BACKGROUND: Dysfunction of vascular endothelium is the initial event of atherosclerosis. Although there are many approaches to evaluate the function of vascular endothelium, few are widely used in clinic. OBJECTIVE: To evaluate the brachial and superficial femoral endothelium-dependent dilation, i.e. flow-mediated dilation (FMD) and endothelium-independent dilation, i.e. nitroglycerin-mediated dilation (NMD), of elderly patients with peripheral artery disease (PAD), and to investigate the correlation and characteristics between brachial and superficial femoral FMD and NMD.DESIGN, TIME AND SETTING: Non-randomized concurrent control trial was performed at Department of Geriatric Cardiology, Chinese PLA General Hospital from October 2000 to May 2002.PARTICIPANTS: Thirty-three PAD patients were selected as PAD group, including 27 male and 6 female, aged (79±6)years, who had more than one focus of plaque and arterial stenosis more than 50% in artery of lower extremity by Doppler ultrasound. Accorded with the standard for Health of China Academy of Geriatrics in 1995, 40 healthy retired cadres undergoing health examination were selected as control, including 29 male and 11 female. In addition, 30 patients with coronary arteriosclerotic heart disease or cardiovascular risk factors (excluding age and sex) were selected as risk factor group.METHODS: Using non-invasive approach, high resolution color Doppler ultrasound diagnosis system was applied to detect the basic caliber of upper and lower extremtity arteries in all participants, then the blood flow of the tested artery was blocked and the vascular caliber was detected again after the blood flow was restored to evaluate the endothelium-dependent dilation. The tested subjects took 0.6 mg nitroglycerin to induce vasodilatation after detecting the basic caliber of upper and lower extremtity arteries, then the difference between the two detections was regarded as the endothelium-independent dilation.MAIN OUTCOME MEASURES: The endothelium-dependent dilation and endothelium-independent dilation of upper and lower extremtity arteries.RESULTS: Both FMD and NMD of the brachial artery and the superficial femoral artery in 33 PAD patients were significantly lower than those of healthy controls and non-PAD patients with cardiovascular risk factors (t=-11.82-10.91, P <0.05). In old PAD patients, the superficial femoral FMD and NMD were significantly lower than brachial FMD (t=3.535,3.315, P < 0.01); There was close relationship between the brachial and superficial femoral FMD (r=0.931 4, P < 0.01), so was the NMD (r=0.919 1, P < 0.01).CONCLUSION: The superficial femoral FMD and NMD may reflect the vasoreactivity of PAD patients more directly and sensitively than those of brachial artery. There is close relationship between brachial and superficial femoral arteries.

Objective To examine the difficulty and discrimination of academic skill diagnostic test(ASDT).Methods About 1000 primary school students were administered the ASDT,and data were analysed by SPSS11.0 program.Results The difficulty of sub-tests ranged from 0.49～0.78(low edition),0.52～0.86(high edition);while the discrimination of sub-tests ranged from 0.31～0.55(low edition),0.21～0.56(high edition).The coefficients for test-retest and the whole test ranged from 0.36～0.61(low edition),0.39～0.60(high edition).Conclusion ASDT developed in the present study attains acceptable psychometric properties.

Objective To evaluate the efficiency of control measures of the noise from a boiler room. Methods The main noise sourcs of the boiler room for attendant apartment near Wuhu railway station including air-blower and water pump were isolated using sound absorptive materials,a kind of modified PVC as sound isulator.The noise levels of the operation table for boiler workers and rooms of attendant apartment were measured before and after adopting noise control measures,then were evaluated based on GB12348-1990,the Criteria for Evaluation on the Noise of Industrial Enterprises. Results The equivalent sound levels of day and night were 76.1 and 73.5 dB(A) for the operation table for boiler workers,68.4 and 54.6 dB(A) for rooms of attendant apartment before and after noise control. The noise levels of above two monitoring points met the requirement of GB12348-1990 after the noise control. Conclusion The modified PVC sound insulator could effectively screen the noise from the boiler room.

Objective To study the clinical significance of transforming growth factor (TGF)-β1 and interleukin (IL)-18 mRNA in the diagnosis and evaluation of disease severity of primary nephrotic syndrome (PNS) in children. Methods The ex-pression levels of TGF-β1 and IL-18 mRNA in peripheral blood mononuclear cells (PBMC) were measured by real-time lfuorescent quantitative polymerase reaction (RT-PCR) in 77 children with PNS and 30 healthy children (control group). Results In children with steroid-sensitive nephrotic syndrome (SSNS), the expression levels of TGF-β1 and IL-18 mRNA before treatment and at 1, 4 weeks after hormone therapy were signiifcantly lower in children with simple type nephrotic syndrome than those in children with nephritic type nephrotic syndrome (P<0.05). The level of TGF-β1 mRNA before treatment was signiifcantly lower in children with SSNS than that in children with steroid-resistant nephrotic syndrome (SRNS). With the extension of hormone therapy, the expression levels of TGF-β1 mRNA showed a trend of declining in children with PNA. In children with SRNS, the expression levels of TGF-β1 and IL-18 mRNA before treatment and at 1, 4 weeks after hormone therapy were signiifcantly lower in children with simple type NS than those in children with nephritic type nephrotic syndrome (P<0.05). In children with SSNS, the levels of TGF-β1 and IL-18 mRNA were signiifcantly higher in acute phase than those in the remission phase. Conclusions At the early stage of PNS, the detection of the expression levels of TGF-β1 and IL-18 mRNA is useful for evaluatation of disease activity, clinical identiifcation of nephritic type nephrotic syndrome and simple type nephrotic syndrome and early prediction of SRNS.

Objective Based on dual channel melting curve analysis-based assay,we developed a method to rapidly detect the drug-resistant mutations in Mycobacterium tuberculosis through real-time PCR.Methods According to the common first-line drug-resistant mutations of Mycobacterium tuberculosis,we designed six dual-labeled fluorescence probes to rapidly detect the drug-resistant mutations through realtime PCR melting curve after amplifications of drug-resistant related gene region of DNA.The targets include rpoB 81 bp core region,katG315,inhA promoter,ahpC promoter and embB306.To validate the sensitivity and specificity of our method,we performed real-time PCR assays to detect drug-resistant mutations in 76 clinical MDR-TB samples,which were collected by Shanghai CDC in 2008.Results In the validation,this method successfully detected drug-resistant mutations in all 76 clinical MDR-TB samples.The △Tm of mutations were from 1.8 to 14.4 ℃.Comparing with the sequencing data,all mutations covered by the six probes were detected with 100％ sensitivity and 100％ specificity (rpoB,80/80; inhA,7/7 ; katG315,59/ 59;ahpC,8/8;embB306,27/27).This method can successfully detect drug-resistant mutations from 100 copies/μl DNA samples.Conclusions A widely applicable real-time PCR assay to detect first line drug-resistant mutations of Mycobacterium tuberculosis has benn developed.This method has proven to have the advantages of high sensitivity,specificity and low risk of contamination.It can be used in rapid diagnosis of clinical drug-resistant tuberculosis and the evaluation of laboratory drug sensitivity test.

Objective:Our purpose was to investigate the function of angiotensis converting enzyme(ACE) in the occurrence and development of pregnancy-induced hypertension(PIH). Methods:The study group included 30 pregnant women diagnosed with PIH( 10 mild, 10 moderate, 10 severe). Thirty healthy pregnant women were selected as the control group. The serum was assayed for the activity of ACE by using color comparison method, hippuric acid used as the substrate. Results:The activity of ACE of the study group was significantly higher than that of the control group. Significantly positive correlationships existed between mean blood pressure, degree of adema, level of urine protein,and uric acid. Conclusion:The elevation of serum activity of ACE is related to the occurrence and development of PIH.

Objective To investigate the effects of arsenic trioxide(As2O3) on the cell proliferation and apoptosis of C6 glioma cells in vitro.Methods The C6 glioma cells were treated by 1,3,5 μ mol/L of As2O3 with different duration and observed under the microscope and electromicroscope.The viability of C6 glioma cells was examined by methyl thiazolyl tetrazolium (MTT) assay,and cell cycle and apoptosis were examined by flow cytometry.Results After treatment of 1,3,5 μ mol/L As2O3,C6 glioma cells were inhibited obviously with a dose- and time-dependent manner (P ＜0.05) by MTT.During flow cytometry,more increasing apoptotic cells were found in different concentration As2O3.Characteristic morphological changes were observed in As2O3 intervention by transmission election microscopy including cell shrinkage,physaliphore,nuclear condensation and apoptosis and so on.Conclusion As2O3 can inhibit the cell proliferation and induce the apoptosis of C6 glioma cells.

Objective To discuss the diagnosis,treatment and following-up of cervical intraepithelial neoplasia (CIN) during pregnancy.Methods Eighteen pregnant women with CIN,presented to the hospital from Jan.2004 to May.2008,were retrospectively reviewed.Pap smear,HPV,copolscopy and cervical biopsy were performed for diagnosis and all were followed up by Pap smear and copolscopy during pregnancy every 12 weeks,while 15 were followed up until 6-8 weeks postpartum.Results The incidence of CIN during pregnancy was 0.16%.All of the 18 women had abnormal Pap smear,followed by colopscopy and biopsy.Conservative management during the pregnancies every 3 months showed no progress in CIN.Among the 18 cases,17 delivered at term and only 1 preterm (36+4 weeks).Two out of the 18 women had normal delivery (11.1%),2 by forceps(11.1 %) and 14 by cesarean sections (77.8%).No neonatal apnea or neonatal respiratory distress syndrome had been observed.Pathological diagnosis was confirmed in all cases prenatally,including 4 CIN1,4 CIN2 and 10 CIN3.Four out of the 10 CIN3 remained after delivery,while 1 changed to CIN2.These 5 cases underwent leep electrical excision procedure and Pap smear results turned to normal at 6 to 11 months after delivery.One HSIL case were lost.The rest 4 CIN3 and all of the 8 CIN1 and CIN2 cases turned to normal or lesser degree.Fourteen of the 18 women received HPV test during pregnancy,and 12 (85.7%) were positive,among which 7 women were followed up at postpartum and 6 of them were HPV positive.Conclusions The three steps method for diagnosis of CIN during pregnancy is safe and effective.Conservative management of CIN during pregnancy is recommended.

Objective To explore the effectiveness and safety of endoscopic papillary balloon dilation( EPBD ) for the removal of common bile duct stones. Methods Three hundred and twenty consecutive patients with common bile duct stones on endoscopic retrograde cholangiopancreatography (ERCP) who met all eligibility criteria were randomly assigned endoscopic sphincterotomy (EST) or EPBD.Complications were classified by an expert panel unaware of treatment allocation and outcome. Results After a single ERCP, all stones were removed from 112 patients ( 70% ) assigned EST and 104 ( 65% )assigned EPBD. Mechanical lithotripsy was used to fragment stones in 36 (22. 5% ) EPBD procedures and 32 ( 20. 0% ) EST procedures. Early complications occurred in 5.6% EST patients and 8.1% EPBD patients. No patient died. Gallstone disease recurrence, which is a long-term complication, is 7. 5% ( 12/160) in EST patients and 2.5% (4/160) in EPBD patients, P ＜0. 05. Conclusions The success rate of EPBD was similar to that of EST. We found no evidence of previously suggested higher risk of pancreatitis with EPBD, and suggest that EPBD is preferred in patients who are not suitable for EST, such as those with high risk of bleeding. This procedure is a valuable alternative to EST in patients with bile duct stones.

Humans ; Imaging, Three-Dimensional ; Neoplasms ; radiotherapy ; surgery ; Radiosurgery ; instrumentation ; methods ; Tomography, X-Ray Computed