Objective To study the relationship between T~(-786)→C mutation in the 5′-flanking region of the endothelial nitric oxide synthase gene and type 2 diabetes(T2DM) with coronary heart disease(CHD). Methods One hundred and eighty-six T2DM were selected,and of them,65 had CHD.Meanwhile,63 healthy individuals were selected as control.PCR/ASO(allele-specific oligonucleotide probe) technique was used to determine the T~(-786)→C mutation.Results Compared with control,the T/C genotype and C allele prevalences were significantly higher in T2DM with CHD(P

Objective To explore hearing loss , the expression of age-related changes of nerve growth factor receptor TrkA (NGFR TrkA ) in the cochlea of the senescence-accelerated mouse. Methods The senescence accelerated mouse/prone 8(SAMP8) at 3, 5, 7 months were chosen as analyzing subjects. The auditory thresholds was monitored by auditory brainstem respons (ABR). The expression of NGFR TrkA protein was analyzed by the optical density of immunohistochemical staining. Results The SAMP8 developed a progressive auditory threshold which showed an age-related significant increase (P < 0.05). There were NGFR TrkA protein expressed in the cochlea of the SAMP8 throughout the development, which developed an age-related significant descend (P<0.05). Conclusion The expression level of NGFR TrkA protein decreases when the SAMP 8 develops a progressive hearing loss which indicates that NGFR TrkA protein probably has relationship with maintaining functional status of the cochlea.

Objective To evaluate the clinical application of CT perfusion imaging (CTPI) and CT subtraction angiography (CTSA) in the diagnosis of acute ischemic cerebrovascular disease (AICVD). Methods 24 cases with AICVD onset within 24 hours were examined with regular CT, CTPI and CTSA. Some of them took CTPI, MRI, MRA, DSA, SPECT by follow up examinations. Results In 24 cases 11 had regular CT negative results after onset of stroke 3～6 hours in 6 cases,6～12 hours in 3 cases,12～24 hours in 2 cases. Ten cases of them were confirmed by CTPI as having ischemic lesions, 2 cases had middle cerebral artery occlusion (MCAO), and 1 had transient ischemic attack (TIA) with CTPI negative. In 24 cases 13 had regular CT positive rseults, 9 cases had ischemic lesions larger in CTPI than in regular CT,1 case had MCAO and 1 case had internal carotid artery occlusion(ICAO). There were 4 cases with ischemic lesions on regular CT almost having the same range as that of lacunar infarction in CTPI. The peak value of time(PT), mean transit time(MTT), relative flow (RF) in all 24 cases were found obviously changed. The side of ischemic lesion as compared with the opposite side, and the core of ischemic lesion as compared with peripheral zone were found changed significantly ( P

OBJECTIVETo evaluate digital rectal examination (DRE) , transrectal ultrasonography (TRUS) , free/total (f-PSA/ t-PSA) prostate-specific antigen (PSA), and PSA density (PSAD) in the diagnosis of prostate cancer (PCa) in patients with PSA < or = 4.0 microg/L.

METHODSBetween April 1996 and December 2012, a total of 343 subjects, aged 30 -91 years, with PSA < or =4.0 microg/L and abnormal findings on DRE or TRUS underwent prostatic biopsy. Based on the levels of PSA, the subjects were divided into four groups: 0 -1.0, 1.1 -2. 0, 2.1 -3. 0, and 3.1 -4.0 microg/L. The diagnostic values of DRE, TRUS, f-PSA/t-PSA, and PSAD were assessed in those with different PSA levels. According to the age, the subjects were again divided into five groups: C49 yr, 50 -59 yr, 60 -69 yr, 70 -79 yr, and > 80 yr. The rates of PCa detection in relation to PSA levels were estimated in different age groups.

RESULTSOf the 343 subjects, 65 (19.0% ) were diagnosed with PCa, with detection rates of 16.28% (21/129) , 17. 17% (17/99), 21.82% (12/55), and 25.00% (15/60) in those with the PSA levels of 0 -1.0, 1.1 -2.0, 2.1 -3.0, and 3.1 -4.0 microg/L, respectively. There were statistically significant differences in f-PSA/t-PSA between the PCa patients and non-PCa subjects with the PSA level > 2.0 microg/L (P <0.05) , but not with the PSA level < or =2.0 microg/L (P > 0.05) , nor did PSAD show any significant difference between the PCa and non-PCa groups ([0.09+/-0. 16] versus [0. 06 +/- 0. 07] micro/L/ml, P > 0. 05). The rate of cancer detection rose -with the elevation of the PSA level, but had no statistically significant difference among different age groups (P >0.05).

CONCLUSIONPSA 2.1 -4.0 microg/L with abnormal DRE and TRUS findings should be considered as a warning signal, which requires regular follow-up and PSA detection. With f-PSA/t-PSA <0. 15 with or without abnormal DRE and TRUS findings, routine prostate biopsy should be performed. PCa diagnosis cannot be effectively established by DRE, TRUS, f-PSA/t-PSA, and PSAD in those with PSA < or = 2.0 microg/L.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology

Objective:To observe the clinical effect of mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in convalescence stage.Methods:A total of 136 patients conforming to the inclusion criteria were randomized into three groups by the random number table,including group A of 46 cases,group B of 44 cases and group C of 46 cases.Patients in group A received swallowing disorder therapeutic apparatus treatment,patients in group B received mind-refreshing and orifice-opening needling method treatment,and patients in group C received mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus treatment.The treatment was given once a day for 10 d as a course,the whole treatment lasted for 4 courses.Therapeutic evaluation items including water-swallowing test (WST),standardized swallowing assessment (SSA) and modified Barthel index (MBI) were measured before treatment,after treatment and at follow-up visit (2 months after treatment).Results:After treatment,scores of WST and MBI in all three groups increased significantly (all P＜0.05),while the SSA score dropped significantly (all P＜0.05).After treatment and during follow-up visit period,score of WST in group C was significantly higher than that in group A and group B (both P＜0.05),while the difference between group A and group B showed no statistical significance (P＞0.05);the SSA score in group C was substantially lower than that in group A and group B (all P＜0.05),the difference between group A and group B showed no statistical significance (P＞0.05);the MBI scores in group B and group C were substantially higher than that in group A (all P＜0.05),the difference between group B and group C showed no statistical significance (P＞0.05).After treatment and during follow-up visit period,the differences in overall therapeutic effect between group A and group B showed no statistical significance (P＞0.05),while the overall therapeutic effect in group C was substantially better than that in group A and group B (all P＜0.05).Conclusion:Both mind-refreshing and orifice-opening needling method and swallowing disorder therapeutic apparatus can alleviate symptoms of deglutition disorder of stroke patients respectively,and the combination of two methods can improve the therapeutic effect.

Based on the performance management theories and methods, the factors affecting clini-cal teachers' teaching motivation were analyzed in domestic university affiliated hospitals. In consideration of the functional position of university affiliated hospitals and the responsibilities of clinical teachers, the Delphi, KPI and other methods were used to identify key index and respective weight of teaching perfor-mance evaluation, therefore the teaching performance evaluation system including teaching load, teaching quality and teaching capacity in three dimensions were constructed. Then this index system was applied to a university affiliated hospital as an example to verify its feasibility, scientificity and effectiveness. Further-more, the evaluation system was embedded to information platform of educational administration manage-ment, and was proved as a useful teaching performance information management tool that provided reference for hospital performance payment distribution, title evaluation and recommendation, and teaching awards evaluation at all levels, etc. Consequently, theoretical and methodological references were provided for improving clinical teachers' teaching enthusiasm.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

Objective To construct and identify the recombinant vector pcDNA3. 1 (-) B/myc-BRMS 1 carrying breast-cancer metastasis suppressor 1 (BRMS 1) which can express in eukaryote cells and which will provide the basis for further researching the mechanisms of metastasis suppression and working on cancer metastasis gene ther-apy. Methods To isolate total RNA from MCF - 7 cells and design a pair of primers, and coding sequence of aRMS 1 cDNA were amplified from human breast cancer cells MCF -7 by reverse transcription-polymerase chain reaction (RT-PCR). Then the product was inserted to the PcDNA3. 1/myc-His (-) B plasmid. The recombined pcDNA3. 1 (-)B/myc-BRMS1 was identified by gene sequence analysis,then recombinants was transfected into HEK-293 cells and was identified by Western blot. Results The recombinant of pcDNA3.1 (-) B/myc-BRMS1 was structurally confirmed by analysis of sequencing. The inserted fragment in the vector was in the right direction and its sequence was structurally confirmed to be consistent with CDS sequence of human BRMSI cDNA that of the published data. GenBank, [AF159141]. The recombinants was transfected into HEK-293 cells ,then the cells expressed protein tagged c-myc identified by Western blot indicated it can express in eukaryote cells. Conclusion cDNA of human BRMS1 can be successfully cloned and inserted into Eukaryote-expression vector. The newly constructed vector may serve as the potential tool to conduct further comprehensive experiments in future on BRMS1 function and on gene therapy.

Objective To explore the value of MRI in differentiation diagnosis of benign ovarian mucin-ous cystadenoma ( MC) and borderline mucous cystadenoma ( BMC).Methods MRI data of 23 cases of benign MC and 14 cases of BMC, confirmed by surgery and pathology, were retrospectively analyzed, including tumor lo-cation, shape, size, loculation, signal intensity of cyst fluid, cyst wall, cyst septum and nodules, and they were compared with pathological results.Results Single loculus benign cystadenoma nodules showed isointensity T2 WI signal, low T1 WI signal, and low DWI signal.Single loculus borderline cystadenoma nodules showed high T2 WI signal, low T1 WI signal, and high DWI signal.Signs such as honeycomb loculi of multilocular cystadeno-ma, cyst fluid of high T1 WI signal, cyst fluid of low T2 W1 signal, cyst wall and irregularly thickened cyst septum ( >3 mm) were more seen in BMC (7/11, 6/11 and 7/11) than in MC (5/18, 4/18 and 5/18);5 cases were with cyst sediments (MC=4, BMC=1), showing moderate T2WI signals, and high T1WI signals.Broken fish-ing net gathering was only restricted to MC (5/18) with characteristics.Benign multilocular cystadenoma nodules showed low DWI signal,and borderline multilocular cystadenoma nodules showed high DWI signal.Conclusion MRI can well display pathological characteristics of ovarian MC, which has practical value for the differentiation and diagnosis of MC and BMC and can provide the reference for clinical surgery.

Objective To investigate clinical features,diagnosis and surgery treatment of Hashimoto thyroiditis associated with thyroid carcinoma. Method Twenty-four cases of Hashimoto thyroiditis diagnosed by surgical pathology from January 2004 to December 2009 were associated with thyroid carcinoma. Results In the all 24 cases,22 cases (91.7% ,22/24) were associated with papillary thyroid carcinoma,including 12 cases (50.0% ,12/24) of micropapillary thyroid carcinoma,and 2 cases (8.3%, 2/24) were associated with medullay thyroid carcinoma. Thyroid colour ultrasound Doppler indicated that diffuse enlargement of thyroid with nodes occurred in 21 cases,account for 87.5%(21/24), single node occurred in 15 cases,account for 62.5%(15/24), 12 cases demonstrated thyroid nodes with calcification,account for 50.0%(12/24). Eight cases were examinated by fine-needle aspiration cytology biopsy(FNACB) before operation,examing results of 3 indicated thyroid carcinoma, account for 37.5%. Twenty cases were followed up 2 months to 6 years,no thyroid carcinoma recurred,4 cases missed. Conclusions Thyroid colour ultrasound Doppler examination plays an important role in diagnosis of Hashimoto thyroiditis associated with thyroid carcinoma before operation. It is necessary to investigate progressively the role of FNACB in diagnosis of Hashimoto thyroiditis associated with thyroid carcinoma before operation. Surgical exploration might become an important approach in diagnosis and treatment of Hashimoto thyroiditis associated with thyroid carcinoma.