Objective: To investigate the changes of gallbadder motive function in diabetics. Method: The size of gnllbadder,recovering rate,echo and half-empty time after fat food were compared and statistically analyzed between 22 healthy individuals and 20 diabetics with ultrssonograph. Results:The gallbadder recovering rate was similar between the healthy individuals and diabetics (P>0.05), but the rate of cholecystitis (30%) and choletethiasis (35%) of diabetics were higher than those in healthy individuals, the gallbadder half-empty time after fat food was obviously slower in diabetics (46.1+12.9 min)than those healthy individuals (27+4.4 mmin). Conclusions: The diabetics had obvious gallbadder motive funciion obstruction and higher rates of chronic cholecystitis and choletethiasis with ultrasonograph observations.

To obtain fusion protein of Mycobacterium bovis with high purity, the recombinant prokaryotic expression vector for Mb2277 gene was constructed and the immunogenicity of its products was initially investigated in the present study.A pair of primer was designed according the gene sequence Mb2277 from the genomic DNA of M.Bovis in GenBank. and was amplified by PCR using DNA of M.Bovis 93006 strain as template. The PCR product and pET-28a(+) was then digested by BamHⅠ and EcoR Ⅰdouble enzyme. To constructed a prokaryotic expression plasmid, the purified Mb2277 was cloned to pET28a(+). Then the recombinant plasmid was transformed into competent cell of E.coli BL21(DE3).The bacteria were induced by IPTG and its lysates were analyzed by SDS-PAGE and Western-blotting. In this way, the prokaryotic expression plasmid for M. bovis Mb 2277 protin was obtained, and a expression band with molecular of 25 ku could be found in SDS-PAGE analysis. As demonstrated by Western blotting this expression product showed excellent reactivity with rabbit immune sera against M. bovis.

Objective To investigate the distribution and effect of endothelial nitric oxide synthase (eNOS) on the zero-stress state of carotid arteries in rats at different ages.Methods Morphometry and microstructure of carotid artery in 3-month-old,6-month-old and 12-month-old Sprague-Dawley rats were studied quantitatively by histological method and computer image analysis.Immunohistochemistry and the NADPH-diaphorase reaction were used to localize the endothelial nitric oxide synthas (eNOS) in different age rats.The changes of opening angle in the zero-stress state was also observed.Results With increasing age,there was a significant reconstruction changes in morphometric parameters and microstructure parameters of the carotid arteries in rats.While the expression of eNOS protein of endothelium and vascular smooth muscle cells were decreased.Compared with 3-month-old rats,the zero-stress state.of opening angle in 6-month-old and 12-month-old group were increased.However,pre-incubation of vessel rings with L-arginine (30 mmol/L),a substrate of eNOS,attenuated the changes of the zero-stress state.Conclusions The results suggest that the carotid arterial wall in different age rats shows unequal growth and different zero-stress state eNOS may be involved in the age-related changes of zero-stress state of the carotid artery in aged rats.The results may provid an experimental base for vascular transplantation and vascular reconstruction.

Objective To investigate the efficacy of butylphthalide on elderly patients with acute cerebral infarction and its effect on serum uric acid,c-reactive protein,and hemorheology.Methods Elderly patients (86 cases) with acute cerebral infarction in Xi'an No.1 Hospital from January 2015 to December 2015 were randomly divided into two groups.The control group was treated with conventional symptomatic treatment of acute cerebral infarction,observation group added with butylphthalide soft capsules.The NIHSS score and efficacy of the two groups,the serum uric acid,c-reactive protein,and the change of hemorheology before and after treatment were compared.Results The effective rate of observation group was 90.70％,significantly higher than that of control group 72.09％ (P ＜ 0.05);The NIHSS score,serum uric acid and c-reactive protein levels,blood viscosity and platelet aggregation rate of two groups after treatment were significantly lower (P ＜ 0.05),the Barthel index were significantly increased (P ＜ 0.05),and the change of observation group were more significant (P ＜ 0.05).Conclusion Butylphthalide has high curative effect on elderly patients with acute cerebral infarction,can reduce the level of serum uric acid,c-reactive protein and the degree of nerve function defect,improve the hemorheology and life self-care activities ability,which can protect the brain.

Objective: To investigate the status of occupational health examination institutions in Zhejiang Province, so as to provide suggestions for quality control of occupational health examination institutions. Methods: The 312 occupational health examination institutions in Zhejiang Province that have completed filing before September 30, 2023 were selected. The comprehensive capability, service quality, technical capability, and information reporting status were surveyed and evaluated through on-site inspection and skill assessment. Results: There were 161 public hospitals (51.60%), 147 private organizations (47.12%), and 4 centers for disease control and prevention (CDCs)/ occupational disease prevention and control institutes (1.28%). The pass rates of comprehensive capability, service quality, technical capability and information reporting were 90.02%, 69.89%, 84.07% and 86.78%, respectively. Among the indicators of comprehensive capability, the compliance rate for staffing was the highest at 95.06%, while the qualification rate of quality control in occupational health examinations was the lowest at 84.83%. Among the indicators of service quality, the compliance rate of the physical examination report format was the highest at 95.83%, while the accuracy rate of the audiometry examination was the lowest at 76.60%. In terms of technical capabilities, the qualification rates for blood lead testing, pneumoconiosis reading, and audiogram diagnostic ability were 87.92%, 89.42% and 75.34%, respectively. In terms of information reporting, the qualification rates for reporting completeness, reporting timeliness, suspected occupational disease reporting timeliness, and reporting accuracy were 89.10%, 81.09%, 96.47% and 80.45%, respectively. Among the three types of institutions, private institutions had the lowest average qualification rates for comprehensive capability, service quality, and technical capability, which were 89.83%, 69.06% and 80.00%, respectively. Conclusions Public hospitals and private organizations were the main types of occupational health examination institutions in Zhejiang Province. However, there were deficiencies in quality control, audiogram examination and diagnosis, and the accuracy of information reporting among occupational health examination institutions.

Objective To investigate the differences in clinical, laboratory and therapeutic aspects of primary Sjogren's syndrome (pSS) between young/middle-age group and old group.Methods The 84 pSS patients were divided into the young and middle-age group (n=54) and the old group (n = 30). The differences in clinical features, laboratory indices and drug therapy were retrospectively analyzed. The chi-square test was used for statistical analysis. Results The positive incidences of xerostomia, dry eye symptom and rampant teeth were 80.0%, 76.7% and 43.3%respectively in the old group. And they were all significantly higher than in young and middle-aged group (57.4%, 51.9% and 20.4%, all P＜0. 05). The positive rates of rheumatoid factor (RF)elevation, antiRo/SSA and antiLa/SSB antibodies were 13. 0%, 36.7% and 16.7% in the old group,and significantly lower than in young and middle-age group (44.4%, 59.3% and 42.6%, all P＜0.05). The incidences of leukopenia and thyroid gland involvement were much lower in the aged group (13.3% and 10.0%) than in the young and middle-age group (48. 1% and 37.0%, P＜0. 05). The percentage of patients receiving hydroxychloroquine as the main medicine was much lower in the aged group than in the young and middle-age group (16.7% vs. 40. 7%, P＜0. 05), while percentage of treatment with exclusive glucosides of Paeony Capsules was much higher (33.3% vs. 14.8%, P＜0.05). There were no statistical differences between two groups in ophthalmological examination,immunoglobulin level and sialography. Conclusions Those pSS patients with late onset exhibit more abnormalities in clinical parameters, but fewer in immunological parameters, which may be helpful in estimating prognosis and pathogenetic factors in pSS.

ObjectiveTo investigate the iodine nutritional status of pregnant women,newborn heel blood thyroid stimulating hormone(TSH) level and their relationship with urinary iodine(UI) level during pregnancy in Zhoupu and Kangqiao districts of Pudong New Area of Shanghai.Methods A total of 993 urinary samples(the first,second and third trimesters of pregnancy were 200 people,respectively),breast feeding(193 people) and non-pregnant women (200 people) in Zhoupu and Kangqiao districts of Pudong New area were collected from Apr 2009 to Dec 2010.Two hundred copies of neonatal heel blood samples were collected.Median of UI was measured by arsenic-cerium catalysis.TSH in neonatal heel blood was analyzed 72 h after birth by time resolved fluoroisnmunoassay(TRFIA).ResultsMedian UI of all pregnant women was 161.35 μg/L,and that in third trimesters of pregnancy( 126.35 μg/L) was lower than that of the first,the second,the breast feeding and non-pregnant women (178.80,180.50,167.90,163.40 μg/L,all P＜ 0.05).The percentage of UI level less than 150 μg/L in the third trimester[57.5％(115/200) ] was higher than that of the first[39.0％(78/200) ],the second[39.5％(79/200) ],the breast feeding [ 16.6％ (32/193) ] and non-pregnant women [ 23.0％ (46/200) ],respectively (all P ＜ 0.05).The percentage of UI level higher than 300 μg/L in the first [9.0％(18/200)],the second[8.0％(16/200) ] and the third trimester [ 5.0％ ( 10/200 ) ] of pregnancy was lower than that of the breast feeding [ 20.2％ (39/193) ] and nonpregnant [20.5％(41/200) ] women,respectively(all P ＜ 0.05).The level of neonatal heel blood TSH was(2.92 ± 1.83)mU/L,the range was 0.01 - 9.76 mU/L,11.0％(22/200) of the neonates heel blood TSH level(5 mU/L)exceeded the ratio of World Health Organization (WHO) standard ( ＜ 3％ ) suitable for iodine nutrition.Conclusions The overall level of iodine nutrition among pregnant women in Zhoupu and Kangqiao districts of Pudong New Area of Shanghai is in the appropriate range,but the pregnant women in the third trimester is in mild iodine deficiencies,and the neonates in these districts may be prone to iodine deficiency.Monitoring of iodine nutrition of pregnant women should be strengthened and iodine supplementation should be done scientifically.

Objective To discuss the value of moving darkroom and accompanying X-rays protective shield in endemic fluorosis areas.Methods Using moving and fixed darkrooms,the X-rays photos of the forearms and shanks of the 320 persons were developed in the endemic fluorosis areas,while the time for development and installing-uninstalling films was documented.The films develpoed in the darkroom were evaluated for the quality.Results Among the 320 films develpoed in the moving darkroom,the 268 had fingerprints,47 had scratches,298 were in good quality(93.13%),while in the fixed darkroom,the figure was correspondingly 735,384,227(70.93%);The moving darkroom increased excellent film rate significantly than fixed darkroom(χ2=53.43,P＜0.01),The detectable rate of skelelal fluorosis and degree Ⅰ skelelal fluorosis were highter than that in the fixed darkroom did (χ2=10.34,χ2=9.56,P＜0.01).Conclusions The films developed in moving darkroom have superior quality and higher diagnostic value,so it is important to use moving X-rays photographing in ecdemic fluorosis areas.

Objective To explore the influence of fluorine on mRNA and protein expression of the insulin-like growth factor-1 (IGF-1) and its receptor of rat osteoblasts.Methods Osteoblasts were isolated from rat bone by enzyme digestion.Different fluorine concentration [0 (control),10-7,10-6,10-5,10-4,10-3 mol/L] was add to the second generation osteoblasts.The IGF-1 in the culture medium was determined by radioimmunoassay (RIA) at different fluorine concentration and different time (24,48 h).The expression of IGF-1 receptor was measured by the method of fluorescent quantitation PCR and the expression of protein IGF-1 receptor was measured by Western blotting.Results ①With increased dose of fluoride exposure,IGF-1 concentration in the osteoblastic culture medium increased first and then decreased at 24,48 h,respectively.Compared to the control group [(38.83 ± 3.48)ng/L],IGF-1 concentration of the 24 h 10-6 mol/L group[(65.45 ± 4.84)ng/L] was higher,and the difference was statistically significant(P ＜ 0.05).The same result was also shown in the 48 h 10-5 mol/L group [(59.14 ± 1.53)ng/L] to its corresponding control group [(33.79 ± 1.84)ng/L,P ＜ 0.05].②The mRNA expression of IGF-1 receptor of the 24,48 h 10-5 mol/L groups (0.0055 ± 0.0004,0.0262 ± 0.0040) was significantly higher than their corresponding control groups (0.0022 ± 0.0001,0.0073 ± 0.0008,all P ＜ 0.05).③With increased dose of fluoride exposure,the protein expression of IGF-1 receptor increased first and then decreased ;the expression of 24 h 10-5 mol/L group (1.39 ± 0.16) was compared with the corresponding control group (0.86 ±0.12),and the difference was statistically significant (P ＜ 0.05) ; the expression of 48 h every fluorine group was also compared with the corresponding control group,and the difference was not statistically significant(all P＞ 0.05).Conclusions Fluorine can affect the mRNA and protein expression of osteoblastic IGF-1 and its receptor.It indicates that IGFS signal transduction pathways play an important role in fluorine regulation of bone metabolism.

Objective To identify predictors of prescription initiation and persistence of warfarin in non-valvular atrial fibrillation ( NVAF ) patients with high risk of stroke ( CHA2 DS2-VASc≥2 ) . Methods NVAF patients consulted in our hospital from Aug , 2011 to Apr, 2015 were enrolled.Patients who underwent radiofrequency catheter ablation were excluded . Patients were divided into two groups (warfarin group and non-warfarin group).Logistic regression was used to estimate the predictors of initiation warfarin prescription.Kaplan-Meier survival and Cox proportional hazards model was performed to determine rate of warfarin persistence and its associated factors .Results A total of 622 AF patients were enrolled and 490 patients with CHA2DS2-VASc≥2.Ten patients lost follow up and 480 patients were followed up with a mean follow-up period of ( 40.0 ±11.55 ) months.Of which 245 NVAF patients ( 51%) had a warfarin prescription.Patients with ischemic stroke ( OR 2.447 , 95%CI 1.435-4.171 , P=0.001 ) , heart failure ( OR 2.009 , 95%CI 1.084-3.724 , P=0.027 ) and persistent AF ( OR 2.231 , 95%CI 1.448-3.437 , P=0.0001 ) had a higher likelihood of warfarin prescription .Anemia ( OR 0.479 , 95%CI 0.238-0.964 , P=0.039), concommitant Traditional Chinese Medicine (TCM) use (OR 0.638, 95%CI 0.456-0.891, P=0.008 ) and longer distance to hospital ( OR 0.759 , 95%CI 0.610-0.945 , P=0.014 ) decreased the likelihood of warfarin prescription . One hundred and seventy-six ( 71.8%) warfarin users continued persistent therapy and the overall proportion of warfarin persistence was 78.3% for one year , 71.0% for 3 years.Seventy-six existing warfarin users continued the warfarin therapy (80%, 76/95),one hundred new users showed persistence to therapy ( 66.7%, 100/150 ) .Warfarin use before enrollment significantly increased warfarin persistence than new prescription ( P =0.008 ) .Variables associated with higher discontinuation were new prescription ( HR 1.786 , 95% CI 1.029-3.100 , P=0.039 ) , TCM use ( HR 1.687 , 95%CI 1.201-2.37 , P=0.003 ) and longer distance to hospital ( HR 1.446 , 95% CI 1.121-1.865, P=0.005).Conclusions In anticoagulation clinic, concommitant TCM use, distance to hospital and other factors were associated with warfarin initiation prescription and persistence .Identifying factors associated with warfarin treatment could help in developing adherence of patients .