Objective To determine the renal function compromised in patients after ST-segment elevation myocardial infarction (STEMI) with left ventricular aneurysms (LVA) by measurement of serum cystatin C (Cy-C) concentrations and Cy-C-based eGFR.Methods A total of 355 patients admitted from January 2011 to December 2012 could be categorized into group A (STEMI without LVA,n =183) and group B (STEMI with LVA,n =172) confirmed by echocardiography in 24 hour after admission.Of them,273 patients were treated with primary percutaneous coronary intervention (PCI) after admission and included in the analysis.Cy-C-based estimated glomerular filtration rate (eGFR) and creatinine (Cr)-based eGFR were calculated for evaluating cardiac function in tern to assess the magnitude of compromised renal function.The correlation between magnitude of compromised renal function and in-hospital mortality was analyzed.Distributions of categorical variables were compared using the chi-square test.Continuous variables were compared by one-way ANOVA with the Bonferroni test.Results The in-hospital mortality rate of whole patient cohort was 14.0％.Mortality in the group B was 18.6％ and in the group A was 9.8％ (P ＜ 0.01).With multivariable regression analysis,the compromised renal function was found when the Cr-based eGFR was ＜60 mL/ (min · 1.73 m2) or Cy-C-based eGFR was ＜ 60 mL/min/1.73m2 which were independently associated with in-hospital mortality (OR 0.13,95％ CI 0.02-0.7,P =0.02 ; OR 0.01,95％CI 0.003-0.05,P ＜ 0.01).Compared with the acute myocardium infarction (AMI) patients with chronic kidney disease (CKD) stage 2,the Cy-C based eGFR was greater in the AMI patients with LVA group (P ＜ 0.05),and compared with AMI with CKD stages 3 or CKD 3-5,this difference was also significant (P ＜ 0.01).Conclusions Renal dysfunction was an independent predictor of in-hospital mortality in patients with STEMI,especially in patients with LVA.Cy-C and Cy-C based eGFR were more sensitive to judge renal dysfunction in STEMI patients with LVA.

Objective To analyze and summarize the clinical-pathological features,immunophenotype and prognosis of the lymphoepithelioma-like gastric carcinoma (LELGC).Methods The clinical,radiographic and histological data of four patients with LELGC were retrospectively analyzed.The expression of cytokeratin (CK),CD20,CD3,CD4,CD8,E-cadherin,β-catenin,bcl-2,p16,p53,p63,c-erbB-2,cyclin D1,Ki67 and DNA methyl-transferase 1 (DNMT1) in tumor was detected by Epstein-Barr virus-encoded small RNA (EBER) in situ hybridization and immunohistochemical methods.Results The size of four tumor was 1.8 cm× 1.6 cm,1.5 cm× 2.0 cm,2.5 cm× 2.0 cm and 4.0 cm× 2.5 cm.Under light microscope,tumor cells appeared like cords,small lumps or scattered single infiltration with vacuolized nucleus; clear nucleoli and obvious interstitial lymphocytic infiltration.The results of immunohistochemical examination indicated that in four tumors CK was positive in membrane of all the tumor cells,while EBER was positive in all cell nucleus.The number of lymphocytes with CD3 positive was over those with CD20 positive,which was mainly CD8 positive lymphocytes.The percentage of E cadherin and β-catenin positive in the cell membrane of four tumors was between 10 ％ and 90 ％,and two cases with β-catenin positive in cytoplasm.The expressions of DNMT1,cyclin D1 and bcl-2 were all positive,while p16 and c-erbB-2 were all negative.The expression of p63 was positive in only one case,and p53 was negative in one case.The percentage of Ki67 positive was 40％,15％,60％ and 40％,respectively.Conclusions LELGC is a rare neoplasm with better prognosis.The features of clinical pathology and immunohistology may help to make a correct diagnosis.

Objective To investigate the efficacy and feasibility of extra-peritoneal larparoscopic radical prostatectomy (eLRP) in the treatment of patients with high-risk prostate cancer (HRPC).Methods From February 2009 to December 2013,121 patients,who were diagnosed as HRPC according to the D'Amico definition,were received eLRP.The mean age was 70 years old (range 54 ～ 82 years old).The mean PSA level was 25.45 (range 2.40 ～ 111.31) μg/L and mean Gleason score was 8 (range 6 ～ 10).The classification of clinic stage in this study included 52 cases in cT1-cT2b,58 cases in cT2c,8 cases in cT3a,and 3 cases incT3b,respectively.The perioperative data were collected,including operative time,blood loss,intraoperative complications,urine leakage,lymph leakage,incontinent ability,erectile function and changing of PSA level.Results All the operations were successfully performed.The mean operative time was 165 minutes (range 105 ～341min),the average blood loss was 150 ml(range 50 ～ 1500ml).The intraoperative complications included hemorrhage in 4 cases and intra-operative obturator nerve injury in 3 cases.The mean duration of intestinal function recovery was 35h (range 24 ～72h) The mean interval of catheter indwelling was 9 days (range 7 ～14 days).The anastomotic leakage was found in 12 cases,including 1 day after surgery in 5 cases,2 days after surgery in 3 cases,3 days after surgery in 2 cases,4 day after surgery in 1 case and 5 day after surgery in 1 case.The anastomotic stricture in 3 cases within 2 to 4 months after operation,which the symptom improved after urethral dilation in 2 cases and urethrotomy in 1 case.Deep vein thrombosis was noticed in 1 case 5 days after the procedure.And lymphatic fistula was recorded in 1 case after the operation.Positive surgical margin,seminal vesicle invasion,and positive iliac vessel lymph node were found in 18,21,and 9 patients,respectively.The mean hospitalization duration was 10 days (range 5 ～ 22 d).Of the 107 patients followed-up,Ninety-six patients were continent in 1 year,except other 11 patients.Nerve sparing procedure was performed in 51 patients,and thirty-three of them were potent.The mean PSA level was 0.14 μg/L (range 0 ～8.75 μg/L) six weeks after the surgey.Fourty-eight patients had biochemical recurrence with 5 ～36 months followed-up,mean 18 months.Conclusions Extraperitoneal LRP is an efficacious approach for patients with high-risk prostate cancer.

Objective To develop a chemiluminescence ( CL ) imaging DNA microarray method for simultaneous detection of seven rickettsiae.Methods Primers and probes were designed based on the specific sequence of seven rickettsia genomes.The probes were immobilized on the aldehyde modified glass surface to prepare DNA microarray for rickettsiae.The nucleic acids of the selected rickettsiae were amplified and labelled by multiplex PCR method, and then hybridized with microarray that was scanned after washing and chemiluminescence coloration, before the results were analyzed.Facilitated by the optimization of the multiplex PCR system, hybridization, and chemiluminescence imagination, we evaluated the specificity,sensitivity and reproducibility of the chip.The serial diluted nucleic acid of Rickettsia mooseri was detected using microarray and real-time PCR approach to compare the sensitivity of these two methods.Double-blind simulated samples were prepared to further evaluate the accuracy of the detection methods.Results One universal primer, four specific primers, one universal probe, and nine specific probes were selected.This DNA microarray demonstrated high specificity and sensitivity.The detection sensitivity of plasmid DNA and double-blind simulated sample DNA was 1.5 ×102 -3 ×103 copies per reaction and 103 -104 copies/μl.The detection results of real-time PCR method was consistent with the microarray, and the microarray possessed 10 fold lower detection sensitivities than the real-time PCR method.The coincidence rate of double-blind simulated sample detection was 100%.Conclusion A chemiluminescence imaging DNA microarray method for simultaneous detection of seven rickettsiae is established successfully,which can serve as a new high throuthput detection method for clinical diagnosis and epidemiological investigation of rickettsiae.

Objective To develop a chemiluminescence imaging DNA microarray method for simultaneous,quick and accurate detection of serotypes of human adenovirus (HAdV ),namely,HAdV3,HAdV7,HAdV11,HAdV14 and HAdV55.Methods Based on the specific gene sequences in the conserved region of adenovirus from GenBank, oligonucleotide primers and probes were designed and synthesized to prepare the oligonucleotide microarray.The specific genomic sequences were amplified by multiplex PCR method.The multiplex PCR amplification products were hybridized with the specific probes of microarray that was scanned after washing and chemiluminescenceb before the result was analyzed.After optimization of the multiple PCR system,hybridization reactions and conditions of chemiluminescence,the specificity,sensitivity and reproducibility of the chip were evaluated.Results The microarray displayed high sensitivity, specificity and reproducibility.The minimum detection limit of plasmidg DNA was 3 ×103 copies/reaction.The microarray detection results of 38 clinical samples were approximately consistent with those using the direct sequencing method(37 /38).Conclusion A chemiluminescence imaging DNA microarray method for quick,sensitive and specific detection of five serotypes of HAdV is established,which can provide a new means for detecting serotypes of HAdV.

Objective To develop a chemiluminescence imaging DNA microarray method for simultaneous,fast and accurate detection of nine rash-and fever-causing pathogens,namely,Measles virus,Rubella virus,Enterovirus type 71, Varicella zoster virus,Dengue fever virus,Human small FDNA virus B19,Coxsackie virus type A16,A-βStreptococcus pyogenes (hemolytic streptococcus)and Salmonella typhi.Methods Primers and probes were designed based on the specific sequence in the conserved region of genomes of the nine pathogens.The nucleic acids of the nine pathogens were amplified and labelled by multiplex PCR method.The multiplex PCR amplification products were hybridized with specific probes of microarray that was scanned after washing and chemiluminescence coloration to identify the nine pathogens.After the optimization of the multiplex PCR system,hybridization and chemiluminescence imaging,the specificity,sensitivity and reproducibility of the chip were evaluated.The serial diluted nucleic acid of Enterovirus type 71 was detected using microarray and real-time PCR approach to compare the sensitivity of these two methods.Results Nine specific primers and eleven specific probes were selected.The microarray demonstrated high sensitivity and specificity.The minimum detection limit of plasmid DNA and in vitro transcribed RNAs was 3 ×103 copies per reaction.The detection sensitivity of this microarray was 10 percent of that by the real-time PCR method.The rate of sensitivity and specificity of clinical sample detection was 95% and 85.7% respectively,and the rate of accuracy was 93.2%.Conclusion A chemiluminescence imaging DNA microarray method for simultaneous,fast and accurate detection of nine pathogens that cause rash and fever illnesses is established successfully,which can serve as a new high throuthput screening method for clinical diagnosis and epidemiological investigation of rash and fever illnesses.

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.

Objective : To investigate the status and influencing factors of home blood pressure monitoring (HBPM) among hypertensive patients, so as to provide the evidence for building and maintaining HBPM among hypertensive patients. Methods: Hypertensive patients hospitalized in the First Affiliated Hospital of Guangdong Pharmaceutical University were sampled from July to December 2022, and subjects' general data, HBPM behaviors and cognition were collected using self-designed questionnaires. In addition, factors affecting regular HBPM were identified using a multivariable logistic regression model. Results: Totally 440 questionnaires were allocated, and 422 valid questionnaires were recovered, with an effective recovery rate of 95.91%. The respondents included 234 males (55.45%) and 188 females (44.55%), and had a median age of 70 (interquartile range, 15) years. There were 239 respondents with regular HBPM (56.64%). Of 422 respondents, 68 had good cognition of blood pressure monitoring (16.11%), and 79.15% did not think regular changes of their blood pressure within 24 hours, while 72.04% did not think it necessary to measure blood pressure more than twice a day. Multivariable logistic regression analysis showed that recommendation of regular blood pressure monitoring by healthcare workers (OR=4.341, 95%CI: 2.493-7.560), number of blood pressure measurements according to real circumstances (OR=3.858, 95%CI: 1.358-10.961), recording of measurement results (OR=4.945, 95%CI: 1.863-13.129), provision of data to doctors at admission (OR=2.023, 95%CI: 1.173-3.488) and good cognition of blood pressure monitoring (good, OR=11.939, 95%CI: 3.972-35.886; general, OR=9.681, 95%CI: 5.157-18.172) resulted in a high possibility of regular HBPM among respondents. Conclusion Hypertensive patients with recommendation of regular blood pressure monitoring by healthcare workers, number of blood pressure measurements according to real conditions, recording of blood pressure measurement results, provision of blood pressure to doctors at admission and good cognition of blood pressure monitoring are more likely to have regular HBPM.

Objective: To observe hypoglycemic effects of Yunu Decoction, Zuogui Pill and Shenqi Pill, three compound traditional Chinese herbal medicines, in treatment of diabetes mellitus induced by alloxan in rats, and to compare the therapeutic effects among the three recipes for nourishing yin, clearing away heat, and nourishing yin and warming yang. Methods: Diabetes mellitus was induced in rats with alloxan at a dose of 60 mg/kg via tail vain injection. The diabetic rats were randomly divided into four groups: alloxan model group, Yunu Decoction-treated group, Zuogui Pill-treated group and Shenqi Pill-treated group. Rats in the three recipe groups were administered intragastrically with water extraction of Yunu Decoction, Zuogui Pill, and Shenqi Pill accordingly for 10 days. Then the level of blood glucose was measured by glucose oxidase method and the glucose tolerance was determined. Results: Compared with the normal rats, blood glucose level in the alloxan model group was obviously increased (P<0.05). Glucose levels in the three recipe groups were obviously decreased as compared with the alloxan model group (P<0.05), and glucose level in the Yunu Decoction-treated group after treatment was significant lower than before treatment (P<0.05). The glucose tolerance test indicated that rats in the alloxan model and three recipe groups revealed impaired glucose tolerance as compared with the normal rats, and there were no significant differences between the alloxan model group and the three recipe groups. Conclusion: Yunu Decoction, Zuogui Pill and Shenqi Pill can effectively decrease the glucose level of the rats with diabetes mellitus induced by alloxan, and Yunu Decoction showed the best therapeutic effects. The glucose tolerance test shows that the three recipes cannot correct the abnormal metabolism of glucose.

Objective To develop a detection method based on the technology of gene chips which can quickly distinguish genes of Enterococcus faecalis, E.faecium and vancomycin resistance.Methods Based on the specific gene ( ddl) sequences of two types of Enterococcus from GenBank, oligonucleotide probes which could detect and distinguish special genes and drug resistance genes ( vanA,vanB) of Enterococcus were designed and compounded.Then,the probes were dotted to modified slide.The target DNA fragments of vancomycin-resistant Enterococcus ( VRE) were labeled with biotin by multiple PCR amplification, and then hybridized with oligonucleotide probes on slide.The results were analyzed by portable imager.The multiple PCR system, hybridization reaction and condition of the chemiluminescence method were optimized before the specificity, sensitivity and reproducibility of the chip were evaluated.Results One universal primer, four specific primers, one universal probe and four specific probes were selected.This gene chip was demonstrated of high specificity and repeatability.The detection sensitivity was 103 CFU/ml.The gene chip detection results of 10 clinical samples were basically consistent with the drug sensitivity test ( 8/10 ) .Conclusion A gene chip technique for the detection of VRE is established successfully.It is possible to distinguish the type of VRE and detect the genetic phenotypes of drug resistance by gene chip technique.