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 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 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.

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 predictive value of the baseline ,week 1 and week 2 model for end‐stage liver disease (MELD) scores ,MELD‐Na scores and MELDNa scores for 3‐month mortality in hepatitis B virus (HBV) related acute‐on‐chronic liver failure (ACLF) patients .Methods Fifty‐three eligible HBV‐related ACLF patients who received initial treatment in People′s Hospital of Deyang City , Sichuan Province from January 2014 to January 2015 were enrolled in this retrospective clinical follow‐up study .Patients were divided into death group and survival group according to the prognosis after 3 months of treatment .Biochemical data and complications were collected .t test was used to compare the means between two groups and χ2 test was used to compare categorical data .Accuracy of scoring models in predicting mortality within 3 months was performed by area under receiver operating characteristic curve (AUC) .Results Of the fifty‐three patients ,twenty‐one HBV‐related ACLF patients died in 3‐month , while thirty‐two patients survived .The AUC of MELD scores ,MELD‐Na scores and MELDNa scores at the baseline in predicting 3‐month mortality were 0 .548 (95% CI:0 .406 -0 .685 , P= 0 .555) ,0 .502 (95% CI:0 .362-0 .643 ,P=0 .978) and 0 .523 (95% CI:0 .381-0 .662 ,P=0 .778) ,respectively .The AUC increased gradually at the first and the second week .At the second week ,the AUC of MELD scores ,MELD‐Na scores and MELDNa scores were 0 .881 (95% CI:0 .762 -0 .953 ,P<0 .01) ,0 .878 (95% CI:0 .759-0 .951 ,P<0 .01) and 0 .897 (95% CI:0 .783 -0 .963 ,P<0 .01) ,respectively .The AUC of the second week was higher than those of the baseline and the first week (both P<0 .05) .The sensitivity ,specificity ,positive predictive value (PPV) ,and accuracy at the second week were best when the cut off was 26 for MELD ,29 for MELD‐Na and 29 for MELDNa , and were higher than the corresponding values of the baseline and the first week .Conclusions The predictive values of MELD scores ,MELD‐Na scores and MELDNa scores at the second week are superior to the baseline and the first week for 3‐month mortality in HBV‐related ACLF patients ,while the predictive values at the baseline could be poor .

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 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 investigate the coagulation and anticoagulation changes in liver cirrhosis(LC)patients with and without portal vein thrombosis(PVT).Methods Patients with LC during 2006 to 2007 in our hospital were reviewed and twenty cases of LC with PVT were included in the study.Forty cases of LC without PVT were chosen as controls.PVT was confirmed by dynamic abdominal computed tomography.Using an analyzer and following manufacturer instructions,we determined PT,APTT,Fib,Antithrombin Ⅲ and Protein S.SPSS software was used for statistic analysis.Results In PVT group,the average level of PS and AT-Ⅲ were(18.68?3.14)mg/L and(94.65?7.96)%,significantly lower than(20.44?3.04)mg/L and(100.26?9.27)% in controls.No difference was found between patients with or without PVT in PT、APTT、Fib.PT and APTT were progressively prolonged from A to B and then to C.Fib and AT-Ⅲ were progressively decreased from A to B and then to C.Low levels of PS was found in LC patients.Conclusion The changes of coagulation and anticoagulation in patients with LC dearly exist.The average level of PS and AT-Ⅲ in PVT group is significantly lower than controls.PS and AT-Ⅲ may play a pathogenetic role in the development of PVT.

Objective To explore the clinical characteristics of Chronic obstructive pulmonary diseases(COPD)(≥65 years old,acute episode)with active pulmonary tuberculosis.Methods62 of COPD(≥65 years old,acute episode)with active pulmonary tuberculosis from 2002 to 2007 in hospital were reviewed and analyzed.ResultsThe attack rate of active pulmonary tuberculosis is 7.3% in COPD(≥65 years old,acute episode).By Clinical analysis showed clinical manifestation and chest X-ray or CT were not typical,but positive morbility of acid-fast bacilli sputum smear and bronchoalveolar lavage fluid was higher.ConclusionThe result suggests that COPD(≥65 years old,acute episode)patients are high-risk group of active pulmonary tuberculosis and need to be diagnosed early as soon as possible.