Objective To explore the detection value of resistance to thyroid peroxidase(TPO-Ab)antibodies in patients with coronary heart disease.Methods A retrospective analysis was performed on 240 patients with coronary angiography in our hospital from January 2014 to December 2015.Research objects were given coronary angiography examination,4 and 2 positions were projected for left coronary artery and right coronary artery,respectively.Counted the imaging results,and the Gensini score method was used for assessing.Spearman method was used for the correlation analysis.Results of A total of 16 cases were diagnosed with TPO-Ab drops increased,among which 2 case of coronary atherosclerosis and 14 cases of coronary atherosclerotic heart disease.Compared with the TPO-Ab negative patients (17.20-8.85)the Gensini score for TPO-Ab positive patients (39.56 4±10.23)increased significantly(P＜0.05).TPO-Ab and Gensini score has a significant positive correlation (r =0.113 2,95 ％ CI 0.099 8-0.269 1,P＜0.05).Conclusion TPO-Ab increased the risk of coronary heart disease,and more severe coronary artery stenosis in patients with normal thyroid function.

OBJECTIVE To determine the distribution of pathogens of bacterial infection in respiratory intensive care unit (RICU) to provide reference for the prevention of hospital infection. METHODS To collect specimens of the patients received endotracheal intubation from Jan 2006 to Dec 2006 in our RICU,to identify pathogens and drug sensitivity test. RESULTS We isolated 105 pathogenic bacteria from 626 specimens of the 58 patients,the G-bacilli accounted for 64.76%,G+ cocci accounted for 20.95%,fungi accounted for 12.38%; Acinetobacter baumannii was one of the main G-bacilli accounted for 19.05%. Staphylococcus aureus of G+ cocci for 9.52%,and Candida albicans of fungi for 7.62%; from 105 pathogens,65 from the respiratory tract,15 from the for urinary tract,eight from a catheter tube,six from the digestive tract,five from the blood,four from the various drainage tubes and two from the incision secretions. CONCLUSIONS Hospital infection pathogens exist in the respiratory tract infection in hospitalized patients of respiratory ICU with risk factors of age,underlying diseases,time in the intensive care unit,ventilator time and the use of invasive procedures in a certain relationship.

Objective To study the effect and mechanism of the Fosinopril combined with Fenofibrate on the prevent?ing of diabetic retinopathy. Methods A total of 150 viripotent ICR mice(100 male mice, 50 female mice) were randomly di?vided into five groups(n=30), including A group (Sham group), B group (Model group), C group [Fosinopril prevented group, 20 mg/(kg·d)], D group [Fenofibrate prevented group, 400 mg/(kg·d)] and E group (Fosinopril combined with Fenofibrate pre?vented group). The expression levels of Bax and Bcl-2 gene mRNA were determined by RT-PCR method. TUNEL staining method was used to detect the apoptosisi of retinal cells. Results The Bcl-2 mRNA of A group, Bax mRNA of B group were higher than those of other four groups. Bcl-2 mRNA of E group was higher than that of C group and D group, while the Bax mRNA was lower than those of two groups(all P<0.05). The TUNEL index of B group was the highest than other groups, which of E group

Objective To explore the effect of big strain rhodiola injection on levels of leptin and leptin receptor mRNA in serum and liver of rabbit with fatty liver.Methods 120 healthy adult male New Zealand white rabbits were grouped with a random number table method.30 rabbits with normal diet for eight weeks in normal group;90 rabbits in fat group were fed with high fat diet for four weeks to prepare fatty liver model in which 30 rabbits were fed with high-fat diet for four weeks as model group,30 rabbits with high-fat diet and glyburide metformin tablets [150 mg/(kg·d)]for 4 weeks as control group,30 rabbits with high-fat diet and big strain rhodiola injection [40 mg/(kg·d)]for four weeks as experimental group.After the test, levels of serum leptin,hepatic leptin,expression levels of leptin receptor mRNA and levels of liver index were compared among groups.Results Serum leptin and liver leptin in experimental group and control group were all increased to varying degrees,and the serum leptin level [(4.51 ±1.17)ng/mL],liver leptin level [(6.43 ±1.93)ng/mL]of experimental group was lower than that of control group respectively,in which the serum leptin was (7.36 ±1.26)ng/mL and liver leptin was (12.33 ±3.27)ng/mL (P<0.05).Serum leptin and leptin liver receptor mRNA in experimental group and control group were all increased to varying degrees,and the serum leptin mRNA level (0.98 ±0.15),liver mRNA level (1.78 ±0.33)of experimental group was lower than that of control group,in which the mRNA level of serum leptin was (2.57 ±0.29)and liver leptin mRNA levels was (3.31 ±0. 26)(P<0.05).Levels of liver index in experimental group and control group were increased,and liver index of experimental group [(3.98 ±0. 13)%]was lower than that in control group [(4.77 ±0.20)%],and the difference was statistically significant (P<0.05).Conclusion Big strain rhodiola injection could significantly reduce leptin levels in serum and liver of rabbits,reduce expression the leptin receptor mRNA levels and improve liver index,which has guiding significance for the treatment of fatty liver.

Objective:To investigate the role of the expression of E-cadherin(E-Cad) and tissue inhibitor of metalloproteinases-2(TIMP-2) in carcinogenesis and progression of colorectal cancer(CRC).Methods:The E-Cad and TIMP-2 expressions were studied immun ohistochemistrically in 30 specimens of colorectal adenoma and 60 specimens of CRC.Results:The expression rates of E-Cad were 87.10% in colorectal adenoma and 55.00% in CRC, the former was apparently higher than that of the later (P0.05);The significant relationship was observed between low TIMP-2 expression and Dukes stage, metastasis of lymph node and distant organs and poor prognosis.Conclusion:The detection of expression about E-Cad and TIMP-2 may be helpful to judge the malignant behavior and metastasis and prognosis with colorectal carcinoma,furthermore the expression of TIMP-2 may be used to know prognosis of patients.

Objective To evaluate the level of IL-17 in rheumatoid arthritis(RA)and explore its clinic value.Methods Serum were collected from 84 RA patients.IL-17 was detected by ELISA.C reactive protein(CRP),glucose-6-phosphate isomerase(GPI),rheumatoid factor(RF),anti-cyclic citrullinated peptide(Anti-CCP)antibody,IL-1? and tumor necrosis factor-?(TNF-?)were assayed,too.The correlations between IL-17 and clinical manifestations as well as laboratory findings were analyzed.Results The serum level of IL-17 in active RA patients was(113.8?21.7)ng/L,significantly higher than that of non-active RA[(76.3?11.9)ng/L,P0.05).There were positive correlations between IL-17 and clinic index,for example swelling joints,tenderness joints and X-ray phase of joints.Conclusion High expression of IL-17 was shown in RA,and related with disease activity.

Objective To observe the curative effect of lumbar sympathetic nerve injury combined with systemic and local medication in intractable lower limb ischemic pain.Methods21 patients with intractable lower limb ischemic pain accepted lumbar sympathectomy,at the same time foot topical Votalinemulgel used and Combined with anticonvulsants and opioids according to circumstances,the visual analogue scale of resting pain(visual analogue scale,VAS),the Local skin temperaturebefore and after treatment were observed and evaluated.ResultsAfter Lumbar sympathetic nerve block and topical Votalinemulgel,21 patients had pain relief.After treatment, 2 patients had poor effect,the remaining 19 patients had pain relief to VAS<3, 4 patients did not need systemic analgesic drugs,the rest of the patients need systemic analgesic drugs.ConclusionIt is necessary to adopt multimodal comprehensive treatment for intractable lower limb ischemic pain.

Objective:To assess the safety and efficacy of riboflavin/ultraviolet-A-induced accelerated epithelium-off corneal collagen cross-linking (CXL) for teenagers with keratoconus.Methods:In this case series study, 25 eyes of 18 patients with primary keratoconus who underwent riboflavin/ultraviolet-A-induced accelerated epithelium-off CXL in Zhengzhou Second People's Hospital from January 2017 to February 2018 were included, and the average age of patients was (14.4±1.3) years.The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), maximum keratometry reading (K max), thinnest corneal thickness (TCT), posterior corneal elevation (PCE) and endothelial cell density (ECD) were measured before and after CXL.The patients were followed up for one year.The complications and adverse reactions were recorded.The study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhengzhou Second People's Hospital (No.KY2017002). Written informed consent was obtained from each patient and their guardian prior to the surgery. Results:The mean UCVA (LogMAR) was 0.96±0.35 at baseline, which was significantly improved to 0.84±0.33 at 1 year postoperatively ( t=-5.765, P<0.01). The mean BCVA (LogMAR) was 0.45±0.22 preoperatively, which was significantly improved to 0.34±0.26 at 1 year postoperatively ( t=-4.843, P<0.01). The mean SE was (8.66±5.11)D at baseline, which was significantly higher than (8.07±5.21)D at 1 year postoperatively ( t=-3.253, P=0.003). The K max was reduced from (58.58±9.07)D preoperatively to (56.25±9.98)D at 1 year postoperatively, with significant difference between the two time points ( t=-4.357, P<0.01). The K max was reduced more than 1 D in 17 eyes (68%), was stable in 6 eyes(24%), and was increased more than 1 D in 2 eyes (8%). The TCT was reduced from (485.0±32.5)μm at baseline to (475.3±35.5)μm at 1 year postoperatively, with significant difference between the two time points ( t=-4.266, P<0.01). The differences of PCE and ECD between preoperative and postoperative 1 year were not statistically significant ( t=1.023, P=0.316; t=-1.424, P=0.167). There was one eye suffering peripheral sterile corneal infiltrate 2 days postoperatively, and favorable prognosis was achieved after the topical steroids application.No complication was encountered in other subjects. Conclusions:Riboflavin/ultraviolet-A-induced accelerated epithelium-off CXL is safe and effective in teenagers with keratoconus during the 1-year follow-up.The long-term effects need further observation.

Objective To study the expression of peripheral blood lymphocyte P-glycoprotein(P-gp)and related impact factors in rheumatoid arthritis(RA)patients,and explore whether the periodic combination of methotrexate(MTX)or leflunomide(LEF)with cyclophosphamide(CTX)could reverse P-gpinduced drug resistance.Methods This study was a cross-sectional study.Forty-two RA patients were enrolled(15 cases in the primary untreatment group,while 27 cases in the treatment group).In the treatment group,patients were divided into the improvement group(12 patients)and the refractory group(15 patients)respectively according to their disease activity scores(DAS 28).According to the medication used,42 patients were divided into 3 groups:the monotherapy group(MTX or LEF),the MTX+LEF combination treatment group and MTX or LEF+CTX treatment group.The expression of peripheral blood lymphocyte P-gp in each group was detected by flow cytometry.T test,ANOVA,LSD test,Bonferroni test,x2 test and Pearson correlation analysis were used for statistical analysis with software 13.0.Results ① Mean relative fluore scence intensity(RFI)of P-gp was 2.0±0.7,2.9±1.0,3.5±1.4,5.0±2.0 respectively in healthy control group,the primary untreatment group,the improvement group and the refractory group,the difference was significant(F=7.955,P＜0.01).in multiple comparisons,the fluorescence intensity was higher in the primary untrea-tment group as compared to the healthy group,but the difference was not statistically significant(P=0.137);however,it was significantly higher in the refractory group as compared to the improvement group(P=0.013).② There was no correlation between the expression of P-gp in RA patients and sex,age of onset,disease duration or positive rate of RF.But the expression of P-gp was significantly correlated with ESR and DAS28(r=0.447,P=0.002;r=0.398,P=0.012).③ RFI of the P-gp group was 5.1±2.2,6.0±1.2,3.4±1.1 respectively in monotherapy group,MTX+LEF group and MTX/LEF+ CTX group(P＜0.05).The expression of P-gp was significantly lower in the MTX/LEF+CTX group as compared to the monotherapy group(P＜0.05),but higher in the MTX+LEF group(P＞0.05).Conclusion The expression of peripheral blood lymphocyte P-gp in RA is correlated with disease activity.The loss of efficacy in DMARDs is due to the enhanced expression of P-gp.Combination of methotrexate or leflunomide with cyclo-phosphamide reverses P-glycoproteininduced drug resistance.

Objective To observe the effect of Hydroxychloroquine (HCQ) on the apoptosis of peripheral blood mononuclear cells (PBMCs) of Systemic lupus erythematosus (SLE) patients and on the level of Th17 cells and IL-17.Methods The peripheral blood of 20 incipient SLE patients in active stage were taken,and PBMC were separated for cell culture.Using HCQ and Chlorambucil (CLB) as an intervention,and after cultured for 24 h and 48 h,the apoptosis of PBMC and the level of Th17 were tested using Flow cytometry (FCM),the supernatants were collected to test for the level of cytokine IL-17 by ELISA.One-way ANOVA was used and SNK-q was used in the comparison between every two groups.Results There was significant difference in the apoptosis rate of mononuclear cells between the HCQ and CLB group at 24 h [HCQ:(10.3±0.7)％,CLB:(8.5±1.1)％] and48 h [HCQ:(13.9±0.6)％,CLB:(11.8±0.8)％] (P＜0.05).There was significant difference between HCQ [24 h:(0.81±0.13)％,48 h:(0.73±0.45)％] and CLB group [24 h:(0.78±0.26)％,48 h:(0.68±0.20)％] in Th17 percentage (P＜0.05).The levels of IL-17 in the supematants of the HCQ group [24 h:(26.3±0.97)％,48 h:(24.2±0).91)％] and CLB group [24 h:(24.6±0.7)％,48 h:(22.6±1.1)％] were significandy different between the two groups(P＜0.05).Conclusion HCQ has apoptosis-induction effect on PBMC,and it can decrease the number of Th17 and IL-17 level in the PBMCs.