Objective To develop a high performance liquid chromatographic method (HPLC) for the analysis of of cholesterol in erythrocyte membranes.Methods The study included 167 consecutive chest pain patients who underwent coronary artery angiography in the Department of Cardiology,Nanjing General Hospital of Nanjing Command between September 2012 and February 2013.According to the clinical symptoms and t angiographic results,patients were divided into three groups:acute coronary syndrome (ACS) group (n =46),stable angina pectoris (SAP) group (n =76) and the control group (n =45).After the erythrocyte sample was hypotonically lysed and washed,saponification was carried out in a polassium hydroxide solution at 70 ℃.After extraction by Hexane/isopropanol mixture,the sample was separated on a Lichrospher column and detected by ultraviolet absorbance at 208 nm.A mobile phase composed of acetonitrile-isopropyl alcohol was found to be the most suitable for this separation.Concentrations of cholesterol in erythrocyte membranes were tested.Analysis of variance with covariates (ANOVA) was used to evaluate differences in CEM levels among groups.The relationship between continuous variables was evaluated by Spearman's correlation coefficient.Results Under the chromatographic conditions described,retention time of the cholesterol was approximately 6.1 min.Good separation and detectability of cholesterol in erythrocyte membranes were obtained.The method proved to be linear in the injection range of cholesterol from 0.05 g to 2.00 g.Cholesterol content in erythrocyte membranes were (87.0 μg/mg,75.4-98.9 μg/mg),(92.9 μg/mg,83.8-109.0 μg/mg) and (173.9 μg/mg,140.0-188.8 μ g/mg) in the control,SAP and ACS groups,respectively.Cholesterol content in erythrocyte membranes was significantly higher in ACS group than that in SAP and control groups (P ＜ 0.01).Conclusion We have successfully developed a method for the determination of cholesterol in erythrocyte membranes with good sensitivity,specificity and repeatability.

Objective To explore the prevalence,socio-demographic and clinical characteristics of deficit schizophrenia in Chinese community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia were recruited in a cross-sectional study in Yuhua-tai District of Nanjing,and deficit schizophrenia was confirmed by Chinese version of the Schedule for the Deficit Syndrome (SDS). Their socio-demographic and clinical characteristics were collected. All patients' psychopathology was assessed by Positive and Negative Syndrome Scale (PANSS). Results The current prevalence of community-dwelling patients with deficit schizophrenia was 0. 67‰. Deficit schizophrenia had significantly higher hospitalizations((2. 4±1. 3)times,(1. 9±0. 9)times),PANSS negative scores((28. 4± 8. 1),(17. 7±6. 3)),PANSS total score((96. 5±17. 3),(87. 3±18. 1)) than non-deficit schizophrenia(all P<0. 05),while non-deficit schizophrenia had higher currently smoking rate,positive scores,marriage per-centage and age of onset( all P<0. 05) . Further multiple logistic regression analysis indicated that male sex, age of onset,smoking and negative PANSS score were independently associated with deficit schizophrenia. Conclusion The study showed that deficit schizophrenia is very common in Chinese psychiatric outpatients. The results partially support deficit schizophrenia as an independent subtype of schizophrenia.

Objective To explore the expressions of Toll-like receptor 2 (TLR2 ) and the downstream proteins in patients with human immunodeficiency virus /Mycobacterium tuberculosis (HIV /M TB) co-infection .Methods A total of 119 subjects were randomly enrolled .The subjects were divided into four groups :HIV group (n = 32) ,HIV /M TB group (n = 30) ,M TB group (n = 28) and healthy control group (n= 29) .Peripheral venous blood was collected and the HIV-1 viral load was determined by standard method .The expression levels of TLR2 mRNA in peripheral blood mononuclear cells (PBMC) were determined by real-time quantitative PCR (qPCR) and mean fluorescent intensity (MFI) of TLR2 protein was detected by flow cytometry .The plasma interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels were measured with enzyme-linked immunosorbent assay kits .The data were statistically analyzed by chi-square test ,students t test ,analysis of variance and rank sum test when appropriate .Results The viral load in HIV /M TB group ([5 .113 ± 1 .018] lg copy/mL ) was significantly higher than that in HIV group ([4 .416 ± 1 .020] lg copy/mL ; t = 3 .449 , P< 0 .01) .The TLR2 mRNA expressions in PBMC
among HIV ,HIV/M TB ,M TB and healthy control groups were 1 .397 ± 0 .601 ,1 .463 ± 0 .702 ,1 .429 ± 0 .630 ,and 0 .970 ± 0 .488 ,respectively ,which was significantly different among the 4 groups (F =4 .197 , P= 0 .007) .The MFI of TLR2 protein expressions on PBMC among HIV ,HIV /M TB ,M TB and healthy control groups were 28 .12 ± 4 .55 ,38 .11 ± 11 .77 ,31 .13 ± 12 .10 and 23 .33 ± 5 .14 ,respectively . The TLR2 protein expression levels were significantly different among 4 groups (F= 13 .976 ,P< 0 .01) . The plasma IL-6 and TNF-α concentrations were significantly different among 4 groups (Z = 19 .088 , 15 .475 ,both P< 0 .01) .The IL-6 concentrations in three patient groups were higher than that in healthy control group ,but the TNF-α concentrations were lower than healthy control group .Conclusions The co-infection of HIV-1 and M TB may enhance the activation of TLR2 signaling pathway ,which leads to the increased expression of IL-6 .

Objective To investigate the expression of TLR 4 and its downstream factor TNF-αin the patients with human immunodeficiency virus and Mycobacterium tuberculosis ( HIV/MTB) co-infection. Methods A total of 119 subjects including 32 patients with HIV infection (HIV group), 30 patients with HIV/MTB co-infection (HIV/MTB group), 28 patients with MTB infection (MTB group) and 29 healthy subjects ( control group ) were recruited continuously from the Fourth People′s Hospital of Nanning City , Guangxi.The expression of TLR4 in peripheral blood mononuclear cells (PBMCs) from the patients was de-termined by flow cytometry .ELISA was performed to detect TNF-αin plasma samples .The HIV-1 viral load was determined by standard method .Results The mean fluorescence intensity ( MFI) for TLR4 expression in PBMCs from HIV, HIV/MTB, MTB and control groups were 21.62±4.67, 18.29±3.87, 16.79±4.45, and 22.85±5.80, respectively, showing significant differences among four groups (F=8.105, P<0.01). The TLR4 levels in MTB and HIV/MTB groups were significantly lower than those in control group ( both P<0.01) and HIV group (P<0.01, P=0.014).The plasma concentrations of TNF-αin HIV, HIV/MTB, MTB and control groups were 15.892 (10.494-21.646) pg/ml, 13.142 (8.014-22.038) pg/ml, 16.284 (11.916-24.005) pg/ml, and 26.657 (16.321-34.541) pg/ml, respectively, that were significantly dif-ferent from each other (F=4.350, P=0.006).The levels of TNF-αin plasma from patients with HIV and HIV/MTB infection were significantly lower than those of healthy subjects (P=0.009 and P=0.001).The viral load in patients from HIV/MTB group (5.113 ±1.018 copies/ml) was significantly higher than that from HIV group (4.416±1.020 copies/ml) (t=3.449, P=0.001).Conclusion MTB infection might promote HIV replication by inhibiting the expression of TLR 4.HIV infection might increase host′s suscepti-bility to MTB infection by reducing the production of TNF-α.Suppressed expression of TLR and TNF-αpro-duction could contribute to the occurrence of HIV /MTB co-infection .

Essential of rheumatoid arthritis (RA) is destruction of invasive pannus formation in cartilage, bone and surrounding tissues Chronic inflammation of synovial membrane. Vascular endothelial growth Factor (VEGF) increases vascular permeability and induces angiogenesis. It plays a very important role in the process of joint erosion and destruction of RA. It not only promotes the formation of RA synovial pannus formation, but also acts as a direct proinflammatory factor in the pathogenesis of RA.

Objective To conduct the biomechanical evaluation of the effect of the new operative method,one stageanterior debridement and fusion combined withtitanium cage and dual screw-rod anterior instrumentation inter-fixation on the reconstruction of lumbosacral spine stability and provide biomechanical support for its further promotion in clinical practice.Methods Fifteen lumbosacral spine specimens were obtained from the department of anatomy,Xi'an Jiaotong University Health Science Center.Fracture,deformity and osteoporosis were removed by CT and bone density examination.The remaining specimens were randomly divided into intact group,anterior fixation group and posterior fixation group.L5 vertebral body and adjacent intervertebraldisc subtotal resection were performed on all specimens in the anterior fixation group and the posterior fixation group.The specimens in the anterior fixation group were fixed through titanium cage and dual screw-rod from front approach and the specimens inthe posterior group were fixed by dual screw-rod from posterior approach.Specimens in the intact group were not treated.All specimens were examined by X-ray and thin-slice CT after surgery to determine whether implant placement was appropriate andwhether there was spinal cord compression or not.Three groups of lumbosacral spine specimens were subjected to mechanical testsunder the conditions of flexion and extension,lateral bending,axial torsion and axial compression to evaluate the mechanical effect of anterior dual screw-rod system combined with titanium cage on the fixation of lumbosacral spine.Results All lumbosacralspine specimens were free of fractures,deformities,osteoporosis and other diseases.Postoperative imaging examination showed thatthe implant was in normal position and no adverse phenomena such as pedicle screw insertion into the spinal canal and spinalcord compression were observed.Mechanical test results in vitro showed that the load required for maximum loading displacement (5 mm) or rotation angle (5°) of the specimens in the intact group was less than that of the specimens in anterior and posterior fixation group in flexion,lateral bending and axial compression and torsion direction (Fflexion=1335.989,Pflexion=0.000;Fextenxion=166.688,Pextenxion=0.000;Fleft latebending=258.872,Pleft lateral bending=0.000;Fright lateral bending=335.766,Pright lateral bending=0.000;Faxial compression=481.444,Paxial compression =0.000;Fleft rotation=21.682,Pleft totation=0.000;Fright rolation=34.990,Pright rotation=0.000).When the maximum loading displacement (5 mm) was reached,the load required for the specimens in anterior fixation group was significantly greater than that for specimens in posterior fixation groupin the direction of flexion,left and right lateral bending and axial compression (Pflexion=0.000;Pleft lateral bending=0.006;Pright lateral bending=0.016;Paxial compression=0.000).However,the load required to reach the maximum loading displacement (5 mm) in the anterior fixation group in the direction of extension was significantly lower than that in the posterior fixation group (P=0.000).When the maximum load angle (5°) was reached intorsion direction,the required load of the specimens in both anterior and posterior fixation groups was similar (Pleft rotation=0.820;Pright rotation=0.259).Conclusion The anterior fixation of lumbosacral spine specimens with titanium cage combined with dualscrew rod can provide better immediate stability and its stability in flexion,lateral bending and axial compression is better than that of back double nailing rodfixed.

OBJECTIVE:To investigate improvement effect of external administration of water extract from Eriocarpous Glochidion on chronic dermatitis-eczema model mice, and to provide reference for developing new dermatological drug. METHODS:A total of 60 mice were randomly divided into blank group (distilled water), model group (distilled water), compound triamcinolone acetonide acetate group (positive control group, original liquid) , high-concentration, medium-concentration and low-concentration groups of water extract from Eriocarpous Glochidion(2.0,1.0,0.5 g/mL,calculated by crude drug),10 mice in each group. Except for blank group,other groups were given 2,4-dinitrochlorobenzene to induce chronic dermatitis-eczema model. Since the third day of the experiment,two sides of right ears of the mice were given relevant medicine twice at 7:00 and 15:00,15 μL each time,for consecutive 12 d. In the tenth,thirteenth,sixteenth day of the experiment,the difference of thickness of right ears of the mice was calculated(the difference value before experiment),the times of scratching in ear of mice were recorded within 30 min. In sixteenth day of the experiment,ear swelling degree of mice was determined,and thymus index and spleen index in mice were calculated. Optical microscope was used to observe the pathological changes of ear tissues of mice. RESULTS:Compared with blank group,the difference of thickness of right ears,ear swelling degree,spleen index and scratching times were increased significantly in model group(P<0.05 or P<0.01). The epidermis of the ear tissue was thickened,the cell proliferation was obvious,and cavernous edema was found in the epidermis. Compared with model group,other indexes in were decreased significantly,except that the difference value of thickness of right ears in sixteenth day of the experiment,scratching times in ninth and fifteenth day of the experiment were decreased slightly in low-concentration group of water extract from Eriocarpous Glochidion and the thymus index and spleen index in medium-concentration, low-concentration groups of water extract from Eriocarpous Glochidion (P<0.05 or P<0.01). The pathological changes of ear tissue were improved in administration groups to certain extent. CONCLUSIONS:External administration of water extract of Eriocarpous Glochidion has good improvement effect against chronic dermatitis-eczema in mice, which is worthy of further development and investigation.

Objective This study examined the prevalence of underweight and its related risk factors of community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia and 323 healthy controls were recruited in a cross-sectional study. Body mass index less than 18.5 was defined as underweight. Their demographic and clinical data including anthropometric data, plasma glucose and lipid parameters were collected. The Positive and Negative Syndrome Scale (PANSS) was used to assess patients' psychopathology. Results The prevalence of underweight was 9.9% (50/503) in schizophrenia patients versus 1.5% (5/323) in the control group ( P<0.01). Further logistic regression analysis showed that male ( OR=2.43, 95%CI:1.74~3.39), smoking behavior (OR=1.50, 95%CI: 1.21~1.86), hospitalization times (OR=1.18, 95% CI: 1.06~1.31), PANSS negative score (OR=1.09, 95% CI: 1.04~1.14) were significant predictors for underweight (all P<0.05). Conclusion The prevalence of underweight is higher in Chinese patients with schizophrenia than in the general population. Some demographic and clinical variables are risk factors for underweight in schizophrenia.

Objective:To analyze the clinical characteristics of severe adenovirus pneumonia with bacterial infection in children, so as to provide clinical evidences for early diagnosis and reliable treatment.Methods:A total of 72 pediatric cases with severe adenovirus pneumonia admitted to Pediatric Intensive Care Unit at the First People′s Hospital of Chenzhou from January 2018 to August 2019 were included.The clinical features, laboratory and imaging data, efficacy of the treatments and prognosis were investigated retrospectively.Patients were divided into with bacterial infection group and without bacterial infection group.The clinical characteristics were analyzed.Results:Among the 72 children, there were 54 males and 18 females, aging from 3 months to 5 years, including 37cases with bacterial infection and 35 cases without bacterial infection.Compared with the group without bacterial infection, the group with bacterial infection had longer heat duration and hospital stay [12.0 (10.0, 18.5) days vs.10.0 (9.0, 12.0) days; 6.0(4.0, 7.0) days vs.11.0(6.5, 16.0) days, P<0.05], the incidences of diarrhea and hepatomegaly were higher[35.1% (13/37) vs.14.3%(5/35); 45.9%(17/37)vs.8.6%(3/35), P<0.05], the proportion of five lobes involved in lung imaging was higher [91.8% (34/37) vs. 57.1%(20/35), P<0.05]. The incidences of complications with respiratory failure, hemophagocytic lymphohistiocytosis, and bronchiolitis obliterans in the group with bacterial infection were significantly higher than those of without bacterial infection group ( P<0.05). Conclusion:For children under 2 years old age with severe adenovirus pneumonia, there are prolonged high fever and extensive pulmonary lesions.We should be highly alert to the combination of bacterial infection and timely anti-infection therapy.Children with severe adenovirus pneumonia with bacterial infection have severe clinical manifestations and many complications with respiratory failure, hemophagocytic lymphohistiocytosis, and bronchiolitis obliterans.

Objective: To evaluate the oncological and reproductive outcomes in patients with seromucinous borderline ovarian tumors (SMBOT) treated with fertility-sparing surgery (FSS). Methods: We retrospectively reviewed the medical records of patients with SMBOT who underwent surgery between 2000 and 2019. A centralized histological review was performed and recurrence rates were compared between different surgical procedures. Results: A total of 105 patients fulfilled the inclusion criteria, of whom 65 underwent FSS and 40 were treated with radical surgery. Fourteen patients had recurrent disease after a median follow-up time of 59.6 months (range: 22.1–256.8 months). All but one relapsed with SMBOT. There was no significant difference in disease-free survival (DFS) between the 2 groups (p=0.141). Multivariate analysis showed that only bilateral involvement was associated with increased recurrence (p=0.008). In the subgroup of patients treated with conservative surgery, there was no significant difference in DFS with regard to surgical procedures (ovarian cystectomy vs. salpingo-oophorectomy, p=0.487). Of the 12 patients in the FSS group who developed recurrence, 11 underwent a second round of FSS and all remained alive with no evidence of disease at the end of follow-up. Of 20 patients desiring pregnancy, 16 patients were successful and resulted in 17 term deliveries. Conclusion FSS is feasible for young patients who wish to preserve their fertility. Patients initially treated with ovarian cystectomy may be managed by close surveillance if post-operative imaging are negative. Repeat FSS remains a valuable alternative for young patients with recurrent SMBOT after thorough communication.