Objective To investigate the predictive value of plasma lipoprotein phospholipase A2 (Lp -PLA2 )and D -dimer in patients with hypertension complicated with stroke.Methods 70 hypertensive patients with stroke were selected as A group,72 patients with simple hypertension were selected as B group,and 71 healthy sub-jects were selected as C group.The light transmitting method was used to detect serum Lp -PLA2 ,and immunoturbi-dimetry was used to detect plasma D -dimer.The clinical value of the two joint detection and single detection in prediction of hypertension complicated with stroke was analyzed.Results The plasma Lp -PLA2 and D -dimer levels of A group were (471.88 ±181.49)ng/mL,(982.54 ±373.28)μg/mL,which were higher than those of B group[(195.17 ±34.74)ng/mL,(263.57 ±29.70)μg/mL]and C group[(122.94 ±46.25)ng/mL,(96.44 ± 8.49)μg/mL](F =189.7,171.1,all P =0.000).The plasma Lp -PLA2 level of A group was positively correlated with D -dimer(r =0.692,P <0.01).The plasma D -dimer >252g/mL forecast hypertension stroke risk sensitivity was 83.3% and specificity was 98.6%,the plasma Lp -PLA2 >176.36ng/mL forecast hypertension stroke risk sen-sitivity was 92.9% and specificity was 83.1%,and the combined prediction of hypertension stroke risk sensitivity was 87.6%,specificity was 93.5%.Conclusion The plasma levels of Lp -PLA2 and D -dimer are significantly increased in hypertensive patients with stroke,and the combined detection of the two indicators can improve the prediction of stroke risk in patients with hypertension.

By analyzing the related indicators [hepatic CYP450 subtype and renal organic anion and cation transporters (OATs and OCTs)], the present study investigated the effects of formula Banxia Houpo decoction principal drug pinellia, assistant drug magnolia, their compatibility and the principle of the whole decoction on the metabolism ability in the liver and the transport change in the kidney of mice. Biochemical and molecular (RT-PCR and western blotting) results indicated that pinellia increased activity and expression of hepatic Cyp2e1 and Cyp3a11 in mice, respectively. Pinellia and magnolia increased expression of renal OAT1, OAT3, OCT1 and OCT2 in mice, respectively. The compatibility of pinellia and magnolia, as well as Banxia Houpo decoction synergistically restrained the activated effect of pinellia on hepatic Cyp2e1, therefore avoiding liver peroxidation and reducing toxicity potential. The compatibility of this drug pair and Banxia Houpo decoction not only reduced activity and expression of hepatic Cyp3a11 to control drug metabolism speed, but also balanced the expression of renal OAT1/3 and OCT1/2 to enhance drug efficacy. The effect of compatibility of Banxia Houpo decoction was better than that of pinellia and magnolia pair, and the normal dosage was better than the high dosage. The present study proved the advantage of the compatibility of pinellia combined with magnolia and the principle of Banxia Houpo decoction, which related to hepatic CYP450 and renal organic ion transporters, and guided the clinical use of Banxia Houpo decoction to exert its toxicity reduction and efficacy enhancement.
Animals ; Cytochrome P-450 Enzyme System ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression ; drug effects ; Kidney ; drug effects ; metabolism ; Liver ; drug effects ; enzymology ; metabolism ; Male ; Mice ; Organic Anion Transporters ; genetics ; metabolism

Objective To investigate the differences of X-ray findings of skeletal fluorosis between coal-burning type endemic fluo-rosis and industrial fluorosis.Methods The patients were randomly selected as research objects including 60 cases of coal-burning type endemic osteofluorosis and 60 cases of industrial osteofluorosis.The X-ray findings on the left forearm,crus and pelvic radio-graphs of these patients were analyzed retrospectively to find out the differences between skeletal fluorosis of coal-burning type endemic fluorosis and industrial fluorosis.Results X-ray features are no significant statistical differences between coal-burning type endemic fluorosis and industrial fluorosis,except these of interosseous membrane ossification of forearm and crus (forearmχ2=10.909,P<0.05;crusχ2=8.547,P<0.05),obturator membrane ossification of pelvis (χ2=36.554,P<0.05),periosteal proliferation outside bone of crus (χ2=4.937,P<0.05),and ossification of soleus (χ2=4.904,P<0.05).Conclusion The X-ray signs of endemic osteofluorosis and industrial skeletal fluorosis are almost similar,but there are some differences between them.

Objective: To preliminarily establish the reference interval for serum creatinine in healthy adults aged 20-79 years in city of Lianyungang. Methods: A total of 34 577 cases of reference individuals were selected from physical examination population by using the principle of complete randomization, and the concentration of serum creatinine was detected by AU5821 automatic biochemical analyzer with its matching reagents.According to the standards of CLSI C28-A3 and WS/T 402-2012 " Clinical Laboratory Test Project Reference Interval Formulation" , the reference interval of serum creatinine was established. Results: There was statistically significant difference of serum creatinine in gender and age between healthy adults in this area (male group: 78[72-84]μmol/L, female group: 61[56-66]μmol/L; aged 20-59 of male group: 78[72-84]μmol/L, aged 60-79 of male group: 77[70-85]μmol/L; aged 20-59 of female group: 60[56-65]μmol/L, aged 60-79 of female group: 63[58-69]μmol/L) (Z=120.93, Z=31.53, Z=28.45; all P<0.05). Therefore, the reference interval of serum creatinine was established based on gender and age, and its reference interval was 61-97μmol/L (aged 20-59 of male), 60-106μmol/L (aged 60-79 of male), 47-76μmol/L (aged 20-59 of female) and 49-86μmol/L (aged 60-79 of female), respectively. Conclusion Establishment of reference interval in serum creatinine plays an important role in the auxiliary diagnosis, progression and prognosis evaluation of various kidney diseases.

Objective:To observe and analyze the atypical magnetic resonance imaging (MRI) findings and misdiagnosis reasons of primary central nervous system lymphoma (PCNSL), and to explore the value of conventional MRI signs combined with minimum apparent diffusion coefficient value (ADCmin) and imaging features of magnetic resonance spectroscopy (MRS) in the diagnosis and differentiation of atypical PCNSL.Methods:The clinical and imaging data of 15 patients with atypical PCNSL confirmed by clinical and pathological findings from Lianyungang Second People′s Hospital and the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2020 was collected. All cases were examined by plain MRI, enhanced and diffusion weighted imaging (DWI), and 3 cases were examined by MRS. The conventional MRI features, DWI signal features and MRS imaging features of 15 cases of atypical PCNSL were observed and analyzed, and the MRI findings of atypical PCNSL and the causes of misdiagnosis were summarized and analyzed. The ADCmin of tumor parenchyma, the mean ADC values of proximal peritumor, distal peritumor and contralateral white matter were detected and compared to explore the variation rules of ADC values in different regions.Results:Of the 15 cases of PCNSL, 14 cases were single and 1 case was multiple, with a total of 21 lesions. (1) Single lesions in rare sites: 4 cases in the superficial part of the brain, 1 case in the bridge arm, 1 case in the cerebellar hemisphere, 1 case in the suprasellar saddle, and 1 case in the third ventricle. (2) Atypical MRI findings: cystic degeneration or necrosis in 5 lesions (5/21), accompanied by hemorrhage in 1 lesion (1/21); There were 3 isosensitive lesions on DWI, and isosensitive lesions on ADC false color images. There were 5 ring enhancement lesions and 3 sheet enhancement lesions. (3) Multi-center growth pattern: 1 case with a total of 7 lesions, located in the right thalamus, basal ganglia and corona radiata, showing multiple nodules and ring enhancement. 1H-MRS examination showed that choline (Cho) peak increased, creatine (Cr) peak decreased, N-acetyl aspartate (NAA) peak decreased, and obvious Lip peak appeared in all the 3 cases with single lesions. 2 cases showed high Lip peak as the first peak. The ADCmin values of tumor parenchyma, proximal peritumor, distal peritumor and contralateral white matter showed a parabola pattern of first rise and then decline, as follows: (0.54±0.06)×10 -3 mm 2/s, (1.55±0.10)×10 -3 mm 2/s, (1.45±0.09)×10 -3 mm 2/s, (0.85±0.03)×10 -3 mm 2/s, overall difference was statistically significant ( F=630.570, P<0.001). The pairwise comparison was statistically significant (all P<0.05). Conclusions:Atypical PCNSL is easy to be misdiagnosed. Conventional MRI feature analysis combined with DWI and MRS imaging features and comparison of ADC values in different tumor areas are helpful for the diagnosis and differentiation of PCNSL and are expected to improve diagnostic accuracy.

Objective To explore the value of diffusion-tensor imaging(DTI)of different gray matter nuclei in the diagnosis and assessment of prodromal Parkinson's disease(pPD)under logistic regression model.Methods A total of 20 patients with pPD were collected as case group and 28 healthy people as control group(HC group).All patients were examined by MRI plain scan and DTI.DSI studio was used to post-process the DTI images of all patients.Parameters(FA,MD,AD,RD)of basal ganglia,midbrain and brainstem of patients with pPD and HC group were automatically extracted and statistically analyzed.Logistic regression analysis was used to draw the Receiver Operating Characteristic(ROC)curve to analyze and compare the diagnostic efficacy of individual diagnosis and combined diagnosis of each parameter.And the correlation between the parameters of each group and MMSE score was analyzed.Results There were statistical differences in basal ganglia,midbrain and brain stem in PPD and HC group(P<0.05).Under Logistic regression equation model,when the optimal threshold was 0.63,the AUC of PPD was 0.964.The sensitivity and specificity of differential diagnosis were 85.0%and 100%respectively(P<0.001).There was correlation between DTI parameters and MMSE score in locus coeruleus in PPD group(P<0.05),and the correlation coefficient of FA value in locus coeruleus(r =-0.646,P = 0.002)was the highest.Conclusions The lesions of basal ganglia,midbrain and brainstem correlated gray matter nuclei in pPD were extensive and differ-ent in degree.AD value of locus coeruleus was valuable for quantitative diagnosis of pPD,FA value of locus coeruleus could be used as a characteristic sensitive index for recognition of the severity of dysfunction in pPD patients.Multi-parameter combined diagnosis of DTI under Logistic regression model could effectively improve the diagnostic efficiency,and provide valuable reference for early diagnosis and intervention of pPD.

Objective:To evaluate whether index of microcirculatory resistance(IMR)is associated with left ventricular(LV)remodeling in acute anterior ST elevation myocardial infarction(STEMI)pa-tients undergoing primary percutaneous coronary intervention(PPCI).Methods:This was a single-center retrospective cohort study.The patients with first anterior STEMI who received PPCI from January 2014 to August 2017 in Peking University Third Hospital was enrolled.After PPCI,IMR was measured immediately by using pressure/temperature guidewire.The success rate of IMR measurement was 100％.Also we collected some related clinical data from the medical records and laboratory results.Infarct size[assessed as creatine kinase(CK)peak],echocardiography at baseline and 1 year follow-up were as-sessed.LV adverse remodeling(LVAR)was defined as ≥20％increase in LV end-diastolic volume(LVEDV).Results:A total of forty-three patients were enrolled,with an average age of(58.7±12.4)years.The patients were divided into two groups as IMR ≤25 and IMR＞25 by normal values recommen-ded by previous literature.Compared with IMR ≤25 group,IMR＞25 group had a higher percentage of initial thrombolysis in myocardial infraction(TIMI)grade 0(95.7％vs.65.0％,P=0.029),higher serum CK peak value[4 090(383,15 833)vs.1 580(396,5 583),P=0.004].The IMR＞25 group suffered higher rates of ventricular aneurysm(30.4％vs.5.0％,P=0.021).There was no difference in LVEDV[(111.0±18.8)mL vs.(115.0±23.6)mL,P=0.503]between the two groups 1 day after MI,but after 1 year,LVEDV in IMR＞25 group was significantly higher than in IMR≤25 group[(141.5± 33.7)mLvs.(115.9±27.9)mL,P=0.018].The incidence of LVAR was more significant in IMR＞25 group(47.4％vs.11.8％,P=0.024).Binary Logistics regression showed that IMR[B=0.079,exp(B)(95％CI)=1.082(1.018-1.149),P=0.011]and serum triglyceride level[B=1.610,exp(B)(95％CI)=5.005(1.380-18.152),P=0.014]were the predictors of LVAR 1 year after MI.IMR had a good predictive value for LVAR 1 year after MI[area under the curve(AUC)=0.749,P=0.019],IMR＞29 was a good cutoff value with sensitivity 81.8％and specificity 68.0％.Conclusion:Our study elaborates that immediate measurement of IMR after PPCI in patients with STEMI can reflect the microvas-cular function.And IMR could be used as a quantitative biomarker to predict LVAR after STEMI.