Objective To investigate the role of total bile acid (TBA) in pathogenesis of essential hypertension.Methods The concentration of serum TBA was measured by enzymatic method in 127 cases including 30 healthy controls,21 secondary hypertensive patients and 76 essential hypertensive patients.Results There was a significant increase of TBA in essential hypertensive group compared with that of control group and secondary hypertension (P 0.05) .In essential hypertensive group,the levels of TBA in grade 3 hypertension were higher than that of grade 1 hypertension (P0.05).Conclusion The abnormal increasing of TBA may play a role in pathogenesis of essential hypertension.

Objective To study the prediction value of C-reactive protein (CRP) level to ankylosing spondylitis disease activity score (ASDAS),the most widely used activity score in ankylosing spondylitis (AS).Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L (n =266) and CRP ＜ 3.5 mg/L(n =120).ASDAS-CRP was evaluated in patients with CRP below the normal range (3.5 mg/L) in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate (ESR).Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L (r =0.899,P =0.000).In the group of CRP ＜ 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L(intra-class correlation coefficient 0.902;kappa coefficient 0.70).By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

BACKGROUND:The human telomerase reverse transcriptase gene (hTERT) transfected into target cel s can play an important role in target cel proliferation and differentiation by increasing telomerase activity and maintaining telomere length. OBJECTIVE:To explore the effect of hTERT transfection on telomerase activity and biological characteristics of precartilage stem cel s culured in vitro. METHODS:Precartilage stem cel s cultured in vitro were subjected to hTERT gene transfection via a retrovirus vector pLXSN. Meanwhile, control and negative control groups were set up. After transfection, TRAP-ELISA assay was used to detect telomerase activity;RT-PCR and western blot employed to detect hTERT mRNA and protein expressions;cel counting kit-8 used to detect cel proliferaiton based on cel growth curve;and flow cytometry adopted to detect cel cycle and distribution. RESULTS AND CONCLUSION:The telomerase activity was significantly increased at 48 hours after hTERT gene was transfected into the precartilage stem cel s. After transfection of hTERT, hTERT mRNA and protein levels were significantly increased, the cel growth rate was significantly increased, the proportion of cel s at G 0/G 1 phase was decreased, and the number of S-phased cel s increased compared with the control group and negative control group. There were significant differences among the groups (P<0.05). In conclusion, hTERT transfection via retrovirus vector pLXSN can promote the proliferation of precartilage stem cel s in rats by increasing the telomerase activity.

OBJECTIVE: To study the classification criteria of adult cuboid fracture and its guidance feasibility and effect of treatment. METHODS: A retrospective analysis was made on the clinical data of 415 adult patients (416 feet) with cuboid fractures who had complete CT data treated between May 2009 and April 2014. There were 337 males and 78 females, aged 19 to 64 years (mean, 38.8 years). The left foot, right foot, and bilateral feet were involved in 220 cases, 194 cases, and 1 case respectively. The causes of injury were sprain in 106 cases, traffic accident in 65 cases, falling from height in 129 cases, and heavy crushing in 115 cases. The interval of injury and hospitalization was 2 hours to 3 days (mean, 8.5 hours). Based on CT findings, the classification criteria of cuboid fracture was proposed and methods of treatment was statistically analyzed. The external fixation surgery was performed in patients of type I (285 feet), type IIa (18 feet), and type III (5 feet); open reduction and internal fixation were performed in patients of type IIb (41 feet) and type III (67 feet), and bone grafting was used to repair defects in 58 feet (type III). RESULTS: All patients were followed up 1 year to 5 years and 11 months (mean, 2 years and 3 months). Primary healing of incision was obtained. In patients with type I fracture, fracture healed in 165 feet at 4-6 weeks (mean, 5.5 weeks), fracture did not heal in the other 120 feet; the American Orthopaedic Foot and Ankle Society (AOFAS) score was 95-100(mean, 96.7) at last follow-up. In patients with type II fracture, fracture healed in all feet at 6-8 weeks (mean, 6.5 weeks); the AOFAS score was 92-100(mean, 95.5) at last follow-up. In patients with type III fracture, malunion was observed at 6-8 weeks in 5 feet undergoing external fixation, and in 9 feet undergoing open reduction and internal fixation with foot lateral column shortening, forefoot abduction deformity, osteoarthritis, lateral foot pain; fracture healed at 8-12 weeks in 58 feet undergoing open reduction and internal fixation, without osteoarthritis, cuboid bone shortening, and pain at cuboid bone; and AOFAS score was 75-97(mean,93.5) at last follow-up. CONCLUSIONS: The classification criteria of cuboid fracture proposed based on CT examination is feasible and has guiding significance to the choice of treatment method.

A rapid, sensitive and convenient LC-MS/MS method was developed for the determination of γ-aminobutyric acid (GABA) in human plasma. d2-γ-Aminobutyric acid (d2-GABA) was synthesized as internal standard (IS). After extraction from human plasma by protein precipitation with acetonitrile, all analytes were separated on a Luna HILIC column (100 mm x 3.0 mm, 3 μm) using an isocratic mobile phase of water: acetonitrile: formic acid (20 : 80 : 0.12) with a flow rate of 0.5 mL x min(-1). Acquisition of mass spectrometric data was performed in multiple reaction monitoring mode (MRM) in positive electrospray ionization using the transitions of m/z 104 --> 69 for GABA and m/z 106 --> 71 for d2-GABA. The method was linear in the concentration range of 5.00 to 1 000 ng x mL(-1). The intra- and inter-day precisions were within 9.9%, and accuracy ranged from 99.1% to 104%, within the acceptable limit across all concentrations. The method was successfully applied to a pharmacokinetic study of GABA tablets in healthy Chinese volunteers.

Objective To explore the influential factors of treatment of the intra-articular calcaneal fractures treated with calcaneal titanic alloy plate.Methods The treatment of intra-articularcalcaneal fractures with calcaneal titanic alloy plate was reviewed.Thefalling height, weight, complication, Sanders evaluation method,mechanism of injured, the change degree of B(o)hler and Gissane angle were recorded and compared.One-way ANOVA, Chi-Square Tests and logistic test were applied to evaluate the relationship of these factors.Results According to AOFAS scale system, the average recovery score was 86.35, excellent rate was 91.6%.Binary logistic stepwise regression showed that the correlation between weight and resu1ts of treatment was statistically significant( P ＜0.01 ).The correlation between the period before operation and the recovery score was statistically significant( P ＜0.01).Sanders evaluation method was statistically significant ( P ＜0.05).The correlation between preoperative B(o)hler'sngle and Gissane's angle and the postoperative functional recovery score was statistically significant ( P ＜ 0.05) .Conclusions Calcaneal titanic alloy plate used in treatment of intra-articular calcaneal fracturcs was a good method.The weight, the period before operation, level of trauma and the B(o)hler's angle and Gissane's angle influenced the treatment effect.

Background and purpose:Cancer of unknown primary (CUP) represents approximately 5%~10%of malignant neoplasms. For CUP patients, identiifcation of tumor origin allows for more speciifc therapeutic regimens and improves outcomes.Methods:By retrieving the gene expression data from ArrayExpress and Gene Expression Omnibus data repositories, we established a comprehensive gene expression database of 5 800 tumor samples encom-passing 22 main tumor types. The support vector machine-recursive feature elimination algorithm was used for feature selection and classiifcation modelling. We further optimized the RNA isolation and real-time quantitative polymerase chain reaction (RTQ-PCR) methods for candidate gene expression proifling and applied the RTQ-PCR assays to a set of formalin-fixed, paraffin-embedded tumor samples.Results:Based on the pan-cancer transcriptome database, we identiifed a list of 96-tumor speciifc genes, including common tumor markers, such as cadherin 1 (CDH1), kallikrein-re-lated peptidase 3 (KLK3), and epidermal growth factor receptor (EGFR). Furthermore, we successfully translated the microarray-based gene expression signature to the RTQ-PCR assays, which allowed an overall success rate of 88.4% (95%CI: 83.2%-92.4%) in classifying 22 different tumor types of 206 formalin-fixed, paraffin-embedded samples. Conclusion:The 96-gene RTQ-PCR assay represents a useful tool for accurately identifying tumor origins. The assay uses RTQ-PCR and routine formalin-ifxed, paraffn-embedded samples, making it suitable for rapid clinical adoption.

Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis (AS). Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire (WPAI) was used to survey the work disability and productivity loss, then explore its in-fluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate linear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 (24.0, 50.0) hours workingtime in the past week. Average AS related absenteeism was 4.4 (0, 10) hour. Average workproductivity loss was 26.4%(2.5%, 40.0%). Logistic multiple regression analysis showed that Bath AS disease activity index (BASDAI), SF-36 physical component summary (PCS) scores might be the important influencing factors among those clinical measures ( OR=1.270, 0.959). Presenteeism and overall work impairment were moderately correlated with patients' global assessment of disease activity (VAS), BASDAI, bath AS functional index (BASFI), SF-36 physical Functioning (PF), SF-36 body pain (BP) and SF-36 Physical Component Summary (PCS) (|r|=0.539-0.648). Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI (P<0.01). Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function;High attention should be paid to AS patients with work disability.

OBJECTIVE:To reduce drug repercussion of outpatient pharmacy,and to promote safe drug use.METHODS:By quality control circle (QCC),the data of drug repercussion were selected from outpatient pharmacy of our hospital in Sept.2016.The drug repercussion reason check list was designed to master the situation of drug repercussion in outpatient department,formulate improvement measures and confirm effect through field inspection.The case number of drug repercussion and the improvement of circle members' ability were compared one month before and after QCC (Mar.2017).Finally,the effects of QCC were evaluated.RESULTS:Referring to the reasons for the repercussion of adjunct drugs for inspection and the repercussion of unsuitable drug use in our hospital,those problems were improved by formulating manual for drug use examination project,optimizing and examining drug delivery process in the department,etc.The case number of drug repercussion in outpatient pharmacy decreased from 31 cases per month to 12 cases per month;the rate of goal achievement was 119％;the rate of improvement was 61％.The ability of QCC members to solve problems and the ability to use QCC skills were increased positively.CONCLUSIONS:The development of QCC activity in our hospital reduces case number of drug repercussion and optimizes drug delivery process in outpatient pharmacy,and promotes safe drug use.

Fluoroquinolones are widely used in clinical practice, but their clinical application in juvenile patients has been controversial.The purpose of this study was to investigate the pharmacokinetic characteristics, indications and adverse reactions of Ciprofloxacin and Levofloxacin in minors.It is shown that the two drugs are effective for infectious diseases and no serious or persistent joint or skeletal muscle injury occurs in minors using the drugs.Hence, in the absence of alternatives, the benefits of Ciprofloxacin or Levofloxacin treatment for minors may outweigh the risks.