Objective To investigate the association between nonalcoholic fatty liver disease (NAFLD) and metabolism or carotid intima-media thickness (CIMT) in Type 2 diabetic(T2DM). Methods According to the liver B-ultrasonography, a total of 321 T2DM patients were divided into two groups, with or without NAFLD. Metabolic indexes such as BMI, BP, blood glucose, blood lipid, uric acid ( UA ), insulin, C-peptipe,insulin resistance index(HOMA-IR) between the two groups were compared, and the relationships between alanine aminotransferase (ALT) and the above indexes were analyzed. Furthermore,the CIMT of the two groups were compared, and the relationships between NAFLD, ALT and CIMT were investigated by correlation and regression analysis. Results Compared with the group without NAFLD, the patients with NAFLD had higher level of BMI, triglyceride ( TG ), UA, fasting blood glucose ( FBG ), fasting insulin ( FIns ), fasting C peptide (FCP) ,HOMA-IR,and lower level of high density lipoprotein ( HDL-C ) significantly; BMI ( OR = 1.25, P ＜0. 001 ), TG ( OR = 1.74, P = 0. 008 ) and HOMA-IR ( OR = 2. 33, P = 0.010) were independent risk factors of NAFLD while H DL-C was independent protective factor; ALT was positively correlated with BMI (r = 0. 255, P ＜0. 001 ) ,TG(r =0. 156,P ＜0. 018) ,UA(r =0. 239,P ＜0. 001 ) ,FIns(r =0. 213,P =0. 001) ,FCP(r =0. 199,P ＜0. 003), HOMA-IR ( r = 0. 247, P ＜ 0. 001 ) and negatively correlated with HDL-C ( r = - 0. 199, P =0. 002) ,and BMI (β =0. 456,P =0. 048) ,UA (β =0. 021 ,P =0. 025) and HOMA-IR(β =3.634 ,P =0. 004)were independent associated facrors. The difference of CIMT between the two groups didn't reach statistical significance, while mutiple regression analysis revealed that ALT was independently associated with CIMT(β =0. 002,P = 0. 013). Conclusion T2DM patients with NAFLD show more serious disorder of metabolism and insulin resistance. ALT is an independent risk factor of CIMT in T2DM patients.

Objective To investigate the precision, trueness, and accuracy of self-developed detection system in clinical chemistry.Methods This was a methodological evaluation.Take serum creatine kinase( CK) for instance, 6 serum sampleswith different leves ( on the upper or lower limit of the reference range or close to the medicine decide levels ( MDLs) , were collected for within-run precision( repeatability) and within-laboratory precision ( intermediate precision ) experiments.5 proficiency testing ( PT ) samples, 5 samples assigned value by reference method, and 40 fresh-frozen serums were measured and compared with reference method for trueness verification.Drawing method evaluation decision chart, calculating total errors and sigma level evaluation experiment based on the CV, bias, and allowed total errors(TEa)were used to evaluate the accuracy performance.The precision, trueness, and accuracy were compared with the quality indicators.Results The within-run precision and within-laboratory precision were less than the highest requirement of Chinese industrial standard.The mean bias was -8.96%, didn′t reachthe required standard (5.5%).After taking corrective actions, all samples but one ( -5.8%) met the required standard. Compared with the reference method, the mean bias on the MDLs was less than TEa.The performance points of the method evaluation decision chart indicated excellence performance.The total errors on MDLs were 14.2%, 10.4% and 7.6%, less than 15%.The sigma levels on MDLs were 5.9, 7.5 and 15, also achieved excellent level. Conclusions The precision, trueness, and accuracy performance of CK measured by self-developed detection system achieved excellent level of the Chinese industry standard, and the same results were found from different evaluation methods.

This study aimed to investigate the anti-apoptotic effects of Tangnaikang (TNK) on islet β cells in Zucker diabetic fatty (ZDF) rats.Six male fa/+ ZDF rats were took as the control group,while other thirty male fa/fa ZDF rats were divided into five groups at random:the model group,the metformin group,the high-,mediumand low-dose TNK groups,depending on their body weight and random blood glucose.Prior to the administration,fasting blood glucose and fasting insulin were measured by drawing blood with inner canthusl.Materials were prepared when administered for six weeks.Fasting blood glucose and fasting insulin were detected again.When the sections of the rat pancreatic tissue were embedded,the morphological changes of the islet were observed via HE staining,and the apoptosis of islet β cell were observed using TUNEL.Positive expression of Caspase-3,the transduction enzyme of cell death signal,was tested by immunohistochemical method.It was found that the fasting blood glucose of the (fa/fa) ZDF rats in the high-,medium-and low-dose TNK group was significantly improved after administration (P ＜ 0.01).The serum insulin of rats in the high-,medium-and low-dose TNK group arised compared with the model group,while the high-and low-dose TNK group showed differences in a statistical sense.Compared with the model group,the HOMA-IR of all the treatment group decreased,while significant difference was presented between the high-dose TNK group and the metformin group.HE staining showed that the morphology of the islet β cell of the rats in all the treatment group was improved.The results of TUNEL showed significantly apoptotic changes on islet β cell of the fa/fa ZDF rats.Compared with the model group,the positive expression of TUNEL in the metformin group and the high-dose TNK group were significantly reduced (P ＜ 0.05).The result of immunohistochemistry method showed that the protein levels of Caspase-3 in the metformin group and the high-dose TNK group decreased (P ＜ 0.05).In conclusion,it was demonstrated that TNK effectively reduced the apoptosis of islet β cells in fa/fa ZDF rats,which presented a protective effect.

Objective To investigate the medicated side warm nest pot combined with letrozole in the treatment of multiple bursal ovarian syndrome (PCOS) superiority of the clinical treatment of kidney deficiency syndrome in ovulation dysfunction infertility,provide the basis for clinical treatment. Methods 78 cases of infertile patients(randomly selected from January 2014 to June 2015 hospitalized in Hainan Medical University Hospital) due to kidney deficiency syndrome in patientswith ovulatory dysfunction resulting from PCOS. 39 cases in the control group received oral letrozole only. 39 cases in experimental group took oral warm nest pot combined with letrozole,continuous treatment for four menstruation cycle. Adverse reactions,ovulation rate,pregnancy rate and safety index of the two groups before and after treatment of menstruation were observed and recorded. Results The effective rate of the control group was 74.36%,and the effective rate of the experimental group was 87.18%. The difference was statistically significant(P < 0.05). The ovulation rate of the control group was 47.71%,which was lower than that of the experimental group (79.07%),and the difference was statistically significant (P < 0.05). The pregnancy rate in the control group was 12.82%,while that in the experimental group was 33.33%,and the difference was statistically significant (P < 0.05). Patient′s irregular menstruation improved in the two groups , while the experimental group did better than the control group. Conclusion Effect of warm nest pot combined with letrozole on kidney deficiency syndrome of ovulation dysfunction in PCOS is remarkable ,with little side effects.

ObjectiveTo investigate the intelligence characteristics and relativity with motor development of children with spastic diplegia.MethodsIntelligence and motor development of 46 children with spastic diplegia were tested by Wechsler Intelligence Scale and Motor Development Milestone (MDM), to find out difference of intelligence between the children with diplegia and the normal control group.ResultsIntelligence quotient (IQ) of children with spastic diplegia was lower significantly than the normal control, specially performance IQ (PIQ). PIQ was related with motor development. The more delayed motor development was, the more lower PIQ was. Subtest scores of animal egg, puzzle, block design and picture generalization were lower in spastic diplegic children with normal IQ than that of the normal control group, while vocabulary IQ (VIQ) was not different.ConclusionThe intelligence structure of children with spastic diplegia is imbalanced and PIQ of those children is significantly lower than the normal children, which is related to hands-eyes correspond, sight-motor correspond and speed, and space-sight ability.

Objective To explore the diagnostic value of virtual touch tissue quantification (VTQ) for the assessment of liver fibrosis in patients with chronic hepatitis B.Methods VTQ was prospectively performed in 181 patients with chronic hepatitis B and a shear wave velocity (Vs) indirectly reflecting liver stiffness was obtained for each patient.With the gold standards of fibrotic stages and inflammation grades,the relationship between Vs,fibrotic stages and inflammation grades was evaluated.Results A relatively high correlation existed between Vs and liver fibrotic stages (r ＝ 0.812,P ＜ 0.001).Significant differences existed among groups with different fibrotic stages except for groups SO vs.S1 and S1 vs.S2 (P ＜ 0.05).The areas under the ROC curve were 0.971,0.96l,0.969 and 0.908 for Vs predicting S≥S1,S≥S2,S≥S3 and S =S4 fibrosis respectively.Moderate correlation existed between Vs and inflammation grades (r =0.476,P =0.000).Conclusion Capable of staging liver fibrosis and preliminarily grading inflammation,VTQ is helpful for the early diagnosis of liver fibrosis and assessment of therapeutic follow-up and prognosis in patients with chronic hepatitis B.

Objective To evaluate the precision,accuracy,linear range and anti-interference performance of HbA1c assay by u-sing Primus Trinity Ultra2 automated analyzer.Methods According to Document EP published in 2004 by American Clinical and Laboratory Standards Institution(CLSI)and relative literatures,the precision,accuracy,linear range and anti-interference perform-ance were evaluated.Results The within-run and between-run CVs of HbA1c determination were both less than that announced by manufacture.In the tests of samples with certain concentrations,all the results were within the verification range respectively.In the linear verification,regression equation between the theoretical and measured values demonstrated that r2 >0.95,and a value was within the range of 0.97-1.03.For Primus Trinity Ultra2 the limit of interference effect didn′t exceed the allowable error at the medical decision concentrations.Conclusion The precision,accuracy,linear range and anti-interference was evaluated of the Primus Trinity Ultra2 automating HbA1c all could meet the manufacture′s declaim and the clinical needs.

Objective To explore the relationship between glucose-6-phosphate dehydrogenase deficiency and type 2 diabetes and to provide reference for clinical diagnosis,monitoring and treatment of Type 2 diabetes.Methods Subjects were selected from our hospital,including 173 cases of healthy volunteers assigned to the control group;1 95 cases with type 2 diabetes conforming to the diagnostic criteria of WHO were assigned to the diabetic group.97 cases were diagnosed with glucose-6-phosphate dehydrogenase deficiency in our hospital,of whom 82 cases were assigned to simple glucose-6-phosphate dehydrogenase deficiency group,and 1 7 cases were assigned to the diabetes with glucose-6-phosphate dehydrogenase deficiency group.The correlation of glucose-6-phos-phate dehydrogenase activity and diabetes was measured by each detected value.Results Compared with the control group,the glu-cose-6-phosphate dehydrogenase activity and RBC count in diabetic group were higher(P <0.05).Positive correlations between glu-cose-6-phosphate dehydrogenase activity and RBC count in the two groups were significant(P <0.05).HbA1c and FBG showed a significant positive correlation in the control group,diabetic group and diabeties with glucose-6-phosphate dehydrogenase deficiency group(P <0.05).But there was no significant correlation in the glucose-6-phosphate dehydrogenase deficiency group.The rate of screening for glucose-6-phosphate dehydrogenase deficiency in diabetes group was 3.6%,and the rate in the control group was 1. 1%.When HbAlc≥6.5%,the rate of screening for glucose-6-phosphate dehydrogenase deficiency in the diabetes group was signifi-cantly higher than that in the control group (χ2 =4.239,P =0.039).Conclusion The level of HbA1c is discordant with that of blood glucose in diabetic patients with glucose-6-phosphate dehydrogenase deficiency group.Diabetes leads to the increasement of the rate of glucose-6-phosphate dehydrogenase deficiency.The glucose-6-phosphate dehydrogenase activity of diabetic patients with non-glucose-6-phosphate dehydrogenase dificiency is higher than that of the normal group.It may be associated with the level of RBC or increase of compensatory.Further more,glucose-6-phosphate dehydrogenase activity may be a good indicator for controlling diabetes,which remains to be further studied.

Objective To evaluate the effect of azithromycin on Pseudomonas aeruginosa PAO1 biofilm formation and virulence factors production. Methods Detect the minimum inhibitory concentration of azithromycin against PAO1 by 2-fold dilution method. Crystal violet staining assay was used for initial adhesion assays. The PAO1 biofilm was established in vitro and observed by scanning electron microscope. Viable bacterial counts were determined by serial dilution. LasB elastolytic activity was determined by using Elastin-Congo Red. Protease activity was determined by Azo-casein. Chloroform extraction method was used for pyoverdine assay . The orcinol assay was used to directly assess the amount of rhamnolipids . Results Scanning electron microscope biofilm and viable bacterial counts of PAO1 adhered to the surface of catheter in PAO1 azithromycin group were less than the PAO1 control group after incubated for 3 d and 7 d ( P ＜0.05), and the initial adhesion was weaker ( P ＜ 0. 05 ). The virulence factors production were obviously decreased (P ＜0.01 ). LasB elastolytic activity and pyoverdine were even reduced to the same as with the PA-JP3 group ( P ＞ 0.05 ), but the protease activity and the rhamnolipids concentration were higher than the PA-JP3 group ( P ＜ 0.05 ). Conclusion Azithromycin can inhibit PAO1 bioflim formation in vitro and virulence factors production.

Objective To estimate the methodology for evaluating the analytical measurement range ( AMR) and the clinically reportable range ( CRR) in lab-developed system in clinical chemistry .Methods Method evaluation .Take serum CK for instance , a series of samples were prepared from both a specimen with a high concentration of the analyte of interest and a specimen with a low concentration for the following assays.Average slope method , linear dilution recovery method and the method recommended by Clinical and Laboratory Standards Institute ( CLSI ) EP6-A were used to established AMR in the lab-developed clinical chemistry system.Based on the maximum valid dilution of the specimen and the results of AMR , CRR were determined.One-half of the total error allowance ( TEa) of Chinese health standard was set up as allowance error (7.5%).Results X-Y scatter plot was made by assigning sample numbers to the horizontal axis and actual measured values to the vertical axis , which determined the upper limit of AMR was approximate 1 651 U/L.The results analyzed by average slope method indicated that the linear correlation between expected values and actual measured values was determined , the correlation (r), the intercept (a) and the slope (b) met the linear standard, and AMR was 5-1 699 U/L.The results analyzed by EP6-A indicated that the best fitting curve was obtained by using cubic polynomial method , and the linearity deviation of the minimum concentration was -77.1%, which exceeded one-half of TEa.Followed by the deletion of the maximum concentration , the resumed experiment was done .The results showed that the nonlinear coefficient c of quadratic polynomial and the nonlinear coefficient c and d of cubic polynomial have no significant difference to 0, and AMR was 7.5-1 458.0 U/L.By linear dilution recovery method , the linear correlation between expected values and actual measured values was determined , the correlation ( r) , the intercept ( a) and the slope ( b) met the linear standard , the recovery rates was between 100.0%and 104.8%, and AMR is 5 -1 699 U/L.The CRR was determined to be 5 -33 880 U/L, which met the standard of TEa . Conclusions Average slope method, linear dilution recovery method and EP 6-A method were all used to established AMR in lab-developed clinical chemistry system .Without complicated statistical analysis , linear dilution recovery method was suitable for clinical use .The linearity deviation of the minimum concentration analyzed by EP6-A did not meet the standard of the quality objective system , suggesting defects in the statistical analysis of the results .CRR was feasibly determined by using linear dilution recovery method align with AMR.