy.

AIM: To investigate the function of matrix metalloproteinase-3 (MMP-3) and urokinase-type plasminogen activator receptor (uPAR) to macroangiopathy in type 2 diabetes mellitus. METHODS: The levels of MMP-3 and uPAR in plasma were determined by ELISA sandwich method in 26 healthy controls and 39 patients with type 2 diabetes mellitus including 15 complication-free cases and 24 with macroangiopathy. RESULTS: The plasma level of uPAR but not MMP-3 was higher in patients without macroangiopathy than that in normal controls (P