Objective To study the influencing factors of raised D-dimer levels in elderly people.Methods 592 elderly people underwent physical examination in our hospital were selected.They were divided into observation group and control group according to the level of D-dimer.The clinical data,liver and kidney function and blood lipid levels between both groups were compared.Re-sults There were no significant difference on gender,BMI,FBG,ALT,AST and Cr between both groups (P >0.05),but the age of patients in the observation group were significantly higher than that of the control group(P <0.05).The PT,CRP,bacterial pneu-monia and (or)of acute exacerbations of chronic bronchitis,cancer,diabetes patients in the observation group were significantly higher than those in control group,while LDL-C,TC were significantly lower than that of the control group,there were significant differences (P <0.05).The plasma D-dimer level in patients showed positive correlation with CRP and age (r =0.27,0.25,P <0.05).Conclusion Malignant tumor,type 2 diabetes,bacterial pneumonia,acute exacerbation of chronic bronchitis are the risk fac-tors of raised plasma D-dimer levels in the elderly.

Objective To determine whether pupil response to dilute tropicamide could be used as a diagnostic test for Alzheimer's disease (AD). Methods Pupil diameters of both eyes were measured simultaneously by an infra red automatic pupil diameter recorder and analyzer every 0 1 second for 30 minutes after instillation of 0 01% tropicamide to one eye and normal saline to the other. Three groups of patients were studied: 52 patients with AD, 33 with vascular dementia (VD), and 58 elderly controls. The percent change in pupil diameter of the treated eye was examined automatically by the analyzer. After finding the cut off point for differential diagnosis by receiver operator characteristic curve (ROC), its sensitivity, specificity and Kappa coefficient were calculated. Results Mean percent change in diameters of the treated eye showed a trend of fastest maximum dilation in AD group, and was significantly different from other groups at all the measurement time points after 10th minute instillation. The difference was most significant at the 18th minute after instillation, and 15% was used as a cut off point, the sensitivity was 0 81,specificity 0 79 0 82, and Kappa coefficient 0 62 0 67. Conclusions Pupil dilation test could be used as a screening method in the diagnosis of Alzheimer's disease, or as a tool for differential diagnosis between AD and VD.

To study the mechanism of therapeutie effect of compound "Huang Dai" tablet in acute promyelocytic leukemia, twenty one patients with acute promyelocytic leukemia were treated with compound "Huang Dai" tablet. Bone marrow cells of the patients were collected before treatment and after treatment, and membrane differentiating antigen (CD33 and CD11b), cell cycle and the apoptosis correlative protein(Fas and Apo 2.7 )were detected with flow cytometry. Results showed that the expression of CD33 was decreased and that of CD11b increased, G 2 /M phase of cell cycle was blocked, and the expressions of Fas and Apo 2.7 protein were increased significantly in all patents after treatment with compound "Huang Dai" tablet. These results suggested that the mechanism of therapeutic effect of compound "Huang Dai" tablet in acute promyelocytic leukemia was induction of both differentiation and apoptosis of leukemic cells, and cell apoptosis might be related to Fas and Apo2.7 protein.

Background:More and more evidences suggest that microRNA plays an important role in the development of gastric cancer (GC).Expression of miR-129 in GC tissues is found abnormal, however, the mechanism of miR-129 in cell proliferation and invasion is still undefined.Aims:To investigate the expression of miR-129 in GC tissue and GC cell lines and the mechanism of miR-129 in proliferation and invasion of SGC-7901 cells.Methods:Eighty-two GC tissues and corresponding paracancerous tissues were collected, human gastric epithelial cell line and different GC cell lines were cultured, qPCR was conducted to assess miR-129 expression.SGC-7901 cells were transfected with miR-129 mimic or miR-NC, and then were transfected with overexpressed HMGA2 plasmid.Colony formation assay was used to detect cell proliferation ability, and Transwell chamber was used to assess cell invasion ability.Pearson correlation analysis was used to analyze the correlation between miR-129 and HMGA2 mRNA expression.Luciferase assay was performed to determine the activity of luciferase.mRNA and protein expressions of miR-129, HMGA2 were determined by qPCR and Western blotting, respectively.Results:Compared with paracancerous tissues, expression of miR-129 was significantly decreased in GC tissues (P<0.05);when compared with human gastric epithelial cells, expression of miR-129 was significantly decreased in GC cell lines (P<0.05).Compared with miR-NC group, proliferation and invasion abilities of SGC-7901 cells were inhibited in miR-129 mimic group (P<0.05).HMGA2 mRNA expression in GC tissues was significantly upregulated (P<0.05), and was negatively correlated with miR-129 expression (r=-0.543 9, P<0.01).Luciferase activity in wild-type miR-129 mimic group was significantly lower than that in miR-NC group (P<0.05);mRNA and protein expressions of HMGA2 were decreased after transfection with miR-129 mimic (P<0.05).Compared with miR-129+vector group, proliferation and invasion of SGC-7901 cells were significantly increased in miR-129 mimic+HMGA2 group (P<0.05).Conclusions:The expression of miR-129 is decreased in GC tissue and cells;miR-129 inhibits SGC-7901 cells proliferation and invasion by negatively regulating HMGA2.

Background: Esophageal variceal bleeding is a clinical emergency and the major cause of death in patients with liver cirrhosis.Aims: To assess the value of platelet count (PC)/spleen diameter (SD) ratio in predicting the presence of esophageal varices (EV) in patients with HBV-related cirrhosis in China.Methods: A total of 91 consecutive HBV-related cirrhosis patients with EV from Aug.2013 to Dec.2015 at Renji Hospital (South Campus),School of Medicine,Shanghai Jiao Tong University were enrolled.Thirty-two HBV-related cirrhosis patients without EV were enrolled as controls.Upper gastrointestinal endoscopy,routine laboratory examinations and abdominal ultrasonography were performed and the related parameters were collected.Binary Logistic regression analysis was carried out to identify independent risk factors associated with EV.ROC curve was used to evaluate the predictive performance of PC/SD ratio for the presence of EV.Results: The PC/SD ratio was significantly lower in EV group than in non-EV group (538.2±327.0 vs.1 105.9±426.6,P=0.001).Binary Logistic regression analysis showed that the PC/SD ratio was independently associated with the presence of EV (OR=57.29,95％ CI: 15～214,P=0.000).In ROC curve analysis,the area under the curve (AUC) of PC/SD ratio in predicting the presence of EV was 0.853;the optimal cutoff value was 842,and the sensitivity,specificity,positive predictive value and negative predictive value were 85.7％,75.0％,90.7％,and 64.9％,respectively.Conclusions: PC/SD ratio can be used as a non-invasive tool for prediction of the presence of EV in patients with HBV-related cirrhosis.It may reduce the number of unnecessary endoscopy.

OBJECTIVE: To study the effect of continuous renal replacement therapy on acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. METHODS: A patient was complicated with acute renal failure, severe acute pancreatitis, lung infection, bleeding in anastomosisbetween duodenum and jejunum, and peritonitis following simultaneous pancreas-kidney transplantation. He was treated with immunosuppressor, antibiotics, amylopsin inhibitor, haemostatic and alimentation; at the same time, he was treated with continuous renal replacement therapy for 22 days. The Baxter system was used for continuous venovenous hemofiltration. RESULTS: The vital signs and hemodynamic indicators were stable during continuous renal replacement therapy. Pulmonary edema was well controlled, and acid-base equilibrium of water electrolyte was maintained. The function of vital organs was stableand graft function was normal following continuous renal replacement therapy for 22 days. He was completely cured and out of hospital on day 40. CONCLUSION: Continuous renal replacement therapy plays an important role in treating acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. Thus, it is a well kidney support for ultaneous pancreas-kidney transplantation.

To examine the relationship between genetic variants in the interleukin-6 receptor gene and obesity. The result showed that the carriers of Asp358 homozygotes had higher risk in developing obesity when compared with Ala358 homozygotes (OR = 1.32,95% CI 1.07-1.68, P = 0. 041). Interleukin-6 receptor gene pulymorphism was significantly associated with obesity.

Objective To investigate the teaching modes of the course of guide to learn in undergraduate nursing students in order to improve their quality of leaning.Methods Questionnaire survey and interview were conducted to collect the students'general appraisal on learning Science and teaching content and teaching modes as well as ingathering and suggestions of the course.Results Totally 79.5%among 117 students thought it necessary to open the course of Learning Science.96.6%students considered ten subjects of the course reasonable.83.8%students were satisfied with the alternate five-teachers'teaching modes.The most digestible teaching approach Was illustration,and the most valuable experience wag how to regulate the psyehology of learning.Conclusions The course of guide to learn in nursing undergraduate education has positive significance.Nursing educators should always explore and improve the teaching mode of this course so as to help students develop SOundly.

Objective To investigate the application of dual volume reconstruction translucent imaging in performing stent- assisted coil embolization for intracranial aneurysm embolization treatment. Methods During the period from Nov. 2011 to Sep. 2012, a total of 30 patients with intracranial aneurysm were admitted to authors’ hospital. Stent-assisted coil embolization was carried out in all patients. The number of all the stent point-marks visualized on routine 2D-DSA, on rotational angiography (3D-RA) and on dual volume reconstruction translucent images were determined, and the results were compared between each other of the three imaging methods. Results A total of 34 stents (206 stent point-marks in total) were implanted in the 30 patients. Of the 206 stent point-marks, 2D-DSA, 3D-RA and dual volume reconstruction translucent image could clearly display 146 (70.8%), 123 (59.7%) and 190 (92.2%), respectively. Statistically significant difference in the displaying rate of the stent point-marks existed between each other among the three imaging methods (P < 0.05). Conclusion Dual volume reconstruction translucent imaging can distinctly display the location of the stent marks, which is of great value in guiding the performance of intracranial stent implantation surgery.

microRNAs (miRNAs) are short non-protein-coding RNAs,which play important roles in the cell proliferation,differentiation,apoptosis,as well as activation of oncogenic and antioncogenic signals.Researches show that the abnormal expressions of miRNAs are closely related to the tumorigenesis,histological type,diagnosis,treatment and prognosis of lung cancer.So miRNAs may be the most potential and promising therapeutic targets for lung cancer.