Objective We conducted a study using MRI and ambulatory blood pressure monitoring(ABPM) to determine whether an inapporpriately low nocturnal blood pressure,or an excess fall in nocturnal blood pressure,might be responsible for lacunar infarct.Method ABPM and Casul blood pressure(CBP) were examined in 35 hypertentives with lacunar infarct( LI） and 33 hypertentives without lacunar infarct as control group.Results There is no significant difference of CBP between two groups.But the mean nighttime systolic blood pressure(nSBP) and diastolic blood pressure(nDBP) in patients with lacunar infarct were significantly smaller than in patients without lacunar infarct.The ratio of nSBP/dSBP and nDBP/dDBP in SI were smaller than in control group respectively.Conclusions The results indicate that an inappropriately low nocturnal blood pressure,or an excessive fall in nocturnal blood pressure,is associated with lacunar infarct.It is necessary not only to controlhigh blood pressure but also to pay attention to circadian changes of blood pressure during the course of anti-hypertensive treatment.

Objective To compare the value of pacemaker implantation using the subclavian vein (SCV) puncture and thecephalic vein(CV) cutdown approach.Methods One hundred and forty-six patients were randomized into SCV group (98 patients) and CV group (48 patients).We observed the success rate,surgery duration,fluoroscopy time and complications of the two groups.Results The SCV group had significantly higher success rate,shorter duration of surgery and fluoroscopy than the CV group (success rate:100％ (98/98) vs.89％ (43/48),x2 =10.5,P ＜ 0.05 ; duration of surgery:(118 ± 35) min vs.(256 ± 75)min,t =12.12,P ＜0.01 ; duration of fluoroscopy:(15 ±5) min vs.(35 ± 10) min,t =13.08,P ＜0.01).Both groups had one case who developed compilations which were pocket hematoma and wire electrode dislocation respectively.The rate of complications was not significantly different between the two groups (P ＞ 0.05).Conclusion The SCV approach should be considered a preferable access in pacemaker implantation.

Objective To observe the variation of helper T cell (Th)9/regular T cell (Treg cell) balance in the inflammatory process of hepatitis B virus (HBV) infection.Methods Two hundred patients with chronic HBV infection in Zhejiang Hospital of Integrated Traditional and Western Medicine during August 2011 to June 2012 were divided into four groups according to alanine aminotransferase (ALT) levels.:chronic HBV carriers,chronic hepatitis B (CHB) with mildly [upper limit of normal (ULN)＜ALT＜3 × ULN],moderately (3 × ULN＜ALT＜5 × ULN),or significantly (ALT＞5 × ULN) elevated ALT,with 50 subjects in each group.In addition,30 healthy volunteers were enrolled as healthy controls (HC).ALT levels,HBV DNA,and Th9/Treg levels were measured by automatic biochemical analyzing equipment,real-time fluorescent quantitative polymerase chain reaction and flow cytometry,respectively.Th9/Treg levels of each group were observed.Means between groups were compared by t test,means of multiple groups were compared by one-way analysis of variance.Spearman rank correlation was used for correlation analysis.Results Age,sex distribution and HBV DNA levels of the four groups were comparable (P＞0.05).ALT levels of HC were significantly different from those of mildly,moderately,or significantly elevated ALT (t=8.48,18.41,28.93; all P＜0.05).Th9 cell levels,Treg cell levels and Th9/Treg ratio of HBV infected individuals were significantly different from those of HC (P＜0.05).With the increasing degree of inflammation,proportion of Th9 cells increased and Treg cells decreased gradually.The differences among the four groups were of statistical significance (P＜ 0.05).Th9 cell level was positively correlated with ALT (r=0.804,P=0.01),while Treg cell level was negatively correlated with ALT (r=-0.828,P=0.01).Conclusions Th9/Treg is imbalanced in patients with HBV infection,and closely correlated with ALT levels.

Objective This experiment was to analyze the impacts of lip -reading information on hearing im-paired subjects'sentence recognition got in noisy environment in comparing with the results obtained from the listen-ing and audio -visual testing ways .Methods Fourteen moderate hearing impaired subjects with 55 .4 ± 9 .1 years old were postlingual deafness .Their sentence recognition ability were tested in noisy environments with speech and audio-visual information separately (speech intensity :30 dB SL ,SNR:5 dB) .Results Compared with the sentence recognition administered in the speech information condition 73 .79% ± 7 .95% ,the subjects sentence recognition un-der the audio -visual condition was 86 .57% ± 5 .42% ,which was significantly different (P<0 .05) .Conclusion In noisy environment ,lip-reading can improve hearing impaired patients’ sentence recognition obviously .

Objective:To analyze the risk factors for protein-energy wasting(PEW)in elderly patients undergoing hemodialysis(HD)and peritoneal dialysis(PD), in order to provide evidence for the prevention of PEW and improve the prognosis in these patients.Methods:According to the diagnostic criteria for PEW proposed by the International Society for Renal Nutrition and Metabolism, 112 elderly patients who had undergone PD and HD without PEW from May 2016 to June 2020 in the renal medicine department of the Eighth People's Hospital of Shanghai, the geriatric medicine department of Zhongshan Hospital Affiliated to Fudan University and the renal medicine department of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University were included as the non-PEW group.During the same period, 114 cases with PEW were recruited as the PEW group.Differences in general patient data, biochemical test values, anthropometric measurements, bioelectrical impedance and other index values were compared between the two groups.Independent risk factors for PEW in elderly HD and PD patients were analyzed by using binary Logistic regression analysis.Results:Compared with the non-PEW group, the PEW group had a higher mean age( t=0.951, P<0.001), a higher proportion of patients aged ≥65 years( χ2=17.161, P<0.001), a lower body mass index( t=6.740, P<0.001), a higher incidence of diabetic nephropathy( χ2=14.176, P<0.001), a higher hemodialysis rate( χ2=4.543, P=0.033), and a longer duration(months)of dialysis( t=2.306, P=0.023). Levels of serum transferrin, prealbumin, total protein, hemoglobin and total cholesterol and body cell mass index were lower( t=6.262, 13.405, 9.507, 8.341, 4.610, 5.599 and 2.499, all P<0.05), high-sensitivity C-reactive protein levels and the body water percentage were higher( t=6.380, 4.519, both P<0.001), and the upper arm muscle circumference was smaller( t=5.418, P=0.000)in the PEW group than in the non-PEW group.Binary Logistic regression analysis showed that age≥65 years, dialysis duration, serum albumin and high-sensitivity C-reactive protein levels were independent influencing factors for PEW in elderly HD patients( OR=2.762, 0.182, 2.694 and 2.980, P=0.023, 0.007, 0.009 and 0.027). Age ≥65 years, body mass index and the hemoglobin level were independent influencing factors for PEW in elderly PD patients( OR=2.452, 0.671 and 0.962, P=0.013, 0.000 and 0.000). Conclusions:The incidence of PEW is lower in elderly HD patients than in elderly PD patients.Clinical intervention should be carried out based on influencing factors, in order to prevent the occurrence of PEW.

Aim To analyze THANK gene expression in peripheral blood mononuclear cells(PBMC) stimulated with different stimulators and to clone whole length human THANK gene. Methods PBMC were conventionally isolated and cultured in RPMI1640 containing 10％ FCS. After stimulated with LPS,TNF α ,IL 2,IFN γ ,PHA or PMA,the THANK gene expression in PBMCs was analyzed by RT PCR and THANK cDNA was cloned. Result RT PCR detection showed that THNAK gene expressed in PBMCs after stimulated with interferon γ for 3 days, whereas THANK'expression could not be detected after stimulated with LPS,TNF α ,IL 2,IFN γ ,PHA or PMA respectively. Then THANK gene was cloned by cloning PCR product and sequenced. Conclusion Human THANK gene is cloned successfully, thus providing the possibility for further research of THANK'function.

Objective :The study discussed the relationship between the cell differentiation and its func-tion differentiation of enamel organ durrng the development of enamel ,explained the meaning of shape andfunction of SA and RA in the mature enameloblasts. Methods:The rats were fixed with pouring hearts ,em-bed with Epon and GMA resin,made semi-thin slice ,stained with toluidine blue and histochemistry, thenwe observed the changes of histomorphology and the law of distribution of enamel. Results:The develop-memt of tooth germ of rat incisor could be divided into proliferation stage, difference stage and maturestage. Enameloblasts expressed special periodic changes in mature stage :SA legion and RA legion present-ed altermately. Histochemical study indicated that most of amelogenin stayed in enamel matrix and othersdiffused to dentin, dental tube and odontoblast layer. Conclusion: (1) The proliferation stage, differencestage and mature stage of tooth of development of enamel organ in rat were similar to the bud stage ,capstage and bell stage of human being. There was a relationship between the RA legion in mature enam-eloblast and mineral substance pouring into them. RA legion was presented because water and protein lost.)That amelogenin spread into dentin could promote the odontoblast differentiation and induce dentin calci-fication.

Objective To establish high level expression system of exogenous hepatocyte growth factor(HGF) protein in mouse livers by in vivo gene transfection and to observe the inhibition effect of exogenous HGF on hepatocyte apoptosis in mice. Methods Mice were divided into four groups, with 10 mice in each arm, which were injected with control solution, empty pcDNA3 plasmids, pCMV-HGF plasmid or 0.9% sodium chloride solution by tail vein. Enzyme-linked immunosorbent assay(ELISA) was used to determine the peak level and the expression duration of HGF protein in the peripheral blood and liver tissue. Western blotting was performed to measure the Caspase-3, tBid, Bax and Cytochrom C in the hepatocyte homogenatea and mitochondrion. Results HGF protein was detected in the mice blood as early as 4 hours after single injection of pCMV-HGF plasmid. The peak level of HGF protein in liver and plasma was respectively achieved by 8 hours and 12 hours after first injection while HGF protein was still detectable in the blood 6 days after the initial injection. D-Galactosamine/lipopolysaeeharide (LPS) led to obvious hepatocyte apoptnsis and induced an increased concentration of tBid, Bax, Caspase-3 and Cytochrom C in the hepatocyte homogenates and mitochondrion. Compared to sodium chloride control group and empty pcDNA3 protected group, the expression of tBid, Bax, Caspase-3 and Cytochrom C decreased in pCMV-HGF plasmid protecting group. Conclusions Hepatocyte apoptosis can be inhibited by exogenous HGF protein expression in mouse livers, which is induced by in vivo gene transfection. Moreover, it may inhibit the activation of downstream apoptotic proteins by blocking the expression of tBid.

Objective To evaluate the clinical application of serum CYFRA21-1 detection during the diagnosis of lung cancer. Methods Serum level of CYFRA21-1 in 196 patients with lung cancer and 39 healthy controls were determined by the Elctro-chemiluminescence Immuno-assay ( ECLIA) , respectively. Results Serum level of CYFRA21 -1 ( range from 0. 30 μgg/L to 500.00 μg/L) in patients with lung cancer were significantly higher than those in the healthy control ( range from 0. 27 μg/L to 3. 29 μg/L,Z = -4. 65,P < 0.01). ROC analysis of diagnosis efficiency showed that the area under curve ( AUC) was 0. 735 (P < 0. 001 ). The confidence interval of 95% was from 0. 663 to 0. 807. Positive detection rate of CYFRA21-1 was 48. 8% (39/80) in squamous,31.7% (20/63) in adenocarcinoma and 22. 6% (12/53) in small cell lung cancer (SCLC) respectively, as well as total positive rate was 36. 2% (71/196). Stepwise regression analysis showed that serum level of CYFRA21-1 had a linear correlation with the squamous and the metastasis to liver or bone (r =0. 505 ,P <0. 05). Conclusions Serum level of CYFRA21-1 increases the diagnostic sensitivity, which is helpful for determining histological types, monitoring the metastasis of liver and bone, and evaluating the treatment response in patients with lung cancer.

Objective: To prepare highly purified THANK protein. Methods: THANK was efficiently expressed in E.coli as inclusion bodies. After bacteria were lysed under ultrasonication, TE buffer,1% TritonX and 2 mol /L urea was used to efficiently extract inclusion bodies. After denaturation with 8 mol/L urea,THANK was partially purified by Sephacryl S-200 chromatography, and then subsequent refolding step was optimized for a maximal recovery of biological active protein. The renatured THANK was purified to homogeneity with Q Sephadex Fast Flow gel filtration and then desalted by Sephadex G-25 chromatography. Results: The purity of biologically active THANK was above 97% in SDS-PAGE densitometric studies. Conclusion: An effective method of denaturation, renaturation and purification of recombinant THANK is established.