Clinical data of 83 patients with obscure gastrointestinal bleeding (OGIB) undergoing capsule endoscopy were reviewed retrospectively.The results showed that the overall detection rate of gastrointestinal lesions for OGIB by capsule endoscopy was 81.9％ (68/83), most lesions (77. 1％, 64/83 )were located in small intestine. Of all the small intestinal lesions, arteriovenous malformation (AVM) was the most common (22 cases, 26.5％ ),followed by small intestinal space-occupying lesion (18 cases,21.7％ ) and single or multiple ulcers of small intestine ( 16 cases, 19. 3％ ). Four cases (4. 8％ ) had lesions outside of the small intestine. Small intestinal AVM was the leading cause of OGIB in patients ＞ 50 y,space-occupying lesion was the most common in patients aged 30 -50 y, while ulcer was the leading cause in patients ＜ 30 y. Bowel obstruction was not found in this group of patients. The results indicate that capsule endoscopy has great diagnostic value in detecting causes of OGIB. Small intestinal AVM is the most common cause of OGIB, followed by space-occupying lesion and ulcer.

Objective To observe the month age distribution of peroxisome proliferators activated receptor gamma (PPARγ) expression in rat kedney. Methods Wistar rats aged 3 months,12 months and 24 months were made as models who represented young, middle-aged and old group respectively. Western blotting, immunohistochemical (IHC) and in-situ hybridization (ISH) were used to detect the expression and location of protein and mRNA of PPARγ in rat kidney. Results Western blotting results showed that the expression of PPARγ protein was higher in 3 months group than in 24 months group (0.94±0.05 vs. 0.78±0.02, P＜0.01) and 12 months group (0.87±0.04, P＞0.05), and it reduced in 24 months group than in 12 months group (P＞0.05). By IHC,the PPARγ protein was localized predominantly in the nuclear of tubular epithelia and collecting duct cells in each group. In old age group, PPARγ protein was also detected little in the mesangial and Bowman's capsule epithelial cells. Meanwhile, the distribution of PPARγ mRNA with ISH was consistent with above findings. Additional, semi-quantitative analysis of ISH results verified that the level of PPARγ mRNA decreased with ageing. Conclusions As a nuclear transcription factor,PPARγ participates in the regulation of rat kidney aging.

Broth microdilution method was hired to measure the minimum inhibitory concentrations (MICs) of luteolin against Trueperella pyogenes,Escherichia coli,Salmonella and Streptococcus in order to evaluate the antimicrobial activity of luteolin in vitro.Meanwhile,the bacteria growth curves in medium containing sub-inhibitory concentration of luteolin were measured in this test.The results indicated that Tureperella pyogenes was the most sensitive to luteolin with a MIC of 0.078 g/L than that of these strains;and Salmonella was also sensitive to luteolin (MIC:1.25 g/L).However,The inhibitory effect of luteolin on Escherichia coli and Streptococcus is relatively weak,and shared the same MIC with 2.5 g/L.Luteolin showed inhibitory effects on the growth curves of all the strains in this test at sub-inhibitory concentration,and the inhibitory effects on the growth curves increased with the concentration of luteolin(P＜0.05).

Objective To Compare postoperative complications between patients with varicose veins of the lower limbs treated with foam sclerotherapy or endovenous laser.Method From 2011 to 2015,simple varicosis of great saphenous vein patients (grade C3-6) in 2 542 cases,3 468 limbs were divided into 2 groups.Combined with high ligation of great saphenous vein plus stripping,foam sclerotherapy group (1 355 cases) underwent calf foam sclerotherapy (1％ polidocanol),endovenous laser group (1 187 cases) underwent endovenous laser therapy.All postoperative patients were treated with stretch socks for 3 months.Postoperative pain (calf),deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis,saphenous nerve injury,ecchymoma,migraine,allergic dermatitis,pigmentation in 2 groups were compared.Result During the follow-up,28 cases in foam sclerotherapy group had saphenous nerve injury (2％),1 071 (79.1％) cases had subcutaneous ecchymosis,613 cases (51.6％) in endovenous laser group had saphenous nerve injury,979 cases (82.5％) had subcutaneous ecchymosis,8 cases (1.0％) had skin burns (x2 =824.660,4.786,9.161,P ＜ 0.05).Endovenous laser group (23.8％) was significantly better than that of foam sclerotherapy group (30.8％) in pigmentation (x2 =15.243,P ＜0.05).Conclusion Treatment of varicose veins of the lower leg with foam sclerotherapy has less postoperative complications compared with endovenous laser.

Objective To construct a prokaryotic expression vector pET-22b+with Middle East respiratory syndrome ( MERS) coronavirus nuclocapsid protein( NP) gene and to express and purify N protein.Methods N gene amplified by PCR was inserted into the prokaryotic expression vector pET-22b+.Recombinant plasmid was confirmed using DNA elec-trophoresis and sequencing.NP was expressed in E.coli BL21(DE3) by IPTG induced and purified by cation exchange chromatography using the AKTA purification system.Results The NP gene sequence was proved to be correct by sequen-cing and the protein was expressed in both soluble and insoluble forms in E.coli BL21 ( DE3 ) after IPTG induction.The purity and concentration of recombinant protein was improved obviously by cation exchange chromatography and enrich-ment.Conclusion Recombiant NP of high purity and concentration is purified and will facilitate NP functional research.

Objective:To explore the clinical pathological characteristics and initial 131I curative responses of familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC). Methods:A total of 66 FDTC patients (19 males, 47 females, age (39.8±11.7) years) and 1 701 SDTC patients (442 males, 1 259 females, age (40.9±11.3) years) who underwent 131I therapy in Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2010 and August 2018 were retrospectively enrolled. The clinical pathological characteristics, preablative stimulated thyroglobulin (ps-Tg), preablative stimulated thyroglobulin antibody (ps-TgAb) and response to initial therapy (excellent response, indeterminate response, biochemical incomplete response, structural incomplete response) of two groups were analyzed and compared. The clinical pathological parameters included age, gender, pathological type, tumour maximum diameter, bilateral, multifoci, nodules goiter, thyroiditis, thyroid membrane invasion, lymph node metastasis (LNM), invasion of the surrounding soft tissues, distant metastasis, TNM staging and American Thyroid Association (ATA) risk stratification (low-risk, intermediate-risk, high-risk). χ2 test or Fisher exact test and independent-sample t test were used to compare the data between two groups. Results:Comparing with SDTC group, FDTC group showed higher proportion of bilateral foci (45.5%(30/66) vs 31.2%(530/1 701); χ2=5.999, P=0.010), thyroid membrane invasion (43.9%(29/66) vs 26.6%(452/1 701); χ2=9.672, P=0.002) and distant metastasis (15.2%(10/66) vs 6.2%(105/1 701); χ2=8.418, P=0.004). There was a statistical difference in risk stratification between two groups (high-risk: 18.2%(12/66) vs 9.2%(156/1 701); intermediate-risk: 68.2%(45/66) vs 72.7%(1 237/1 701); low-risk: 13.6%(9/66) vs 18.1%(308/1 701); χ2=6.898, P=0.030). But the tumor maximum diameter of FDTC group was smaller than that of SDTC group ((1.24±0.74) vs (1.50±0.92) cm; t=-2.275, P=0.020). There were no significant differences in other clinical pathological parameters between FDTC group and SDTC group ( t=-0.804, χ2 values: 0.101-5.359, all P>0.05). There were no significant differences between two groups in the postoperation ps-Tg, ps-TgAb levels and the response to initial therapy after 131I treatment ( χ2 values: 0.059-1.915, all P>0.05). Conclusions:The FDTC group displays distinct characteristics as increased aggressiveness at diagnosis. But after accurately treatment, there is no significant difference in the response to therapy between two groups.

Objective To investigate the relationship between serum inflammatory cytokines and atherosclerosis in type 2 diabetic patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods One hundred and three patients with type 2 diabetes were divided into OSAHS group (OSAHS group) and type 2 diabetes mellitus group (non-OSAHS group) according to the results of polysomnography(PSG),and 35 healthy subjects were selected as control group.Serum levels of total cholesterol,triglyceride,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (IMT) were measured,and their relationship with OSAHS were analyzed.Results The waist circumference,BMI,FPG,HbA1c,IMT,TNF-α and CRP in OSAHS group were significantly higher than those in non-OSAHS group (P＜0.05).Logistic regression analysis showed that,IMT was independently associated with TNF-α and hs-CRP.Conclusion Patients of T2DM with OSAHS have poor blood glucose control and higher incidence of atherosclerosis.High levels of TNF-α and hs-CRP may be involved in the formation of atherosclerosis and plaque occurrence and development.

Objective:To observe any effect of fast walking on walking speed, 6-minute walking test (6MWT) time, and on serum levels of growth differentiation factor-8 (GDF-8) and insulin-like growth factor-1 (IGF-1) in patients with sarcopenia.Methods:A total of 61 sarcopenia patients were randomly divided into an observation group ( n=31) and a control group ( n=30). Both groups were given conventional drug therapy. In addition, the observation group underwent 30-minutes of walking at 100-120 steps/min (about 60% of maximum heart rate) three times a week for 12 weeks. The control group also walked, but at 70-90 steps/min (less than 50% of maximum heart rate). Grip strength, walking speed, 6MWT time, skeletal muscle index (ASMI) and serum GDF-8 and IGF-1 were compared before and after the intervention. Results:There were no significant differences in grip strength or ASMI between observation group and control group (comparing males with males and females with females) before the experiment. Afterward, grip strength and ASMI in the observation group had increased significantly on average. Both were then significantly higher than the control groups′ averages, which had not changed significantly. Average walking speed, 6MWT time and serum IGF-1 levels had improved significantly in both groups, but the observation group′s average improvement was significantly greater. A significant decrease the average serum GDF-8 level was observed in the observation group, but not in the control group.Conclusion:Fast walking can improve the walking of persons with sarcopenia, raise serum IGF-1 levels, and significantly reduce serum GDF-8.

Objective:To understand the current status of quality control of medical X-ray diagnostic equipment in Tianjin, discuss the problems existing in the process of quality control, and provide technical basis for the relevant regulatory agencies.Methods:Using stratified random sampling, a total of 401 pieces of medical X-ray diagnostic equipment distributed over 111 medical institutions in Tianjin was used for this study. X-ray multifunctional dosimeters and other types of equipment were used to perform quality control testing and evaluation under the relevant health industry standards.Results:The initial testing pass rate of these equipment was 90.0%, with the pass rates of X-ray imaging equipment lower than those of X-ray fluoroscopy equipment, digital subtraction angiography (DSA) and X-ray computed tomography (CT) ( χ2=9.203, 3.383, 5.754, P<0.05). Among the imaging equipment, the screen X-ray equipment had the lowest pass rate, followed by the breast X-ray equipment and medical digital radiography (DR). The main unqualified items were output repeatability, deviation of tube voltage indication and limit spatial resolution. DR accounted for the highest percentage of X-ray equipment that were below testing condition. The unqualified proportion of X-ray imaging equipment was higher than that of X-ray fluoroscopy equipment ( χ2=8.216, P <0.05). Among the imaging equipment, the screen X-ray equipment was seen to have the highest unaqualified proportion, followed by computed radiography (CR). Among the 401 devices in this study, the initial testing pass rates of private medical institutions was not statistically different from those of public medical institutions ( P>0.05). The initial pass rates of domestic equipment was lower than those of imported equipment ( χ2=4.576, P<0.05). Conclusions:The performance of medical X-ray diagnostic equipment in Tianjin needs to be further improved. Medical institutions should pay attention to the quality control testing of medical X-ray diagnostic equipment. The relevant regulatory agencies should strengthen oversight and management of equipment that contains unqualified items, no baseline values and below the testing conditions.

Objective To study the efficacy and safety of percutaneous transhepatic one-step biliary fistulation (PTOBF) with rigid cholangioscopic lithotripsy for treatment of complicated hepatolithiasis under the ultrasonic navigation technique.Methods In this retrospective study,PTOBF lithotripsy surgery was performed in 94 patients with hepatolithiasis under general anesthesia with tracheal intubation,and with percutaneous transhepatic puncture of targeted bile duct under ultrasonic navigation in The First Affiliated Hospital of Guangzhou Medical University.Biliary expanders were used along a guidewire to expand the sinus gradually until 14Fr to establish a fistulous channel.Lithotripsy was then performed through the channel by rigid cholangioscopy.The operation-related data were collected and analyzed,including puncture and fistula establishment success ratio,complication rate,intraoperative blood loss,residual and recurrence hepatolithiasis rates.Results 94 patients (total 122 patient-times) underwent PTOBF lithotripsy.There was no perioperative mortality.The overall puncture success rate was 100％,and the fistula/puncture rate was 97.5％ (119/122).In 118 patients success was achieved in 2 time (96.7％).The complication rate was 9.6％ (9/94).The average intraoperation blood loss were (24.9 ± 21.3)ml.The residual calculus rate after therapy was 13.8％ (13/94).All patients were followed-up for a period that ranged between 18 and 30 months.The recurrence rate was 14.9％ (14/94).Conclusions Ultrasonic navigation technique plays an important role in bile duct puncture,sinus expansion and rigid cholangioscopic lithotripsy for treatment of complicated hepatolithiasis.PTOBF lithotripsy is a safe and effective procedure,which provides a new way in mini-invasive treatment for hepatolithiasis.It is worth generalizing.