Objective: To evaluate feasibility of using European Nutritional Risk Screening 2002(NRS2002) for nutritional status assessment in primary hospital.Methods: 799 patients were enrolled in this study.697 patients who were according NRS request were assessed using NRS method in hospitalization day.The patient whose NRS scores were higher than 3 were justified under nutritional risk.102 patients who were not according NRS request were assessed by exeamining the serum albumin(ALB) in the next day.The patients whose serum ALB was lower than 35 g/L were justified malnutrition.Results: There were 697 patients could be evaluated by NRS method.Body Mass Index(BMI) was lower than 18.5 in 159(22.8%) cases and NRS scores were ≥3 in 240 cases(34.4 %) among 697 cases.Serum albumin was lower than 35 g/L in 31 (30.4%) cases among 102 cases who could not be evaluated by NRS method because of incapable of standing up(66/102,64.7%) and ascites or hydrothorax(17/102,16.7%) and concomitance of above-mentioned causes(11/102,10.8%) and coma(8/102,7.8%).Conclusion: Assessment of nutritional status of hospitalized patients in primary hospital using NRS2002 method is feasible.The patients who could not be evaluated by NRS 2002 method can be assessed by assaying serum ALB.

Objective To assess the diagnostic value of the single-photon-emission computed tomography (SPECT) and the magnetic resonance imaging (MRI) for Alzheimer's disease (AD) and vascular dementia (VD), and to explore the correlation between cerebral atrophy and cerebral regional blood flow and the degree of cognitive impairment in AD patients. Methods The temporal and frontal lobes and hippocampus were quantitatively detected by MRI and the cerebral regional blood flow in these regions was analysed semi-quantitatively by SPECT for 36 patients with AD, 32 with VD and 30 sex-matched non-demented elderly controls (NC). Results The hippocampal atrophy of AD and VD groups detected on MRI was significantly different from that of the NC group. Left hippocampal height was (9.27?3.43)mm in AD, (11.62?5.72)mm in VD and (12.13?2.97)mm in NC(P0.05, compared to that of NC), showing that hippocampal atrophy could not be detected by MRI. However, RAR of the left hippocampus by SPECT detection was 0.61?0.07 (P

Objective To study the mirror writing in elderly patients with senile dementia and vascular dementia. Methods Thirty-three senile dementia patients and 30 vascular dementia patients were studied. Age- and education-matched 63 healthy elder people were included in control groups. Ten items for determination of handedness, Mini Mental Status Examination(MMSE), Global Deterioration Scale (GDS) and the written language of Chinese Aphasia Examination Scale(draft) were adopted to examine all patients. Hachinski Ischemic Scale was used for differentiation between senile dementia and vascular dementia. Results Seventeen (51.51%) of senile dementia patients and 23 (76.60%) of vascular dementia patients were mirror writiers. In the corresponding control groups, these numbers were found to be 2(6.06%) and 7 (23.30%) respectively. The occurrence rate of mirror writing in senile dementia group and vascular dementia group was markedly higher than in the normal controls(P

Objective:To analyze the podocalyxin (PCX) expression in the kidney and the number of urinary podocytes in different pathological grades of Henoch-Sch(o)nlein purpura nephritis (HSPN),and to determine whether the number of urinary podocytes reflects the renal damage in HSPN.Methods:Fifty-six children diagnosed with HSPN in our hospital were enrolled in the study and classified into 4 groups by renal pathology:grade Ⅱ (Ⅱa+Ⅱb) (n=10),grade Ⅲ (Ⅲa+Ⅲb) (n=21),grade Ⅳ (n=16),and grade Ⅴ (n=9).Four kidney autopsy specimens without histomorphologic lesions and 8 urine samples from healthy children served as controls.With immunofluorescence assay,the PCX expression in 4 normal renal tissues and in the renal tissues of the 56 HSPN children was detected and quantitatively analyzed.Positive rate and the number of urinary podocytes were detected in the 8 healthy children and 56 HSPN children.Results:In the renal tissues of the normal control group and grade Ⅱ (Ⅱa+Ⅱb) HSPN group,the PCX expression was complete.The percentage of the PCX positive area out of the total glomerular area in the renal tissues of 2 groups had no significant difference (P＞0.05).In the renal tissues of grade Ⅲ (Ⅲa+Ⅲb),Ⅳ,and Ⅴ HSPN groups,the PCX expression showed various degrees of loss,decreasing in turn from grade Ⅱ (Ⅱa+Ⅱb),Ⅲ (Ⅲa+Ⅲb),Ⅳ to Ⅴ,with significant differences between each group (P＜0.01).For HSPN with grade Ⅲ (Ⅲa+Ⅲb) or higher,positive PCX expression was found in the urine,suggesting the presence of enough podocytes in the urine.The percentage of fluorescence positive area out of the total glomerular area of PCX in the renal tissues was negatively correlated with the total number of urinary podocytes (r=-0.637,P＜0.01).Conclusion:Podocyte injury plays a certain role in the pathological progression of HSPN.The urinary detection ofpodocytes can reflect the degrees of pathological damage in HSPN.

Objective To explore the relationship between vascular endothelial growth factor (VEGF) concentration in urine and renal vascular damage in children with Henoch Schonlein purpura nephritis (HSPN).Methods The kidney pathological lesion of 78 biopsy-proven HSPN children was assessed with renal vascular damage, glomerular pathological damage, and tubulointerstitial pathological damage semi-quantitative points. The children were divided into 3 groups (light, medium, and heavy group) according to the renal vascular, glomerular, tubulointerstitial, glomerular and tubulointerstitial total pathological points. Blood and urine vascular endothelial growth factor concentration was detected by enzyme linked immunosorbent assay;the localized renal VEGF expression and microvessel density were detected by immunohistochemistry assay in the kidneys. Results The semi-quantitative points of glomerular, tubulointerstitial, renal vascular, and glomerular and tubulointerstitial total points in different groups had significant difference (all P＜0.01);the minor renal vascular damage, the higher light microvessel density, blood and kidney concentration of VEGF, and the VEGF excretion in the urine were also lower in different groups, and there were significant differences (all P＜0.01). Glomerular points were positively related with tubular points, vascular points, kidney total score (r=0.596,0.612, and 0.728;P＜0.05, 0.05, and 0.01 respectively). Microvessel density was highly positively related with blood VEGF and renal VEGF, and negatively rela-ted with urine VEGF (r=0.601, 0.696, and -0.639,all P＜0.01). Conclusion The urinary excretion of VEGF leads to the decrease of local kidney VEGF concentration resulting in the renal vascular injury, which may be the important reason for renal vascular damage and pathology chronic progress in HSPN children.

Objective To explore the difference involved in the activation of inflammation pathway and the plasma level of inflammatory factors in the subjects with different sorts of insulin sensitivity. Methods The study was carried out in 38 women, consisting of obesity (n = 22 ) and control (n = 16 ) groups according to body mass index. The insulin sensitivity was assessed by homeostasis model assessment of insulin resistance (HOMAIR). Plasma concentrations of interleukin-6 (II-6) and IL-1β were determined by enzyme immunoassay. Western blot analysis was used to examine total protein expression and phosphorylation levels of IκB kinase (IKK) ,inhibitor of nuclear factor-κB ( IκB ) in peripheral blood leukcocytes. Electrophoretic mobility shift assay (EMSA)was used to detect the binding activity of NFκB. Results The levels of fasting plasma insulin[62.2 ( 20.0-127. 0) pmol/L vs 19. 15 ( 14. 2-47. 8 ) pmol/L, P<0. 01], HOMA-IR[2. 32 ( 0. 76-5.49 ) vs 0.70(0.53-1.7),P<0.0l], HbA1 C[(5.42±0. 45 ) % vs ( 5.08 ±0. 38) %, P<0. 05], triglyceride[( 1.75 ±0. 68 vs 1.22 ±0. 58 )mmol/L, P<0. 05], plasma IL-6[3. 15 (0. 03-22. 2) pg/ml vs 1.26 (0. 74-6.06 ) pg/ml, P<0. 01], and IL-1 β[6. 53 ( 0. 84-36 ) pg/ml vs 3. 16( 1.48-8. 86 ) pg/ml, P<0. 01]in obesity group were significantly higher than those in control group. Compared with control group, the levels of IKKo, IKKβ expression and IκBα serine phosphorylation in obesity group were markedly increased, while the expression of IκBα was significantly reduced. Accompanied with the degradation of IκBα protein, the binding activity of NFκB in obesity group was significantly increased. Conclusions The plasma levels of IL-6 and IL-1β were significantly raised in obesity group. The activation of IKK-IκB-NFκB pathway is closely associated with the genesis and development of insulin resistance in obese subjects.

Objective To compare the efficacy of laparoscopic gallbladder bed dissection(LGBD)between retrograde plus anterograde and anterograde only manners.Methods All of 575 cases of laparoscopic cholecystectomy(LC)were randomly divided into two groups(group A and group B).Patients underwent LGBD with retrograde plus anterograde mannerin group A(297 cases)oronly with anterograde manner in group B(278 cases)respectively.The efficacy and safety were compared between two groups.Results The operative time were(10.0±3.7)min and(13.0±3.9)min in group A and group B respectively (P<0.05).There were 33 cases of bleeding volume more than 5 ml in group A with 85 cages in group B (P<0.05).Three cases of gallbladder rupture were found in group A compared with 10 cases in group B (P<0.05).Postoperative fluid collection in gallbladder bed occurred in 5 cases in group A compared with 19 cases in group B(P<0.05).The conversion rate was 3.70%(11/297)and 3.96%(11/278)in group A and group B respectively(P>0.05).One cage of abdominal fluid collection was observed in group A whichwas relieved after conservative therapy.No other complications occurred.Conclusions LGBD applying retrograde plus anterograde manner may shorten the operative time,decrease the bleeding during operation and minimize the postoperative complications.Surgeons might benefit from its advantage of easier manipulation.

Objective To understand the prevalence of Cryptosporidium infection in diarrhea infants under 2 years old in Wuhan City,so as to provide the epidemiological evidence for the prevention and treatment of cryptosporidiosis. Methods The fecal samples from infants under 2 years old with diarrhea were collected in Hubei General Hospital and Central South Hospital in Wuhan City,Hubei Province from August 2014 to July 2015. The fecal samples were stored in 2.5%potassium dichromate at 4℃after filtered. The DNA was extracted from the fecal pellets with the phenol-chloroform method. The Cryptosporidium species were detected by a nested PCR assay targeting the SSU rRNA gene of the parasite. All the positive PCR products were sequenced on ABI 3100 automated sequencer,and the amplified sequences were compared to homologous sequences in the NCBI database by using the Basic Local Alignment Search Tool(BLAST). Phylogenetic analyses were performed by using the software MEGA (version 4.0)based on the Neighbour-Joining method. Results The human stool specimens(n=298)were screened for the presence of Cryptosporidium by nested PCR. The infection rate of Cryptosporidium was 3.02%(9/298). The infection rate of Cryp-tosporidium was 5.93%(7/118)in the infants between 1-2 years old,and the infection rate was 1.11%(2/180)in the infants un-der 1 year old,and there was a significant difference between the two groups(χ2 =4.13,P<0.05). The nine samples which were positive by nested PCR were successfully sequenced and compared with the reference sequences in GenBank. The results revealed the nine positive specimens were all infected with C. parvum,and two of them were co-infected with C. hominis. Neigh-bor-joining trees were constructed from the aligned partial SSU rRNA sequences of these nine isolates,and in the SSU rRNA lo-cus,the nine isolates were grouped with C. parvum. Conclusion There exists Cryptosporidium infection in the infants under 2 years old with diarrhea in Wuhan City,and the main species of Cryptosporidium is C. parvum.

Objective:To investigate ulinastatin (UTI) combined with Xingnaojing injection in the treatment of acute cerebral hemorrhage (ACH) and its effect on the serum high sensitivity C reactive protein (hs-CRP),D-dimer (D-D) and neuron specific enolase(NSE) levels.Methods:110 cases of ACH patients admitted in our hospital from January 2015 to December 2016 were selected and divided into two groups according to the random number table method.The control group was given UTI treatment,while the observation group was given UTI combined with Xingnaojing treatment.Then the brain edema absorption effect,NIHSS score,serum hs-CRP,D-D and NSE levels before and after the treatment of the two groups were recorded and compared;the safety ofmedicidstion of the two groups was evaluated.Results:At the 14th day after treatment,the total effective rate of cerebral hematoma absorption in the observation group was 89.1％,which was significantly higher than 67.3％ of the control group (P＜0.01).At the 14th day after treatment,the NIHSS scores of both groups were significantly lower than those before the treatment (P＜0.01);compared with that of the control group of the same time period,at the 14th day after treatment,the improvement effect of NIHSS score in the observation group was more significant (P＜0.01).Compared with those before the treatment,the serum hs-CRP,D-D and NSE levels of both groups at the 14th day after treatment were significantly decreased (P＜0.01);at the 14th day after treatment,the serum indicators of the observation group improved more significantly than those of the control group (P＜0.01).The incidence rate of adverse reaction in the observation group was 3.6％ compared with 5.5％ of the control group (P＞0.05).Conclusion:Ulinastatin combined with Xingnaojing Injection could rapidly relieve or eliminate hematoma in the treatment of acute cerebral hemorrhage,control the inflammatory response,improve the blood coagulation system and fibrinolytic system,protect the nerve cells and reduce the neurological damagee.

Objective To evaluate the roles of plasma p-tau(~ 181P)protein for clinical diagnosis of Alzheimer′s Disease (AD). Methods Subjects including 23 mild AD(19≤MMSE≤26) and 35 moderate and severe AD(MMSE0.05). Level of p-tau(~ 181P) protein was significantly higher in the moderate and severe AD group(18.3?20.3)ng/L than that in HC( P