Objective To analyze the levels of serum lipoprotein (a)[Lp(a)]and homocysteine (CHY)in type 2 diabetes mellitus (T2DM)patients and todetermine the relationship between them and diabetic insulin resistance.Methods A total of 108 patients with T2DM and 50 healthy volunteers (control group)were studied.T2DM group according to the presence of kidney disease complications could be divided into simple diabetes group (SDM)in 48 patients with diabetic nephropathy (DN)group of 60 cases.Collected patients general data and determined two groups of glycosylated hemoglobin (HbA1c), low density lipoprotein (LDL),urea nitrogen (BUN),serum creatinine (SCr),urinary inhibition C (CysC),Lp(a)and HCY levels;Compared differences between groups and how they related to T2DM kidney disease,and the relationship between in-sulin resistance.Results ①Compared between three groups only the weight (NC group 60.1±10.34 kg,SDM group 67.2 ±11.38 kg,DN group 68.8±1.35 kg),the difference was statistically significant (F=0.457,P=0.035).②compared be-tween the three groups,the levels of HbA1c (F=3.421,P=0.013),LDL-C (F=2.963,P=0.041),BUN (F=4.637,P=0.031),SCr (F=2.369,P=0.024),CysC (F=3.697,P=0.011),Lp(a)(F=1.236,P=0.021),HCY (F=4.317,P=0.027)were increased significantly.③FPG,FINS and HOMA-IR in SDM group were 5.99±0.94 mmol/L,61.11±28.46 pmol/L and 2.93±1.97 respectively,FPG,FINS and HOMA-IR in DN group were 9.01±2.23 mmol/L,98.56±62.14 pmol/L and 4.34±2.74 respectively.Compared between the two groups,FPG (t=0.47,P=0.017),FINS (t=0.55,P=0.039),HOMA-IR (t=0.69,P=0.024)differences were statistical significance.④The Lp(a),HCY were significantly pos-itive correlation with HOMA-IR (r=0.761,P=0.044;r=0.840,P=0.021).Conclusion Lp(a)and HCY levels in serum associated with diabetic nephropathy,and insulin resistance.And the detection of serum Lp(a)and HCY has important sig-nificance for early detection of diabetic nephropathy.

Objective Understanding of red blood cell distribution width (RDW-CV),blood homocysteine (HCY),lipoprotein a [LP(a)] a merger with high blood pressure and high blood,coronary heart disease (CHD) relevance and explore its clinical application value in CHD.Methods 563 cases of patients with high blood pressure were enrolled,which divided into 62 cases of primary hypertension,501 cases of hypertension combined with coronary heart disease,according to the results of coronary angiography.141 normal cases were chosen as control group.Compared the three groups of RDW-CV,HCY and LP (a) level,the group of coronary artery disease was divided into Ⅰ,Ⅱ,Ⅲ and Ⅳ,and compared the RDW-CV level of each group,and the correlation between RDW and cardiac function was analyzed.Results ①Heart disease groups RDW-CV,LP (a) and HCY (13.25 ± 1.22％,17.82 ± 8.36 μmol/L,172.05 ± 122.32 mg/L) were higher than blood pressure groups (12.98 ± 0.57 ％,14.35 ± 6.36 μ mol/L,124.49 ± 75.88 mg/L) and normal control group (11.41 ± 2.85 ％,11.41 ± 2.85 μmol/L,71.07±27.55 mg/L,P＜0.05).②RDW-CV and HCY were positively correlated with the mental function classification (r=0.461,0.1970;P=0.000,0.032).③The area under the ROC curve was the order of the diagnostic value:HCY ＞LP(a) ＞RDW-CV.LP(a) sensitivity was 82.5 ％ and specificity was 31.7 ％.RDW-CV sensitivity was 48.8 ％ and specificity was 22.2 ％.Conclusion High levels of RDW-CV,HCY,and LP(a) were closely related to the occurrence of coronary heart disease;RDW-CV and HCY were related to the severity of coronary heart disease and cardiac function,and could be a potential biomarker for the development of cardiac function of coronary heart disease.

60%) MR early-phase enhancement rate and time-SI curve type Ⅱ and Ⅲ showed an association with increased MVD and higher VEGF expression level. All the differences mentioned above showed statistical significance except that the difference between VEGF expression and the distribution of curve types had no statistical significance. No significant relationships were observed between the mean of enhancement amplitude and MVD or VEGF expression. Regarding the distribution of MVD, the study showed that the greater MVD was most frequently observed at the marginal region of breast cancer, although the distribution of MVD was heterogeneous in each lesion. Conclusion MVD and VEGF affect the contrast medium enhancement of breast lesions. The early-phase enhancement rate and time-SI curve types of benign and malignant breast lesions are closely related to MVD and VEGF. As a noninvasive method, contrast enhanced MRI has a potential role in estimating the degree of angiogenesis of breast neoplasm.

Multiple myeloma is common in the older population and is treated mainly with chemotherapy. However, chemotherapy-related side effects imitate the clinical manifestations of Sheehan's syndrome, which leads to misdiagnosis and missed diagnosis, particularly for older patients without a clear history of postpartum hemorrhage. Therefore, when older women with malignant myelomas show refractory hyponatremia and gastrointestinal disorders while under chemotherapy, a diagnosis of Sheehan's syndrome should be considered. The early detection of the disorder will guarantee timely individualized treatment.

Objective To investigate two-dimensional color Doppler commissure real-time shear wave elastrography (SWE) examination and its application value in the diagnosis of breast diseases.Methods One hundred and thirty patients (158 breast lesions) confirmed with breast disease were chosen from September 2013 to September 2014,and all patients underwent two-dimensional color Doppler ultrasound and SWE examination.The receiver operating characteristic (ROC) curve was examined to obtain maximum elasticity modulus value,average elastic modulus value and the corresponding critical value for the diagnosis of benign and malignant breast lesions.According to the results of pathological examination,sensitivity,specificity and accuracy of two-dimensional ultrasound and SWE for the diagnosis of breast lesions were evaluated and compared.Results Of all 158 breast lesions in 130 patients,90 were malignant lesions and 68 were benign lesions.The sensitivities of two-dimensional ultrasound and SWE in diagnosis of breast cancer were 89.7％ and 89.5％,the specificities were 85.6％ and 95.3％ and the accuracy were 87.3％ and 91.4％,respectively.The sensitivity,specificity and accuracy in the diagnosis of breast cancer by combination of two-dimensional ultrasound and SWE were 98.5％,93.3％,95.6％,respectively.Conclusions Although two-dimensional color Doppler ultrasound is a commonly used method in the diagnosis of breast lesions,it has certain limitation.The specificity of diagnosis can be improved by SWE,which is a useful complement to traditional two-dimensional ultrasound technology.Combination of the two methods can significantly increase the sensitivity and accuracy of the diagnosis and provide a reliable basis for the differential diagnosis,reduce the rate of misdiagnosis,missed diagnosis and unnecessary biopsy,which has important clinical application value.

Objective To investigate the relative percentage of normal cognitive function (NCF),age associated memory impairment (AAMI),mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly,and the correlation between cognitive function and ApoE genotypes.Methods A total of 2666 elderly people aged ≥65 years (2132 males and 534 females)were divided into 3 groups according age:65-74-year age group (925 cases),75-84 year age group (1054 cases) and 85-100-year age group (687 cases).ApoE genotypes were determined in the controls and patients with AAMI and MCI.The degrees of fundus arteriosclerosis were detected in all subjects except for patients with AD.Results There were 867 cases with NCF,860 cases with AAMI and 782 cases with MCI.The incidence of AAMI was higher in 65-74-year age group than in the other two groups (42.0％ vs.31.1,20.96).The incidences of MCI and AD were higher in 85-100-year age group than in the other groups (42.5％,13.3％).The major degrees of fundus arteriosclerosis were Ⅰ+,Ⅰ-Ⅱ°,Ⅱ in subjects with AAMI (34.7％,x2=10.02,P＜0.01) and were Ⅱ °/ Ⅱ + / Ⅲ° in subjects with MCI (34.9 ％,x2 =23.39,P＜0.001).The APOEε4 allele frequency was significantly higher in patients with MCI than in the controls (x2=8.31,P＜0.05).However,no significant differences in APOEε4 allele frequency were found between patients with AAMI and the controls.Conclusions The incidence of AAMI is highest in 65-74-year age group,while the incidences of MCI and AD are highest in 85-100-year age group.Compared to patients with AAMI,the more serious fundus arteriosclerosis and higher allele frequency of APOEε4 appear in patients with MCI.

Objective To investigate the genotype distribution of microsatellite locus CAI among Candida albicans ( C.albicans ) strains and to evaluate its relationship with the epidemic of vulvovaginal candidiasis ( VVC) in Guizhou region .Methods Ninety independent C.albicans strains isolated from pa-tients with VVC in Guizhou were investigated based on single-strand conformation polymorphisms ( SSCP ) and GeneScan analysis .The genotypes of C.albicans strains were identified by microsatellite locus CAI pol-ymorphism analysis .The gene polymorphism and the cluster of C.albicans strains were analyzed by using software SPSS 19.0.A logistic regression model was used to analyze the relationship between genotype distri -bution of CAI microsatellite among C.albicans strains and VVC infection .Results Twenty-seven distinct CAI genotypes with various patterns were identified from 90 C.albicans strains by GeneScan analysis .Clus-ter analysis showed that the C.albicans strains were classified into three clusters ( ClusterⅠto Cluster Ⅲ) . Three predominant genotypes including 30-45, 32-46 and 30-46 and other 7 highly similar genotypes be-longed to clusterⅡthat accounted for 70.0%(63 strains) in all strains.The odds ratio for the predominant genotypes associated with VVC infection was 4.3.Conclusion The predominant distribution of genotypes was observed among the isolated C.albicans strains.The predominant genotypes of C.albicans were highly associated with the occurrence of VVC .

Objective: To assess the relationship between mammographic features and molecular subtypes in invasive breast cancer pa-tients. Methods: We performed a retrospective review of mammographic images from a total of 182 histopathologically diagnosed-breast cancer patients treated in Tianjin Medical University General Hospital and Tianjin Medical University Cancer Institute and Hospi-tal between January 2016 and March 2016. Mammographic features were assessed according to the Breast Imaging Reporting and Da-ta System(BI-RADS). Molecular subtypes were classified according to the St Gallen International Expert Consensus. Statistical analysis was performed to assess the correlation between mammographic features and molecular subtypes of breast cancer. Results: There was a relationship between mammographic calcifications and molecular subtypes of invasive breast cancer (V=0.221, P<0.05). In com-parison with Luminal A (12/20), Luminal B (80/132), and HER-2 enriched (4/10) breast cancers, most triple-negative breast cancers (18/20) were non-calcified lesions (P<0.05). The proportion of spiculated masses was higher in Luminal breast cancer (30/85) than in non-Luminal breast cancer (1/16) (P<0.05). Conclusions: There is a relationship between mammographic features and molecular subtypes of invasive breast cancer.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective:To explore the effects of Tongdu Tiaoshen acupuncture on vascular endothelial function and inflammatory factors in patients with mild cognitive impairment (MCI) after ischemic stroke (IS).Methods:A retrospective analysis was performed on the clinical data of 71 patients with MCI after IS in the hospital between January 2020 and September 2022. According to different treatment methods, they were divided into Tongdu Tiaoshen acupuncture group ( n=31, Tongdu Tiaoshen acupuncture + oral nimodipine tables) and routine body-acupuncture group ( n=40, routine body-acupuncture group + oral nimodipine tables). Both groups were treated for 2 courses (14 d/course). Before and after treatment, levels of serum NO and endothelin-1 (ET-1) were detected by radioimmunoassay, and levels of serum basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF), plasma homocysteine (Hcy) and IL-6 were detected by ELISA. The cognitive function of patients was evaluated and intelligence level by Montreal Cognitive Assessment Scale (MoCA), Mini-Mental State Examination(MMSE) and the clinical curative effect was also evaluated. Results:The total response rates in Tongdu Tiaoshen acupuncture group and routine body-acupuncture group were 90.32% (28/31) and 70.00% (28/40), and the difference between the two groups was statistically significant ( χ2=4.33, P=0.037). After treatment, levels of plasma Hcy and IL-6 in Tongdu Tiaoshen acupuncture group were lower than those in the routine body-acupuncture group ( t=2.57, 9.36, P<0.05 or P<0.01). After treatment, levels of serum bFGF, VEGF and NO in Tongdu Tiaoshen acupuncture group were significantly higher than those in the routine body-acupuncture group ( t=10.03, 9.29, 8.17, P<0.01), while ET-1 level was significantly lower than that of the routine body-acupuncture group ( t=2.41, P=0.019). After treatment, MoCA score [(28.24±4.45) vs. (25.32±4.34), t=2.78], MMSE score [(28.73±1.44) vs. (28.02±1.22), t=2.25] in Tongdu Tiaoshen acupuncture group were higher than those in the routine body-acupuncture group ( P<0.01). Conclusion:Tongdu Tiaoshen acupuncture is beneficial to improve vascular endothelial function, reduce levels of inflammatory factors, promote the recovery of cognitive function and improve curative effect in patients with MCI after IS.