Objective To observe the expression levels of 8 - hydroxy-deoxyguanosine (8-OHdG) in patients with different glucose metabolism and its relationship with islet dysfunction.Methods Based on the 75 g oral glucose tolerance test (OGTT), the patients were divided into 3 groups: normal glucose tolerance (NGT) group (30 patients), isolated impaired glucose tolerance (IGT) group (28 patients), type 2 diabetes mellitus (T2DM) group (28 patients), and 30 healthy subjects were selected as the healthy control group (healthy control, HC) . The triglyceride (TG) and total cholesterol (TC), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), insulin resistance index, insulin and c-peptide area under the curve (AUC) were detected, and compared between groups, and the correlation between 8-OHdG and these indexes was analyzed. Results There was no difference in FBG values between NGT group and HC group, the indicators of patients in other groups were higher than HC group,the difference was statistically significant (P<0.01). The values of FBG, 8-OHdG, HbA1C and HOMA-IR of patients in IGT group were higher than NGT group, the difference was statistically significant (P<0.01) . The values of FBG ,8-OHdG, HbA1C and HOMA-IR in T2DM group were higher than IGT group. There were no differences in insulin AUC between NGT group, IGT group and T2DM group (P> 0.05) . 8-OHdG was correlated with FBG, HbA1c, HOMA-IR, C peptide AUC, insulin AUC, and the correlation coefficients were 0.704, 0.713, 0.665, 0.825 and 0.653, respectively, the differences were statistically significant. Conclusions 8-OHdG levels can reflect the status of islet dysfunction,and can be used as an indicator of islet function for diabetic patients.

Objective To discuss the distribution of irregular antibodies of red blood cells and its clinical significance .Methods Micro-column gel anti-globulin technique was used to screen and identify the irregular antibodies in 6 352 patients .Results In 6 352 patients ,there were 62 cases(27 males ,35 females)having positive results in irregular antibody detection ,and the positive rate was 0 .97% .There were 54 cases having transfusion history and/or pregnancy history ,including 43 cases of irregular antibodies of Rh system(containing 34 cases of anti-E antibody) ,7 cases of MNSS system ,2 cases of Lewis system ,2 cases of Kidd system ,2 cases of P system ,1 cases of Diego system ,and 5 cases with non-specificity .All of the patients whose irregular antibodies of Rh blood group system were positive had transfusion history and/or pregnancy history .Conclusion Most of the patients with irregular anti-body positive are females ,who mostly have transfusion history and/or pregnancy history ,and the irregular antibodies of Rh system are the most common .

Objective To investigate effects of continuous positive airway pressure (CPAP)treatment on pulmonary function, frequency of asthmatic attack, and quality of life in patients of moderate to severe obstructive sleep apnea syndrome (OSAS) accompanying with asthma. Methods Twenty-three patients of OSAS accompanying with mild-to-moderate asthma were studied. They were divided into two groups, gastroesophageal reflux ( GER ) group ( n = 9 ) and non-GER group ( n = 14 ), based GER questionnaire score equal to or greater than 12, or less than 12. Pulmonary function tests (PFTs), Epworth sleepy score (ESS), quality of life for obstructive sleep apnea (QOLAp) score, quality of life for asthma (QOLAs) score and polysomnography (PSG) were measured for all the patients before and after four-week CPAP, respectively. Results No significant difference in PFTs was revealed before and after four-week CPAP between the two groups. However, there was significant difference in scores of QOLAp, ESS and QOLAs before and after four-week CPAP treatment, ( 12. 8 ± 2. 8 ) and (4. 6 ± 0. 9), ( 5. 1 ± 0. 7 ) and (6.3 ±0.6), and (4. 1 ±0.5) and (6.3 ±0.5) in GER group, and (13.0 ±2.9) and (4.6 ± 1.1),(4.7±0.5) and (5.6±0.6), and (3.6±0.3) and (5.8 ±0.6) in non-GER group, respectively (P＜0. 01 or 0. 05). Frequencies of asthmatic attack and nocturnal asthmatic attack reduced to ( 1.7 ± 1.1 )episodes per week and (0. 7 ± 0. 3) episodes per week after four-week treatment from (2. 9 ± 2. 0) episodes per week and ( 1.4 ± 0. 8) episodes per week before treatment ( P ＜ 0. 05 ) in GER group, but no significant difference was found before and after treatment in non-GER group. Scores of QOLAs increased more significantly in GER group than that in non-GER group ( P ＜ 0. 05 ). Conclusion CPAP treatment can significantly improve quality of life, rather than pulmonary function, in patients of OSAS accompanying with asthma, especially in those with GER symptoms.

Objective To explore the effectiveness of transcranial magnetic stimulation (TMS) combined with hyperbaric oxygen (HBO) in treating cerebral infarction.Methods Totally 120 patients with cerebral infarction were randomly divided into a control group,a treatment group A and a treatment group B,40 cases in each group.The control group was given conventional treatment,the treatment group A was treated by HBO on the basis of conventional therapy,and the treatment group B was treated by HBO combined with TMS,10 d for a period of treatment.Before and after 2 courses of treatment,all patients' neurological defect was evaluated using National Institutes of Health Stroke Scale (NIHSS).Their central motor conduction time (CMCT) and the expression of brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were also assessed.Results After treatment,the average NIHSS score and effective rate of the treatment group B was (7.35 ± 1.98) and 92.5％ respectively,significantly better than the other two groups.Moreover,the average BDNF content [(4.96 ± 1.20) ng/ml] and NGF content [(152.36 ± 18.01)pg/ml] of the treatment group B after treatment were significantly better than before treatment,and those of the other two groups after treatment.Conclusion TMS combined with HBO is effective in treating cerebral infarction.This may relate to its strengthening the expression of neurotropic factors.

AIM　To investigate the chemical constituents of the rhizomes of Dioscorea panthaica Prain et Burkill and look for new active compounds. METHODS　The compounds were isolated with silica gel and HPLC, and their structures were elucidated on the basis of chemical evidences and spectral analysis (IR, ESI-MS, 1HNMR, 13CNMR, DEPT, 1H-1H COSY, HMQC, HMBC, NOESY). RESULTS　Three steroidal saponins were isolated from the rhizomes of Dioscorea panthaica. They were elucidated as 26-O-β-D-glucopyranosyl-3β,26-diol-23(S)-methoxy-25(R)-Δ5,20(22)-diene-furosta-3-O-［α-L-rhamnopyranosyl-(1→2)-O-α-L-rhamnopyranosyl-(1→4)］-β-D-glucopyranoside (I), pseudoprotodioscin (II), 26-O-β-D-glucopyranosyl-3β,26-diol-25(R)-Δ5,20(22)-diene-furosta-3-O-α-L-rhamnopyranosyl-(1→2)-O-β-D-glucopyranoside (III). CONCLUSION　Compound I is a new steroidal saponin and was named as dioscoreside C. Compound II and III were obtained from this genus for the first time.

Objective To describe the real experience of nurses from different grade hospitals during further study in the three-level hospital.And to provide the basis to make plans,improve the effect of fustther study and ensure the realization of further study aim.Methods In-depth interviews were canied out with 28 nurses by using Hidegerian phenomenological method.The acquired data were reorganized,analyzed and extracted themes.Results Different grade hospital nurses had different psychological experience such as aims,willingness,effects,obtainment and stress.Condusions Further study should be based on subjective willingness and definite goals.Hospitals should strictly select nursing teachers,give differential treatment in education,fully understand the pressure source and provide corresponding measures to reduce stress of nurses.

Objective To assess the safety and efficacy of gabapentin in treatment of refractory uremic pruritus in maintenance hemodialysis (MHD)patients. Methods A randomized controlled trial was performed.Forty-nine MHD patients with severe pruritus were randomly divided into treatment group(gabapentin 100-300 mg at dialysis day before sleep)and the control group(loratadine 10 mg daily).The efficacy was assessed by visual analogue score,pruritus score and improved Duo's VAG Score after 12-week treatment,and the side effect was also observed to assess the safety. Results After treatment,the frequency,degree and area of pruritus in 25 patients of treatment group were significantly reduced,and VAS score(1.46±1.38vs 8.71±1.17,P＜0.01),VAG score(2.92±1.63 vs 8.29±0.68,P＜0.01)and the improved Duo's pruritus score(11.33±3.99 vs 30.75±4.87,P＜0.01)decreased significantly compared with that of prior treatment.The symptoms of 24 patients in control group were improved partly,which were not as good as those in treatment group(P＜0.01).The side effects of gabapentin were drowsiness and dizziness,but most symptoms were relieved or disappeared within 1 week and no patient interrupted therapy.No serious adverse events were observed. Conclusion Gabapentin is safe and effective for refractory uremic pruritus,but long-term efficacy and safety requires larger sample and long-term observation.

The amino acid sequences of the NP,P, M, F,HN and L proteins of the paramyxovirus Tianjin strain were analyzed by using the bioinformatics methods. Phylogenetic analysis based on 6 structural proteins among the Tianjin strain and 25 paramyxoviruses showed that the Tianjin strain belonged to the genus Respirovirus, in the subfamily Paramyxovirinae, and was most closely related to Sendal virus (SeV). Phylogenetic analysis with 14 known SeVs showed that Tianjin strain represented a new evolutionary lineage. Similarities comparisons indicated that Tianjin strain P protein was poorly conserved, sharing only 78.7%-91.9% amino acid identity with the known SeVs, while the L protein was the most conserved, having 96.0%-98.0% amino acid identity with the known SeVs. Alignments of amino acid sequences of 6 structural proteins clearly showed that Tianjin strain possessed many unique amino acid substitutions in their protein sequences, 15 in NP, 29 in P, 6 in M, 13 in F, 18 in HN, and 29 in L. These results revealed that Tianjin strain was most likely a new genotype of SeV. The presence of unique amino acid substitutions suggests that Tianjin strain maybe has a significant difference in biological, pathological, immunological, or epidemiological characteristics from the known SeVs.

Objective To study the relativity between pathology and CT diagnosis and CT classified types of the golioma of the brain.Methods Seventy cases of golioma confirmed by CT diagnosis and pathology by way of non-contrast CT scanning and enhanced scans were analysed in comparison the results of the pathology and CT appearances.Results (1)The accuracy rate of CT diagnosis was 85.7%;(2)having pointed out the CT classified types of the golioma of the brain a acording of CT appearances comibined with shape.Type Ⅰ was(low-tensity,non-enhancement types)16 cases,which can be only seen in Ⅰ and Ⅱ grade of astrocytoma oligodendroglioma,and the latter was often characterized by bending stripe-like calcification or cluster dot-like calcification,both of which occupy 33% of the total (3/9).Type Ⅱ was (ring-like enhanced patterns)13 cases,which often appeared in Ⅱ?Ⅲ?Ⅳ grade astrocytoma,charactenied by parietal-node which took up 53.8%(7/13).The pathology changes were mainly caused by the internal neceosis and a few by cystic changes.Type Ⅲ(nodular or mass-like enhancement) in 31 cases revealed by various types of goliomsas,which were typical CT appearances of medulloblastoma and ependymoma.Type Ⅳ(mixed types)in 10 cases had showed the CT appearances of malignant goliomas.(3)The results indicate that no or slight edema and mass effect as well as intensification were mainly seen in Ⅰ and Ⅱ grade astrocytomas,Ⅲ and Ⅳ grade astrocytomas were classified as the less serious and the serious both of which had distinctive differences.(4)Analyse the CT appearances of brain golioma in terms of tumor cytology had provided the pathology evidences for CT classified patterns.Conclusion CT appearances and CT classified patterns can reflect some pathologie characteristics and provide an important reference for astrocytoma pathology grading.

Objective To investigate the relationship between serum homocysteine (Hcy)and N -terminal brain natriuretic peptide (NT -proBNP)and the severity of coronary artery disease in elderly patients with coronary heart disease (CHD).Methods 129 cases of inpatient with concurrent coronary angiography whose age was over 60 years old were selected as the research object.Serum Hcy and NT proBNP level were detected,and parallel coronary angiography were administrated.Angiography was normal in 24 cases (CONTROL group),while 28 cases were stable angina pectoris(SAP group),non ST segment elevation acute coronary artery comprehensive syndrome group (NSTEACS group)had 47 cases,acute ST segment elevation myocardial infarction group had 30 cases(AMI group).was used to The severity of coronary artery lesions were assessed by Gensini score and the relationship be-tween serum Hcy and NT proBNP levels and coronary angiography in the diagnosis of coronary artery disease severity were analyzed.Results AMI group,the mean serum Hcy and NT proBNP levels[(18.13 ±8.26)μmol/L,(450.45 ± 230.45)pg/mL]were significantly higher than those of NSTEACS group [(16.96 ±9.04)μmol/L,(300.96 ± 170.94)pg/mL],SAP group[(14.35 ±5.31)μmol/L,(130.35 ±85.31)pg/mL]and control group[(10.19 ± 3.18)μmol/L,(65.19 ±40.18)pg/mL](t =5.73、3.64;t =5.53、3.23;t =4.96、3.46;P <0.05).In NSTEACS group,average of Hcy and NT proBNP levels were significantly higher than those of SAP group and control group (t =5.06,3.54;t =4.79,3.25;P <0.05).In SAP group,the average of Hcy and NT proBNP levels were higher than those in the control group (t =5.89,4.23;P <0.05).The levels of serum Hcy and NT -proBNP in patients with cor-onary artery stenosis,double vessel disease and single vessel disease were(16.13 ±7.26)mol/L,(7.29 ±14.35)mol/L, (12.67 ±6.48)pg/mL,(210.45 ±416.45)pg/mL and (160.71 ±140.57)pg/mL,the difference was statistically significant (F =140.25,F =13.15;P <0.05,P <0.01).The levels of serum Hcy and NT -proBNP were signifi-cantly correlated with Gensini score (r =0.342,P <0.05;r =0.962,P <0.01).Conclusion Correlation between serum Hcy,NT -proBNP levels in elderly patients with coronary heart disease and the severity of coronary artery disease and stenosis count is positive.Determining the levels of serum Hcy and NT -proBNP in patients with coronary heart disease and the assessment of the severity of the disease has important clinical significance.