BACKGROUND: Vascular complications usually occur in diseases related to obesity such as primary hypertension or diabetes. Treating obesity with the method of promoting blood circulation to remove blood stasis gains a curative effect, so we presume that obesity may be correlated to blood stasis syndrome.OBJECTIVE: Analyzing the relationship between leptin(Lep) and insulinmetabolism of sugar and fat,endothelin(ET),blood pressure,body mass index(BMI), etc. Comparison of the differences in Lep and BMI between the blood stasis syndrome group and the non-blood stasis syndrome group was conducted to explore the correlation between obesity and the blood stasis syndrome.DESIGN: An observatory and controlled study based on patients with hypertension or diabetes.SETTING: Wards of the department of dardiovascular dedicine and the department of dndocrinology of a university of traditional Chinese medicine.PARTICIPANTS: All the patients in the present study were hospitalized at the Department of Internal Medicine of the Second Affiliated Hospital(Jinan City, Shangdong Province) of Shandong University of Traditional Chinese Medicine from September 2000 to January 2001.Among them, 126 cases with hypertension were at the Department of Cardiovascular Medicine, and 133 cases with type 2 diabetes were at the Department of Endocrinology. Inclusion criteria: ① The diagnosis of diabetes followed the diagnostic criteria for diabetes that was formulated by the WHO in 1980; ② The diagnosis of hypertension followed the diagnostic criteria in"China' s Guidebook for Hypertension Prevention and Treatment." The patients were aged between 45-76 years. Exclusion criteria: ① Secondary hypertension,diabetics; ②Complicated with severe diseases; ③ Complicated with severe disfunction of the heart,lung,liver, kidney or severe primary diseases in hematopoietic system; ④ Patients with mental disorder or pregnant women or in the state of lactation; ⑤ Patients aged <45'years old or>76 years old; ⑥ Patients who refused to participant in the study. Eighty-four cases with primary hypertension and 85 diabetics met the inclusion criteria, with a total of 169 cases including 73 male cases and 96 female cases. The cases were divided into blood stasis syndrome group and non-blood stasis syndrome group according to the clinical symptoms. There were 23 male cases and 37 female cases in the blood stasis syndrome group.METHODS: Drawing vein blood at the state of empty stomach for making plasma and serum. ET was detected with the radioimmuoassay(RIA) kit of ET by the method of RIA(the Arithmometer of Amma5500γ) . Lep and Ins were detected with the radioimmuoassay(RIA) kit of Lep and the radioimmuoassay(RIA) kit of Isu. The fasting blood sugar, total cholesterol(TC),triamid-glycerin(TG), high dense lipoprotein-cholesterol(HDL) and low dense lipoprrotein-cholesterol(LDL) were detected by the full-automatic bio-chemical analytical instrument of AMS-SaBa/8.MAIN OUTCOME MEASURES: Comparing the difference of Lep,Ins,ET between different diseases,syndromes; analyzing the relationship between Lep and Ins,BMI,blood sugar,blood lipid,blood pressure,etc.RESULTS: The detectable rate of the blood stasis syndrome in the diabetes group was higher than that in the hypertension group (P<0.05) . The ET density,Lep density,BMI,the percentage of fat of the blood stasis syndrome group were higher than those of the non- blood stasis syndrome group (P<0.05 ). The Ins density of the blood stasis syndrome group was lower than that of the non-blood stasis syndrome group(P<0.01 ). There was a positive correlation between Lep and BMI,the percentage of fat,ET,systolic pressure (SP),pulse pressure(PP) (P<0.05 or P<0. 01).CONCLUSION: There was a positive correlation between obesity and the blood stasis syndrome. Lep of patients with type 2 diabetes or hypertension was positively correlated to BMI,the percentage of fat and the level of ET.

0.05). Compared with primary trigeminal neuralgia group and normal control group,the LPs in each wave of BR were significantly prolonged in secondary trigeminal neuralgia group(all P

Objective To test comparative effect of capecitabine and S-1 (Tegafur/gimeracil/oteracil) on advanced colorectal cancer.Methods 106 cases of advanced colorectal cancer in our hospital oncology were collected and randomly divided into 2 groups:capecitabine group (52 cases) and S-1 group (54 cases).The chemotherapy effect and adverse effect of 2 groups were collected.Results After one treatment period,3 cases of complete remission,19 cases of partial remission,15 cases of stable disease,15 cases of disease progression,efficient rate of 42.3％and control rate of 71.2％ were observed in capecitabine group.5 cases of complete remission,21cases of partial remission,19 cases of stable disease,9 cases of disease progression and efficient rate of 48.1％ and control rate of 83.3％ were observed in S-1 group.There were no significant differences in efficient rate,control rate adverse effect rate and survival time between 2 groups(P ＞ 0.05).Conclusion Capecitabine and S-1 are both safe and effective in treatment of advanced colorectal cancer.

Objective To explore the appliacation value of FPSAR between the serum f-PSA and t-PSA in hyperplasia of prostate by YAG Laser.Methods 150 cases with benign prostate hyperplasia(BPH)and 24 cases with prostate pcaancer were selected.The value of f-PSA、t-PSA、FPSAR was determined by TRFIA.Results The tPSA,f-PSA after treatment were significantly lower than before treatment in the two groups(t =2.984,2.701,P ＜0.05).The FPSAR after treatment was significantly higher than before treatment in the two groups(t =2.335,P ＜0.05);The patients of FPSAR≤0.05 in the overlapped field(t-PSA 4～45.5μg/L),the sensitivity of diagnosing PCa is 91.7％(22/24)[t-PSA ＞ 45.5 μg/L(17/24)+(t-PSA 4～45.5 μg/L,FPSAR ≤ 0.15)(5/24)].To examine the PCa with high sensitiveity,it provided the reliable basis for selecting BPH correctly.The patients of BPH group after TUEP was followed up for 6～12 months.The t-PSA is(2.13 ± 0.45)μg/L、f-PSA is(0.85 ± 0.26)μg/L、FPSAR is (0.39 ± 0.06)μg/L.There is no significant difference compared with that after treatment for a month.The international prostate symptom score,(I-PSS)is from(28.3 ± 5.8)points dropped to(12.5 ± 2.1)points.The quality of life,(QOL)is from(4.1 ± 0.6)points dropped to(1.3 ± 0.1)points.The residual urine volume(RUV)is form(93 ±61)ml reduced to(15 ±9)ml.The urination after operation have improvedsignificantly.The Qmax is from average 6.3(2.6～9.5)ml/s before operation raise to 18.4(14.6～22.3)ml/s after operation.Campared with the pre-operation,there is significant difference.Conclusion The application of serum PSA was impoetantin case selection hyperplasia of prostate,comparison of the level changing before and after operation and following up the patients after operation by YAG Laser.

Objective To report three cases of localized primary sclerosing cholangitis (PSC) mimicking a hilar cholangiocarcinoma (Klatskin tumor) and to summarize their clinical characteristics and the ways to differentiate them through a literature review.Method The clinical data of three patients with localized PSC mimicking a hilar cholangiocarcinoma were retrospectively analyzed.The characteristics of laboratory tests and imaging examination were reviewed,and therapy and prognosis were discussed.Results The three patients were all diagnosed to have a hilar cholangiocarcinoma preoperatively,but the diagnosis of PSC was confirmed by histopathology post-operatively.All the three patients had elevated CA19-9,2 patients had elevated anti-nuclear antibody (ANA) and 2 patients had elevated IgG.All the three patients underwent surgical resection and histopathological study showed chronic inflammation of the hilar bile ducts and cholangitis of the intrahepatic portal area.The three patients were followed up from 7 months to 8 years with no symptoms.Conclusions Localized PSC is rare and it can casily be misdiagnosed as a hilar cholangiocarcinoma.Biopsy before surgery is helpful for the differential diagnosis but it is difficult to get a good biopsy sample.Surgical resection is an effective treatment.

Objective To evaluate the efficacy and safety of 650 nm,810 nm diode laser on the treatment of moderate to severe acne.Methods A total of 87 patients with moderate to severe acne were divided into diode laser group (group A) and medication group (group B).In group A,the patients were irradiated with 650,810 nm diode laser at the fluence of 400-450 mW distance of 2-3 cm.In group B,the patients were treated with roxithromycin combined with vitamin B6 and gel lincomycini.Clinical follow-up was performed every week for 4 months.All the adverse effects were recorded.Results There was no significantly statistical difference in the cure rate between the two groups (group A versus group B at 2 weeks:65.0 ％ versus 42.6 ％,P＞0.05; at 4 weeks:92.5 ％ versus 76.5 ％,P＞0.05).However,the recurrence rate of group A was much lower than that of group B (30.0 ％ versus 61.7 ％,P＜0.01).There were no severe adverse effects in both groups during the period of the follow-up.Conclusions Compared to the medication,650,810 nm diode laser appears to be associated with lower recurrence rate in the treatment of moderate to severe acne.

Objective To investigate the changes in serum matrix metalloproteinase(MMP)-2 and MMP-9 and their relationship with serum B-type brain natriuretic peptide(BNP)in patients with chronic heart failure.Methods MMP-2,MMP-9 and serum BNP levels were measured in 184 patients with chronic heart failure and 61 healthy controls.The relationship between changes in MMP-2 and-9 and serum BNP was analyzed.Results Chronic heart failure was categorized into grade Ⅱ,Ⅲ and Ⅳ according to NYHA.In grade Ⅱ,Ⅲ and Ⅳ and the control group,the levels of MMP-2 were(309.1±60.1)nmol/L,(422.6±89.6)nmol/L,(694.8±126.2)nmol/L and(217.2±26.3)nmol/L respectively,and the levels of MMP-9 were (321.2±63.2)nmol/L,(454.4±96.3)nmol/L,(634.1±51.2)nmol/L and(210.8±23.6)nmol/L respectively.The levels of MMP-2 and MMP-9 were significantly higher in chronic heart failure subgroups than in the control group(F=3.65,12.52;P=0.000,0.000).According to the pairwise comparison among the chronic heart failure subgroups,the levels of serum MMP-2 and MMP-9 were significantly higher in NYHA Ⅳ grade than in NYHA Ⅲ grade,and higher in NYHA Ⅲ grade than in NYHA Ⅱ grade(all P<0.05).In patients with chronic heart failure groups,MMP-2 was positively correlated with serum BNP(r=0.866,P=0.000),and with MMP-9(r=0.516,P=0.001).Conclusions MMP-2 and MMP-9 levels might be closely correlated with chronic heart failure and show an upward trend with the progression of chronic heart failure.The levels of MMP-2 and MMP-9 are associated with BNP,which indicates that clinical monitoring of the serum level changes can provide a certain reference for diagnosis,treatment and prognosis in patients with chronic heart failure.

To evaluate the virulence genes and antibiotics resistance of Staphylococci species in mastitis cows isolated from parts of Guangdong,and then provide scientific basis of the prevention of bovine mastitis.Forty strains Staphylococci isolated from milk samples of 110 mastitis cows were collected,and virulence genes,resistance genes and disinfectant resistant genes were detected by PCR,and antibiotics resistance with K-B paper method.The results showed that the highest virulence gene was fnbp (17.5％),followed by seb (15％) and tsst (15％),and virulence genotype was complex.The most prevalent antibiotic resistance drug wvas streptomycin,followed by erythromycin and penicillin G,and CNS were susceptible to oxacillin,ceftraxone and cefazolin.The most prevalent antibiotic resistance genes was quinolones gene qnrA/B/C/D(20％),the resistance to streptomycin was mediated by aac6-aph2.The most prevalent disinfectant resistant gene was qacG (225 ％).The genotype of antibiotics resistance gene and disinfectant resistant gene was complex.

Objective To investigate the relationship between the systolic/diastolic orthostatic hypotension(OH S/OH-D) and myocardial infarction (MI) in the elderly.Methods 200 subjects without myocardial infarction (MI) aged 60 years and over in our urban district were selected.The orthostatic and supine blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 minutes after standing.All eases were divided into systolic orthostatic hypotension(OH-S)or diastolic orthostatic hypotension(OH-D)groups based on the results of orthostatic hypotension,and followed up by telephone with mean period of 325 days.The primary endpoint was MI occurrence for analyzing the correlation between OH-S/OH-D and MI incidence.Results The prevalence rate of OH in this cohort was 38％,with OH-S 20％ and OH-D 18％.In the very elderly group(≥80 years)versus the elderly group,the occurrences of 0H and OH-S were(27％ vs.21 ％,P =0.036;22 ％ vs.15 ％,P =0.020),respectively,while no significant difference was found in OH-D between the two groups.After 325 day follow up,the prevalence of MI was significantly(P＜ 0.05)higher in the OH positive subjects than in the 0H negative subjects,which result was the same as the prevalence of MI in OH-S or and OH-D group.After adjusting for age,supine blood pressure,creatinine and cerebrovascular history,logistic regression analysis showed that MI was correlated with OH(HR 15.72,95％CI 3.29～74.23,P=0.002),OH-S(HR 8.552,95％CI 2.51～30.21,P=0.004)and OH-D(HR 3.80,95 ％CI 1.14～13.80,P=0.042).Compared with OH-D,OH-S had more significant correlation with MI.Conclusions Orthostatic hypotension,particularly systolic orthostatic hypotension,is common in elderly patients.The OH-S and OH-D have a significant correlation with MI.

Objective The aim of this study was to compare recent clinical efficacy between a novel guidance method for percutaneous pedicle screw placement and the conventional fluoroscopic method for long segments thoracolumbar vertebral fracture without nerve injury. Methods A total of 38 patients with thoracolumbar vertebral fracture in our hospital from September 2010 to December 2012 were divided into group A and group B.Eighteen patients in group A underwent 200 percutaneous pedicle screw fixation by conventional fluoroscopic meth-od.Twenty patients in group B underwent 210 percutaneous pedicle screw fixation by a novel guidance method.All the operation for 38 cases were performed by the same surgeon.The time of insertion,radiation exposure,and accuracy of the screw placement between the two groups were compared.The accuracy of screws was evaluated and graded by two consecutive postoperative CT of operation segment for two groups. Results The mean time for a single pedicle screw placement was (13.11 ±2.32)minutes in group A and (10.35 ±1.92)minutes in group B,respectively.The average radiation exposure was (8.11 ±1.15)s in group B and (13.07 ±2.06)s in group A respectively.The differ-ences were statistically significant for both screw placement and radiation exposure times (P <0.05).A total of 172 screws (86.00%)in group A and 185 screws (88.09%)in group B were perfectly located within the pedicle.The statistical difference of grade A between two groups was not significant(P >0.05).Conclusion The novel guidance system can significantly reduce the insertion time and radiation expo-sure for long segments percutaneous pedicle screw placement,which provides the same accuracy for screw placement compared with the con-ventional method.