Objective To explore the levels of plasma P-selectin and serum vascular endothelial growth factor(VEGF)and the correlations with blood lipid and c-reative protein(CRP)in patients with subcortical arteriosclerotic encephalopathy(SAE).Methods The levels of plasam P-selectin,serum VEGF,blood glucose,blood lipid and CRP from the SAE group with 54 patients,and normal control(NC)group with 57 healthy elder were compared and correlated analyzed.Results The levels of P-selectin [(17.61?5.63)ng/ml ]and VEGF[(126.33?47.51)pg/ml] in SAE group were significantly higher than those in NC group[(14.72?3.89)ng/ml,(102.59?40.16)pg/ml](all P

Face ; Facial Paralysis ; Humans

Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were

Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Objective:To investigate the current situation of network ethics among the college students , to pro-vide evidence for cultivating correct network ethics .Methods:A survey was conducted in 1200 students with a self-designed questionnaire .Results:College students in the network ethics exist conflicts .They eager to trust but face a crisis of confidence , tool enhancements but responsibility fall , network security but network open , virtual but reality.Conclusion:The government should strengthen the network legislation and network credit system , should increase the development of network security technology so as to build networks ethical norms .Colleges should pay attention to culture the social responsibility , and promote the quality level of network ethics among the college students .

Adults-onset nesidioblastosis,as a differential diagnosis of organic hyperinsulinemic hypoglycemia,is very rare and has been recognised as "noninsulinoma pancreatogenous hypoglycaemia syndrome(NIPHS)".Here we described an extremely rare case of NIPHS in an eldly type 2 diabetes mellitus with insulin therapy.A 84-year old male was diagnosed as type 2 diabetes six years ago and switched from an oral hypoglycemic drug to pro-mixed insulin treatment 3 years ago.According to medical records,he had good-glucose control over few hypoglycemia.He was admitted to hospital due to frequent fasting hypoglycaemic episodes and comas despite withdrawal of any anti-diabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin/C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinemic hypoglycemia with high C-peptide level was consistent with the possible diagnosis of insulinoma,but localizing studies including computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% distal pancreatectomy was performed.Histological examination of the resected pancrease revealed an increased number and size of islets consistent with nesidioblastosis.After transient decline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglycemia was mild and controlled by regular night eating postpancreaectomy.Abstract:SUMM ARY Adults-onset nesid ioblastosis,as a d ifferential d iagnosis of organic hyperinsulinem ic hypo-glycem ia,is very rare and has been recognised as"noninsulinoma pancreatogenous hypoglycaem ia syn-drome(NIPHS)".Here we described an extremely rare case ofNIPHS in an eldly type 2 d iabetesmelli-tus with insulin therapy.A 84-year old male was d iagnosed as type 2 d iabetes six years ago and switched from an oral hypoglycem ic drug to pro-m ixed insulin treatment 3 years ago.Accord ing tomed ical records,he had good-glucose control over few hypoglycem ia.He was adm itted to hospital due to frequent fasting hypoglycaem ic episodes and comas despite withdrawal of any anti-d iabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin /C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinem ic hypoglycem ia with high C-peptide level was consistentwith the possible d iagnosis of insulinoma,but localizing stud ies includ ing computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% d istal pancreatectomy was performed.H istological exam ination of the resected pancre-ase revealed an increased number and size of islets consistent with nesid ioblastosis.After transient de-cline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglyce-m ia was m ild and controlled by regular night eating postpancreaectomy.

Forensic Medicine ; Formaldehyde

Objective To investigate the relation among the results of thyroid fine needle aspiration cytology(FNAC),thyroid ultrasonography(US)and histopathologic diagnosis about the thyroid nodules detected by physical examination,meanwhile to analyze the etiopathogenesis of the nodtries and to evaluate the risk of thyroid cancer and the clinical diagnostic value of FNAC.Methods The data of thyroid FNAC results of the thyrroid nodules detected by physical examination in 271 cases were analyzed and compared with thyroid US and histopathologie diagnosis.Resuit (1)The FNAC results showed that the incidences of malignant and suspected mali-gnant lesions were 1.48%and 5.90%respectively.The rate of benign lesions was 78.60%and that of goiter was 29.15%,Hashimoto's thyroiditis 26.57%and thyroid adenoma 15.13%.Benign lesions were more common than malignant ones.(2)Comparison of the FNAC and US results of the thyroid nodules showed that of 96 cases with single nodule the rates of malignancy and suspected malignancy were 3.12%and 7.29%,but of 137 cases with multiple nodules the rates of the two lesions were 0.73%and 6.57%.In 108 cases with smaller nodules(≤1.5 cm)the rate of malignancy and suspected malignaney found with FNAC were 0.93%and 7.41%,while in 125 cases with greater nodules (＞1.5 cm)the rate of the two lesions were 2.40%and 6.42%.In 99 solid nodules the rates of malignancy and suspected malignancy were 2.02%and 12.12%,while in 85 cystic or mixed nodules the rates of the two lesions were 2.35%and 2.35%.In the above-mentioned three groups,only the suspected malignaney rate in solid nodules was higher than these in cystic or mixed ones with significant difference (P=0.013).(3)As compared with the cytological and histological diagnoses in 24 cases,the diagnostic accuracy of FNAC was 75.00%and the rates of false positive and false negative were 25.00%and 0,respectively.Conclusions The common causes of the thyroid nodules detected in physieal examination are goiter,Hashimoto's thyroiditis and thyroid adenoma.FNAC is a reliable method to define the benign or malignant nature of thyroid nodules with a high diagnostic accuracy.US features of the nodule alone,no matter it is single,solid or of greater size do not sufficiently increase the incidence of thyroid carcinoma.

Objective To evaluate the clinical effect of group cognitive behavioral therapy on blood glucose levels,anxiety and depression in patients with type2 diabetes mellitus.Methods Ninety three patients with type 2 diabetes mellitus were recruited and randomly divided into intervention group (n =48) and control group (n =45).Both groups received diabetes health education,patients in intervention group received additional group cognitive behavioral therapy.The glucose tolerance,glycosylated hemoglobin A1c were measured; the HAMA(Hamilton Anxiety Scale)scores,HAMD(Hamilton Depression Scale)scores and CSQ (Coping Styles Questionnaire) scores in patients were analyzed before and 6 months after treatment.Results After 6-month treatment the fasting blood glucose (6.33 mmol/L vs.5.94 mmol/L),1 h postprandial plasma glucose(12.40 mmol/L vs.11.46 rmool/L),2 h postprandial plasma glucose (10.24 mmol/L vs.9.13 mmol/L),A1 c (6.31％ vs.6.07％) in intervention group were decreased significantly,compared to baseline values (all P ＜ 0.05).The HAMA total score (9.98 vs.8.14),somatic anxiety (3.98 vs.3.48),psychic anxiety(6.00 vs.4.67),HAMD total score(10.74 vs.6.93),anxiety somatic(5.02 vs.3.26),block(2.24 vs.1.38)and sleep disorders(2.40 vs.1.40)in intervention group were all decreased significantly(P ＜ 0.01 or 0.05).There were significant differences in HAMA total score (8.14 vs.9.15),HAMD total score(6.93 vs.9.33),anxiety somatic(3.26 vs.4.38),block(1.38 vs.1.98)and sleep disorders(1.40 vs.2.03)between the intervention group and control group(P ＜ 0.01 or 0.05).And the negative coping style scores in intervention group was also lower than that of the baseline (26.74 vs..29.43).Conclusion The group cognitive behavioral therapy combined with diabetes health education for patients with type 2 diabetes mellitus may improve the glucose metabolism and depression and anxiety status of patients.

The genus Nodulisporium, is known to produce secondary metabolites with structural diversity. A new alkaloid, 2-hy- droxy-1,1-dimethyl-1,2,3,9-tetrahydro-4H-carbazol-4-one(1), was isolated from the extract of a fungal strain Nodulisporium sp. fermented with rice, together with three known phenols, tyrosol(2), hydroxytyrosol(3), and hydroxytyrosol acetate(4). Their structures were identified by detailed spectroscopic analyses.
Alkaloids ; chemistry ; isolation & purification ; Xylariales ; chemistry