156 stroke patients were assessed retrospectively by Self Depression Scale. The incidence of depression after stroke,and the relationship of depression between age, course, location of impairment, the character of the stroke,and ADL ability were included in the study. The conclusion showed that depression was related significantly to severe impairment in ADL.

Objective:To investigate the methods and nutritional effects of endoscopic jejunal ac cess for enteral feeding.Methods:106 cases placed jejunum feeding tube were randomly divided into the observation group and the control group,54 cases in the observation group and 52 cases in the control group.43 patients underwent nasogastric enteral nutrition were as the nasogastric tube group.The traditional endoscopic jejunal access method was used in control group,and the modified endoscopic jejunal access method was used in observation group.The operation time,the success rate of indwelling,complications and nutritional indexes were compared among these three groups.Results:The operative time of the observation group and nasogastric tube group was significantly shorter than that of the control group (P ＜ 0.05).The success rate of indwelling was significantly lower in the control group (P ＜ 0.05).There was no significant difference in the incidence of postoperative complications among these three groups (P ＞ 0.05).After intubation and nutritional treatment in all the groups,hemoglobin,plasma albumin and serum albumin levels were significantly improved (P ＜ 0.05).There were no significant differences in nutritional indexes between the observation group and the control group (P ＞ 0.05).The levels of hemoglobin,plasma albumin and plasma prealbumin in nasogastric tube group were significantly lower than those in the observation group and the control group (P ＜ 0.05).Conclusion:Modified endoscopic jejunal access for enteral feeding can effectively shorten the intubation operation time and improve success rate and nutritional indexes.

Objective To investigate the changes of anticardiolipin antibody(ACA) and protein C(PC) in cirrhotic patients with or without portal vein thrombosis(PVT). Methods During Jan. 2006 to Dec. 2007, 60 cirrhotic patients with (n=20) or without (n=40) PVT were analyzed. The concentrations of prothrombin time (PT), activited patial thromboplastin time (APTT), fibrogen, ACA and protein C (PC) were determined. Results The positive rate of ACA was 35% (7/20) in PVT group and 10% (4/40) in control group (P=0.045). The average level of ACA-IgG was significantly higher in PVT group [(10.15±5.31)U/ml] than that in control group [(6.70±3.75) U/ml]. The concentration of PC was significantly lower in PVT group [(2.47±0.62) mg/L] than that in control group [(2.93±0.88)mg/L]. No difference was found in APTT, levels of fibrogen and ACA-IgM between two groups. PT and APTT were progressively prolonged and fibrogen and PC were decreasing with the severity of Child-Pugh, respectively. The levels of ACA-IgG and ACA-IgM were increasing with the severity of Child-Pugh. Conclusions The coagulation and anticoagulation system is abnormal in patients with PVT who has higer ACA-IgG level and lower PC level. It is indicated that the ACA and PC may play an important role in formation of PVT.

Objective To study the protective effects of rosiglitazone against early skin changes in experimental diabetic rats. Methods Diabetic models were established in male Wistar rats aged 8 to 10 weeks by using streptozotocin (STZ). Then, 39 experimental diabetic rats were equally divided into insulin-treated diabetic group (DI group), rosiglitazone-treated diabetic group (DR group), diabetic control group (DC group),and 13 normal rats served as the control (C group). The rats were given subcutaneous insulin (1 - 2 U) twice daily in DI group, intragastric rosiglitazone (5 mg/kg) once daily in DR group, and intragastric sterile water in DC and C groups. Sixteen weeks later, heart blood samples were collected from all the rats for the measurement of tumor necrosis factor (TNF)-α, interleukin (IL)-6, C reactive protein (CRP), superoxide dismutase (SOD) and P substance (SP) levels, then the rats were killed and tissue samples were obtained from the medial area of the dorsal skin and subjected to pathological observation, measurements of skin as well as dermal thickness, and immunohistochemical examinations for the expression of advanced glycation end products(AGEs) and peroxisome proliferator activated receptor-γ (PPAR-γ). Results The levels of IL-6, TNF-α and CRP in the DC group were significantly higher than those in the C group (135.05 ± 43.39 ng/L vs. 99.92 ±32.36 ng/L, 1.45 ± 0.67 μg/L vs. 0.86 ± 0.60 pg/L, 3.51 ± 0.62 mg/L vs. 2.54 ± 1.31 mg/L, all P < 0.05),while no significant difference was found between C group and DI group or DR group (all P> 0.05). Decreased levels of SOD and SP were noted in the DC group (70.71 ± 37.52 U/ml, 22.22 ± 7.93 ng/L), compared withthe C group (137.76 ± 27.6 U/mL, 29.57 ± 3.74 ng/L, both P< 0.01), DI group (149.96 ± 13.25 U/mL, P<0.01; 29.79 ± 5.21 ng/L, P< 0.05) and DR group (128.50 ± 38.27 U/mL, P< 0.01; 33.35 ± 15.0 ng/L, P<0.05 ). Micrometer measurements indicated that the skin thickness was significantly lower in the DC group than in the C group, DI group and DR group (0.77 ± 0.18 mm vs. 1.59 ± 0.26 mm, 1.47 ± 0.50 mm and 1.22 ±0.47 mm, P < 0.01, 0.01, 0.05 respectively). Histological observation found a mild disarrangement of epidermal cells, shrinkage, swelling and degeneration of dermal collagen as well as progressive atrophy or disappearance of subcutaneous fat in the DC group. No obvious histological changes appeared in the DI or DR group. Immunohistochemistry indicated that AGEs and PPAR-γ proteins, which were stained into brown granules, were located in the vascular basement membrane, stromal cells, etc, of skin. The DC group showed the highest expression of AGEs but lowest expression of PPAR-γ. Conclusions There is an accumulation of AGEs and elevated expressions of inflammatory factors in the skin of experimental diabetic rats, and rosigLItazone shows a protective effect against the early skin changes.

Objective To detect mutations in the STK-11 gene in a pedigree with Peutz-Jeghers syndrome (PJS).Methods Blood samples were collected from a 19-year-old male patient with PJS and his unaffected mother,as well as from 100 unrelated healthy human controls.PCR was performed to amplify all the exons of the STK-11 gene followed by sequencing.Results A novel heterozygous missense mutation (G-to-T transition) was identified at position 1251 in the exon 9 of the STK-11 gene in the patient,but not in his mother or the unrelated healthy human controls.Conclusions The missense mutation A417S,which may affect gene transcription and translation,is a specific novel mutation of STK-11 gene.

Objective To evaluate the diagnostic value of multi-slice spiral CT for non-angle caused nutcracker syndrome(NCS). Methods A total of 177 cases of clinical suspected nutcracker syndrome patients recevied multi-slice spiral CT examination,,inclu-ding 33 patients with negative results,144 cases patients with positive results.The analysis was performed by measuring the angle between superior mesenteric artery(SMA)and the abdominal aorta(AA),and the ratio of the diameter of the narrowest and expan-sion in the left renal vein.Results Within 33 cases of nutcracker-negative patients,the angle of SMA and AA was (46.06 ± 24.46)°;the ratio was (2.11±0.76).144 cases was diagnosed as nutcracker-positive patients,the angle of SMA and AA was (23. 10±9.63)°;the ratio was (3.83±1.24).There was positive correlation between angle and ratio in NCS (P<0.0001).Among9 ca-ses of nutcracker syndrome caused by non-angle factors three were oppressed by the uncinate process pancreas,two cases were caused by the malformations of the left renal vein,one case was posterior nutcracker syndrome,one case was oppressed by portal veinOne case of pressured renal vein due to tortuosity renal vein coiled renal artery.One case of the left renal vein compression lumen narrowing,causing significant downward pressure on the left renal vein.Conclusion Spiral CT angiography reconstruction can clear-ly show the cause and the location of the left renal vein compression,which may provide helpful information in diagnosing nutcracker syndrome caused by non-angle factors.

Objective To investigate the relationship between thrombomodulin(TM), fibrinolytic system changes and the score of the model for end-stage liver disease(MELD)in liver cirrhosis patients.Methods Eighty-five liver cirrhosis patients admitted from January 2008 to December 2009 were included in this study. TM, D-dimer, tissue plasminogen activator(t-PA), plasminogen activator inhibitor -1(PAI-1),serum creatinine, serum total bilirubin and international normalized ratio(INR)on all patients were measured and then the score of the MELD was calculated. Results The score of the MELD was 1-29(11.35 ± 6.02)scores. The score of the MELD ≤ 9 scores was 40 cases(47.1%), 10- 19 scores was 32 cases (37.6%),20-29 scores was 13 cases(15.3%).TM and D-dimer were progressively increased with MELD score. There was significant difference among the three groups(P＜0.01). The levels of TM and D-dimer had positive correlation with the score of the MELD(r = 0.706,0.425,P ＜ 0.01). Conclusions The levels of TM and D-dimer have positive correlation with the score of the MELD in liver cirrhosis patients. These indices can help predicting the degree of liver function disorder and prognosis.

Objective To investigate the relationship of thyroid hormone (TH), thyroid stimulating hormone (TSH) and blood calcium in hyperlipidemic acute pancreatitis (HLAP) patients. Methods Fifty patients with HLAP were selected, among whom 37 patients with mild acute pancreatitis (MAP) were enrolled into MAP group, and 13 patients with moderately severe acute pancreatitis (MSAP) were enrolled into MSAP group. The albumin, blood glucose, creatinine, blood lipids, blood calcium, free tri-iodothyronine (FT3), free thyroxine (FT4) and TSH levels were measured and analyzed. Results The blood calcium, FT3 and TSH levels in MAP group were significantly higher than those in MSAP group:(2.02 ± 0.26) mmol/L vs. (1.75 ± 0.27) mmol/L, (1.88 ± 0.46) ng/L vs. (1.52 ± 0.35) ng/L and (0.28 ± 0.20) mU/L vs. (0.17 ± 0.12) mU/L, but the blood glucose and triglycerides (TG) levels were significantly lower than those in MSAP group: (13.36 ± 5.83) mmol/L vs. (19.99 ± 7.97) mmol/L and (24.01±12.46) mmol/L vs. (34.76 ± 20.39) mmol/L, and there were statistical differences (P<0.01 or<0.05). There were no statistical differences in albumin, creatinine, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C) and FT4 levels between 2 groups (P>0.05). The correlation analysis result showed: in patients with HLAP, TSH and albumin had a positive correlation with blood calcium (r=0.344 and 0.372, P=0.014 and 0.008), LDL-C and TG had negative correlation with blood calcium (r=-0.315 and-0.444, P=0.026 and 0.001), and other indexes had no correlation with blood calcium (P>0.05). Conclusions Blood calcium, FT3 and TSH levels are decreased with severity of HLAP. Decreased blood calcium may be one of reasons for decreased TSH in HLAP patients.

Objective To study the relationship between fibrinolysis,anticoagulation system indexes and serum albumin (ALB) in patients with liver cirrhosis.Methods One hundred and thirty-seven patients with liver cirrhosis were enrolled.Serum ALB,D-dimer (D-D),tissue plasminogen activator (t-PA),plasminogen activator inhibitor-1 (PAI-1),protein C (PC),protein S (PS) and antithrombin-Ⅲ (AT-Ⅲ) levels were measured.Results D-D level was increased with deterioration of liver function.D-D levels were (0.38 ± 0.24),(0.58 ± 0.43) and (0.90 ± 0.55) mg/L in Child-Pugh class A,B and C,respectively.PC,PS and AT-Ⅲ levels were decreased with deterioration of liver function.PC levels were (3.29 ± 1.04),(2.50 ± 1.27) and (2.29 ± 1.05)mg/L in Child-Pugh class A,B and C,respectively.PS levels were (20.74 ± 5.91),(17.97 ± 5.26) and (17.79 ± 5.12) mg/L,respectively.AT-Ⅲ levels were (104.62 ± 8.59)％,(101.76 ± 10.08)％ and (92.91 ± 10.48)％,respectively.D-D showed negative correlation with ALB (r =-0.402,P ＜ 0.01).On the contrary,PC,PS and AT-Ⅲ levels showed positive correlation with ALB (r =0.266,0.286 and 0.405,P ＜0.01).Conclusions Fibrinolysis and anticoagulation system indexes are changed with deterioration of liver function and are related with ALB directly.The indexes may be a helpful tool to evaluate the liver function in patients with liver cirrhosis.

Objective To investigate the correlation and differences of serum calcium ( Ca) and intact parathyroid hormone ( i-PTH) in patients with hyperlipidemic or biliogenic acute pancreatitis ( AP) .Methods From Jan 2012 to Jan 2014 , total 80 AP patients admitted to Bejing Chaoyang Hospital were enrolled . According to the etiology , AP patients were divided into 2 groups, hyperlipidemic acute pancreatitis ( HLAP) group and biliogenic acute pancreatitis (BAP) group.Blood routine, function of liver and kidney , blood lipids, Ca, and i-PTH were measured .Differences between Ca and i-PTH in HLAP group and BAP group were analyzed, and found the correlation with disease severity of AP .Results 80 AP patients included 43 HLAP and 37 BAP patients, 55 mild acute pancreatitis(MAP) and 25 moderately severe acute pancreatitis (MSAP) patients.HLAP group had 34 male and 9 female patients, average age was 37 years, 31 MAP and 12 MSAP patients.BAP group had 17 male and 20 female patients, average age was 58 years, 24 MAP and 13 MSAP patients.proportion of males was significantly higher in HLAP group than BAP group .on the contrary, average age was significantly lower (P<0.01 and <0.01, respectively).No significantly difference was found in MAP/MSAP ration.Level of serum Ca in HLAP group was significantly decreased than BAP group (1.92 ± 0.24 mmol/L vs 2.14 ±1.99 mmol/L, P<0.05).No significantly difference was found in i-PTH between two groups.Level of serum Ca in MAP and MSAP subgroup in HLAP group were 1.98 ±0.20 mmol/L and 1.76 ± 0.27 mmol/L.Accordingly, Level of serum Ca were 2.23 ±0.15 mmol/L and 1.98 ±0.19 mmol/L in BAP group. i-PTH in MAP and MSAP subgroup in HLAP group were 43.41 ±18.40 ng/L and 56.07 ±33.61 ng/L.Accordingly, i-PTH was 39.22 ±17.19 mmol/L and 52.73 ±29.42 mmol/L in BAP group.Compared to MAP, Ca in MSAP group was significantly decreased in HLAP and BAP group ( P<0.01 and <00.5, respectively).In HLAP group, Ca was a negative correlation with low density lipoprotein cholesterol (LDLC-) and triglycerides(TG) (P<0.05 and <0.01, respectively).In BAP group, Ca was a negative correlation with i-PTH(P<0.05).Conclusions Serum Ca is decreased with severity of HLAP and BAP .Decreased Ca has correlation with increased LDL-C, TG in HLAP and increased i-PTH in BAP.