To investigate the relationship between sex hormone binding globulin (SHBG) and metabolic syndrome in elderly males in Shanghai,all the subjects (≥ 60 years old,male) underwent measurements of weight,height,waist and hip circumferences,and blood pressures,serum levels of fasting plasma glucose,total cholesterol,triglyceride,high density lipoprotein-cholesterol (HDL-C),and low density lipoprotein-cholesterol were determined (Hitachi,7600),while the levels of serum insulin,total testosterone,and SHBG were determined by using chemiluminescence methods.Free testosterone was calculated by using the Vermeulen equation.Metabolic syndrome was defined according to the criteria of the Chinese Diabetes Society (CDS 2004).The SHBG level in the metabolic syndrome group was significantly lower than that in non-metabolic syndrome group [(40.50 ± 26.16) nmol/L vs (47.80± 20.34) nmol/L,P＜0.01].With increasing number of metabolic syndrome components,the level of SHBG became lowered progressively.The subjects were divided into four subgroups according to SHBG Quartiles.From Quartile 1 to Quartile 4,body mass index,waist-hip ratio,diastolic blood pressure,fasting plasma glucose,triglyceride,fasting insulin,homeostasis model assessment for insulin resistance(HOMA-IR),free testosterone,free androgen index,and free testosterone percentage became progressively lowered,while age and HDL-C became raised (P＜0.05).SHBG was correlated significantly with age,body mass index,waist-hip ratio,diastolic blood pressure,fasting plasma glucose,HDL-C,and triglyceride.Age,HDL-C,and body mass index remained independently associated with SHBG in the multivariate regression analysis.In a logistic regression taking metabolic syndrome as the dependent variable,SHBG and HOMA-IR were included in the final model with statistical significance.Lowered SHBG is a risk factor of metabolic syndrome in elderly males.SHBG may be an independent predictor of metabolic syndrome,but the mechanism of how SHBG is involved in the metabolic syndrome needs to be further studied.

Objective To explore the relationship between serum uric acid and fasting blood glucose ( FBG) in newly-diagnosed type 2 diabetes in regard to different genders. Methods In 282 patients of newly diagnosed type 2 diabetes(208 males and 74 females), detection of serum FBG, uric acid, creatinine, transaminases, blood lipids, etc were determined. FBG<7. 0 mmol/L was found in 118 cases (89 males and 29 females);7. 0 mmol/L≤FBG≤9. 0 mmol/L in 114 cases ( 88 males and 26 females ); FBG>9. 0 mmol/L in 50 cases ( 31 males and 19 females). Results (1)Serum uric acid showed statistically significant difference in regard to sex[Male:(325. 82±92. 26)μmol/L, Female:(292. 26±76. 19)μmol/L, P<0. 01]. (2) FBG and serum uric acid were negatively related(r=-0. 316, P<0. 01). (3) FBG and serum uric acid were negatively related both in male(r=-0. 320, P<0.01)andinfemale(r=-0.291,P<0.05). (4)Multiplestepwiseregressionanalysisshowedthatthethreegroups of FBG and serum uric acid showed regression relationship in male and female patients(P<0. 01). Conclusion With the increased FBG, serum uric acid was decreased in both males and females. Therefore, serum uric acid might serve as a potential biomarker of glucose metabolism.

Objective To study the changes of Young's modulus value of the renal cortex,vertebral body and sinus when there was a different degree of acute renal artery stenosis.Methods 10 Japanese white rabbits were used for this study.The left renal artery was dissected.An ultrasound probe was placed on the left kidney,Young's modulus of the renal cortex,vertebral body and sinus were recorded using shear wave ultrasound elastic imaging technique during three stages:when the renal artery was intact (0％ stenosis),tied with a suture (＞ 50％ stenosis),and ligated (100％ stenosis).Renal tissue elasticity with different degrees of renal artery stenosis were compared.Pathological study was carried out in the kidneys,each with either 0％,＞ 50％ or 100％ renal artery stenosis.Results The mean values of Young's modulus from the renal cortex,vertebral body and sinus with different degrees of renal artery stenosis were as follows:0％ stenosis,(16.31 ±1.70) kPa,(13.38± 1.63) kPa,and (12.75±2.26) kPa;＞ 50％ stenosis,(14.16±2.34) kPa,(11.49±2.70) kPa,and (10.72±2.56) kPa;100％ stenosis,(11.35 ± 1.48) kPa,(8.39± 1.29) kPa,and (7.08 ± 1.52) kPa.The mean value of Young's modulus from the renal cortex was significantly higher than those from the renal vertebral body and sinus (P ＜ 0.05).The mean values of Young's modulus from different parts of the kidney decreased progressively with an increase in renal artery stenosis (P ＜ 0.05).The pathological study demonstrated that with the increase in the severity of renal artery stenosis,glomerular volume,renal interstitial capillary diameter and red blood cells decreased.When renal artery stenosis reached 100％,there was patch degeneration and inflammatory cell infiltration within the renal interstitium,and mild degeneration of tubular epithelial cells with obscure cell borders.Conclusions The value of Young's modulus from the renal cortex was higher than those from the renal pyramid and sinus in rabbits.The values of Young's modulus from the renal cortex,pyramid and sinus decreased with an increase in the severity of renal artery stenosis,which suggest that,in the study of the elasticity of the kidney,the renal artery blood flow dynamic state can obviously affect the value of the elasticity of the kidney.

Objective To describe the time trend of esophageal and gastric cardia adenocarcinomas in Chongqing of China in the past 30 years .Methods The medical records of all patients who underwent gastroscopy from Janaury 1983 to December 2012 at the Southwest hospital were reviewed .The rate of endoscopic detection and proportion of adenocarcinoma in all upper gastrointestinal tumors (esophageal adenocarcinoma ,esophageal squamous cell carcinoma ,gastric cardia adenocarcinoma and gastric non-cardiac ad-enocarcinoma) were compiled and serial comparisons were made .Results 435 829 patients who underwent gastroscopy were re-viewed .Totally ,there were 352 patients with esophageal adenocarcinomas(0 .08% ) ,10 301 with esophageal squamous cell carcino-mas(2 .40% ) ,3 058 with gastric cardia adenocarcinomas(0 .70% ) and 5 543 with gastric non-cardiac adenocarcinomas(1 .30% ) .O-ver the 30-year period ,the rate of endoscopic detection of esophageal adenocarcinomas did not show a statistically significant .How-ever ,the proportion of esophageal adenocarcinomas increased from 1 .90% to 3 .20% ,suggesting an increased proportions .The rate of endoscopic detection of gastric cardia adenocarcinomas increased from 0 .70% to 0 .81% and the proportions of gastric cardia ade-nocarcinomas increased from 25 .30% to 38 .30% .Conclusion Over the 30-year period ,it seems that the incidence of esophageal adenocarcinoma had increased .An increasing trend of gastric cardia adenocarcinoma is also observed in this study ,especially in male patients .

OBJECTIVETo study the types of subspecies of Francisella tularensis from China and to investigate the genetic relationships between F. tularensis strains from China and from other countries.

METHODSTen strains of F. tularensis isolated from China were amplified by using typing primers C1/C4 and RD1. On the basis of the lengths of the polymerase chain reaction (PCR) products, it was concluded that these strains of F. tularensis belonged to the same subspecies. At the same time, the fopA, tul4, and 16S rRNA genes of the 10 strains were amplified, and a three-gene based phylogenetic analysis was performed using the Molecular Evolutionary Genetics Analysis software version 4.0.

RESULTSThe 10 strains of F. tularensis from China were all identified as belonging to subspecies holarctica (type B). We found no direct relationship between the genotypes of F. tularensis subsp. holarctica and the geographical area from where they were isolated.

CONCLUSIONThe F. tularensis strains isolated from North China mainly belong to subspecies holarctica (type B). The strains of F. tularensis subsp. holarctica from China may have evolved earlier than those from Europe and North America.

Cellular and Molecular Basis of Medicine is a basic module course newly established by our school that is compulsory for medical students. This module course overthrows traditional disciplinary boundaries, and adopts the forms of combining classroom teaching with students' self-learning and teachers' instruction with topic discussion of students guided by teachers. In the teaching of the module course, discussion was adopted among students which involves teachers giving out the range of topics to students so that they can prepare for the topic of their intertest. After group discussion during class, the head of the teaching group gave comment on students' discussion and prize for whom had the best performance. Then, students were asked to summarize and analyze the questions raised during discussion after class. In conclusion, discussion class has stimulated students' interest in learning, improved their ability to think independently and encouraged them to demonstrate their abilities, which has achieved good teaching outcomes.

Objective:To explore the relationship between executive function and gait in cases of mild amnestic cognitive impairment (aMCI).Methods:Twenty aMCI hospital patients formed an observation group, while 20 healthy counterparts were the control group. Both groups underwent the Tinetti test, followed by the " normal walking" single-task test and the " normal walking + Go/No-go" dual-task test. The pace, step width, stride length, Go/No-go task response time and accuracy rate were recorded.Results:In the single-task test, there was no significant difference in pace or stride width between the two groups, but the average stride length of the observation group (1.11±0.04)cm was significantly shorter than that of the control group. However, in the dual-task test, the average pace time (0.96±0.08)sec and stride length (1.02±0.06)cm of the observation group were significantly smaller than the control group′s averages, while their step width (0.11±0.02)cm was significantly wider. There was no significant difference between the two groups in the response time in a single (Go/No-go) task, but in the dual-task test, the observation group′s average time was significantly longer than the control group′s and the accuracy was significantly poorer. Both the error rate and the non-response rate were significantly higher than among the control group.Conclusions:Mild amnestic cognitive impairment reduces stride length and pace when walking and impairs executive function.

Objective To compare the coding sequences (CDS) of Yersinia pestis D106004 strain from Yulong County in Yunnan Province and Z176003 strain from Qing-Tibet Plateau in order to find the differences between their genomes and the genetic characteristics. Methods The CDS of Yersinia pestis D106004 strain and Z176003 strain were searched and compared by BLAST. Twenty-two differential CDS were selected to design 22 pairs of primers. PCR amplification was carried out in 119 representative plague strains from different isolation sources (natural foci of Himalayan marmot plague in the Qinghai-Tibet Plateau, natural foci of Apodemus chevrieri and Eothenomys miletus plague in Yunnan), time span of about 50 years, and distribution in six ecological types including Tibet, Qinghai, Sichuan, Gansu and Yunnan, and PCR products were sequenced and verified. The strains were all from the State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention. Results In 119 representative plague strains of 6 ecological types, the cumulative sequence length of 22 differential CDS PCR amplification products was 2.13 × 106 bp. Among the 119 representative plague strains in the foci of Yulong D106004 strain and Qinghai-Tibet Plateau Z176003 strain, 22 differential CDS had high homology, there was no difference in 78.2％ (2047/2618) sequences of differential CDS, and 21.8％ (571/2618) sequences had three types of gene mutations ( deletion , missense and frameshift mutations). The characteristics of the differences were stable in the 6 ecological plague strains of the foci, and they were divided into 6 geographical distributions. Conclusion Yulong D106004 strain and Qinghai-Tibet Plateau Z176003 strain have high homology, close genetic relationship, and little difference in genome, but the genetic characteristics of different ecotype strains are stable.

Objective:To investigate whether the squirrels in Yunnan Province carried Yersinia pestis phages and their epidemiological significance. Methods:From 2015 to 2018, plague host animals were investigated in five of Yunnan plague foci and non-plague foci. The spleen, liver and intestinal specimens of the squirrels captured in the investigation were taken and stored at low temperature for later use. Intestinal specimens with PBS solution, were filtered by 0.22 μm and added to LB liquid medium containing 100 μl suspension of plague vaccine strain (EV76) and then oscillated in a constant temperature gas bath at 28 ℃ and 220 r/min for 18 to 24 h. The double-layer plate method was used to isolate and observe the growth of plaque. The morphology and structure of Yersinia pestis phages were observed under electron microscope. Meanwhile, spleen, liver and intestinal specimens were taken for detection of Yersinia pestis specific marker gene caf1. Results:A total of 10 squirrels were captured (8 Callosciurus erythraeus and 2 Dremomys pernyi), and four Yersinia pestis phages were isolated (2 in Callosciurus erythraeus and 2 in Dremomys pernyi). Two were isolated from non-plague foci (Yongshan County), two from house rats plague foci (Mile County and Xinping County), and none was isolated from wild radents plague foci (Jianchuan County and Eryuan County). By naked eye observation, two bacteriophages from the plague foci produced transparent plaques and grew well, while two bacteriophages from non-plague foci produced translucent plaques and with poor growth. By electron microscopy, these Yersinia pestis phages were of typical Myoviridae family, their head diameter was about 40 nm, muscle tail was about 120 nm, and tail filament cluster was slightly visible at the end of muscle tail. And all the 10 samples of squirrels were negative of plague-specific caf1 gene. Conclusions:The proportion of plague phages carried by Yunnan squirrels is relatively high. Although the detection of caf1 is negative. Squirrels may be a carrier of plague transmission due to the existence of Yersinia pestis phages.