Objective:To analyze the relationship between free androgen index and insulin function in obese young men aged from 20 to 35.Methods:A total of 82 young obese men in Obesity Clinic from February to October 2019 were enrolled in the study. The subjects were divided into 3 subgroups according to free androgen index level tertiles. The blood glucose and insulin levels were tested after oral glucose tolerance test. Homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for β cell function (HOMA-β), insulin secretion index, and insulin sensitivity index (Matsuda index) were used to evaluate β cell function in oder to analyze the relationship between free androgen index and insulin function.Results:In young obese men, participants with higher free androgen index levels exhibited less waist circumference, lower body mass index, 1 h postprandial insulin, 2 h postprandial insulin, HOMA-IR level but with a higher total testosterone, sex hormone binding globulin, and Matsuda index level (all P<0.05). There was a negative correlation between the free androgen index and the HOMA-IR ( r=-0.386, P=0.016), and the correlation tended to a linear trend after adjustment for age, sex, body mass index, and waist circumference ( Ptrend=0.034). Free testosterone was positively correlated with Matsuda index ( r=0.280, P=0.004), but the correlation disappeared after adjustment ( Ptrend=0.623). The results of further regression analysis showed that the level of free testosterone index decreased by 14.1% ( OR=0.869, 95% CI0.767-0.984, P=0.028) for each increase of HOMA-IR after adjustment. Conclusion:The level of free testosterone index is a predictor of insulin resistance in obese young men, but the association between this parameter and insulin sensitivity may be caused by obesity.

Objective: To analyze the incidence and mutation characteristics of FLT3 gene mutation and clinical efficacy of tyrosine kinase inhibitor (TKI) in patients with mixed phenotype acute leukemia (MPAL). Methods: A total of 48 patients with MPAL who were admitted to Hebei Yanda Lu Daopei Hospital from June 2015 to February 2018 were retrospectively analyzed. The common mutated 58 genes in hematologic malignancies were detected by using amplicon-targeted next generation sequencing, of which internal tandem duplication (ITD) and point mutation occurred in the hotspot region of exon 14, 15 and 20 in FLT3 gene. Multiplex polymerase chain reaction (PCR) analysis was used to detect 35 gene fusions in hematological neoplams. Results: There were 7 cases of FLT3 mutation in 48 MPAL patients, which were all ITD mutations. The median length of the inserts of FLT3-ITD was 48 bp, and one MPAL patient carried 2 multiple length inserts simultaneously, and the median variant allele frequency (VAF) was 40.5% (7.9%-84.7%). There were no statistically significant differences in clinical and genetic characteristics between FLT3 mutation-positive and FLT3 mutation-negative MPAL patients (both P > 0.05). Among 7 FLT3 mutation-positive MPAL patients, 4 cases were often accompanied with RUNX1 mutation. A total of 4 MPAL patients with FLT3-ITD-positive received sorafenib or sunitinib combined chemotherapy, and 3 of them achieved complete remission. Conclusions ITD mutation is the main part in the FLT3 mutation of MPAL patients. FLT3-ITD-positive MPAL patients are often accompanied with RUNX1 mutation, which may benefit from targeted therapy with FLT3 kinase inhibitor.

Objective:To observe the effect of nocturnal nutritional support on the improvement of nutritional status and liver function in patients with hepatitis B cirrhosis.Methods:A total of 60 patients with hepatitis B cirrhosis who were treated at the Affiliated Hospital of Guizhou Medical University from April 2011 to August 2018 were selected, and they were divided into nutritional intervention group and control group according to the random digital table method, with 30 cases in each group.The two groups were given basic medical treatment, and the nutritional intervention group was given basic treatment plus 30g of complex functional nutrients, once per night, for 12 weeks.The changes of liver function and nutritional status of the two groups were observed every 4 weeks, and the occurrence of complications was recorded.Results:Before intervention, the ALB, PA, TBIL, body mass index, triceps cutaneous fold thickness and grip strength had no statistically significant differences between the two groups(all P>0.05). After 12 weeks of intervention, the albumin [(32.61±1.78) g/L], pre-albumin [(116.65±11.92) g/L], total bilirubin [(36.6±5.86)μmol/L], body mass index [(22.23±2.92) kg/m 2], skinfold [(17.34±1.31) mm], the grip strength [(23.36±2.44)kg] in the intervention group were superior to the control group[(30.38±1.58)g/L, (101.22±7.76)g/L, (47.75±4.83)μmol/L, (21.07±2.11)kg/m 2, (16.07±1.40)mm, (20.01±2.70)kg], the differences were statistically significant between the two groups( t=4.946, 5.105, 5.881, 2.407, 2.272, 3.805, all P<0.05). The incidence of the complications in the intervention group was 10%(3/30), which in the control group was 33%(10/30), the difference was statistically significant between the two groups(χ 2=4.381, P=0.033). Conclusion:Providing nutritional support at night can improve the nutritional status of patients with hepatitis B cirrhosis, promote the repair of liver function, and reduce the incidence of complications.

Objective Analyze the application status and existed problems of clinical biobank in China,propose possible application mechanisms for clinical biobank.Methods Through questionnaire survey and case analysis combined with relevant literature reports from home and abroad,conduct qualitative analysis to understand the application status and problems of clinical biobank.Results With the rapid development of biobank,its application rate was far from expected.The construction of clinical database lags behind in China will affect the application of samples.The lag of application mechanism will affect the opening and application of the biobank.Conclusions At the beginning of construction,the clinical biobank should take full account of what and how resources can be used,and establish tailored application mechanism.More attention should be paid to the possible benefit of biobank construction.

Pharmaceutical cocrystals are a promising technology that can be used to improve the solubility of poor aqueous compounds. The objective of this study was to systematically investigate the solubility of myricetin (MYR) cocrystals, including their kinetic solubility, thermodynamic solubility, and intrinsic dissolution rate (IDR). The effects of pH, surfactant, ion concentration, and coformers on the cocrystal solubility were evaluated. Furthermore, single crystal structures of MYR, myricetin-isonicotinamide (MYR-INM) and myricetin-caffeine (MYR-CAF) cocrystals were analyzed to discuss the possible reasons for the enhancement of cocrystal solubility from the perspective of the spatial structure. The results indicated that the kinetic solubility of MYR cocrystals was modulated by pH and cocrystal coformer (CCF) ionization in buffer solution, while it primarily depended on the CCF solubility in pure water. In addition, the solubility of MYR cocrystals was increased in a concentration dependent fashion by the surfactant or ion concentration. The thermodynamic solubility of MYR-INM (1:3) cocrystals decreased with the increases of the pH value of the dissolution media. The IDR of MYR cocrystals was faster than that of MYR in the same medium and extremely fast in pH 4.5 buffer. The improved solubility of MYR cocrystals was probably related to the alternate arrangements of MYR and INM/CAF molecules and increased intermolecular distance. The present study provides some references to investigate the solubility behavior of pharmaceutical cocrystals.

Objective To explore the effectiveness and safety of branch protection technique with provisional stenting strategy in coronary bifurcation lesions by utilizing jailed balloon protection technique after pre-dilation in branch with cutting balloon. Methods 32 patients undergone jailed balloon protection technique after pre-dilation in branch with cutting balloon during January, 2015 to May, 2016 in Peking University of People's Hospital were enrolled consecutively in our study. 32 patients were involved including a total of 32 bifurcation lesions which were medina type 1,1,1 (n = 25, 78. 1% ), Medine type 0,1,1 (n =5,15. 6% ) and Medine type 1,0,1 (n = 2, 6. 3% ). For side branch diameter ≥2. 5 mm, the diameter ratio of cutting balloon to side branch was 1: 1. The angiography success rate after using branch protection during main branch stent implantation, perioperative complications and major adverse cardiac events were observed. Results ( 1 ) The angiography success rate of branch protection was 100% . ( 2 ) No perioperative complications and major adverse cardiac events were observed. Conclusions Side branches were effectively protected in provisional stenting strategy by applying jailed balloon protection technique after pre-dilation using branch cutting balloon.

Objective To investigate the effect of humidex combined with mean temperature and relative humidity on the incidence of bacillary dysentery in Hefei. Methods Daily counts of bacillary dysentery cases and weather data in Hefei were collected from January 1, 2006 to December 31, 2013. Then, the humidex was calculated from temperature and relative humidity. A Poisson generalized linear regression combined with distributed lag non-linear model was applied to analyze the relationship between humidex and the incidence of bacillary dysentery, after adjusting for long-term and seasonal trends, day of week and other weather confounders. Stratified analyses by gender, age and address were also conducted. Results The risk of bacillary dysentery increased with the rise of humidex. The adverse effect of high humidex (90 percentile of humidex) appeared in 2- days lag and it was the largest at 4-days lag (RR=1.063, 95%CI:1.037-1.090). Subgroup analyses indicated that all groups were affected by high humidex at lag 2-5 days. Conclusion High humidex could significantly increase the risk of bacillary dysentery, and the lagged effects were observed.

This study aims to investigate the current situation of the enrollment , training model and career planning of medical students in the targeted admission program .After analyzing the implementation process of this targeted admission policy in medical education , we raised some feasible strategies to increase the attraction and reten-tion of health professionals in rural China .The study covered 4 medical universities in central and western China .A cohort of 308 medical graduates from this targeted admission program were recruited in June 2015 .A baseline survey , including questionnaire survey , in-depth interviews and the focus group discussions , were conducted right before their graduation .The first follow-up online survey was done 6 months after their graduation .he findings of this investiga-tion show that 72.9%of the investigated students in the program used to live in rural areas before 15 years old.The average annual household income was 28,200 Yuan.The top three reasons of choosing this program were guaranteed job after graduation , low performance in the college entrance examination , and wavier of tuition fee .There were sig-nificant differences of implementation of this policy between different provinces , especially the contract-signing and job deployment .Income and working environment were the main influencing factors of the medical graduates 'job-see-king intention .Based on the findings of this study , it can be concluded that the targeted admission program is rather successful in attracting medical graduates for rural health services .However , extra efforts are needed to improve the implementation of the policy and to retain the medical graduates in rural area .

Objective To investigate the safety and short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified coronary long lesions. Methods From Jan 1, 2011 to May 31, 2016, 109 cases with 114 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stenting in Peking University People's Hospital were included. They were divided into diffuse lesion group ( lesion ≥25 mm, 68 cases, 72 lesions ) and focal lesion group (lesion ﹤25 mm,41 cases, 42 lesions). All patients were followed up in hospital. Procedure parameters, procedural complications ( dissection, perforation, slow flow/no flow and procedural related myocardial infarction),procedural success and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and stent thrombosis) were analyzed. Results The procedural success rate was 98. 5%(67/68) in diffuse lesion group and 100% ( 41/41 ) in focal lesion group ( P=0. 453 ) . Complication rates did not differ between the two groups (41. 2% and 34. 1%, P=0. 673). Major adverse cardiovascular events rates were 41. 2% and 31. 7%, P =0. 484. Conclusions Treating coronary lesions ≥25 mm in length with rotational atherectomy followed by drug-eluting stenting does not impact the short-term outcome when treating carefully and correctly . Procedural success rate and in-hospital outcome is satisfactory.

Objective: Based on scores by number of vessels diseased and age (NVDA), the minimum lumen area (MLA) of left anterior descending (LAD) proximal or middle intermediate lesions were examined by intravascular ultrasound (IVUS) to analyze the clinical characteristics, to ifnd the factors affecting lumen area and to establish a scoring system for predicting MLA in relevant patients.
Methods: A total of 90 patients were enrolled including 58 male and 32 female with the age of (41-77) years. The demographic information, medical history and laboratory results were studied by simple linear regression analysis to screen relevant factors affecting MLA; multi regression analysis was conducted to establish a regression equation for predicting MLA and to calculate the risk factor coefifcient for obtaining relevant scoring system.
Results: NVDA score≤4 was deifned as negative result with speculated MLA≥3.0mm2, while NVDA score>4 was deifned as positive result with speculated MLA<3.0mm2. The sensitivity, speciifcity and negative predictive value of NVDA scoring system for predicting MLA were 83.35%, 75% and 90% respectively.
Conclusion: NVDA scoring system had the better accuracy, sensitivity and speciifcity for predicting MLA in coronary artery intermediate lesions, it had certain value for guiding coronary interventional therapy in relevant patients.