The parathyroid hormone related peptide (PTHrP) participates in regulating calcium and phosphorus metabolism and multiple organ growth,and plays an important role in the processes of malignant tumor bone metastasis and hypercalcemia.Currently,more and more researches have confirmed that PTHrP can be secreted by a variety of types of tumor cells.PTHrP participates in regulating tumor cell proliferation and invasion,and it is closely related to the prognosis of patients,which provides a new target of cancer treatment.

Due to the dysontogenesis of the arterial duct wall and the abnormal secretion of prostaglandin,symptomatic patent ductus arteriosus is thus often presented in preterm infants.In the past,Indomethacin or Ibuprofen (cyclooxygenase inhibitor) was always chosen to be the interventional medication.While in recent years,Acetaminophen (prostaglandin synthetase inhibitor) has become another therapeutic option for symptomatic patent ductus arteriosus with similar efficacy but less adverse events.The latest research of the mechanism,the therapeutic strategy of time,mode,dosage and duration,the efficacy and the adverse events of Acetaminophen were reviewed.

Umbilical venous catheterization (UVC) is associated with many complications, such as displacement of the catheter, infection, exudation, thrombosis, pericardial effusion/pleural effusion, of which central line-associated bloodstream infections has been of long-standing interest. There is currently no optimal method for estimating the depth of UVC insertion. Ultrasound examination can be used to evaluate the position of the end of the tube after catheterization to avoid organ damage and complications caused by displacement and dislocation. However, whilst it is known that there is a correlation between the duration of UVC and central line-associated bloodstream infection, a consensus is yet to be reached regarding the optimal duration of UVC retention. More, high quality evidence through multi-center, prospective randomized controlled study is needed.

Objective To study the effects of endolymphatic sac decompression and on semicircular canal plugging in treating intractable Meniere's disease.Methods A total of 14 cases of intractable Meniere's disease were included in this study.The age was from 33~67 years old and the history was from 1 to 40 years.The hearing level of bone was from 35 to 65 dB for the speech frequencies.All cases received the treatments according to the pre-op-erative design.The endolymphatic sac was decompressed and the three semicircular canal bones were drilled to cre-ate a fenestra followed by soft tissue plugging into the canal.The vertigo,hearing level and tinnitus were included in the following up.Results All cases had no facial palsy,no cerebrospinal leak,and no vertical after surgery.In the period of 3 to 18 months following up,the attack of Meniere's disease was completely controlled for 13 cases excep-tion of one lost case.For five cases,the hearing level descended 10 to 15 dB compared to pre-operation.Conclusion Although the endolymphatic sac decompression can relieve endolymphatic pressure,this may not adequately pro-tect the hearing caused by the semicircular canal plugging.The surgical technique is reliable and safe;however fur-ther clinical data should be gathered.

An α-amylase inhibitor (α-AI) was isolated from white kidney beans (Phaseolus vulgaris. L) by ethanol fractional precipitation, ion exchange chromatography and gel filtration column chromatography. It was a homogeneity glycoprotein demonstrated by SDS-PAGE and gel filtration on CL-6B. The glycoprotein contained 88.2% protein and was rich in aspartic acid, glutamic acid, leucine, threonine and serine. The carbohydrate moiety was consisted of Man, Glc, Gal and Xyl in a mole ratio of 2.42∶1.50∶1.52∶1.00. The glycan and the core protein backbone was connected by O-linkage as determined by β-elimination reaction. The continuous oral administration of the α-AI (150 mg·kg-1·d-1 ) for 7 days can lower fasting blood glucose and 300 mg·kg-1 ·d-1 α-AI for 7 days can improve the sugar tolerance on alloxan-dependent diabetic model rats. The result showed the α-AI obtained from white kidney beans had good hypoglycemic effect on alloxan induced diabetic rats and may have high potential pharmaceutical value as a regulative digestive-starch degradation in patients suffering from diabetes.

Objective To investigate Treg and Th17 cell numbers in the peripheral blood of patients with unexplained recurrent spontaneous abortion (URSA),with an aim to elevate their potential for predicting pregnancy outcomes.Methods Peripheral blood was collected from 60 URSA pregnant women and 56 healthy pregnant women during their first trimester in the Department of Reproductive Endocrinology of the Second Affiliated Hospital of Soochow University from January 2014 to June 2015.The counts of regulatory T cell (Treg),T helper cell 17 (Th17),CD4 positive T cell (CD4+ T cell) and total lymphocytes in the peripheral blood were determined by flow cytometry.Calculated the ratios of Treg/CD4+ T cells,Treg/total lymphocytes,Th17/CD4+ T cells,Th17/total lymphocytes and Treg/Th17,then the pregnancy outcomes were followed up.According to the different pregnancy outcomes,the patients were divided into three groups: URSA successful delivery group (23 cases),URSA re-miscarriage group (37 cases) and normal successful delivery group (44 cases).Non-parametric test were used to compare the differences between groups.Results There were no difference between the URSA re-miscarriage group and URSA successful delivery group in the CD4+ T cell counts[(1 570.16±519.56) vs (1 571.83±450.37),t=0.01,P=0.99]and total lymphocytes[(4 497.11±975.48) vs (4 558.52±1 032.54),t=0.23,P=0.82].However,the ratios of Treg/CD4+ T cells[(1.09±0.62) vs (3.32±2.30),t=4.55,P=0.000 1],Treg/total lymphocytes[(0.42±0.24) vs (1.31±1.14),t=3.67,P=0.001 3]and Treg/Th17[(0.56±0.41) vs (2.51±2.38),t=3.89,P=0.000 8]in the URSA miscarriage again group were significantly lower whereas the ratios of Th17/CD4+ T cells[(1.85±0.92) vs (0.93±0.36),t=5.40,P<0.001]and Th17/total lymphocytes[(0.64±0.31) vs (0.31±0.14),t=5.52,P<0.001]were significantly higher.Similarly,There were no difference between the URSA re-miscarriage group and normal successful delivery group in the CD4+ T cell counts[(1 570.16±519.56) vs (1 566.86±651.36),t=0.03,P=0.98]and total lymphocytes[(4 497.11±975.48) vs (4 720.91±1 572.92),t=0.78,P=0.44].However,the ratios of Treg/CD4+ T cells[(1.09±0.62) vs (3.17±1.81),t=7.16,P<0.001],Treg/total lymphocytes[(0.42±0.24) vs (1.03±0.51),t=7.08,P<0.001]and Treg/Th17[(0.56±0.41) vs (1.87±1.68),t=4.98,P<0.001]in the URSA re-miscarriage group were significantly lower whereas the ratios of Th17/CD4+ T cells[(1.85±0.92) vs (1.12±0.50),t=4.29,P<0.001]and Th17/total lymphocytes[(0.64±0.31) vs (0.36±0.15),t=5.01,P<0.001]were significantly higher.Conclusions Treg and Th17 cell counts in the peripheral blood of patients with URSA might be useful in predicting their pregnancy outcomes.The decrease of Treg cell counts and the increase of Th17 cell counts might imply another abortion.

Objective To evaluate the efficacy of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in the treatment of idiopathic pulmonary fibrosis through the method of system evaluation. Methods A computer-based online search of Pubmed, Embase, Cochrane Library, CNKI, CBM and Wanfang were used for database retrieval. Revman 5.0 was used to assess the bias of the included studies. The Stata 14.0 was used to evaluate the extraction indexes of efficacy, p (O2), p (CO2), DLco, FEV1 and VC. GRADE score was used to evaluate the level of evidence. Results A total of 17 articles (related with 1381 patients) were included in this study, including 14 studies using ARB and 3 studies using ACEI. Compared with the control group ACEI and ARB drugs showed advantages in the treatment of pulmonary fibrosis (RR=1.34, 95%CI:1.24-1.44, Z=7.81, P<0.001). Auxiliary index analysis showed that the test groups were treated with enalapril (SMD=0.72, 95%CI:0.21-1.22, Z=2.77, P=0.006), telmisartan (SMD=3.86, 95%CI:2.44-5.27, Z=5.35, P<0.001), valsartan (SMD=1.94, 95%CI:1.33-2.55, Z=6.27, P<0.001) and captopril (SMD=0.60, 95%CI:0.11-1.09, Z=2.41, P=0.016), the p(O2) levels were significantly improved in patients ≥65 years old (SMD=0.76, 95%CI:0.52-1.00, Z=6.18, P<0.001) and patients < 65 years old (SMD=3.97, 95%CI:2.61-5.32, Z=5.73, P<0.001), and disease duration≥5 years (SMD=1.39, 95%CI:0.45-2.33, Z=2.89, P=0.004) and disease duration<5 years (SMD=3.26, 95%CI:2.06-4.46, Z=5.34, P<0.001) compared with those of control group (SMD=2.95, 95%CI:1.95-3.94, Z=5.82, P<0.001). The curative effect of telmisartan was better than that of other drug groups (P < 0.001), and which was much better for patients under 65 years old (P<0.001). There was no significant difference in the disease duration between two groups (P=0.307). The p (CO2) levels were significantly improved in patients treated with telmisartan [SMD=-12.94,95%CI:(-14.01)-(-11.86),Z=23.51,P<0.001), valsartan [SMD=-1.95,95%CI:(-2.56)-(-1.34),Z=6.29,P<0.001] compared with those of control group [SMD=-11.13,95%CI:(-17.03)-(-5.24),Z=3.70,P<0.001]. The effect of telmisartan was better than that of valsartan (P<0.001). In addition, values of DLco (SMD=0.64, 95%CI:0.45-0.83, Z=6.72, P<0.001), FEV1 (SMD=1.19, 95%CI:0.52-1.86, Z=3.47, P<0.001) and VC (SMD=0.51, 95%CI:0.16-0.85, Z=2.85, P=0.004) were improved in test group compare with those of control group. And the GRADE scores of relevant indexes were low quality to moderate quality. Conclusion ACEI and ARB can improve the efficacy, the p (O2) and p (CO2) in the treatment of pulmonary fibrosis. Patients with age<65 years old and treated with telmisartan have the best curative effect, and which is not related to the disease duration.

Objective To evaluate the effectiveness and safety of continuous intravenous pumping of heparin and nitroglycerin before coronary artery bypass grafting (CABG). Methods The clinical data of 62 patients received continuously intravenous pumping of heparin and nitroglycerin before CABG admitted from Jan. 2007 to Jul. 2009 were analyzed retrospectively. Among them 23 cases underwent off-pump CABG (OPCAB) and 39 cases underwent on-pump CABG (CCABG). Another 80 cases (40 underwent OPCAB and 40 underwent CCABG) who received operation during the same period but not treated with heparin and nitroglycerin before surgery were enrolled as controls. The effectiveness of heparin and nitroglycerin in relieving unstable angina was investigated,and the influence on transfusion volume,platelet count and coagulation function was compared between OPCAB and CCABG. Results The continuously intravenous pumping of heparin and nitroglycerin before surgery efficiently relieved unstable angina and reduced the incidence of cardiovascular events. No significant differences were observed between OPCAB and CCABG (either before or after operation) in activated clotting time before and after heparinization,the dosage of heparin for heparinization,transfusion volume,24h drainage volume,platelet count and coagulation function. Conclusion The continuous usage of heparin and nitroglycerin before CABG is effective and safe for patients with serious coronary stenosis or acute coronary artery syndrome,and has no obvious adverse effect on operation.

Objective:To investigate the prevalence and influencing factors of amnestic mild cognitive impairment of rural elderly in Guizhou province, which aims to provide scientific basis for the prevention and control of cognitive impairment in the elderly.Methods:Adopting a multi-stage cluster sampling method, a total of 1 535 rural Han and Bouyei elderly people aged 60 and above were selected from Guiyang city and Qiannan prefecture in Guizhou province as the survey subjects for the current situation survey, including demographic sociological characteristics, such as social was utilized behavior, social behavior disease history, height and weight and so on.Mini-mental state examination was utilized to measure cognitive function and SPSS 26.0 statistical software was used to perform χ 2 inspection and multivariate unconditional Logistics regression analysis to calculate odds ratio ( OR) and 95% confidence interval (95% CI). Results:A total of 242 elderly patients with aMCI were detected (15.8%). The results of univariate analysis showed that ethnicity(χ 2=4.333, P<0.05), gender(χ 2=18.367, P<0.01), marital status(χ 2=9.721, P<0.01), occupation(χ 2=7.786, P<0.01), annual family income(χ 2=28.085, P<0.01), current smoking(χ 2=11.873, P<0.01), specific hobbies(χ 2=25.968, P<0.01), physical exercise(χ 2=11.871, P<0.01), living style(χ 2=13.190, P<0.01), and activity participation(χ 2=13.004, P<0.01) all had an impact on aMCI. Multivariate Logistic regression analysis showed that Bouyei nationality( P<0.05, β=0.288, OR=1.333, 95% CI=1.002-1.775) and the women( P<0.05, β=0.516, OR=1.676, 95% CI=1.233-2.278)were risk factors for aMCI, and high annual family income( P<0.05, β=-0.839, OR=0.432, 95% CI=0.308-0.606), specific hobbies( P<0.05, β=-0.580, OR=0.560, 95% CI= 0.394-0.795), physical exercise( P<0.05, β=-0.410, OR=0.664, 95% CI=0.493-0.894), participation in activities( P<0.05, β=-0.424, OR=0.654, 95% CI=0.488-0.877), and non-living alone( P<0.05, β=-0.563, OR=0.569, 95% CI= 0.374-0.866) were the protective factors.Comparison of the prevalence of the disease between the Han and Bouyei nationalities, the detection rate of aMCI for the Bouyei elderly (18.0%) was higher than that of the Han (14.1%) (χ 2=4.333, P<0.05). After stratification according to gender, family annual income, specific hobbies, physical exercise, participation in activities and living style, the detection rate of elderly female subjects of Bouyei nationality was higher than that of Han nationality, whose difference was statistically significant (χ 2=5.562, P<0.05). The detection rate of Bouyei elderly was higher than that of Han when the annual household income was less than 30 000, and the difference was statistically significant (χ 2=8.570, P<0.01). Conclusion:The incidence of aMCI among the elderly of Bouyei nationality is higher, and the incidence of aMCI among females is higher than that of males, which should be paid more attention to.It is of vital importance to strengthen health education and publicity, guide the formation of knowledge-belief-behavior health-related behavior patterns, so as to improve the quality of life and reduce the risk of cognitive impairment.

Objective To study the change and the correlation of serum soluble vascular cell adhesion molecuh-1(sVCAM-1)level with diabetic retinopathy in type 2 diabetic patients.Methods 60 type 2 diabetic patients were selected for the study through the examination of ophthalmoscope and/or fundus fluorescence angiography by ophthalmologist.Diabetic patients were divided into three main groups:No signs of diabetic retinopathy(NDR)(n=20);Background DR(BDR)(n=20)Proliferative DR(PDR)(n=20).Healthy individuals matching sex and age of the patients were used as controls(n=20);Serum sVCAM-1 level was measured by ELISA,compared in diabetes without DR,with BDR,with PDR.These levels were compared with those of 20 controls.Results The serum level of sVCAM-1 in the DM patients with PDR or BDR and those without DR were significantly higher than those in healthy controls(all P＜0.001);Serum level of sVCAM-1 in PDR groups were higherthan those in DM patients with BDR or patients without DR(all P＜0.001);There was no difference between the patients with BDR and those without DR (P＞0.05).(4)In the DM patients,there was a positive correlation between serum sVCAM-1 and the course of diseases(r=0.338,P＜0.05),but no relationship with HbA1C,FBG,CHO,TG,LDL and INS.Conclusion Increased serum level of sVCAM-1 in different stage of DR patients suggested that they hagbe play an important role in the development of DR,and may assess the severity of diabetic retinopathy.The measuremem of serum sVCAM-1 levels in type 2 diabetic patients could be clinically useful for early diagnosis or treatment of diabetic retinopathy.