Objective To explore the value of combined measurement of urine N-acetyl-beta-D-glucosaminidase (NAG) activity and serum Cystatin C in diagnosing diabetic nephropathy (DN) in early phase. Methods Sixty-two cases with type 2 diabetes (diabetic group) were divided into three groups according to their 24 hours urinary albumin excretion (24hUAE) : group A (normal albuminuria, 20 cases), group B (microalbuminuria, 22 cases) and group C (macroalbuminuria, 20 cases). Furthermore, 30 healthy people were involved in control group. 24hUAE,NAG,serum creatinine (SCr) and serum Cystatin C were measured, and endogenous creatinine clearance rate (Ccr) was calculated by Cockcroft-Gault formula. All these indexes among three groups were compared. Results The levels of urinary NAG activity and serum Cystafin C in diabetic group was significantly higher and Ccr was significantly lower than those in control group(P < 0.01). The levels of urinary NAG activity and serum cystatin C gradually increased in group A, B and C(P< 0.05 or < 0.01). While no significant difference was observed between group A and group B in the level of SCr (P > 0.05). There were significant positive correlations among the levels of urinary NAG activity, serum Cystatin C,24hUAE and SCr (P< 0.01),and all above showed negative correlations with Ccr (P<0.01). Co-detection of urinary NAG activity and serum Cystatin C had significantly higher positive rate [80.6%(50/62)] than single one [58.1%(36/62),61.3%(38/62)](P<0.05). Conclusion Co-detection of urinary NAG activity and serum Cystatin C may indicate early renal damage in DN, and it is valuable in diagnosing DN in early phase.

Objective To observe the value of speckle-tracking imaging (STI) in evaluation on degree of coronary artery stenosis in patients with coronary artery disease (CAD).Methods Totally 74 CAD patients,including 59 with coronary artery stenosis (coronary artery stenosis group) and 15 without coronary artery stenosis (no coronary artery stenosis group) underwent STI and echocardiography.Based on Gensini scores,the patients in coronary artery stenosis group were further divided into mild,moderate and severe subgroups.The average global longitudinal strain (GLS-Avg),basement global longitudinal strain (GLS-Bas),middle global longitudinal strain (GLS-Mid) and apical global longitudinal strain (GLS-AP) value were measured and compared.Results GLS-Avg,GLS-Bas,GLS-Mid and GLS-AP value in coronary artery stenosis group were lower than those in no coronary artery stenosis group (all P ＜ 0.001).In coronary artery stenosis group,with the increase of stenosis severity,GLS-Avg,GLS-Bas,GLS-Mid and GLS-AP value decreased,and statistical differences were found between each two subgroups (all P＜0.05).In coronary artery stenosis group,there were positive correlations between GLS-Avg,GLS-Bas,GLS-Mid,GLS-AP value and Gensini scores (r=0.861,0.847,0.819 and 0.778,all P＜ 0.05).Conclusion GLS value of STI can reflect the severity of coronary artery stenosis in CAD patients.

Zwitterionic sulfobetaine-based monolithic stationary phases have attracted increasing attention for their use in hydrophilic interaction chromatography.In this study,a novel hydrophilic polymeric monolith was fabricated through photo-initiated copolymerization of 3-(3-vinyl-1-imidazolio)-l-propanesulfonate(SBVI)with pentaerythritol triacrylate using methanol and tetrahydrofuran as the porogenic system.Notably,the duration for the preparation of this novel monolith was as little as 5 min,which was significantly shorter than that required for previously reported sulfobetaine-based monoliths prepared via conventional thermally initiated copolymerization.Moreover,these monoliths showed good morphology,permeability,porosity(62.4％),mechanical strength(over 15 MPa),column efficiency(51,230 plates/m),and reproducibility(relative standard deviations for all analytes were lower than 4.6％).Mechanistic studies indicated that strong hydrophilic and negative electrostatic interactions might be responsible for the retention of polar analytes on the zwitterionic SBVI-based monolith.In particular,the resulting monolith exhibited good anti-protein adhesion ability and low nonspecific protein adsorption.These excellent features seem to favor its application in bioanalysis.Therefore,the novel zwitterionic sulfobetaine-based monolith was successfully employed for the highly selective separation of small bioactive compounds and the efficient enrichment of N-glycopeptides from complex samples.In this study,we prepared a novel zwitterionic sulfobetaine-based monolith with good performance and developed a simpler and faster method for preparation of zwitterionic monoliths.

Objective To monitor the evaluation of heparin dose in activated clotting time (ACT) during PCI perioperation,and explore its application in clinical care.Methods Totally 327 patients with coronary angiography,PTCA and stent implantation,using heparin to anticoagulating simultaneously in conduit room of the 306th Hospital of PLA from April 2014 to April 2015.By ACT monitoring and preoperative nursing visit,we collected patients' risk factors,and made operation plans;patients were assigned to five groups by the stage of age,and ten year-old was taken as a stage.ACT was closely observed in the operation,and the risk situation of patients was also observed;after operation,specific guidance was taken.Results There were patients with substandard ACT in each group after operation,and needed additional heparin.71 cases of patients with preoperative application of tirofiban,their postoperative ACT were within the target range 200-250 s;among 256 patients without preoperative application of tirofiban,there were 41 patients whose ACT value does not reach the required target value and needed additional heparin,wherein the incidence rate of substandard VCT value of 55-64 year-old group was the highest and was 20％.Eight cases without preoperative application of tirofiban,had sheath pipe pulled out because of errhysis in femoral artery sheath pipe puncture after operation,but their VCT value was within the target range of target value.All patients had no intraoperative and postoperative stroke,bleeding and thrombosis,etc.Conclusions ACT monitoring and effective coordination of care,can ensure the safety of heparin used in interventional procedures.

Objective To explore an auxiliary method to improve DWI image quality of testis.Methods Thirty healthy male volunteers were selected,and EPI-DWI and FSE-T2WI scanning with the same parameters were successively performed according to three different schemes.Scheme A:Padding ultrasonic coupling agent-soft rubber bag at the scanning position.Scheme B:Padding physiological saline-soft rubber bag at the scanning position.Scheme C:No preexamination treatment at the scanning position.FSE-T2WI (the same scheme and the same slice) was used as the reference of anatomic form,and the images were conducted by two attending doctors.The image geometric distortion,signal uniformity and anatomical clarity were scored by 5 points method.SNR and CNR of were calculated by one of the two doctors.The scoring consistency between the two doctors was evaluated.The scoring of image geometric distortion,signal uniformity,anatomic clarity,SNR and CNR of the three schemes were statistically analyzed.Results The scoring consistency of image geometrical distortion,signal uniformity and anatomical clarity of the three schemes were relatively good or better between the two doctors (Kappa=0.805,0.737 and 0.713).There were significant differences of image geometrical distortion,signal uniformity and anatomical clarity scoring obtained from three schemes (comparisons between groups and overall comparison,all P＜ 0.05),superiority:Scheme A＞ Scheme B＞ Scheme C.Conclusion Ultrasonic coupling agent-soft rubber bag padding method can significantly improve DWI imaging quality of testis.

Background:The musk glands of adult male Chinese forest musk deer(Moschus berezovskii Flerov,1929)(FMD),which are considered as special skin glands,secrete a mixture of sebum,lipids,and proteins into the musk pod.Together,these components form musk,which plays an important role in attracting females during the breeding season.However,the relationship between the musk glands and skin of Chinese FMD remains undiscovered.Here,the musk gland and skin of Chinese FMD were examined using histological analysis and RNA sequencing(RNA-seq),and the expression of key regulatory genes was evaluated to determine whether the musk gland is derived from the skin.Methods:A comparative analysis of musk gland anatomy between juvenile and adult Chinese FMD was conducted.Then,based on the anatomical structure of the musk gland,skin tissues from the abdomen and back as well as musk gland tissues were obtained from three juvenile FMD.These tissues were used for RNA-seq,hematoxylin-eosin(HE)staining,immunohistochemistry(IHC),western blot(WB),and quantitative real-time polymerase chain reaction(qRT-PCR)experiments.Results:Anatomical analysis showed that only adult male FMD had a complete glandular organ and musk pod,while juvenile FMD did not have any well-developed musk pods.Transcriptomic data revealed that 88.24%of genes were co-expressed in the skin and musk gland tissues.Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway analysis found that the genes co-expressed in the abdomen skin,back skin,and musk gland were enriched in biological development,endocrine system,lipid metabolism,and other pathways.Gene Ontology(GO)enrichment analysis indicated that the genes expressed in these tissues were enriched in biological processes such as multicellular development and cell division.Moreover,the Metascape predictive analysis tool demonstrated that genes expressed in musk glands were skin tissue-specific.qRT-PCR and WB revealed that sex-determining region Y-box protein 9(Sox9),Caveolin-1(Cav-1),and androgen receptor(AR)were expressed in all three tissues,although the expression levels differed among the tissues.According to the IHC results,Sox9 and AR were expressed in the nuclei of sebaceous gland,hair follicle,and musk gland cells,whereas Cav-1 was expressed in the cell membrane.Conclusions:The musk gland of Chinese FMD may be a derivative of skin tissue,and Sox9,Cav-1,and AR may play significant roles in musk gland development.

Objective: To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods: Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results: A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL (P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment (P < 0.05). Conclusion US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.Keywords: Ultrasound; Radiofrequency ablation; Te

【Objective】 To improve the efficiency and screening strategy by evaluating the performance of HBsAg screening before blood donation in Dalian. 【Methods】 The confirmed HBsAg positive samples were detected qualitatively and quantitatively, and retested with HBsAg rapid testing kit pre-donational used parallelly. Efficiency of HBsAg screening before donation was calculated, and compared between first-time and repeated donors. 【Results】 The pre-donation HBsAg screening was conducted for 199 553 cases, including 95 321 first-time donors (63.2%) and 55 396 repeated donors(36.8%).1 015 donors (first-time/repeated: 999/16) were reactive in HBsAg rapid testing. 113 samples (first-time/repeated: 108/5), initially negative in HBsAg rapid testing, were confirmed HBsAg positive by laboratory testing. The efficiency of pre-donation HBsAg screening for first-time donors(10.9‰) was significantly higher than that of repeated donors(0.3‰)(P<0.05). The positive rate of retesting was 41.1% (39/95), among which 70% were classified as median or strong positive.Significant difference was observed among HBsAg values(IU/mL) [median(range)] of negative, weak positive, median positive and strong positive samples (P<0.05) which were 0.41 (<0.05-11.35), 6.71 (2.49-23.15), 36.48 (7.01->130) and 92.44 (18.7->130), respectively. 【Conclusion】 The HBsAg rapid testing kit used in Dalian Blood Center could meet requirements for blood donor screening before donation, while good efficiency of HBsAg pre-donation screening could be achieved only in first-time blood donors.

OBJECTIVETo study the risk factor of perioperative complication in gastric cancer patients with radical therapy and its influence on prognosis.

METHODSClinical, pathological and follow-up data of 1 148 gastric cancer patients undergoing radical gastrectomy at Tianjin Medical University Affiliated Tumor Hospital between January 2009 and August 2011 were retrospectively collected. Pearson 2 test and Logistic regression analysis were used to analyze the risk factor of perioperative complication. Cox regression analysis was used to evaluate the influence of perioperative complications on the prognosis in patients after radical gastrectomy. Kaplan-Meier survival curve was applied to calculate the survival.

RESULTSOf 1 148 patients, 851 were male, 297 were female, age ranged from 19 to 89 (average 59.9) years. Perioperative complication occurred in 312 cases (27.2%), including 140 cases of pulmonary infection and 53 cases of abdominal infection. Multivariate Logistic regression analysis showed that ≥65 years old (OR:0.736, 95%CI: 0.558 to 0.971, P=0.030), serum albumin less than 35 g/L(OR:2.626, 95%CI: 1.479 to 4.665, P=0.001), Borrmann type IIII((OR: 0.748, 95%CI: 0.610 to 0.917, P=0.005), tumor site at upper 1/3 of stomach (OR:1.326, 95%CI:1.167 to 1.506, P=0.000), combined organ resection(OR:0.624, 95%CI:0.428 to 0.909, P=0.014) were independent risk factors of perioperative complication. Tumor site at upper 1/3 of stomach (OR:1.649, 95%CI: 1.368 to 1.988, P=0.000), ≥65 years old (OR:0.548, 95%CI:0.379 to 0.792, P=0.001), without intraoperative chemotherapy (OR:1.671, 95%CI:1.146 to 2.437, P=0.008) were independent risk factors of perioperative pulmonary infection; Borrmann type IIII((OR:0.576, 95%CI:0.369 to 0.900, P=0.015), with intraoperative chemotherapy (OR:0.431, 95%CI:0.230 to 0.810, P=0.009), intraoperative blood loss ≥400 ml(OR:0.411, 95%CI:0.176 to 0.959, P=0.040) and combined organ resection (OR:0.412, 95%CI:0.215 to 0.789, P=0.008) were independent risk factors of perioperative intraperitoneal infection. Cox regression analysis revealed that without intraoperative chemotherapy, proximal subtotal or total gastrectomy, TNM stage III(, N3 stage lymph node metastasis, positive soft tissue outside lymph node, combined organ resection and organ failure were independent risk factors affecting the prognosis of gastric cancer patients after radical resection (all P<0.05), however the perioperative complication was not independent risk factor affecting the prognosis (P=0.259). The median survival time was 35 months, and 5-year survival rate was around 38.7%. The median survival time of gastric cancer patients with operative complications and without complications were 28.0 and 36.5 months, and the 5-year survival rates were 37.2% and 39.3%, whose difference was not statistically significant (P=0.259).

CONCLUSIONThere is a higher risk of perioperative complication in those gastric cancer patients with old age, preoperative low serum albumin level, tumor site at upper 1/3 of stomach, Borrmann type IIII(, intraoperative combined organ resection, while the perioperative complication has no significant effects on the long-term survival.

ObjectiveTo investigate the effects of the inoculation of potassium-solubilizing bacteria on the rhizosphere soil microenvironment of Paris polyphylla var. yunnanensis. MethodThe effects of different potassium-solubilizing bacteria on the physical and chemical properties， microbial community structure， and soil enzyme activity in the rhizosphere soil of P. polyphylla var. yunnanensis were investigated by pot planting at room temperature. The correlation of various indexes was analyzed. ResultThe inoculation with different potassium-solubilizing bacteria could significantly affect the physical and chemical properties of rhizosphere soil of P. polyphylla var. yunnanensis. The mass fractions of available nitrogen， available phosphorus， and available potassium were 24.5-90.5 mg·kg^-1， 2.53-25.9 mg·kg^-1， and 132-312 mg·kg^-1， respectively， and the soil pH was 7.08-7.75， which were in line with the optimal ranges of P. polyphylla var. yunnanensis planting. The inoculation of different potassium-solubilizing bacteria could affect the number of bacteria， actinomycetes， and fungi in rhizosphere soil to varying degrees. The transformation of soil from "fungal type" to "bacterial type" marks the improvement of soil fertility. It also affected the enzyme activity of rhizosphere soil， and the activities of neutral phosphatase， protease， and polyphenol oxidase showed an increasing trend. The correlation analysis showed that the number of bacteria was negatively correlated with the number of fungi （r=-0.856， P<0.01）， positively correlated with the number of actinomycetes， the content of available nitrogen and available potassium， and negatively correlated with soil pH. ConclusionThe inoculation of potassium-solubilizing bacteria can effectively improve the content of available potassium， available nitrogen， available phosphorus， and other nutrients in the rhizosphere soil of P. polyphylla var. yunnanensis， improve soil fertility， alleviate the continuous cropping obstacles of P. polyphylla var. yunnanensis， and lay a theoretical foundation for the green and sustainable development of P. polyphylla var. yunnanensis.