ObjectiveTo observe the changes of high sensitive serum C-reaction protein (hsCRP) in macrovascular disease with or without type 2 diabetes.MethodsThere were 3 groups population in our study:148 type 2 diabetic patients were divided into 2 subgroups:77 patients with macrovascular disease and 71 without macrovascular disease, 73 non-diabetic patients with macrovascular disease and 75 health controls. The concentration of serum hsCRP of all patients were determined by ELISA.ResultsThere was significant difference in concentration of serum hsCRP between type 2 diabetes with or without macrovascular disease groups, non-diabetes macrovascular disease group and control(P<0.01 or P<0.001). However, there was not significant difference between 2 diabetes groups and non- diabetic macrovascular disease group(P>0.05). There was no significant difference in hsCRP between type 2 diabetes with and without macrovascular disease (P>0.05).ConclusionThere may be a chronic inflammatory reaction in patients with type 2 diabetes or macrovascular disease. hsCRP might be a well forecasting factor of the occurrence and development of type 2 diabetes and atherosclerosis.

Objective To investigate the significance of treadmill exercise test in male patients with coronary heart disease.Methods Two hundred and twenty-four male patients who diagnosed as coronary heart disease by coronary angiography were enrolled in this study,and treadmill exercise test were performed before and 1 month after coronary angiography.The coronary artery stenosis degree and scope were compared between two methods.Results In coronary angiography of 224 patients,the positive was 171 patients and negative was 53 patients.The single stenosis,double stenosis and triple stenosis was 87,55,29 patients.In treadmill exercise test of 224 patients,the positive was 143 patients and negative was 81 patients.The sensibility of treadmill exercise test compared the standard of coronary angiography was 81.3％,positive predictive value was 97.2％.Meanwhile in patients combined with hypertension or diabetic,treadmill exercise test found that the ST segment depression appeared earlier,persistence time longer.The persistence time and the number of down lead in double stenosis and triple stenosis was higher than that in single stenosis.Conclusion Treadmill exercise test is an important method in the diagnosis of coronary artery disease,and can preliminarily estimate the extent of coronary artery stenosis.

Objective To identify the GNAS gene mutation resulting in pseudohypoparathyroidism type Ⅰa (PHP-Ⅰa) in one patient. Methods The clinical data of a patient with pseudohypoparathyroidism type Ⅰa was retrospectively analyzed. All the 13 exons of GNAS were sequenced using Sanger method for the patient and the parents. The distribution of suspected causal mutation was screened in 478 healthy controls. To clarify the origin of the mutation, we performed targeted high-depth sequencing of GNAS exon harboring the mutation for the patient and the parents. Results The clinical data of the patient with the laboratory results of hypocalcaemia, hyperphosphataemia, elevated serum PTH, together with the features of AHO, conformed to the characterization of PHP-Ⅰa. The sequencing of GNAS exons identified a missense mutation (c.479G>C, p.R160P) located at exon 6 in the patient, which was absent in DNA of the parents. The mutation was not reported previously and was not found in the 478 healthy controls. We obtained about 8000-fold coverage from high-depth sequencing of DNA from peripheral blood of the patient and the parents. The disease-associated allele C identified in the patient was not observed in the parents. The number of reads with G allele (3984 reads) was roughly equal to that of C allele (4019 reads) from the targeted reanalysis of DNA of the patient. The results from high-depth sequencing indicated a de novo mutation in maternal germ cells. Conclusions We identified a new GNAS gene mutation (c.479G>C, p.R160P) caused PHP-Ia in a patient. Our results suggested the mutation was a maternal germline de novo mutation.

Objective To explore the influence of continuing nursing care on sexual quality of patients after laparoscopic subtotal hysterectomy.Methods Seventy-eight patients with selective laparoscopic subtotal hysterectomy enrolled from March 2014 to April 2015 were numbered according to their enrollment date,and divided into control group and intervention group randomly.Both groups were conducted laparoscopic subtotal hysterectomy under general anesthesia.After the surgery,the control group was treated with standard nursing care and the intervention group received continuing nursing care beyond the standard nursing care.Participants' sexual quality of 3 months and 6 months after surgery were evaluated using the female sexual function index (FSFI) Results The scores of FSFI of intervention group were significantly higher than those of the control group.Conclusion The continuing nursing care of patients after laparoscopic subtotal hysterectomy can effectively improve patient's short-term sexual quality,which is worth of being applied in gynecology nursing care in the future.

Gastric cancer is one of the most common cancers in the world,and it is also one of the most common causes of death due to cancer.Most patients have been in the late stage when coming for treatment,and drug therapy is the main scheme for most patients with advanced gastric cancer.In recent years,the progress of drug treatment for advanced gastric cancer has developed rapidly,from simple chemotherapy to targeted drug therapy,and a number of traditional or new treatment programs have shown the indispensability of drug treatment.

Objective To analyze the relationship between syndrome differentiation of traditional Chinese medicine (TCM) and the clinical stage of western medicine, histological type and EGFRgene in patients with lung cancer and to find out the regularity among them. Methods From February 2015 to September 2017, 101 patients with lung cancer were enrolled in this study. Statistical analysis of relationship between TCMsyndrome differentiation and clinical stage, histopathological type and EGFRgene expression was carried out. Results There was a significant difference (P＜0. 05) between TCMtypes and histopathological types of lung cancer(P＜0. 05), among which, there was a significant difference (P＜0. 05) between adenocarcinoma and small cell lung cancer and non-adenocarcinoma. There also had a significant difference(P＜0. 05) between TCMtypes and TNMstage of lung cancer. Intergroup analysis demonstrated that there was a significant difference (P＜0. 05) between stage Iand IV, and also stage Ⅱ and IV. There was a significant difference (P＜0. 05) between TCMtypes and positive expression of EGFR. From phlegm-heat syndrome, qi-stagnation syndrome, qiyin deficiency syndrome to cold-dampness syndrome, The positive expression of EGFRwas gradually ascending. There was significant difference between cold-dampness syndrome and phlegm-heat syndrome(P＜0. 05). Conclusion There is a certain correlation between syndrome differentiation of TCMand clinical stage, histopathological classification and EGFRgene expression in lung cancer, which can provide dialectical evidence for objective and standardized TCMsyndrome differentiation.

Objective The annual incidence of Alzheimer's disease in China is increasing year by year.The herbicide paraquat widely used in early China may be the factor inducing Alzheimer's disease.This study intends to analyze the mechanism of inducing Alzheimer's disease by constructing an animal model of paraquat poisoning.Methods SD rats were fed paraquat,and the integrity of blood-brain barrier was observed by Evans blue staining.The expression level of Aβ42 in brain tissue was detected by Western-blot,and the expression levels of inflammatory cytokines interleukin-1β,tumor necrosis factor-α and inducible isoform of nitric oxide synthase were detected by ELISA.Results Paraquat could significantly increase the expression level of Aβ42 in brain tissue,destroy the integrity of blood-brain barrier,and increase the expression level of GSK-3β in blood-brain barrier.Further results showed that the use of GSK-3β inhibitors significantly alleviated paraquat induced blood-brain barrier damage and Aβ42 levels.Conclusion Paraquat can damage the integrity of the blood-brain barrier by up-regulating GSK-3β,and eventually lead to paraquat entering the brain,which increases the expression level of Aβ42.

OBJECTIVETo evaluate the feasibility and effectiveness of transcatheter aortic valve implantation assisted with snare to fix the delivery system.

METHODSThis study was made in 5 healthy goats. After the abdomen was opened and the abdominal aorta was exposed, a stiff guide wire was advanced into the apex of the left ventricle through abdominal arterial puncture points. The delivery catheter equipped with valved stent was inserted into the descending aorta under fluoroscopy along the stiff guide wire. A minimal thoracic surgery approach was used to access the apex of the heart. A J-type guidewire and 5 F multifunction catheter were placed transapically and across the aortic valve down to the descending aorta. The snare was introduced through the 5 F catheter into the ascending aorta and was controlled to seize the head of stent delivery catheter. Then the delivery catheter was advanced into the left ventricle. The valved stent was positioned in the desired position under aortography and then the balloon was dilated and the valved stent was deployed into the aortic annulus assisted with snare to fix the catheter to prevent stent dispositions. Aortic angiography and echocardiography were performed to evaluate of valve performance post procedure.

RESULTSThe interventional procedure was completed successfully in all 5 goats. The mean aortic annulus diameter was (23.8 ± 2.6) mm, two valved stent of 23 mm diameter and three valved stent of 26 mm in diameter were implanted. The operation duration and X-ray exposure time were (112.3 ± 19.5) min and (16.8 ± 5.2) min, respectively. Immediate observation after procedure showed that the valved stents were in the desired position after implantation by angiography and echocardiography. No moderate to severe aortic regurgitation was observed. All goats were alive at 1 month post procedure.

CONCLUSIONSThe procedure of transcatheter implantation of a balloon-expandable valved stent into the aortic valve position of goats assisted with snare to fix the delivery catheter is feasible and effective. This procedure might be suitable also for patients with noncalcified aortic stenosis.

Animals ; Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Catheterization ; Echocardiography ; Fluoroscopy ; Goats ; Stents ; Transcatheter Aortic Valve Replacement

Objective:To investigate the factors for serious complications within 30 days after surgery in elderly patients with advanced epithelial ovarian cancer(EOC)who undertook primary debulking surgery(PDS).Methods:The clinical data of International Federation of Gynecology and Obstetrics(FIGO)stage ⅢC/Ⅳ EOC patients aged≥60 years who received PDS in gynecological department of National Cancer Center and National Center of Gerontology between January 2014 and December 2018 were retrospectively analyzed.Clavien-Dindo scoring system was applied to grade the complications within 30 days after surgery.The serious early postoperative complications were those of grade Ⅲ or above occurred within 30 days after surgery.Multivariate Logistic regression analysis was used to screen the independent risk factors of serious complications within 30 days after surgery.Results:A total of 133 patients were included in this study and serious complications rated 11.3%(15/133). The mean age of patients in severe complication group was significantly higher than that in the control group[(69.80±6.56) vs.(65.87±5.14), t=2.699, P=0.008]. The proportion of patients with preoperative ECOG score≥2 was significantly higher in the severe complication group than that in the control group[26.7%(4/15) vs.5.9%(7/118), χ2=4.985, P=0.026], and the proportion of preoperative hypoalbuminemia(<35 g/L)was significantly higher in the severe complication group[20.0%(3/15) vs.3.4%(4/118), χ2=4.897, P=0.027]. However, there was no significant difference in intraoperative bleeding, R0 resection rate as well as surgical complexity( χ2=1.964, 0.330, 4.637, all P>0.05)between the two groups.Multivariate Logistic regression analysis showed that the independent factors for serious early postoperative complications were age≥70 years( OR=4.345, P=0.028), ECOG score≥2( OR=25.619, P=0.008)and preoperative albumin <35 g/L( OR=6.733, P=0.040). Conclusions:In the elderly ovarian cancer patients, individualized perioperative management should be strengthened for the patients with factors associated with serious early postoperative complications, in order to reduce severe complications and improve the prognosis.