Objective To investigate the correlation between atherosclerotic renal artery stenosis and the severity of coronary lesions in patients with confirmed coronary artery disease and the impact of renal artery stenosis on serum inflammation related factors.Methods 163 patients from Peking University First Hospital with confirmed coronary heart disease by coronary angiography underwent selective renal artery angiography from Dec 2002 to Sep 2003.Serum hypersensitive C reactive protein(hs-CRP)and Interleukin-6(IL-6)were measured.Results Patients combined with coronary disease and renal artery stenosis were presented with more acute coronary syndrome(ACS)and triple-vessel CAD.Serum hs-CRP and IL-6 levels were also higher in this group.Conclusion Renal artery stenosis is correlated with severe coronary disease.Inflammation state could be one of the reasons for this connection.

Objective To investigate the correlation between atherosclerotic renal artery stenosis and hypertension.Methods One hundred and seventy-nine patients underwent renal artery angiography after coronary artery angiography. Results Among the 179 patients, 56.4% patients were detected as renal artery normal, 24% as renal artery disease, and 19.6% as renal artery stenosis. Compared with hypertensive patients with normal renal artery, ARAS patients had higher systolic blood pressure (148?23 mm?Hg vs 136?18 mm?Hg, P

Objective To analyze the impact and its mechanism of down-regulation of AnnexinA2 expression on prostate cancer(PCa) invasion and metastasis.Methods The expression of AnnexinA2 in three prostate cancer cell lines with different metastasis ability,including LNCaP (lower metastasis ability),PC3 (lower metastasis ability),C4-2B (higher metastasis ability) were detected by Western blot.The correlations between the expression of AnnexinA2 and the metastasis ability of prostate cancer cells were also evaluated.The siRNA was used in PC3 cells to down-regulate the expression of AnnexinA2,the cell proliferation assay was performed by MTT method,the cell apoptosis level was detected by flow cytometry,the expression of MMP-2 and MMP-9 were detected by Westrn blot,the in vitro invasiveness of PC3 was detected by transwell cabinet test,and the migration ability of PC3 cells was detected by scratch test,respectively.Results The grayscale value of AnnexinA2 expression in C4-2B cells is 0.22,in contrast with the internal reference,which was obviously lower than those of LNCaP and PC3 cells with lower metastasis potency(relative grey value is 0.93 and 0.95,respectively.P＜0.01).After RNAi was used in PC3 cells to down-regulate the expression of AnnexinA2,the growth became faster for PC3-ANXA2-siRNA cells than PC3,PC3-Lip and PC3-empty vector cells (P＜0.05).After RNAi was used in PC3 cells to down-regulate the expression of AnnexinA2,the ratio of apoptosis was detected by flowcytometry in PC3,PC3-Lip,PC3-empty vector and PC3-ANXA2-siRNA cells,and the apoptosis ratio in PC3-ANXA2-siRNA cells was the highest.However,the difference was not significant compare to others (P＞0.05).After RNAi was used in PC3 cells to downregulate the expression of AnnexinA2,the expression of AnnexinA2 in PC3-ANXA2-siRNA cells was decreased while the expression of MMP-2 and MMP-9 were increased.After RNAi was used in PC3 cells to down-regulate the expression of AnnexinA2,invasiveness of PC3-ANXA2-siRNA cells detected by transwell cabinet test was increased in vitro,and migration of PC3-ANXA2-siRNA cells detected by scratch test was increased in vitro.Conclusions The down-regulation of expression of AnnexinA2 could increase the invasive and metastatic ability of prostate cancer,and this may attribute to the up-regulation of MMP-2 and MMP-9 expression in prostate cancer.

Objective To evaluate the accuracy of point-of-care testing (POCT) for blood glucose monitoring in critically ill patients.Methods Two hundred and forty critically ill patients,of both sexes,aged 20-88 yr,with Acute Physiology and Chronic Health Evaluation Ⅱ score of 1-45,were enrolled.The venous,arterial and capillary blood samples were collected to determine the real-time blood glucose level using glucose oxidase (GOD) and glucose dehydrogenase (GDH) methods.The blood glucose level measured by central laboratory hexokinase method simultaneously was served as standard level.Error Grid analysis (EGA) and Bland-Altman analysis were used to determine accuracy and consistency,respectively.The accuracy of real-time blood glucose levels within the consistent limits was evaluated.Results 1.The results of EGA showed that 98.7 ％,98.3 ％,98.3 ％(GDH method) and 96.2％,96.6％,96.7％ (GOD method) of the difference between venous,arterial and capillary blood glucose levels measured and the standard level were located in the A and B zones,respectively,and 1.2％,1.7％,1.7％ (GDH method) and 2.9％,3.3％,3.3％ (GOD method) in the D zone.0.8％ (GOD method) of the difference between venous blood glucose levels and the standard level were located in the C zone.2.Bland-Altman analysis showed that the difference between the standard level and glucose level measured in blood samples from the vein,artery and capillary.was-0.1,-0.3,-0.2 mmol/L (GDH method) and-0.9,-1.0,-0.9 mmol/L (GOD method),respectively,and the incidence beyond the upper and lower limits of consistency zone was 4.5 ％,6.7 ％,6.6 ％ (GDH method) and 4.6 ％,5.0 ％,7.1％ (GOD method),respectively.The accuracy of venous,arterial and capillary blood glucose levels within the consistent limits was 94.3 ％,92.1％,93.7％ (GOD method) and 96.6％,95.1％,95.5％ (GDH method),respetively.Conclusion The accuracy of POCT for blood glucose monitored by GOD and GDH methods is good in critically ill patients,but it is possible to overestimate the patient's real glucose level.

Objective To investigate the guidance of a new classification on the treatment methods selection for cystic dilation of bile duct (CDBD).Methods The clinical data of 213 patients with CDBD who received treatment according to the Todani 2003 classification at the Peking Union medical College Hospital from September 1968 to July 2013 were retrospectively analyzed.The CDBD was reclassified with a new classification proposed by Dong Jiahong et al,and the guidance of the new classification on the treatment methods selection for CDBD was analyzed.Patients were followed up via out-patient examination and telephone interview till August 2013.Results Of the 213 patients,139 were with Todani type Ⅰ CDBD (type C CDBD of the new classification) ; 3 were with Todani type Ⅱ CDBD (type C1 CDBD of the new classification) ; 1 was with Todani type Ⅲ CDBD (type E CDBD of the new classification); 52 were with Todani type Ⅳa CDBD (35 with type D1 and 17 with type D2 CDBD of the new classification) ; 1 was with Todani type Ⅳb CDBD (type C CDBD of the new classification) ; 8 were with Todani typeⅤ-Ⅰ CDBD (type B CDBD of the new classification) ; 9 were with Todani type Ⅴ-Ⅱ CDBD (type A CDBD of the new classification).Eighteen patients did not receive the surgical treatment.Of the 195 patients who received surgical treatment,patients with type C and D CDBD of the new classification took a large proportion.Patients with type C CDBD of the new classification received cystectomy,biliary cyst resection,Rouxen-Y cholangiojejunostomy or internal drainage.Patients with type D CDBD of the new classification received extrahepatic biliary cyst resection,Roux-en-Y cholangiojejunostomy.Patients with severe intrahepatic disease and with type D1 CDBD of the new classification received concomitant left hemihepatectomy or pancreaticoduodenectomy.Patients with type A1 CDBD of the new classification received right hemihepatectomy.Patients with type A2 CDBD of the new classification were cured by conservative treatment after split liver transplantation.Patients with type B1 CDBD of the new classification received left hemihepatectomy and Roux-en-Y cholangiojejunostomy.Patients with type B2 CDBD of the new classification received bile duct stone extraction.There was 1 patient with type E CDBD,and partial resection of the CDBD ± bile duct reconstruction was carried out.Pancreatic fistula,biliary fistula,reflux cholangitis,cholangitis and anastomotic stricture were detected on 74 patients,and they were cured by conservative treatment or lithotomy.A total of 187 patients were followed up with the median time of 85 months (range,1-432 months).One hundred of seventy-five patients recovered well,and 12 patients with canceration of the bile duct died of tumor metastasis at postoperative 1-282 months.Conclusion This new classification simplifies the typing of extrahepatic bile duct dilation,refines the typing of intrahepatic bile duct dilation,and has better guidance for surgical treatment.

Objective To analyze the clinical features and risk factors of invasive fungal infections (IFI) in children with acute leukemia.Methods Ninety-six acute leukemia children complicated with IFI admitted in Guangzhou Women and Children's Medical Center during January 2005 and February 2017 were retrospectively reviewed, and 96 cases of acute leukemia without IFI admitted at the same period were randomly selected as control group.The clinical manifestations of IFI were analyzed, multivariate Logistic regression was used to study risk factors of the complication of IFI in pediatric acute leukemia.Results Among 96 children complicated with IFI, fungus were detected in samples from sputum, bronchoalveolar lavage fluid, or blood in 78 cases, in which 42 cases (43.75％) were oral infection, 36 cases (37.50％) were pulmonary infection.Candida albicans (33.33％, 26/78) was the most commonly isolated pathogen, followed by Candida parapsilosis (20.51％, 16/78) and Candida tropicalis (20.51％, 16/78).Univariate analysis revealed hormone-containing chemotherapy, neutropenia (＜ 0.5 × 109/L), time duration of neutropenia ≥ 10 days, usage of carbapenem antibiotics and combined drug administration ≥2 types were associated with fungal infection (P ＜ 0.05 or ＜0.01).Multivariate Logistic regression showed that the time duration of neutropenia ≥ 10 days (OR =11.390, 95％ CI 4.145-55.263, P ＜ 0.01),usage of carbapenem antibiotics (OR =4.825, 95％ CI 1.681-13.842, P ＜ 0.01) and hormone-containing chemotherapy (OR =2.220, 95％ CI 1.542-8.246, P ＜ 0.05) were the independent risk factors of IFI.Conclusion Rational usage of antibiotics and effective measures taken to restore the granulocytes can help to reduce the incidence of IFI in children with acute leukemia.

Objective To investigate the risk factors of gallbladder carcinoma,so as to provide theoretical base for the prevention of gallbladder carcinoma.Methods The clinical data of 153 patients with gallbladder carcinoma (gallbladder carcinoma group) who were admitted to the Peking Union Medical College Hospital from January 2000 to December 2010 were retrospectively analyzed. A total of 300 patients with cholecystolithiasis (cholecystolithiasis group) and 300 patients without gallbladder carcinoma or cholecystolithiasis (control group)were collected and matched at the ratio of 1∶2 to conduct the controlled study.Data were statistically analyzed by the Chi-square test and conditional Logistric regression.Results Univariate analysis showed significant difference in age,history of cholecystolithiasis,postmenopausal age,accumulated menstrual period,giving birth or not and number of birth between gallbladder carcinoma group and control group ( x2 =58.22,180.14,9.59,24.30,18.66,15.17,P ＜0.05).Age,history of cholecystolithiasis,accumulated menstrual period and number of birth were the independent risk factors of gallbladder carcinoma (x2 =55.76,180.95,24.30,8.54,P ＜ 0.05).The risk of having gallbladder carcinoma in patients who had a history of cholecystolithiasis was 34 times higher than those who did not have the history of cholecystolithiasis (OR =34.22).Late postmenopausal age (51 -55 years old),longer accumulated menstrual period ( ≥30 years),and the number of birth ( 3 times) were associated with higher risk of gallbladder carcinoma (OR =3.96,9.68,3.51 ). Age,course of cholecystolithiasis and accumulated menstrual period and number of birth were the risk factors of gallbladder carcinoma when comparing patients who have history of cholecystolithiasis in the gallbladder carcinoma group with those in the cholecystolithiasis group (x2 =70.66,16.66,11.59,4.69,P ＜ 0.05 ).Age,course of cholecystolithiasis and accumulated menstrual period were the independent risk factors of gallbladder carcinoma ( x2 =64.29,8.82,5.58,P ＜ 0.05).The risk of gallbladder carcinoma increased as the increase of age and course of cholecystolithiasis. The accumulated menstrual period ≥ 30 years was also a risk factor of gallbladder carcinoma. Conclusions Age,history of cholecystolithiasis,course of cholecystolithiasis,accumulated menstrual period and number of birth may be the risk factors of gallbladder carcinoma.For patients with age above 60 years and course of cholecystolithiasis above 3 years,cholecystectomy should be conducted to reduce the incidence of gallbladder carcinoma,and great importance should be attached to female patients with indications mentioned above.

Insulin resistance, lipid metabolism disorders, independent autonomic neuropathy are high risk factors for gallstone formation in type 2 diabetic patients. In recent years, there have been a lot of new developments on the relationship between type 2 diabetes and gallstones, such as adiponectin, leptin and metabolic syndrome, etc. Based on these studies, the risk factors of type 2 diabetes complicated with gallstones are summarized in this paper.

Objective To determine the risk factors of gallstones. Methods A case-control study was conducted on 4087 patients with gallstones (the study group) and 20435 individuals without gallstones (the control group) at the Health Center of Peking Union Medical College Hospital (PUMCH) between January 2007 to May 2010. Using age and sex, the study and the control groups were matched in 1 : 5 ratio. Data were statistically analyzed using Chi-square test and conditional logistic regression.Results Univariate analysis showed significant differences in diabetic mellitus (DM), systolic blood pressure (SBP), diastalic blood pressure (DBP), triglyceride (TG), high density lipoprotein cholesterol (HDL-CH) and body mass index (BMI) between the study and the control groups (P＜0.05). Multivariate analysis confirmed that DM, SBP, HDL-CH and BMI were associated with gallstones, and their adjusted odds ratio (95％ confidence interval) were 0. 825 (0. 736 ～0. 925), 0. 908 (0. 828～0. 996), 1. 211 (1. 056～1. 389) and 0. 746 (0. 691～0. 805), respectively.The incidences of total cholesterol (TCH) and low deasity dipoprotein cholesterol (LDL-CH) were not significantly different between the two groups (P＞0.05). ConclusionsDM、SBP、HDL-CH and BMI were found to be the risk factors for gallstones. To prevent gallstones, weight reduction, blood pressure control and normalization of blood lipid are important measures.

Objective To explore risk factors for type 2 diabetes mellitus complicated with gallstone disease. Methods The clinical data of 429 type 2 diabetes mellitus patients complicated with gallstone disease (case group) and 2145 type 2 diabetes mellitus patients without gallstone disease (control group) were collected from the Health Center of Peking Union Medical College Hospital from January 2007 to May 2010. According to sure (SBP), diastolic blood pressnre (DBP), fasting blood glucose (FBG), total cholesterol (TC), Triglyceride (TG), high-density lipoprotein cholesterol (HDL-CH), low-density lipoprotein cholesterol (LDL-CH) and body mass index (BMI) were statistically analyzed by fourfold table chi-square test or conditional Logistic regression.Results Univariate analysis showed that there was a significant difference in the levels of SBP, FBG, TC, HDL-CH and BMI between the case group and the control group (x2 =20.323, 4.365, 4.028, 7.049, 7.319, P＜0.05). Multivariate analysis confirmed that SBP, TC, HDL-CH and BMI were risk factors for gallstone disease in patients with type 2 diabetes mellitus (x2 = 18. 047, 6. 905, 12. 884, 7. 557, P ＜ 0. 05). Conclusion Increased SBP, TC and BMI and decreased HDL-CH may be the risk factors for type 2 diabetes mellitus complicated with gallstone disease.