Objective To compare the placement of peripherally inserted central catheters(PICC)by using vascular ultrasound guidance system and traditional method.Methods Totally 938 patients undergoing PICC were divided into the traditional method group and the vascular ultrasound system and microintroducer techniques group according to the puncture time.The differences in the one-attempt success rate and the overall success rate of the placement and the incidences of complications were compared between the two groups.Results The one-attempt success rate was 93.01％ in the traditional method group and 98.76％ in the vascular ultrasound system and microintroducer techniques group(P =0.005).The successful rate of PICC placement was 100％.The incidence of complication was 11.29％ in the traditional method group and 2.47％ in the vascular ultrasound system and microintroducer technique group(P =0.000).Conclusion The PICC placement using vascular ultrasound guidance system and microintroducer techniques can increase one-attempt success rate and decrease complications.

Objective To investigate the health-related quality of life (HRQOL), demographic characteristics, and health behaviors of the Chinese elderly to find out high-risk population and behaviors. Methods Data was collected from a cross-sectional survey performed in Jiangsu, Anhui, Gansu,Qinghai, Fujian, Beijing, Jilin, Jiangxi, and Henan province. MOS SF-36 was used for HRQOL assessment, t test was used for HRQOL comparison between the elderly and the general population. Multiple stepwise linear regression analysis was used to evaluate the affecting factors. Results The HRQOL among the Chinese elderly were PF ( Physical Functioning) 79 ± 21, RP ( Role-Physical ) 68 ± 40, BP ( Bodily Pain) 72 ± 23, GH ( General Health) 57±22, VT ( Vitality ) 69 ± 20, SF ( Social Functioning) 79 ± 23, RE ( Role-Emotional ) 72 ±40, M H ( Mental Health)76 ± 18, which were lower than Sichuan Norm on 7 dimensions ( P ＜ 0. 05 ; except on M H dimension) and lower than Hangzhou Norm on 5 dimensions (P ＜ 0. 05 ;except on GH, VT, and MHdimensions). The important affecting factors included physical exercise, education level, medical history of chronic disease, age, race, marriage, body mass index ( BMI ), sleeping habits, and gender. Conclusions Compared with the general population, the HRQOL in the elderly might be lower. The health policy and community heahhcare services should focus on the elderly individuals with insufficient exercise, lower education level, chronic disease history, and ethnic minority, or widows. Health education should encourage them to improve physical exercise and sleeping behavior.

BACKGROUND: Multiple sclerosis(MS) is a chronic autoimmune disease induced by the interaction between genetic and environmental factors. Its pathogen and the mechanism of the relapse and remission m the course of the disease are still unknown. Most of the MS research centers are looking for the pathogenic polypeptide epitope in proteolipid protein(PLP), myelin sheath basic protein (MBP) and oligodendrocyte glycoprotein (MOG) OBJECTIVE: To compare the proliferation of T cell lines(TCL) in MS induced by myelin sheath and delipidated myelin sheath towards 11 components of myelin sheath to mainly search the possible pathogenic polypeptide epitope in PLP, and investigate the possible effects of abnormal dcgrease in myelin sheath.DESIGN: A case-controlled trial.SETTING: Department of neurology in a hospital of a university.PARTICIPANTS: Mononuclear cells(MNC) of 16 MS cases(clinical relapsing-remitting type, patients did not receive any immunosuppresant for at least 3 months when their peripheral blood samples were taken) and 12 HLA-DR15 healthy volunteers were furnished by Dr. Trotter JL of MS Research Center of Washington University from the cell database.INTERVENTIONS: MS-TCL and normal TCL were induced twice by stimulation with myelin sheath and delipidated myelin sheath in vitro by cell culture in vitro. TCL proliferation was tested by 11 antigens including PLP,MBP, M87-106, P30-49, P40-60, P89-106, P95-117, P117-137,P139-151, P178-191, and P185-206.MAIN OUTCOME MEASURES: Difference of scintillation counting in every minute of every well, and the stimulative index of each well were calculated, and the mean wells with positive proliferation of TCL towards each antigen were confirmed as well.RESULTS: The general specific proliferation towards myelin sheath antigens was bigger in MS group than control group 5.49 ±5.31 to 3.10 ± 3. 17, and delipidated myelin sheath-induced TCL was bigger than myelin sheath-induced one 5. 49 ± 5.31 to 3.41 ± 4. 83 . Delipidated myelin sheath significantly changed the immune responses of MS group,especially the changes of responses towards P30-49, P40-60, P89-106,P117-137, P139-161, and P185-206 were significant compared with that the control group only responded to two polypeptides, which indicated that the antigen epitope of MBP, PLP, M87-106, P95-117, P40-60, and P185-206 might have significance in the triggering of MS autoimmune responses.CONCLUSION: TCL induced by MS myelin sheath has different proliferation towards antigen components of myelin sheath from control group. Delipidated myelin sheath significantly increases TCL proliferation in MS group, which suggests that if MS patients developed abnormal degrease in myelin sheath, TCL would produce autoimmune response towards self-myelin sheath, MBP, PLP and its polypeptide segments all can trigger MS or aggravate the state of the illness. Our finding supports the hypothesis of MS autoimmune pathogenic mechanism.

Objective To explore the effect of execution sheet for health education in chronic heart failure (CHF) patients. Methods About 50 CHF patients hospitalized from October 2015 to December 2015 were assigned as the control group and another 50 CHF patients hospitalized from January to March 2016 were set up as the experiment groups. The control group was instructed by the regular health education and the experiment group was instructed by the execution sheet for health education. Results The executive ability in the experiment group were stronger than that of control group (P<0.01). The level of self management among the patients in the experiment group was higher than those of the that control group. Conclusions The health education execution sheet increase the patients' self-management and strengthen nursing ability for discharged patients. It is worthy of popularization in clinical practice.

Objective To analyze the major risk factors of elderly type 2 diabetes mellitus (T2DM) complexing with coronary heart disease(CHD) via principal component analysis (PCA).Methods The clinical data of 503 subjects aged ＞ 60 years with T2DM were retrospectively analyzed.Urinary albumin excretion rate(UAER) from urine collected from 10:00 PM to 6:00 AM was measured by chemiluminescence.The degree of angiostegnosis was evaluated by Judkins coronary arteriography and Gensini score. According to UAER level, the patients were divided into microaibuminuria group (20 mg/L＜UAER＜200 mg/L,n= 226) and normal urinary albumin group (UAER＜20 mag/L,n=277).PCA was used to discuss the major risk factors to affect T2DM patients with CHD in the elderly. Results Characteristic values of the principal component from first to seventh were all more than 1,their cumulative rate was 64.7％. The first to fourth principal components and their variances were UAER(14.1％),blood fat (11.8％),blood pressure(10.2％)and uric acid( 8.7 ％),respectively.The fifth to seventh principal components were all blood glucose and the cumulative variance was 19.8％.The numbers of angiostegnosis were 36.5G％ single,34.7％double and 28.9 ％ three in patients with normal urinary albumin,while1(10.2％) single,27.9％ doubleand 61.9％ three in patients with microalbuminuria,respectively(P＜0.05).The Gensini scores was increased in microalbuminuria group (50.7± 35.8) as compared with normal urinary albumin group (19.74±23.0) (P＜0.05). UAER was independently related to Gensini scores (β=0.442,P=0.000). Conclusions UAER is the most important factor of elderly T2DM complexing with CHD and positively correlated with severity of CHD as its independent factor.

Objective To investigate the expression of Toll-like receptors(TLRs) in condyloma acuminatum(CA) lesions and their possible roles in the pathogenesis of CA. Methods The expressions of TLR1-10 mRNA level in the lesions of CA and in the cervix scrape cells from the patients with human papillomavirus(HPV) negative chronic cervicitis were detected by real-time quantitative fluorescent PCR. HPV typing was detected by HPV GenoArray test kit. Results Low-risk HPV type 6 and type 11 were the most prevalent types in the forty CA cases with positive rate of 77.5% and 55% respectively. 55% CA patients were found infected with more than two types of HPV. 35% CA patients were concurrently infected with high-risk HPV. The expressions of TLR3, 7, 8 mRNA were higher than other TLRs and the expression of TLR9 mRNA was lower than others in the lesions of CA. No significant differences of the TLR1-10 mRNA levels were found between HPV6 and HPV11 positive CA lesions, so did it between low-risk and high-risk HPV concurrent infected CA lesions. The expressions of TLR1-3, TLR5-8, TLR10 mRNA, especially TLR2, TLR7 and TLR8 in the lesions of CA were significantly higher than that in cervix scrape cells of HPV negative chronic cervicitis. There were no significant differences of TLR4 and TLR9 mRNA levels between the two groups. Conclusion There were higher expressions of some TLRs (3, 7, 8) and lower expression of TLR9 in the lesions of CA. Compared with HPV negative chronic cervicitis, the expressions of TLR1-3, TLR5-8, TLR10 mRNA in the lesions of CA were up-regulated. The expression profile of TLRs in different type of HPV infected CA lesions had no significant differences. Our results suggested that the expression profile of TLRs in CA may be associated with the HPV infection. Whether it was associated with the immune escape mechanism and persistent infection of HPV need further demonstration.

Objective:To assess the feasibility and accuracy of real-time three dimensional echocardiography(RT-3DE) in quantitative evaluation of left ventricular(LV) volume and ejection fraction(EF) in patients with ventricular aneurysm and myocardial infarction.Methods: Twenty-three patients with left ventricular aneurysm combined with myocardial infarction were examined by RT-3DE,two dimensional echocardiography Simpson's method,and M-mode Teichholz method separately.The following parameters: left ventricular end diastolic volume(LVEDV),end systolic volume(ESV),stroke volume(SV) and EF were obtained by each method and the results were compared with those obtained by left ventriculography(LVG).Results: The values of LVEDV,LVESV,SV,and EF determined by RT-3DE showed good correlations with those determined by LVG(r=0.92,0.90,0.88,and 0.91,respectively;P(0.05).) The values of LVEDV,LVESV,SV,and EF determined by Simpson's method also showed good correlations with those determined by LVG(r=0.85,0.87,0.86,0.91,respectively;P

OBJECTIVE: To analyze the effects of Astragalous Injection on oxidative stress and micro-inflammatory status in patients undergoing maintenance hemodialysis (MHD). METHODS: Sixty MHD patients were included and randomized into treatment group and control group, with another 10 healthy volunteers as normal control. The patients in the treatment group were treated with Astragalous Injection and the patients in the control group were treated with normal saline for 12 weeks. A spectrophotometric method was used for the measurement of plasma concentrations of oxidative parameters including advanced glycation end products (AGEs), advanced oxidation protein product (AOPP), malondialdehyde (MDA) and vitamin E (Vit E). The content of C-reactive protein (CRP) was evaluated by enzyme-linked immunosorbent assay. RESULTS: Compared with the normal control group, the plasma levels of AGEs, AOPP, MDA and CRP were significantly increased, while plasma level of Vit E was significantly decreased in MHD patients ( P<0.01). After Astragalous Injection treatment, the plasma levels of AGEs, AOPP, MDA and CRP were decreased as compared with the control group ( P<0.01), while there was no significant difference in plasma Vit E level between the treatment group and control group. CONCLUSION: There exist oxidative stress and micro-inflammation in MHD patients. Astragalous Injection can ameliorate the accumulation of oxidative products and micro-inflammatory status, but it has no significant effect on plasma Vit E level.

After target blood glucose (HbA1C,fasting plasma glucose),serum lipid profiles (total cholesterol,triglyeeride) and control of blood pressure were achieved in 532 patients with type 2 diabetes mellitus, the level of serum uric acid was significantly decreased and the number of case of hyperuricacidemia also reduced (all P<0.01).

OBJECTIVEThis study aims to detect microRNA-17(mir-17) expression on the osteogenic differentiation of advanced glycation end products (AGEs)-stimulated hunman periodontal ligament stem cells (HPDLSCs) and to analyze the influence of these cells on this process.

METHODSHPDLSCs were isolated using limited dilution technique. After osteogenic differentiation occurred, different time points of mir-17 expression in the experimental groups were detected by real time polymerase chain reaction (PCR). The mir-17 overexpression and inhibition were evaluated using cell transfection technique. Differences in gene expressions were detected by real time PCR; differences in protein expressions were analyzed by Western blot.

RESULTSThe mir-17 expression was reduced after osteogenic differentiation occurred at 3, 7, and 14 d compared with that in the control group (P < 0.05). The expression levels of bone sialoprotein (BSP), Runt-related transcription factor-2 (Runx-2)and alkaline phosphatase (ALP) in the experimental groups were lower than those in the mimic control group when mir-17 expression increased. In addition, the protein expression levels of Runx-2 in the experimental groups were lower than those in the control group. The expression levels of BSP, Runx-2 and ALP in the experimental groups were higher than those in the inhibitor control group when mir-17 expression decreased. Likewise, the protein expression levels of Runx-2 in the experimental groups were higher than those in the control group.

CONCLUSIONAGEs inhibit the osteogenic differentiation of HPDLSCs by affecting mir-17 expression.