Objective To evaluate differences of serum bone gamma-carboxyglutamic-acid-containing protein (BGP)levels be-tween different gender in the middle-aged and elder population and the correlation between serum BGP and osteoporosis,as well as the correlation between BGP and other bone metabolic markers.Methods The study population consisted of 270 health care middle-aged and elder people,who were excluded malignancy and chronic diseases,during 2011 January to Au-gust.Of all the Recipients,101 cases were male,aged 50 to 89 years,with a median age of 68 years old,female 169 cases, aged 50 to 89 years,with a median age of 64 years.Bone density were measured by absorptiometry and was evaluated by the T index values.Serum BGP,25-hydroxyvitamin D,calcium and phosphorus were measured by different assays systems.The different level of BGP between genders was also analyzed by Mann-Whitney test.Correlation between BGP and serum calci-um,phosphorus,25-hydroxyvitamin D,osteoporosis risk index were analyzed Spearman rank correlation analysis.Results T value,BGP,25-hydroxy vitamin D,calcium and phosphorus levels range of 270 cases were-3.5~-0.7 (median-1.6 ng/ml),3.59~264.90 ng/ml (median 12.84 ng/ml),4.0~34.0 ng/ml (media 10.5 ng/ml),1.79~2.69 mmol/L (median 2.36 ng/ml),0.43~2.89 mmol/L (median 1.12 ng/ml),respectively.BGP levels in the female groups were significantly higher than the male groups.Serum concentration of BGP was positively correlated with serum phosphorus,but the serum BGP with calcium,25-hydroxy vitamin D,age and osteoporosis risk indices were not correlated.Conclusion In the elder groups,female BGP levels were significantly higher than male,the gender factor should be considered in the clinical applica-tion of BGP.Since BGP and osteoporosis risk index T had positive correlation,those two tests can be combined to evaluate osteoporosis.

ObjectiveTo explore the significance of intrauterine infection of hepatitis B virus in pregnant women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) negative by nested polymerase chain reaction (PCR). MethodsTwenty-four pregnant women with HBsAg and HBeAg negative but other HBV markers positive together with their infants were included as study group. Sixteen pregnant women with HBV marker negative and their infants were in the control group. HBV DNA in sera and peripheral blood mononuclear cells (PBMCs) of two groups was detected by nested PCR respectively. Results(1)In the study group, the positive rates of HBV DNA of pregnant women were 33% (8/24) in the sera and 42% (10/24) in PBMCs. Three women were detected HBV DNA in both serum and PBMCs. The rate of HBV infection was 63% (15/24); (2)also in the study group, the positive rates of HBV DNA of the infants were 13% (3/24) in the sera and 25% (6/24) in PBMCs. One newborn was detected HBV DNA in both serum and PBMCs, the rate of intrauterine infection of HBV was 33% (8/24); (3) HBV DNA was detected in sera and/or in PBMCs from four newborns of pregnant women with HBV DNA positive only in PBMCs, the positive ratio was 4/7. ConclusionsHBV intrauterine infection is possible in pregnant women with HBsAg and HBeAg negative. Detecting HBV-DNA in sera and PBMCs of pregnant women and their newborns by PCR is important clinical significance.

Objective To investigate the different diagnostic value of serum Chitinase 3-like 1 protein(CHI3L1)and Alpha-fe-toprotein(AFP)in diagnosing hepatocellular carcinoma (HCC).Methods One hundreds HCC patients confirmed by histopa-thology were recruited between December,2015 to April,2016 from the First Affiliated Hospital of Nanjing Medical Univer-sity.Simultaneously,100 patients with chronic hepatitis B and 59 healthy individuals,matched by sex and age with HCC pa-tients,were recruited as control groups.Serum CHI3L1and AFP were measured in different groups and the difference were analyzed by STATA 1 2.0 Statistical software.The ability of these two items in differentiating different group was analyzing by ROC curve using MedCal Ver 15.2.2 software.Results Serum CHI3L1 were significantly differences in the three groups using Kruskal-Wallis analysis (χ2=93.19,P=0.000),the differences were further compared in different two groups using Mann-Whitney analysis.The results showed that serum CHI3L1 in HCC group were significantly higher than in chronic hepatitis B and healthy control group (P=0.000,z=8.766,7.400).Serum AFP were significantly differences in the three groups using Kruskal-Wallis analysis (χ2=147.54,P=0.000),and the differences were further compared in different two groups using Mann-Whitney analysis.The results showed that serum AFP in HCC group were significantly higher than in chronic hepatitis B and healthy control group (P=0.000,z=10.938,9.033).The ROC curve analysis of serum CHI3L1 and AFP for differentiating HCC group from CHB group showed that CHI3L1 yield AUC of 0.859 (95% CI:0.803~0.904) with 85% sensitivity,79% specificity and 76.8 pg/ml cut-off value,AFP yield AUC of 0.948 (95% CI:0.904~0.974)with 85% sensitivity,98% specificity and 7.6 ng/ml cut-off value,in distinguishing HCC with CHB group,the power of AFP was superior to that of CHI3L1 (P=0.006).The ROC curve analysis of serum CHI3L1 and AFP for differentiating HCC group from healthy individuals group showed that CHI3L1 yield AUC of 0.852 (95% CI:0.787~0.903)with 85% sensi-tivity,76% specificity and 76.8 pg/ml cut-off value,AFP yield AUC of 0.929 (95% CI:0.878~0.964)with 84% sensitivi-ty,100% specificity and 7.8 ng/ml cut-off value,in distinguishing HCC with healthy individuals group,the power of AFP was also superior to that of CHI3L1 (P=0.045).Conclusion Serum CHI3L1 similar to AFP has much power ability to di-agnosis HCC,but AFP was superior to CHI3L1.

Objective To investigate the serum concentration of 25-hydroxyl vitamin D in the common autoimmune diseases and whether the differences of the 25-hydroxyl vitamin D level exist in different autoimmune diseases.Methods 137 cases of autoim-mune diseases,including 71 cases of rheumatoid arthritis(RA),36 cases of systemic lupus erythematosus(SLE),16 cases of Sjogren syndrome(SS)and 14 cases of ankylosing spondylitis(AS),in our hospital from January 2012 to April 2013 were selected as the re-spondents.The serum samples were collected for detecting the 25-hydroxyl vitamin D level by the electrochemiluminescence method and comparing the differences of the 25-hydroxyl vitamin D level among different autoimmune diseases.At the same time whether the differences in the proportion of the normal level,insufficiency and lack of 25-hydroxyl vitamin D exist among different kinds of disease.Results The serum 25-hydroxyl vitamin D concentration had statistically significant difference among the patients with dif-ferent autoimmune diseases(P =0.006),which in the RA group was significantly higher than that in the other groups;the propor-tion of 25-hydroxyl vitamin D insufficiency in RA,SLE,SS and AS were 29.6%,52.8%,62.5% and 57.1% respectively,which in the SLE,SS and AS groups was significantly higher than that in the RA group(P <0.05).Conclusion The 25-hydroxyl vitamin)D insufficiency is general in common autoimmune diseases,the vitamin D supplements needs to be strengthened.

Objective To observe tigecycline (TGC),minocycline (MH)and polymyxin B (PB)in vitro antibacterial activity of pan-resistant Acinetobacter baumannii (PDR-Ab)for clinical treatment,provide the basis for infection control.Methods Collected 76 patients’clinical specimens used for no repeat count of isolation and identification with pan-resistant Acineto-bacter baumannii in Shaanxi Provincial People’s Hospital from October 2013 to March 2013.Used tigecycline,minocycline and polymyxin B to do susceptibility testing with disk diffusion method (KB).Results 76 pan-resistant Acinetobacter bau-mannii ,sensitive to the rate for tigecycline and polymyxin B were 100% sensitivity rate of minocycline and intermediary rates were 67.11%,27.63%.Conclusion Tigecycline,minocycline and polymyxin B for the Pan-resistant Acinetobacter bau-mannii had good in vitro antibacterial activity.It provide a reference for clinical pan-resistant Acinetobacter baumannii infec-tions caused by diseases treatment.

Objective:To explore the risk factors of left ventricular thrombosis (LVT) after acute myocardial infarction.Methods:A retrospective analysis was conducted on the clinical data of 300 patients with acute myocardial infarction admitted to the Xuhui District Central Hospital in Shanghai from January 2019 to January 2022. Based on the results of echocardiography, the patients were divided into LVT group (27 cases) and non LVT group (273 cases). Single factor analysis and multivariate logistic regression analysis were used to screen for the influencing factors of LVT formation after acute myocardial infarction. The value of predicting LVT formation was analyzed through receiver operating characteristic (ROC) curve analysis of each indicator.Results:There was no significant difference between the two groups in gender, age, body mass index (BMI), smoking history, drinking history, hypertension, diabetes, duration of chest pain<12 h, white blood cell count (WBC), platelet count (PLT), myocardial creatine kinase isoenzyme (CK-MB), creatinine, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) (all P>0.05), The differences in neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), C-reactive protein (CRP), brain natriuretic peptide (BNP) levels, left ventricular ejection fraction (LVEF), and left ventricular end diastolic diameter (LVDD) between the two groups of patients were statistically significant (all P<0.05); The area under the curve predicted by NLR, PLR, CRP, BNP, LVEF, and LVDD for LVT formation after acute myocardial infarction were 0.707, 0.771, 0.859, 0.754, 0.875, and 0.796 (all P<0.05), respectively. The predicted critical values for LVT formation were 3.571, 121.761, 45.215 mg/L, 415.196 pg/ml, 51.271%, and 43.364 mm, respectively; The results of multivariate analysis showed that PLR≥121.761, CRP≥45.215 mg/L, BNP≥415.196 pg/ml, LVEF≤51.271%, and LVDD≥43.364 mm were independent risk factors for LVT formation after acute myocardial infarction (all P<0.05). Conclusions:PLR, CRP, BNP, LVEF, and LVDD are independent risk factors for LVT formation after acute myocardial infarction.

Objective To investigate the role of fibroblast growth factor-23 (FGF23) in secondary hyperparathyroidism (SHPT). Methods (1)Serum FGF23 and intact parathyroid hormone (iPTH)from 38 maintenance hemodialysis (MHD) patients were measured by ELISA and chemiluminescence enzyme immunoassay respectively.(2) Parathyroid cells from six SHPT patients underwent parathyroidectomy with forearm autotrlansplantation were cultured for 24 h,then were induced by 0.1 mg/L FGF23.The supernatant was collected at 0.6,12,24 and 48 h respectively. The concentration of iPTH was measured by chemiluminescence enzyme immunoassay. (3)Protein expression of Klotho,FGFR1,FGFR3,GATA-3 and PCNA in parathyroid tissue from 33 SHPT eases and 3 healthy people were detected by immunohistochemistry SP and PV methods respectively. Positive cell rate and absorbance were calculated. Results (1) Serum FGF23 [(3901.85±2618.11) ng/L] was positively correlated with serum iPTH [(460.00±489.77) ng/L] in MHD patients. (2) 0.1 mg/L FGF23 suppressed iPTH secretion of parathyroid cells only at 24 h time point in vitro (P<0.05). (3) Expression of GATA-3, FGFR3, Klotho and PCNA was significantly increased and FGFRl was signiticantly decreased in parathyroid tissue of SHPT-patients as compared to healthy people. (4) Positive cell rate of GATA-3 was positively correlated with iPTH (r~2=0.1901, P=0.0425) and PCNA (r~2=0.2584, P=0.0025). Klotho was positively correlated with FGFRI and FGFR3 (r~2=0.2046, P=0.0082;r~2=0.2833, P=0.0014). PCNA was negatively correlated with FGFR1 (r~2=0.1292, P=0.0399) and positively correlated with FGFR3 (r~2=0.1226, P=0.0457). FGFR1 was negatively correlated with serum phosphate (r~2=0.2329, P=0.0044) and positively correlated with serum calcium (r~2=0.1422, P=0.0305). Conclusions FGF23 level is positively correlated with iPTH level in MHD patients. FGF23 can inhibit iPTH secretion of parathyroid cells in a weak and short way, which may be associated with the proliferation of GATA-3 positive cells and parathyroid cells, the up-regulation of FGFR3 and the down-regulation of FGFR1 expression.

Objective To investigate the changes of the morphology,structure and biological characters of mutated Candida and through its genetic characteristics,research and reveal the mechanism of the variation at the molecular level.Methods Used different nutritional conditions,different growth conditions and different azole antifungal agents to induce mutation of the standard strains of Candida albicans.In clinical study,Candida mutant strains was isolated from vaginal secretions,pleu-ral effusion and gastric juice samples in patients of poor effect with Antifungal therapy,and studied on the morphological characteristics,and the nuclear structure,the biochemical reaction,the drug resistance,the bacterial composition and the ge-netic characteristics of above variants,etc.Results Mycelial?morphology:Candida were prone to mutation like bacteria, mutant bacteria could show G+ Aureus shape,G+ Bacillus,G+ long filamentous,G- Aureus shape,G- Bacillus and G- long filamentous;Nuclear structure:Candida mutant strains changed like prokaryotes under the electron microscope because it lost the original structure of eukaryotic cells.Biochemical reaction:there were 5 different items in 20 biochemical test ob-served.Drug sensitivity test:Candida mutated to antifungal drugs being originally sensitive was completely resistant,sensi-tive and resistant originally was completely sensitive,and the same as ordinary bacteria resistant.The cell component chan-ges:there was significantly different in Candida variant strain and the atavism of variant strain identified by mass spectrome-try.The most conservative fungalgene expression:Candida mutated had conservative gene expression of eukaryotes.It could be demonstrated that oidiomycetes mutant strains like bacterial morphology with prokaryotic cell biological characteristics was derived from Candida with eukaryotic cells.Conclusion Candida was prone to variation like bacterial morphology.The biological characteristics of mutant resembled prokaryote.There was a qualitative change among the standard strains of Can-dida albicans,mutant strains of oidiomycetes like bacterial morphology and the atavism of variant strain with clear genetic re-lationship under the electron microscope in the form of nuclear matter.The study on biological evolution,especially contact in prokaryotic cells and eukaryotic evolution has very important significance.