Objectives To clarify the differential diagnostic value for iron deficiency anemia (IDA)and anemia of chronic disease(ACD)with analysis method of multiple parameters.Methods The serum concentrations of iron parameters (SI,TIBC,TF,SF and sTfR),inflammatory index(IL-1,IL-6,TNF-β),CRP and hepcidin were detected in patients with IDA and ACD by biochemical method and ELISA respectively.Results In the differential diagnosis of IDA versus ACD,the SF (98.6 versus 6.0,P=0)and sTfR/logSF[(13.1-±-4.4) versus (27.6 ± 16.5),P=0.002] had clinical value for the differential diagnosis.Inflammatory factors level was increased in two groups,only the difference in CRP between IDA and ACD showed a statistical significance.The hepcidin had the clinical value in differential diagnosis for single disease diagnosis of IDA and ACD and for differential diagnosis between IDA and ACD [(144.6 ±-1.9) versus (86.5-±-3.1),P＜ 0.05].Correlation analysis showed that the sTfR/logSF had a significantly negative correlation with SI(P=0.002),a significantly positive correlation with TIBC and TRF,and no significant correlation with inflammatory factors.The hepcidin had significantly positive correlation with IL-6 and TNF-β,and a significantly negative correlation with SI.The positive correlation was observed between sTfR/logSF and Hepcidin(r=0.376,P=0.005).Conclusions Analysis method of multiple parameters could make a differential diagnosis of ACD in the elderly.

Objective To investigate the association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods Ninetyfour stable CAPD patients from a single center were enrolled in this cross-sectional study.Ultrasound evaluation was conducted on brachial artery to estimate endothelial-dependent flow-mediated dilation (FMD).Automatice pulse wave velocity (PWV) measuring system was applied to examine the carotidfemoral PWV.Blood pressure and biochemical parameters were detected.Pearson's correlation and Stepwise multiple regression analysis were performed to explore the relationship between FMD and PWV.Results PWV was significantly higher in patients with diabetes as compared to those without diabetes[(13.25± 1.66) m/s vs (11.24±1.92) m/s,P ＜ 0.01].Furthermore,PWV was positively correlated with age(r=0.319,P=0.002),SBP (r=0.289,P=0.005) and C-reactive protein (r=0.211,P=0.041),was negatively correlated with albumin (r =-0.429,P =0.001) and FMD (r=-0.466,P=0.001).In multivariate regression analysis,diabetes mellitus,albumin,FMD,age and SBP were independently associated with PWV after adjustment.Conclusion Endothelial dysfunction is associated with greater arterial stiffness in CAPD patients.

Objective To develop a method for dynamically observing the biological efficacy of botulinum toxin A (BTX-A) and to investigate the dose-effect relationship between BTX-A dosage and muscle strength.MethodsFifty-four male Sprague Dawley rats were randomly divided into 9 groups.Groups 1-7 were injected intramuscularly with 0.1 ml BTX-A (0.01 U to 4.0 U) into the gastrocnemius on the right side.Rats in group 8 were injected intramuscularly with an equal volume of saline solution as the control group,and group 9 was used to determine the location of injection.Gastrocnemius muscle strength was evaluated using a self-made evaluation system before and after the toxin injection and on the 3rd,7th,14th,21st,30th,45th,60th and 75th day following.ResultsMuscle strength reached its lowest level on days 3 to 7,with a significant difference in the decline of muscle strength between the test groups and the control group up to day 60.With the lower BTX-A doses (0.01 U,0.1 U,0.5 U,1.0 U),muscle strength had decreased significantly on the 21st day,but recovered to its initial levels in all groups at the same time.There was no significant difference among the 1.0 U,1.5 U,2.0 U and 4.0 U groups.ConclusionsStandardized gastrocnemius injection combined with neuromuscular functional evaluation can establish a model of BTX-A dosage and muscle paralysis which can be used to assess the evolution of the biological efficacy of BTX-A.

Objective To study the changes of behavior and depression-like classic indicators after hippocampal microinjection of K252a,and to establish a new animal model of depression.Methods SD rats were randomly divided into five groups,namely the control group,sham group,chronic stress depression model group,hippocampal of K252a microinjection group,and hippocampal microinjection K252a plus chronic stress group.Open field experiments,sucrose consumption test,and Morris water maze behavioral assay were used to assess the behavioral changes in the rats.ELISA was used to detect the plasma monoamine neurotransmitter,radioimmunoassay was used to determine the plasma CRH,ACTH,CORT contents,and western-blotting was performed to observe the protein expression of BDNF,CREB,ERK1/2,and BCL-2 in the hippocampus.Results Compared with the control group,the amount of activity,sugar consumption,learning and memory abilities were decreased(P<0.05 or P<0.01),also the serum monoamine neurotransmitters were decreased (P<0.01),HPA axis function was improved (P<0.01),and the expression of BDNF,CREB,ERK1/2,BCL-2 decreased in the CUMS group(P<0.05 or P<0.01),but there was no significant difference in the DMSO group.Compared with the DMSO group,the activity,consumption of sucrose,learning and memory ability were significantly decreased(P<0.05 or P<0.01),while the HPA axis function was increased (P<0.05 or P<0.01),the serum monoamine neurotransmitters decreased(P<0.05 or P<0.01),and the BDNF,CREB,ERK1/2,BCL-2 expressions in the hypocampus were significantly decreased(P<0.05 or P<0.01) in the K252a group and K252a + CUMS group.Compared with the CUMS group,the K252a group and K252a + CUMS group did not show significant changes in these parameters.Compared with the K252a group,these indicators were not significantly changed in the K252a + CUMS group.Conclusions The results of behavior,hematology,and molecular biology analysis show that this model has a great similarity to the classical model of CUMS in surface validity,construct validity,and functional validity.It may provide an alternative investigative technology platform for basic research and antidepressant drug screening.

OBJECTIVETo study the mechanisms of tuina manipulation for treating the dislocation of bone in cervical spondylosis (CS) patients by observing the effects of tuina manipulation on the three-dimensional (3D) angles.

METHODSFrom August to December 2009 20 CS patients were assigned to Group 1 (10 cases, treated with relaxing manipulation) and Group 2 (10 cases, treated with relaxing manipulation and joint regulation). Besides, 10 healthy subjects were recruited as the normal group (treated with relaxing manipulation). Before and after manipulation intervention, all of them were scanned from the base of the skull to the first thoracic vertebra using Philips 64 spiral CT under equal conditions, thus obtaining the volume data. The 0.625 mm thickness was reconstructed using ITK reconstruction software provided by the digital medical laboratory, Software College of Shanghai Jiaotong University. The reconstruction of each cervical skeleton was finished referring to CT data. Changes of the 3D angles were compared among the three groups.

RESULTSThe regulation of the 3D C2 vertebra: Results of Group 2 were significantly larger than those of the normal group at X-, Y-, and Z-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at Z-axis (P < 0.05). The regulation of the 3D C3 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at X-axis (P < 0.05). The regulation of the 3D C4 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). There were no significant difference among the three groups in the 3D spaces of C1, C5, C6, and C7. The larger 3D space was shown in Group 2 than in Group 1 and the normal group.

CONCLUSIONSThe relaxing manipulation combined with joint regulation significantly improved the 3D angles of C2, C3, and C4 in CS patients. The mechanism of tuina manipulation for treating the dislocation of bone in CS patients might lie in adjusting the 3D space of the cervical spine, and improving its functions.

Aged ; Cervical Vertebrae ; diagnostic imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Manipulation, Spinal ; Spondylosis ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed ; methods

Objective To analyze the risk factors of retinopathy and nephropathy in hospitalized patients with type 2 diabetics. Methods 24 h-urinary albumin was measured in 2 338 patients with type 2 diabetic hospitalized from July, 2002 to Sep, 2008 in our hospital. All the subjects were divided into normalbuminuria group (NA) and diabetic nephropathy group (DN), the latter consisted of microalbuminuria group (MAU) and macroalbuminuria group (CAU). All the patients were divided into normal retina group (NR) and diabetic retinopathy group (DR), the latter consisted of background diabetic retinopathy group (BDR) and proliferative diabetic retinopathy group (PDR) according to fundus photography. Results (1) The percentages of DR and DN of this cohort were 28.8% and 28.7%, respectively.The percentage of DR and DN had no statistical difference between male and female (27.8% vs 30.0%;29.6% vs 27.6%, P>0.05). (2) The percentage of DR was 23.1%, 37.7% and 56.6% in NA, MAU and CAU group, respectively. There was significant difference among different albuminuria group (P<0.01). (3) The percentage of DN was 23.1%, 41.1% and 59.3% in NR, BDR and PDR group, respectively. There was significant difference among different DR group (P<0.01). (4) Combined with DN, diabetes duration, systolic pressure, hemoglobin A1C, triglyceride were independently associated with DR by Logistic regression analysis. Meanwhile, combined with DR, systolic pressure, hemoglobin A1C, and triglyceride were all independently associated with DN. Conclusions The onset and progression of microvascular complications in type 2 diabetic patiens are correlated with hemoglobin A1C and systolic pressure. Diabetic retinopathy is closely correlated with diabetic nephropathy.

Objective:To introduce a novel surgical technique for dissecting perforator vessels (orderly retrograde four-side dissection) in anterolateral thigh perforator flap (ALTPF) and explore its clinical outcome.Methods:Respective analysis of 94 patients who underwent reconstruction of soft tissue defects with ALTPF which were dissected by orderly retrograde four-side dissection between June, 2013 and December, 2016. After surgery, the survival of flaps, recovery in shape and function of the recipient sites, and the effect on shape and function of the donor sites were observed.Results:The size of ALTPF ranged from 7 cm×5 cm to 32 cm×10 cm. Ninety-four perforators were included in 94 ALTPF, which were 89 perforators of the descending branch of circumflex femoral lateral artery, 4 perforators of the transverse branch of circumflex femoral lateral artery and 1 perforator of femoral medial artery. The time for flap harvesting was 35-95(54.39±16.39) min. Success rate of perforator harvesting was 98.9%, only 1 perforator was injured and another encountered vasospasm during surgery. Three cases had vascular crisis after flap transfer with 2 venous crises and 1 artery crisis. All of the flaps completely survived except 1 that had a partial necrosis. The follow-up time was (12.91±9.17) months. No muscular weakness on donor sites was shown in all cases.Conclusion:Orderly retrograde four-side dissection of perforator vessels in the ALTPF has achieved less donor site morbidity, shorter surgical time and is safer than the traditional techniques. It is a reliable technique to harvest perforator flaps.

A child who suffered a complex and exceptionally large soft tissue defects of both lower extremities and feet was referred in January, 2017. A debulking deep inferior epigastric perforator (DIEPF) was used to cover the defect in right shank. The defects in left shank and foot were reconstructed by latissimus dorsi flap and bilateral debulking anterolateral thigh perforator flap (ALTPF) . Two years after operation, the appearance and texture of both lower limbs were good, and the child could walk and run almost normally. There were slightly noticeable scars left in both thighs and the back.

Objective To evaluate whether the protein SP70 could be used as a serum biomarker for the diagnosis of non-small cell lung cancer (NSCLC).Methods Polyclonal antibody was prepared by immunizing New Zealand rabbit with SPC-A1 cells.Sandwich ELISA was carried out by using newly-prepared polyclonal antibody(PcMb) coating assay plates,monoclonal antibody (McAb) NJ001 and HRP goat antimouse antibody as primary antibody and labeling antibody respectively.After optimizing the experiment conditions,serum from 175 lung cancer patients [ 80 NSCLC adenocarcinoma,70 NSCLC squamous carcinoma and 25 small cell lung cancer ( SCLC) ],25 benign lung disease ( BLD) patients and 300 healthy controls (HC) were examined.CEA,NSE,CYFRA21-1 were measured by ECLIA for comparison.Results Positive rates of NSCLC adenocarcinoma,NSCLC squamous carcinoma,SCLC and BLD were 68.8％,51.4％,16.0％ and 12.0％ respectively,obviously higher than that of HC (7.3％).NSCLC (adenocarcinoma,Squamous carcinoma) had significantly higher positive rate than SCLC (60.7％ υs 16.0％,x2 =17.23,P＜0.05)and BLD(60.7％ υs 12.0％,x2 =20.41,P ＜0.05).Among 68 NSCLC patients who had definite staging,positive rates at early stage ( Ⅰ/Ⅱ,n=30) reached up to 76.7％.Meanwhile,positive rates of CEA,NSE and CYFRA21-1 (32.7％,18.0％ and 37.3％) were significantly lower than the targeting antigen to McAb NJ001 in NSCLC(60.7％ υs 32.7％,x2 =23.63,P ＜0.05;60.7％υs18.0％,x2 =57.22,P＜0.05;60.7％ υs37.3％,x2=16.34,P＜0.05).Conclusions It showed high positive rates of SP70 in the serum of NSCLC patients,which suggested thai SP70 might be a potential valuable biomarker for the diagnosis of NSCLC.

0.05), and the total score were similar in the two groups. Type Ⅱ collagen in the two groups was strongly positive by immunohistochemistry staining. CONCLUSION: Cryopreserved allogenic osteochondral pillars transplantation can repair small full-thickness articular cartilage defects. The chondrocytes are alive in short time, and they can secret cartilage matrix without obvious rejection. It has similar efficacy in histology with autogenic osteochondral pillar transplantation.