Objective The aim of the study was to determine the prevalence and incidence of diabetes mellitus (DM) and to investigate the epidemiological characteristics as well as associated risk factors in the elderly army people in Beijing area. Methods A survey was conducted among 2 239 elderly subjects aged 60 to 90 years while physical examination was undergoing in Chinese PLA General Hospital from 1996 to 2000. FPG and PPG of steam-bread meal test were measured. Subjects with PPG≥7.2 mmol/L received a standard 75 g OGTT with 10 h overnight fasting. The risk factors for incidence of DM and IGT during survey were analyzed with multiple logistic regression. Results The average follow-up duration was 3.7 years. The adjusted prevalence of DM increased from 15.8% in 1996 to 23.9% in 2000 and it increased significantly with age(P

Objective To observe the all-cause and cardiovascular mortality in the senile population and to analyze influence of impaired glucose metabolism. Methods A survey was conducted among 2239 old subjects aged 60 to 90 who had health examination in PLA General Hospital from 1996 to 1997. The subjects were examined every year and followed for 3-4 years. Diabetes mellitus (DM) and impaired glucose tolerance (IGT) were diagnosed according to WHO criteria (1985). The cumulative survival rates of different groups were calculated by Kaplan-Meier method and Cox′s proportional hazard model. Results The elderly people were classified into three groups: normal glucose tolerance (NGT) (n=1521), IGT (n=279) and DM (n=439) at baseline. At the end of four observed years, the mortalities of IGT group and DM group were 7.55 and 8.86 per 1000 observation person-year, respectively, both groups were significantly higher than the mortality in NGT group (2.43/1000 person-year) (P0.05). The cumulative survival rates from cardio-cerebrovascular disease in IGT and DM were 0.982 and 0.980 respectively, both significantly lower than that in NGT group (0.996,P

Objective To evaluate the sensitivity and the specificity of WHO and American Diabetes Association (ADA) diagnosis criteria for diabetes mellitus (DM) in senile population and to assess the use of fasting plasma glucose (FPG) alone for the screening of DM as defined by a 2 hour plasma glucose (2hPG)≥11.1 mmol/L during oral 75 g glucose tolerance test (OGTT) and to determine optimal FPG cut point for DM diagnosis. Methods One thousand two hundred and four subjects without DM aged 60 to 90 year, who had resided in Beijing for over 5 years, were recruited, and grouped into different glucose levels by WHO or ADA criteria and analyzed the concordance and the discordance between these subpopulations. The WHO criterion for DM (2hPG≥11.1 mmol/L) was taken as the gold standard. The variations of sensitivity and specificity on ADA criterion for DM (FPG≥7.0 mmol/L) were assessed and determined the optimal FPG cut point in the seniles. Results The prevalence of DM was 3.16% and 16.28% by ADA (FPG) criterion and WHO(2hPG) criterion respectively. The sensitivity of diagnosed DM was 15.3% and the specificity was 99.2% according to ADA criterion. The coincidence percentage under the two criteria was only 15.3%. The coincidence percentage under impaired fasting blood glucose (IFG) and impaired glucose tolerance (IGT) was only 4.5%. The optimal FPG cut point of diagnosed DM was 5.5 mmol/L in the seniles, which was affected by gender, age, body mass index and the presence of hypertension. Conclusion There is lack of concordance between WHO and ADA criteria for DM diagnosis in the seniles. The ADA IFG criterion is not able to replace WHO criterion for DM diagnosis. The senile people with FPG≥5.5 mmol/L but

AIM To study the antiinflammatory and immunomodulatory effects of actarit(Acta). METHODS To abserve the change of primary and secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Acta and to detect the effect of Acta on T cell subgroup in mice in vitro. RESULTS Acta(10,30,90 mg?kg -1 ) intragastric injection(ig) did not significantly inhibit primary reaction of AA in rats. But Acta(10,30,90 mg?kg -1 ?11 d) ig signifcantly inhibited secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats. The lowered response of ConA induced splenolytes and the decreased IL 2 synthesis were restored to normal in AA rats treated with Acta, while the elevated IL 1 released from peritoneal macrophate (PM?) was reduced. Acta(1～100 ?mol?L -1 ) could inhibit ConA induced T h cells and enhance ConA induced T s cells culture in vitro . CONCLUSION Acta do not show obvious antiinflammatory action. But Acta has therapeutic action on AA rats, which may be related to its immunomodulatory activities,mainly through modulate cell mediated immunity.

Objective To investigate the precision and trueness of results from six imported commercial systems for measurement of gamma-glutamyltransferase (GGT) in serum in order to provide reference for the clinical laboratories to verify the target accuracy. Methods Five fresh frozen human serum samples that differed in catalytic concentration were analyzed in two candidate domestic reference laboratories and the target values for GGT were assigned using IFCC reference measurement procedure. The same samples were tested by six commercial systems which were calibrated using the matched calibrator. Each system consisted of five instruments in five laboratories, which had been well maintained before measurement. The data was collected. Precision from the same manufacturer and different manufacturers and biases between target values and mean values from each system were calculated. Results The differences of the mean values for five levels of commercial systems varied from 16. 1% to 35.4%. For the five levels, the coefficients of variation (CVs) of the results from all measurement system were from 5.3% to 8. 8% , and CVs from each level were A 2. 17%- 5.07%, B 4. 21%-10. 98%, C 0. 52%-2. 38%, D 1.35%-2. 59%, E 0. 23%-1..54%-), F 1.83%-2. 38%. Biases between the mean values of each commercial systems and the target values were A 0. 43% -8.41% ), B -1.49% - -13.04% ), C 11.20% -17.73% ), D 0. 19% -4. 62% ), E -0. 30% - -2. 63% ), F 4). 46%-7.90%, respectively. The investigation showed that biases of two manufacturers were less than a quarter of the total allowable error (TAE) of The Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) in the whole range of investigated concentrations and the other two manufacturers' biases could meet a quarter of TAE in a relative limited range. The biases of two manufacturers were near or more than half of TAE in most levels. It also revealed that the biases of more than half of manufacturers were more than a quarter of TAE in the low or high level of investigated concentrations. Conclusions The mean values of each manufacturer were significantly different. The variances of commercial systems from different manufacturers were much higher than those from the same manufacturer. Some imported commercial systems for measurement GGT should be better calibrated with the reference method, especially in the whole measurement linearity.

Objective To evaluate the accuracy of Cr measurement value from commonly used homogenous detection systems,to investigate the variation among different systems and the corresponding bias of eGFR.Methods According to the CLSI EP14-A2 protocol,commutability of LN24 was validated among 10 enzymatic assays and 1 picrate assay.LN24 included 6 vials of solution with Cr values assigned by IDMS at NIST,and concentrations of Cr for each vial were 68.1,126.9,185.7,244.5,303.2 and 361.9μmol/L LN24 was used to evaluate the accuracy of the included systems and the variation among them,and the assigned values were taken as the target values.eGFR were calculated by MDRD equation using IDMStraced picrate Cr and CKD-EPI equation using enzymatic Cr.Results Commutability was exist among the 11 systems for LN24 detection.Four systems showed bias ＜ 4.4 μmol/L at each level of LN24,two system showed bias ＞4.4 μmol/L at each level of LN24,one system showed a fixed negative bias( -4.2 ±0.7)μ mol/L,the other 4 systems showed diverse bias at different levels.Cr-bias-caused eGFR bias could reach 14.9 ml · min-1 · (1.73 m2) -1 at Cr level of 68.1 μmol/L SD among systems ascended with Cr level (2.6 -6.1 μmol/L) ;CV among systems descended with Cr level(4.0％ - 1.7％ ) ;After the 2 systems with obvious negative bias were removed,SD,CV among systems and eGFR bias decreased obviously.By measuring fresh serum,it was found that Cr bias among enzymatic systems was mostly ＜ 10 μmol/L;that between enzymatic assays and picrate assay was much diffused(from - 15 to 20 μmol/L).When Cr ＜ 100μmol/L,the eGFR difference between result of MDRD equation and that of CKD-EPI equation ranged from - 18 to 40 ml · min-1 (1.73 m2) -1.Conclusions Some enzymatic systems show good accuracy.Difference of Cr value is relatively fixed among enzymatic systems,and comparability can be reached through mathematic way.Un-acceptable difference between picrate assay and enzymatic assays still exists,thus comparability cannot be reached through mathematic way.At low Cr level,bias of Cr and using different equations may lead to significant bias of eGFR.We recommend that clinical laboratory should pay much attention to the accuracy and comparability at low level of Cr,and use uniform equation to calculate eGFR.

Objective To investigate the related risk factors caused the retained common bile duct (CBD)stones after laparoscopic cholecystectomy,to provide the evidence for preventing from retained common bile duct stones of laparoscopic cholecystectomy.Methods Selected 654 cases of laparoscopic cholecystectomy patients as the objects whom hospitalized in Beijing Chuiyongliu Hospital from January 2002 to June 2013.All cases were divided into the group of retained CBD stones (27cases) and the group of non-retained CBD stones (627 cases).Collected the potentially relevant factors of two groups with the retained CBD stones,including medical history of jaundice and pancreatitis,common bile duct internal diameter (B Ultrasound) ≥ 8 mm,acute cholecystitis,emergency surgery,gallbladder removal order,calot triangle adhesion,sludge calculus,stones neck incarcerated,fulltype stones,cystic duct thickening,cystic duct reserved≥ 1 cm,the minimum diameter stones ≤5 mm,the number of gallbladder stones ≥ 5,partial cholecystectomy,purulent bile.Statistics analyses was proceeded using the IBM SPSS 20.0.Result Through dichotomy logistic regression analysis to the univariate analysis results with statistical significance,sorted the results according to the influence degree,found the independent risk factors:common bile duct internal diameter (B Ultrasound) ≥8 mm,gallbladder removal order (retrograde removal),medical history of jaundice pancreatitis,cystic duct reserved ≥ 1 cm,sludge calculus,in total of 5 indexes,which caused the retained CBD stones after laparoscopic cholecystectomy.Conclusion There are several independent risk factors for retained CBD stoes after LC such as medical history of jaundice and pancreatitis,common bile duct internal diameter (B Ultrasound) ≥ 8 mm,the order of cholecystectomy (retrograde remoral),shudeg calculus and the remaining length of bile duct ≥ 1 cm.The surgeons should pay close attention to them and take appropriate measures in the preoperation and intraoperation of LC,which contribute to preventing the acurence of postoperative retaimed CBD stone.

Objective To investigate the radiological features of granulomatous mastitis (GM) in dynamic contrast enhanced MRI (DCE-MRI) and DWI and to differentiate it from the breast cancer in diagnose.Methods Forty five cases of GM and 64 cases of breast cancer confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study.All of the patients were examined preoperatively by DCE-MRI and DWI.Including lesion type,location,enhancement pattern,nipple retraction,supplying arteries,skin thickening and axillary adenopathy in the two groups were evaluated and analyzed by using x2 test.One-way ANOVA was employed to compare the ADC values between the abscess area of GM and non-abscess area,and the difference among the breast cancer lesion area.Dynamic enhancement MR pharmacokinetic parameters were used to measure including early-phase enhancement rate (EER),peak enhancement ratio(Emax),and time to peak ehhancement(Tmax).The statistical differences of EER,Emax and Tmax between the two groups were calculated by using Wilcoxon test.Results In 45 cases of GM,DCE MR images showed nonmass-like lesions (43 patients) and mass-like lesions (2 patients); the nipple involved(16 patients) and segment involved (29 patients);rim-like with heterogeneous enhancement (40 patients) and heterogeneous enhancement (5 patients); nipple retraction (24 patients) supplying arteries dilatation (42 patients),skin thickening (29 patients),and axillary adenopathy (17 patients).Corresponding to the radiological features above,in the 64 breast cancer cases,it showed 54,10,5,59,30,34,16,51,12 and 20,respectively.There were statistical significance between GM and breast cancer in lesion type,location,enhancement pattern,and nipple retraction (x2=67.574,13.075,20.297,20.398 and 23.510,respectively,all P＜0.01).But no differences were existed between 2 groups in supplying arteries and axillary adenopathy(x2=3.928 and 0.502,P＞0.05).EER,Emax and Tmaxin GM were 146.58％,191.13％,195.00 s in GM and 118.13％,159.43％,183.33 s in breast cancer,respectively.Significant statistic differences between GM and breast cancer were found in EER and Emax(Z values were-2.271 and-2.948,P＜0.01).But it did not show significant difference in Tmax (Z =-0.548,P＞0.05).The ADC values of GM on abscess area,non-abscess area,and breast cancer lesion area were (8.0±2.6) × 10-3,(11.3± 1.7) × 10-3 and (8.2± 1.1) × 10-3mm2/s,respectively.There were significant differences in the groups (F=52.167,P＜0.01).Conclusions The characteristic of radiological findings can be found in GM by using advanced MR imaging techniques.DCE-MRI combined with DWI is useful in the differential diagnosis between GM and breast cancer.

AIM　To observe the preventive action of leflunomide (Lef) on CCl4-induced liver fibrosis and explore its mechanism. METHODS Model of liver fibrosis in mice was induced by subcutaneous injection of CCl4(20%). The levels of ALT、AST、NO in plasma and Hyp in liver tissue were determined by spectroscopy. The content of HA in plasma was determined by radioimmunoassay. RESULTS Pretreatment of Lef (4,12,36 mg·kg-1) significantly reduced the elevated levels of ALT、AST、NO in plasma and Hyp in liver tissue, Pathological examination suggested Lef has preventive action on experimental liver fibrosis with significance. CONCLUSION Lef has significantly preventive action on CCl4-induced liver fibrosis possibly mediated by reduction of NO.

AIM　To study the therapeutic action of leflunomide(Lef) on adjuvant arthritis (AA) rats and its mechanisms. METHODS　To observe the change of secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Lef and to detect the effect of A771726—the active product of Lef on T cell subgroup in mice in vitro.RESULTS　Lef(2,6,18 mg*kg-1×12 d) intragastric injection(ig) could signifcantly inhibit secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats.Lef couldnt effect the lowed response of Con A-induced splenolytes, and the decreased IL-2 synthesis in AA rats. But lef(2,6,18 mg*kg-1) could inhibit the elevated IL-1 released from peritoneal macrophage (PMΦ) in AA rats. A771726—the active product of Lef(0.1，0.5，2.5，12.5，25，100 μmol*L-1) could inhibit Con A-induced Th cells but has no effect in Con A-induced Ts cells in vitro.CONCLUSION　Lef has therapeutic action on AA rats which could be related to its immunosuppressory activities——mainly through inhibit cell-mediated immunity.