Objective:To investigate the changes of serum neopterin (NPT) level in adults patients with Kashin-Beck disease (KBD) in Qinghai Province.Methods:In July 2018, according to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), in KBD endemic region of Xinghai and Guide counties in Hainan Tibetan Autonomous Prefecture of Qinghai Province, adult KBD patients and healthy people over 20 years old were selected as KBD group and internal control group, respectively. At the same time, healthy people over 20 years old were selected as the external control group in non-KBD endemic region of Xunhua County with similar production scale and lifestyle. Fasting elbow vein blood samples of the 3 groups of people were collected, serum NPT levels were determined by enzyme linked immunosorbent assay (ELISA).Results:Totally 272 people were enrolled in the study, 104 cases (50 males and 54 females) in KBD group, aged (47.61 ± 12.72) years old; 95 cases (35 males and 60 females) in internal control group, aged (48.28 ± 14.87) years old; and 73 cases (35 males and 38 females) in external control group, aged (51.88 ± 13.93) years old. There were no significant differences in gender composition and age among the 3 groups (χ 2 = 3.135, F = 2.236, P > 0.05). The serum NPT levels of KBD, internal control, and external control groups were (504.35 ± 413.92), (417.34 ± 109.90) and (397.49 ± 118.07) ng/L, respectively, and the difference among the 3 groups was statistically significant ( F = 4.129, P < 0.05). Among them, the serum NPT level of KBD group was significantly higher than that of internal control group and external control group ( P < 0.05); there was no significant difference in the serum NPT level between internal control group and external control group ( P > 0.05). Conclusion:The serum NPT level of adult KBD patients in Qinghai Province is elevated.

Objective:To investigate the effects of celecoxib and anti-osteogenesis tablets on urinary biomarkers pyridinoline (PYD) and deoxypyridinoline (DPD) in adult patients with Kashin-Beck disease (KBD) in Qinghai Province, and to provide scientific basis for treatment of adult KBD.Methods:According to the "Diagnosis of Kaschin-Beck disease" (WS/T 207-2010), in July 2017, 120 cases of adult KBD that were selected from the KBD area in Qinghai Province were divided into non-drug treatment group ( n = 66) and drug treatment group ( n = 54), and 89 healthy adults were selected as control group. The drug treatment group was taken celecoxib and anti-osteogenesis tablets for 6 months. Morning urine samples were collected from the three groups. The contentss of PYD and DPD in urine were detected by enzyme linked immunosorbent assay (ELISA), and the test results were corrected with creatinine (Cre). Results:There were no statistically significant differences in gender ratio and age among non-drug treatment group, drug treatment group and control group (χ 2 = 0.820, F = 0.379, P > 0.05). The medians of urinary PYD in the three groups were 1 106.39, 812.18, 702.53 ng/μmol Cre, and the medians of DPD were 1 325.58, 802.54, 752.38 ng/μmol Cre, respectively. The differences were statistically significant among the three groups ( H = 13.849, 34.621, P < 0.01). The contents of PYD and DPD in drug treatment group were lower than those in non-drug treatment group ( P < 0.05). Conclusion:Celecoxib and anti-osteogenesis tablets can reduce the urinary levels of PYD and DPD in adult patients with KBD.

Objective To evaluate the clinical efficacy of the covered stent placements in the treatment of malignant esophageal stenosis and to analyze the interrelated factors and countermeasures of complications.Methods 102 patients with malignant esophageal stenosis were undergone treatment with the covered stent placements through the mouths under X-ray fluoroscopy.The stents included China-made and imports,and the specifications were various.92 patients underwent radiotheraphy before or after process.All cases were followed up after operations.Results The successful rate of operation was 100%,110 covered stents were placed in total.The clinical symptoms of patients disappeared or abated obviously.Complications included:chest pain in 36 cases(35.3 %),restenosis in 7 cases(6.9%),stomach-esophageal countercurrent in 6 cases(5.9%),stent migration in 6 cases(5.9%),esophageal bleeding in 4 cases(3.9%),esophagus-mediastinum fistula in 1 case(1%),stent jam in 1 case(1%)and stent fell off accompanied with rupture partially in 1 case(1%).The mean survival time was 10.6 months.Conclusion The covered stent placement in the treatment of malignant esophageal stenosis is a high effective and easy method,but it is not very safe.

Objective To evaluate the role of adrenal venons sampling (AVS) in differential diagnosis of subtypes in primary aldosteronism.Methods Twenty-two patients diagnosed as primary aldosteronism in the Third Central Hospital of Tianjin from November 201 1 to July 2014, were undergone AVS for measurement of plasma aldosterone and cortisol levels in each adrenal vein and infrarenal inferior vena cava.The data were compared with the results of the thin slice incremental scanning in adrenal and postoperative pathologic diagnosis.Other 8 patients, whose screening test and confirmed diagnosis did not support the primary aldosteronism, with nodule larger than 4 cm pathologically confirmed as non-functioning adrenal adenoma, were also recruited.Results Among all the 22 patients with primary aldosteronism, the incidence rate of hypertention was 95.4％, and the incidence of hypokalemia was 81.8％.Compared with idiopathic hyperaldosteronism patients, the patients with aldosterone producing adenoma had higher blood pressure and aldosterone level in plasma, but lower plasma potassium, while the clinical and biochemical index of the non-functioning adrenal adenoma group were within the normal range.The overall accuracy rate of adrenal CT in the diagnosis of subtypes of primary aldosteronism was 77.27％ (17/22), and the accuracy rates were 78.95％ (15/19) in aldosterone producing adenoma and 66.7％ (2/3) in idiopathic hyperaldosteronism, respectively.The accuracy rate of AVS was 100％ with the ratio of aldosterone to cortisol as the criterion.Conclusions Misdiagnose may occur when using CT scan only to differentially diagnose primary aldosteronism.Compared with CT imaging of the adrenal glands, AVS has higher coincidence rate and is an elective approach to establish the subtype diagnosis of questionable primary aldosteronism.

Objective To assay the plasma omentin level in patients of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD) and investigate the relationship between plasma omentin level,glucose and lipid metabolism,insulin resistance and NAFLD.Methods The plasma omentin level was assayed by enzyme-linked immunosorbent assay(ELISA) in all subjects,including patients of T2DM controls with NAFLD (group A,50 cases),T2DM without NAFLD (group B,50 cases),simple with NAFLD(group C,51 cases) and normal controls (group D,49 cases).Meanwhile,blood glucose,glycosylated hemoglobin(HbA1c),lipids and insulin levels were also measured.Body mass index (BMI) and waist-to-hip ratio were evaluated.Insulin sensitivity was assessed by HOMA-IR.Results The plasma omentin level was (17.85 ±3.68),(13.89 ±10.68),(26.05 ±7.26) and (22.92 ±2.71)μg/L in group A,B,C and D respectively.The plasma omentin level of group A and group B was significantly lower than that of group C and group D(P ＜ 0.05).The plasma omentin level of group A was higher than that of group B (P ＜ 0.05).The plasma omentin level of group C was higher than that of group D (P＜ 0.05).Correlation analysis showed that the plasma omentin level was negatively correlated to weight,BMI,waist,triglyceride,fasting blood glucose,fasting insulin (FINS) and HOMA-IR (P ＜0.05 or ＜0.01),and positively correlated to high-density lipoprotein cholesterol (HDL-C)(P ＜0.01).Multiple stepwise regression analysis showed that BMI,HOMA-IR and FINS was independent variable of omentin.The concentration of omentin was 24.82 μ g/L which could predict the risk of NAFLD in people with normal glucose regulation.Conclusions The plasma omentin level is closely correlated with glucose,lipid metabolism and insulin resistance.Plasma omentin may play an important role in the pathogenesis of T2DM and NAFLD.

Objective To observe the effect of low dosage of uhrashortwave(USW) on infarction volume, B cell lymphocytoma-xl (Bcl-xl) and tumor necrosis factor alpha (TNF-?) after cerebral ischemia-reperfusion in rats and discuss its acting mechanisms. Methods Focal ischemia-reperfusion model was established in 25 rats by re- versible right middle cerebral artery occlusion with filament. The right side cerebral ischemia was lasted for 2 hours and then followed with 24 hours of reperfusion. The content of neurological deficits were evaluated by the Zea-Longa 5-degree scoring system to select rats. After surgery, the rats were divided into 3 groups: blank control group, control group and USW treatment group. The brain of all rats was taken at 24 hours after reperfusion. The cerebral infarction volume, the expression of Bcl-xl and TNF-?were measured and analyzed. Results Twenty-five rats were used in the analysis of results. When compared with the control group, the infarction volume and rate in total cerebral volume of USW group significantly decreased (t = 2.54, 2.33, P

Objective To study the relationship between advanced liver fibrosis and peripheral neuropathy in patients with type 2 diabetes mellitus (DPN). Methods A total of 173 patients (89 men and 84 women) with type 2 diabetes who hos?pitalized in Tianjin Third Central Hospital within nearly three years (2013.02-2015.02) were divided into three groups ac?cording to non-alcoholic fatty liver disease (NAFLD) fibrosis score:group A (NFS≤-1.455), group B (-1.455

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.

Objective: To evaluate the accuracy and clinical value of fractional lfow reserve (FFR) determined by CT coronary angiography (CTA) in relevant patients. Methods: A total of 43 patients treated in our hospitals from 2013-10 to 2015-10 were retrospectively studied. There were 29 (67.40%) with male gender, the average age was (60.2±10.1) years. The patients received CTA at 1 week prior coronary angiography (CAG), the interval between CTA and CAG was (5.4±1.6) days. FFR was measured by both CAG and CTA (FFRCT) in selected target vessel which was deifned as maximal diameter reduction 50% to 70%. The imaging data were recorded and compared, FFRCT was calculated. Results: 48 vessels from 43 patients were eligible for analysis as target vessels. FFRCT vas evaluated based on the gold criteria of FFR. FFRCT had the diagnostic accuracy at 83.3%, sensitivity 75.0%, speciifcity 89.3% and positive predictive value was 83.3%, negative predictive value was 83.3% respectively. FFR and FFRCT showed obvious correlation (r=0.704,P<0.001); Bland-Altman analysis presented good concordance with 95% limits of agreement for FFRCTand FFR value ranged from -0.12 to 0.16, and 95.8% of the points (46/48) fell in the 95% limit of agreement, Receiver operating characteristic curve indicated that AUC of FFRCT was 0.871 (95% CI 0.770-0.973). Conclusion: CTA could accurately assess FFR, and FFRCT might be used in guiding the treatment for patients with intermediate coronary stenosis in clinical practice.

Objective To investigate the relationship between plasma levels of chromogranin A (CHGA) and adi-pose triglyceride lipase (ATGL) in patients with type 2 diabetes (T2DM) combined non-alcoholic fatty liver disease (NAFLD). Methods The plasma levels of CHGA and ATGL were assayed by enzyme-linked immunosorbent assay (ELISA) in T2DM patients with NAFLD (group A, n=74), T2DM without NAFLD (group B, n=76), and normal group (group NC, n=75). The correlation between CHGA, ATGL and other metabolic index was analyzed. Results The plasma level of CHGA was significantly higher in group A (83.15±9.46) and group B (70.90±2.75) than that of group NC (46.74±8.15, P<0.01), and the level of CHGA was significantly higher in group A than that of group B (P<0.01). The plasma level of ATGL was sig-nificantly lower in group A (21.36±13.42) and group B (40.29±22.83) than that of group NC (72.30±26.41, P<0.01), and the level was lower in group A than that of group B (P<0.01). There was a negative correlation between the plasma CHGA, AT-GL and carbohydrate oxidation rate in group A. There was a positive correlation between fasting insulin (FINS), insulin resis-tance index (HOMA-IR), free fatty acid (FFA) and fat oxidation rate in group A. There was a negative correlation between plasma level ATGL and body mass index (BMI), FINS, cholesterol (TC), triglyceride (TG) and HOMA-IR, meanwhile, it was positively correlated with FFA. The multiple stepwise regression analysis showed that FINS, ATGL and FFA were indepen-dent variables for CHGA. The Logistic regression analysis showed that plasma levels of CHGA, ATGL and FFA were the in-dependent predictors of T2DM with NAFLD. Conclusion The plasma levels of CHGA and ATGL are closely correlated with substance and energy metabolism, and the interaction between them may play an important role in the pathogenesis of T2DM with NAFLD .