Objective To investigate the associations between the left ventricular geometry and the insulin resistance (IR) in elderly patients with essential hypertension (EH) and the effect of the IR on the left ventricular geometry. Methods According to left ventricular mass index (LVMI)and relative wall thickness(RWT),72 EH patients were divided into normal geometry group (34 cases ),concentric remodeling group (18 cases ),concentric hypertrophy group (11 cases ),and eccentric hypertrophy group (9 cases ).The oral glucose tolerance test and insulin release test were performed in all patients and 35 healthy subjects as control.The area under curve of glucose tolerance (AG), area under curve of insulin release (AI), fasting serum insulin /fasting serum glucose (FIS/FSG) ratio, AI/AG ratio and insulin sensitivity index (ISI) were calculated.Correlation between RWT,LVMI and 7 insulin-sensitivity parameters were respectively obtained using linear regression analysis,and the stepwise regression analysis was used to assess the independent effect of each parameter. Results RWT was positively correlated with AG、 AI(r=0.160、0.227, respectively, all P0.05). Only ISI was independently correlated with RWT (r2=0.071,P

Objective: To explore the correlation among plasma level of brain natriuretic peptide (BNP), serum D-dimer level and patient's status in patients with acute pulmonary embolism (APE).Methods: A total of 122 APE patients who were hospitalized from Mar 2012 to Dec 2015 were selected.According to right heart function and clinical symptoms, patients were divided into low risk group (n=61), medium risk group (n=36) and high risk group (n=25);after discharge, all patients were followed up for six months, then according to survival or not, they were divided into survival group (n=105) and death group (n=17).Plasma BNP and serum D-dimer levels were measured and compared among all groups, then correlation among BNP, D-dimer levels and severity of patient's status was analyzed.Results: Compared with low risk group, there were significant rise in levels of plasma BNP [(133.28±74.92)ng/L vs.(273.89±179.29)ng/L vs.(834.80±509.09)ng/L] and serum D-dimer [(761.80±333.65)ng/ml vs.(966.67±370.33)ng/ml vs.(1228.40±569.11)ng/ml] in medium risk group and high risk group, and those of high risk group were significantly higher than that of medium risk group, P<0.01 all.Compared with survival group, there were significant rise in levels of plasma BNP [(257.33±27.11)ng/L vs.(696.47±64.92)ng/L] and serum D-dimer [(818.57±64.92)ng/ml vs.(1513.25±48.14)ng/ml] in death group, P<0.01 all.Pearson correlation analysis indicated that plasma BNP, serum D-dimer levels were significant positively correlated with severity of patient's status (r=0.69, 0.41, P<0.01 both), and plasma BNP level was significant positively correlated with serum D-dimer level (r=0.79, P=0.002).Conclusion: Measurements of plasma BNP and serum D-dimer in APE patients are help to assess severity of patient's status and short-term prognosis, and provide basis for clinical individualized therapy.

Objective To compare the consistency of the results of clinical specimens between Tecan Freedom Evolyzer-2200 automated enzyme immunoassay analyzer and manual ELISA method,so as to explore more scientific and reliable test method.Methods Ninety samples were randomly selected from clinical and physical examination,the IMARK2 microplate reader and the instrument operating manual sample measurement was used to test hepatitis A,hepatitis B 5,hepatitis C,hepatitis E 2,TP and HIV,and the results were given correlation and linear regression analysis.Results For the test items of HBsAg,HBsAb,HBeAg,TP,HIV,the correlation coefficient was r2＞ 0.9,the data showed a good correlation,and for HAV-IgM,HBeAb,HBcAb,HCV,HEV-IgM,HEV-IgG,the correlation coefficient was 0.9＞ r 2 ＞ 0.6.Compared with manual method,the total coincidence rate of automated enzyme immunoassay analyzer was 96.9％ in 11 indexes of 90 samples.Conclusions Automatic and manual ELISA method has a good correlation.Automatic ELISA also greatly reduce the labor burden of laboratory personnel,improve efficiency,should be strengthened in clinical practice.

Objective To explore the curative effect of quetiapine combined with paroxetine in the treatment of bipolar depression,and to provide reference for the choice of clinical treatment.Methods According to the digital table,96 patients with bipolar disorder were randomly divided into observation group and control group,48 cases in each group.The control group was treated with quetiapine orally,the observation group was treated with quetiapine combined with paroxetine.After 6 weeks of treatment,the clinical curative effect,the Montgomery Asberg Depression Rating Scale and the Beck pull fan Sen Mania Rating table score before and after treatment were compared between the two groups.At the same time,the adverse reactions of the two groups were compared.Results After 6 weeks of treatment,the total effective rate of the observation group was 70.83％,which was significantly higher than 50.00％ in the control group,the difference was statistically significant(x2 =4.356,P =0.037).After 6 weeks of treatment,the Montgomery Asberg Depression Rating quantity score in the observation group was (14.01 ± 2.95) points,which was significantly lower than (18.07 ± 3.05)points in the control group,the difference was statistically significant (t =5.527,P =0.036).The Baker-pull fan Sen Mania Rating score before and after treatment between the two groups had no statistically significant differences.There were no serious adverse reactions in the two groups.Conclusion Quetiapine combined with paroxetine can effectively inhibit bipolar depressive episodes,avoid manic episodes,has good clinical efficacy and high safety,it is worthy of popularization and application.

Objective To study effects of shuganjieyu capsule of plasma glucose and lipid metabolism and sleep and body weight in patients with depression.Methods 90 patients of depression who received therapy from July 2013 to July 2016 in our hospital were selected.According to random number table, those patients were divided into the observation group ( n =45 ) and the control group ( n =45 ) .The control group was treated with citalopram, while the observation group was treated with shuganjieyu capsule, then glucose and lipid metabolism, sleep, weight and clinical curative effect were compared.Results After treatment, the fasting blood glucose (FBG), postprandial 2h blood glucose (2 hPG), triacylglycerol (TG), total cholesterol (TC) in the observation group were lower than the control group(all P<0.05), the sleep state self rating scale (SRSS) and the Pittsburgh sleep quality index ( PSQI) in the observation group were lower than the control group ( all P <0.05 ) .The body weight and body mass index in the observation group were lower than the control group (all P<0.05).The total effective rate in the observation group 95.56% (43/45)was higher than the control group 77.78% (35/45) (P<0.05); the incidence of adverse reactions in observation group 20.00% (9/45) was lower the control group 46.67% (21/45) ( P <0.05).Conclusion Shuganjieyu capsule is well for depression, which can conducive to maintaining glucose and lipid metabolism, weight stability, and improve sleep quality and clinical symptoms, and high security,it's worthy of application and promotion.

Objective To investigate the correlation between the reason of heterotopic ossification after cervical artificial disc replacement and the degeneration of cervical facet joints.Methods From May 2009 to May 2012,133 patients who had undergone cervical artificial disc replacement were included into this study.There were 74 males and 59 females with an average age of 42.63±4.15 years old (range,23-56 years old).There were 109 patients who had undergone single level implant,and 24patients double level implant.Cervical spine A-P and the flexion-extension X-rays were taken to assess the range of motion (ROM)of the surgical level.Degeneration degree of patients' cervical facet joints were evaluated by Park grading standards with the preoperative cervical CT scan images on GE-PACS system.Heterotopic ossification (HO) situation were evaluated by McAfee classification through cervical lateral X-ray film.Patients were divided into two groups (HO group and non-HO group) according to whether heterotopic ossification appeared during the follow-up period.The data were collected before surgery to the latest follow-up.Results The average follow-up time was 2.9 years (range,2.0-4.8 years).HO was detected in 25 patients (18.80％,25/133) at latest follow-up.The ROM of surgical level of patients in HO group was significantly lower than non-HO group (6.8°±3.9° vs 9.1 °±2.4°).In addition,the degeneration degree of cervical facet joints of patients in HO group was significantly higher than that in non-HO group.There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR (r=0.683,P=0.033).Conclusion There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR.Patients present HO after surgery have significantly higher degeneration degree of cervical facet joints than patients without HO.Patients with higher degree of HO may have a higher level of cervical facet joints degeneration.

BACKGROUND: Nerve growth factor (NGF) is characterized by poor stability both in vitro and in vivo, and liable to lose its bioactivity.OBJECTIVE: To study the stability of liposome-encapsulated NGF injection preserved under various conditions.DESIGN: A controlled study of liposome-encapsulated NGF.SETTING: Department of Surgery of the First Affiliated Hospital of Nanjing Medical University.MATERIALS: This study was carried out at the Central Laboratory of the First Affiliated Hospital of Nanjing Medical University between July 2002and March 2004. NGF from rat submaxillary gland was purified, encapsulated by liposome, and prepared into lyophilized dosage form before preserved under different conditions (at 4 ℃, room temperature, 40 ℃ or 40 ℃ with saturated humidity, respectively).METHODS: Chicken embryo dorsal root ganglion cultured in serum-free medium was used to evaluation the bioactivity of NGF in vitro. The dorsal root ganglion from 8-day-old chicken embryo was inoculated in a polylysine-coated 24-well culture plate and cultured in Dulbecco modified Ea-gle medium (DMEM) containing different testing samples. Only DMEM was used for culture in the negative control group, while DMEM containing NGF at different concentrations used in the positive control group. The ganglion was cultured at 37 ℃ with 50 mL/L CO2 and saturated humidity for 24 hours, and the growth of the nerve fibers was observed under an inverted microscope. The bioactivity of NGF was also evaluated in simulated condition in vivo by adding lyophilized liposome-encapsulated NGF and positive control NGF specimen into 0.5 mL rat serum, which, along with the blank control serum, was added into 2.5 mL DMEM at 0.5, 1, 2, 3, 4,6 hours and thoroughly mixed. The bioactivity of NGF was assessed accord-ing to the length and density of the dorsal root ganglion and graded the prominences (recorded as "++" or "+++ "), and very long and dense growth of the prominences (++++).MAIN OUTCOME MEASURES: In vitro bioactivity of NGF preserved for 10, 30, 60, and 90 days by testing the growth of cultured chick embryo dorsal root ganglion in serum-free DMEM and in test of rats serum containing NGF added at 0, 0.5, 1, 2, 3, 4, and 6 hours into DMEM.RESULTS: Lyophilized liposome-encapsulated NGF exhibited stable bioactivity (+++) after preservation at 4℃ and room temperature for 10-90days; at 40 ℃ for 10-60 days, the it retained its the bioactivity (+++),which, however, slightly decreased by 90 days (++); its bioactivity was preserved (+++) at 40 ℃ with saturated humidity for 10 days (+++), slightly decreased at 30-60 days (++) and noticeably lowered (+) at 90 days. When preserved for 0, 0.5, 1, 2, and 3 hours in rat seum, the NGF preparation retained stable bioactivity (++++ or +++), which slightly decreased at 4 hours and 6 hours (++).CONCLUSION: Liposome-encapsulated NGF has stable bioactivity but its preservation at relatively high temperature with high humidity is difficult.Lyophilized liposome-encapsulated NGF exhibits better bioactivity than NGF-liposome suspension after preservation under various conditions.

ObjectiveTo investigate the expression of E-cadherin and β-catenin in the primary colorectal carcinoma and metastatic lymph nodes and it's clinical significance. MethodsImmunohistochemical analysis of Ecadherin and β-catenin was performed in colorectal mucosa( n =20 ,group A) ,colorectal carcinoma without metastasis ( n = 25, group B) and colorectal carcinoma with metastatic lymph nodes ( n = 39, group C) The expression of E-cadherin and β-catenin and the metastasis and prognosis of colorectal carcinoma were observed. ResultsThe strongly positive expression of E-cadherin in primaries of group C (5.1％ ) was obviously lower than in group B ( U = 2. 149,P =0. 032) ,whereas no statistic differences of the expression of E-cadherin between primaries and metastases of group C were observed(P =0.186). There was no difference of the expression of β-catenin between group B and group C,the same of primary colorectal carcinoma and self control lymph nodes of group C(P =0.235 and P =0. 715). There was positive correlation between membranous down regulation of E-cadherin and β-catenin in group C( r = 0.387 ,P =0.024) ,but no relationship was found in group B( r = 0.080 ,P = 0.723 ). ConclusionThe decreased membranous expression of E-cadherin in the colorectal carcinoma was correlated with lymph nodes metastasis, and was obviously related to membranous down regulation of β-catenin. There was no relevance between the expression of β-catenin and the lymph nodes metastasis of colorectal carcinoma.

Objective To investigate the association between mycoplasma infection and pathogenesis of renal cell carcinoma(RCC). Methods There were 95 samples of archived embedded tissues of RCC and 60 samples of archived embedded normal renal tissues around the tumor for comparison.We detected mycoplasma hyorhinis P40 expression in archived embedded renal tissues by immunohistochemistry(IHC) with mycoplasma hyorhinis monoclonal antibody(MAb) PD4. Results Mycoplasma hyorhinis P40 was present in 64.2%(61/95 cases) of RCC and in 21.7%(13/60 cases) of the paratumor normal renal tissues in controls.The mycoplasma hyorhinis P40 expression ratio in RCC was significantly higher than that in the normal renal tissue,around the tumor(P

Objective To investigate the association between mycoplasma DNA and renal cell carcinoma (RCC). Methods There were 95 samples of archived embedded tissues of RCC. We detected mycoplasma DNA in the tissues by nested polymerase chain reaction (PCR) with mycoplasma universal primer. Results The mycoplasma DNA detection ratio in RCC samples was 81.1%. The samples with moderate and low differentiation had a higher mycoplasma DNA ratio (90.9%) compared with that of high differentiation samples (72.6%) (P