Objective To explore the efficiency and safety of fondaparinux and low molecular weight heparin(LMWH) on the elder patients with non-ST-segnent elevation acute coronary syndromes (NSTE-ACS).Methods One hundred and forty patients over 75 years old with NSTE-ACS were randomly divided into treatment group(n =70) and control group (n =70).Patients in treatment group were given the conventional treatment combined with fondaparinux,and in control group were given the basis of conventional treatment combined with LMWH.The therapeutic efficacy,the cardiovascular events at 4 d,7 d and 30 d during the treatment and bleeding incidence rate were observed.Reslts There was no statistically significant difference between the treatment group and control group in the total effective rate (x2 =0.475,P ＞ 0.05.Meanwhile,no significant differences were found between the two groups in cardiovascular events at 4 d,7 d and 30 d (x2 =0.257,0.475 and 0.317,P ＞0.05).The incidence rate of bleeding in treatment group was obviously lower than that in control group and there was statistically significant difference (2.9％ vs.31.4％ ; x2 =20.115,P ＜0.01).Conclusion The effectiveness of fondaparinux used in elderly patients with non-ST-segment elevation acute coronary syndromes is similar with LMWH,but the incidence rate of bleeding is lower than LMWH.

Objective To compare the short-term prognostic value of glycohemoglobin (HbA1c) and admission plasma glucose in non-diabetic patients with acute ST-elevation myocardial infarction.Methods Eighty-four non-diabetic patients with acute ST-elevation myocardial infarction from January 2010 to June 2011 were included.Both HbA1c and plasma glucose was measured on admission.Cardiovascular event was followed up in 30 days.Results The average of HbA1c and admission plasma glucose was as cut-off point.The patients were divided into HbA1c ＜ 5.5％ group (40 cases) and HbA1c ≥5.5％ group (44 cases) according to HbA1c level.The patients were divided into admission plasma glucose ≤ 8.6 mmol/L group (42 cases) and admission plasma glucose ＞ 8.6 mmol/L group (42 cases) according to admission plasma glucose.The incidence of cardiovascular event in 30 days in admission plasma glucose ＞ 8.6 mmol/L group was higher than that in admission plasma glucose ≤ 8.6 mmol/L group [19.0％ (8/42) vs.2.4％ (1/42)],and there was significant difference(P＜ 0.05).There was no significant difference in the incidence of cardiovascular event in 30 days between HbA1c ≥5.5％ group and HbA1c ＜ 5.5％ group (P ＞ 0.05).Admission plasma glucose showed weak correlation with blood creatine kinase isoenzyme MB peak (r =0.233,P ＜0.05).Conclusion In non-diabetic patients with acute ST-elevation myocardial infarction,elevated admission plasma glucose levels are associated with higher cardiovascular event in 30 days.

Objective To investigate whether soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) as the early diagnostic biomarker of acute ST elevation myocardial infarction (STEAMI).Methods Sixty-five patients with STEAMI and 30 patients with stable coranary heart disease or other heart disease(control group) were enrolled as our subjects.Serum sLOX-1 levels were measured.Results The median(P25,P75) of Serum sLOX-1 in the patients with STEMI were 210.0 (130.0,356.0) ng/L,significantly higher than that of control group(65.5 (55.2,85.2) ng/L,Z =6.17,P ＜ 0.001).Logistic regression analysis revealed that sLOX-1 alone was an independent factor associated with STEAMI (B =0.036,P ＜ 0.001).The area under the ROC curve of sLOX-1 for detecting STEMI was 0.895,and 95％ CI was 0.831-0.959 (P＜0.001).Taking sLOX-1 =87.5 ng/L as cut-off value,the sensitivity was 89.6％ and specificity was 82.4％for the diagnosis of STEAMI.Conclusion Serum sLOX-1 was significantly higher in the STEAMI and it might served as the early diagnostic marker for STEAMI.

ObjeclJve To definine the corresponding value to glycated albumin(GA)for a specific target of HbAlc,and to elvaluate the relationship between GA and HbA1c.Methods From Oct.2006 TO Apr.2009, 2 532 subjects were enrolled who accepted oral glucose tolerance test(OGtt)in out-patient department,including 898 with normal glucose regulation,695 with impaired glucose regulation,and 939 with newly-diagnosed diabetes.GA was measured with liquid enzymatic method.HbA1c was measured with high performance liquid chromatography method.The plasma glucose was measured at fasting,0.5 h,1 h,2 h,and 3h after glucose load.The correlation among GA,HbA1c and the other parameters monitored was analyzed.Results (1)The levels of HbA1c and GA in 2 532 subjects were(6.3±1.1)% and(17.9±4.5)%.The ratio of GA/HbA1c was 2.85±0.51.(2)HbAlc and GA were positively correlated with fasting,0.5 h,1 h,2 h and 3 h plasma glucose(r was in 0.567-0.776,atl P<0.01).(3)GA was significantly correlated with HbA1c(r=0.701,P<0.01).Linear regression analysis,using GA and HbA1c summarized by patient(n=2 532),produced a relationship of GA=2.871×HbA1c-0.112.The change in GA per increase of 1% HbA1c was 2.87%.When HbA1c level was 6.5%,the expected value of GA was 18.5%.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy with GA≤18.5% to predict HbA1c≤6.5% were 82.32%,72.49%,86.48%.65.73%,and 79.19%,respectively.When HbA1c level was 7.0%,the expected value of GA was 20.O%.When HbA1c level was 7.5%.the expected value of GA was 21.4%.Conclusions We initially establish the corresponding value to GA for a specific target of HbA1c and provide the basis for clinical application.

Objective To research the consistency of testing results with three different antimajor histocompatibility complex class Ⅰ-related chain A(MICA) specific antibody reagents in order to evaluate their clinical application's value.Method An collaborative study of 18 laboratories was undertaken at the 16th International HLA and Irnmunogenetics Workshop.Total of 16 sera(4 batchs)were tested for anti-MICA antibodies by Luminex method with three different reagents (Kit-A,-B and -C).Result Anti-MICA antibodies were found in 15 sera,except one sera(no.S04) ; No.S10 sera showed positive results in all the laboratories.The anti-MICA antibodies were divided into MICA-G1 group (MICA01,02,07,12,17 and 18) and MICA-G2 group (MICA 04,06,08/27,09 and 19).MICA-G1 group specific antibodies were detected in 5 sera with Kit-A and-B reagent; but there were false-positive results of anti-MICA08/27 and MICA19 antibodies in this 5 sera with Kit-C.MICA-G2group specific antibodies can be detected in other 5 sera with Kit-A and-B,But the MICA specific antibodies testing gave different results with Kit-A,-B and-C in all the last 5 sera samples.Testing of MICA08/27 showed highest consistency results (86.67％,13/15) with Kit-A,-B and-C; and testing of MICA19 showed lowest consistency results (40％,6/15) with this 3 reagents.There were 80％ consistency results of anti-MICA specific antibodies in 13 sera with Kit-B.Conclusion There are the same effect to judgment positive or negative result for anti-MICA antibodies with 3 different reagents,but the results of anti-MICA specific antibodies are not the same.Therefore,it's better to use two or more reagents to test anti-MICA specific antibodies,or choose reagent with wide detection range.

Objective To compare the values of automated breast volume scanner(ABVS) and conventional ultrasound(US) in the diagnosis of breast microcalcifications.Methods Sixty-eight cases of patients with breast microcalcifications 71 lesions were found by mammography,which were also examined by ABVS and US.The detection rate of microcalcifications under different background which have masses or not by the two methods were compared respectively,and the detection rate in the different pathological types of breast were also compared.All the cases were confirmed with histopathology.Results Sixty-five cases with breast microcalcifications were detected by ABVS and 55 cases detected by US,respectively.The detection rate of ABVS was significantly higher than that of US (91.5％ vs 77.5％,x2 =5.379,P =0.020).Forty-four cases of microcalcifications were found within the masses,but the other 27 cases without mass.The detection rate of microcalcifications within the masses had no siginificant difference between ABVS and US (97.7％ vs 93.2％,x2 =0.262,P =0.609),but ABVS was significantly higher than US (81.5％ vs 51.9％,x2 =5.333,P =0.021) in the detection rate of microcalcifications without the masses.The detection rate of ABVS in microcalcifications for those patients with invasive ductal carcinoma,were found the same as US (both 100％).However,the detection rate of microcalcifications by ABVS was much higher than US (94.1 ％ vs 58.8％,P =0.039) in patients with ductal carcinoma in situ.Conclusions ABVS can improve the detection rate of microcalcifications,especially without mass.The microcalcifications distribution can be observed in the coronal plane of ABVS,which increases the detection rate of ultrasound in the diagnosis of ductal carcinoma in situ.

To investigate the relationship between serum glutamic acid decarboxylase antibody (GAD-Ab)titer and the first-phase insulin release (1PH)in newly-diagnosed type 2 diabetic patients. 1053 newly-diagnosed type 2 diabetic patients were divided into 3 groups, including 71 individuals with GAD-Ab≥1 U/ml (positive group), 171 individuals with GAD-Ab ranging from 0 to 1 U/ml (negative-1 group), and 811 individuals with GAD-Ab=0 (negative-2 group). IPH was evaluated by arginine stimulation test. In the patients of negative-2, negative-1, and positive groups, the respective values of 1 PH were subsequently decreased significantly (P< 0. 01) , and the detection rates of the decreased insulin secretion were 74. 85%, 87. 13%, and 100%, respectively. Stepwise regression analysis indicated that disease duration, GAD-Ab titer, HbA_1C, and body mass index were the major independent contributing factors. The titer of GAD-Ab has an important impact on 1PH defect in type 2 diabetic patient. Detection of GAD-Ab not only provides an evidence for clinical type, but would also be helpful in determining the islet β-cell function.

Objective To investigate the effect of solute cartier organic anion transporter family, member 1B1 (SLCOIBI) gene variants on the response to therapy with repaglinide in type 2 diabetes. Methods 100 newly-diagnosed type 2 diabetic patients were treated with repaglinide during a course of 48 weeks. Anthropometrie parameters and indices related to glucose metabolism were measured periodically. Genotypes of SLCO1B1 D130N and V174A were detected by PCR-restriction fragment length polymorphism (RFLP) and sequencing respectively. Results Eighty-nine patients accomplished the 48-week follow-up visits. D130N variant in SLCO1B1 gene was associated with repaglinide treatment, DD genotype had better HbA1C lowering effect than N allele carrier [△HbA1C: (-2.29±0.23) % vs (-1.49±0.21)%, P<0.05]. No association was detected between D130N and the other effects of repaglinide on glucose metabolism related phenotypes. Conclusion D130N variant in SLCO1B1 gene is associated with the response to repaglinide treatment in patients with type 2 diabetes. DD homozygotes had a better effect than N allele carriers.

Objeclive To explore relationship between TCM constitution and primary dysmenorrhea of female students in adolescent age,and to observe clinical effect of treating dysmenorrhea of students whose constitution tends toward Qi-deficiency and Yang-deficiency with wanning meddian therapy.Methods Relationship between TCM constitution and dysmenorrhea was performed in 789 students by questionnaire.Results Students with dysmenorrhea accounted for 50.3%,in which students with mild constitution accounted for 70.2%,and students with constitution tending toward Qi-deficiency and Yang-deficiency accounted for 80%.Conclusion Dysmenorrhea is associated with constitution.Warming meridian therapy can adjust constitution tending toward Qi-deficiency and Yang-deficiency.

ObjectiveTo investigate the value of the automated breast volume scanner (ABVS) in the diagnosis of ductal carcinomain situ(DCIS).MethodsSixty-seven patients who were diagnosed as DCIS by histopathology from December, 2010 to December, 2012 were retrospectively analyzed. Their image results and detection rates of mammography, conventional ultrasound and ABVS were analyzed and compared by Nonparametric Cochran'sQ test, and the further comparison were performed between groups by McNemar test.ResultsThe cases diagnosed as mass (with or without microcalcifications) by mammography, conventional ultrasound and ABVS were 13 (19%), 22 (33%) and 25 (37%), respectively. The detection rates of conventional ultrasound and ABVS were higher than mammography, and the differences were statistically significant (χ2=7.11, 10.08, bothP<0.05). However, the detection rate of mass between conventional ultrasound and ABVS were not statistically different (P>0.05). The cases diagnosed as simple microcalcification or associated with microcalcification by mammography, conventional ultrasound and ABVS were 42 (63%), 30 (45%) and 39 (58%), respectively. The detection rates of simple microcalcification or associated with microcalcifications by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant (χ2=8.64, 5.82, bothP<0.05). However, the detection rate of simple microcalcification or associated with microcalcifications between conventional ultrasound and ABVS were not statistically different (P>0.05). The detection rates of DCIS by mammography, conventional ultrasound and ABVS were 84%, 70% and 91%. The detection rates of DCIS by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant. But the rate between mammography and ABVS showed no statistical significance.ConclusionsABVS can improve the ultronic detection rate of breast DCIS. Its detection rate is similar with mammography performance.