Objective To investigate the change of high sensitivity c-reaction protein( hs-CRP)on carotid artery plaque. Methods A total of 5 852 individuals were selected as our subjects who randomly stratified from the health examination survey participants in Tangshan Kailuan Company community during 2006 - 2007. A total of 5 440 people(age above 40 years old,free of stroke,transient ischemic attack(TIA)and myocardial infarction ) were qualified and enrolled in the final analysis. A questionnaire survey,blood biochemical analysis and carotid artery ultrasound examination were finished by trained medical staff. According to the hs-CRP 3 mg measurements at the first and third times health examinations,all subjects were divided into four groups,including continued decreasing group(hs-CRP < 3 mg/ L),decreasing group(hs-CRP decreased from≥3 mg/ L to < 3 mg/ L ),increasing group((hs-CRP increased from < 3 mg/ L to≥3 mg/ L)and continued high group((hs-CRP ≥3 mg/ L). Multiple logistic regression analysis was used to test the impact of change of hs-CRP on carotid artery plaque. Results Incidence of carotid artery plaques in continued decreasing, decreasing,increasing and continued high groups were 33. 6%(1 308 / 3 577),44. 7%(178 / 398),45. 1%(186 / 412)and 54. 9%(151 / 275),respectively. The dependent variable was named based on carotid artery plaque(1 = plaque and 0 = no plaque),and in dependent variable was named based on hs-CRP value change (0 = continued decreasing group;1 = decreasing group;2 = increasing group;3 = continued high group). Multiply factors logistic regression analysis showed that the risk of carotid artery plaques for women increased compared to decreasing group( RR = 1. 17,95% CI:1. 01 - 1. 35,P = 0. 035). After adjusting gender,age,smoking,low density lipoprotein cholesterol,fasting blood-glucose,baseline lg( hs-CRP)and body mass index,the risks of developing carotid artery plague in increasing group and continued high group were increased compared to decreasing group among the women and whole population(for all subject:RR = 1. 33,95% CI:1. 04 - 1. 70,P =0. 023;for women subject:RR = 1. 63,95% CI:1. 08 - 2. 46,P = 0. 021). Conclusion Increasing hs-CRP is a risk factors of incidence of carotid artery plaque possibly.

Purpose:To evaluate ~(18)F-deoxyglucose dual-head tomography with hPET in the detection of suspected recurrence in non-small cell lung cancer, as compared with CT/MRI imaging. Methods:21 patients with clinically suspected recurrences in non-small-cell lung cancer underwent ~(18)F-FDG hPET and CT/MRI imaging. The final diagnosis of recurrence was proved by pathology or clinical following-up. Results:The ~(18)F-FDG hPET sensitivity, specificity,accuracy,postive predictive value in defining local recurrence were 94.1%,75%,90.5 %,94.1%,respectively ; and those of CT/MRI were 60%,66.7%,61.9%,81.8%, respectively. Conclusions:In comparison with CT/MRI,~(18)F-FDG hPET possesses a higher sensitivity、specificity and accuracy in detecting recurrence in non-small-cell lung cancer.~(18)FDG hPET is quite valuable methd to define the tanget in the radiotherapy of recunent non-small-cell lung cancer,and is less expensive than PET.It is thus recommended for clinical use.

Purpose:To evaluate the acute side effects an d efficacy of three-dimensional conformal radiotherapy(3-DCRT)combined with hype rthermia for locally advanced non-small-cell lung cancer(LANSCLC). Methods:From Jan.2001 to April.2003,35 patients with LANSCLC we re treated with three-dimensional conformal radiotherapy(3-DCRT) combined with hyperthermia. Results:The overall response rate(CR+PR)was 91.4%for the primar y tumor. Acute radiation esophagistis occurred in 48.6%of patients(Grades Ⅰ,Ⅱ ). Acute radiation pneumonitis was observed in 8.6% of patients (Grades Ⅰ,Ⅱ). Grade Ⅰ-Ⅱ bone marrow suppression occurred in 8.6%(3/35)of patients and Grade Ⅰ-Ⅱ myocardical injury was present in 14.3%(5/35) of patients. The median fo llow-up duration was 24(6-28) months. Conclusions:Hyperthermia combined with 3-DCRT is well tolerate d in most patients with LANSCLC. Its early responses are milder than the convent ional radiotherapy. Remote results await futher follow-up.

Objective To analyse risk factors for bile leakage after liver resection.Methods Between January 2011 and December 2012,469 patients underwent elective hepatectomy.We prospectively collected and retrospectively analyzed demographic data,pathological variables,and perioperative variables.Univariate analysis screened the related factors of bile leakage after liver resection.Multivariate analysis identified the independent risk factors of postoperative bile leakage.Results 469 patients were included in the analysis.The prevalence of bile leakage was 22.6％ (n =106).Univariate analysis identified the following risk factors as male gender,portal hypertension,steatosis,cirrhosis,ChildPugh grade,ascites,operative time,intraoperative transfusion,intraoperative blood loss,portal triad clamping,microwave solidification,lymphadenectomy,number of tumor,tumor margin,tumor capsular,diameter of tumor,portal vein invasion or portal branch thrombosis,number of abdominal drains.Multivariate analysis identified 4 independent risk factors for postoperative bile leakage:Cirrhosis [OR =13.2 (2.3,76.9),P =0.004],steatosis [OR =73.1 (17.7,301.5),P ＜ 0.001],infusion volume of the surgery day [OR=1.0 (1.0,1.0),P=0.019] and diameter of tumor [OR=1.2 (1.1,1.3),P=0.003].Conclusions Cirrhosis,steatosis,transfusion volume of the surgery day,and tumor size were risk factors for bile leakage after major liver resection.

Objective To investigate the relationship between arsenic in drinking water and skin lesions in endemic arsenism area in Shanyin County of Shanxi Province,in order to provide epidemiologic data for further arsenism research.Methods One hundred and eighty-nine endemic arsenism patients and 59 controls were randomly selected in 17 endemic amenism countries in Shanyin County of Shanxi Province.The content of arsenic in drinking water which wa8 collected indoom was half-quantitatively screened by a kit made by Chinese Center for Disease Control and Prevention,then quantitatively determined by HPLC-ICP-MS.Patients of endemic arsenism were diagnosed by "The Standard of Diagnosis for Endemic Amenism"(WS/T 211-2001).Results There were 64.9% (87/134)samples above the arsenic level(50μg/L)of drinking water and the median value of arsenic in drinking water was 91.43 μg/L in 134 water samples.The OR(95%CI)value between arsenic in drinking water and hyperkeratosis,hyperpigmentation,depigmentation was 2.46(1.22-4.94),3.34(1.50～7.44)and 2.86(1.50-5.46),respectively.The prevalence of hyperkeratosis,hyperpigmentation and depigmentation increased,as the arsenic in drinking water increased(≤10,≤50,≤200,＞200μg/L),especially in＞200μg/L group(OR=6.15,13.96,11.41,P＜0.05).The arsenic level in drinking water of Ⅲ degree of depigmentation patients(318.300μg/L)was higher(P＜0.05)than that of 0,Ⅰ and Ⅱ degree groups(86.670,131.800,1 10.590μg/L,P＜0.05).Conclusions Shanyin County is a medial arsenic pollution area. Arsenic in drinking water is considered as a risk factor of skin lesion. The degree of skin lesions increased,as the arsenic in drinking water increased.

Objective To investigate the clinical significance of detecting cardiac troponin Ⅰ (cTnⅠ) and CK -MB in children with hand-foot-and-mouth disease and myocardial injury.Methods 90 children with hand-foot-and-mouth disease (observation group) were detected the level of serum cTnⅠ and CK-MB.At the same time,40 healthy children were chosen as control group.Results Compared with the control group,the levels of CK-MB and cTnl in observation group were significantly higher than those of the control group (t =8.92,5.46,all P ＜ 0.01),which indicated that children with hand,foot and mouth disease was easier to merge myocardial injury.CK-MB and cTnl levels in high-risk group were significantly higher than those in normal children group (t =9.17,6.13,all P ＜ 0.01),and the levels of CK-MB and cTnl were positively correlated with severe degree (r =0.767,0.683,all P ＜ 0.01).For children with hand,foot and mouth disease merged myocarditis,cTnl diagnostic sensitivity (53.8％) was lower than that of CK-MB diagnostic sensitivity (71.8％),but the specificity was better than that of CK-MB,and the diagnosis of cTnl detection window 2 weeks longer than CK-MB,but after 2 weeks both lose their clinical diagnostic significance.Conclusion Children with hand,foot and mouth disease easily merge myocardial damage,dynamic measuring CK-MB and cTnl levels could help early diagnosis of children with hand,foot and mouth disease whether merged myocardial damage,both applications can also complement each other,more timely and accurate reflection of disease progression and recovery,it is worth promoting.

Objective To explore the possible association of single nucleotide polymorphism (SNP) rs3738435 of muscarinic acetylcholine receptor subtype M3 gene (cholinergic receptor, muscarinic 3, CHRM3) with risk of type 2 diabetes mellitus (DM) and metabolic disturbance. Methods The genotypes of T-149C variant of CHRM3 gene were determined by PCR-RFLP in 573 Chinese individuals in Shanghai, including 220 newly-diagnosed type 2 DM patients without taking any drug and 353 subjects with normal glucose tolerance (NGT). In the subjects, height and weight were measured for body mass index(BMI), waist, hip and femoral circumstances for waist-to-hip ratio (WHR) and waist-to-femur ratio (WFR), and serum lipid level including total cholesterol, triglyceride, high-density and low-density lipoprotein cholesterol, blood pressure, plasma glucose levels both at 0 and 120 minute during oral 75 g glucose tolerance test (OGTT) were also determined. Results (1) There was no statistical difference in the gene frequency between groups of type 2 DM and NGT. (2) In the group of type 2 DM, significant differences were observed between TT genotype carriers and TC+CC genotypes carriers for BMI, with an obvious increase in TY genotype carriers [(26.99±3.59vs25.34±3.48)kg/m2, P=0.001]. (3) In the subgroup of type 2 DM with BMI≥25 kg/m2, total cholesterol was higher in TT genotypes than in TC+CC genotypes[(5.75±1.26vs5.27±1.14)mmol/L, P=0.030], so was the low-density lipoprotein cholesterol. Conclusion The genetic variation T-149C in the CHRM3 gene seems to attribute to weight regulation and lipid metabolism of patients with type 2 diabetes mellitus in Chinese population.

BACKGROUND: Induced pluripotent stem cells (iPSCs) are a special type of cells with self-renewal and multi-differentiation potential, which can differentiate into intestinal organoids under certain conditions. OBJECTIVE: To explore whether iPSCs can differentiate into intestinal organoids under specific conditions in vitro.METHODS: iPSCs from B6J mice were recovered and cultured for 3 days until clone units covered about 80％ of the culture dish, and then the cells were cultured in the medium containing Activin A for 3 days until the deterministic endoderm formed. Further, the culture medium was replaced by the medium with fibroblast growth factor 4 and Wnt3A for 4 days to differentiate into the spheroids with CDX2+. After that, spheroids were collected and mixed with Matrigel,and then the mixture was dropped into the 4-well plate and cultured with Rspondin1, Noggin, epidermal growth factor, B27 and other growth factors to differentiate into intestinal organoids. Cell morphology was observed, FoxA2 and Sox17 expresson in the deterministic endoderm was detected, and CDX2, Sox9, CGA, MMP7 were measured.RESULTS AND CONCLUSION: iPSCs were cultured with Activin A for 3 days with higher cell fusion, initial differentiation and FoxA2/Sox17 expression (P < 0.05) than those of non-induced iPSCs. Spheroids began to appear at the 3rd day after culture with fibroblast growth factor 4 and WNT3A, and formed a lot at the 4th day. And CDX2 expression in spheroids was significantly increased compared with that in the deterministic endoderm (P < 0.05). Organoids gradually formed after 3 days culture, which contained all cell types of intestinal organoids, and expressions of specific markers, Sox9, CGA, MMP7, were significantly higher than those in spheroids (P < 0.05). To conclude, iPSCs can be induced to differentiate into intestinal organoids in three-dimensional niche in vitro.

Apoptosis of PK-15 cells induced by Foot-and-Mouth Disease Virus (FMDV) in vitro was reported in this paper. Typical cell apoptosis was detected by use of Hoechst 33258 fluorescence probe, agarose gel electrophoresis and in situ end-labeling (TUNEL). After PK-15 cells were infected by titration of 4.8 lg TCID50/mL FMDV for 32 h, apoptosis characteristics of nuclear condensation, fragmentation, accompanied by apoptotic bodies formation (Hoechst 33258 staining), 180-200 integer-fold sized pieces DNA Ladders (agarose gel electrophoresis) and strong green fluorescence dots (TUNEL) were all exhibited, and cell apoptosis was approximately 20%. In addition, the quantitative analysis of apoptosis in PK-15 cells induced by FMDV showed that apoptosis was correlated with infection of virus, and it was also time-dependent. Results indicate that FMDV can induce apoptosis of host cells and apoptosis plays an important role in the cytopathogencity effect of FMDV.

In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years (14-83 years) and with a medium follow-up period of 18 months (12-24 months). Of all the cases of acute trauma, there were 10 cases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes (2 cases), advanced age (>65 years, 3 cases) and cigarette smoking (6 cases). The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.