Objective To evaluate the feasibility of detecting peripheral artery disease (PAD) using ankle-brachial index (ABI) determined by an electronic sphygmomanometer in patients with type 2 diabetes mellitus (DM). Method The brachial blood pressure and the ankle blood pressure were measured in each upper limbs and lower limbs by the Doppler ultrasound method and the electronic sphygmomanometer method in fifty-nine DM patients who were selected from Department of Geriatric Endocrinology of General Hospital of PLA. ABI was calculated with the formula of ABI = ankle systolic blood pressure/ brachial systolic blood pressure. The measurement data were expressed as x?s. Then the data of systolic pressure and ABI were analyzed by paired Student's t tests and correlations. The related diagnosis criteria of PAD, such as sensitivity, specificity, positive predictive value, negative predictive value, and the global accuracy were calculated. Furthermore, the correlation of brachial blood pressure as measured by the electronic sphygmomanometer and the mercury column sphygmomanometer was compared. Results There were no significant differences but good correlations between the data of systolic pressures and ABI obtained as measured by two methods. The correlation for systolic pressure was: right upper limbs 0.92, P

Objective To carry out a pharmacokinetic evaluation of oral FK506 in 13 patients after renal transplant. Methods 13 patients after renal transplantation were given prograf based immunosupressive regimen 24 hours after surgery.Blood samples to determine FK506 levels were drawn in heparinized tube at 0、20、40、60、90 min and 2、3、6、8、10 hours after the first oral dosing.The whole blood concentrations were measured by MEIA and the pharmacokinetic parameters were calculated by 3P87 program.The FK506 doses were recorded in detail for the first month. Results Cmax was (13.6259?4.1117)ng/ml;T(peak) was (1.4866?1.0725)h;t1/2 ? was (0.7749?0.7791)h,t1/2 ? was (10.7267?10.4926)h;AUC was (91.0415?40.7694)ng?ml -1 ?h -1 ,CL was (0.046?0.0036)ng?ml -1 ?h -1 and MRT was (8.1540?4.2937)h.AUC was negative correlateld with prograf dose in the first month posttransplant (r=-0.53, P =0.038). Conclusions The absorption of oral administration of FK506 was rapid in patients after renal transplantation,and can achieve Cmax in (1.5?1.1)h,the mean half life time being 10.7 h.The pharmacokinetic parameters can be the guideline for FK506 application.

Objective To analyze the characteristics of hypertension by cross-sectional study of the aged patients with metabolic syndrome (MS). Methods The data, collected from senile population who underwent medical examination in the General Hospital of PLA in 2005, were analyzed retrospectively in order to identify the clinical features of hypertension in aged patients with MS, and the significance of hypertension, as single or one of the components of MS, the prevalence of MS, including the prevalence of MS and its component ailments, prevalence of hypertension in MS population, the constituent ratio of MS and coronary heart disease, and cerebrovascular disease in patients with hypertension. Results The prevalence of MS was 32.19%, in which 8.16% patients were having all the four metabolic abnormalities. Hypertension was the most common metabolic abnormality with a prevalence of 61.78%, which tended to increase with increasing age. The most common combination in MS was abnormalities of blood pressure, glucose and BMI, with a prevalence of 24.67%. Among the population with hypertension, 46.67% of them could be diagnosed as MS, accounting for 89.57% of all MS patients. Patients with MS but without hypertension accounted for only 10.43%. Hypertension complicated with MS or another metabolic disorder showed a high risk of cardiovascular diseases, and the prevalence was 73.52% and 72.69%, respectively. No significant difference was found in the incidence of cerebrovascular disease. The prevalence of abnormal renal function was significantly increased in the group of MS with hypertension, by 1.69 and 1.65 folds of that in the group without MS and the group only with MS and without hypertension. Conclusions There was higher prevalence of MS in the elderly people, and in about 2/3 hypertensive patients it co-existed with one of the components of MS. Hypertension was the most common disorder in MS. Patients with MS and hypertension are having a higher risk of suffering from cardiovascular diseases and abnormal renal function.

Objective To explore if there is a difference in blood pressure in left and right extremities.Methods A total of 20164 adults who took part in health check-up at Health Examination Center of Chinese PLA General Hospital between December 2009 and August 2011were enrolled in this study.Age,height and body weight were recorded,and blood pressure in extremities was measured in synchronous way by using an arteriosclerosis detector.Results (1) Blood pressure in upper left extremity was slightly higher than that in upper and lower right extremity ( all P =0.0001).( 2 ) Difference in diastolic blood pressure in upper left and right limbs in females (2.1±6.7) mm Hg(1mm Hg =0.133 kPa) was more significant than that in males (1.4 +6.5 ) mm Hg ( P =0.0000).In males,difference in systolic blood pressure between two lower extremities ( 2.3 ± 9.6 )mm Hg was more significant than that in females (1.9 ±13.4) mm Hg ( P =0.0225 ).( 3 ) The above mentioned differences were found in low or normal weight and over-weight/obesity populations,which was not correlated with body mess index.(4) The difference of diastolic blood pressure in left and right limbs of relatively taller adults ( ＞170 cm) was more significant than that in shorter populations ( ＜170 cm ) (P =0.001).Conclusion The differences in blood pressure in left and right extremities do exist.

Objective To conduct the statistical analysis on the free carnitine and acylcarnitines levels in 0?6 years old children by detecting the contents of free carnitine and acylcarnitines in dry blood spot to provide the biological reference range for the diagnosis of fatty acid metabolic disorder and organic acidemia.Methods The levels of acylcarnitines of peripheral blood dry blood spot in 263 normal children were detected by using the isotopic dilution non-derived tandem mass spectrometry.All children were divided into male and female groups according to different genders and divided into the groups according to the age,1-28 d(gestational weeks ≥37 weeks),1-12 months old,13 months-3 years old and 4-6 years old.Results The detection results after normality test found that the levels of free carnitine and acylcarnitines in children showed a normality distribution.The free carnitine and various acylcarnitines levels had no statistical difference between male children and female children (t=0.5,P=0.619).The C4,C5,C6,C10,C12 and C18 had equal variance among various age groups(P>0.05) and could conducted the one way variance analysis;C0,C2,C3,C5,OH,C6,C8,C14,C16 and C18 had the variance heterogeneity among different age groups(P<0.05) and could conduct the rank-sum test(P<0.05).The C0,C2,C3,C5,OH,C6,C8,C10,C12,C14,C16 and C18 had statistical differences among different age groups,the reference value ranges were calculated according to different ages.The difference in C4 and C5 had no statistical significance and the reference value range could be calculated by the merged group.Conclusion It is a very important for the diagnosis and treatment of fatty acid metabolic disorder and organic acidemia to establish the reference value ranges of dry blood spot free carnitine and acylcarnitines in children according to different ages.

Objective To identify the metabolites of loganin in rat urine through using ultra high performance liquid chromatography combined with triple TOF mass spectrometry (UPLC-Q-TOF/MS/MS) after oral administration of loganin;To summarize the metabolic pathway of loganin. Methods Rats were given a gavage with loganin. The urine samples were prepared by use of solid phase extraction (SPE). The chromatographic separation was performed on an UPLC C18 column with gradient elution program of acetonitrile and 0.1% formic acid aqueous as mobile phase. Dynamic background subtraction (DBS) technology was employed to trigger information dependent acquisition (IDA) to obtain the characteristic fragment ions of metabolites. Results MetabolitePilot software including several data processing methods were employed to speculate the structures of liganin metabolites and three metabolites were identified. Then, the metabolic pathway of loganin in rats was summarized. Conclusion The analytical method was simple, credible and highly-sensible, which is useful for screening and identifying trace constituents in vivo.

BACKGROUND:CTLA-4Ig as a tolerance-induction agent is a potential strategy in graft-versus-host disease prevention. OBJECTIVE:To investigate the efficacy of CTLA4Ig-gene-modified bone marrow stromal cels mediated by adenovirus to induce T-cel tolerance of haploidentical donors. METHODS: The bone marrow stromal cels isolated culture from the bone marrow of HLA haploidentical donors were transfected by recombinant adenovirus encoding CTLA4IgcDNA (AdCTLA4Ig) at a multiplicity of infection=50 for 72 hours. The expression rate and the location of CTLA4Ig in the transfected cels were detected by fluorescence microscope after immunofluorescence staining. CTLA4Ig-modified bone marrow stromal cels (2×104, 4×104and 8×104) were respectively co-cultured with 105 T cels from the peripheral blood of HLA haploidentical donors and 105 peripheral blood mononuclear cels from recipients. The proliferative inhibition rate was determined by MTT assay, and the level of interleukin-2 in the supernatant was detected by ELISA. The bone marrow mononuclear cels (1×105/wel) were co-cultured with CTLA4Ig-modified bone marrow stromal cel layers constructed in 6-wel plates. The number of bone marrow mononuclear cels and colony-forming unit-granulocyte macrophages were calculated after 5-day culture. RESULTS AND CONCLUSION: The expression rate of CTLA4Ig at the multiplicity of infection=50 was as high as 85%, and the immunofluorescence signals of CTLA4Ig were distributed unevenly in the cytoplasm. The inhibition rates of 2×104, 4×104, and 8×104 CTLA4Ig-modified bone marrow stromal cels on proliferation of T cels were higher than that of untransfected cels. The levels of interluekin-2 in the corresponding cel groups were significantly lower than that in the untransfected cels (P < 0.05). At 5 days of culture, there was no significant difference in the number of bone marrow mononuclear cels and colony-forming unit-granulocyte macrophages between the transfected and untransfected cel groups (P > 0.05). These findings indicate that CTLA4Ig-modified bone marrow stromal cels mediated by adenovirus can induce immune tolerance of T-lymphocyte from HLA haploidentical donors in vitro.

Objective To investigate influences of co-culture with the bone marrow stromal cells (BMSCs) on imatinib sensitivity,and the role of stromal cell-derived factor-1 (SDF-1)/chemokine receptor 4 (CXCR4) axis in imatinib resistance of K562 cells in the co-culture model.Methods The model was constructed by co-culturing K562 cells with BMSCs isolated and cultured from the patients with chronic myeloid leukemia.The apoptosis rate and the CXCR4 expressing rate of the K562 cells exposed to 0.5 μmol/L imatinib for 72 hours were detected by fluorescent-activated cell scanning (FACS) machine.The K562 cells were exposed to 0.5 μmol/L imatinib for 4 hours,and labelled by calckin-AM fluorescent labeling sytem.The adhesion rate of the K562 cells co-cultured with BMSCs for 24 hours was calculated with fluorescence intensity.The IC50 value of K562 cells exposed to imatinib was detected by methyl thiazolyl tetrazolium (MTT) assay while the SDF-1/CXCR4 axis was blocked by 10 μg/ml monoclonal antibody of CXCR4.Results The apoptosis rate of K562 cells exposed to 0.5 μmol/L imatinib for 72 hours in co-culture group and suspension culture group was (15.48 ±4.17) ％ and (32.01 ±6.83) ％,respectively.The apoptosis rates of K562 cells in the two groups were significantly different (t =5.587,P =0.001).For the co-culture group,the CXCR4 expressing rates of K562 cells unexposed and exposed to 0.5 μmol/L imatinib for 72 hours were (20.31 ± 3.76) ％ (suspension cultured:11.28％ ± 3.44％) and (53.64 ± 5.35) ％ (suspension cultured:25.34％ ± 3.21％),respectively.Those results showed that co-culture with BMSCs and exposure to imatinib induced the K562 cells to express CXCR4.The adhesion rates of the K562 cells to the BMSCs were elevated from (42.18 ± 6.17) ％ to (68.97 ± 11.08) ％ when the K562 cells were exposed to 0.5 μmol/L imatinib for 4 hours.The IC50 values of block group (the SDF-1/CXCR4 axis was blocked by 10 μg/ml monoclonal antibody of CXCR4) and unblock group were (0.68 ± 0.04) μmol/L and (1.27 ± 0.05) μmol/L,respectively.The IC50 values of two groups were significantly different(t =4.869,P =0.001).Conclusions The K562 cells co-cultured with the BMSCs from the patients with chronic myeloid leukemia can obtain resistance to imatinib,which was related with that co-culture with the BMSCs and exposure to imatinib can induce the K562 cells to express CXCR4.To a certain extent,the imatinib resistance mediated by co-culture with BMSCs can be reversed by monoclonal antibody of CXCR4.

Objective To assess the left ventricular synchronization and global systolic function in patients with implanted dual-chamber (DDD) mode cardiac pacemakers by real-time three-dimensional echocardiography(RT-3DE). Methods Left ventricular systolic synchronization and global function were evaluated in 20 patients with implanted DDD mode cardiac pacemakers and 20 normal people by RT-3DE. The left ventricular end-diastolic volume (LEDV), end-systolic volume ( LESV), stroke volume (SV), left ventricular ejection fraction (LVEF), the mean value of time from the start of electrocardiographic QRS wave to the point of minimal systolic volume (Tmean) of the 17 segments and those standard deviation(T-SD),the maximal difference of time among all 17 segments(Tmax) were obtained by RT-3DE. Results Compared with control group, LESV was significantly increased,SV, LVEF were significantly decreased and T-SD,Tmax were significantly prolonged (P <0.01 ). There were no differences in LEDV and Tmean between the two groups (P>0.05). In patients group,LVEF correlated closely with T-SD (r =-0.674, P<0.05) and Tmax (r = - 0. 634, P < 0. 05). Conclusions There were left ventrieular systolic asychronization and global systolic dysfunction in patients with implanted dual-chamber (DDD) mode cardiac pacemakers,which could be assessed by RT-3DE.