Objective To test the hypothesis that even low-grade microalbuminuria(LGAU) could predict subclinical target organs damage in untreated essential hypertensive(EH) patients.Methods Three hundred and one patients with EH were classified into three groups according to morning urine albumin concentration(MUAC): normoalbuminuria(NAU) group(n=107,MUAC

Objective To investigate the relationship between low-grade albuminuria and unfavourable cardiac geometric adaptations and left ventricular diastolic dysfunction in non-treated essential hypertensive(EH ) patients. Methods Three hundred and one patients of EH were divided into three groups acording to morning urine albumin concentration ( MU AC ): normoalbuminuria (NAU) group ( 107 cases,MUAC ＜ 10 mg/L) ;low-gradealbuminuria (LGAU) group ( 127 cases, MUAC 10-30 mg/L); microalbuminuria (MAU) group (67 cases, MUAC ＞ 30 mg/L). The blood pressure,body height and weight was measured for all the patients. The serum creatinine (SCr),blood urea nitrogen (BUN), uric acid (UA),fasting plasma glucose (FBG), plasma glucose 2 hours after oral glucose load (2hPG), total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer.Echocardiogram exarmination was performed to detect left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic posterior wall thickness (LVPWT) and interventricular septum thickness at end-diastole (IVST). Color Doppler ultrasound was used to measure indicators of left ventricular diastolic function, including peak E velocity of mitral diastolic flow (E) and peak A velocity of mitral diastolic flow ( A ), calculated E/A, measured the deceleration time of peak E ( DT ), and isovolumic relaxation time (IV RT ).Left ventricular mass index (LVMI) and relative wall thickness(RWT) were calculated by formula, and LVMI,RWT,left ventricular configuration diastolic dysfunction was compared. Results The level of MUAC had positive relationship with LVMI (r = 0.43 ,P ＜ 0.01 ). Compared with that in NAU group, IVST, LVPWT,RWT, LVMI increased (P ＜ 0.01 ), the ratio of left ventricular normal configuration decreased (P ＜ 0.01 ), the incidence of concentric reconstitution, concentric hypertrophy increased (P ＜ 0.05 ), A increased (P ＜ 0.05 ),and E/A decreased (P ＜ 0.01 ) in LGAU group. The total incidence of left ventricular diastolic dysfunction was 28.6%(86/301 ),12.1%(13/107),33.9%(43/127) and 44.8%(30/67)in NAU group,LGAU group and MAU group. The incidencerates of left ventricular diastolic dysfunction in LGAU group and MAU group were higher than that in NAU group (P ＜ 0.01 ). Conclusion LGAU is positively related to incidence of unfavourable cardiac geometric adaptations and left ventricular diastolic dysfunction in EH patients.

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.

Objective To investigate the significance of calcification in thyroid node for diagnosis of thyroid carcinoma.Method Retrospective analysis of 107 thyroid nodules' pre-operative ultrasonic and postoperative pathologic results.Results Total ultrasonic thyroid calcification ratio was 27.1%(29/107),which in benign samples was lower than Ihat in malignant samples(17.2%vs 70.0%,P＜0.01).Micro-calci-fication ratio in benign samples Was lower than thai:in malignanl samples(8.0%vs 50.0%,P＜0.01).Conclusion The ralio of thyroid carcinoma with calcification is higher,so the detection of thyroid carcinoma,especially micro-single-calcification should be significant.

Objective To evaluate the clinical efficacy of long-pulsed 1064 nm Nd ∶ YAG laser combined with intralesional injection of triamcinolone in the treatment of keloids.Methods A total of 78 cases were randomly divided into two groups.The treatment group was treated with long-pulsed 1064 nm Nd ∶ YAG laser combined with intralesional injection of triamcinolone.The control group was only given intralesional injection of triamcinolone.The efficacy and adverse reactions were determined at the end of the first and the second course,respectively,and follow-up for one year was conducted in order to observe the recurrence.Results When the first course was over,cure rate of 21.95 ％ and efficiency rate of 73.17 ％ were observed in the treatment group,while they were 10.81％ and 45.95 ％,respectively,in the control group; the efficacy rate was statistically significant different in these two groups (P＜0.05).After two courses,cure rate of 70.73 ％ and efficiency rate of 100 ％ were observed in the treatment group while they were 45.95 ％ and 83.78 ％,respectively,in the control group,showing that both of the rates were statistically higher in the treatment group (P＜0.05).Conclusions Compared to intralesional injection of triamcinolone,long-pulsed 1064 nm Nd ∶ YAG laser combined with injection of triamcinolone has a more satisfactory effect on keloids.

Objective To explore the value of retinoblastoma binding protein 4 ( RBBP4 ) in diagnosing prostate cancer ( PCa).Methods From January 2015 to December 2015, the prostate tissue after prostatectomy were collected and the differentially expressed degree of RBBP4 protein was analyzed in PCa and adjacent tissues by 2D-DIGE technology.The RBBP4 score of prostate tissue chip which contains 3 normal prostate tissues, 7 cancer adjacent normal prostate tissues, 50 adenocarcinoma and 20 hyperplasia tissue was checked by immunohistochemistry( IHC).In 50 patients with PCa, 4 cases were less than 60 years old and 46 cases were more than 60 years.In those patients, the Gleason scores were less than 7 scores in 18 cases, and more than 7 scores in 30 cases.22 cases were confirmed less than Ⅱ stage, and 28 cases were confirmed more than Ⅲ stage.Finally, the RBBP4 IHC score and the clinic-pathological parameters such as age, Gleason score and clinical stage of PCa patients were analyzed together.Results We found that the protein of RBBP4 increased by 2.15 times in PCa tissues compared to adjacent tissues by using 2D-DIGE technology( P=0.008).The expression of RBBP4 was higher than that in benign tissues by IHC ( F=43.972,P=0.000).And the expression of RBBP4 was positive correlation with Gleason score( t=5.589, P=0.000) and clinical stage(t=5.620,P=0.000), but was negative correlation with age(t=1.125,P=0.266).Conclusions The detection of RBBP4 can help to separate PCa from benign tissues.The overexpression of RBBP4 might result in the rapid growth of malignant cells.It may have certain value in determine the clinical staging and pathological grading of PCa.

Objective To explore the effects of different doses of sodium fluoride (NaF) on cartilage lesion and expression of interleukin-6 (IL-6) in serum and cartilage tissue of Balb/c mice.Methods Sixty-four 5-week-old male Balb/c mice were divided into 4 groups based on body weight via the random number table method and 16 mice were in each group.The mice in control group were fed with distilled water,and experimental animals in low,middle and high fluoride groups were fed with distilled water containing NaF 25,50 and 100 mg/L,respectively.The mice were weighed once a week and fed for three months to establish the drinking water fluorosis model.The fluoride contents in spine were detected via the fluorin-ion selective electrode method.The pathological changes in articular cartilage and epiphyseal plate cartilage were observed through optical microscope.The levels of serum IL-6 and souble IL-6 receptor (sIL-6R) were detected via the enzyme-linked immunosorbent assay.The expression of IL-6 protein in articular cartilage and epiphyseal plate cartilage was examined by immunohistochemistry.Results From the sixth week of the experiment,compared with other 3 groups,the body weight of high fluoride group decreased significantly (all P ＜ 0.05);from the seventh week,compared with control and low fluoride groups,the body weight of middle fluoride group decreased significantly (all P ＜ 0.05);throughout the experiment,compared with control group,the body weight of low fluoride group had not changed significantly (all P ＞ 0.05).The fluoride contents of bone in control group,low fluoride group,middle fluoride group and high fluoride group were (842.46 ± 89.27),(1 705.05 ± 105.76),(2 614.17 ± 156.10) and (3 444.58 ± 233.69) mg/kg,respectively.The differences between groups were statistically significant (F =309.716,P ＜ 0.05),and fluoride contents of bone increased with increase of fluoride doses (all P ＜ 0.05).Under optical microscope,the cartilage tissue of control group was normal,while articular cartilage and epiphyseal plate cartilage showed different degrees of cartilage ossification in fluorosis mice and the changes increased with the increase of fluoride doses.The levels of serum IL-6 in control group,low fluoride group,middle fluoride group and high fluoride group were (5.98 ± 1.43),(7.54 ± 2.16),(5.25 ± 1.97) and (6.31 ±-1.36) ng/L,respectively.The differences between groups were statistically significant (F =3.840,P ＜ 0.05),low fluoride group was significantly higher than control group (P ＜ 0.05),and middle fluoride group was significantly lower than low fluoride group (P ＜ 0.05).The levels of serum slL-6R in control group,low fluoride group,middle fluoride group and high fluoride group were (0.83 ± 0.20),(0.93 ± 0.23),(0.82 ±0.27) and (0.92 ± 0.28) μg/L,respectively.The differences between groups were not statistically significant (F =0.738,P ＞ 0.05).Immunohistochemical results showed that articular cartilage full-layer cells in each group expressed IL-6 protein especially in the middle layer of chondrocytes,while IL-6 protein only expressed in hypertrophic chondrocytes of epiphyseal plate cartilage.Comparing with other groups,IL-6 positive cells were the most and had the deepest staining in low fluoride group.Conclusions Different doses of NaF could not only cause cartilage lesion,but also change the expression of IL-6 in serum and cartilage tissue of Balb/c mice.The results indicate that IL-6 may be involved in the cartilage lesion caused by fluoride.

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.

Objective To investigate the effects of fluoride on trabecular bone of the tibia and lumbar in BALB/c mice.Methods Totally 64 four-week-old BALB/c mice were randomly divided into 4 groups by weight,16 per group:control group (treated with distilled water) and 3 sodium fluoride (NaF) exposure groups (treated with NaF at 25,50 and 100 mg/L F-),respectively.At 12 weeks,mice were killed and blood,two hind limbs and lumbar were collected.Bone fluoride content and incidence rates of dental fluorosis were determined.Serum content of alkaline phosphatase (AKP) and acid phosphatase (ACP) were detected by micro enzyme labeled method.The ultrastructure of osteoblasts and osteoclasts in lumbar were observed via transmission electron microscope.The pathological changes of the trabecular bone of the tibia and the lumbar were observed under optical microscope,the percentage of trabecular area (％Tb.Ar) was measured with Image-Pro Plus (IPP) software.Results Bone fluoride contents of low,middle and high fluoride groups [(1 828.62 ± 102.93),(3 308.27 ± 185.63),(4 933.36 ± 301.16) mg/kg] were higher than that of the control group [(775.23 ± 92.56) mg/kg,all P ＜ 0.05].The incidences of dental fluorosis in the 4 groups were 0(0/16),47％(7/15),93％(14/15) and 100％(16/16),respectively;the difference was statistically significant (x2 =27.23,P ＜ 0.05).In middle and high fluoride groups,serum AKP [(18.30 ± 1.99),(24.50 ± 3.14) king unit/100 ml] and ACP [(11.97 ± 1.73),(11.31 ± 1.46) king unit/100 ml] were significantly higher than those of control [(14.63 ± 1.21),(9.07 ± 1.47) king unit/100 ml,respectively,all P ＜ 0.05].Under the electron microscope,osteoblast had developed organelles in each fluoride group,rough endoplasmic reticulum,Golgi body,and mitochondria were abundant,and nucleolus was obvious in the osteoblast.Osteoclast was rich in mitochondria,ruffled border clear and distributed phagocytic vacuoles in low fluoride group and middle fluoride group.Compared with the control group (17.03 ± 3.73),HE staining of tibia ％Tb.Ar in high fluoride group (28.79 ± 8.26) was significantly increased (P ＜ 0.05).The lumbar spine ％Tb.Ar in low,middle and high fluoride groups (15.87 ± 2.59,18.28 ± 0.89,21.99 ± 1.81) were higher than that of the control group (12.06 ± 1.76,all P ＜ 0.05].Conclusions BALB/c mice could be used as a model of skeletal fluorosis.Osteoblast and osteoclast are activated in BALB/c mice with skeletal fluorosis.Bone formation is more obvious than bone resorption and bone mass is increased.What is more,bone mass has increased more significantly in the lumbar spine of mice.

Objective To explore the correlation between depressive symptoms and frailty,in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients.Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5),and frailty was identified by the frailty phenotype method.Results In all respondents,50 (20.2 ％)patients showed depressive symptoms,93(37.5 ％)patients had pre-frailty and 39 (15.7 ％)patients had frailty.Correlation analysis showed that frailty degree,low grip strength,slow gait speed,low physical activity,fatigue,and weakness were all positively correlated with depressive symptoms in elderly inpatients (r =0.441,0.315,0.426,0.316,0.395 and 0.151,respectively,P ＜ 0.05).Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms (OR=2.608,P＜0.05).Of the 5 indicators of frailty,slow gait speed and frailty also increased the risk of having depressive symptoms (OR =2.801 and 3.484,P ＜ 0.05).Conclusions Frailty degree,gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.