Objective: To explore risk factors for complicated cardiovascular and cerebrovascular diseases in patients with refractory hypertension (RH).Methods: Clinical data of 536 RH patients, who were treated in our hospital from Jun 2010 to Jul 2015, were retrospectively analyzed.According to presence of cardiovascular and cerebrovascular diseases or not, patients were divided into complication group (n=217) and pure RH group (n=319).Results: Compared with pure RH group, there were significant rise in percentages of drinking and smoking, hypertension course, mean arterial pressure (MAP), mean systolic blood pressure, pulse pressure, serum uric acid (SUA), creatinine (Cr), total cholesterol and low density lipoprotein cholesterol (LDL-C), and significant reductions in high density lipoprotein cholesterol (HDL-C) mean diastolic blood pressure and mean heart rate in complication group, P<0.01 all.Multi-factor unconditional Logistic regression analysis indicated that hypertension course, SUA,MAP, Cr and LDL-C levels were independent risk factors for complicated cardiovascular and cerebrovascular diseases in RH patients (OR=1.014~3.217, P<0.05 or <0.01).Conclusion: Hypertension course,MAP,Cr,SUA and LDL-C are independent risk factors for refractory hypertension.Enhancing their monitor, prevention and treatment are important to reduce incidence rates of cardiovascular and cerebrovascular complications in patients with refractory hypertension.

OBJECTIVETo explore the value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer.

METHODSClinical data of 206 cases of gastric cancer undergoing radical surgery in the First Hosptial of China Medical University from August 2009 to June 2011 were analyzed retrospectively. Preoperative CT findings and intraoperative judgement of serosal invasion in gastric cancer were compared with pathological results in order to investigate their values.

RESULTSThe sensitivity and specificity of preoperative CT findings and intraoperative judgement of serosal invasion were 88.5%, 81.5% and 98.9%, 61.3%, respectively. The accuracy of preoperative CT in diagnosing serosal invasion was higher than that of intraoperative judgement, while the difference was not statistically significant (84.5% vs. 77.2%, P=0.060). The rates of serosal invasion of normal type, reactive type, nodular type, tendonoid type and color-diffused type were 0 (0/29), 2.5% (1/40), 40.5% (15/37), 59.2% (29/49), and 82.4% (42/51) respectively. The accuracy of preoperative CT in diagnosing serosal invasion of gastric cancer with tendonoid type was higher than that of intraoperative judgement, and the difference was statistically significant (61.2% vs. 87.8%, P=0.002).

CONCLUSIONSMultidetector CT plays an important role in aiding intraoperation judgement of serosal invasion of gastric cancer. For gastric cancer with tendonoid and color-diffused macroscopic serosal appearance, surgeons should pay attention to the value of preoperative CT findings.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Intraoperative Care ; Male ; Middle Aged ; Neoplasm Invasiveness ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Serous Membrane ; diagnostic imaging ; pathology ; Stomach Neoplasms ; diagnostic imaging ; pathology ; Tomography, Spiral Computed ; methods

Objective To evaluate the association of apM1 gene single nucleotide polymorphisms (SNP) with type 2 diabetes mellitus in Chinese population. Methods Odds ratios (OR) of apM1 gene SNP distribution were analyzed. The Meta-analysis software (RevMan 4.3.1) was employed for summarizing the studies,calculating the pooled OR and its 95% CI and testing the overall effects. Egger's test and fail-safe number for P=0.05 (Nfs<,0.05>) were performed for evaluating the publication bias. The sensitivity analysis by different effect models and sample sizes were employed for the reliability of Meta-analysis. Results Nine literatures were obtained, apM1 gene SNP45 showed remarkable heterogeneity among the studies (P<0.10). Sub-group analysis revealed that the discrepancy based on southern Chinese individuals was the main source of the total heterogeneity.The distribution frequencies of apM1 gene SNP45G, SNP45GG, SNP276G and SNP276GG were significantly higher in Chinese type 2 diabetes mellitus group than those in NGT group (P<0.05). Their pooled OR and 95% C/were 1.50[1.12,2.02], 2.15[1.53, 3.02],1.23[1.03, 1.46] and 1.26[1.00,1.59], respectively (all P<0.05). The distribution of apM1 gene SNP45TG and SNP276GT between type 2 diabetes mellitus and normal glucose tolerance group revealed no difference among these studies. The results of publication bias diagnostics and sensitivity analysis accounted for the reliability and stability of this Meta-analysis. Conclusion apM1 gene SNPs are strongly associated with type 2 diabetes mellitus in Chinese population. SNP45G and SNP276G seem to be risk factors for type 2 diabetes mellitus.

ObjectiveTo investigate the effect of rhPTH (1-34) and elcatonin on bone metabolism and serum secreted protein acidic and rich in cysteine ( SPARC ) in postmenopausal women with osteoporosis.Methods One hundred and twenty-four postmenopausal women with osteoporosis were randomly divided into 2 groups:One group was treated with recombinant human parathyroid hormone ( 1-34 ) [ rhPTH ( 1-34 ) ] 200 U/d by subcutaneous injection (PTH group,n =89 )and another group was treated with elcatonin 20 U/week by intramuscular injection (CT group,n =35 ) for 12 months.All patients received a basic therapy with oral calcium ( Ca 600 mg+ Vit D3125 U,q..d.).The bone mineral density ( BMD ) of lumbar spine( L2-4 ),the left femoral neck,greater trochanter,and Ward's triangle,serum calcium and phosphate were measured by baseline,6 months' and 12 months.Levels of serum bone-specific alkaline phosphatase( BSAP),serum secreted protein acidic and rich in cysteine (SPARC)were determined by an ELISA assay.ResultsBy 12 months,rhPTH ( 1-34 ) treatment significantly increased the lumbar spine L2-4 BMD 7.9％ (P＜0.05),serum calcium 8.3 ％ ( P＜ 0.05 ),serum BSAP 93.4％ ( P＜ 0.05 ),serum SPARC by 12.6％[ ( 195.68±59.57 vs 173.81 ±81.33 ) pμg/L,P＜0.05 ].Elcatonin therapy increased the lumbar spine L2-4 BMD by 3.2％ (P＜0.05) at the end of 12 months,but elcatonin did not influence serum calcium,BSAP and SPARC.The rhPTH( 1-34 ) increased lumbar spine L2-4 BMD more than elcatonin did at 12 months( P＜0.05 ).ConclusionrhPTH (1-34) could promote the bone anabolism more effectively than elcatonin did.Serum SPARC may play an important role in promoting osteogenesis by rhPTH.

(3S)-Linalool synthase (LIS) is a key enzyme involved in the monoterpene biosynthetic pathway. Based on our previous transcriptome study, the expression level of LIS gene was exceedingly related to glycyrrhizic acid (GA) biosynthesis. Therefore, we used hairy root culturing to further investigate the effect of LIS on the GA biosynthesis. A LIS gene (GenBank accession number: MZ169552) was cloned from Glycyrrhiza uralensis. The plant binary overexpression vector pCA-LIS was constructed by gene fusion. G. uralensis hairy roots overexpressing LIS were induced by the Agrobacterium rhizogenes ATCC15834. The expression levels of LIS were analyzed by real-time quantitative PCR (RT-qPCR) and the contents of GA in hairy root lines were determined by UPLC. It was found that in the hairy root lines overexpressing LIS, the expression levels of LIS were significantly higher than that in the wild type, while the contents of GA were remarkably lower than those in the wild type and negative control. These findings indicate that the expression level of LIS is negatively correlated with the accumulation of GA. In this study, LIS was cloned from G. uralensis for the first time and the negative regulatory effect of LIS on GA biosynthesis was confirmed by reverse genetics. This work provides support for further improvement of the molecular regulatory network of GA biosynthesis in G. uralensis.

Adenocarcinoma, Mucinous ; pathology ; Adult ; Breast ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma ; metabolism ; pathology ; Female ; Humans ; Keratins ; metabolism ; Metaplasia ; Mucin-1 ; metabolism ; S100 Proteins ; metabolism

Objective To investigate the MR features of pituitary abscess.Methods The MR features of 14 cases of pituitary abscess proved by surgical pathology and clinical treatments were analyzed retrospectively.Results Pre-contrast MR showed hypointense heterogeneous intensity on T_1 WI in 12 cases and iso-hyperintense on T_1 WI in 2 cases,hyperintense on T_2 WI in all cases.Post-gadolinium MR showed the ring-like enhancement around the uneven edge of abscess and the surrounding enhanced meninges connecting to the focus.The normal pituitary could not be identified in all 14 cases.The MR specific findings include the fluid-fluid level,nodule on the edge and the enhanced patchy shadow.Conclusions The pituitary abscess has specific findings on MR examination,which can be used to combine with clinical symptoms to achieve the diagnosis before operation,so that the cases could be treated with antibiotic without operation.

Objective To investigate the effects of repeated exposure by inhalation to several concentrations of formaldehyde 5 hours/day 7 consecutive days  on the content of neurotransmitters in the brain of adult female BALB/c mouse. Methods The 24 mice were randomly divided into 3 groups(groups A to C) 8 in each and exposed respectively to formaldehyde of 0.02-0.07 mg/m3 controls 0.99-1.2 mg/m3(3 m2 plywood/m3 room)and 3.44-3.63 mg/m3(10 m2 plywood/m3 room). After sacrifice the brain were excised and the neurotransmitters were examined. Results Asp、NE、Glu、E and Ach in animals of the exposed groups were significantly decreased but GABA was increased. Conclusion Exposure of formaldehyde escaped from plywood may result in neurochemical change such as Asp NE GluE Ach and GABA in the brain of mouse.

Abstract: Objective　To understand the distribution and drug resistance of common pathogens of fungal bloodstream infection in Sichuan, and to provide reference for clinicians to empirically treat fungal bloodstream infection. Methods　From November 1, 2019 to December 31, 2020, fungal strains isolated from blood culture of patients diagnosed with bloodstream infection in 19 tertiary first-class general hospitals in Sichuan Province were collected for mass spectrometry identification and drug susceptibility, and the results were statistically analyzed, along with a retrospective analysis of clinical data. Results　A total of 255 fungal strains were received and identified by mass spectrometry, 215 strains of Candida spp (84.3%), 28 strains of Cryptococcus neoformans (11.0%), 4 strains of Talaromyces marneffei (1.6%) and 8 strains of others (3.1%). Among the Candida spp 90 strains of Candida albicans, 39 strains of Candida parapsilosis complex, 36 strains of Candida glabrata, 33 strains of Candida tropicalis, 8 strains of Candida guilliermondii, and 9 strains of other Candida. In the department, the ICU was predominant, accounting for 35.7%. The top four Candida (Candida albicans, Candida parapsilosis complex, Candida glabrata, Candida tropicalis) were analyzed for drug sensitivity, Candida albicans and Candida parapsilosis complex group were more sensitive to antifungal drugs, the sensitivity rates of Candida albicans to fluconazole, voriconazole, anidulafungin, caspofungin, micarafungin were 89.2%, 92.8%, 97.6%, 97.6%, 96.4%, respectively. The sensitivity rates of Candida parapsilosis to fluconazole and voriconazole were 89.7% and 94.9%, and to anidulafungin, caspofungin and micafungin were all 100%. Echinocandins had stronger antibacterial activity against Candida spp., Candida parapsilosis complex and Candida tropicalis had 100% sensitivity to echinocandins, Candida albicans had more than 95% sensitivity to echinocandins, and Candida glabrata had about 90% sensitivity to echinocandins. Candida tropicalis was less sensitive to fluconazole and voriconazole with 66.7% and 54.5%, and the sensitivity of Candida glabrata to fluconazole was mainly concentrated in susceptible dose dependent (SDD), accounting for 91.4%. The four Candida species did not show resistance to amphotericin B, all of them showed wild-type strains, Candida tropicalis showed the highest non-wild-type rate to posaconazole and itraconazole with 21.2% and 36.4%, and the drug sensitivity results of Cryptococcus neoformans showed that 4 out of 23 strains showed resistance to amphotericin B (non-wild-type) and 3 strains showed resistance to fluconazole (non-wild-type). Conclusions　The fungus of bloodstream infection is mainly Candida spp.. Among of them, Candida albicans accounts for the highest percentage, echinocandins have good antibacterial effect on Candida, Candida is sensitive to amphotericin B as wild type, but Candida tropicalis has slightly higher resistance rate to fluconazole and voriconazole, and the non-wild type rate of Cryptococcus neoformans to amphotericin B is increasing, and clinicians should pay high attention to the rational use of antifungal drugs.

Objective To observe the clinical efficacy of electroencephalogram (EEG)-guided scalp acupuncture plus body acupuncture in treating epilepsy.Method Sixty epilepsy patients in interictal stage were randomized into a guided acupuncture group, a body acupuncture group, and a Western medication group. The guided acupuncture group was given scalp plus body acupuncture under the guidance of EEG; the body acupuncture group was given ordinary body acupuncture treatment; the Western medication group didn't receive acupuncture treatment. The clinical efficacy was evaluated; before and after the treatment, the powers ofα,β,θ andδ bands and interictal epileptic activity (IEA) were observed by EEG and brain electrical activity mapping (BEAM).Result After the treatment, IEA declined significantly in all cases according to EEG (P<0.05), while the guided acupuncture group was insignificantly different from the other two groups in comparing IEA (P>0.05). In the guided acupuncture group and body acupuncture group, the absolute powers ofα1,α2 andβ2 bands were significantly improved, and the powers ofθ andδ bands were decreased significantly (P<0.05); the values of these two groups were significantly different from those of the Western medication group (P<0.05), but the guided acupuncture group showed a more significant effect in improving EEG power spectrum compared to the body acupuncture group (P<0.05).Conclusion EEG-guided scalp plus body acupuncture is effective in treating epilepsy, which is possibly related to the inhibition of IEA and improvement of EEG power spectrum.