To clarify the relationship between angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and diabetic retinopathy in type 2 diabetic patients by meta analysis. 16 eligible articles were selected in this study, including 1 014 patients with diabetic retinopathy and 1 135 controls. The meta analysis revealed that systematic data Z= 2.91 ( P = 0.004 ), OR = 1.69 ( 95% CI 1.19-2.40). There is association between ACE gene I/D polymorphism and the diabetic retinopathy in type 2 diabetic patients.

Objective To study the relationship between the serum paraoxonase-1(PON1) activity, PON1Q/R192 polymorphism and atherosclerotic thrombotic cerebral infarction(ATCI) in Chinese Han people.Methods In 48 cases with ATCI and 55 normal controls (NC group), serum PON1 activity was assayed by infrared spectrophotometer;the PON1Q/R192 polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphism.Results Serum PON1 acuivity in the ATCI group was significantly lower than that in NC group[(74.41?18.85) U/ml,(113.65?26.64) U/ml, P

0.05). There were 7 cased in the polypropylene mesh group had abdominal discomfort due to stiffness, which higher than that of the expanded polytetrafluroethylene patch and control groups (P 0.05). CONCLUSION: Both prosthetic patches are safe and effective when used in the repair of inguinal hernia in aged patients with low recurrence rate, especially, the expanded polytetrafluroethylene patch, which is more comfortable than polypropylene mesh.

Objective To translate the English version of Revised Dental Beliefs Survey (R- DBS) into Chinese and to test the reliability and validity of the Chinese version of R- DBS. Methods The R- DBS was translated and adapted according to Chinese culture. The reliability and validity of Chinese version of R- DBS was tested in 348 adult patients in department of stomatology. Results The Chinese version of R- DBS consisted of 23 items. Three factors were extracted by factor analysis which could explain 54.236% of the total variance. The internal consistency coefficient of the Chinese version of R- DBS was 0.891 and the test- retest reliability was 0.856. Using DAS as an external criterion, the correlation coefficients of the DBS and DAS scores were 0.781 (P<0.01). Conclusions The Chinese version of R- DBS is reliable and valid, and can be used to assess the patient′s subjective perceptions of the behavior of dentists and the delivery of dental care.

Objective To investigate the impact of obstructive sleep apnea hypopnea syndrome (OSAHS) on development of nonalcoholic fatty liver disease (NAFLD) in the non-obese elderly.Methods A total of 91 non-obese elderly patients were divided into 3 groups,29 cases with mild to moderate SAHS (mild-to-moderate OSAHS group),31 cases with severe OSAHS (severe OSAHS group),30 cases without OSAHS and matched with age,sex and BMI (control group).The changes in NAFLD severity index including serum liver enzyme levels,Type Ⅲ procollagen peptide (PⅢ P)and liver/spleen CT ratio were observed,and the influence factors for the changes were analyzed.Results Serum alanine aminotransferase (ALT),aspartate aminotransferase (AST)ALT/AST ratio and serum PⅢ P levels were significantly higher in severe OSAHS group than in mild-to-moderate OSAHS and the control group(F=25.71,15.15,18.64,respectively,all P＜0.01).There was no significant differences in serum liver enzyme ALT,AST and P Ⅲ P levels between mild-to-moderate OSAHS and the control groups(all P＞0.05),and the ALT/AST ratio was significantly higher in mild-to-moderate OSAHS group than in the control group(P＜0.01).The Liver/spleen CT ratio was significantly lower in OSAHS groups than in control group,while the ratio was lower in severe OSAHS group than in mild-to-moderate OSAHS group(all P＜0.01 or 0.001).Serum PⅢ P level was significantly higher in OSAHS groups than in control group(F=31.46,P＜0.01),while PlⅢ P levels were not significantly different between the mild-to-moderate OSAHS group and the control group(P ＞ 0.05).The correlation analysis showed that the liver/spleen CT ratio in OSAHS group was negatively correlated with AHI(r=-0.785,P＜0.001),but was positively correlated with the lowest oxygen saturation(r=0.517,P=0.001).The ALT/AST ratio and serum P Ⅲ P level in OSAHS patients were positively correlated with AHI (r=0.463,0.770,both P＜0.001),but were negatively correlated with the lowest oxygen saturation (r=-0.395,-0.514,P＜0.01 or 0.001).The multiple regression analysis showed that AHI was the only variable that affected liver/spleen CT ratio and serum P Ⅲ P level in OSAHS patients.Conclusions OSAHS patients in the non-obese elderly are always complicated with NAFLD,characterized by abnormal liver enzymes,hepatic steatosis and fibrosis.The severity of lesion is increased with the deterioration of OSAHS.AHI may play an important role in the development of NAFLD in the non-obese elderly with OSAHS.

Objective To investigate the effect of chronic intermittent hypoxia (CIH) on myocardial tissue pathology,oxidative stress and apoptosis in rat fed a high-fat diet,and to explore the possible mechanism of CIH induced cardiomyocyte injury.Methods A total of 24 male Wistar rats were randomly divided into 3 groups (n=8 each).The control group was fed common rat forage,the high-fat group was fed high-fat forage,and the high-fat plus intermittent hypoxia group was fed high-fat forage combined with a 7h/d intermittent hypoxia treatment.The changes of myocardial tissue pathology and ultrastructure of cardiomyocyte,and the activities of apoptosis regulating factor cysteine-containing aspartate-specific proteases-3 (caspase-3) and oxidative stress marker myeloperoxidase (MPO) were observed in the 3 groups after 4 weeks of treatment.Results There were significant differences in the activities of caspase-3 and MPO among the three group (F=89.94,71.24,both P＝0.001).The activities of caspase-3 and MPO were lower in the control group than in the high-fat group and in high fat plus intermittent hypoxia group [(0.21±0.06) vs.(0.80±0.11),(1.15±0.21),(3.20±0.58) vs.(10.87±1.96),(13.17±2.22),P＜0.01].The activities of caspase-3 and MPO were higher in the high-fat plus intermittent hypoxia group than in the high fat group[(1.15±0.21) vs.(0.80±0.11),(13.17±2.22) vs.(10.87±1.96),P＜0.01].No abnormal findings in the structure of cardiomyocyte were observed in the control group,while multiple pathologic damages in cardiomyocyte were detected in the high-fat group,and more obvious injuries in the high-fat plus intermittent hypoxia group.Conclusions The pathologic damages to cardiomyocyte are more serious in high fat and intermittent hypoxia group than in the high-fat group.Apoptosis induced by oxidative stress may play an important role in the pathogenesis of these injuries.

Objective:To investigate the status of mental health and work engagement of clinical nurses, to explore the correlation between them, and to provide scientific basis for improving the mental health and increase work engagement levels of nurses.Methods:From August to September 2018, 1 140 nurses in Taihe Hospital of Shiyan City of Hubei Province · Affiliated Hospital of Hubei University of Medicine were selected as survey objects by convenient sampling method, and the mental health and work engagement of nurses were investigated by Symptom Checklist-90 (SCL-90) and Utrecht Work Engagement Scale (UWES-9), correlation analysis was used to explore the relationship between mental health and work engagement, and multiple linear regression was used to analyze the influencing factors of work engagement in clinical nurses.Results:The score of SCL-90 of clinical nurses was 123.01±38.14 and the score of UWES-9 was 3.53±1.40. Correlation analysis showed that the nurse with total scores of mental health and work engagement, vitality, dedication, and concentration were negative correlation( r values were -0.250--0.218, P<0.01). Multiple linear regression analysis showed that age, depression, and paranoia were the influencing factors of clinical nurses work engagement ( t values were 4.682, -3.211, -2.715, P<0.01). Conclusions:The mental health level of nurses is good, and their work engagement level is average. Mental health is closely related to work engagement. Nursing managers should take effective measures to improve the mental health and increase work engagement levels of nurses.

Objective To summarize the contrast enhanced ultrasonographic (CEUS) features of benign focal liver lesions, on and to investigate the value of contrast enhanced ultrasound techniques in the diagnosis of benign focal liver lesion. Methods The contrast enhanced ultrasonographic performance of 68 benign focal liver lesions cases which were dififcult for routine ultrasound diagnosis and conifrmed by pathology or follow-up were retrospectively analyzed. Chi-square test of four-fold table were used to compare the diagnostic coincidence rate of conventional ultrasound and contrast-enhanced ultrasound. Results The 68 cases of benign focal liver lesions included complex cysts (n=7), liver hydatids (n=2), liver abscess (n=15), focal nodular hyperplasia (n=8), angiomyolipoma (n=2), hepatocellular adenoma (n=4), focal fat accumulation (n=16), inlfammatory pseudotumor (n=12), solitary necrotic nodule (n=1), intrahepatic biliary cystadenoma (n=1). There were no enhancement among 7 complex cysts, 2 liver hydatids and 1 solitary necrotic nodule. Isoenhancement was detected in focal fat accumulation (n=16);hypoenhancement during the arterial phase and sustained enhancement during the portal or late phase was found in focal nodular hyperplasia (n=8) and angiomyolipoma (n=2). Grid-like enhancements during the arterial phase and isoenhancement or hypoenhancement during the portal phase, and hypoenhancement during the late phase was presented in liver abscess (n=15). Hyperenhancement during the arterial phase were detected in 4 cases of hepatocellular adenoma, 3 of which showed isoenhancement or hyperenhancement during the portal and delayed phase, one case showed hypoenhancement during the portal phase. Eight cases of all the inlfammatory pseudotumor showed no enhancement during all phases;3 cases showing grid enhancement during the arterial phase and the enhancement washed out rapidly;1 case showed mild edge enhancement during the arterial phase and hypoenhancement during the delayed phase. The solid part of the intrahepatic biliary cystadenoma showed hyperenhancement during the arterial phase and hypoenhancement during the portal and late phase.The central area showed no enhancement during all phase. The coincidence rate between pathology and conventional ultrasound diagnosis was 61.8%(42/68). The coincidence rate between pathology and contrast- enhanced ultrasound diagnosis was 92.6%(63/68). The coincidence rate of contrast-enhanced ultrasound diagnostic was higher than that of conventional ultrasound, with a statistically signiifcant difference (χ2=8.17, P < 0.01). Conclusion Real-time gray-scale contrast-enhanced sonography can improve the accuracy of the diagnosis and differential diagnosis for benign focal liver lesions.

Objective investigate the correlation between plasma soluble receptor for advanced glycation endproducts (sRAGE) and arterial stiffness in patients with different types of metabolic syndrome (MS).Methods A total of 180 subjects were drawn from a epidemiologic follow-up study,including 60 cases non-metabolic syndrome (NMS),60 cases metabolic syndrome without diabetes mellitus (NDMMS),60 cases metabolic syndrome with diabetes mellitus (DMMS).Carotid femoral arterial pulse wave velocity (CFPWV) was assessed by the French KangPuLe atherosclerosis measurement instrument,and plasma sRAGE levels were measured by ELISA.Comparison of mean in multiple groups was conducted by analysis of variance.Multivariate analysis was done with multiple linear stepwise regression analysis.P ＜ 0.05 was considered as statistically significant difference.Results Compared with NMS group,plasma sRAGE levels were significantly lower in DMMS and NDMMS groups [(635.07 ± 229.20) pg/mL vs.(671.17 ± 358.16) pg/mL vs.(992.99 ± 427.83) pg/mL,P =0.001].CFPWV of DMMS group was significantly higher than that of NMDMS and NMS groups (14.22 ±3.14) m/s vs.(12.15 ±2.79) m/s vs.(11.66 ± 2.52) m/s,P =0.002).Plasma sRAGE level was negatively correlated with CFPWV (r =-0.278,P =0.005).(3) Multiple linear regression analysis demonstrated that age (β =-0.091,95％ CI-0.096 ～-0.095,P =0.031),HDL-C (β =1.295,95％ CI 1.231 ～ 1.360,P =0.022) and sRAGE (β =0.119,95％ CI 0.118 ～ 0.130,P =0.032) had a significant effect on CFPWV.Conclusions The increased arterial stiffness is closely related to the discreased plasma sRAGE levels in MS.Plasma sRAGE maybe a novel target for vascular disease prevention and treatment in patients with metabolic syndrome.

AIM:To study the correlation of serum uric acid ( UA) level with carotid plaques and arterial stiff-ness in the patients with essential hypertension ( EH) , and to explore the predictive value of serum UA for evaluating EH preclinically .METHODS:A total of 92 patients with EH and 30 healthy individuals were enrolled .The value of UA and other indicators were detected .B-mode ultrasound examination was performed to measure the common carotid artery intima -media thickness ( IMT) and the sites of plaque in the internal carotid-artery, external carotid artery and carotid bifurca-tions.Carotid-femoral arterial pulse wave velocity ( CFPWV) was assessed by Complior?atherosclerosis measurement in-strument.RESULTS:The serum level of UA in the patients with EH was higher than that in control group [(361.51 ± 83.81) μmol/L vs (317.03 ±62.22) μmol/L, P<0.05].The mean value and abnormal rate of IMT between hyperten-sion group and control group were significant difference [(0.69 ±0.14) mm vs (0.60 ±0.12) mm, 42.39%vs 10.00%, P<0.05].In 92 EH patients, 45 cases had carotid plaques .These 45 cases were divided into 3 groups according to the plaque severity, among which the serum UA level had statistically significant differences [(285.25 ±78.41) μmol/L, (341.19 ±63.99) μmol/L and (401.33 ±88.49) μmol/L, P<0.05].Compared with rigid plaque group ( n=34), the serum UA level in soft plaque group (n=11) was significantly higher [(389.00 ±69.45) μmol/L vs (323.03 ± 72.71) μmol/L, P<0.05].A stepwise multiple linear regression analysis demonstrated that age ( r=0.414), systolic blood pressure (r=0.224), pulse pressure (r=0.270) and uric acid (r=0.219) were predisposed factors for higher CFP-WV (P<0.05).CONCLUSION:UA is one of the risk factors causing hypertension .Serum UA level may reflect the sever-ity and stability of carotid plaques .The increased arterial stiffness is closely related to the increased serum UA level in EH .