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.

Aim: To develop a practical synthetic route of raltegravir, a drug for HIV treatment. Methods: Raltegravir was synthesized through an eight-step process including aminonitrile formation, protection with benzyloxy-carbonyl group, conversion of the nitrile to the amidoxime, cyclization to form hydroxypyrimidinone, N-methyla-tion, amidation with microwave-assistance, deprotection, amidation with acyl chloride. Results: The overall yield of the eight-step synthesis is about 12. 0% and the structure of the target compound was confirmed by ~1H NMR, ~(13)C NMR, LR-MS and HR-MS. Conclusion: The reported synthetic process of raltegravir highlights the advantages in terms of readily available starting materials, convenient operation and low cost.

Background and purpose: Extraskeletal myxoid chondrosarcoma (EMC) is a malignancy of uncertain differentiation tumor characterized by a multinodular structure and abundant myxoid matrix. Its preferred sites were the deep soft tissues of the extremities. The aim of this study was to investigate the clinicopathologic characteristics, diagnosis and differential diagnosis of EMC. Methods: Seven cases of EMC were analyzed for clinicopathological and immunohistochemical features with review of the related literature. Results: It occurred predominantly in females (male/female=2︰5). Five cases were located in low extremities and two in upper limb girdles, more commonly near the joint. Grossly, the masses showed as grey, lobular and somewhat transparent with a relatively well-deifned margin. Microscopically, the small ovary or plump spindle-shaped cells arranged in strand and cord patterns and lobular architecture which separated by delicate fibrous networks with an abundant myxoid but hypovascular background. And the tumors were immunoreactive for vimentin, and partly for S-100 and EMA, meanwhile, negative for CK. Conclusion:EMC is a rare soft tissue sarcoma with distinctive histopathological features. It should be distinguished from some mimics especially those tumors with a myxoid stroma or chondroid differentiation, such as chordoma and chondrosarcoma.

OBJECTIVE To explore the relationship between urinary tract infection(UTI) and urological surgical site infections(SSI).METHODS The surgical site infections of 115 patients underwent urological operations were observed.Patients were screened for the presence of UTI before the operation and subcutaneous swabs for culture were collected at the end of the operation by brushing with a sterile cotton-swab just before skin closure.The resistance and similarity of the isolates were analyzed by antimicrobial susceptibility test and pulsed field gel electrophoresis(PFGE).RESULTS Surgical site infection occurred in 14 of 115 patients.The isolates from infected surgical sites showed higher resistance to antimicrobial agents than those from non-infected surgical sites(P

OBJECTIVE To analyze the antimicrobial resistance of Acinetobacter baumannii.METHODS A.baumannii was collected in our hospital from Jan 2003 to Dec 2006.Antimicrobial susceptibility testing was performed by disk-diffusion method.RESULTS A total of 548 A.baumannii were collected during 4 years.Of these isolates,130(23.7%) strains were from intensive care unit(ICU),190 strains(34.7%)from surgical,and others from medical and emergency departments.Most of strains(78.5%) were isolated from sputum,next from wound.The prevalence of A.baumannii was increasing during last 4 years.Results of susceptibility test showed that imipenem was the most active antibiotic against A.baumannii.The resistance rates were high to most antibiotics.Most of the resistant strains was from the ICU and the general ward differentand had significant difference.More than 50% of isolates were resistant to all antimicrobial agents tested except imipenem and ciprofloxacin in ICU.CONCLUSIONS The prevalence of A.baumannii is increasing.A.baumannii isolates show high resistance to multiple antibiotics,especially in ICU.

Objective To construct single chain antibody specific to membrane protein of Schistosoma japonicum by gonetic engineering technique. Methods The V\-H (heavy-chain variable region) and V\-L (light-chain variable region) genes were amplified by PCR from the genomic DNA of NP11-4 cell line, and sequenced by Sanger's method. The ScFv was constructed in pTHA90 vector using V\-H and V\-L genes, then expressed by IPTG. Results The V\-H and V\-L genes were obtained through PCR. The DNA sequences showed that V\-H and V\-L were new variable region genes of antibody. They were registered by GenBank. A ScFv gene with (Gly4Ser) 3 intralinker in the pTHA90 vector was successfully constructed. The ScFv was expressed as thioredoxin-fused proteins about 36\^2 kDa. Conclusion A specific ScFv against the membrane protein of Schistosoma japonicum was constructed and expressed.

To screen common traditional Chinese medicine (TCM) syndrome factors of chronic renal failure (CRF) via questionnaire investigation among experts.

Objective] To amplify and sequence the light chain of anti idiotypic monoclonal antibody NP30 of Schistosoma japonicum. [Methods] By comparing the conserved regions at each end of the nucleotide sequences of murine germ line genes enco ding FR1 and FR4 regions of immunoglobulin light chain variable regions, we designed a set of primers for amplification of V L gene. The hybridoma cells secreting anti idiotypic monoclonal antibody NP30 of Schistosoma japonicum were cultured and their genome DNAs were extracted and used as templates for PCR. The PCR product was then cloned into pUC19 vector. The recombinants were sequenced by Sanger′s method. The V L gene was compared with GenBank and published mouse V L genes. [Results] The full length of V L gene was 318 bp. The V L gene was a member of mouse Ig ? light chain subgroup IV and generated from rearrangement of germ line V and J? 4 genes. The V L gene sequence has been registered by GenBank(accession No. AF206720). [Conclusion] The obtained V L gene was a potentially functional gene of anti idiotypic monoclonal antibody NP30 of Schistosoma japonicum .

OBJECTIVETo investigate the correlation of neurochemical metabolism in hippocampus with memory function in young adult patients with first-episode depression.

METHODSTwenty patients with first-episode depression (patient group) and fifteen health subjects (control group) were enrolled in the study. The neurochemical metabolism, including the levels of N-acetylaspartate (NAA), Choline (Cho), Creatine (Cr), Myoinositol (mI) were measured by proton magnetic resonance spectroscope (1H-MRS) in bilateral hippocampus. Wechsler Memory Scale (WMS) were used to examine the memory function in both groups.

RESULTSThe memory quotient (89.15 ±6.62) of patient group was significantly lower than that of controls (P <0.01),the scores of long-term memory,short-term memory and immediate memory in patients were also lower than those of controls (P<0.05 or 0.01). In patient group, the ratio of NAA/Cr (1.34 ±0.08) in the left hippocampus was significantly lower than that of control group (P<0.01); and the ratio of mI/Cr in the bilateral hippocampus [(0.63 ±0.13) in left and (0.6 ±0.1) in right] was significantly higher than those in control group (P<0.05). In patient group,the ratio of NAA/Cr in the left hippocampus was positively correlated with WMS scores (P<0.01), and the ratio of mI/Cr in the left hippocampus was negatively correlated with WMS scores (P<0.05).

CONCLUSIONThe memory deficit and abnormal metabolism function of neuron cell in hippocampus coexist in young adult patients with first-episode depression, and the lower NAA/Cr and higher mI/Cr ratio in the left hippocampus may result in the memory deficit.

Adolescent ; Adult ; Aspartic Acid ; analogs & derivatives ; metabolism ; Case-Control Studies ; Creatine ; metabolism ; Depressive Disorder ; metabolism ; physiopathology ; Female ; Hippocampus ; metabolism ; Humans ; Inositol ; metabolism ; Magnetic Resonance Spectroscopy ; Male ; Memory ; Neuropsychological Tests ; Young Adult

Syndrome differentiation treatment is the traditional model of diagnosis and treatment of diseases in traditional Chinese medicine (TCM). To establish scientific diagnostic criteria of TCM syndrome is one of the key points in TCM study. In this paper, the basic models of the relevant diagnostic criteria of TCM syndrome and existed problems were reviewed. The authors pointed out the advantages of establishing diagnostic criteria of TCM syndrome based on TCM syndrome factors and combination of disease in Western medicine system and TCM syndrome, in which not only the characteristics of the disease in Western medicine were considered, but also the complexity and flexibility of syndrome identification and convenient application in clinical practice were resolved. The basic model and frame of the above diagnostic criteria and the procedures and methods used in developing the diagnostic criteria were also described and discussed.