Female ; Fibromatosis, Abdominal ; diagnostic imaging ; pathology ; surgery ; Humans ; Middle Aged ; Radiography ; Rupture, Spontaneous ; surgery

Objective To investigate the clinical value of urinaryα1-acid glycoprotein (AAG)in the early diagnosis of diabetic nephropathy(DN).Methods 266 cases of diabetic patients in Drum Tower Hospital Affiliated to Medical School of Nanjing University from May 2013 to October 2014 were recruited,and patients were divided into four groups based on the urine al-bumin/creatinine (ACR)levels,as follows:non-diabetic nephropathy group (Non-DN)152 cases,low urinary albumin/cre-atinine group (LUA)49 cases,high urinary albumin/creatinine group (HUA)32 cases,and very high urinary albumin/cre-atinine group (VHUA)33 cases.63 cases of healthy subjects (NC group)and 66 cases of fracture patients (stress group) were recruited as control group.The urinary AAG and other biochemical indicators were measured for all subjects.Results The level of urinary AAG in DN group was significantly higher than that in stress group,Non-DN group and NC group (t=7.951,7.985,8.021,P <0.05),and gradually increased from LUA,HUA to VHUA group (P <0.05).The urinary AAG level was positively correlated with UA,Cr,CRP and ACR (r=0.169,0.286,0.373,0.606,P <0.01).Stepwise logistic re-gression analysis showed that the urinary AAG was the independent risk factor of DN (P <0.05).Conclusion The level of urinary AAG has good application value in the early diagnosis and monitoring progression of DN.

Objective To evaluate the effect of the setup error on the dosimetric verification for the nasopharyngeal carcinoma patients and cervical carcinoma patients treated with volumetric modulated are therapy (VMAT).Methods VMAT plans for 10 cervical cancer patients and 10 nasopharyngeal carcinoma patients were transplanted into the Delta4 phantom and calculate the dose,next,implement the treatment on the Varian iX linear accelerator.on the Varian iX linear accelerator.To simulate the setup error by moving the treatment couch in,out,up,down,left,right by 3 mm,5 mm,7 mm.Thereby study the effect of the setup error on the pass rate of the dose verification.Results The results for the dose distribution using the gamma evaluation method showed that the pass rate (3％/3 mm) was less than 90％ when the setup error were greater than 3 mm and 5 mm for the nasopharyngeal carcinoma patients and the cervical carcinoma patients.The pass rate of head direction were (64.7 ± 8.2) ％ and (63.3 ± 3.6) ％ on setup error of 5 mm and 7 mm for nasopharyngeal carcinoma patients and cervical carcinoma patients,respectively.Conclusions Setup error has great effect on the dose verification of the VMAT plans,the greater of the setup error,the lower of the pass rate.The setup error of head direction is more sensitive than other directions especially.

Objective:To observe the effect of Pidotimod and Thalidomid to enhance the immune response and protective immunity induced by the epitope Vaccines From W2b2a of Toxoplasma gondii in mice.Methods:Mice were immunized intramuscularly with Pidotimod and pcDNA3-W2b2a,thalidomide and pcDNA3-W2b2a,respectively,then the immune response and the survival time of mouse attacked by Toxoplasma gondii were observed.Results:After the immunization,the level of IFN-γin sera of mice inculated with pcDNA3-W2b2a and Pidotimod,pcDNA3-W2b2a and Freund adjuvant,pcDNA3-W2b2a and Thalidomid were significantly higher than pcDNA3-W2b2a (all P<0.05).After the immunization,IgG,CD4+/CD8+T cell ratio ,proliferation of T cell induced by pcDNA3-W2b2a and Pidotimod,pcDNA3-W2b2a and Freund adjuvant were higher than pcDNA3-W2b2a,pcDNA3-W2b2a and thalidomid ( all P<0.05).After challenged with highly virulent tachyzoites,the mean survival time in immunized groups were significantly longer than control group (all P<0.05).Conclusion:Pidotimod ,Thalidomid adjuvant can increase protective immunity of epitope Vaccines From W2b2a of Toxoplasma gondii in mice.

Objective To determine the changes in the prevalence of type 2 diabetes mellitus and prediabetes in residents aged over 20 years in Shandong coastal areas during years 2004-2014. Methods A random stratified cluster sampling was conducted, and 3 944 inhabitants were investigated in Qingdao, Yantai, Weihai, and Rizhao regions. Results (1)The standardized rate of diabetes mellitus prevalence was 10.36% in 2014, increased by 2.38% as compared with 2004 and 0.85% as compared with 2009 (P<0.05). There were 341 newly diagnosed diabetes mellitus patients, accounting for 57.4% of the diabetes mellitus patients, increased by 6.09% as compared with 2004 and decreased by 4.11% as compared with 2009 (P<0.05). The standardized rate of prediabetes was 12.47% in 2014, increased by 2.63% as compared with 2004 and 0.61% as compared with 2009 (P<0.05). (2) The prevalence of diabetes mellitus and impaired glucose regulation in individuals aged under 50 years in 2014 was significantly higher than that in 2004, but lower than that in 2009 (P<0.05). (3) Compared with 2004 and 2009, the levels of diastolic blood pressure, total cholesterol, low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol in subjects with prediabetes and diabetes mellitus increased significantly in 2014 (all P<0.05). The levels of serum uric acid in subjects with prediabetes and diabetes mellitus decreased significantly in 2014 (P<0.05). (4) The logistic regression analysis showed that the age, body mass index, waist-hip ratio, triglyceride, LDL-C, systolic blood pressure, and diabetic family history were the risk factors for abnormal glucose regulation, while total cholesterol was the protective factor. Conclusions The prevalence of diabetes mellitus and prediabetes increased during 10 years (2004-2014), but the growth rate dropped precipitously during last five years as compared with the first five years. The age of diabetes mellitus onset is getting older in residents of Shandong coastal area, especially in females. Aging, overweight, hypertension, lipid disorders, and diabetic family history were the risk factors of diabetes mellitus.

Objective To study the iodine nutritional status and the thyroid function of pregnant women during different periods,and provide scientific basis for iodine supplementation.Methods Totally 728 pregnant women who visited the obstetric outpatient of Nanjing Drum Tower Hospital for routine prenatal care from December 2014 to August 2016 were recruited in this study,and at the same time 182 non-pregnant women were recruited as control group.The thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured by Roche 601.The urinary iodine level was measured by SR-I-100 kit.Results The median urinary iodine of 728 pregnant women was 168.24 g/L,and the median urinary iodine of those women in the T1,T2 and T3 period were 186.31,162.65 and 148.76 g/L,respectively.The TSH at T1 period was lower than T2 and T3 period (t=3.429,3.135,P＜0.05).The FT4 at T1 period was higher than T2 and T3 period (t=5.251,5.965,P＜ 0.05).The prevalence rate of thyroid disease in normal urinary iodine group was lower than that in low urinary iodine group and high urinary iodine group (x2 =4.139,4.131,P＜0.05).Conclusion There was no iodine deficiency among those pregnant women groups,but only 34.75 ％ individuals reached the appropriate iodine nutritional level,and the ratio of iodine insufficient increased with the extension of pregnancy.The whole prevalence rate of thyroid disease in abnormal urinary iodine pregnant women was obviously higher than that in normal.It is necessary to improve the pregnant women's knowledge of iodine nutrition,moreover it is suggested that urinary iodine monitoring and thyroid function should be conducted in pregnant women.

Objective To explore the molecular mechanisms of carbapenem-resistant Klebsiella pneumoniae.Methods Carba NP confirmatory test were used to detect carbapenemases.Carbapenemase genes,ESBL genes and plasmid-mediated AmpC genes were amplified by polymerase chain reaction (PCR).The genetic correlation analysis was carried out by using multiple sequence type (MLST).Results 42 out of the 50 carbapenem-resistant Klebsiella pneumoniae strains were KPC-2-positive strains,1 strain was positive for NDM-1,the other 7 strains were not detected for any carbapenemase genes.The percentages of KPC-2-positive Klebsiella pneumoniae with the bla CTX-M,bla SHV,bla TEM,bla DHA were 21.5 ％,42.9 ％,69.1％ and 4.8％ respectively.The results of MLST showed that 37 out of 42 KPC-2 positive strains were ST11.Conclusion The production of KPC-2 is the main mechanism of Klebsiella pneumoniae resistance to carbapenem and there is an outbreak of ST11 KPC-2 Klebsiella pneumoniae in this hospital.

OBJECTIVETo study the clinical features of juvenile primary fibromyalgia syndrome (FMS) and to evaluate outcome after treatment.

METHODSSix patients with juvenile primary FMS were registered in department of rheumatology and their clinical data were assessed, including degree of pain (visual analog scale, VAS), fatigue, depression, anxiety, sleep disturbances, arthrodynia, subjective joint swelling, abdominal pain, irritable bowel symptoms, urinary urgency, dysmenorrhea, morning stiffness, paresthesias, illness changes with weather, feeling worse with exercise, laboratory examination and outcome of treatment.

RESULTSAbdominal pain was the first symptom in 5 of the cases with juvenile primary FMS, diffuse aching and left knee pain were the first symptoms in one patient. All the 6 patients were misdiagnosed prior to their rheumatological evaluation. Diffuse aching, fatigue, sleep disturbances, illness changes with weather and feeling worse with exercise existed in all the 6 patients (100%), the mean pain score was 8.8 and the mean initial tender points (TP) count was 13.7. Arthrodynia, subjective joint swelling, abdominal pain, irritable bowel symptoms and urinary urgency existed in 5 of the 6 patients (83%). Dysmenorrhea existed in 4 (67%), depression in 3 (50%), morning stiffness in 2 (33%), paresthesias in 2 (33%) and anxiety in 2 (33%), respectively. The results of laboratory examination were normal and the outcomes of treatment were good.

CONCLUSIONJuvenile primary FMS may not be a rare disease and the clinicians should pay more attention to it for avoiding misdiagnosis.

Adult ; Choristoma ; Humans ; Male ; Neck ; Palatine Tonsil

Objective To retrospectively analyze the effect of abdominal acupuncture for the casino workers with sleep disorder in chronic fatigue syndrome and analyze the correlation between them.Method 65 patients were all from the Acupuncture Department of Health Center of the Black Sand, Macao Health Bureau, 2011 October to 2013 January, who were diagnosed with sleep disorder in chronic fatigue syndrome and in accordance with the inclusion criteria. They were received abdominal acupuncture treatment for 4 weeks. Pittsburgh sleep quality index(PSQI) and Fatigue Assessment Instrument(FAI)were adopted to evaluate the effect before treatment 、after treatment and one month follow-up. Multiple regression analysis model was used to analyze the correlation of each factor of FAI and PSQI. Results Compared with before treatment (13.78± 3.23), the total score of PSQI after treatment(8.66 ± 4.26)and follow-up(8.26 ± 4.66) were significant decreased(P<0.05);the score of 6 dimensions(sleep quality, Time to fall asleep, sleep time, sleep efficiency, sleep disorders daytime function) after treatment and follow-up were significant decreased(P<0.05),compared with those before treatment;the FAI score after treatment (92.60±14.64) and follow-up(90.75±14.75) were significant lower(P<0.05)than those before treatment (147.55±7.03) .Multiple regression analysis showed that 4 dimensions of PSQI (sleep quality, sleep time, sleep disorders, daytime function)had close relationship with FAI score(r=0.373~0.702, P<0.05). Conclusion Abdominal acupuncture can improve the casino workers' sleep disorder in chronic fatigue syndrome and is worth of further study.