Objective To discuss the rehtionship between lipoprotein [Lp (a)],homocysteine (Hcy) and coronary artery disease (CAD) in men.Methods Two hundred and twenty-two male patients admitted for coronary angiography were classified into CAD positive group (111 cases) and CAD negative group (111 cases).The clinical data and plasma Hcy and Lp(a) levels were recorded in both groups.Logistic regression analysis was used to analyze males CAD risk factors.Results Lp (a) ≥0.3 g/L was a risk factor for CAD (OR =5.04,95％ CI 1.88-13.51,P =0.001),whereas Hcy was not related to CAD (OR =1.35,95％ CI 0.63-2.89,P =0.443).However,when both factors were considered together in an interaction model,plasma high Hcy and high Lp (a) levels were risk factors for CAD (OR =11.54,95％ CI 2.62-45.61,P=0.003).Conclusion Plasma Lp (a) and Hcy levels may increase the incidence of male CAD process.

The dental clinical internship is the critical stage of combining theory and practice and changing the knowledge into ability for medical smdents through clinical practice.It should be based on the characteristics of oral medicine such as integrating the teaching content firstly,promoting the discussion teaching;then carrying the seminar teaching,including three steps,question-making,question-suspecting and question-solving Meanwhile,the training of scientific research and cultivate the innovative ability should be strengthened to cultivate students'creative ability by guiding studetents to refer to data.fill in the proposal of medical students and process an opening report,make medical records discussion and write professional summary and thesis.

Objective:To evaluate the role of esophagogastric junction contractile index (EGJ-CI) in distinguishing patients with refractory gastroesophageal reflux disease (RGERD) from functional heartburn (FH).Methods:From March 2014 to January 2018, 82 patients with proton pump inhibitor (PPI) refractory heartburn and/or regurgitation, who visited the Outpatient Department of Gastroenterology at The First Affiliated Hospital with Nanjing Medical University were enrolled, among them 50 patients with RGERD (RGERD group) and 32 patients with FH (FH group). EGJ-CI of RGERD group and FH group were compared. The sensitivity and specificity of EGJ-CI to distinguish RGERD from FH patients. The correlation between EGJ-CI and high resolution esophageal manometry parameters, baseline impedance level and 24 h impedance-pH monitoring parameters were analyzed. Mann-Whitney U test, receiver operator characteristic curve analysis and Spearman correlation analysis were used for statistical analysis. Results:The EGJ-CI of RGERD group was lower than that of FH group (25.8 mmHg·cm (14.1 mmHg·cm, 35.9 mmHg·cm)(1 mmHg=0.133 kPa) vs. 39.2 mmHg·cm (23.0 mmHg·cm, 60.8 mmHg·cm)), and the difference was statistically significant ( Z=-2.833, P=0.005). When the cut-off value of EGJ-CI was 35.8 mmHg·cm, the sensitivity and specificity to distinguish RGERD from FH were 76.0% and 62.5%, respectively; area under the curve was 0.69 (95% CI 0.57 to 0.81). EGJ-CI was positively correlated with lower sphincter resting pressure, integrated relaxation pressure, distal contractile integral, distal esophageal pressure, and mean nocturnal baseline impedance ( r=0.812, 0.631, 0.451, 0.490 and 0.401, all P<0.01). EGJ-CI was negatively correlated with DeMeester score, acid exposure time, total reflux episodes, acid reflux episodes, long reflux episodes and longest reflux time ( r=-0.363, -0.372, -0.346, -0.318, -0.300 and -0.291, all P<0.01). Conclusions:EGJ-CI can help to distinguish patients with FH from RGERD.

Objective To explore the mechanisms of individual, social and environmental factors influencing physical activity and the relationships among the factors in patients with type 2 diabetes. Methods A survey was conducted from January to July 2015 among 225 patients with type 2 diabetes using convenience sampling. The questionnaire included 9- item Patient Health Questionnaire, the International Physical Activity Questionnaire,Perceived Social Support Scale, Chinese Walkable Environment Scale, Bandura′s Exercise Self- efficacy Scale. Results The effective questionnaire recovery rate was 98.7%(222/225). Exercise self- efficacy was a mediator of factors influencing physical activity. Exercise self- efficacy and physical activity were positively correlated (β=0.24, P<0.05). Walkable environment only affected physical activity indirectly medicated by exercise self- efficacy (β=-0.26, P<0.05). Perceived social support directly associated with physical activity (β=0.14, P<0.05). Depression not only affected physical activity directly (β=-0.28, P<0.05), but also associated with physical activity indirectly medicated by exercise self-efficacy (β=-0.32, P<0.05). Conclusions Interventions should be taken to increase the perceived social support, improve depression and walkable environment, especially to enhance exercise self- efficacy, so as to improve the physical activity level of patients with type 2 diabetes.

Objective To analyze the status and influencing factors of physical activity in patients with diabetes.Methods A survey was conducted in patients with diabetes from one hospital in Tianjin city using the International Physical Activity Questionnaire, Exercise Self-efficacy Scale, 9-item Patient Health Questionnaire,Perceived Social Support Scale, Chinese Walkable Environment Scale, Visual Analogue Scale.The cumulative logits model was used to explore the influencing factors of physical activity in diabetic patients.Results The average of sitting time for diabetic patients was 6.1 hours per day.41.2％ of patients with diabetes were at high level of physical activity ,42.7％ were at moderate level of physical activity, and 16.1％ were at low level of physical activity.The cumulative logits model showed that perceived social support (β=0.029, OR=1.03, P=0.039,95％ CI=0.001-0.057) ,exercise self-efficacy (β=0.014, OR=1.01, P=0.001,95％ CI=0.005-0.023),and beautiful neighborhood surroundings(β=-0.366, OR=0.69, P=0.008,95％ CI=-0.635--0.096) were protective factors of physical activity, and depression(β=-0.093, OR=0.91, P=0.020,95％ CI=-0.172--0.015) was a risk factor of physical activity.Conclusion The physical activity status of diabetic patients are not ideal.Measures should be taken to improve the exercise self-efficacy, perceived social support and environment of surroundings, to reduce the symptoms of depression, so as to promote regular physical activities in patients with diabetes mellitus.

Objective To investigate the prevalence of liver damage in B-cell lymphoma patients with positive HBV surface antigen(HBsAg)after rituximab and chemotherapy.Methods Records of 19 B-cell lymphoma patients with positive HBV surface antigen(HBsAg)after rituximab and chemotherapy from June,2001 to Aug,2007 in Beijing Cancer Hospital were reviewed to analyze the prevalence of liver damage.At the same time,the relationship between the level of HBV-DNA and the damage of liver was analysed.Results According to WHO criteria of liver toxicity,of the 19 patients,12(63.2%)suffered liver damage,4(21.1%)patients in grade Ⅰ,6(31.2%)patients in grade Ⅱ and 2(10.5%)patients in grade Ⅲ.None of the patients in this study experienced grade Ⅳ liver toxicity.Of the 6 patients with HBV-DNA＞104 copy/ml before therapy,5(83.3%)suffered liver damage.Of the 5 patients with HBV-DNA＜104 copy/ml before therapy,3(60%)suffered liver damage.Conclusion The prevalence of liver damage is higher in B-cell lymphoma patients with positive HBsAg after rituximab and chemotherapy.These patients should be closely monitored for liver function when they received rituximab therapy and should reveive anti-HBV therapy.

OBJECTIVE:To explore the improvement effect of different polar parts of Sanye Chongcha on models rat with ul-cerative colitis(UC). METHODS:The total extract was obtained from Sanye Chongcha by extraction with 80% ethanol,and dis-persed in water,from which the extracts of corresponding parts were obtained after extraction successively with trichloromethane and ethyl acetate and drying. 60 rats were randomized into normal group,model group,positive group(sulfasalazine enteric-coated tablets,312.5 mg/kg),trichloromethane extraction part group(70 mg/kg),ethyl acetate extraction part group(35 mg/kg)and wa-ter extraction part group(320 mg/kg). The rats except for normal group received 2,4,6-trinitrobenzenesulfonic acid solution(TN-BS)to establish UC model. 24 h later,the rats in the drug administration groups were given corresponding drugs ig,while those in normal group and model group were given normal saline ig,once a day,for 14 consecutive days. For the rats,the pathological change of the colon tissue was observed,and the colon mucosa damage index(CMDI)was scored;the activity of superoxide dis-mutase(SOD)and the content of malondialdehyde(MDA)in serum were determined. RESULTS:Compared to normal group,the rats in model group had obvious UC-like lesion,higher CMDI,lower activity of SOD and higher content of MDA in serum(P<0.01). Compared to model group,the rats in the drug administration groups had the lesion which became less serious or improved and had lower CMDI score,among which those of the ethyl acetate extraction part group and the positive group demonstrated a sta-tistically significant difference(P<0.01);and the rats in the drug administration groups except for trichloromethane extraction part group had higher activity of SOD and lower content of MDA in serum,among which the activity of SOD of the ethyl acetate ex-traction part group and the activity of SOD and content of MDA of the positive group demonstrated a statistically significant differ-ence(P<0.05 or P<0.01). CONCLUSIONS:The ethyl acetate extraction part of Sanye Chongcha can reduce colonic lipid peroxi-dation and thus has obvious improvement effect on the rats with UC caused by TNBS.

Objective To explore the feasibility of expansion for NK cells and the therapeutic efficacy improvement of rituximab by combinational Chemo-immunotherapy of rituximab and inter]eukin-2. To establish a clinical chemo-immunotherapy therapy regime of rituximab and interleukin-2(IL-2) for patients with diffuse large B-cell lymphoma (DLBCL). Methods The clinical data of 24 initially treated inpatients with DLBCL from Aug 2008 to Mar 2009 were analyzed by prospective non-randomized study. Patients in the treatment group (12 cases) were treated by IL-2 plus R-CHOP regime and those in the control group (12 cases)only by R-CHOP. The absolute quantity of NK cells before and after IL-2 and/or R-CHOP treatment in both groups were detected with FCM and compared, and the therapy efficacy and adverse reactions were evaluated.Results The complete remission (CR) rate was 60%(6/10) and the overall response (OR)rate was 80%(8/10)in the treatment group. The CR rate was 50%(5/10) and the OR rate was 70 %(7/10) in the control group.The proliferation of the NK cells in the treatment group was significantly effective compared with that in the control group (P=0.015). The descending range of NK cells between pre-and post-treatment in the treatment group was significantly lower than that in the control group(P =0.005). The quantity of NK cells after treatment by IL-2 was significantly increased than that before treatment by IL-2 in the treatment group (P=0.03). Among 10 patients in the treatment group, 3 cases have got diarrhea and 3 fever. Conclusion Treatment by IL-2 plus R-CHOP can increase the NK cell quantity in patients with DLBCL and may reduce lethal effect for NK cells by chemotherapy. The patients can tolerant the adverse reactions of IL-2 combined with R-CHOP therapy.

Objective:To summarize the clinical characteristics of Burkitt lymphoma(BL)and Burkitt-like lymphoma(BLL)and the effect of treatment on 13 cases,and to explore the treatment-related complications and optimal treatment.Methods:Clinical data of 13 BL and BLL patients treated between August 1996 and October 2008 in our hospital were retrospectively analyzed.All of these patients received chemotherapy as the first-line treatment.The efficacy and adverse reactions were evaluated.Results:Of the 13 patients,there were 12 males and 1 female,with a median age of 15 years(ranging from 11 to 62).There were 3 stage Ⅰ cases,2 stage Ⅱ cases,2 stage Ⅲ cases,and 6 stage Ⅳ cases.The advanced stage(stage Ⅲ and Ⅳ)patients accounted for 61.5%(8 cases).CNS was involved in 4 cases and bone marrow was involved in 2 cases at diagnosis.The commonly involved sites included superficial lymph nodes(61.5%),abdominal organs(53.8%),and celiac and retro-pentoneal lymph nodes(38.5%).B symptoms were observed in 7 patients(53.8%).Serum lactate dehydrogenase level was elevated in 8 of 10 cases,while serum udc acid level was elevated in 1 of 10 cases.Eleven patients were diagnosed as BL and 2 patients were diagnosed as BLL.Of the 13 patients,11(84.6%) achieved complete remission(CR)or CR/unconfirmed(CRu),and 1 patient(7.7%) got partial remission(PR).Dudng the follow-up of 8 months(ranging from 5 to 35),6 patients were still alive.The 1-year overall survival,progression-free survival and disease-free survival were 56.98%,32.31% and 39.77%,respectively.Nine patients(69.2%)developed grade Ⅲ or Ⅳ myelosuppression.Conclusion:Intensive short-course chemotherapy is the optimal first-line treatment for BL and BLL.

Objective:To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL). Methods:Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively an-alyzed. Results:The median age was 61 years old, and the male-to-female ratio was 2.9∶1. Among these cases, 85 (86.8%) were in Ann Arbor stageⅢ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR,>60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors. Conclusion: Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL.