A total of 175 patients with type 2 diabetes mellitus (T2DM) were composed of 69 with normoalbuminuria,60 with microalbuminuria,and 46 with macroalbuminuria.The control group consisted of 64 healthy individuals.Serum YKL-40 levels were determined with ELISA method and related metabolic data were collected.Serum YKL-40 levels were significantly higher in T2DM group than in control group(P＜0.01).Significant correlations of YKL-40 were found with the ratio of microalbuminuria to uric creatinine(r=0.677,P＜0.01),HbA1C (r =0.562,P＜0.01),systolic blood pressure (r =0.372,P =0.001),HOMA-IR (r =0.460,P =0.001),low density lipoprotein-cholesterol (r=0.304,P=0.012),age(r=0.260,P=0.015),blood uric acid (r=0.329,P=0.018),and high density lipoprotein-cholesterol (r=-0.247,P=0.032).YKL-40 may play a role in the occurrence and development of diabetic nephropathy.

Objective To survey the prevalence of the pulmonary function test in Liaoning province and investigate the cognition of chronic obstructive pulmonary disease（COPD）patients to the test.Methods One hundred and twenty nine comprehensive hospitals of Grade Three and Grade Two have been included to survey the prevalence of the pulmonary function test by telephone.A cross-sectional study was carried out among 206 COPD outpatients to investigate their cognition to the pulmonary function test.Results The total prevalence of the hospitals with the equipment and ability to do pulmonary function tests was only 51.2%.The prevalence of the hospitals of Grade Three（79.4%）was higher than that of the hospitals of Grade Two（24.2%）.In 206 COPD patients,100 cases（48.5%）had been provided with pulmonary function test,53 cases（25.73%）had been diagnosed as COPD in the past.The patients diagnosed as COPD accounted for 33.8% of all chronic bronchitis patients surveyed.The span during the diagnosis of chronic bronchitis and the definitive diagnosis of COPD was 11.79±10.96 years.Conclusion The prevalence of pulmonary function test in Liaoning province is relatively low,especially in the comprehensive hospitals of Grade Two.Few chronic bronchitis patients received pulmonary function test.Thus the time span from the diagnosis of chronic bronchitis to definitive diagnosis of COPD is long as well.

Objective To assess the application of the phage amplified biologically assay (PhaB) in the detection of the mycobacterium tuberculosis (TB) in sputum.Methods To determine the TB patients in the 53 suspected patients we detected 53 sputum samples by PhaB method,BACTEC MGIT960 rapid culture method,and conventional methods (direct auramine smear microscopy and concentrated auramine smear microscopy) individually.Results TB positive samples detected by PhaB,BACTEC MGIT960 rapid culture,direct auramine smear microscopy and concentrated auramine smear microscopy were 24,22,11 and 17 respectively.Thus the sensitivity,specificity,positive predictive value and negative predictive value were 86.4%,83.9%,79.2% and 89.7%,when the PhaB is combined with concentrated auramine smear microscopy,the sensitivity,specificity,positive predictive value and negative predictive value were increased up to 90.9%,83.9%,80.8% and 92.9%.Conclusion PhaB method is a simple and rapid method to detect the Mycobacterium Tuberculosis in sputum with a relatively higher sensitivity and specificity than the conventional methods.When combined with concentrated auramine smear microscopy,PhaB method is even more sensitive.Thus the PhaB method is accessible and applicable in the clinical use of the TB detection.

Objective To find out the relationship between the serum resistin levels and obesity, insulin sensitivity, blood-glucose as well as blood lipid in the elderly with diabetes. Methods Senile patients (51) suffering from type 2 diabetes and non-diabetic controls(42) were selected. Their serum resistin levels after an overnight fasting were measured by competitive ELISA. Other data including fasting blood-glucose, insulin, blood lipid, insulin sensitivity index, waistline, hipline and WHR were measured. Results (1)In non-diabetic controls, fasting resistin level was significantly higher in obese subjects than that in those persons with normal weight (P

Objective To investigate changes of serum silent information regulator 1 (Sirt1) and inflammatory cytokines in type 2 diabetes patients with different stages of diabetic nephropathy.To explore the relationship between serum Sirt1 level and inflammatory cytokines in type 2 diabetic patients with different urinary albumin excretion rates.Methods A total of 436 cases with type 2 diabetes were divided into three groups:normoalbuminuric [D1,n =168],microalbuminuric [D2;n =152],and macroalbuminuric [D3,n =116].Serum Sirt1,hypoxia-inducible factor-1α (HIF-1α),early growth response protein 1 (EGR1),insulin-like growth factors-Ⅰ (IGF-Ⅰ),and monocyte chemotactic protein-1 (MCP-1) were determined by enzyme-linked immunosorbent assay (ELISA).Results The levels of serum Sirt1 in type 2 diabetes patients were significantly lower than that in control group,and with the increase of urinary protein excretion rate,the levels of serum Sirt1 in group D1,D2 and D3 were decreased gradually (P ＜ 0.01).Compared to control,serum inflammatory cytokines (HIF-1α,EGR1,IGF-Ⅰ,and MCP-1) levels were significantly increased in type 2 diabetic patients and gradually increased in the patients of D1,D2 and D3 groups (P ＜0.01).Furthermore,Serum Sirt1 was negatively correlated with the levels of inflammatory cytokines.Age,duration,fasting blood glucose (FBG),fasting insulin (FINS),homeostasis model assessment insulin resistance index (HOMA-IR),glycosylated hemoglobin (HbA1c),low density lipoprotein (LDL),total cholesterol (TC),triglyceride (TG),serum creatinine (Scr),blood urea nitrogen (BUN),uric acid (UA),HIF-1α,EGR1,IGF-Ⅰ,and MCP-1 were positively correlated with Ln Koc of urinary albumin to creatinine ratio [Ln(ACR)] (P ＜ 0.05);and Sirt1 were negatively correlated with Ln(ACR)(P ＜ 0.01).HIF-1α,MCP-1,IGF-Ⅰ,duration,BUN,Sirt1,UA,LDL,and EGR1 were independent factors that significantly influenced Ln (ACR) (P ＜ 0.05).Conclusions Serum Sirt1 might be a new target for the treatment of diabetic nephropathy.Enhancing serum Sirt1 levels might have a role in delaying the progression of diabetic nephropathy.

The different levels and clinical significance of high sensitivity C reactive protein(hs-CRP) , tumor necrosis factor-a ( TNF-α) , erythrocyte sedimentation rate ( ESR) , and urinary monocyte chemoattractant protein-1 (uMCP-1) in 84 type 2 diabetic patients with different urine albumin excretion (UAE) were observed. The results indicated that the levels of hs-CRP,TNF-α,urinary MCP-1 ,and ESR in diabetic patients were significantly higher than those in control group,and the first three indexes increased with the levels of UAE. The results suggest that diabetic nephropathy seems to be correlated with inflammatory reactions.

Objective: Our aim was to evaluate effects of magnesium sulfate(MgSO4) on pulmonary hypertension in patients with chronic pulmonary heart disease(CPHD). Methods: Eight patients with CPHD undergone right-heart catheterization. The parameters of hemodynamics and arterial blood gases in patients were measured before and after MgSO4 intravenous infusion(2% MgSO4,40 mg/min). Results: Mean pulmonary artery pressure(mPAP), pulmonary vascular resistance(PVR),mean systemic artery pressure(mSAP), and total systemic vascular resistance(TSVR) significantly decreased(P＜0.05) at 30 minutes after MgSO4 infusion. The decreased percentage of mPAP and PVR at 60 minute after MgSO4 infusion was 13.37% and 18.70% respectively(P＜0.05), but mSAP and TPVR decreased only by 8.15% and 7.43% respectively. The decreased degree of mPAP and PVR at 60 minutes after MgSO4 infusion significantly correlated with mPAP(r=0.712, P＜0.05)and PVR(r=0.802, P＜0.01) before MgSO4 infusion. No unfavorable effect of MgSO4 on other parameters of hemodynamics and arterial blood gases was found. Conclusion: Magnesium sulfate can attenuate pulmonary hypertension in patients with CPHD but may cause transient systemic hypotension.

Objective To evaluate the value of fetal dual Doppler ultrasonography in the diagnosis of fetal arrhythmias.Methods 77 53 1 fetuses were examined by echocardiography.If fetal arrhythmias were found,information of pulsed wave Doppler signals in hepatic vein(HV) and descending aorta(DAo) using dual Doppler were collected simultaneously.Results On dual Doppler examination,13 1 of the fetuses showed signals of cardiac dysrhythmias,including 60 fetuses with irregular fetal heart rhythm but having normal heart rate,45 with tachyarrhythmias and 26 with bradyarrhythmias.Sixteen and 2 with tachy- or bradyarrhythmias fetuses complicated fetal malformation or severely maternal systemic diseases.Eighteen and 3 with tachy- or bradyarrhythmias fetuses revealed intrauterine death or intermediate pregnancy induction.The three main kinds of fetal arrhythmias had statistical differences in complicating with fetal malformation,maternal diseases,intrauterine fetal demise or intermediate pregnancy induction(all P <0.05).There was a significant difference in the accuracy of diagnosing rhythm abnormalities in the fetus between conventional ultrasonography and dual Doppler ultrasonography(k = 0.562,P < 0.05).Sixty cases of irregular fetal heart rhythm,42 cases of fetal tachyarrhythmias,and 8 cases of fetal bradyarrhythmias were changed to normal rhythm at the third-pregnancy or prenatal period through appropriate treatment.All surviving fetuses were examined by echocardiography within 3 days,without any combination of congenital heart disease,and 1 months after the delivery,the ECG were shown as sinus rhythm.Conclusions Dual Doppler ultrasonography is a precise and rapid method of assessing various types of fetal arrhythmias.Different types of fetal arrhythmias have different fetal prognosis.

Objective To investigate the effects of sensory cueing (SC) on unilateral spatial neglect after stroke.Methods Five stroke survivors with unilateral spatial neglect underwent a tailored sensory cueing treatment (wearing a sensory cueing device 3 hours a day, 5 days a week for 2 weeks) in addition to their conventional rehabilitation.Two weeks before and one day before the treatment, and then one day, two weeks and 4 weeks after the treatment, all five patients were assessed using the Hong Kong edition of the behavioral inattention test (BIT-C).Results No significant changes were identified in the average BIT-C ratings at the two time point before the intervention.However, the average score had increased significantly only one day after the start of the intervention, with further significant improvement at each of the succeeding 2 week intervals.The greatest improvement was in finishing cancellation tasks, and the most severely affected patient showed the greatest improvement.Conclusion Sensory cueing treatment may be useful and feasible in reducing unilateral spatial neglect for stroke survivors.However, randomized and controlled trials with larger samples are needed to further verify its effects.

[Summary] The aim of this study was to detect the levels of serum miR-130b expression in patients with type 2 diabetes mellitus and to analyze their correlation with diabetic renal damage. 243 patients with type 2 diabetes mellitus were divided into three groups according to urinary albumin/creatinine ratio ( UACR ): normoalbuminuria group (UACR<30 mg/g, n=103), microalbuminuria group (UACR 30-300 mg/g, n=86), and macroalbuminuria group(UACR>300 mg/g, n=54). The levels of serum miR-130b were validated by realtime polymerase chain reaction. Serum transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α(TNF-α) were determined by enzyme-linked immunosorbent assay ( ELISA) in all patients and 59 healthy volunteers. Compared with control group, the level of serum miR-130b in the type 2 diabetes mellitus group were significantly decreased, gradually with the increases of UACR. The level of serum miR-130b was inversely correlated with blood urea nitrogen ( r=-0. 295, P<0.05), serum creatinine(r=-0. 316, P<0. 05), UACR(r=-0. 463, P<0. 05), but positively related to the estimated glomerular filtration rate(r=0. 367, P<0. 01). The level of serum miR-130b was also negatively correlated to homeostasis model assessment for insulin resistance, triglyceride, low density lipoprotein-cholesterol, TNF-α, and TGF-β1 (r=-0. 257,-0. 345,-0. 242,-0. 562,-0. 622, all P<0. 01). The present study indicates that serum miR-130b might be a potential new biomarker for early diagnosis of diabetic nephropathy. Serum miR-130b might be involved in the pathogenesis of diabetic nephropathy.