Objective To observe the expression levels of 8 - hydroxy-deoxyguanosine (8-OHdG) in patients with different glucose metabolism and its relationship with islet dysfunction.Methods Based on the 75 g oral glucose tolerance test (OGTT), the patients were divided into 3 groups: normal glucose tolerance (NGT) group (30 patients), isolated impaired glucose tolerance (IGT) group (28 patients), type 2 diabetes mellitus (T2DM) group (28 patients), and 30 healthy subjects were selected as the healthy control group (healthy control, HC) . The triglyceride (TG) and total cholesterol (TC), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), insulin resistance index, insulin and c-peptide area under the curve (AUC) were detected, and compared between groups, and the correlation between 8-OHdG and these indexes was analyzed. Results There was no difference in FBG values between NGT group and HC group, the indicators of patients in other groups were higher than HC group,the difference was statistically significant (P<0.01). The values of FBG, 8-OHdG, HbA1C and HOMA-IR of patients in IGT group were higher than NGT group, the difference was statistically significant (P<0.01) . The values of FBG ,8-OHdG, HbA1C and HOMA-IR in T2DM group were higher than IGT group. There were no differences in insulin AUC between NGT group, IGT group and T2DM group (P> 0.05) . 8-OHdG was correlated with FBG, HbA1c, HOMA-IR, C peptide AUC, insulin AUC, and the correlation coefficients were 0.704, 0.713, 0.665, 0.825 and 0.653, respectively, the differences were statistically significant. Conclusions 8-OHdG levels can reflect the status of islet dysfunction,and can be used as an indicator of islet function for diabetic patients.

Objective To discuss the distribution of irregular antibodies of red blood cells and its clinical significance .Methods Micro-column gel anti-globulin technique was used to screen and identify the irregular antibodies in 6 352 patients .Results In 6 352 patients ,there were 62 cases(27 males ,35 females)having positive results in irregular antibody detection ,and the positive rate was 0 .97% .There were 54 cases having transfusion history and/or pregnancy history ,including 43 cases of irregular antibodies of Rh system(containing 34 cases of anti-E antibody) ,7 cases of MNSS system ,2 cases of Lewis system ,2 cases of Kidd system ,2 cases of P system ,1 cases of Diego system ,and 5 cases with non-specificity .All of the patients whose irregular antibodies of Rh blood group system were positive had transfusion history and/or pregnancy history .Conclusion Most of the patients with irregular anti-body positive are females ,who mostly have transfusion history and/or pregnancy history ,and the irregular antibodies of Rh system are the most common .

Objective To investigate effects of continuous positive airway pressure (CPAP)treatment on pulmonary function, frequency of asthmatic attack, and quality of life in patients of moderate to severe obstructive sleep apnea syndrome (OSAS) accompanying with asthma. Methods Twenty-three patients of OSAS accompanying with mild-to-moderate asthma were studied. They were divided into two groups, gastroesophageal reflux ( GER ) group ( n = 9 ) and non-GER group ( n = 14 ), based GER questionnaire score equal to or greater than 12, or less than 12. Pulmonary function tests (PFTs), Epworth sleepy score (ESS), quality of life for obstructive sleep apnea (QOLAp) score, quality of life for asthma (QOLAs) score and polysomnography (PSG) were measured for all the patients before and after four-week CPAP, respectively. Results No significant difference in PFTs was revealed before and after four-week CPAP between the two groups. However, there was significant difference in scores of QOLAp, ESS and QOLAs before and after four-week CPAP treatment, ( 12. 8 ± 2. 8 ) and (4. 6 ± 0. 9), ( 5. 1 ± 0. 7 ) and (6.3 ±0.6), and (4. 1 ±0.5) and (6.3 ±0.5) in GER group, and (13.0 ±2.9) and (4.6 ± 1.1),(4.7±0.5) and (5.6±0.6), and (3.6±0.3) and (5.8 ±0.6) in non-GER group, respectively (P＜0. 01 or 0. 05). Frequencies of asthmatic attack and nocturnal asthmatic attack reduced to ( 1.7 ± 1.1 )episodes per week and (0. 7 ± 0. 3) episodes per week after four-week treatment from (2. 9 ± 2. 0) episodes per week and ( 1.4 ± 0. 8) episodes per week before treatment ( P ＜ 0. 05 ) in GER group, but no significant difference was found before and after treatment in non-GER group. Scores of QOLAs increased more significantly in GER group than that in non-GER group ( P ＜ 0. 05 ). Conclusion CPAP treatment can significantly improve quality of life, rather than pulmonary function, in patients of OSAS accompanying with asthma, especially in those with GER symptoms.

Objective To explore the effectiveness of transcranial magnetic stimulation (TMS) combined with hyperbaric oxygen (HBO) in treating cerebral infarction.Methods Totally 120 patients with cerebral infarction were randomly divided into a control group,a treatment group A and a treatment group B,40 cases in each group.The control group was given conventional treatment,the treatment group A was treated by HBO on the basis of conventional therapy,and the treatment group B was treated by HBO combined with TMS,10 d for a period of treatment.Before and after 2 courses of treatment,all patients' neurological defect was evaluated using National Institutes of Health Stroke Scale (NIHSS).Their central motor conduction time (CMCT) and the expression of brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were also assessed.Results After treatment,the average NIHSS score and effective rate of the treatment group B was (7.35 ± 1.98) and 92.5％ respectively,significantly better than the other two groups.Moreover,the average BDNF content [(4.96 ± 1.20) ng/ml] and NGF content [(152.36 ± 18.01)pg/ml] of the treatment group B after treatment were significantly better than before treatment,and those of the other two groups after treatment.Conclusion TMS combined with HBO is effective in treating cerebral infarction.This may relate to its strengthening the expression of neurotropic factors.

Objective To describe the real experience of nurses from different grade hospitals during further study in the three-level hospital.And to provide the basis to make plans,improve the effect of fustther study and ensure the realization of further study aim.Methods In-depth interviews were canied out with 28 nurses by using Hidegerian phenomenological method.The acquired data were reorganized,analyzed and extracted themes.Results Different grade hospital nurses had different psychological experience such as aims,willingness,effects,obtainment and stress.Condusions Further study should be based on subjective willingness and definite goals.Hospitals should strictly select nursing teachers,give differential treatment in education,fully understand the pressure source and provide corresponding measures to reduce stress of nurses.

AIM　To investigate the chemical constituents of the rhizomes of Dioscorea panthaica Prain et Burkill and look for new active compounds. METHODS　The compounds were isolated with silica gel and HPLC, and their structures were elucidated on the basis of chemical evidences and spectral analysis (IR, ESI-MS, 1HNMR, 13CNMR, DEPT, 1H-1H COSY, HMQC, HMBC, NOESY). RESULTS　Three steroidal saponins were isolated from the rhizomes of Dioscorea panthaica. They were elucidated as 26-O-β-D-glucopyranosyl-3β,26-diol-23(S)-methoxy-25(R)-Δ5,20(22)-diene-furosta-3-O-［α-L-rhamnopyranosyl-(1→2)-O-α-L-rhamnopyranosyl-(1→4)］-β-D-glucopyranoside (I), pseudoprotodioscin (II), 26-O-β-D-glucopyranosyl-3β,26-diol-25(R)-Δ5,20(22)-diene-furosta-3-O-α-L-rhamnopyranosyl-(1→2)-O-β-D-glucopyranoside (III). CONCLUSION　Compound I is a new steroidal saponin and was named as dioscoreside C. Compound II and III were obtained from this genus for the first time.

Objective To assess the safety and efficacy of gabapentin in treatment of refractory uremic pruritus in maintenance hemodialysis (MHD)patients. Methods A randomized controlled trial was performed.Forty-nine MHD patients with severe pruritus were randomly divided into treatment group(gabapentin 100-300 mg at dialysis day before sleep)and the control group(loratadine 10 mg daily).The efficacy was assessed by visual analogue score,pruritus score and improved Duo's VAG Score after 12-week treatment,and the side effect was also observed to assess the safety. Results After treatment,the frequency,degree and area of pruritus in 25 patients of treatment group were significantly reduced,and VAS score(1.46±1.38vs 8.71±1.17,P＜0.01),VAG score(2.92±1.63 vs 8.29±0.68,P＜0.01)and the improved Duo's pruritus score(11.33±3.99 vs 30.75±4.87,P＜0.01)decreased significantly compared with that of prior treatment.The symptoms of 24 patients in control group were improved partly,which were not as good as those in treatment group(P＜0.01).The side effects of gabapentin were drowsiness and dizziness,but most symptoms were relieved or disappeared within 1 week and no patient interrupted therapy.No serious adverse events were observed. Conclusion Gabapentin is safe and effective for refractory uremic pruritus,but long-term efficacy and safety requires larger sample and long-term observation.

Objective To investigate the relationship between serum homocysteine (Hcy)and N -terminal brain natriuretic peptide (NT -proBNP)and the severity of coronary artery disease in elderly patients with coronary heart disease (CHD).Methods 129 cases of inpatient with concurrent coronary angiography whose age was over 60 years old were selected as the research object.Serum Hcy and NT proBNP level were detected,and parallel coronary angiography were administrated.Angiography was normal in 24 cases (CONTROL group),while 28 cases were stable angina pectoris(SAP group),non ST segment elevation acute coronary artery comprehensive syndrome group (NSTEACS group)had 47 cases,acute ST segment elevation myocardial infarction group had 30 cases(AMI group).was used to The severity of coronary artery lesions were assessed by Gensini score and the relationship be-tween serum Hcy and NT proBNP levels and coronary angiography in the diagnosis of coronary artery disease severity were analyzed.Results AMI group,the mean serum Hcy and NT proBNP levels[(18.13 ±8.26)μmol/L,(450.45 ± 230.45)pg/mL]were significantly higher than those of NSTEACS group [(16.96 ±9.04)μmol/L,(300.96 ± 170.94)pg/mL],SAP group[(14.35 ±5.31)μmol/L,(130.35 ±85.31)pg/mL]and control group[(10.19 ± 3.18)μmol/L,(65.19 ±40.18)pg/mL](t =5.73、3.64;t =5.53、3.23;t =4.96、3.46;P <0.05).In NSTEACS group,average of Hcy and NT proBNP levels were significantly higher than those of SAP group and control group (t =5.06,3.54;t =4.79,3.25;P <0.05).In SAP group,the average of Hcy and NT proBNP levels were higher than those in the control group (t =5.89,4.23;P <0.05).The levels of serum Hcy and NT -proBNP in patients with cor-onary artery stenosis,double vessel disease and single vessel disease were(16.13 ±7.26)mol/L,(7.29 ±14.35)mol/L, (12.67 ±6.48)pg/mL,(210.45 ±416.45)pg/mL and (160.71 ±140.57)pg/mL,the difference was statistically significant (F =140.25,F =13.15;P <0.05,P <0.01).The levels of serum Hcy and NT -proBNP were signifi-cantly correlated with Gensini score (r =0.342,P <0.05;r =0.962,P <0.01).Conclusion Correlation between serum Hcy,NT -proBNP levels in elderly patients with coronary heart disease and the severity of coronary artery disease and stenosis count is positive.Determining the levels of serum Hcy and NT -proBNP in patients with coronary heart disease and the assessment of the severity of the disease has important clinical significance.

Objective To analyze the prevalence of the various hematological malignancies (HM) in Harbin.Methods Study data was collected from January 2010 to December 2011.All cases were diagnosed and classified on the basis of blood test,bone marrow puncture,histochemical staining and typing and classified by the French American British classification.The age and sex distribution of HM and its subtypes were analyzed.Results Of 2214 Chinese people diagnosed with HM,acute myeloid leukaemia (AML) (33.5 ％) and myelodysplastic syndromes (MDS) (29.9 ％) were the most prevalent and of 742 AML,the most frequent subtypes were M3.With the growth of age,the rates of chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) were increased,but in acute lymphocytic leukemia (ALL),this trend was reversed.The distribution of HM increased with age between 0-60 years old,in above 60 years old,the frequency of some chronic HM including CLL,chronic myelomonocytic leukemia (CMML),chronic neutrophilic leukemia (CNL) and MM were continued to rise,but other HM subtypes were decrease,lower than in 41-60 years old groups.This study also revealed that M0 and MPAL were more common in 0-20 years as well as ALL.For patients never drinking alcohol and drinking for at least 10 years maybe associated with acute leukemia [OR =1.53 (95 ％ CI 1.05-2.23)],while smoking wasn' t a substantial risk factor for acute and chronic leukemia (P =0.20,0.48).Conclusions The epidemiology of HM in Harbin indicates that AML is the most prevalent,followed by MDS.Prevalence of CLL and MM increases with the age in patients above 60 years old.Drinking for at least 10 years maybe associated with acute leukemia.

A benzyl functionalized ionic liquid, 1-benzyl-3-methylimidazolium bis [( trifluoromethyl ) sulfonyl]imide ([BeMIM][Tf2 N]), was synthesized and characterized as an extraction solvent of dispersive liquid-liquid microextraction ( DLLME) for enrichment and determination of 5 organophosphorus pesticides (phoxim, fenitrothion, chlorpyrifos, phorate and parathion) and 2 aromatic compounds (chloronaphthalene and anthracene) from environmental water samples by high-performance liquid chromatography ( HPLC). [BeMIM] [ Tf2 N] had higher extraction efficiency than 1-octyl-3-methylimidazolium bis [( trifluoromethyl) sulfonyl]imide and common organic solvents such as CCl4 and C2 Cl4 . The extraction was performed using 40 μL of [BeMIM][Tf2N] and 1 mL of methanol as extraction solvent and dispersive solvent respectively with centrifugal time of 5 min. Under the optimal conditions, the method proposed here provided a good linearity for all analytes with correlation coefficients between 0. 9994 and 0. 9998. The repeatability values, described as intra-day and inter-day relative standard deviations (RSDs) of five replicate experiments at three different concentrations of 10, 40 and 100 μg / L, were 1. 1% -4. 3% and 0. 8% -4. 8% , respectively. The limits of detection (LOD) were 0. 01 μg / L-1. 0 μg / L at a signal-to-noise ratio (S / N) of 3. This developed method was convenient and speedy, and could be employed to detect the analytes in three real environmental water samples with satisfactory relative recovery of 82. 7% -118. 3% and RSD of 0. 7% -5. 6% . Introduction of benzyl group into the imidazolium could obviously enhance the extraction efficiecny for analytes due to the π-πinteraction between [BeMIM] [ Tf2 N] and analytes. [ BeMIM] [ Tf2 N] was a satisfactory extraction solvent with a high enrichment factor of 339 and extraction efficiency of 81. 4% . Partition coefficients of all analytes in [BeMIM][Tf2 N]-DLLME system were determined and the extraction mechanism was discussed.