Objective To investigate the relationship between the serum dehydroepiandrosterone sulfate ( DHEAS) level and bone mineral density ( BMD) in aged women. Methods Two hundred and seven elderly women aged 60-84 years were enrolled in the study. Acquisition histories, including age, body mass index, and blood pressure were recorded. Serum steroid hormones ( DHEAS, testosterone, estradiol, and cortisol) and bone metabolic markers:β-C-terminal telopeptide of type Ⅰ collagen (β-CTx ) , osteocalcin, and total procollagen type Ⅰ N propeptide ( TPINP) were determined. The BMD was also determined. The enrolled subjects were divided into 3 groups according to T values(T>-1. 0 s、-2. 5 s

Objective:To separate chemical and active constituents from the stem bark of Albiza julibrissin . Methods:Chromatography and spectral methods were used. Results:3 O ? D xylopyranosyl (1→2) ? L arabinopyranosyl (1→6) ? D glucopyranosyl 21 O {(6 S) 2 trans 2 hydroxymethyl 6 methyl 6 O [3 O (6 S ) 2 trans 2 hydroxymethyl 6 methyl 6 hydroxy 2,7 octadienoyl) ? D xylopyranosyl] 2,7 octadienoyl} acacic acid 28 O ? D glucopyranosyl (1→3) [? L arabinofuranosyl (1→4)] ? L rhamnopyranosyl (1→2) ? D glucopyranosyl ester (1) was separated and identified. Conclusion: Compound 1 is a new saponin named as Julibroside J 24 .

Objective To determine whether the single nucleotide polymorphisms (SNPs) rs231775 and rs3087243 of the cytotoxic T lymphocyte antigen 4 (CTLA-4) gene are associated with susceptibility to Graves' disease (GD) in Chinese Han population.Methods Patients were enrolled from outpatient department and wards.Blood samples from each subject were collected to extract DNA,and the genotypes were determined by TagMan-MGB probe.Results The frequencies of allele G (OR =1.244,95％ CI 1.124-1.377,P＜0.01) and genotype GG (55.3 ％ vs 49.1％,OR =1.279,95 ％ CI 1.126-1.454,P＜0.01) of rs231775 in GD group were higher than those in control group.The frequencies of allele G (OR =1.303,95％ CI 1.166-1.457,P＜0.01) and genotype GG (76.8％ vs 71.8％,OR=1.302,95％ CI 1.143-1.484,P＜0.01) of rs3087243 in GD group were also higher.Conclusion GG genotypes in rs231775 and rs3087243 of CTLA-4 gene are related to the high risk of GD.

Purpose To investigate the application value of 18F-FDG PET/CT in the diagnosis and staging of tongue cancer,in order to improve the accuracy of preoperative staging.Materials and Methods The 18F-FDG PET/CT findings of 52 patients with pathologically confirmed tongue cancer were retrospectively analyzed.The tumor location,size,FDG metabolic characteristics and tumor staging were observed,and compared with postoperative pathology.Results PET/CT showed that most patients were at middle or late stage when initially diagnosed (28/52).The lesions were mostly located on middle or middle-back region of tongues,and the average SUVmax was 6.81 ± 3.81.The sensitivity of PET/CT diagnosing tongue cancer was 94.2％.There was no significant difference in SUVmax between high,medium-high and medium differentiated tongue cancer primary lesions (P＞0.05).The SUVmax of tongue cancer at stage Ⅲ and Ⅳ was obviously higher than that at stage Ⅰ and Ⅱ,and the difference was statistically significant (P＜0.008).The diagnose and staging of tongue cancer using preoperative PET/CT and postoperative pathology were in excellent consistence (Kappa=0.859,P＜0.01).The staging accuracy reached 90.4％ (47/52).Conclusion Higher SUVmax value indicates worse tongue cancer staging,but it is of little significance in predicting differentiation.PET/CT can provide an objective imaging basis for preoperative diagnosis and accurate staging of tongue cancer.

Objective To explore the role of dehydroepiandrosterone ( DHEA) in fatty acid metabolism in the liver of obese rats induced by high fat diet. Methods Twenty-seven SD rats were divided into control group, high-fat diet group ( HF group ) , and high-fat diet combined with DHEA treatment group ( DHEA group ) . The serum glucose and insulin levels were determined, while the free fatty acids ( FFA ) level was measured by liquid chromatography-tandem mass spectrometry (LC-MS). The mRNA expressions of hormone-sensitive lipase (HSL), lipoprotein lipase ( LPL ) , acetyl-CoA carboxylase ( ACC ) , fatty acid synthase ( FAS ) , carnitine acyl-CoA transferase (CPT), and stearoyl-CoA desaturase 1 ( SCD1) were measured by real-time PCR. Finally, oil red O staining was also used to observe the changes in hepatic lipid deposition. Results ( 1) The content of hepatic FFA in HF group was significantly higher than that in control group ( P<0.05) , but decreased in DHEA group compared with that in HF group (P<0.05). (2) Compared with HF group, the mRNA expressions of HSL, LPL, ACC, FAS in DHEA group were significantly lower while the mRNA expressions of CPT1, CPT2, and SCD1 were significantly higher ( all P<0.05). (3) Oil-red O staining showed that the liver lipid content in high fat diet-fed rats were significantly increased compared with that in the chow diet group( P<0.05) , but there was no difference between HF and DHEA groups. However, the structural damage of HF group was more evident compared with DHEA group. Conclusion DHEA may reduce the content of hepatic FFA in high-fat diet-induced obese rats via inhibiting the production of FFA and promoting theβ-oxidation of FFA.

Objective To investigate the target blood pressure level of restrictive fluid resuscitation in patients with traumatic hemorrhagic shock. Methods Sixty patients with traumatic hemorrhagic shock admitted to the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2018 were enrolled. All patients were resuscitated with sodium acetate ringer solution after admission. According to the difference of mean arterial pressure (MAP) target, the patients were divided into low MAP (60 mmHg ≤ MAP < 65 mmHg, 1 mmHg = 0.133 kPa), middle MAP (65 mmHg ≤ MAP < 70 mmHg) and high MAP (70 mmHg ≤ MAP < 75 mmHg) groups by random number table using the admission order with 20 patients in each group. Those who failed to reach the target MAP after 30-minute resuscitation were excluded and supplementary cases were deferred. The restrictive fluid resuscitation phase was divided into three phases: before fluid resuscitation, liquid resuscitation for 30 minutes and 60 minutes. The most suitable resuscitation blood pressure level was further speculated by monitoring the inflammatory markers and hemodynamics in different periods in each group of patients. Pearson correlation analysis was used to detect the correlation of variables. Results Before fluid resuscitation, there was no significant difference in hemodynamics or expressions of serum cytokines among the three groups. Three groups of patients were resuscitated for 30 minutes to achieve the target blood pressure level and maintain 30 minutes. With the prolongation of fluid resuscitation time, the central venous pressure (CVP), cardiac output (CO) and cardiac index (CI) were increased slowly in the three groups, and reached a steady state at about 30 minutes after resuscitation, especially in the high MAP group and the middle MAP group. The expressions of serum inflammatory factors in the three groups were gradually increased with the prolongation of fluid resuscitation time. Compared with the low MAP group and the high MAP group, after 30 minutes of resuscitation the middle MAP group was superior to the other two groups in inhibiting the expressions of pro-inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and promoting anti-inflammatory factors IL-10 [TNF-α mRNA (2-ΔΔCt):0.21±0.13 vs. 0.69±0.34, 0.57±0.35; IL-6 mRNA (2-ΔΔCt): 0.35±0.31 vs. 0.72±0.39, 0.59±0.42; IL-10 mRNA (2-ΔΔCt): 1.25±0.81 vs. 0.61±0.46, 0.82±0.53; all P < 0.05], but there was no significant difference in promoting the expression of IL-4 mRNA among three groups. At 60 minutes of resuscitation, compared with the low MAP group and the high MAP group, the middle MAP group could significantly inhibit the expressions of TNF-α, IL-6 and promote IL-10 [TNF-α mRNA (2-ΔΔCt): 0.72±0.35 vs. 1.05±0.54, 1.03±0.49; IL-6 mRNA (2-ΔΔCt): 0.57±0.50 vs. 1.27±0.72, 1.01±0.64; IL-10 mRNA (2-ΔΔCt): 1.41±0.90 vs. 0.81±0.48, 0.94±0.61; all P < 0.05]. Compared with the high MAP group, the middle MAP group had significant differences in promoting the expression of IL-4 mRNA (2-ΔΔCt: 1.32±0.62 vs. 0.91±0.60, P < 0.05). There was no significant difference in serum cytokine expressions at different time points of resuscitation between the low MAP group and the high MAP group (all P > 0.05). Correlation analysis showed that there was a strong linear correlation between MAP and mRNA expressions of TNF-α, IL-6, IL-10 in the middle MAP group (r value was 0.766, 0.719, 0.692, respectively, all P < 0.01), but had no correlation with IL-4 (r = 0.361, P = 0.059). Fitting linear regression analysis showed an increase in 1 mmHg per MAP, the expression of TNF-α mRNA increased by 0.027 [95% confidence interval (95%CI) = 0.023-0.031, P < 0.001], IL-6 mRNA increased by 0.021 (95%CI = 0.017-0.024, P < 0.001), and IL-10 mRNA increased by 0.049 (95%CI = 0.041-0.058, P < 0.001). Conclusions When patients with traumatic hemorrhagic shock received restrict fluid resuscitation at MAP of 65-70 mmHg, the effect of reducing systemic inflammatory response and improving hemodynamics is better than the target MAP at 60-65 mmHg or 70-75 mmHg. It is suggested that 65-70 mmHg may be an ideal target MAP level for restrictive fluid resuscitation.

Objective To study the clinical effect of evidence-based prevention strategies of ventilator-associated pneumonia (VAP) in newborns with endotracheal intubation in neonatal intensive care unit (NICU).Method A retrospective analysis was carried out in neonates undergoing mechanical ventilation,who were admitted to the NICU of the hospital from 2016 to 2017.Intubated newborns from January 2016 to December 2016 were conducted with traditional method of preventing VAP and included as control group.While intubated newborns admitted from January 2017 to December 2017 with newly developed evidence-based prevention strategy for VAP were included as observation group.The positive rates of culture from swab or sputum or endotracheal intubation tube ends obtained within 48 hours after intubation and 48 hours after extubation were compared between groups.The neonates whose swab or sputum culture was negative before intubation were included.The positive rate was presented as the number of positive cases/1 000 intubation days.Result A total of 1 221 intubated infants were included,with 632 cases in the control group which were intubated 798 times,and 589 cases in the observation group which were intubated 720 times.The gestational age and birth weight of the observation group was lower than the control group.The rate of extremely low birth weight infant of the observation group was higher than that of the control group.The mechanical ventilation days were also longer in the observation group.The differences were statistically significant (P ＜ 0.05).In the control group,the number of positive cases was 112 and the total intubation days were 3 079 days,the positive rate was 36.4 cases/1 000 intubation days.In the observation group,the number of positive cases was 72 and the total intuhation days were 3 475 days,the positive rate was 20.7 cases/1 000 intubation days.The positive rate of observation group was lower than the control group,the differences was statistically significant (x2 =4.060,P =0.044).Conclusion Evidence-based neonatal VAP bundle can reduce the invasion of respiratory pathogenic bacteria in NICU.In the future work of NICU nursing,we should use bundle strategy to care for babies more and more,and the bundle should be supported by evidence.

Objective RY-15, a specific agonist of Sphingosine 1-phosphate Receptor 3, was synthesized for investigating the function and mechanism of S1PR3 in bacterial clearance. Methods Measure the ability of RY-15 with FITC to enter the THP-1 cell after coculture for 5 min, 10 min, 20 min, 30 min through confocal microscopy. The function of GY-5 and RY-15 in bacterial clearance was observed by gentamicin protection test. The phosphorylation level of ERK and p-ERK in THP-1 cell was detected by Western Blot after GY-5 and RY-15 stimulation for different times. Results According to confocal microscopy, RY-15 started to enter the THP-1 cell after stimulating for 10 min and the effect of entering cell was very obvious after stimulating for 30 min. Compared to GY-5 group, live bacteria in the macrophage were largely decreased in the RY-15 group( P<0.05). Conmpared to GY-5 group, the p-ERK level raised largely at different poins. Conclusions RY-15, a specific agonist of Sphingosine 1-phosphate Receptor 3, can promote bacterial clearance through entering cell and the phosphorylation level of ERK is a possible mechanism.

BACKGROUNDN-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury. However, it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.

METHODSIn a community based study, levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years. The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml. The association of hs-cTnT levels and NT-proBNP levels was analyzed.

RESULTSWhen the subjects with undetectable (<0.003 ng/ml), intermediate (0.003-0.014 ng/ml), and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r = 0.175, P < 0.001), a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β = -0.206, P < 0.001; β = -0.118, P < 0.001, respectively). In multivariable analyses, older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β = 0.341, P < 0.001; β = 0.143, P < 0.001, respectively), and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels. When the subjects with normal or elevated NT-proBNP were analyzed separately, the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group, whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β = 0.399, P < 0.01).

CONCLUSIONSIn this community based population, NT-proBNP elevation was common. In addition to female gender and older age, subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

Biomarkers ; analysis ; Female ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Troponin T ; blood