To explore the clinicopathological characteristics of parathyroid crisis.The data of 3 cases from our hospital and 125 cases reported domestically were retrospectively analyzed.All 3 cases were male.And their disease course was 3 months to 10 years.The serum calcium ranged from 3.72 to 5.19 mmol/l.Among 177 retrieved cases,125 had complete basic data.The male/female ratio was 1∶ 1.17,average age (46 ± 14) (15-75) years and average serum calcium (4.30 ± 0.58) (3.75-7.28) mmol/L.There was no difference between genders or benign and malignant pathological types.Among 117 eases with pathological diagnosis,the most common type was adenoma (74.4％).The ratio of parathyroid carcinoma was higher in males than that in females (33.3％ vs.11.7％).Misdiagnosis rate was 25.0％ upon initial presentations.Case fatality rate stood at 9.4％ (17/180) and half of them died preoperatively.

Objectives To explore the significance of measuring free/total(f/t) prostate-specification antigen (PSA) ratio, testosterone (T) and free testosterone (FT) in the patients with prostate cancer for performing biopsy with PSA values between 2 and 4 ng/ml.Methods The f/tPSA ratio and total and free testosterone levels in two hundred and seventy-five men with serum PSA values between 2 to 4 ng/ml were quantified.Serum free testosterone levels were measured by immuno-radiometric assay (IRMA), f/tPSA and testostorone levels were determined by chemiluminescence immunoassay (CLIA), underwent transrected ultrasound-guided biopsy (TRUS) was used as the diagnostic standard to detect the earlier prostate cancer in these patients. The diagnostic sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and confidence interval of 95% were determined by receiver operating characteristic (ROC) curve.Results Prostate cancer was detected in 44 of 275 patients(16%). f/tPSA ratio and total and free testosterone levels in the patients with prostate cancer were significantly lower than those in nonprostatic cancer groups (P

Objective:To study the positive expression rate of M2 subtype of macrophage cell surface molecules and the inflammatory factors of PPS in IL-4-induced M2 macrophage.Methods:The experiment was divided into 5 groups:blank control group, Model group,PPS groups(50 μg/ml,100 μg/ml and 200 μg/ml).The expression of CD206 and CD23 was used as bio-maker to confirm IL-4 induced macrophages by treating RAW264.7 with 20ng/ml of IL-4.IL-4 induced RAW264.7 cells were treated with PPS of 50μg/ml,100μg/ml and 200μg/ml for 24 h.Then the expression of CD206,CD16/32 and CD40 were analyzed by flow cytometry, and the mRNA expression of IL-1β,TNF-α,IL-10 and iNOS were detect by qRT-PCR.Results: After treated with IL-4,the positive rate of CD206 of RAW264.7 were high.After treated with PPS ,the rate of CD16/32 and CD40 in IL-4 induced RAW264.7 cells were high ,the expression of CD206 decreased,and the mRNA level of IL-1βand TNF-αincreased.Conclusion:RAW264.7 cells can be polarlized to M2 subtype macrophage by using 20 ng/ml IL-4.PPS enhances the mRNA of IL-1β,TNF-αand the expression of CD40, CD16/32 in IL-4-induced RAW264.7 cells .These results indicate that PPS can induce the M2 subtype to become M1 macrophages, can improve immune function of macrophages.

Objective To explore the value of 64-slice multi-detector computed tomography coronary angiography (64SCTA) in detecting the coronary artery plaque and to analyze the risk factors for unstable plaque. Methods A total of 112 inpatients who had been diagnosed as coronary artery disease by 64SCTA received catheter coronary angiography (CAG). The levels of serum endothelin-1 (ET-1), matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) were measured. The effect of 64SCTA in detecting the coronary artery plaque was evaluated as compared with CAG. The patients were divided into the soft plaque group (n=51) and non-soft plaque group (n=61) according to the CT value of correctly detected plaque. The differences in the above detection indexes between two groups and the risk factors for soft plaque forming were analyzed. Results The 64SCTA had 87.4% sensitivity and 87.1% specificity in detecting coronary artery plaque, the positive predictive value was 82.2% and the negative predictive value was 91.0%. There were significant differences between soft plaque group and non-soft plaque group in the levels of MMP-9, IL-6, hs-CRP, the number of coronary lesions and the composition ratios of gender, diagnosis and diabetes. Logistic regression analysis showed that MMP-9>5.231 ng/L (P=0.0215, OR=2.33, 95%CI 1.13-4.79), hs-CRP>3.583 mg/L (P=0.0008, OR=4.32, 95%CI 1.84-10.15) and unstable angina pectoris (P=0. 0339, OR=4.33, 95% CI 1.12-16.77) were the risk factors for soft plaque formation. Conclusions 64SCTA has highervalue in detecting the coronary artery plaque, and is one of most reliable means in non-invasive methods. MMP-9, hs-CRP and unstable angina pectoris are independent risk factors of plaque instability.

BACKGROUND: Whether overweight and obesity have impact on the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment remains poorly understood.OBJECTIVE: To investigate the effect of women's body mass index (BMI) on the outcome of IVF-ET treatment. METHODS: A total of 184 cases were divided into 3 groups according to BMI: lankness group (BMI < 18.5 kg/m2), normal group (18.5kg/m2 ≤ BMI < 24 kg/m2), overweight and obesity group (BMI≥ 24 kg/m2). Treatments of ovulation induction and IVF-ET were regularly performed in the Reproductive Medical Center, Renmin Hospital of Wuhan University. The duration and dose of gonadotrophic hormone (GTH) treatment, estradiol level at the day of human chorionic gonadotropin (hCG) injection, and the differences of retrieved oocytes numbers, fertility rate, embryo quality, implantation rate, pregnancy rate and abortion rate were compared.RESULTS AND CONCLUSION: The dose of GTH used was in the overweight and obesity group was greater than that of the other groups (P< 0.05), and the dose was increased with BMI increasing. There was no significant difference in other aspects such as estradiol level, retrieved oocytes numbers, fertility rate, embryo quality, implantation rate, pregnancy rate and abortion rate at the day of hCG injection among the three groups (P> 0.05). All results demonstrated that overweight and obese patients require a higher hCG dose to achieve follicular maturation than normal weight patients. However, overweight and obesity does not affect negatively results of IVF-ET.

Objective To study the effect of pereutaneous electrical stimulation of acupuncture points on blood oxygen free radical induce by ischemia-reperfusiou injury in limbs. Methods 30 patients who received the unilateral lower limb surgery were randomly allocated to A and B groups equality. All the patients were received spinal-epidural anesthesia. Before the anesthesia,B groups patients were stimulated bilateral at NeiGuan and WaiGuan acupuncture points by HAN stimulate instruction until the end of the operation. The concentration of malondialdehyde(MDA), glutathione(GSH) and superoxide dismutase(SOD) were measured by venous blood draw from their elbow in four different periods-before the anesthesia(T0), 10 minutes after the tourniquet released(T1), 30 minutes after the tourniquet released(T2) and 60 minutes after the tourniquet released(T3) respectively. Results Gender, age, weight and the time of using tourniquet shows no different between-group differents. There is also no significant different between two groups before theanesthesia in MDA, GSH and SOD. The two groups all shows obviously increase of MDA(P<0.01) and significant decrease of GSHand SOD (P<0.01) in T1, T2 and T3 in contrast to in T0 compare with the A group, B group shows a significant decrease of MDA (P<0.01) and a significant increase in GSH and SOD (P<0.01) in T1,T2,T3. Conclusion The percutaneous electrical stimulation of acupuncture points can protect the limb by ischemia-reperfusion injury.

Objective: To analyze the relationship between inflammatory factors and relevant risk factors in patients of essential hypertension (EH) combining acute coronary syndrome (ACS) with its clinical significance. Methods: Our research included 3 groups: EH group, n=79 patients with standard criteria, EH+ACS group, n=85 and Control group, n=48 normal subjects. Blood levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), tryptase (TPS) and relevant clinical, biochemical parameters were measured; risk factors for cardiovascular disease were examined and the relationship between above parameters, risk factors and ACS occurrence in EH patients was studied by Logistic regression analysis. Results: The OR values were all greater than 1 in fibrinogen (Fbg), high-sensitivity C-reactive protein (hs-CRP), TPS, atherosclerotic plaque, Lp-PLA2 and EH grading. Fbg was the most significant independent risk factor (OR=22.242, 95% CI 6.458-76.609, P<0.0001), the standardized partial regression coefficient b'as absolute value (b') was 1.079 which was the highestone in above 6 variables with the strongest impact for ACS occurrence in EH patients. Conclusion: Fbg, hs-CRP, TPS, atherosclerotic plaque and EH grading were the independent risk factors for ACS occurrence in EH patients; Fbg was the highest risk factor for ACS occurrence with the strongest impact, which provided a new direction for ACS prevention and treatment.

An improved and practical synthesis of racemic 11-demethylcalanolide A [(±)-1] was developed. This improved process involved Pechmann reaction on phloroglucinol with ethyl butyrylacetate to give 5, 7,-dihydroxy-4-n-propylcoumarin(3). Poly phosphoric acid (PPA) catalyzed acylation of compound(3) with crotonic acid, then intramolecular cyclization was achieved simultaneously in one step to afford the key intermediate chromanone(4). A microwave assisted synthetic method preparing chromene(6) using chromenynation of chromanone(4) with 1, 1-diethoxy-methyl-2-butene was conducted. Luche reduction of chromene(6) using NaBH<,4> with CeCl3·7H2O preferably gave (±)-1. The overall yield of this four step synthesis of (±)-1 was around 32% increasing one fold more than that of the previous method. An in vitro investigation showed that (±)-1 exhibited inhibitory activities against both wild-type and drug-resistant HIV-1 in HIV-1 RT and cell culture assay, and significant synergistic effects in combination with AZT, T-20, and indinavir. Its LD50 of acute toxicity in mice by intragastric administration and by intraperitoneal injection were 735.65mg·kg-1 and 525.10mg·kg-1, respectively. The C<,max> and AUC<,0-∞> were 0.54μg·mL-1 and 1.08(μg·mL-1)·h, respectively. The dynamics study of the inhibition of mice sera on HIV-1 RT showed that mice treated with 100mg·kg-1 (±)-1 once intraperitoneally were similar to that of 5mg·kg-1 of known clinical effective anti-HIV-1 drug neverapine. The results suggested that further investigation of the anti-HIV candidate (±)-1 was warranted.

Objective:To determine whether insulin resistance is associated with all-cause mortality in subjects without diabetes.Methods:A total of 505 participants without diabetes, 198 with normal glucose tolerance (NGT) and 307 with impaired glucose tolerance (IGT), were recruited from the Daqing Diabetes Study. The participants were followed up for 30 years. They were stratified into three groups (tertiles) according to baseline homeostasis model assessment of insulin resistance(HOMA-IR) levels, as the HOMA-IR 0, the HOMA-IR 1 and the HOMA-IR 2 groups, to assess the predictive effect of insulin resistance on risk of all-cause mortality.Results:During the 30-year follow-up, 52, 56 and 78 participants died across the three HOMA-IR groups, respectively. The corresponding mortality per 1 000 person-years (95 %CI) were 12.12 (9.56-15.01), 13.10 (10.46-16.03) and 19.91 (16.73-23.15), respectively. Participants in the HOMA-IR 2 group had a significantly higher risk of death than those in the HOMA-IR 0 group after adjustment of age, sex and smoking status ( HR=1.97,95 %CI 1.38-2.81, P<0.001). Cox analyses showed that a one standard deviation increase in HOMA-IR was associated with a 22% increase in the mortality after adjustment of potential confounders ( HR=1.22, 95 %CI 1.08-1.39, P=0.002). Conclusions:Insulin resistance is associated with increased risk of all-cause death in Chinese people without diabetes, suggesting that improving insulin resistance could be beneficial for people without diabetic in reducing risk of long-term all-cause mortality.