Objective To study the current status of morning blood pressure peak in elderly masked hypertension patients and study the correlation between morning blood pressure peak and cognitive function.Methods A total of 72 elderly masked hypertension patients were selected in this study,.Morning blood pressure peak was measured by ABPM examination.The patients were divided into three groups according to the morning blood pressure peak.Morning blood pressure peak ≤ 30 mmHg were divided into non-Morning blood pressure surge group ( NMS group),morning blood pressure peak ＞30 mmHg were divided into Morning blood pressure surge group ( MS group).The cognitive function scale was determined (MMSE and MoCA).T-test and linear regression analysis were performed.Results MMSE score(27.69±2.04) and MoCA scores(24.85 ± 1.52) in MS group were lower than NMS group (28.87 ± 1.34,26.54± 1.53) ( P ＜0.01 ).MMSE and MoCA scores were negatively correlated with the morning blood pressure peak ( r =- 0.308,- 0.447,P ＜ 0.01 ).Conclusions Elderly masked hypertension patients remained the phenomenon of the morning blood pressure peak,the morning blood pressure peak could lead to cognitive impairment.

As one of the gastrointestinal malignancies,pancreatic cancer is well known because of high degree of malignancy,low survival rate and very poor prognosis.Lymphatic metastasis,the most important metastasis of pancreatic cancer,has the characteristics of metastasis in an early stage and high occurrence rate.Recently,some studies have suggested that widespread micrometastasis of lymph nodes occurring in the early stage of pancreatic cancer could play an important role in influencing postoperative neoplasm recurrence.Further studies on lymph node micrometastasis of pancreatic cancer are needed to help to understand pancreatic cancer more deeply and to comprehend metastasis rule more clearly.So we can choose more reasonable surgical treatment for every patient,achieving individual treatment,so as to improve the prognosis of the pancreatic cancer patients.

OBJECTIVE:To control the drug quality risk in drug withdrawal links of hospital pharmacy,and provide reference for the application of quality risk management(QRM)in hospital pharmacy. METHODS:Drug QRM was developed in drug with-drawal links through risk identification,risk assessment,risk control,risk assessment and other steps. Using the incidence of risk factors and reusable rate of withdrawal drug as indexes,related data of before(Jul.-Dec. 2015)and after(Jan.-Jun. 2016)devel-oping QRM in our hospital were compared to evaluate the effect of drug QRM. RESULTS:Determining whether specific storage drugs kept the required storage conditions,whether the numbers of withdrawal drugs counted to minimal packaging and other 5 fac-tors were high-risk factors(the risk score of each factor>4 points);control measures were taken separately for high risk factors, then high-risk factors were reduced to acceptable levels(risk score<4 points). After developing QRM,the incidence of risk factors were reduced than before(reduce 1.35%-6.19%),reusable rate of withdrawal drug was increased(98.64% vs. 86.32%)(all P<0.05). CONCLUSIONS:Developing QRM in drug withdrawal links of hospital pharmacy can reduce the drug quality risk.

Objective To evaluate the value of HE4 ,CA125 in the diagnosis of epithelial ovarian cancer (EOC) .Methods A to‐tal of 54 samples with epithelial ovarian cancer ,64 suspicious benign pelvic mass ,and 60 health controls were consecutively enrolled in this study .Results Good diagnostic performance in discriminating benign from EOC patients was obtained for CA125 and HE4 . Serum level of HE4 of the patients in the three group were 189 .94 pmol/L ,56 .74 pmol/L and 46 .36 pmol/L .Levels of CA125 were 89 .39 U/L ,45 .11 U/L and 34 .24 U/L .There were stastically significant differences between the groups(P<0 .05) .The ser‐um HE4 and CA125 levels of the patients with ovarian cancer at stage Ⅲ ,Ⅳ(HE4=236 .25 pmol/L ,CA125=206 .35 U/L) were significantly higher than the cases at stage Ⅰ ,Ⅱ(HE4=96 .36 pmol/L ,CA125=67 .8 U/L P<0 .05) .Benign pelvic mass as con‐trol ,the specificity (SP) was 86 .6% ,sensitivity (SN) was 82 .6% ,positive predictive value and negative predictive value of the ser‐um HE4 were 85 .71% ,71 .67% ,73 .84% ,and 84 .31% respectively .SN of CA125 was 86 .67% ,higher than that of HE4 (71 .67% ,P<0 .01) .The area under curves (AUC) of HE4 was 0 .87 higher than that of CA125 (0 .81) ,(P<0 .01) .Combing de‐tection of ovarian cancer was higher than that of HE4 and CA125 alone .SP was 95 .15% ,negative predictive value was 92 .13%(P<0 .01) .Conclusion Overall ,the level of serum CA125 and HE4 increase significantly ,which showes well diagnostic perform‐ance to EOC from benign diseases .The combined detection of CA125 and HE4 could improve the diagnostic power in cervical cancer prominently ,so it has great reference value in the diagnosis of epithelial ovarian cancer .

Objective To evaluate the prevalence of aspirin resistance in old-aged patients with cerebral infarction and to analyze the mechanisms and clinical predictors of aspirin resistance. Methods 300 old-aged patients with cerebra] infarction were selected and the platelet aggregation ratio was determined by nephelometry with CHRONO-LOG PA-meter. And some information of these patients, such as age, sex, smoking, taking non-steroid anti-inflammatory drug (NSAD)or proton pump inhibitor (PPI), obesity, coronary artery disease (CAD), peripheral vascular disease, hyperpiesia, diabetes and hyperlipemia were recorded. Results 112 cases (37.33%) were aspirin sensitiveness, 108 cases(36.0%) were aspirin semi-resistance and 80 cases (26.67%) were aspirin resistance. These cases were divided into two groups. One was aspirin sensitive (AS) group, which included 112 patients of aspirin sensitiveness. The other was aspirin resistant (AR) group, which consisted of 188 patients of aspirin semi-resistance and aspirin resistance. The prevalence of CAD, hypercho]esteremia and RBC count in AR group was higher than that in AS group The percentage of patients who took NSAD, PPI and smoke in AR group was also higher than that in AS group. Conclusion Aspirin resistance existed in old-aged patients with cerebral infarction to great extent, and which was correlated with CAD, hypercholesteremia, smoking, RBC count, taking NSAD and PPI.

Objective To explore guide adult giant young cell anemia cause. Methods Retrospective analysis 48 cases adult giant young cell anemia clinical data. Results The adult giant young cell anemia majority in elderly patients of(34/48) 70.8% ,its cause a majority in gastrointestinal diseases (41/48) for 85.4% , among them 9 cases of chronic gastritis(18. 8% ) Gastrointestinal diverticula 8 cases, the digestive tract of release,duodenal ulcer and gastric 16.7% each 4 cases total resection for 8.3, hiatal hernia and gastric ulcer each 3 cases of gastric polyps, oral 6.3% lesions, jejunum resection 2 cases 4.1 percent of all the rest a few Crohn,Crohn's disease,intestinal lymphoma,chronic colitis each 1 case of 2.0%.The gastrointestinal lesions accounted for only 14.6% cases. Conclusion Giant young cell anemia majority with old people,and to the digestive system disease primarily

Purpose There is no agreement for contrast enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant thyroid nodules. This paper aims to evaluate the diagnostic value of the conventional and contrast-enhanced ultrasonography in the diagnosis of thyroid nodule by meta analysis. Materials and Methods Literature search was performed in PubMed, CNKI and Wanfang databases to identify relevant English and Chinese literatures by using pathological results as the gold standard from January 1990 to September 2014. The quality of each selected study was evaluated by QUADAS. The pooled weighted sensitivity, specificity and the corresponding 95% CI were calculated. Summary receiver operating characteristic curves (SROC), area under curve (AUC) and the Q* index were also calculated. Results A total of 14 literatures (1970 nodules) were included, the pooled weighted sensitivity and specificity of conventional ultrasonography were 0.74 and 0.70; those of contrast-enhanced ultrasonography were 0.86 and 0.82. The AUC by using the two methods were 0.84 and 0.93, respectively, and the Q* index were 0.77 and 0.86, respectively. Conclusion In the diagnosis of thyroid nodule, the accuracy of contrast-enhanced ultrasonography is better than conventional ultrasound; however, both of them have high clinical value in the diagnosis of thyroid nodule, thus they are helpful in avoidance of unnecessary surgical treatment in patients with thyroid disease.

Objective To evaluate the technique and efficacy of retroperitoneal laparoscopic simple enucleation for renal angiomyolipoma(RAML).Methods Between June 2005 and December 2006,11 patients with RAML underwent simple enucleation of the tumor by retroperitoneal laparoscopy.During the operation,the renal capsule was incised along the edge of the tumor by using spatula or harmonic scalpel,and then the whole tumor entity was removed,and the rest rich-fat tumor tissues were sucked with attractor.Finally,the surface of the wound was cleaned with gauze;the hemorrhage was controlled by bipolar coagulation.Fibrin sealant and hemostatic gauze,and absorbable sutures were used to close the surgical wound in the kidney.Results All the procedures were completed without conversion to open surgery.The mean operation time was 84.5 minutes(60-110 min),the mean blood loss was 51 ml(20-100 ml),and the mean postoperative hospital stay was 8.8 d(6-14 d).No intraoperative complications occurred in this series.The renal function was normal in all the cases after the operation.The patients were followed up for 7-23 months(mean 13.4 months).During this period,radiological examination found no local residual tumor or recurrent tumors.Conclusions Retroperitoneal laparoscopic simple enucleation is superior in less trauma and blood loss,quick recovery,and shoru period of hospitalization.

Objective To study the effects of diabetes mellitus(DM)on fas receptor-induced cardiomyocytes apoptosis and inflammatory response in patients with acute myocardial infarction(AMI).Methods 70 patients with ST-elevated myocardial infarction were divided into two groups:without(n=36)and with diabetes mellitus(n=34).Strepavidin-biotin ELISA was used to examine the serum levels of sFas,sFasL,TNF-? and IL-6.Results As the concentrations of sFas and sFasL immediately after primary PCI were higher in patients of AMI with DM than without DM(4.18?0.86 vs 3.30?0.82 ng/ml,6.15?1.56 vs 4.34?1.37 ng/ml,respectively,P

Along with the progressing of micro-electronics technology and the improving of FPGA's performance, it's more and more common to process digital signals using FPGA. In most cases, FPGA is used to do the preprocessing or postprocessing besides processor in order to get a higher processing speed. This article introduces how to construct the signal processing unit of Doppler measurement system with FPGA and universal digital signal processor.