Objective To investigate the levels of serum tHcy and Lp(a)and their association with insulin resistance in patients with type 2 diabetes and CHD. Methods T2DM patients were divided into two groups with CHD and without CHD in addition to normal control.The fasting serum levels of tHcy,Lp(a),FPG and FIns were detected, ISI were calculated，and the correlations among them were analyzed. Results The serum levels of tHcy,Lp(a),FIns,FPG of T2DM plus CHD were significantly higher than those of T2DM without CHD and controls(P<0.01~0.05).ISI was significantly lower in T2DM cases with CHD than those of T2DM cases without CHD and controls(P<0.01). ISI was negatively correlated with tHcy and Lp(a)in T2DM plus CHD group(P<0.05)but not correlated with those in T2DM case without CHD group(P>0.05). Conclusions Detections of the serum levels of tHcy and Lp(a)of T2DM play significant roles in knowing patient condition,guiding clinical treatment and earlier preventing and treating vascular complication of diabetes.

Objective To investigate the effect of establishing external device quality management system in the operating room of primary hospital.Methods 100 pieces external orthopaedic surgical instrument cleaned and packaged by company personnel in 2012 were randomly selected as control group,and 100 packages of orthopaedic surgical instrument cleaned by the professional of our hospital were randomly selected and set as the observation group.The cleaning quality of the two groups were compared.Results The numbers of no blood on the surface,sur-face of the device without rust,instrument storage box no stains,cloth bag no stains in the control group were 92,91, 86,90,respectively,which in the observation group were 99,98,97,98.The cleaning quality improved obviously in the observation group,and there were statistically significant differences between the two groups (χ2 =4.19,471,7.78, 5.67,all P <0.05).Conclusion To establishment of surgical patients external device quality management system in the operating room of primary hospital,standardized management of external devices,can ensure that the management and implementation of quality control of external devices in all aspects and to ensure clinical safety.

Objective To explore the clinical value of wave intensity (WI) in evaluating early changes of cardiovascular function in patients with type 2 diabetes mellitus (T2DM).Methods Thirty T2DM patients without atherosclerosis by conventional ultrasonography were enrolled as case group,while thirty healthy volunteers were enrolled as control group.Two groups were well-matched in age and sex.Both of the case and control groups were taken WI test of carotid artery.The parameters of WI examinations in two groups were measured and compared.Results Compared to the control group,values of arterial stiffness index (β),elasticity modulus (Ep),pulse wave transit velocity (PWVβ),and decelerating wave intensity (W2) were significantly higher in T2DM group (P ＜0.05).Arterial compliance (AC) value was significantly reduced in T2DM group (P ＜0.05).Accelerating wave intensity (W1) value was higher in T2DM group without significant statistical differences (P ＞ 0.05).Conclusions WI technique which can early assess the changes of left ventricular function and vascular elasticity in T2DM patients has important clinical value.

Objective To understand the incidence trend of ventilator -associated pneumonia(VAP)in ICU and to evaluate the effects of the interventions on the incidence of VAP,so as to provide scientific evidences for the prevention of VAP.Methods A study of 149 patients with VAP occurred in the 3 710 patients of ICU before and after intervention during 7 /2010 -12 /2014 in Wujin People's Hospital,Changzhou city was conducted.It was divided into two stages:baseline survey and stem expectations,VAP interventions included:training and education,chlorhexidine oral care and maintain appropriate endotracheal tube cuff pressure,elevated head of bed to up to 30°and improved hand hygiene.Hospital infection control professionals collected the number of patients,basic information,length of hospital stay,days of receiving mechanical ventilation and the VAP incidence data in ICU.And then change of the VAP incidence of the intervention before and after the intervention was compared and evaluation of the effect of combined intervention measures.Results Prospective data from 3 710 patients hospitalized in ICU were collected for an aggregate of 14 831 days,the utilization rate of ventilator was 55.2%.The occurrence of VAP was 149 cases.The average rate of VAP was 18.2 cases per 1 000 ventilator -day.VAP was associated with a crude mortality of 7.56%and with increased ICU LOS of 13.2d.As the results of the interventions,the rate of VAP was decreased from 52.38 /1 000 during 7 /2010 -6 /2011 to 5.71 /1 000 during 1 /2014 -12 /2014.Conclusion The rate of VAP in the inves-tigated ICU has led to a decreased incidence of VAP under the comprehensive interventions.

Objective To establish adriamycin-induced focal segmental glomerular sclerosis(FSGS) mice model,and observe the expressions of and relation between oxidative stress and p38 MAPK signal pathway in renal injury.Methods Eight-week-old male Balb/c mice were randomly divided into FSGS group (n=20) and control group (n=20).In FSGS group mice were intravenously injected with a single dose of adriamycin (0.01 rag/g),and mice in control group were received saline with the same dose.At day 3,7,14,22 and 32,urine protein-to-urine creatinine ratio (P/C) was detected.At day 22 and 32,serum creatinine,blood urea nitrogen,nitric oxide (NO) and reactive oxygen species (ROS) in blood and urine,and ROS in kidney tissues were detected;changes of pathological morphology in renal tissue were analyzed by HE stain;the expressions of NF-κB,CD36,IL-13,BAX and Bcl-2 mRNA were detected by real time quantitative PCR;the expressions of NF-κB,p-p38 and p-ERK1/2 protein were detected by Western blotting.Results Compared with that in control group,P/C was gradually increasing in FSGS group,and peaked at day 22 (P ＜ 0.05).At day 22 and 32,mice had higher creatinine,serum creatinine,urea nitrogen,ROS and NO in FSGS group than those in control group (all P ＜ 0.05).There were mild hyperplasia of mesangial cells and mesangial matrix,segment with moderate exacerbations,podocytes with significant proliferation,and the capillary loops of the stenosed in the glomerular in FSGS group at day 32.Compared with those in control group,the mRNA expression of NF-κB,BAX,IL-13 and CD36,and the protein expressions of NF-κB and p-p38 MAPK were gradually increased in FSGS group,all showed statistical differences at day 32 (all P＜ 0.05);the expression of p-ERK1/2 was increased at day 22 (P ＜ 0.05) but was reduced at day 32 (P ＜ 0.05).Conclusions Adriamycin has induced FSGS in mice successfully,which may through oxidative stress activating p38,up-regulating NF-κB,increasing the inflammatory cytokines and inducing apoptosis pathways.

Objective: To explore the effects of thiazolidinediones pioglitazone on the mRNA expressions of adiponectin and its receptor in human adipocytes.Methods: We obtained omental adipose tissue biopsies from patients undergoing elective open-abdominal surgery,performed primary culture and differentiation induction of the human preadipocytes,treated them with pioglitazone at different concentrations,and detected the mRNA expressions of adiponectin and its receptor in them by RT-PCR.Results: The mRNA expressions of adiponectin and its receptor were higher in the pioglitazone groups than in the non-pioglitazone control.Conclusion: Pioglitazone promotes the mRNA expressions of adiponectin and its receptor in human adipocytes.

Objective To investigate the reliability of Berg Balance Scale (BBS) applied in patients with Parkinson's disease (PD). Methods 121 PD inpatients from March to December, 2011 were assessed with BBS by 2 raters, and the testing procedure was videoed. One of the raters assessed with BBS via video 4 weeks later. The intraclass correlation coefficient (ICC) and Kappa coefficient between raters and between tests were investigated. Results The ICC was 1.00 of the total score between raters and 0.99 between tests, while the Kappa co-efficient were 0.66 to 0.93 and 0.69 to 0.99 of the items. Conclusion BBS is reliable in interrater and test-retest as applied in PD patients.

Objective To evaluate the clinical value of CHO-hTSHR cells in detecting thyroid stimulating antibody (TSAb). Methods The cAMP production and TSAb activity were measured and cal-culated by stimulating CHO-hTSHR cell line with IgGs of normal control group and Graves" disease ( GD )group. TSAb positive standard was set to more than the mean + 2SD of TSAb activities in control subjects.The positive percentage of TSAb activity in GD group was calculated. Results The cAMP production and TSAb activities of GD group were higher than those of normal group[( 353. 65±126. 34 ) pmol/L vs (237.21±77. 15)pmol/L, ( 149. 08±53. 26)% vs ( 100±32. 52)%, P <0. 05] . The value that higher than 165% was set to be positive for TSAb. The positive percentage of TSAb in GD group was 50% ( 14/28). Conclusion CHO-hTSHR cell line constructed by our group is suitable for detecting TSAb activity in the sera of patients with GD.

Objective To investigate the imaging characteristics of rabbit liver VX2 tumor with contrast-enhanced ultrasonography(CEUS) and multidetector spiral CT(MDCT), to explore the criterion of phase timing apllicable to the model.Methods CEUS and MDCT were acquired in thirty-three New Zealand rabbits with hepatic VX2 tumors.The initial time of hepatic arterial phase was verified as the time the hepatic artery beginning to enhance,the initial time of portal phase as the time the VX2 tumor reaching peak enhancement and the initial time of hepatic parenchymal phase as the time the hepatic parenchyma reaching peak enhancement.The enhancing characteristics were observed.The time-intensity curve of VX2 tumor and peripheral parenchyma in CEUS was analysed and compared with the time-desity curve of abdominal aorta, portal vein, hepatic parenchyma and tumor in MDCT.Results The initial time of heptic arterial phase,portal phase and parenchymal phase in CEUS and MDCT was (6.82±1.36)s and (9.43±2.23)s,(11.64±2.03)s and (13.77±2.01)s,(20.24±4.17)s and (22.71± 4.58)s,respectively.The initial time of each phase in CEUS was earlier than that in MDCT (P<0.01).The contrast enhancing characteristics in CEUS and MDCT were consistent as fast wash-in and fast wash-out.Conclusions The status of hemodynamic perfusion in rabbit hepatic VX2 tumor could be well displayed by CEUS and the phase timing criterion concluded in this experimental study could offer fundmental theory basis for relevant imaging evaluation.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Biomarkers ; blood ; Child ; Cough ; diagnosis ; drug therapy ; etiology ; Cryptococcosis ; Fever ; diagnosis ; drug therapy ; etiology ; Fluconazole ; administration & dosage ; therapeutic use ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Diseases, Fungal ; complications ; diagnosis ; drug therapy ; Male ; Radiography, Thoracic ; Tomography, X-Ray Computed