Objective To investigate the clinical significance of serum chemokine and hs-CRP levels in patients with type 2 diabetes mellitus with asymptomatic subclinical atherosclerosis.Methods The clinicpathological and follow-up data of 55 patients with Type 2 diabetic from 2012.1 to 2015.12 were collected and reviewed.At the same time,55 patients with non type 2 diabetes were taken as control.Determination of FPG,HbA1c,HDL-C,TC,TG,LDL-C,INS and other indicators by automatic biochemical analyzer,the application of color Doppler ultrasound equipment measurement C-IMT.Correlation using Pearson correlation analysis,risk factor analysis using multiple linear stepwise regression analysis.Results Compared with the control group,the two groups in BMI,WHR,systolic blood pressure,ankle brachial index,FPG,HbA1c,HDL-C,hsCRP,C-IMT,HOMA2-IR and serum chemokines were significantly different,with statistical significance (t =-6.31 ～5.79,P≤0.01 ～ 0.03).In 110 cases of experimental group and control group,the levels of serum chemokines were positively correlated with WHR,HOMA2-IR,C-IMT and hs-CRP (r=0.24～0.29,P=0.01～0.04).C-IMT and age,WHR,systolic blood pressure,diastolic blood pressure,FPG,HbA1c,diabetes duration,hs-CRP was positively correlated (r=0.15 ～0.68,P≤0.01～0.0.04),and the ankle brachial index was negatively correlated (r=-0.32～0.29,P≤0.01).Hs-CRP was positively correlated with HbA1c,HOMA2 IR,serum chemokine,C-IMT (r=0.25～0.32,P≤0.01～0.04),and was negatively correlated with TC and HDL-C (r=-0.27～-0.25,P all 0.02).Cox proportional hazard regression model for multivariate analysis showed that high serum chemokines,hs-CRP and HbA1c were the risk factors of C-IMT (β=0.026～0.658,SE=0.015～0.033,t=2.532～3.421,P≤0.01～0.04).Conclusion High serum levels of chemokines and hs-CRP are the risk factors of C-IMT,and it has important clinical significance for the diagnosis of asymptomatic subclinical atherosclerosis in patients with type 2 diabetes mellitus.

AIM　To detect chemical components of the essential oil of Schisandra chinensis(Turcz.)Baill.. METHODS　The essential oil was analyzed with GC/MS, heuristic evolving latent projections(HELP) resolution and overall volume integration method. RESULTS　HELP method along with the data from GC/MS can be used to conduct the peak purity examination and resolution of overlapping peaks to obtain pure chromatogram and MS spectrum of each component. Fifty six components were separated and 49 of them were qualitatively and quantitatively analyzed. All the components represent about 98.27% of the total content. CONCLUSION　The resolved pure chromatogram and MS spectrum can greatly enhance the reliability of similar searches in the commercial MS database and thus contribute to the accuracy of the qualitative and quantitative analysis of the essential oil.

Objective To study the relationship between the cerebral artery stenosis and the carotid artery elasticity in the ischemia stroke patients by echo-tracking technique.Methods Ninety-two ischemia stroke patients were divided into both the mild cerebral arteries stenosis and moderate-severe cerebral arteries stenosis groups.CT angiography was performed to evaluate the stenosis of cerebral artery.The changes of the carotid diameter during cardiac cycles were obtained by echo-tracking technique and the quantitative parameters of pressure-strain elastic modulus (Ep),stiffness (β) and arterial compliance (AC) were calculated automatically. Results①There were significant differences (P＜0.05) between the ischemia stroke patient group and the normal adults group in β，Ep and AC.② There were significant differences (P＜0.05) between the mild cerebral arteries stenosis groups and the moderate-severe cerebral arteries stenosis groups in β and Ep.AC was lower in patients with the mild cerebral arteries stenosis groups than that in the moderate-severe cerebral arteries stenosis groups.Conclusions The carotid artery elasticity in ischemia stroke patients were significantly different from normal adults.In the ischemia stroke patients,the stiffer the carotid artery was,the higher the likelihood of moderate-severe cerebral stenosis was.

Objective To study the value of time intensity curve of contrast enhanced ultrasound in the discrimination of benign and malignant soft tissue tumors. Methods Thirty-seven cases of soft tissue tumors were carried out contrast-enhanced ultrasound examination. The region of interest in the dynamic images were chosen to carry out Gamma-Variate curve fitting through Q-LAB software and made a quantitative analysis. Then they were compared with pathological diagnosis to analyze the ultrasound imaging performance of benign and malignant tumors and their characteristics of micro-irrigation. Results Thirty-seven cases of soft tissue tumors were pathologically diagnosed 21 cases of benign and malignant in 16 cases. The perfusion of benign tumors were mainly uniformity (19/21) or potentialization (2/21). The perfusion of malignant tumors were mainly uniformity (10/16) or nonuniformity (6/16). There were no significant differences in time to peak(TTP) and arrival time of contrast agent(AT) between benign and malignant tumors( P ＞0.05). The upslope rate(A) and the derived peak intensity(DPI) in benign group were significantly less than malignant group ( P ＜0.05). Conclusions Time-intensity curve analysis of contrast-enhanced ultrasound showed that benign and malignant soft tissue tumors were different in perfusion,and it will be of a certain value for the clinical differential diagnosis.

Objective To explore the clinical effect of dopamine,phentolamine,recombinant interferon α combined with nasal continuous positive airway pressure(CPAP) ventilation in treating severe infantile bronchiolitis.Methods Ninety-five cases of infantile severe bronchiolitis were divided into the observation group(55 cases) and control group (40 cases).The control group was given the combined treatment scheme of dopamine,phentolamine and recombinant interferon α,while on this basis the observation group was added with NCPAP.The curative effects were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0.05);the temperature recovery time,wheezing disappearance time,cough stopping time,lung wheezing sound disappearance time and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05);the breathing rate,heart rate and PaCO2 level after treatment in the two groups were significantly lower than those before treatment,the levels of PaO2,PaO2/FiO2 and pH were significantly higher than those before treatment in the same group,the differences were statistically significant(P<0.05);the breathing rate,heart rate and PaCO2 level after treatment in the observation group were significantly lower than those in the control group(P<0.05);the levels of PaO2,PaO2/FiO2 and PH after treatment in the observation group were significantly higher than those in the control group(P<0.05);the levels of IL-8,sVCAM-1and LTE4 after treatment in the two groups were significantly lower than those before treatment(P<0.05);there was no statistically significant difference in the levels of serum IL-8,sVCAM-1 and urine LTE4 between the two groups(P>0.05);the recurrence rate and death rate in the observation group were significantly lower than those in the control group with statistical difference(P<0.05);the occurrence rate of adverse situation during treatment period had no statistical difference between the two groups(P>0.05).Conclusion Dopamine,phentolamine,recombinant interferon α combined with NCPAP has obviously clinical effect for treating infantile severe bronchiolitis,can effectively improve the blood gas analytical indexes,reduces the signs and symptoms relief time,reduces the rates of relapse and death,and has higher clinical application value.

Objective To evaluate the association between the concentration of particulate matter (PM2.5)and asthma attack in children.Methods The computer and databases were used to search the key wordsAsthma andChild were searched by means of the subject headings ( Asthma andChild) and free words (Asthma * , Child *andPediatric * etc.),moreover PM2.5 was searched on the basis of free words such asPM2.5, Particulate Matter *which were linked withAND in PubMed and Medline database.Furthermore,the key words asthma AND (Child OR Pediatric OR Infant) AND (PM2.5 OR Particulate Matter OR Inhalable Particles) for keywords were searched in CBM,CNKI,VIP and Wanfang databases.The literatures included those from the initial computer database up to those of December 2014 from computer database.Meanwhile manual research was added to screen literatures according to the standards of inclusion and exclusion.Newcastle-Ottawa Scale was employed to assess the quality of the included literatures including selection,comparability and outcomc.Data wcre synthesized and analyzed by Rcvman5.3 and Stata12.0 version for statistical analysis,heterogeneity test,sensitivity analysis,subgroup analysis,and so on.Results A total of 17 literatures involving 1326573 children were included.The findings from quality assessment involved 2 studies for 8 scores,2 for 7 scores,7 for 6 scores,5 for 5 scores,and 1 for 4 scores,respectively.The result of Meta-analysis showed that the combined the odds ratio (OR) of PM2.5 with childhood asthma attack was 1.06,and 95％ confidence interval(CI) was 1.03-1.08.Subgroup analysis showed that the OR on the asthma hospital visit equaled to 1.03 (95％ CI 1.01-1.06),and the OR on the asthma symptom equaled to 1.11 (95％ CI 1.06-1.16),moreover,subgroup analysis between developed and developing countries showed that the OR of the asthma on developing countries corresponded to 1.04 (95％ CI 1.02-1.06),and the OR of the asthma on developed countries corresponded to 1.06 (95％ CI 1.03-1.09).Conclusion There is a positive correlation between concentration of PM2.5 and asthma attack in children.

OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy combined with terbutaline in the treatment of mycoplasma pneumonia. METHODS:130 children with mycoplasma pneumonia were randomly divided into control group and observation group. Control group was given azithromycin sequential therapy by using 10 mg/kg Azithromycin dispersible tablet by intravenous infusion,once a day,for continuous 3-5 d,then rested for 4 d,and then given 10 mg/kg Azithromycin dis-persible tablet at a draught,once a day,for continuous 3 d,then rested for 4 d;observation group was additionally given 2.5 mg Terbutaline injection adding into 5 ml sodium chloride injection by inhalation via oxygen atomization,twice a day,10-15 min ev-ery times,and then the children were fed with warm boiled waterafter atomization. The treatment course for both groups was 4 weeks. Clinical efficacy,and changes of cytokines levels [tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),IL-8],disap-peared time of related symptoms and signs (wheezing,rales,coughing,fever),hospitalization time before and after treatment, and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,the effective rate in observation group was significantly higher than control group,levels of TNF-α,IL-6 and IL-8 were significantly lower than control group,disap-peared time of related symptoms and signs and hospitalization time were significantly shorter than control group,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Azithromycin sequential therapy combined with terbutalineaerosol therapycan effectively improve the cytokines levels and clinical efficacy,with good safety.

Objective To investigate the safety and feasibility of endovascular stent angioplasty in treating symptomatic stenosis of middle cerebral artery.Methods Endovascular angioplasty with coronary stents was performed in 27 patients with symptomatic stenosis of middle cerebral artery.The clinical results were reviewed and analyzed.Results Of the total 27 patients,successful placement of the coronary stents Was achieved in 24.Angiography immediately after the procedure showed that the stenotic degree of the diseased artery was markedly decreased from preoperative (80±19)%to postoperative (8±4)%,the improvement was very obvious.Percutaneous transcatheter angioplasty had to be employed in two cases because of the failure of stent placement.A mean follow-up period of 18 months was carried out.During the following up period no transient cerebral ischemia attack occurred in 25 patients and no newly-developed cerebral infarction in region fed by the responsible vessels occurred either.Re=irrigation cerebral hemorrhage was seen in one patient,which occurred three hours after the placement of the stent.In one case the placed stent fell off and immigrated into the siphon of internal carotid artery,and the displaced stent Was took out later with a catching apparatus.In another case re-stenosis occurred six months after the stenting.Conclusion Percutaneous endovaacular stent angioplasty is a safe and effective treatment for symptomatic stenosis of middle cerebral artery,although its long-term results need to be further evaluated.

Objective To study the characteristics of patients with low body mass index (BMI) chronic obstructive pulmonary disease(COPD). Methods A total of 38 clinically stable patients with moderate-to-severe COPD were enrolled. They were divided into two groups: underweight (UW) group (n=16,BMI<20);normal weight(NW) group(n=22, 20≤BMI<26). Body height and weight, smoking indexs, and six minutes walk distance (6MWD) were assayed. The British Medical Research Council (MRC) dyspnea scale was used to assess the degree of dyspnea. St. George's Respiratory Questionnaire (SGRQ) and Short Form 36 item Questionnaire (SF-36) were used for health-related quality of life (HRQoL) evaluation. The serum concentrations of leptin and ghrelin were detected by enzyme-linked immunosorbent assay (ELISA). Results Compared with the NW group, the inspiratory eapacity(IC), forced expiratory volume in one second (FEV), vital capacity (VC) ,most ventilate volume (MVV) and peak expiratory flow(PEF) were lower(P<0. 05) in the UW group. Residual volume-to-total lung capacity ratio (RV/TLC), smoking indexs and MRC score were higher (all P<0. 05) and 6MWD was significantly lower (P<0. 05) in the UW group than in NW group. Activity scores,impact scores and total scores of SGRQ showed significant deterioration in the UW group (P<0. 05). SF-36 also showed significantly worse scores for the parameters of the emotional and social functioning (P < 0. 05 ). Serum leptin was significantly lower ( P< 0.01 ) and ghrelin was higher in UW group than in NW group (P<0. 05). Stepwise multiple regression analyse showed that lC,mental health(MH) and physical function (PF) of SF-36, leptin,6MWD and smoking indexs were independently correlated with BMI. Conchtsions The pulmonary function, nutritional status, PF and life quality of COPD patients with low BMI were more deteriorative. The most significant influencing factor for BMI in COPD patients was IC. M H,exercise capacity,leptin level and smoking indexs were independently correlated with BMI in COPD patients. It is important to retrieve low BMI in the management of COPD patients.

Objective To explore the anatomic character of brachial plexus nerve by ultrasonography,and provide a basis for ultrasound-guided brachial plexus block.Methods Twenty-four healthy volunteers were chosen for high-frequency sonography examination,the features of brachial plexus distributions were studied in the axilla location and the interscalene location.Results Brachial plexus of all the 24 cases were detected.At the axilla level,main braches of brachial plexus nerves were very close to the axillary artery.At the interscalene level,the brachial plexus was consistently found between the scalenus anterior and medius muscles in the interscalene groove.Conclusions Using high-frequency sonography,the main braches of brachial plexus can be observed clearly.