Aged, 80 and over ; Amyloid beta-Peptides ; metabolism ; Brain ; pathology ; Cerebral Amyloid Angiopathy ; complications ; metabolism ; pathology ; Cerebral Hemorrhage ; etiology ; pathology ; Consciousness Disorders ; etiology ; pathology ; Humans ; Male

ObjectiveTo investigate the incidence and the cause of chronic pain in maintenance hemodialysis(MHD) patients,and the effect of chronic pain on quality of life.Methods Seventy MHD patients in dialysis centre of our hospital were enrolled in the study and divided into 2 groups according to pain symptoms.There were 32 patients with chronic pain in pain group,and 38 patients without chronic pain in painless group.Pain degree was evaluated by numerical rating scale (NRS,1 to 10) in pain group.Parathyroid hormone (PTH),β2-microglobulin (β2-MG) and bone mineral density(BMD) of all the patients were measured.Depression and insomnia degrees were examined by Beck depression index (BDI) and Pittsburgh sleep quality index (PSQI) respectively.Correlations were performed among parameters.Results The incidence of chronic pain in MHD patients was 45.7％ and the mean pain intensity of NRS was 5.71±1.86(95％ CI,5.04-6.38).There were significant differences of PTH,BMD,β2-MG,BDI score and PSQI score between two groups(all P＜0.01).The painful degree was positively correlated with levels of PTH and β2-MG,and the scores of PSQI and BDI,and was negatively correlated with BMD in pain group.Conclusion Chronic pain is common in MHD patients with different location and moderate degree,which can aggravate the depression and insomnia and may be associated with the changes of PTH,β2-MG and BMD.

Acupuncture Points ; Adult ; Electroacupuncture ; Female ; Head ; innervation ; Humans ; Neuritis ; therapy

Object To develop a simple and reliable method to detect the presence of uronic acids in polysaccharides Methods Uronic acid containing polysaccharides and standard glucons were subjected to acid hydrosis for 2 h and 4 h respectively. Samples of the products, before and after hydrolysis were analyzed by TLC using standard uronic acid as the control and aminobenzen alizaric acid as the chromogenic agent, to compare the sensitivities in the detection of uronic acid used in the present conventional analysis. Results The fluorescent spots used as criterion in traditional TLC method were not shown by uronic acids, but by CF 3COOCH 3 and other by products in reaction 0 5 ?g of uronic acid could be detected with our method, without false positive reaction Conclusion The traditional TLC method seemed to lack theorectical background and may mislead structural study The present method in more reliable to detect uronic acids in polysaccharides by analyzing the complete hydrolytic products of polysaccharides using TLC with standard uronic acids as control and aminobenzene alizaric acid as chromogenic agent

Objective To investigate the safety and clinical prognosis of breast conserving operation in treat-ment of triple negative breast cancer.Methods 157 patients with breast cancer were divided into the non triple nega-tive breast cancer group (n=76) and triple negative breast cancer (n=81) according to its receptor expression,clin-ical pathological features, local recurrence after 5 years.Distant metastasis and survival situation were compared between two groups.Results The age<35 years patients of triple negative group accounted 17.3%,significantly higher than 7.9%of the non triple negative group(χ2 =5.331,P<0.05);the size of tumor≥5cm of triple negative group accounted 79.0%,significantly higher than 59.2% of the non triple negative group(χ2 =7.022,P<0.05);The patients with positive family history and lymph nodes of the triple negative group were 9.9%and 28.4%,signifi-cantly higher than 2.6%and 17.1%of non triple negative group,the difference between the two groups was statisti-cally significant (χ2 =6.283,4.865,all P<0.05);The local recurrence,distant metastasis rate and 5 year survival rates between the two group were not significantly different(χ2 =2.559,2.829,2.361,all P>0.05);The 5 year dis-ease free survival rate of the triple negative group was 80.25%,significantly lower than 94.74%of the non triple neg-ative group (χ2 =6.572,P<0.05).Conclusion The patients with triple negative breast cancer is younger,their tumor size is large and has a high proportion of family history.Their recurrence rate,distant metastasis rate and 5 year overall survival rate are as better as the patients with non triple negative breast cancer after breast preservation opera-tion,which has high security and good clinical application value.

BACKGROUND: As a kind of polypeptide, angiotensin-converting enzyme (ACE) inhibitory peptide can lower the blood pressure of human body through restraining the formation of angiotensin Ⅱ.OBJECTIVE: To investigate the influence of AGE inhibitory peptide on endothelial cell proliferation and endothelin expression in cultured human umbilical vein cells based on cellular and molecular levels in order to provide the experimental evidences for ACE inhibitory peptide to be the potential blood pressure-lowering health food.DESIGN: Repeated measures design.SETTING: School of Bioscience and Bioengineering, South China University of Technology; School of Applied Chemistry and Biological Technology,Shenzhen Polytechnic.MATERIALS: The experiment was carried out in the Institute of Applied Chemistry and Biological Technology, Shenzhen Polytechnic from September 2004 to March 2005. The AGE inhibitory peptide was provided by the Institute of Applied Chemistry and Biological Technology, Shenzhen Polytechnic. Under certain circumstance, 15 μ mol/L of the inhibitor was needed to decrease half of the AGE activity. The human umbilical vein endothelial cells of the 4th generation were cultured randomly in 7 groups with different concentrations: medium group, 150, 300 and 600 mg/L ACE inhibitory peptide groups, captopril group, norepinephrine(NE) group, and ACE inhibitory peptide+NE group.METHODS: ①The endothelial cells were cultured as recommended. The medium was M199+FBS(0.15, v/v)+penicillin(10 000 U/mL)+streptomycin (100 mg/L). After cellular fusion, the cells were carried on the passage with the ratio of 1:2. The 4th generation cells were used for experiment. ②M199(0.15, v/v) was contained in each group. ACE inhibitory peptides were added to make the final concentration 150, 300 and 600 mg/L in the 150, 300 and 600 mg/L ACE inhibitory peptide groups respectively. Captopril was added to make the final concentration 10-5 mol/L in the captopril group. NE was added to make the final concentration 100 μg/L in the NE group. ACE inhibitory peptide and NE were added to make the final concentration 300 mg/L and 100 μg/L in the ACE inhibitory peptide+NE group respectively. ③The state of cell growth was determined with cytometry. The contents of endothelial cells in the medium with different culture times were determined with radioimmunoassay. The expression of endothe lin mRNA was determined with reverse transcriptase-polymerase chain reaction. The expression of cellular endothelin protein was determined with immunohistochemical method.MAIN OUTCOME MEASURES: ①The influence of ACE inhibitory peptide on endothelial cell proliferation. ②The influence of ACE inhibitory peptide on the endothelin mRNA and endothelin protein.RESULTS: ①The influence of ACE inhibitory peptide on endothelial cell proliferation and endothelin secretion: Compared with the medium group,in the captopril and 150, 300, 600 mg/L ACE inhibitory peptide groups,the growth of endothelial cells was restrained and the endothelin content in the medium was lowered(P ＜ 0.01 or 0.05). NE could promote the growth of endothelial cells and the secretion of endothelin, but the cell density and endothelin content after treatment with ACE inhibitory peptide were similar to those in the medium group (P ＞ 0.05). ②The influence of ACE inhibitory peptide on the expressions of endothelin mRNA and protein in endothelial cells: Compared with the medium group, the expressions of endothelin mRNA and protein might be lowered in the captopril and 150,300, 600 mg/L ACE inhibitory peptide groups(P ＜ 0.01 or 0.05). The expressions of endothelin mRNA and protein could be up-regulated by NE.The gene expression after treatment with ACE inhibitory peptide was similar to that in the medium group(P ＞ 0.05).CONCLUSION: The ACE inhibitory peptides of different dosages can all restrain the growth of endothelial cells, lower the endothelin content, decrease the expression of endothelin gene and resist NE improved growth and secretion of endothelial cells in umbilical vein cell effectively.

Objective To investigate the relationship between inflammatory factors,including C-reactive protein( CRP),tumor necrosis factor alpha (TNF-α),adiponectin,leptin and gestational diabetes mellitus (GDM) and their changes in puerperiunr Methods From June 2008 to May 2010,40 cases with gestational diabetes mellitus,40 cases of normal pregnancy were enrolled in this study.Fasting venous blood were obtained at early pregnancy (10 - 12 weeks),late pregnancy (36 -38 weeks) and day 3 and 42 of postpartum.Serumal adiponectin,leptin and TNF-α were measured by ELISA,and serumal CRP were measured by particle enhanced immunoturbidimetric method.The levels of those 4 cytokines and homeostasis model assessment insulin resistance (HOMA-IR) index were compared between two groups.And the changes of 4 cytokines were calculated in puerperium.The receiver operating characteristic (ROC) for TNF-α predicting GDM was designed.Results ( 1 ) The relationship between cytokines and HOMA-IR:the levels of adiponectin of (5.7 ± 1.8 ) mg/L in the GDM group were significantly lower than ( 8.1 ± 2.7 ) mg/L in control group in early pregnancy,and the level of adiponectin was negatively correlated with HOMA-IR (r=-0.333,P＜0.05).The levels of (28 ± 10) μg/L of leptin,( 10.0 ±3.4) ng/L of TNF-α and (4.7 ± 1.1 ) mg/L of CRP in GDM group were significantly higher than ( 20 ± 8 ) μ,g/L of leptin,(4.6 ±2.7) ng/L of TNF-α,(2.4 ± 1.2 ) mg/L of CRP in control group,which were positively correlated with HOMA-IR ( r =0.411,0.529,0.308,all P ＜ 0.05 ).In late pregnancy,the level of adiponectin ( 3.9 ±2.2) mg/L in the GDM group was significantly lower than ( 6.6 ± 2.7 ) mg/L in control group,and the level of adiponectin was negatively correlated with HOMA-IR ( r =- 0.344,P ＜ 0.05 ).The levels of ( 37 ±13) μg/L of leptin,( 12.7 ±2.6) ng/L of TNF-α and (6.7 ±3.6) mg/L of CRP in the GDM group were significantly higher than ( 30 ± 13 ) μg/L of leptin,(5.8 ± 2.1 ) ng/L of TNF-α,( 4.4 ± 3.1 ) mg/L of CRP in control group,which were positively correlated with HOMA-IR (r =0.414,0.487,0.285,all P ＜0.05).Multiple linear regression analysis showed that the level of TNF-α at early and late pregnancy was most correlated with HOMA-IR ( r =0.390,0.284,all P ＜ 0.05 ).( 2 ) The level of the cytokines and HOMA-IR in puerperium:at day 3 of postpartum,the level of adiponectin of (3.3 ± 1.1) mg/L in the GDM group was significantly lower than (6.2 ± 1.5 ) mg/L in control group,which was negatively correlated with HOMA-1R (r =- 0.283,P ＜ 0.05 ).The levels of ( 31 ± 13 ) μg/L of leptin,( 10.1 ± 5.7 ) ng/L of TNF-α and (35.1 ±6.5) mg/L of CRP in the GDM group were significantly higher than (21 ± 15) μg/L of leptin,(5.6 ± 3.0) ng/L of TNF-α,(30.5 ± 8.5) mg/L of CRP in control group.And leptin and TNF-α levels were positively correlated with HOMA-IR (r=0.372,0.494,all P ＜0.05).At day 42 of postpartum,the level of adiponectin in GDM group was negatively correlated with HOMA-IR ( r =- 0.299,P ＜ 0.05 ),and the levels of leptin and TNF-α were positively correlated with HOMA-IR ( r =0.401,0.442,all P ＜0.05 ).Multiple linear regression analysis showed that the level of TNF-αt at day 3 and day 42 was most correlated with HOMA-IR ( r =0.363,0.274,all P ＜ 0.05 ).( 3 ) ROC analysis of data from early pregnancy showed that the threshold for TNF-α to predict GDM was 5.45 ug/L.Conclusion TNF-ot might be the index to predict GDM and evaluate prognosis.

Objective To investigate the correlation between QRS amplitudes and left ventricular wall thickness in autopsy specimens of elderly men.Methods The data of autopsy cases in our hospital since 1990 were retrospectively analyzed.The cases with QRS duration≥0.12 s and the pacing electrocardiogram were excluded.QRS amplitudes of standard 12-lead electrocardiography in 3 months before death were measured and the correlation between QRS amplitudes and left ventricular wall thickness was analyzed in the elderly men.Results Correlations were found between the amplitudes of the R waves in leads V5 ,V6, Ⅰ ,aVL[(1.1±0.7) mV, (0.95±0.6) mV, (0.44±0.3)mV and(0.35±0.3)mV] and left ventricular wall thickness[(13.6±5.4)mm;r=0.22,0.14,0.22,0.23,all P<0.05], and between the combination of QRS amplitudes SV1 +RV5 or RV6(1.9±1.2) mV] and left ventrieular wall thickness [(13.8± 5.4) mm; r = 0.23, P < 0.05].The correlationbetween the combination of QRS amplitudes (SV1 + RV5 or RV6 ) and left ventricular wall thickness was the strongest in 60-79 years old cases (r=0.48, P<0.01) ,and was decreased in 80-89 years old cases (r= 0.23, P<0.05).There was no correlation between the combination of QRS amplitudes (SV1+RV5or RV6) and left ventricular wall thickness in 90-101 years old cases (r= 0.03, P> 0.05).Conclusions Electrocardiogram is a reliable method for diagnosis of left ventricular hypertrophy in elderly men aged < 90 years.

Objective To investigate the clinical effectiveness of dynamic hip screw (DHS) internal fixation and proximal femoral nail (PFN) internal fixation for intertrochanteric femoral fractures.Methods One hundred and sixty-five patients with intertrochanteric femoral fractures were randomly divided into 2 groups,85 patients were in DHS group and 80 patients were in PFN group.The clinical effectiveness,index in operative procedure and complications were compared between two groups.Results The fine rate of DHS group and PFN group was 75.3％(64/85 ) and 83.8％( 67/80 ) (P ＞ 0.05 ).The indexes of function recover time,fracture healing time,amount of bleeding in operation,operation time in PFN group were significant lower than those in DHS group [(54.3 ± 11.7 ) d vs.(92.6 ± 10.5 ) d,(63.8 ± 12.2) d vs.(71.3 ± 10.6) d,(453.3 ± 50.7) ml vs.(627.5 ± 46.8) ml,(77.9 ± 25.2) min vs.( 115.7 ± 32.8) min](P＜0.05 ).The rate of short-term complications was 16.2％ (13/80) in PFN group,and 12.9 ％ ( 11/85 ) in DHS group(P ＞ 0.05 ).The rate of long-term complications was 1.2％( 1/80 ) in PEN group and 4.7％(4/85 ) in plts group (P ＜ 0.05).Conclusions As the treatment of intertrochanteric femoral fractures,PFN internal fixation has less bleeding and better efficacy,and can improve function recovery.PFN internal fixation is a better method for unstable femoral fracture.

Command of the JCI standard is conducive to promoting the "Patient-centered" quality management concept awareness and realizing the patient safety objective. To this end, a campaign to stage the hospital quality management system and bottom-up quality activities has been launched. These efforts may help improve the hospital quality management system, covering such aspects as standardized document management, human resource management, normalized diagnosis and therapy management centering on clinical path, clinical nursing service quality, safety management, equipment and facility management, as well as data analysis and quality improvement system. These have been subject to and certified by JCI with a gold medal.