The intima-media thickness (IMT) of common carotid artery was measured using B-mode ultrasonography in 55 patients with type 2 diabetes mellitus (DM) and 25 normal controls. The serum levels of soluble intercellular adhesion molecule-1 ( sICAM-1) and high-sensitivity C-reactive protein ( hs-CRP) were measured by ELISA and high-sensitivity particle enhanced immunonephelometry respectively. The results suggest that sICAM-1 and hs-CRP were risk factors of thickened IMT in type 2 DM.

Aim To investigate the role of NO/cGMP in the cardioprotective effects of intrathecal morphine preconditioning against myocardial ischemia-reperfu-sion injury in rats. Method 54 Male Sprague-Dawley Rats were used to establish the model of intrathecal catheter placement. The rats were randomly assigned to
9 groups. SHAM (sham group), CON (control, sa-line) , ITMP ( intrathecal morphine preconditioning, 3μg·kg-1 ) , L-NAME+ITMP ( NO synthetase inhibi-tor,L-NAME ) , ODQ + ITMP ( guanylate cyclase in-hibitor, ODQ ) , KT5823 + ITMP ( PKG inhibitor, KT5823),L-NAME,ODQ,KT5823,6ratsineach
group. ITMP were produced by three cycles of 5 min intrathecal injection of morphine and 5 min intermis-sion before myocardial ischemia, CON were achieved by intrathecal injection of saline in the same way, L-NAME+ITMP, ODQ +ITMP, KT5823 +ITMP were prepared by intrathecally administering L-NAME ( 30 nmol), ODQ(11 nmol) and KT5823(20 pmol) 10 minutes prior to ITMP respectively, L-NAME, ODQ, KT5823 worked as the control of inhibitors themselves respectively without ITMP. Subsequently, all rats were subjected to 30 min of left coronary artery occlusion followed by 2 h of reperfusion except the SHAM group. Myocardial infarct size, as a percentage of the AAR,
was determined by 2 , 3 , 5-triphenyltetrazolium stai-ning. Results Compared with CON, the volumes of IS and IS/AAR were reduced in ITMP ( P <0.01 );the protective effects of ITMP were abolished by pre-treatment with L-NAME, ODQ and KT5823 ( P <0.01 );Conclusions NO/cGMP might be involved in the cardioprotective effect of intrathecal morphine pre-conditioning against myocardial ischemia and reperfu-sion injury in rats.

Objective To study the association between serum prolactin(PRL)level,prolactin receptor(PRLR)expression on peripheral blood mononuclear cells and the disease activity in the patients with systemic lupus erythematosus(SLE).Methods Serum PRL level was measured by time-resolved fluoroimmunoassay(TrFIA)in113patients of SLE and in28gender-and-age matched control subjects,SLEDAI index was estimated.It was also investigated by logistic multiple regression analysis that the association between clinical manifestations,immunologic parameters,anti-dsDNA antibody titers and hyperprolactinemia in113patients of SLE.The specific binding(SB)rate of peripheral blood lymphocyte PRLR was measured by radioactive binding ligand assay(RLBA)and the mRNA expression of PRLR by reverse transcription polymerase chain reaction(RT-PCR)in24active SLE patients,22inactive SLE patients and15gender-and-age matched control subjects.Results The serum PRL levels of63active patients were much higher than those of50inactive patients and28control subjects.The serum PRL levels ranged9~51.2?g/L in79.3%of active patients.It was also found that PRL level was in positive linear correlation with the titer of anti-dsDNA antibody.The concentration of interleukin2receptors in hyperprolactinemia group was higher than that in normal group.It was shown that proteinuria,low levels of complement3and high titers of anti-dsDNA antibody were associated with hyperprolactinemia by logistic multiple regression analysis.The SB rate of PRL receptor was5.03?2.51%(x?s),the total binding rate(TB)was15.4?6.98%in24active patients with SLE.The SB rate of active patients was much higher than that of22inactive patients(SB4.18?2.26%,TB rate14.03?6.54%)and that of15gender-and-age matched control subjects(SB1.62?1.05%,TB8.19?1.47%).The mRNA expression of PRLR in active patients(x?s,0.85?0.45)was much higher than in inactive patients(0.58?0.43)and that in control subjects(0.20?0.13).Conclusion The slightly increased serum level of PRL,high expression of PRLR and the increased specific binding rate are associated with the disease activity of SLE.

Objective To evaluate five detection methods for the laboratory diagnosis of Clostridium difficile infection in the hospitals of USA, and explore a sensitive, specific, accuracy and rapid regimen for the early diagnosis of Clostridium difficile infection. Methods A total of 174 stool specimens submitted to the clinical microbiology laboratory for Clostridium difficile testing were separately tested by five methods including toxigenic culture (TGC), Premier Toxin A&B EIA( A/B-EIA), C. Diff Quick Chek Complete( DEIA), BD G eneOhm Cdiff assay(BD-PCR) and Laboratory-developed PCR(LD-PCR). The gold standard of TGC was used as a reference criterion, and the sensitivity, specificity, positive predictive value ( PPV )and negative predictive value (NPV) of A/B-EIA, D-EIA, BD-PCR and LD-PCR assays were determined. Results Among the 174 specimens studied, 24 were defined as true positives for Clostridium difficile infection by TGC assay, giving a positive rate of 13.8% (24/174). In comparison to the standard,the sensitivity, specificity, PPV and NPV were 62.5%, 99.3%, 93.8% and 94.3% for A/B-EIA;66.7%, 98.7%, 88.9% and 94.9% for D-EIA; 83.3%, 98.7%, 90.9% and 97.4% for BD-PCR;79.2%, 93.3%, 65.5% and 96.6% for LD-PCR. Among all tested specimens, 34 were positive by atleast one of five methods, and of which 15 were concordant by all five methods. The D-EIA results were divided into three groups depending on results of GDH and (or) toxins A/B: 18 were positive for both GDH and toxins A/B, 23 were positive for only GDH, and 133 were negative for both GDH and toxins A/B. Of 18 positive specimens by D-EIA assay, all were concordant with results of BD-PCR assay and 16 were agreement with results of TGC assay. Twenty-two of 24 positive specimens by TGC assay were included in 41 specimens that were positive for GDH. Among eight false negative specimens by D-EIA assay, four were differentiated as positive results by BD-PCR. According to the present study, the sensitivity, specificity,PPV and NPV of a two-step detection algorithm in combination with D-EIA and BD-PCR assays were 83.3%, 98.7%, 90.9% and 97.4%, respectively. Conclusions From the point of technological evaluation, BD-PCR is preferable. A two-step detection algorithm combining D-EIA with BD-PCR is proposed for the laboratory diagnosis of Clostridium difficile infection. This algorithm has demonstrated an excellent sensitivity and specificity, as well as decreased test turnaround time and test cost.

Objective To investigate the diagnostic potential of magnifying narrow-band imaging endoscopy (NBI-ME) for different intrapapillary capillary loop (IPCL) for the diagnosis of esophageal lesion.Methods Patients with abnormal esophageal mucosa found by white light gastroscopy in digestive endoscopy center,Chinese PLA General Hospital during the period of November 2009 to November 2010 were enrolled in this study.IPCL was observed and divided into different types by NBI-ME.Histopathology of biopsy or endoscopic submucosal dissection (ESD) specimens was evaluated and used as the gold standard to evaluate the diagnostic value of NBI-ME for IPCL.Results A total of 146 lesions from 145 subjects with esophageal mucosa abnormal were collected. Among them, 88 were pathology-proven inflammation,5 were pathology-proven esophageal cancers,20 were pathology-proven low intraepithelial neoplasia (LIN) and 33 were pathology-proven high intraepithelial neoplasia (HIN) detected with NBI-ME.By a per-lesion analysis,the accuracy of inflammation and cancer were 100％ (88/88) and 7/7.For the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio of LIN and HIN were 7/10,69.8％ ( 30/43 ),69.8％ ( 37/53 ),35.0％ (7/20),90.9％ (30/33),12.5％ (70/559),2.3％ (30/1290) and 87.1％ (27/31),72.7％ ( 16/22),81.1％ ( 43/53 ),81.8％ ( 27/33 ),80.0％ ( 16/20 ),634.1％ ( 837/132 ) and 35.2％ ( 124/352 ),respectively.Conclusions NBI-ME can classify the different esophageal IPCL.Higher diagnostic accuracy of IPCL indicates the feasibility of NBI-ME for the efficacious diagnosis of esophageal inflammation and cancer.There is the higher diagnostic accuracy of HIN than LIN.

Objective To reduce the screening positive rate (SPR) and improve clinical efficiency of maternal serum screening for Down's syndrome.Methods Nine thousand and thirty-three cases of second trimester maternal serum screening for Down's syndrome were included from Apr.2013 to Apr.2014 in the present study.The screening results,all basic data and equation curves were analyzed retrospectively.Based on the data from the authors' laboratory,the important adjustment parameters were simulated.Combined with postnatal follow-up results,the quality and clinical performance of second trimester serum screening for Down's syndrome were evaluated.Results The SPR of second trimester serum screening for Down's syndrome was 6.69％(604/9033),the detection rate (DR) was 75％(3/4),and FPR was 6.65％(601/9033).The median multiple of median (MOM) of alpha-fetoprotein (AFP) was low and SPR was high,and MOM of free human chorionic gonadotropin β subunit (free hCGβ) were high and SPR was high,while MOM of unconjugated estriol (uE3) were a little bit low,and SPR was slightly high.Considering these three factors,it is believed that the screening positive rate is high.By the simulation adjustments of MOM value equations (AFP and free hCGβ) and weight correction equation,the SPR reduced to 4.11％(371/9033) after recalculating the risk,FPR declined to 4.07％(368/9033),and no more Down's syndrome fetus were missed compared with postnatal follow-up results.Conclusion Based on a localized setting depending on the local laboratory data,we suggest that the MOM value distributions(AFP,free hCGβ and uE3) and maternal weight should be regularly adjusted since it is a useful way to reduce the false-positive rate and improve clinical efficiency of maternal serum screening for Down's syndrome.

Objective To investigate the parental origin for a rare case of complete hydatidiform mole and coexisting fetus and to discuss its diagnosis and differential diagnosis.Methods Tissues from the fetus,mole and placenta were collected and pathology analysis and chromosome analysis were done.The DNA from the fetus,mole and parents' peripheral blood leukocytes was amplified with five short tandem repeat (STR) markers (D4S2460,D18S488,D21S2039,DXS1205 and DYS219) at the same time to confirm the parental source of the hydatidiform.Results (1) Casereport:A 27-year-old woman,gravida 1,para 0,was found high risk for neural tube defects at 20 weeks of gestation.At 24+5 weeks of gestation,ultrasound examination demonstrated a normal fetus,a normal placenta and a huge mass with a multicystic appearance attached to the placenta with an obvious demarcation.The fetus died at 26 weeks of gestation.Serum human chorionic gonadotropin-β(β -hCG) level decreased obviously during the first two weeks after artificial induction,but elevated at the third week,and β-hCG titers fell to normal after 2 courses of chemotherapy.Fetus autopsy showed no structure abnormality.Histopathologic examination of the hydatidiform showed swelling of chorionic villi with hyperplasia of the trophoblast and formation of central cisterns suggesting of a twin pregnancy consisting of a complete hydatidiform mole and coexisting fetus.(2) Genetic analysis:The karyotype analysis of the normal placental villi was 46,XY; the cell cultures of fetal cartilage tissue and hydatidiform were failed.STR analysis showed that the fetus was diploid from biparental source;the mole was androgenetic source.And the mole had locus both from Y and X chromosome of the father,so it was heterozygous.It was suggested that this case was derived from one single oocyte fertilized with three spermatozoas.Conclusions STR analysis could be used to confirm the diagnosis of complete hydatidiform mole and coexisting fetus and to find the pathogenetic rnechanism.

Objective To investigate serum DJ-1 expression and its significance in ovarian cancer. Methods The expression levels of DJ-1 protein were detected by double antibody sandwich method in 52 cases of ovarian tumors (9 cases of benign ovarian tumors, 5 cases of borderline ovarian tumors and 38 cases of ovarian cancer,ovarian tumor group and 20 non-ovarian tumors (control group). Results The expression of DJ-1 protein was lower in the control group than that in ovarian tumor group (P<0.05). The expression of serum DJ-1 protein was higher in ovarian cancer than that in borderline ovarian tumors and in benign ovarian tumors. The expression of serum DJ-1 protein was higher in borderline ovarian tumors than that in benign ovarian tumors (P<0.05).The expression of serum DJ-1 protein was higher in poorly differentiated and moderately differentiated ovarian cancer than that in high-grade differentiated ovarian cancer (P<0.05). No significant dif-ference was found in the expression serum of DJ-1 protein between different pathological and different histological types of ovarian cancer (P>0.05). Conclusion DJ-1 might be used as a serum marker in the diagnosis of ovarian cancer. It might be involved in the pathogenesis of ovarian cancer,and could predit the development and prognosis of ovarian cancer.

OBJECTIVETo investigate the value of maternal plasma cell-free fetal DNA (cff-DNA) examination in detection of fetal chromosomal aneuploidy in pregnant women at advanced maternal ages during the first trimester of pregnancy.

METHODSA total of 136 pregnant women (11 to 13+6 gestational weeks) with advanced maternal ages were screened for fetal chromosomal aneuploidy with ultrasound and maternal plasma cff-DNA examination during March 1, 2011 to August 31, 2013, and the results were then confirmed by karyotype analysis and fluorescence in situ hybridization (FISH).

RESULTSOf the 136 women examined, cff-DNA screening detected chromosomal aneuploidy in 5 cases, including trisome-21 in 3 cases, trisome-18 in 1 case, and 45,X in 1 case as confirmed subsequently by karyotype analysis. Ultrasound screening reported a normal finding in one case of trisomy-21, thickening of the NT in the case of trisomy-18, and fetal anasarca in the case of 45,X. Karyotype analysis and follow-up of the women did not find chromosomal abnormality in the 131 negative cases screened by cff-DNA detection.

CONCLUSIONScreening of material plasma cff-DNA allows accurate and early detection of fetal chromosomal aneuploidy in women of advanced maternal ages to avoid unnecessary invasive antenatal examinations.

Aneuploidy ; Chromosomes, Human, Pair 18 ; DNA ; blood ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Maternal Age ; Pregnancy ; Pregnancy Trimester, First ; Prenatal Diagnosis ; Trisomy

Objective To investigate the role of p16,Ki-67 and human papilloma virus(HPV)type in the shunt treatment of cervical intraepithelial neoplasia (CIN) Ⅱ. Methods The paraffin block on file and the pathological results from loop electrosurgical excision procedure (LEEP) of 377 CIN Ⅱpatients diagnosed with colposcope examination accompanied by cervical high-risk HPV infection in the Affiliated Hospital of Inner Mongolia Medical University of Obstetrics and Gynecology Department from January 2014 to October 2016 were collected. The paraffin sections were stained with p16 and Ki-67 immunohistochemistry. The correlation between the expression of p16 and Ki-67 in biopsy tissues and the pathological results after LEEP was analyzed.HPV type and pathological results after LEEP were also analyzed.Results LEEP postoperative pathological grade in 337 cases of CINⅡpatients was divided into two groups(＜CINⅡ and ≥CINⅡ). There was no statistical difference in age between the two groups (t = 3.078, P = 0.063). There were statistical differences in the expressions of p16+and Ki-67+between the two groups[3.6 %(8/233) vs. 88.5 % (92/104), χ 2=235.54,P<0.001; 3.0 %(7/233) vs. 76.9 % (80/104), χ 2= 197.63, P< 0.001]. There was a statistical difference in HPV infection type between the two groups (χ2= 12.713, P = 0.005). The sensitivity and specificity of p16+and Ki-67+for LEEP postoperative≥CINⅡ was 88.89 % vs.77.78 % and 95.96 % vs.95.80 % respectively. There was a statistical difference in group type of p16 and Ki-67 in both groups (χ2=304.28, P< 0.001). The sensitivity of p16+Ki-67+was 90.73 % and the specificity was 98.74 % in CINⅡpatients for LEEP postoperative. Conclusions The expressions of p16 and Ki-67 can guide the colposcopic biopsy for the treatment of CINⅡ. For CINⅡpatients with p16+Ki-67+, the active treatment should be taken. Close observation needs to follow for p16 and Ki-67 single negative or double negative patients. Active treatment should be performed for CINⅡpatients with HPV16 type infection in CINII. Age can not be used as the basis for the patients with shunt CINⅡ.