Objective To investigate the altered lipid in systemic sclerosis(SSc),and the relationship between the altered lipid and inflammation.Methods A total of 58 SSc patients were recruited into SSc group,and 58 healthy persons were recruited into control group from 2012 to 2014.Triglyceride(TG),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-c)and high density lipoprotein-cholesterol(HDL-c),lipoprotein a[LP(a)],C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR) were assessed using standard techniques in all cases,antinuclear antibody(ANA)and anti-Scl-70 antibody were assessed only in SSc patients.The levels of lipids between SSc patients and healthy controls,patients with antibody and patients without antibody were compared by using t test,corrections between lipid and inflammation were analyzed by Spearman′s correlation test.Results The clinical manifestations of SSc were mostly Raynaud′s phenomenon(91.4%),large area of black hard shin(87.9%),gastrointestinal manifestations(75.9%).The rates of an increased level of TG and decreased level of HDL-c were 29.3%,89.7% respectively.The level of TG in SSc was significant higher than in healthy controls(P =0.021),and the level of HDL-c in SSc was significant lower than in healthy controls(P =0.033).The levels of lipids in patients with ANA and anti-Scl-70 antibody had no significant difference with the patients without ANA and anti-Scl-70 antibody (P >0.05 ).Spearman′s correlation test demonstrated that HDL-c level correlated negatively with serum CRP (r=-0.285,P =0.039)and ESR (r =-0.271,P =0.043)in SSc.Conclusion Dyslipi-demia is a common feature in SSc patients that are characterized by an increase in TG and a decrease in HDL-c,inflammation might partly account for the changes.

Objective To evaluate the reliability and accuracy of the fully automated erythrocyte sedimentation rate (ESR) analy‐ser Monitor‐100 for determining ESR .Methods 146 outpatients and inpatinets were selected and detected ESR by the fully automa‐ted ESR analyser 1 h ,30 min and the Westergren method .Then these three kinds of method were compared and the repeatability test was performed .Results (1)The ESR values determined by the analyser 1 h ,analyser 30 min and Westergren method were 37 . 8 ± 34 .1 ,38 .1 ± 33 .7 ,36 .4 ± 32 .9 respectively ,there were no statistical significance between any two methods (P>0 .05) .(2)The detection rates of the positive results by the analyser 1 h ,analyser 30 min and Westergren method were 43 .2% ,44 .5% and 45 .2%respectively ,no statistical difference between them was found (P>0 .05) .(3)The Kapper values between the analyser 30 min with the analyser1h ,between the analyser 30 min with the Westergren method and between the analyzer 1h with the Westergren method were 0 .944 ,0 .875 and 0 .903 .4 respectively .(4)The CV values in the repeatability test were very lower and within the acceptable limits .Conclusion Compared with the Westergren method ,the fully automated ESR analyser Monitor‐100 has lower false positive rate and lower false negative rate ,moreover its consistency and repeatability are excellent ,it is convenient ,fast ,safe and should be largely promoted in clinic .

Objective To investigate the distribution of age and relationship of ESR with HCT.Methods The HCT,age and ESR datas of the patients which all ages were above 40 years were Collected,then count the mean and standard deviation x±s with different groups of HCT,t test was made to identify the significance of difference.Results HCT:The levels of hct in males was 0.47±0.26 in higher groups of HCT,0.39±0.27 in normal groups and 30.01 ±3.59 in lower groups.The levels of HCT in fe-males was 0.42±0.17 in higher groups,0.30±0.36 in normal groups,0.27±0.45 in lower groups;Age:The average age in males was 57.41±10.62 years in higher HCT groups of patients,67.23 ±12.75 in lower hct groups,there were significantly difference between them.The avarage age in females was 60.70 ± 11.60 in higher HCT groups of patients,61.60 ± 12.40 in lower HCT groups,there were no significantly difference between them.ESR:The levels of ESR in males was (3.95 ±3.26)mm/h in higher HCT groups,(61.61±40.04)mm/h in lower HCT groups;The ESR in females was (28.26±28.62)mm/h in higher HCT groups, (60.20±43.71)mm/h in lower HCT groups,there were significantly difference between different groups included both males and femals.Conclusion When the HCT were decreased,the age and ESR were increased in males,the ESR were also increased but had no relationship with ages in females.Conjuction the age and ESR,it could improve the prevention and monitoring in heart-brain blood disease through the HCT.

Objective To construct a novel bioartificial liver (BAL) system and evaluate its functions in vitro. Methods Chinese experimental minipig hepatocytes were isolated by in situ recirculating collagenase perfusion method and 1.0?10~(10) hepatocytes were cultured in serum-free medium with restriction of(attachment), and using spinner method to form hepatocyte(spheroids).cted by inoculating the hepatocyte(spheroids) into cell circuit of a hollow fiber bioreactor from BIOLIV A3A. Observing the number and viability of the(hepatocytes), the changes of alanine aminotransferase (ALT), total bilirubin (TBI), albumin (ALB) in(circulating) hepatocyte suspension and(RPMI1640) medium; in addition, lidocaine metabolism test was(determined),(during) 6h circulation of the system. (Results) There were no significant differences in number and viability of the hepatocytes before and after 6h(circulation). The BAL system has relatively strong albumin synthesis and lidocaine(metabolism) functions. (Conclusions) The BAL system that we developed had ability to support liver functions and could be used in the treatment of liver failure, or to provide temporary liver support for candidates of liver(transplantation).

Objective To investigate the incidence of middle ear barotrauma due to hybaric oxygen therapy by using Health Education Atlas.Methods 100 patients were divided into two groups by random number table. The research group(49 patients)was educated by Health Education Atlas.The control group(51 patients)was educated by traditional education approach.During the first three days,we observed and recorded the eardrum injury and asked patients ear discomfort everyday.Results The incidence rate of middle ear barotrauma of the research group was 6.1%,which of the control group was 19.6%.The eardrum injury of the research group was milder than the control group(χ2 =4.02,P <0.05).Conclusion Education using Health Education Atlascan reduce the incidence of middle ear barotrauma due to hybaric oxygen therapy.

MicroRNA (miRNA),sharing the character of regulating the transcriptional level and expression level of mRNAs,is one kind of small non-coded RNAs.At present,innate immune has become one of the hot topics for researchers,and miRNAs as a sort of bioactive substance greatly take part in the whole regulation progress.In detailed,miRNAs can influence the immune state of immune cells during innate immune period and further regulate inflammatory conditions in whole body.By systematically summarizing miRNA function during innate immunity,this present review may provide a reference for peer researchers.

Objective The aim of this study was to investigate and analyze the etiology, seizure type and anti-epileptic drugs (AEDs) utilization of in-patients with epilepsy Methods The study included 5563 cases in-patients with epilepsy. The etiology and seizure type and the date of type, quantity of AEDs in-patient department were collected and their usage frequency were analyzed statistically. Results The most common etiology of epilepsy was traumatic brain injury(13.64%), followed by hippocampal sclerosis (11.52%), stroke (5.24%), nervous system infection (4.98%), perinatal injury ( 5 . 28 % ) and undefined etiology ( 40 . 80 % ) . The most common seizure type was partial seizures (45.43% ). The AEDs of carbamazepine and valproate were the most common used drugs in the clinical and their average usage frequency were 36.88% and 30.80%, respectively. The newer AEDs of Lamotrigine and Levetiracetam were used more frequently. The use of Lamotrigine increased from 16.16% to 28.44% and the Levetiracetam from 0.61% to 20.87% whereas the use of Oxcarbazepine and Topiramate remained a stable level of 15.07% and 9.42%. Conclusion The etiology of epilepsy is complicated and the seizure type of epilepsy was diverse. Among a great variety of anti-epileptic drugs, the newanti-epileptic drugs are being increasingly used.

Objective:To investigate the clinical characteristics and risk factors of frailty syndrome in elderly patients undergoing maintenance hemodialysis (MHD) and the effect of frailty syndrome on all-cause mortality.Methods:This was a prospective cohort study. MHD patients aged≥60 years in 5 hemodialysis centers in Beijing from April to June 2017 were selected as the study subjects. Baseline data were collected and compared, and the patients were then classified into non-frailty, pre-frailty and frailty syndrome groups according to the Fried criteria and followed up until June 2018. The end point event was all-cause death. Multivariate logistic regression was used to analyze the independent risk factors of frailty syndrome. Kaplan-Meier survival analysis was used to compare the difference in the cumulative survival rate among the 3 groups. A multivariate Cox regression model was used to analyze the independent risk factors of all-cause mortality.Results:A total of 204 patients aged (71.65±5.89) years (60-81 years) were enrolled into this study, including 123 males (60.29%), 147 patients (72.06%) in the frailty syndrome group, 41 patients (20.10%) in the pre-frailty group, and 16 patients (7.84%) in the non-frailty group. Patients with frailty syndrome tended to be older, longer dialysis vintage, a higher proportion of diabetes, lower urea clearance index (Kt/V) and lower serum albumin level (all P<0.05). Multivariate Logistic regression showed that factors independently associated with frailty syndrome included age ( OR=1.393, 95% CI 1.241-1.563, P<0.001), history of diabetes ( OR=3.610, 95% CI 1.262-10.327, P=0.017), dialysis vintage ( OR=1.011, 95% CI 1.002-1.020, P=0.019), Kt/V ( OR=0.711, 95% CI 0.516-0.979, P=0.037), serum albumin ( OR=0.754, 95% CI 0.644-0.882, P<0.001) and intact parathyroid hormone (iPTH, OR=1.344, 95% CI 1.024-1.763, P=0.033). Kaplan-Meier survival analysis showed that the cumulative survival rate in frailty syndrome group was significantly lower than those of pre-frailty (Log-rank χ2=7.265, P=0.007) and non-frailty groups (Log-rank χ2=5.238, P=0.022). Multivariate Cox regression analysis indicated that frailty syndrome ( HR=3.832, 95% CI 1.116-13.157, P=0.033), age ( HR=1.074, 95% CI 1.014-1.136, P=0.014), history of diabetes ( HR=2.009, 95% CI 1.067-3.784, P=0.031), cognitive impairment (Montreal cognitive assessment<26, HR=2.627, 95% CI 1.142-6.042, P=0.023), Kt/V ( HR=0.701, 95% CI 0.545-0.902, P=0.006), serum albumin ( HR=0.891, 95% CI 0.806-0.986, P=0.025) and iPTH ( HR=1.226, 95% CI 1.100-1.367, P<0.001) were independently associated with all-cause mortality. Conclusions:The prevalence of frailty syndrome in elderly patients undergoing hemodialysis is high. Ageing, diabetes history, long dialysis vintage, low levels of Kt/V and serum albumin, and elevated iPTH level are independent risk factors for frailty syndrome in such patients. Frailty syndrome is independently associated with an increased risk of all-cause mortality.

Objective:To investigate the clinical features and associated influencing factors of cognitive impairment in middle-aged and elderly Chinese adult patients undergoing maintenance hemodialysis (HD).Methods:A cross-sectional study was conducted among HD patients from 11 centers in Beijing city from April 2017 to June 2017. A neuropsychological battery covering domains of attention/processing speed, executive function, memory, language, and visuospatial function was applied in cognitive function assessment. Patients were classified as normal cognitive function group and cognitive impairment group according to the fifth version of the diagnostic and statistical manual of mental disorders criteria (DSM-V). Multivariate binary logistic regression was used to analyze the independent influencing factors of cognitive impairment. Results:A total of 613 HD patients were included in the study, and the prevalence of cognitive impairment was 80.91% (496/613). Attention impairment (81.05%) and memory impairment (63.51%) were the most common impaired domains, and 79.23% was concomitant impairment across two or more cognitive domains among those with cognitive impairment. Compared with the patients in the normal cognitive function group, the patients in the cognitive impairment group had senior age, longer dialysis vintage, higher proportion of diabetes, hypertension, and stroke, higher level of serum intact parathyroid hormone (iPTH), lower education level, and lower urea clearance index (Kt/V) (all P<0.05). Factors were independently associated with cognitive impairment including increasing age ( OR=1.110, 95% CI 1.072-1.150, P<0.001), education time>12 years (with education time<6 years as reference, OR=0.323, 95% CI 0.115-0.909, P=0.032), history of diabetes ( OR=2.151, 95% CI 1.272-3.636, P=0.004), history of stroke ( OR=2.546, 95% CI 1.244-5.210, P=0.011), increased dialysis vintage ( OR=1.016, 95% CI 1.010-1.022, P<0.001), reduced Kt/V( OR=0.008, 95% CI 0.002-0.035, P<0.001), and increased iPTH level ( OR=1.002, 95% CI 1.002-1.003, P=0.012). Conclusions:The prevalence of cognitive impairment in middle-aged and elderly adult Chinese patients undergoing HD is high. Memory and attention are the most commonly impaired domains. Increasing age, low education level, history of diabetes and stroke, increased dialysis vintage, reduced Kt/V and increased serum iPTH are the independent influencing factors associated with cognitive impairment.

Objective:To investigate the association between cognitive impairment and all-cause mortality in middle and elderly adult patients undergoing maintenance hemodialysis (HD).Methods:A prospective cohort study was conducted. Patients from 11 HD centers in Beijing between April and June 2017 were enrolled. Baseline data were collected, and a series of neuropsychological batteries covered 5 domains of cognitive function were applied for the assessment of cognitive function. The patients were then classified as normal and cognitive impairment groups according to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders criteria (DSM-V) and followed-up until June 2018. The clinical characteristics of the two groups of patients were compared. Kaplan-Meier survival analysis was used to compare the difference in the cumulative survival rate between the two groups. Multivariate Cox regression model was used to analyze the independent influencing factors of all-cause mortality, to determine the relationship between cognitive impairment and different cognitive domain impairments and all-cause death.Results:A total of 613 patients were enrolled, of which 496(80.91%) patients had cognitive impairment. Compared with the normal cognitive function group, the patients in the cognitive impairment group tended to be older, longer dialysis vintage, a higher proportion of diabetes, hypertension, and stroke, increased serum iPTH level, and lower education level and urea clearance index (Kt/V) (all P<0.05). After (49.53±8.42) weeks of follow-up, Kaplan-Meier survival analysis showed that the cumulative survival rate of cognitive impairment group was significantly lower than that of cognitive normal group (Log-rank χ2=8.610, P=0.003). Multivariate Cox regression analysis showed that history of diabetes ( HR=2.742, 95% CI 1.598-4.723, P<0.001), coronary heart disease ( HR=1.906, 95% CI 1.169-3.108, P=0.010), dialysis vintage (every increase of 1 month, HR=1.007, 95% CI 1.003-1.011, P=0.001), serum level of albumin (every increase of 1 g/L, HR=0.859, 95% CI 0.809-0.912, P<0.001), cognitive impairment ( HR=2.719, 95% CI 1.088-6.194, P=0.032) were independently associated with all-cause mortality. Multivariate Cox regression analysis on different cognitive domains also indicated that memory impairment ( HR=2.571, 95% CI 1.442-4.584, P<0.001), executive function impairment ( HR=3.311, 95% CI 1.843-5.949, P=0.001) and three, four, five domains combined impairment ( HR=5.746, 95% CI 1.880-17.565, P=0.002; HR=12.420, 95% CI 3.690-41.802, P<0.001; HR=13.478, 95% CI 3.381-53.728, P<0.001) were independently related to all-cause mortality. Conclusions:Cognitive impairment is an independent risk factor of all-cause mortality in middle and elderly adult patients undergoing maintenance hemodialysis, and the risk is significantly increased in patients with the impairment of the domains of memory, executive function, or in the combination of three to five cognitive domains.