Objective To explore the correlation among serum immunoglobulin G4 (IgG4),transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF) and Hashimoto thyroiditis (HT) thyroid fibrosis.Methods Case-control study.A total of 159 patients with HT visiting the Wuhan Union Hospital were collected from May 2013 to March 2015.All patients were divided into IgG4 HT group (IgG4≥1.35 g/L,n =39) and non-IgG4 HT group (IgG4 ＜ 1.35 g/L,n =120).The serum IgG4,TGF-β1 and CTGF were determined by enzyme-linked immunosorbent assays.The levels of serum thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured by electrochemiluminescence immunoassay.Meanwhile,ultrasound of the thyroid gland was performed.Statistical analysis was performed by use of SPSS 17.0 software.The Mann-Whitney U test was used to compare two independent samples of non-normal distribution data,Fisher's exact test was employed to analyze thyroid imaging differences,correlation test was performed to examine various correlations,multivariate Logistic regression analysis was used to evaluate thyroid fibrosis risk factors.Results Compared with that of non-IgG4 HT group,IgG4 HT group:TPOAb [(455.2 ± 169.7) vs.(186.5 ± 102.3),U =27.0,P=0.003],TgAb [(984.6±452.7) vs.(289.3 ±245.1),U=30.5,P=0.017],TGF-β1 [(1.45±0.97) vs.(0.30±0.22),U=119.0,P=0.035] andCTGF [(88.65±14.39) vs.(62.21± 8.76),U =69.0,P =0.039] were significantly higher,thyroid ultrasound showed obvious fibrosis (35/4 vs.32/88,x2 =48.03,P =0.000);significant positive linear correlation between IgG4 and TPOAb (r =0.719,P =0.000),CTGF and TGF-β1 (r =0.500,P ＜ 0.01) respectively.Logistic regression analysis indicated that all the serum IgG4,TPOAb,TGF-β1 and CTGF were independent risk factors of thyroid fibrosis [IgG4,odds ratio (OR) =1.968,P =0.014,95％ confidence interval (CI) =1.287-2.041;TPOAb,OR =2.537,P =0.012,CI =1.322-2.869;TGF-β1,OR =1.549,P =0.023,CI =1.105-1.498;CTGF,OR =1.185,P =0.046,CI =1.204-1.625].Conclusion The highlevel of circulating antibodies,IgG4,TGF-β1 and CTGF were significantly associated with thyroid fibrosis,and were independent risk factors of HT fibrosis.

Objective:To explore the serum IgG4 level in patients with IgG4-related Hashimoto thyroiditis(IgG4 HT),and its clinical implications.Methods:The serum IgG4 was determined in 129 patients with HT using enzyme-linked immunosorbent assays and classified into two subgroups based on IgG4 level:IgG4 HT group(IgG4≥135 mg/dl)and non-IgG4 HT group(IgG4<135 mg/dl).And the levels of serum thyroid hormone and thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibodies(TgAb)were measured by electro-chemiluminescence immunoassay.Ultrasonic imaging of the thyroid gland were detected.Results:The TPOAb levels correlated significantly with both serum IgG4 levels(r=0.437 1,P=0.012 7)and IgG4/IgG ratios(r=0.396 2,P=0.023 5)in the patients with HT.Compared with that of non-IgG4 HT group(n=97),IgG4 HT group(n=32):①The mean age was lower(P=0.029 3);②Higher levels of serum TPOAb(P=0.002 1)and TgAb(P=0.012 8);③Ultrasound imaging:the more obvious thyroid nodule(P=0.022 6);④Logistic regression analysis showed that serum IgG4 and TPOAb were the risk factor for thyroid nodules(OR=1.672,P=0.021;2.549,P=0.014 ).Conclusion: IgG4 HT patients existed corresponding clinical characteristics.For the HT-patients with elevated serum IgG4,thyroid function and morphology should were more closely monitored.

[Summary] To investigate the difference in serum pigment epithelium-derived factor ( PEDF) among type 2 diabetic patients before and after use of dipeptidyl peptidase-4 inhibitors linagliptin for treatment, and to explore the correlation of serum PEDF with lipids, body mass index, and HbA1C . 39 patients with recently diagnosed type 2 diabetes and 30 healthy individuals were enrolled. Baseline weight, waist circumference, body mass index, fasting plasma glucose, HbA1C , serum glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol ( LDL-C) , and PEDF measured by enzyme linked immunosorbant assay were determined both in the diabetic and control subject. The treatment group was treated with oral linagliptin 5 mg/d for six month, serum PEDF and clinical parameters were determined in the diabetic group during 6 months of treatment. ( 1 ) PEDF levels were found to be comparable with the controls ( P=0. 584);LDL-C and waist circumference showed positive correlation with PEDF(P<0. 05 or P<0. 01). (2) PEDF level was significantly increased in patients with type 2 diabetes after linagliptin treatment [(3. 21 ± 1. 91 vs 2. 45 ± 1.53)μg/ml,P<0.01]. SerumPEDFlevelinpatientswithtype2diabeteswassimilartothatofhealthycontrolswith associated LDL-C and waist circumference. After linagliptin treatment, serum PEDF level was raised, suggesting that it may have certain protective effect for diabetic vascular complications.

Objective To analyze the influencing factors of perioperative coagulation dysfunction in neonates with gastrointestinal surgery.Methods Coagulation indexs, including plasma prothrombin time (PT), partial activated thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen (Fib), were collected retrospectively from June 2002 to April 2016 in gastrointestinal neonatal surgery, as well as perioperative clinical data and the perioperative coagulation dysfunction associated risk factors were analyzed.Results There were 158 cases with abnormal coagulation indexs within 4 hours after operation, including 61 cases of mild abnormalities and 97 cases of obvious abnormalities.Multivariate logistic regression analysis showed that preoperative pneumonia (OR=2.880, 95%CI 1.417-5.852), perioperative low calcium (OR=2.381, 95%CI 1.167-4.857) and invasive puncture catheter (OR=2.490, 95%CI 1.299-4.773) were independent risk factors for neonatal coagulation index abnormality within 4 hours after surgery (P<0.05).Conclusion In the perioperative management, pneumonia should be actively treated, correcting hypocalcemia and choosing concentrations of less than 6.25 U/ml of heparin solution or normal saline careing arteriovenous catheter reduces the occurrence of neonatal postoperative coagulation dysfunction.

0.05).(2) Expression levels of Akt : At baseline,Akt was already activated in NCU-SGA rats compared to no Akt activation in normal control rats.However,post-stimulating of insulin,the increase level of phosphate Akt in NCU-SGA rats was remarkably lower than that in control rats(P

Objective To evaluate the diagnostic values of ultrasound elastography (UE) technology and acoustic radia?tion force impulse (ARFI) technology in the differential diagnosis of benign and malignant single solid thyroid nodule showed by ultrasonography. Methods A total of 100 patients with solitary thyroid nodule diagnosed by the Affiliated Hospital, School of Medicine of Shihezi University in December 2013 to July 2014 were selected in this study. The routine ultrasound, UE examination and ARFI technology were used in patients before operation. All patients were performed operation for thy?roid nodules and the diagnosis was confirmed by the pathologic results. A flexible classification method was used in UE. ARFI was used to detect shear wave velocity (SWV) of lesions. The diagnostic values of three methods were evaluated by the gold standard of pathologic results. ROC curves were plotted according to SWV values of benign and malignant thyroid nod?ules. Results The area under the curve (ACU) was 0.960. The best cut-off value of SWV was 2.76 for diagnosis. The diag?nostic sensitivities of malignant thyroid solid nodules were 82.61%(19/23), 82.61%(19/23) and 91.30%(21/23) for US, UE and ARFI, respectively. The diagnostic specificities were 87.01%(67/77), 88.31%(68/77) and 93.51%(72/77) respectively. And the positive predictive values (PPV) were 65.52%(19/29), 67.86%(19/28) and 80.77%(21/27) respectively;the nega?tive predictive values (NPV) were 94.37%(67/71),94.44%(68/72) and 97.29%(71/73). Conclusion ARFI technology is superior to US and UE technology in predicting malignancy in solitary solid thyroid nodule, which is worth of clinical applica?tion and promotion.

Objective To investigate changes in serum sclerostin (SO) in postmenopausal women before and after treatment with recombinant human parathyroid hormone (1-34) [rhPTH (1-34)],and to explore the relationship of serum SO with estradiol (E2),and bone mineral density (BMD).Methods Ninety-five postmenopausal women were divided into normal BMD group (n =41) and osteoporosis group (n =54).Body mass index,alkaline phosphatase (ALP),serum E2,calcium,phosphate,and SO were determined in both groups.The patients in osteoporosis group were treated with rhPTH (1-34) 20 μg/d by subcutaneous injection and oral calcium 500 mg/d for 12 months.Serum calcium,serum phosphate,BMD,serum ALP,serum E2,and sclerostin were determined in osteoporosis group by 6 months and 12 months of treatment.Results (1) Serum level of SO in osteoporosis group was raised significantly as compared with normal BMD group (P ＜ 0.05) ; E2 and BMD were negatively correlated with SO; age and postmenopausal years were positively correlated with SO (P ＜ 0.05).(2) Serum SO was reduced gradually with treatment of rhPTH (1-34) by 6 months and 12 months (P ＜ 0.05).Conclusions Serum SO was increased in postmenopausal women,which was related to E2 and BMD,and was reduced gradually with treatment of rhPTH (1-34).SO may participate in the development of postmenopausal osteoporosis.

Objeetive To evaluate the protective effects of decorin on the inner blood-retinal barrier function under high-glucose plus hypoxia conditions,and explore its potential mechanism.Methods The human umbilical vein endothelial cells (HUVEC) were cultured,and the effect of decorin with different concentrations on HUVEC viability was determined by using the cell counting kit-8 assay (CCK-8).At different hours after incubation under high-glucose plus hypoxia conditions (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),the suppression effects of various concentrations of decorin on the vascular endothelial growth factor (VEGF) expression of HUVEC was detected by enzyme-linked immunosorbent assay (ELISA).HUVEC were divided into normal control group (5.5 mmol · L-1 D-glucose),high-glucose plus hypoxia group (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),mannitol control group(5.5 mmol· L-1 D-glucose +19.5 mmol · L-1 mannitol) and decorin treatment group (25 mmol · L-1 D-glucose+ 100 μmol · L-1 CoCl2 + 100 nmol · L-1 decorin).HUVEC barrier function was evaluated by detecting transepithelial electrical resistance (TER) and permeability of fluorescein isothiocyanate-dextran (FITC-dextran).The content of tight junction proteins (claudin-5,occludin,and ZO-1) and p38 mitogen-activated protein kinase (MAPK) phosphorylation were examined by Western blotting.Results According to the results of CCK-8,the survival rates of HUVEC in all groups were more than 90％,different concentrations of decorin showed no significant effect on HUVEC survival (all P ＞ 0.05).According to the results of CCK-8 and ELISA,the stimulation of hypoxia for 48 hours and 100 nmol · L-1 decorin was taken as the condition of further experiment.At 14 days,TER of HUVEC reached its peak of (170.67 ±9.07) Ω.TER of high-glucose plus hypoxia group (97.33 ±6.11)Ω was significantly lower than that of decorin treatment group (157.67 ± 11.72)Ω (P ＜0.05).The FITC-dextran permeability of high-glucose plus hypoxia group increased to (2.12 ±0.07) times of normal control group(P ＜0.05).Decorin reversed this effect to (1.16 ± 0.03) times of normal control group (P ＜ 0.05).The expression of claudin-5,occludin and ZO-1 in high-glucose plns hypoxia group were 0.38 ±0.05,0.43 ±0.02,0.25 ± 0.02,compared to the normal control group (0.72 ±0.05,0.90 ±0.01,0.75 ±0.02),there were statistical differences (all P ＜0.05).The expression of claudin-5,occludin and ZO-1 m decorin treatment group were 0.65 ±0.08,0.87 ±0.03,0.60 ±0.01,there were statistical differences compared with high-glucose plns hypoxia group (all P ＜0.05).The ration of p-p38 MAPK/p38 MAPK in high-glucose plus hypoxia group (0.88 ± 0.02) was increased,while the decorin treatment group (0.58 ± 0.04) reached the level of the normal control group (0.56 ±0.02),there was statistical difference compared with high-glucose plns hypoxia group (P ＜0.05).Conclusion Decorin can protect the HUVEC barrier function under high-glucose plus hypoxia conditions and inhibit the activation of p38 MAPK signaling pathway.So it may be used to treat diabetic retinopathy.

Objective To explore the clinicopathological characteristics of small renal mass .Methods We reviewed the medical records of patients who had received partial nephrectomy ( PN) or radical nephrectomy ( RN) in 2011 in the tumor hospital of harbin medical university .We identified xxx patients who were treated with PN or RN for renal masses within a size of 4 cm.All small renal masses were localized ,sporadic,solid,and had reports of renal carcinoma measurement by CT or MRI .Results Of the 36 SRMs,there were 32(88.89%)clear cell renal cell carcinoma,3(8.33%)papillary renal cell carcinoma,1(2.78%)begin tumor.Of the 36 patients, 34 patients received radical nephrectomy ( RN) and only 2 male patients received partial nephrectomy ( PN) .The mean tumor size of 36 SRMs was 2.9 cm.Conclusion The majority of 36 SRMs are categorized to clear cell re-nal cell carcinoma by histological type .Most of the 36 patients receive radical nephrectomy ( RN) .

Objective To develop a rapid and accurate technique for pathogens identification from positive blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry ( MALDI-TOF MS) .Methods A total of 266 culture-positive blood samples from clinical laboratory in the Second Affiliated Hospital of Soochow University during January to July 2015 were collected.The blood was transferred into separation-gel tubes, and the bacteria were enriched and purified by differential centrifugation.MALDI-TOF MS was applied to identify the bacteria and the results were compared with conventional bacterial culture. Results Among 266 culture-positive blood samples, 260 were monomicrobial cultures and 6 were polymicrobial cultures.Of 260 monomicrobial cultures, 98.8% (257/260) and 96.2% ( 250/260 ) of organisms were identified at the genus level and the species level, respectively.Of 140 Gram-negative bacterial isolates, 99.3% (139/140) and 97.9% (137/140) were identified at the genus level and the species level, respectively.Of 120 Gram-positive bacteria isolates, 98.3%(118/120) and 94.2% (113/120) were identified at the genus level and the species level, respectively.None of the 6 polymicrobial cultures were identified.Conclusion MALDI-TOF MS can directly identify the bacteria from positive blood cultures, which provides a rapid and accurate method for the diagnosis of bloodstream infection.