Objective:To establish a nicotine-treatment and-withdrawal rat model and to evaluate its characteristics and application through analyzing 3 parameters.Methods:Male Sprague-Dawley rats,aged 10-11 weeks old,were randomly divided into normal saline group(subcutaneous injection of saline [0.5 ml/kg] for 6 weeks),nicotine-treated group(injection with nicotine [0.5 ml/kg,3 mg/(kg?d)] for 6 weeks),and nicotine-withdrawn group(injection with nicotine [0.5 ml/kg,3 mg/(kg?d)] for 3 weeks and followed by saline injection for additional 3 weeks).Body weight,food intake,and water intake of animals were recorded during the treatment in 3 groups.The model was evaluated through analyzing body weight,serum parameters and adipose tissue weights.Results:The body weight of rats,as well as the serum levels of triglyceride and insulin,were all decreased after nicotine treatment;the weights of subcutaneous fat,visceral fat and periaortic fat were also decreased.The above indicators increased after withdrawal of nicotine.Conclusion:The established model can be used to study multiple pharmacological effects of nicotine;it can also be used for smoking and smoking cessation related studies.

Objective To explore the therapeutic effect and nursing points of different linked modes in hemodialysis combined with hemoperfusion on renal osteopathy disease in maintenance hemodialysis (MHD) patients.Methods Sixty-four MHD patients with renal osteopathy disease were enrolled in the study.They were divided into two groups by random digits table method:the front connection group and the back connection group with 32 cases each.Their clinical data,serum parameters and complications were recorded.The therapeutic effect of two groups were compared.Results The serum level of intact parathyroid hormone(iPTH) was (191.36 ± 53.96) ng/L in the front connection group,while (133.02 ± 38.63) ng/L in the back connection group,and there was significant difference,t=3.517,P＜0.05.The incidence of lower blood pressure and blood coagulation were 8.85％(51/576),6.94％(40/576) in the back connection group,while 14.93％(86/576),15.97％(92/576) in the front connection group,and there were significant differences,x2=10.149,23.136,P＜0.01.Conclusion The back linked mode in hemodialysis combined with hemoperfusion can obviously decrease iP:TH of MHD patients combined with renal osteopathy disease and has less complications,worth clinical promotion.

Objective To investigate the changes in lung resistance-related protein (LRP) and vascular endothelial growth factor (VEGF) expressions and micro-vessel density (MVD) in non-small cell lung cancer (NSCLC), and to elucidate their possible relationship and mechanism. Methods Immunohistochemistry was used to detect changes in LRP and VEGF expressions, and MVD level in lung tissues of 56 NSCLC cases and 27 normal controls. Results ① LRP expression (66.1%) was concentrated in the cytoplasm of cancer cells, which was significantly higher than that in lung tissues of control group (P<0.01); the significance was not related to the pathological type. There was no significant difference in LRP expression among gender, TNM stage, lymph node metastasis, and two-year survival in NSCLC (P>0.05). ② In comparison to the control group, NSCLC group had significantly increased VEGF expression (P<0.01), which was not related to the pathological type. VEGF expression in NSCLC group had a significant association with TNM stage and lymph node metastasis (P<0.05). ③ The NSCLC group had a significantly higher MVD than the control group (P<0.01), which was not affected by the pathological type or degree. MVD value (18.5±5.8) of stage Ⅲ and Ⅳ in NSCLC group was significantly higher than that (13.8±5.1) of stage Ⅰ (P<0.05); MVD value for patients with lymph node metastasis was higher than that without lymph node metastasis (P<0.05); MVD value for patients with two-year survival was less than those who died within two years (P<0.01). ④ NSCLC group with high VEGF and LRP expressions had a consistently increased MVD value (P<0.05). Conclusion There is a certain relationship between tumor angiogenesis and LRP expression in NSCLC. VEGF is responsible for the high expression of LRP through up-regulating LRP gene and augmenting tumor MVD. Inhibition of angiogenesis in tumor is expected to reduce or inhibit drug resistance to NSCLC.

OBJECTIVED: To explore the prevalence and risk factors of type 2 diabetes mellitus (T2DM) and impaired glucose regulation (IGR) in Zhangzi Island of Dalian, additionally to provide a better understanding of further intervention. METHODS: A cross-sectional study was performed in 907 residents aged over 18 years from Zhangzi Island of Dalian. The questionnaire, physical measurement, food intake frequency and previously dietary investigation were used in the analysis. Simultaneously, a series of biochemistrical and immune index was measured, including blood uric acid, blood sugar, total cholesterol, triacylglycerol, as well as serum insulin.RESULTS: The recovery rate of questionnaire was 95.9%, which demonstrated that the prevalence rates of T2DM and IGR in Zhangzi Island were 11.36% and 37.38%, there was no significant differences between males and females (P > 0.05). Only 29.13% of the people with T2DM were aware of the condition. The prevalence of DM and IGR were increased significantly with age (P < 0.01). The results of the logistic regression showed that age, education, alcohol drinking and hypercholesteremia were the risk factors of IGR. In addition, age, education, hypercholesteremia, hypertriglyceridemia, body mass index and hypertension were the important risk factors for the development of DM. CONCLUSION: The prevalence rates of T2DM and IGR in Zhangzi Island of Dalian are high with a low awareness. Health promotion on lifestyle changes may help to increase the public awareness and reduce the prevalence.

Objective To assess the disorders of glucose metabolism and insulin resistance in patients with rheumatoid arthritis (RA) and its relationship with disease activity.Methods One hundred and twenty-three RA patients along with 98 age and sex matched controls were studied.Seventy-five g oral glucose tolerance test was performed.The homeostasis model assessment of insulin resistance (HOMA-IR) and beta cell function (HOMA-β) were evaluated.Disease activity score (DAS28) was used to assess disease activity.According to their DAS28 values,patients were divided into high disease activity group and low to moderate disease activity group.Glucose tolerance and HOMA-IR were compared between the two groups.Parameters that reflects disease activity,such as CRP and ESR,as well as disease activity scores were compared between patients with T2DM or prediabetes and patients with normal glucose tolerance.The data was analyzed by t test,Pearson correlation analysis and chi-square test.Results The prevalence of T2DM [20.3％(25/123) vs 5.1％ (5/98),x2=10.774,P＜0.01] and prediabetes [39.0％ (48/123) vs 7.1％ (7/98),x2=29.657,P＜0.01] increased in RA patients compared to controls.RA patients had higher HOMA-IR (2.5±1.5 vs 0.8±0.4; t=5.185,P＜0.01) and lower HOMA-β (83±69 vs 192±85; t=3.768,P＜0.01) compared to controls.ESR [(55±30) mm/1 h vs (37±26) mm/1 h; t=3.159,P＜0.01],CRP [(40±23) mg/L vs (19±10) mg/L; t=3.628,P＜0.01] and DAS28 score (5.6±1.3 vs 4.8±1.2; t=2.923,P＜0.01) were higher in RA patients with T2DM or prediabetes than in RA patients with normal glucose tolerance.In RA patients,the HOMA-IR was significantly positively correlated with DAS28 (r=0.39,P＜0.01),ESR (r=0.54,P＜0.01)and CRP (r=0.20,P＜0.05).The HOMA-IR value and fasting insulin levels were higher in high disease activity patients (DAS28＞ 5.5) than in low-to-moderate disease activity patients (DAS28 ≤5.5) although fasting plasma glucose level did not differ significantly in these two groups.Conclusion The prevalence of T2DM and prediabetes increases in RA patients comparing to controls.RA patients have insulin resistance that is associated with disease activity and systemic inflammation.

Objective To study the correlation of multi-slice CT portography (MSCTP) and digestive endoscopy in the diagnosis and evaluation of esophageal and gastric varices (EGV) caused by cirrhosis.Methods A total of 92 patients with cirrhosis were enrolled in the prospective study.All the patients were examined by endoscopy and 64-slice spiral CT scan in 4 weeks.The types,grading of EGV were observed by endoscopy and MSCTP,and Kappa conformance test was applied with the endoscopic findings as gold standard.The sensitivity,specificity,consistency,and Youden index were evaluated for the diagnosis of sophageal and gastric varices by MSCTP.Results Sixty-five patients were diagnosed to have EGV by endoscopy and 27 were negative.The positive patients included 45 patients of GOV1,19 of GOV2 and 1 patient of IGV1.MSCTP diagnosed 67 cases of EGV and 25 patients of negative results.The positive patients included 46 of GOV1,18 of GOV2 and 3 of IGV1.Two patients of IGV1 varicose veins without positive findings on endoscopy were diagnosed by using MDCTP,which revealed isolated varicose veins under the gastric mucosa.There was high consistency between MSCTP and EGV in the diagnosis of EGV (Kappa =0.732,P ＜ 0.01).The sensitivity of MSCTP was 93.8％,specificity was 77.8％,consistency was 89.1％,and Youden index 71.6％.There was high consistency between MSCTP and EGV in the classification of EGV (Kappa values were 0.743 and 0.763,P ＜ 0.01).Conclusions There is high consistency between MSCTP and digestive endoscopic in the diagnosis and classification of EGV in cirrhosis.MSCTP is superior to endoscopy in the detection of gastric varices.

Objective To understand the status and difference of breastfeeding behavior in urban and rural areas of Southwest China.Methods From March to July in 2011,3659 infants aged 6-24 months were selected by stratified cluster randomized sampling method in urban and rural areas of three provinces of Southwest China (Sichuan,Yunnan and Guizhou),including 1801 (49.2％)infants from urban areas and 1858(50.8％) from rural areas.Basic information of these infants,their families and breastfeeding was obtained by a questionnaire for the mothers or baby-carers.Descriptive analysis and survival analysis (Kaplan-Meier method) were used to describe breastfeeding behavior.Chi-square test and Log-Rank test were used to identify the differences of breastfeeding behavior between urban and rural areas.Results Early breastfeeding initiation rate within one hour after birth was 10.7％(355/3315),and the numbers of urban and rural areas were 12.3％(198/1604) and 9.2％ (157/1711),respectively,x2 =8.691,P＜0.05.Totally,20.3％(725/3575) of all infants were initially fed by breast milk after delivery,and 25.1％ (440/1754) in urban areas and 15.7 ％ (285/1821) in rural areas,x2 =49.192,P＜0.05.The exclusive breastfeeding rate and breastfeeding rate within four months after birth were 35.5％ (27.4％ in urban and 43.6％ in rural areas,x2=88.678,P＜0.05)and 76.2％ (68.5％ in urban and 84.3％ in rural areas,x2 =124.702,P＜0.05),respectively.However,the exclusive breastfeeding rate and breastfeeding rate within six months after birth reduced to 11.3％ (7.9％ in urban and 14.4％ in rural areas,x22 =18.001,P＜0.05) and 65.0％ (54.0％ in urban and 76.3％ in rural areas,x2 =199.662,P＜0.05),respectively.The median breastfeeding duration was 8.0 months (7.0 months in urban and 9.0 months in rural areas,x2 =96.780,P＜ 0.05).The most common reason of weaning was insufficient breast milk which accounting for 48.7 ％ of families [56.9％ (1161/2385) in urban and 39.9％(462/1157) in rural areas,x2=68.840,P＜0.05].Conclusions In Southwest China,intervention program should be implemented to improve the breastfeeding status.Breastfeeding behaviors are different between urban and rural areas in Southwest China.The initiation of breastfeeding in urban area is better,but the sustainability of breastfeeding is better in rural area.

ABSTRACT:Objective To investigate the clinical features of seronegative rheumatoid arthritis (RA)in western China and its outcomes after one-year treatment with disease modifying anti-rheumatoid drugs (DMARDs) so as to provide evidence for effective therapy.Methods We made a retrospective analysis of 240 RA patients treated in our department from May 2013 to June 2014.We compared the 47 seropositive and 25 seronegative RA patients in clinical features,laboratory parameters and outcomes after one-year DMARDs medication.Results The percentage of seronegative RA was 10.4% (25/240).The number of swollen small joints was significantly smaller in seronegative RA group (P<0 .0 1 ).Compared with those in seropositive RA,the level of hemoglobin was lower,the level of platelets was higher,and the level of alkaline phosphatase was lower in seronegative RA (P<0 .0 5 ).The remission rate was higher in seronegative RA group than in seropositive RA group after one-year DMARDs administration (P<0.05).Conclusion Seronegative RA is not rare in clinic.Even though seronegative RA patients often present fewer swollen small joints, it is difficult to distinguish between seronegative and seropositve RA just based on the clinical features.Besides,hematological damage is more severe in some patients with seronegative RA.Only after one-year treatment with DMARDs,the remission rate is higher in seronegative RA patients than in seropositve RA ones.

Objective To investigate the serum and placental expressions of asymmetric dimethylarginine (ADMA) and nitric oxide(NO) in fetal growth restriction (FGR),and explore the biological role and mechanisms of ADMA in FGR.Methods Fifty patients with FGR (FGR group)and 50 normal term pregnant women (control group) were detected for the levels of ADMA in maternal sera and placentas with enzyme linked immunosorbent assay (ELISA).The level of NO in maternal sera was analyzed with nitrate reductase method,and the placental tissue sections were analyzed with pathological morphologly.Results For FGR group,the main pathological changes were growth retardation of villi,increased syncytiotrophoblast nodules,and the lack terminal villi;and the incidence rate of pathological change of placental tissue was significantly higher than that in control group [64.0％ (32/50) vs 12.0％ (6/50),x2 =7.90,P ＜ 0.01].For the placental pathological change group,the concentrations of ADMA in the placentas and sera were significantly higher than the normal group [placenta ADMA:(2.21 ± 0.72) μmol/L vs (1.69 ± 0.77) μmol/L,t =3.33,P ＜ 0.01;serum ADMA:(2.01 ± 0.70) μmoL/L vs (1.18 ± 0.54) μmol/L,t =6.66,P ＜0.01].The expression of ADMA was up-regulated in maternal sera and placentas from FGR group compared to normal pregnancy [placenta ADMA (2.24 ± 0.81) μmol/L vs (1.53 ± 0.59) μmol/L,t =5.00,P ＜0.01;serum ADMA (1.89 ±0.75) μmol/L vs (1.10 ±0.43) μ mol/L,t =6.45,P ＜ 0.O1].The NO was extremely lower expressed in maternal sera with FGR than normal pregnancy [(39.59 ± 9.15) μmol/L vs (58.02 ± 15.45) μmol/L t =-7.26,P ＜ 0.01)].For FGR group,a significant negative correlation was observed between ADMA and NO expressions in sera (r =-0.693,P ＜ 0.01).Conelusions ADMA was associated with the occurrence and development of the FGR,and its mechanism maybe inhibits NO synthesis to result in placental malperfusion.

Objective:To observe the hemorheological change of vitiligo patients both before and after treatment by Vitiligo Granules or Vitiligo Liniment combined with UVA phototherapy, researching the relationship and clinical significance between vitiligo and hemorheology. Methods: Hemorheological detection was made before and after treatment for 30 normal cases and 58 cases of vitiligo. Results: The total effective rate was 74.15%. The indexes levels of hemorheology of treatment group was higher than those of normal group before treatment (P