Objective To investigate the effects of estrogen receptor alpha (Erα) gene polymorphism on the efficacy of ursodeoxycholic acid (UDCA) in female primary biliary cirrhosis (PBC) treatment. Methods The polymorphism of Xba Ⅰ and Pvu Ⅱ sites in No. 1 Intron of Erαgene was detected by polymerase chain reaction-restriction fragment length polymorphism in 65 female patients with PBC. The patients were treated with UDCA tablets daily (13-15 mg·kg-1 · d- 1,divided for 3 times oral taking). The variations of patients' serum total bilirubin (Tbil), alanine aminotransferase (ALT), alkaline phosphatase (ALP), γ-glutamyle transpeptidase (GGT) were followed up totally for 24 months. Results Totally the complete follow-up data had been obtained in 60 patients. Four indicators of XX or PP type patients slowly declined till the end of follow-up point still had not reached the effective treatment standard. Four indicators of Xx type patients were also slowly declined, while the effective treatment standard was achieved till the end of follow-up. Four indicators of Pp/pp or xx type patients were rapid declined to the effective treatment standard. The effective rate of UDCA in PBC treatment was 75.0％ (45/60). The distribution difference of Pvu Ⅱ between the UDCA treating effective group and the ineffective group in PP, Pp, pp types patients and XX、Xx、xx types patients was statistic significant (x2 = 12.13、 P = 0.003 and x2 = 9.95 、 P = 0.007 respectively). The distribution difference of Xba Ⅰ between the effective group and the ineffective group with UDCA treatment in XX, Xx and xx types patients was also significant (P ＜0.05). The effective rate of Pp, pp, Xx, xx types patients [82.61％ (19/23)、80.65％ (25/31) 、9/14、83. 33％ (35/42) respectively] was higher than PP and XX types patients (1/6 and 1/4 respectively).Conclusion Erα gene polymorphism influenced the efficacy of ursodeoxycholic acid in treating primary biliary cirrhosis.

Objective To study the changes of reactive astrocytosis after heat shock protein 70 (HSPT0) was blocked by anti-HSP70 antibody. Methods We established cell model of scratch inju-ries by in situ culture and prurification of rat astrocytcs. Anti-HSP70 antibody was added into the nutrient medium at once after injury for intervention (intervention group). Then, immunocytochemical staining of glial fibrillary acidic protein (GFAP) was done at different time points in control group and intervention group to observe astrocytosis and morphologic changes, mRNA expression of GFAP was observed by means of reverse transcriptase-polymerase chain reaction (RT-PCR). Results Compared with the con-trol group, average cell area, average dentritic length and number of dentrities of astrocytes were signifi-cantly reduced in the intervention group(P < 0.05 or P < 0.01), with down-regulated mRNA expression of GFAP (P < 0.05). Conclusion HSP70 plays a facilitative role in reactive astrocytosis after injury of astrocytes. Reactive astrocytosis can be controlled to some extent by blocking HSP70 with anti-HSP70 antibody.

Objective To investigate the prevalence and risk factors of metabolic syndrome (MS) in patients with type 2 diabetes in special care unit.Methods Two thousand three hunrded and sixty patients with type 2 diabetes were selected as our subject in The Sixth People's Hospital Affiliated to Shanghai Jiaotong University from Jan.2010 to Jul.2012.Among these patients,462 patients from special care unit were served as special care group and 1 898 patients from endocrinology ward were assigned to control group.The disease history information was recorded and physical examination and biochemical tests,including blood lipids,blood pressure,fasting glucose,glycosylated hemoglobin,serum insulin,C peptide were measured.Results (1) In special care group,there were 335 male (72.5％) and the prevalence of smoking,alcohol drinking and the proportion of the high income people were 40.5％,24.9％,76.6％ respectively,higher than that of control group (56.6％,24.6％,10.7％,12.7％ ;x2 =32.1,16.9,12.3,32.8 ;P ＜ 0.01).The body mess index (BMI),levels of waist circumference,alanine aminotransferase (ALT),gamma glutamyhransferase (γ-GT),triglyceride (TG),serum uric acid and fasting C peptide in special care group were ((25.6 ± 3.7) kg/m2,(91.0 ± 9.5) cm,(27.8 ±19.7) U/L,(34.1 ±26.3) U/L,(2.35 ±2.31) mmol/L,(333.7 ±85.5) μmol/L,(2.11 ±1.04) μg/L) higher than those of control group ((24.8 ± 3.5) kg/m2,(89.1 ± 10.3) cm,(23.0 ± 16.1) U/L,(29.2 ±23.2) U/L,(1.82 ±1.64) mmol/L,(317.1 ±85.2) μ mol/L,(1.74 ± 1.05) μg/L;F =11.44,6.90,16.65,8.35,18.23,7.34,21.21 ; P ＜ 0.01).The age,duration of diabetes,systolic blood pressure,level of serum high-density lipoprotein-cholesterol (HDL-C),and glycosylated hemoglobin were ((52.9 ± 11.1) years,5 (2,10) years,(126.7 ± 15.2) mmHg,(1.02 ± 0.32) mmol/L,(8.44 ± 1.99) ％) lower than those of control group((60.4 ± 12.2) years,7 (2,12) years,(131.9 ± 17.3) mmHg,(1.10 ± 0.32) mmol/L,(9.16 ±2.32)％;F =79.41,12.71,18.93,12.78,18.52; P ＜ 0.01); (2) The rate of overweight/obesity,dyslipidemia and MS prevalence rates in special care group were 55.6％,68.4％,60.2％,significantly higher than the control group(46.1％,52.9％,50.6％ ;x2 =7.59,18.76,7.18,P ＜ 0.01).While the prevalence of hypertension in special care group was significantly lower than control group(39.6％ vs 50.7％,x2 =10.15,P =0.01).There was on significant difference between male and female in term of the prevalence of the MS in the special care group(61.2％ vs 57.5％,x2 =0.01,P =0.92).According to age,patients in special care group were divided into three groups and that were ＜45 years group,45-59 years group and ≥60 years group.With the increase of age group of female,the prevalence of MS was increasing(33.3％,48.0％,74.1％ ;x2 =4.43,P =0.04).Among the male patients,there was no significant different was seen among three groups (58.8％,62.5％,55.6％ ;x2 =0.05,P =0.87).(3) Multiple Logistic regression analysis showed that the independent risk factors of MS in special care group including age(OR =1.071,95％ CI(1.027-1.117),P =0.01),BMI (OR =1.391,95％ CI(1.112-1.739) ; P =0.013),waist circumference (OR =1.126,95％ CI(1.039-1.222) ; P =0.004),TG (OR =1.747,95 ％ CI(1.124-2.717) ; P =0.013) and diastolic blood pressure (OR =1.111,95％CI(1.045-1.180);P =0.001).HDL-C(OR=0.048,95％CI(0.005-0.464) ;P =0.009) were protective factors of MS in special care group.Conclusion Approximately 3/5 patients with diabetes in special care unit got MS.The factors including age,BMI,waist circumference,diastolic blood pressure,TG,HDL-C were related to MS occurrence.

Objective:To analyze the molecular characteristics of dengue virus (DENV) strains circulating in Shantou city in 2018 and 2019 for elucidating the reasons causing strikingly different dengue fever epidemics during the two years and understanding the transmission characteristics and routes of DENV, and to provide reference for the prevention and control of dengue fever.Methods:Detection of viral nucleic acid contents and amplification and sequencing of E gene were carried out on 872 samples positive for DENV acid in 2018 and 2019. Phylogenetic trees were constructed based on the E gene sequences to analyze the homology of DENV strains. The sources and transmission routes of the strains were also analyzed. Results:A total of 99 sequences of DENV E gene were acquired, including 68 DENV-1 sequences and 31 DENV-2 sequences. The cases of dengue fever were sporadic in 2018. Phylogenetic tree showed the strains isolated in 2018 were from multi-sources and closely related to those found in Guangzhou city and Southeast Asia area. Dengue fever outbreaks occurred in 2019 and most of the prevalent strains were from a single source, which was speculated to be Cambodia. Conclusions:Dengue fever in Shantou city was mainly caused by imported strains of the same year rather than by local strains in previous years. DENV strains in Shantou might be traced back to Southeast Asia area and transmitted to Shantou through many routes.

Objective The purpose of this study was to evaluate the hemodynamic effects of an extra-thoracic paraaortic counterpulsation device(ETPACD) with various capacities in an animal model with acute heart failure.Methods The acute heart failure model was successfully induced by snaring branch of anterior descending coronary artery in sheep(weighting 35-42 kg,n =8).The ETPACD is a single port,40 ml,60 ml and 80 ml stroke volume blood chamber designed to be connected to descending aorta through a valveless graft and placed extra-thorax.The hemodynamic indices of 40 ml,60 ml and 80 ml stroke volume were recorded respectively during counterpulsation assistance.Results 40 ml,60 ml and 80 ml ETPACD increased cardiac output 36.98％ (P =0.009),34.16％ (P =0.012) and 53.26％ (P =0.000) respectively,80 ml compared with 60 ml and 40 ml respectively P =0.001,P =0.005.And on diastolic mean aortic pressure 43.40％ (P =0.000)、63.20％ (P =0.000) and 78.76％ (P =0.000),80ml compared with 60ml and 40ml respectively P =0.329,P =0.025.The ETPACD (40 ml,60 ml and 80 ml) increased left carotid artery flow 45.19％ (P =0.007) 、61.51％ (P =0.001) and 81.50％(P=0.000),80 ml compared with 60ml and40 ml respectively P=0.016,P =0.000.Conclusion This study demonstrated that ETPACD (40 ml,60 ml and 80 ml) provided benefit of circulatory support in acute heart failure with better effect on hemodynamic parameters provided by 80 ml.Therefore,ETPACD with larger stroke volume may become a promising counterpulsation device for treatment of heart failure.

ObjectiveAn out-thoracic paraaortic counterpulsation device(PACD) developed in the Reseach Center of our hospital was evaluated for its hemodynamic effects in an animal model with induced acute heart failure.MethodsEight healthy adult sheep with a weight of 38.5 to 54.5 kg were used as models for acute heart failure by snaring branches of coronary arteries.Thoracotomy was performed through the space under the left 4th rib.A Satinski clamp was used for partially clamping the descending aorta, and the Dacron vascular graft of out-thoracic PACD was sutured end-to-side to the descending aorta.The out-thoracic PACD used in this study had a blood chamber that was separated from the gas chamber by a movable polyurethane membrane .A stroke volume of 60 ml could be pumped when it was fully inflated.A 4F multipurpose catheter was inserted through the left ventricular apex for measuring and recording left ventricular pressures.A standard 40-ml intraaortic balloon was inserted into the descending aorta via the surgically exposed left femoral artery.Baseline hemodynamic data were collected after the model for acute heart failure was created without mechanical support.Mechanical support was randomly initiated either by the IABP or by the out-thoracic PACD in each experimental phase.Both devices were driven by the same console and synchronization with electrocardiogram was performed.Hemodynamic indexes and left carotid artery flow were calculated at baseline (device off) and during the period of 1 : 2 support for the 60-ml out-thoracic PACD and 40-ml IABP in the same animal.Baseline and support modes for devices were maintained for 15 minutes individually to ensure that a steady-state was achieved.ResultsBoth out-thoracic PACD and IABP resulted in a increase in the cardiac output (17.79％ with out-thoracic PACD vs.13.46％ with IABP, P =0.803) and the mean diastolic aortic pressure (29.48％ with out-thoracic PACD vs.15.01％ with IABP, P = 0.001).The use of out-thoracic PACD also led to a greater reduction in left ventricular end-diastolic pressure (35.09％ with out-thoracic PACD vs.15.79％ with IABP, P = 0.004).Meanwhile the out-thoracic PACD increased left carotid artery flow (14.52％ with out-thoracic PACD vs.6.70％ with IABP, P =0.006).No evidence of hemolysis, thrombus formation or major organ injury was identified during the experiment.ConclusionThe study indicated that a 60-ml out-thoracic PACD, which providing an improved mechanical circulatory support, was superior to a 40-ml IABP in the setting of experimental acute heart failure.This device may be used as a desirable alternative for the long-term mechanical support in patients with severe heart failure or those waiting for a heart transplantation, owing to its properties of low cost,easily to be implanted and removed, as well as a high biocompatibility.

Objective To investigate the relationship of the changes of bone density and biochemical marker of bone turnover with osteoporosis in the elderly with type 2 diabetes mellitus(T2DM). Methods A total of 102 elderly patients with type 2 diabetes and 42 healthy subjects (normal controls) were included in this study.The bone mineral density (BMD) of lumbar vertebrae and femur were measured by dual-energy X-ray absorptiometry (DXA).The T2 DM subjects were divided into two groups:osteoporosis group (56 cases) and non-osteoporosis group (46 cases).The levels of total procollagen type Ⅰ amino-terminal propeptide (TP Ⅰ NP),β-isomerized carboxyterminal propeptide (β-CTx),parathyroid hormone (PTH),serum calcium (Ca2+),serum phosphorus (P),alkaline phosphatase (ALP),fasting blood glucose(FBG),glycosylated hemoglobin (HbAlc) and body mass index (BMI) were detected. The correlations between BMD of the osteoporosis group and other related factors were analyzed. Results The BMD values of lumbar vertebrae and femur neck,troch,ward's triangle in the osteoporosis group were decreased as compared with control(t=9.006,6.347,7.387,5.321,P＜ 0.01) and the serum TP Ⅰ NP,β-CTx,PTH,ALP,FBG,HbAlc,Creatinine and albumin/Cr in the osteoporosis group were significantly higher than controls(t=2.212,4.431,2.215,3.544,0.433,1.629,0.365,5.436,P＜0.01 or P＜0.05),the 25-(OH)VD3 in the osteoporosis group was lower than in controls(t=2.700,P＜0.01).Correlation analysis showed TP Ⅰ NP was negatively correlated with the BMD of femoral Troch and Ward's triangle (r=-0.413,-0.375,P＜0.01),and β CTx was negatively correlated with the BMD of femoral Troch (r=-0.301,P＜0.05).The TP Ⅰ NP,β-CTx in the overweight group and obesity group were higher than in normal group(F=50.59,51.28; F =96.20,95.71,all P＜0.01);the melbine group had higher TP Ⅰ NP,β-CTx than the thiazolidinedione and sulfonylurea group(F=32.33,33.35,F=31.07,39.18,P＜0.01);the TP Ⅰ NP,β-CTx in the better blood glucose control group were lower than in the bad control group(F=11.32,13.69,P＜0.01);the TP Ⅰ NP,β-CTx in the group with complication were increased as compared with no complication group(F=52.75,70.34,P＜0.01).Conclusions The spine BMD in elderly T2DM patients is decreased to some degree.The combined application of TP Ⅰ NP and β-CTx is helpful for the early diagnosis of osteoporosis in patients with type 2 diabetes.

Objective To evaluate the short-term and long-term efficacy of interventional therapy for acute hepatic artery thrombosis.Methods We analyzed retrospectively the interventional treatment and long-term follow-up data of 34 patients with acute hepatic artery thrombosis in Zhongshan hospital of Fudan University from March 2003 to October 2015.Results Thirty-four patients with acute hepatic artery thrombosis were performed with urokinase thrombolytic therapy.Twenty-one patients were implanted stents in the thrombolytic therapy.Splenic artery embolization were performed in 3 patient with splenic artery steal syndrome.Technical and clinical success rates were 91％ (31/34).The complication associated with interventional procedures were observed in 2 patients.The patency rates of hepatic artery in 1,2,3 and 5 years were 82％,73％,57％ and 57％ respectively.The median obstruction free time was 94 months.Conclusions Good short-term and long-term effect have been obtained in interventional treatment for acute hepatic artery thrombosis,which can be used as the first treatment for acute hepatic artery thrombosis after liver transplantation.

OBJECTIVE:To ensure drug use safety and lower drug-induced risks.METHODS:Based on risk management theory and USA-EU drug risk management system,we analyzed the contents of drug risk management,the relationship between drug safety and drug risk,and the classification of drug-risk factors etc.And some suggestions were put forward.RESULT & CONCLUSION:The introduction of drug-risk management system can help facilitate the normalization and standardization of drug safety control,maximize drug benefit and minimize drug risk.

ObjectiveTo investigate the relationships between T and NK cells in peripheral blood and the relapse or metastasis of malignant tumors.MethodsFlow cytometry was used to test the percentages ofT and NK cells in peripheral blood of 48 malignant tumor patients with relapse or metastasis (relapse or metastasis group) and 48 malignant tumor patients without relapse or metastasis(control group).ResultsCompared with control group,the ratio of Th/Ts decreased,CD4+/CD25+ raised and the activities of NK cells decreased in relapse or metastasis group (0.95 ±0.52 vs.1.35 ±0.43,7.15 ±3.81 vs.6.01 ±2.67,0.2053 ±0.1135 vs.0.2501 ±0.0745)(P＜0.01 or ＜0.05).ConclusionsTesting the T and NK cells in peripheral blood of malignant tumor patients regularly can know their immune status and find the relapse or metastasis early.It is easy and useful in patients' follow-up.