Objective To acknowledge the spouse comorbid conditions of diabetes patients by comparing the average blood sugar level of the spouse of the diabetes patients with normal Guangzhou residents.Methods To sift and analyze the spouse test results of 152 hospitalized diabetes patients from January 2012 to January 2013,by testing the blood sugar level of the experimental subjects,comparing the different blood sugar level results between when they were with empty stomach and 2 hours after oral glucose tolerance test (OGTT).Results There were 32 cases with diabetes,9 cases with impaired glucose tolerance (IGT) and 11 cases with impaired fasting glucose (IFG) in the above 152 experimental subjects.The morbidity rates were 21.05％,5.92％ and 7.24％.All the above results were higher than the Guangzhou residents survey level,there were statistical differences between them.Conclusions The high morbidity rates of diabetes and impaired glucose regulation in diabetes patients spouse are obvious.The works for diabetes sifting and analyzing together with the health education instruction need to be strengthened.

Objective To investigate the curative effect of methotrexate in treating systemic lupus erythema-tosus(SLE). Methods The chosen outpatients were divided into 2 groups,group A(28 cases) :MTX combined with small dosage of prednisone (prednlsone 10mg/d) ; group B (20 cuses) : medium dosage of prednisone (prednisone 30rag/d). Observation includes SLE disease activity index(SLEDAI) ,relapse while dosage of prednisone was reduced to small amount and drug side effects. Results The SLEDAI score of group A was reduced from (9.4±2.1) to (4.1±0.9) ,and group B from (8.6±2.5) to (4.0±1.0). Compared the result of before and after treatment be-twcen the two groups, the curative effect is obvious (P<0.01). However, there was no significant difference of efficacy between the two groups(P>0.25). While dosage of prednisone was reduced to 10mg/d ,there were 8 cases of relapse in group B,and only 3 cases in group A during the entire observation period. The difference is significant (P<0.025). The side effect of group A is gastrointestinal reaction and for B is mainly the cushing syndrome. Conclusion MTX is an effective treatment fw the light and medium activity SLE,and can reduce the dose of prednisone, prevent long-term using large dose of prednisone which will cause side effect.

Objective To investigate whether lipids and reagents would interfere the results when serum total bile acid(TBA) was measured by enzymatic cycling assay.Methods The serum TBA was measured by enzymatic cycling assay.The carry-over contaminations of high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),cholesterol(TC),and triglyceride(TG)rea-gents were evaluated.In order to reduce the interference and carry-over contaminations,different washing procedures and detection sequence were set.Results By measuring the levels of TBA in pooled serums with low and high levels of lipids,the results showed that there was statistically significant difference between the groups with and without the addition of cleaning process before and af-ter TBA measurement(P <0.01).Cleaning with water might be more effective on reducing interference than those with acid solu-tion.Moreover,the mean of TBA levels in HDL-C,TC,TG and LDL-C reagents were (476.06 ± 1.88 ),(127.78 ± 1.18 ), (121.05±1.08),and (2.23±0.51)μmol/L,respectively.The stability of TBA level was greatly affected by HDL-C regents,fol-lowing by TC and TG reagents,and was little affected by LDL-C reagent.Setting up proper detection sequence and flushing proce-dures could obviously reduce the interference(P <0.01),but not completely rule out.Conclusion Analysis sequence and flushing procedures of biochemical analyzer as well as exogenous substance from reagents may seriously affect the accuracy of determination results.To ensure the accuracy and reliability of the results,it is necessary not only to set up reasonable irrigation and reaction se-quence,but also to master the instrument operation,to know the principle of test reaction and the components of reagents as well as equipment maintenance.

Objective To analyse the changes of metabolic parameters and condition of metabolic syndrome(MS)in females with obstructive sleep apnea-hypopnea syndrome(OSAHS),and explore the interaction between OSAHS and MS.Methods Sixty females undergoing polysomnography were included,and were divided into simple snorer group(n=19),mild OSAHS group(n=21)and moderate to severe OSAHS group(n=20).Epworth sleepiness scale(ESS)scores and metabolic parameters were compared among groups.Forty-one patients with OSAHS were subdivided into group with MS(MS group,n=15)and group without MS(non-MS group,n=26).ESS scores,apnea hypopnea index(AHI),oxygen desaturation index(ODI)and lowest pulse oxygen saturation(LSpO_2)were compared between MS group and non-MS group.Results There was no significant difference in age,body mass index(BMI),total cholesterol(TC),triglyceride(TG),low density cholesterol(LDL),high density cholesterol(HDL),apolipoprotein A-I(apoA-I)and apolipoprotein B(apoB) among simple snorer group,mild OSAHS group and moderate to severe OSAHS group(P>0.05).Correlation analysis revealed ESS was positively related to AHI(r=0.327,P=0.011).ESS scores and proportions of hypertension,fasting plasma glucose(FPG)and MS were significantly higher in moderate to severe OSAHS group than those in simple snorer group(P<0.05).BMI,FPG,TG,proportion of hypertension,ODI and ESS score in MS group were significantly higher than those in non-MS group(P<0.05),while there was no significant difference in AHI and LspO_2 between these two groups(P>0.05). Conclusion ESS score may reflect the severity of OSAHS in females.Females with OSAHS matched for age and BMI have no difference in blood fat.With the increase of severity of OSAHS,glycometabolism can be impaired,the prevalences of hypertension and MS increase.MS can exacerbate the severity of OSAHS,indicating that MS and OSAHS interact with each other.

uate and should be standardized.

Objective To evaluate effectiveness of prevention and treatment for patients with chronic obstructive pulmonary disease (COPD) for one year at community health-care service (CHS)centers. Methods A quasi-experiment design was used to evaluate effectiveness of community management for patients with COPD who visited and registered at Xiaokunshan and Xinbang CHS centers in Songjiang district of Shanghai in 2008, with COPD patients from Xiaokunshan community CHS center as management group and those from Xinbang as control. Measures for community management included training for local general practitioners in essential knowledge of COPD prevention and treatment, allocation of necessary drugs for COPD treatment, and health education for COPD patients and their family members. No special measures were taken for control group except routine treatment. Results A total of 132 patients were diagnosed as COPD according to their pulmonary function on 2008, 61 at Xiaokunshan and 71 at Xinbang CHS canters.One hundred and two patients, 47 at Xiaokunshan and 55 at Xinbang, finished one-year follow-up. Five patients from Xiaokunshan who were smokers at their first visits and three of them quitted smoking after oneyear management. Meanwhile, none of nine smoked patients from Xinbang quitted smoking in the same period. There was no statistically significant difference in symptom scores, pulmonary function, and forced expiratory volume at the first second (FEV1) between patients in the two groups during one-year follow-up.Average score of quality of life in patients at Xiaokunshan dropped to 39. 12 after one-year management from 46. 96 at their first visits, and that in patients at Xinbang increased to 62. 11 from 56. 55 (P＜0.01).Average six-minute walking distance (6-MWD) in patients at Xiaokunshan reduced to 354. 26 meters after one-year management from 361.66 meters at their first visits, meanwhile that in patients at Xinbang reduced to 351.18 meters from 398.07 meters (P =0. 008). Scores of functional dyspnea in patients at Xiaokunshan fell to 0.34 from 0.40 at their first visit, meanwhile that in patients at Xinbang increased to 1.00 from 0.95(P =0.038). During the one-year follow-up, 13 patients at Xiaokunshan and 53 at Xinbang visited emergency departments for treatment, and four at Xiaokunshan were hospitalized and none died, and five at Xinbang were hospitalized due to acute exacerbation of COPD and four of them died. Conclusions The study suggests that strengthening prevention and treatment for COPD patients at community level by general practitioners, patients themselves and their family members can improve their quality of life, reduce emergency visits and hospitalization, alleviate dyspnea symptoms and delay the decline of 6MWD.

PURPOSE: Asthma affects approximately 30 million patients in China; however, tiotropium data for Chinese patients is limited. This study aimed to assess the efficacy and safety of tiotropium in Chinese patients with moderate symptomatic asthma. METHODS: A post hoc subgroup analysis was conducted on 430 Chinese patients pooled from two 24-week, replicate phase 3 trials (NCT01172808 and NCT01172821), in which they received once-daily tiotropium 2.5 µg (Tio R2.5) or 5 µg (Tio R5) (n = 106 or 109, respectively), twice-daily salmeterol 50 µg (Sal 50) (n = 110), or placebo (n = 105), while maintaining inhaled corticosteroids (ICS). The co-primary endpoints assessed in week 24 were forced expiratory volume in 1 second (FEV1) peak0–3h response, trough FEV1 response, and responder rate as assessed using the Asthma Control Questionnaire (ACQ). RESULTS: For both FEV1 peak0–3h responses and trough FEV1 responses, the mean treatment differences were greater for Tio R2.5, Tio R5, and Sal 50 compared with placebo at 0.249 L, 0.234 L, and 0.284 L, and 0.172 L, 0.180 L, and 0.164 L, respectively (P< 0.001). The ACQ responder rate in placebo, Tio R2.5, Tio R5, and Sal 50 was 58.7%, 62.3%, 59.3%, and 69.1%, respectively. Furthermore, 11 (2.6%) of 430 patients had serious adverse events (Tio R5, n = 4; Tio R2.5, n = 1; Sal 50, n = 1; and placebo, n = 5). CONCLUSIONS: Once-daily tiotropium, as add-on to medium-dose ICS, was effective and well tolerated for Chinese patients with moderate symptomatic asthma, consistent with the main analysis.
Adrenal Cortex Hormones ; Adult ; Asian Continental Ancestry Group ; Asthma ; China ; Forced Expiratory Volume ; Humans ; Salmeterol Xinafoate ; Tiotropium Bromide

Objective: To analyze the genetic characterization of glycoprotein M(gM.),glycoprotein L(gL) of varicella zoster virus. Methods: According to the program of "Ministry of Science and Technology of China" , Based on the 12 suspected VZV patients monitored in Beijing (1 case), Shanghai (5 cases), Jilin (2 cases), Qinghai (1 case), Guangdong (2 case) and Sichuan (case) in 2007-2015. A total of 12 Vesicle fluid and throat swab samples were collected. Positive samples were identified by Agarose gel electrophoresis and two glycoprotein genes were amplified by polymerase chain reaction (PCR). Nucleotide sequences were determined and analyzed by PCR amplification of VZV positive specimens V-OKA-BK of the domestic varicella attenuated live vaccine and the Varilrix-1 of the imported attenuated live vaccine. Nucleotide sequences of VZV positive specimens, vaccine strains (V-OKA-BK, varilrix-1) and GenBank foreign wild strains (41 strains), parent strains (P-oka), vaccine strains (V-oka, Varilrix, Varivax) were compared using BioEdit and MEGA 5.0. Results: 12 specimens were VZV positive. Compared with the vaccine strains and the parent strains, the GM gene of 1 positive specimen had radical mutation at 86686 sites, which resulted in amino acid mutation, 5 positive specimens had base mutation at 87844 sites, and 30 strains of foreign wild strains had the same variation at 87 844 sites. 1 positive specimens of gL gene in 101245 sites had base mutation, and led to amino acid mutation, 6 positive specimens at 101624, 101625, 101626 sites had base of loss and the foreign wild strains in these 3 sites had the same variation. Compared with the vaccine strains, the nucleotide and amino acid homology of gM of 12 VZV positive specimens were 99.2%-100% and 98.2%-100%, respectively, and gL of those were 99.3%-100% and 98.6%-100%, respectively. Compared with 41 strains of foreign wild strains, homology of gM's nucleotides and amino acid were 99.3%-100% and 98.5%-100%, respectively; 99.1%-100% and 98.6%-100% for gL. The results of phylogenetic analysis showed that 7 VZV positive samples were on the same branch with 4 vaccine strains and p-oka strain. Based on gL, 12 VZV positive samples were on the same branch as the vaccine strains and p-oka strain. Conclusion This study demonstrates that the genes of gM, gL are highly conserved and remain stable immunogen, which may be involved in the attenuation of VZV and need to be further researched.

Objective:To analyze the laboratory test results of two outbreaks of neonatal enterovirus infections in Guangdong Province in 2019 and the genetic characteristics of Echo11, aiming to provide reference for the prevention and control of neonatal enterovirus infections.Methods:The pathogenic specimens of neonatal cases suspected of enterovirus infection were collected. Fluorescence quantitative PCR and sequencing were used for enterovirus typing and identification, and virus isolation was carried out for positive specimens.The complete sequences of VP1 of Echo11 were amplified and sequenced and the phylogenetic analysis was performed using the bioinformatics software such as Danstar6, Bioedit7.09 and MEGA6.06.Results:A total of 93 specimens from 36 neonatal cases were collected. After identification, 55 specimens from 24 cases were positive for enterovirus, of which 23 cases were positive for Echo11 and one case was positive for Coxsackievirus B4(CVB4). A total of 29 enterovirus strains were isolated from the specimens of 19 cases, of which 28 were Echo11 from 18 cases, and one was CVB4. Phylogenetic analysis revealed that the nucleotide homology between the 18 strains of Echo11 in this study was 98.2%-100.0%, and the nucleotide homology between the Echo11 strains causing the two neonatal infections was 99.7%-100.0% and 99.8%-100.0%, respectively. Echo11 could be divided into six genotypes as A, B, C, D, E and F, in which genotype A and genotype C were further divided into A1-5 and C1-4, and genotype D could be divided into D1-5. The 18 strains of Echo11 in this study were all subtype D5.Conclusions:In 2019, two outbreaks of neonatal infections in medical institutions in Guangdong Province were caused by Echo11, which belonged to the genotype D5.

The theory of "equal stress on bones and muscles" emphasizes that "the tendons bind to the bones, the bones are stretched, the bones are connected, and the bones are fractured. The relationship between bone and soft tissues are important, which is the law of Traditional Chinese Medicine in the treatment of orthopedic diseases. For patients with lumbar disc herniation, the percutaneous intervertebral foraminal technology remodels the disordered internal biological balance of the spine under pathological conditions. Among them, two common clinical minimally invasive approaches under endoscopy are paid attention to soft tissue protection, and active and appropriate functional exercises after surgery, which have become a typical manifestation of the theory of "equal stress on bones and muscles" in modern spinal orthopedic surgery.