Objective To investigate the therapeutic effects of Tongxinluo and its influence on the expression of CD40 and CD40L in artherosclerosis rabbits. Methods 60 male rabbits were divided into three groups randomly,20 of each group: normal control group, model group and Tongxinluo group. The rabbits in model group and Tongxinluogroup were used to prepare the atherosclerosis model induced by high-cholesterol diet. The levels of ET-1, NOwere measurde. Before and 12 weeks after durg treatment,serum total cholesterol ,plaque areas and ratios of intima/media thickness were detected. The expression of CD40 and CD40L mRNA were determinated by quantitive RT-PCR. Results Serum total cholesterol level of Tongxinluo group was decreased compared with model group ( P < 0. 05 ), and they were both much higher than those of normal control group ( P < 0. 01 ); as compared with the model group, aortic plaque areas and ratios of intima/media thickness in Tongxinluo group reduced significantly [ (0.56 ± 0. 07) vs ( 1.16±0.08),P<0.01;(36.88±2.38)% vs (76.58 ±2.86) %,P <0. 0l] ;The expression of CD40 and CD40L mRNA also decreased in Tongxinluo group with statistic significance[ (0.798 ± 0.115 )、 (0. 592 ± 0. 132) vs (0.686±0. 132) 、(0.498 ±0. 108) ,P <0. 01 ) ]. Conclusion Tongxinluo had the ability to anti-artherosclerosis and its possible mechanism was down-regulate the expression of CD40 and CD40L.

Objective To establish normal reference ranges for serum cystatin C (Cys C)in relatively healthy middle-aged and elderly(＞50 years)Chinese individuals.Methods A total of 1087 candidates were consecutively selected and serum Cys-C levels were measured by transmission turbidimetry.Frequency analysis and histogram were used to establish the 95％ confidence reference range according to methods provided by CLSI (C28-A2).Results Based on the definition and verification procedures for clinical laboratory reference ranges(CLSI C28-A2,second edition),Cys-C levels of 1087 participants fell within the range of 0.30-1.55 mg/L;Male participants had higher serum Cys-C levels than female participants(Z=-10.19,P＜0.01).The serum Cys-C level increased with age,regardless of gender(R =0.600,P＜ 0.01).Differences in Cys-C levels between age groups were statistically significant (x2=411.17,P＜ 0.01).The reference ranges of normal serum Cys-C levels for different age groups (50-,55-,60-,65-,70-,75-,) were 0.42-0.98mg/L,0.45-1.04mg/L,0.47-1.34mg/L,0.46-1.38mg/L,0.61-1.33mg/L,0.61-1.28 mg/L,respectively,for males,and 0.39-0.94mg/L,0.42-1.01mg/L,0.40-0.91mg/L,0.46-1.03mg/L,0.57-1.04mg/L,0.55-1.27mg/L,respectively,for females.Conclusions This study established preliminary normal serum Cys-C reference ranges for healthy middle-aged and elderly(＞ 50 years)individuals in this region,which can serve as parameters for disease diagnosis and treatment evaluation.

Objective:To explore the prognostic value of CysC and NT‐proBNP in patients with non‐ST elevation a‐cute coronary syndrome (NSTE‐ACS) .Methods :A total of 166 NSTE‐ACS patients hospitalized in our hospital from Jan 2012 to Dec 2012 were selected .They were followed up for 12 months ,then general data ,levels of CysC , NT‐proBNP ,hsCRP and cTnI etc .and incidence rate of MACE were recorded and measured .According to MACE occurrence during follow‐up or not ,156 cases were divided into non‐MACE group (n=137) and MACE group (n=19) ,risk factors for MACE in NSTE‐ACS patients were analyzed ,receiver operator characteristic curve (ROC) was performed ,and the optimal cutoffs of related indexes predicting MACE occurrence in these patients were analyzed . Results :Compared with non‐MACE group ,there were significant rise in age [ (60.26 ± 10.45) years vs .(64.16 ± 11.21) years] ,levels of CysC [ (1.02 ± 0.11) mg/L vs .(1.15 ± 0.12) mg/L] ,NT‐proBNP [ (251.97 ± 89.65) pg/ml vs .(347.93 ± 107.29) pg/ml] ,hsCRP [ (14.69 ± 3.53) mg/L vs .(17.13 ± 3.68) mg/L] and cTnI [ (0.36 ± 0.46) ng/ml vs .(0.90 ± 0.88) ng/ml] in MACE group ,P<0.05 or <0.01. Multi‐factor regression analysis indica‐ted that CysC ,NT‐proBNP and cTnI levels were independent predictors for MACE in NSTE‐ACS patients ( P<0.05 or <0.01) .ROC curves of CysC ,NT‐proBNP ,cTnI and hsCRP judging prognosis were drawn , only AUC of CysC and NT‐proBNP curves were >0.7 [CysC:0.784 ,95% CI:0.687~0.881 ;NT‐proBNP:0.753 ,95% CI :0.639~0.867] , and it′s analysis indicated that CysC=1.07 mg/L and NT‐proBNP=279.60 pg/ml were their optimal cutoff predicting MACE .Kaplan‐Meier survival curves with above two cutoffs as risk stratification cutoff indicated that survival time of high risk group was significantly shorter than that of low risk group (P<0.05) .Conclusion:Serum CysC and NT‐proBNP levels are independent predictors assessing prognosis in NSTE‐ACS patients .

OBJECTIVETo compare the effect of the two methods of back propagation network (BPN) test on TCM syndrome typing of depression.

METHODSTest was carried out by two methods as following: (1) Cross train-test method: 1731 patients with depression typed to 5 syndrome types were randomly divided into 2 groups, and they were trained and tested in turn; (2) Round-Robin method: Test was conducted in an altered cycle mode, that is, in a cycle, one out of the 1731 patients were selected to be tested, while the others were trained, the next cycle started when the test on the selected patient was finished and another one for test was selected. In this way, one cycle after the other, until all patients had been tested.

RESULTThe total training sensitivity of the two methods was 97.9% and 98.2% respectively, and the total testing sensitivity was 72.7% and 74.2% respectively.

CONCLUSION(1) The five TCM syndrome types of depression could be well differentiated by BPN, which is valuable for TCM syndrome typing in certain extent; (2) The sensitivity of Round-Robin method is slightly higher than that of Cross train-test method, but in comparison between them no remarkable significance was shown.

Adolescent ; Adult ; Depressive Disorder ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Neural Networks (Computer) ; Sensitivity and Specificity

OBJECTIVETo assess the value of contrast-enhanced ultrasonography (CEUS) and fluorodeoxyglucose positron emission tomography-computed tomography (¹⁸F-FDG PET/CT) in evaluating the stability of carotid atherosclerosis.

METHODSSeventeen patients with 21 carotid artery plaques received examinations with CEUS. According to the nature of the plaques, the patients were divided into soft and mixed plaque group and hard and calcified plaque group. The maximal enhancement intensity of the plaques (I(MAX)) and maximal plaque density (D(MAX)) were measured to quantify the neovasculature. The patients also underwent concurrent ¹⁸F-FDG PET/CT, and ¹⁸F-FDG uptake was quantified by the mean standard uptake values (SUV(mean)), an index reflecting the inflammatory activity in the plaque. The findings in CEUS and PET/CT were comparatively analyzed for these cases.

RESULTSThe D(MAX) of the plaque in soft and mixed plaque group was significantly greater than that in hard and calcified plaque group (4.26±3.65 vs 1.41±1.47, P<0.05); the I(MAX) was also greater in the former group, but this difference was not statistically significant (26.83±19.61 vs 24.73±29.85, P=0.869). The soft and mixed plaques tended to have higher SUVmean than the hard and calcified plaques (1.70±0.45 vs 1.47±0.12, P=0.099). The values of I(MAX) and D(MAX) were not found to correlate to SUV(mean) in these patients.

CONCLUSIONCEUS can sensitively show the status of neovascularization within the carotid atherosclerosis plaques, and PET/CT reflects the inflammatory activity in the plaques. The combination of these two imaging modalities allows the evaluation of plaque stability in terms of neoangiogenesis and inflammatory activity.

Aged ; Aged, 80 and over ; Carotid Stenosis ; diagnostic imaging ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.