Objective To investigate the effects of Huangkui Capsules on oxidative stress and micro-inflammation state in diabetic nephropathy patients with maintenance hemodialysis. Methods Forty-six patients with diabetic nephropathy who had received maintenance hemodialysis for over six month in Gansu Provincial People's Hospital were randomly divided into observation group (23 cases) and treatment group (23 cases) from January to December in 2014. Twenty healthy subjects who had physical examinations were selected as the control group at the same time. Observation group were given conventional hemodialysis for 4 hours, 3 times a week; treatment group were given conventional hemodialysis combined with Huangkui Capsules, orally, 2.5 g each time, 3 times a day. Both groups were treated for 8 weeks. Blood was collected before and after treatment for detection of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), white blood cell (WBC), malondialdehyde (MDA), cycle of advanced oxidation protein products (AOPP), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels. Results The levels of IL-6, TNF-α, AOPP, WBC, MDA and hs-CRP were significantly higher in the observation group and the treatment group compared with the control group before treatment (P<0.01), SOD and GSH-Px levels decreased (P<0.01); there was no statistical significance between the observation group and the treatment group (P>0.05). After treatment, the levels of IL-6, hs-CRP, MDA and AOPP increased in the observation group (P<0.05), GSH-Px and SOD decreased (P<0.05), there were no statistical significance in TNF-αand WBC (P>0.05);The levels of AOPP, TNF-α, hs-CRP, WBC, MDA and IL-6 in treatment group significantly decreased (P<0.01), GSH-Px and SOD significantly increased (P<0.01); there was statistical significance between the observation group and the treatment group (P<0.01). Conclusion Micro-inflammation state and oxidative stress exist generally in diabetic nephropathy maintenance hemodialysis patients. Huangkui Capsules can improve oxidative stress and micro-inflammation state in diabetic nephropathy maintenance hemodialysis patients.

Objective To investigate serum amino acid spectrum in patients with acute stroke in response to different nutritional support strategies and its effects on neurological function.Methods A total of 60 cases of acute stroke with dysphagia were randomly distributed into two groups:enteral nutrition group (30 cases) and control group (30 cases) using simple randomized design.Serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and infection rate were assessed at three time points:within 48 hours,(7 ± 1) days and (14 ± 1) days after admission,and neurological deficit and activities of daily living are scored according to National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI).Results (7 ± 1),(14 ± 1) days after admission,serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and neurological deficit scores of enteral nutrition group patients were significantly better than those of non-enteral nutrition control group; and infection rate was lower than that of control group.Follow-up for a month,3 months,NIHSS of enteral nutrition group patients (9.0 ± 1.4,7.9 ± 1.3) were significantly better than nonenteral nutrition control group(11.1 ± 1.5,10.6 ± 1.4,F =46.042,P ＜ 0.05).While BI score seemed to be not insignificant different between enteral nutrition group (50.1 ± 1.8,52.0 ± 2.4) and control group (49.0±2.1,51.3 ±2.8,F=2.707,P＞0.05).Conclusion For patients suffering acute stroke with dysphagia,enteral nutrition support could reduce infectious complications,improve short-term neurological function and long-term prognosis by improving serum amino acids level and thus the whole body' s nutritional status.

Objective To assess the value of susceptibility weighted imaging (SWI)in the diagnosis of different cerebral diseases complicated with cerebral microbleeds (CVBs)and cerebral vascular malformations (CVMs).Methods The MRI data of 76 cases with CMBs and 25 cases with CVMs were retrospectively analyzed and the data were translated as follows:(1 )To compare the counts and detecting sensitivity of CMBs on routine MRI sequences (T1 WI,T2 WI,T2 FLAIR,DWI)with SWI.(2)To assess the difference of SWI,MIP and Phase in detecting the size,counts,intensity and edge features of CMBs.(3)To assess the advantages of SWI in the diagnosis of different CVMs.Results (1)In all 1 524 CMBs detected on SWI,294,87,361,391 CMBs were detected on T1 WI,T2 WI,T2 FLAIR and DWI respectively.The sensitivities were 19.3%,5.7%,23.7% and 5.7% on T1 WI,T2 WI,T2 FLAIR and DWI respectively.It was of statistical significance (P <0.05)in the counts and detecting sensitivity on different MRI sequences.(2) 1 524 and 1 539 CMBs were detected on SWI and MIP respectively.CMBs showed oval,dotted hypointensity or hypointensity domi-nated mixed intensity lesions which were ≤10 mm in size on SWI and MIP.1 521 CMBs were detected on Phase,which appeared as hyperintensity or hyperintensity dominated mixed intensity lesions.MIP and SWI were similar in detecting the size,counts and edge features of CMBs.And Phase was inferior compared with MIP and SWI .(3)12 cases of cerebral venous malformation were detec-ted,which all appeared as the classic Medusa head sign on SWI.6 cases of intracerebral capillary telangiectasia were detected , which were characterized as multiple small rounded even hypointense lesions ortarget signon SWI .2 cases of arteriovenous malformation (AVM)were detected on SWI,in which one case only showed multiple small vessels and gross drainage vein,and the other showed clear nidus and gross drainage veins into the sigmoid sinus.4 cases of cerebral cavernous angioma were detected.Mulberry sign, which was characterized as dotted mixed intensity lesion with hypointense ring,was noted in all the cases on SWI.One case of Sturge-Weber syndrome was detected,which showed gyriform low signal lesion on MIP imaging.And many broadened,tortuous veins in the cerebral hemispheres and near the tentorium were also noted.Conclusion SWI can be used as an important sequence for detecting CMBs.Different CVMs show their specific signs in SWI sequence.Combined with conventional MRI sequences an accurate diagnosis can be achieved most of the time.

Objective To assess the epidemiology and clinical characteristics of sleep disorders in a single center in northwest China.Methods Using the International Classification of Sleep Disorders, 3rd Edition, all consecutive patients which were suspected as sleep disorders in Tangdu Hospital between January 2007 and December 2016, were included retrospectively.Results The average age of 8 037 patients was (46.59±15.83) years with male-female ratio 1∶1.24.Chronic insomnia was found in 3 848 (47.9%) patients, obstructive sleep apnea was found in 2 648 (32.9%) patients, narcolepsy was found in 294 (3.7%) patients, Kleine-Levin syndrome was found in 11 (0.1%) patients, circadian rhythm sleep-wake disorders were found in 14 (0.2%) patients, rapid eye movement behavior disorder was found in 193 (2.4%) patients, restless legs syndrome was found in 139 (1.7%) patients, periodic limb movement disorder was found in 109 (1.4%) patients, and other possible sleep disorders were found in 478 (5.9%) patients, respectively.Chronic insomnia and obstructive sleep apnea combided with somatic diseases.Conclusions Patients diagnosed by polysomnography in our single center suggested consultation rate of sleep disorders was increasing in past ten years, of which chronic insomnia and obstructive sleep apnea were dominant and comorbided with somatic diseases.

Yunnan sudden death syndrome (YSDS) is an abruptly fatal disease of unknown etiology, found mostly in central or northwestern mountain area (with altitude between 1 815 and 2 225 meters ) of Yunnan province from June to September every year. It occurs mostly in young female adults, with high incidences in Lisu, Yi and Miao ethnics and high familial aggregation. The clinical manifestation of YSDS is changeful and the pathological characteristic is lack of specificity. The pathogenesis may be at-tributed to several factors including poor hygiene and lower socioeconomic conditions, lack of Selenium or Chromium, infection of Coxsackie B virus, mushroom consumption and special geological conditions. This article reviews the epidemiologic features, clinical manifestations, pathological features, etiology and hypothesis in order to provide clues for the research of YSDS.

Objective Carbonic anhydrase 1 (CA1) not only enhances the hydration reaction but also promotes the formation of CaCO3,which is an essential step for new bone formation in vitro.However,there is no direct evidence to demonstrate the involvement of CA1 in bio-mineralization in cells and tissues.This study is aimed to evaluate the important role of CA1 in bio-mineralization and ossification in cultured cells.Methods Calcification in Saos-2 cells was induced using osteogenic medium (OM) and the calcification was determined by Alizarin Red-S staining.The expressions of ossification protein marker Runt-related transcription factor-2 (Runx2),osterix (OSX),alkaline phosphatase (ALP),osteocalcin (OCN) and bone sialoprotein (BSP) were detected in the process of bone formation by real-time PCR.The expression of CA 1 in the calcified cells were measured using real-time PCR and Western blotting.We also detected calcification in Saos-2 cells in the presence of acetazolamide,an anti-carbonic anhydrase drug to CA1,to determine the role of CA1 in biomineralization in culture cells.T test analysis was used to compare the two groups,M-ANOVA of repeated measurs was conducted for different time point.Results Following the stimulation of OM,Saos-2 cells produced a great amount of calcium-rich deposits [0.68±0.03 vs 2.76±0.13,P＜0.01].Increased transcriptions of ossification protein markers were also detected in these stimulated Saos-2 cells,indicating that the OM launched the process of bone formation in the cells.CA1 had a significantly increased expression during this process [0.25±0.03 vs 0.94±0.06,P＜0.01].Following treatment with acetazolamide,the expression of CA1 evidently declined [1.09±0.05 vs 0.55±0.07,P＜0.05],and the mineralized nodule formation was declined [2.76±0.13 vs 2.19±0.07,P＜0.01].Conclusion These findings indicate that CA1 participates in the biomineralization and ossification,and may play an important roles in bone formation.

Syndrome, a very important concept in traditional Chinese medicine (TCM), is the essence and characteristics of TCM theory. Progress of related studies on syndrome will drive the development of TCM. Therefore, clinical and basic researches on syndrome have focused on the hotspot of TCM. In recent 60 years, many scholars have discussed the concept, essence and the establishment of standardization of syndrome from different angles and layers. Although many results have been obtained, there is still a certain one sidedness and dispute. Therefore, looking for a new theoretical tool to reveal the scientific connotation of TCM syndrome is imperative. TCM syndrome and biological entropy belong to two different subject concepts, but can also reveal the physiological and pathological state in the changes of life body growth. This article discussed isomorphism of TCM syndrome and biological entropy from the concept, theoretical background and characteristics, with a purpose to provide certain guiding significance to study and promote standardized researches on TCM syndrome.

Objective The goal of the present study was to determine the effects of different location perfora-tions on the middle ear transfer functions by measuring the velocity and pattern of the tympanic membrane vibration in guinea pigs with intact and perforated TM .Methods A laser Doppler vibrometer was used to measure the sound transmission properties on the movement of the tympanic membrane on 6 fresh temporal bones of guinea pigs in the frequency range of 0 .5~8 kHz at 90 dB SPL .The velocity was measured at three points on the manubrium before and after a different location perforation was made with a 20-gauge needle(1 .1 mm diameter) .The locations of the perforations were in anterior -inferior quadrants of left ears and in posterior -inferior quadrants of right ears .And the velocity was measured from 6 poins with the intact tympanic membrane .Results The highest velocities were re-corded at the site of inferior umbo throughout the frequency range .The manubrium vibration velocity losses were noted in the perforated ears below 1 .5 kHz ,the velocity losses were smaller above 1 .5 kHz ,and the maximum ve-locity loss was about 7 dB at 500 Hz with the posterior -inferior quadrant perforation .Although there was a trend for anterior-inferior perforations to show a slighter loss than posterior -inferior perforations in velocity below 1 .5 kHz ,no statistical differences in velocity loss were found between different perforations .The average ratio of short process velocity to umbo velocity at all frequencies was approximately 0 .5 ,and the ratios were found no systematic differences before and after perforation at almost all frequencies from different perforations .Conclusion The manu-brium vibration velocity losses from TM perforation are frequency -dependent and the largest losses occur at the lowest sound frequencies .Different sites of small perforation have not any important effects on middle ear sound transmission .

Objective To investigate the diagnosis and treatment of ectopic opening of the common bile duct in the duodenal bulb.Methods The clinical data of 3 patients who were admitted to the Binzhou People's Hospital and 9 patients who were admitted to the Tianjin People's Hospital from January 2006 to December 2013 with ectopic opening of the common bile duct in the duodenal bulb were retrospectively analyzed.Seven patients had choledocholithiasis and 5 had stenosis at the end of common bile duct.The medical histories and clinical features in patients were analyzed and routine blood test and serum liver function test were done.All the patients received the endoscopic retrograde cholangiopancreatography (ERCP) examination and were cured.All the patients were followed up via outpatient examination and telephone interview up to August 2014.Results Six patients had histories of cholangitis recurrence and 2 had histories of duodenal ulcer recurrence.All the patients had pain in the right hypochondriac region of the abdomen.Seven patients had fever,chills,skin yellowing sclera and tenderness in the right hypochondriac region of the abdomen.The levels of alkaline phosphatase (ALP) and glutamyltranspeptidase (GGT) in 11 patients,the levels of TBil and DBil in 8 patients and the count of WBC in 7 patients were increased.(1) The results of ERCP showed as follows:there was no papillar opening at the second and third segment of duodenum.The crack-like opening located at the duodenal post-bulb with rough and erosive mucosal surfaces and intermittent outflow of bile.Duodenal ulcer was detected in 5 patients and duodenal bulb metamorphosis in 3 patients.All the 12 patients received successfully intubations.(2)The results of retrograde cholangiography showed as follows:the end of common bile duct of 12 patients was taper and sickle-shaped.Intra-and extrahepatic bile duct dilation was detected in 10 patients,choledocholithiasis in 7 patients and clear findings for the pancreatic duct in 5 patients.Among the 12 patients,8 received balloon dilation (5 with stenosis at the end of common bile duct,3 with choledocholithiasis),3 received laparoscopic common bile duct exploration (LCBDE) combined with cholangioenterostomy due to diameter of stone more than 1.5 cm and ectopic opening stenosis of the common bile duct in the duodenal bulb.One patient was treated by percutaneous transhepatic cholangiography (PTC) lithotomy of common bile duct after unsuccessful ERCP without bleeding and pancreatitis-related complications.The symptoms of cholangitis in 3 patients were alleviated after balloon dilation,2 patients had recurrence of cholangitis and were cured by Roux-en-Y cholangioenterostomy.The mean open surgery time and mean duration of postoperative hospital stay in 5 patients were 85 minutes (range,60-150 minutes) and 10 days (range,8-14 days),respectively.All the 12 patients were followed up with a median time of 38 months (range,8-90 months).During the follow-up,10 patients survived well without recurrence of cholangitis and cholelithiasis.Two patients had recurrence of cholangitis at postoperative month 2 and month 14,including 1 patient with the recurrence of common bile duct sand-like stones,and they were readmitted to hospital and treated by Roux-en-Y cholangioenterostomy without recurrence by follow-up.Conclusions The clinical symptoms of ectopic opening of the common bile duct in the duodenal bulb included recurrence of cholangitis,duodenal ulcer history,pain in the right hypochondriac region of the abdomen,skin yellowing sclera,abnormal liver function,crack-like openings in the duodenal bulb by ERCP examination with outflow of bile,cholangiography-guided taper and sickle-shaped end of common bile duct.The treatment should be aimed at the concomitant diseases.

Objective To isolate, culture and identify mouse umbilical cord mesenchymal stem cells( mUCMSCs) and to study whether they can be induced to differentiate into adipocytes, chondrocytes and osteoblasts.Methods The mUCMSCs were isolated and expanded by adherent culture from fresh mouse umbilical cord.The morphological characteris-tics of the resulting cells were observed under inverted phase contrast microscope, and their expression of mesenchymal sur-face markers was identified and analyzed by flow cytometry.Then mUCMSCs were induced to differentiate into chondro-cytes, adipocytes and osteoblasts in vitro.Results Fibroblast-like cells could be isolated from the fresh umbilical cord by adherent culture.These adherent cells highly expressed mesenchymal markers including CD29, CD90 and CD105 while low expression of CD34.The cells were successfully induced to differentiate into chondrocytes, adipocytes and osteoblasts. Conclusions The mUCMSCs isolated from fresh mouse umbilical cord by adherent culture have potential of differentiation into chondrocytes, adipocytes and osteoblasts.