Objective To analyze the relationship between insulin resistance (IR) and left ventricular hypertrophy ( LVH ) in patients with early chronic kidney disease ( CKD ). Methods Homeostatic model method was used for detecting insulin resistance index (Homa-IR) in 108 patients with early CKD and 25 normal healthy cases, and the other clinical data such as Hb, creatinine clearance rate (Ccr) , parathyroid hormone (PTH) , ambulatory blood pressure monitoring ( ABPM ) data, including day average systolic blood pressure (dSBP), day average diastolic blood pressure (dDBP), night average systolic blood pressure ( nSBP) , night average diastolic blood pressure ( nDBP) , 24-hour mean systolic blood pressure (mSBP), 24-hour mean diastolic blood pressure (mDBP), decline in the percentage of diastolic blood pressure at night (nDPD) and decline in the percentage of systolic blood pressure at night (nDPS) were also measured. Echocardiography was used for measuring LVH relevant data, and left ventricular mass index (LVMI) was calculated. Then, the relationship between LVH and IR and other clinical data were analyzed retrospectively. Results IR existed in early CKD patients. With the decline of Ccr, both the value of Homa-IR and the incidence of IR increased significantly (both P < 0. 05). LVH existed in early CKD patients and with the decline of Ccr, both LVMI value and the incidence of LVH increased significantly (both P <0. 01). Compared with the non-IR group, the IR group had higher LVMI value (P<0. 05) and higher incidence of LVH (P<0. 01). Compared with the non-LVH group, the LVH group had higher levels of Fins, 2hPG, Homa-IR (all P <0. 05), and higher incidence of IR (P <0. 01). The LVH group had significant lower levels of Ccr, Hb and nDPD (all P <0. 05) , higher levels of dSBP, dDBP, nSBP, nDBP, mSBP, mDBP and PTH (all P<0.05) than the non-LVH group. LVMI had significant positive correlations with 2hPG, Fins, Homa-IR, dSBP, nSBP, mSBP and PTH (r = 0.255, 0.373, 0.376,0.222,0.199,0.225,0.221,0.246, respectively; all P<0.05), but significant negative correlations with Hb and Ccr (r = -0.588,-0.313, respectively; both P<0.01). Multi-factor regression analysis showed that Hb, Homa-IR, and Ccr entered the regression equation (y = 167. 106 - 0. 755x_1 + 0. 250x_2 +0.322x_3, y = LVMI; 167. 106 = constant, t = 12. 138, P =0.000; x_1 =Hb, t= -6.800, P = 0. 000; x_2 = Homa-IR, t = 3. 229, P = 0. 002; x_3 = Ccr, t = 2. 898, P = 0. 005). Conclusion IR existed in early CKD patients and become more severe with the decline of renal function. IR had a significant correlation with LVH, and it may be an important risk factor for the development of LVH. Besides, both anemia and decline of renal function are also associated with LVH.

Objective To explore identification method for genuine glabrous greenbrier rhizome and ensure an accurate clinical medication. Methods Such aspects as characters, microscope appearance, physicochemical analysis,chemical composition, and efficacy were used to identified the genuine glabrous from its adulterants. Results There are significant differences between glabrous greenbrier and its adulterants in the above-mentioned aspects. Conclusion Genuine glabrous greenbrier rhizome can be identified since it has obvious differences from its adulterants.

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Objective To analyze the cases of malignant tumors found in health examination in our hospital, and to determine the prevalence and characteristics of malignant tumor, and to provide evidence for the development of effective early screening program. Methods A total of 468673 subjects were included from those who had health checkup from July 2009 to December 2014 at the physical examination center. The subjects were between 4 to 96 years of age, with average age of (56.0±12.5) years. Of them, there were 278484 men, 190189 women. All cases found in the examination were confirmed with pathological testing. Prevalence comparison was done withχ2 test, statistic significance level was set at P<0.05. Results Totally 753 cases of malignant tumors were found in 6 consecutive years, with an overall prevalence rate at 160.7/100000. The prevalence rate increased yearly from 50.0/100000 for the first year, and 100.6/100000, 146.1/100000, 149.1/100000, 188.9/100000, 221.6/100000 thereafter. The difference between each 2 years was statistically significant (P<0.01). The top ten malignant tumors were liver cancer, cervical cancer, lung cancer, renal cell carcinoma, esophageal cancer, gastric cancer, colon cancer, breast cancer, leukemia and thyroid cancer. The prevalence rates of malignant tumors in the top three were liver cancer, lung cancer and kidney cancer for man and cervical cancer, lung cancer and breast cancer for women respectively. With the increase of age, the incidence of malignant tumor showed a rising trend, especially for the group of over 80 years old. But women with cervical cancer in the 50-years age group was the highest. Conclusion The number of cases of malignant tumors found in the health checkup population was rising. It is important to include early screening for malignant tumor in physical examination. We should also pay attention to the relevant departments, in order to improve the early cancer detection rate and decrease the morbidity and mortality of malignant tumors.

AIM: To observe the efficacy, feasibility and safety of endovascular stent-grafts in treating aortic dissection.METHODS: Six patients with aortic dissecting aneurysm (3 males and 3 females, aged 32-67 years, average of 50 years old) were selected from Department of Cardiology, First Affiliated Hospital of Gannan Medical College between March 2005 and March 2006. They were diagnosed by transthoracic magnetic resonance imaging (MRI) and aortic angiography, and as type Ⅲ aortic dissecting aneurysm according to Debakey typing. The tumor diameter was ranged from 3.2 to 4.3 cm. The informed consent was obtained from all patients. Two weeks after the onset, the blood pressure was control between 90-110 and 60-70 mm Hg and heart rate at 60-65 times/min, then the straight circular and bifurcated stents, the product of Yuhengjia Company, composed of single naked membrane, straight circular and bifurcated stents made of nickel-titanium memory alloy, and cover of domestic artificial blood vessel were implanted with the patients generally anesthetized. The aortic dissection and general condition of patients after operation were observed with angiography, and the patient recovery condition was examined by spiral CT at postoperative months 3 and 12.RESULTS: All 6 cases were involved in the result analysis.①The diameters of stents for the patients were appropriate. The angiography showed that the thoracic aortic dissection in 4 cases disappeared, and thrombogenesis was found in false lumen; the thoracic aortic dissections in 2 cases disappeared, however, a little contrast agent was found in false lumen, but the blood flow was very slow. The general condition of all patients was good with stable vital signs, all patients discharged after 7-10 days.②CT results at 3 month after operation suggested that the original false lumen significantly contracted, and the true lumen restored to normal level. In case 3, there was mural thrombus in the distal stent that connected with stent vessel wall, and the thrombus hyperplasia was not obvious during follow up. At 12 months after operation, there was no distinct alteration in the stent location and appearance, and the life quality of patients was significantly improved.CONCLUSION: Endovascular stent-grafts are effective and safe in treating aortic dissection.

Monocyte chemoattractant protein-1 (MCP-1) is a cytokine which belongs to the CC chemokine family.Retinal pigment epithelium (RPE) cells,photoreceptors and microglial cells in the retina can secrete MCP-1.Physiological level of MCP-1 is important for preserving morphology of RPE and glial cells,as well as retinal function and gross morphology.MCP-1 is likely released from Müller glia and the RPE cells when retina under stress,and attracts microglia/macrophages to the sites of retinal damage,activates the microglia to ingest cell debris.MCP-1 has been found upregulated in the intraocular fluid of retina in patients and animal models with retinal detachment,posterior uveitis and age-related macular degeneration.The expression of MCP-1 may be response to retinal inflammation.Therefore,it is tempting to speculate that pharmacological targeting of MCP-1 may be a safe and viable strategy in treatment of retinal disease.

Aim: The tandem Claisen rearrangement/Diels-Alder reaction in ionic liquid was carried out to find better changes for the conversion. Methods: The synthesis started with replaced benzoic acid via acylation, cycli-zation, demethylation, allylation and then tandem Claisen rearrangement/Diels-Alder reaction in trational solvent and ionic liquid separately. Results: BmimBF_4 raised the yield of the target compound and shortened the reaction time compared with the traditional solvent Conclusion: BmimBF_4 can promote the tandem Claisen rearrange-ment/Diels-Alder reaction.

BACKGROUND:Artificial cornea titanium scaffold has a higher complication rate in clinical usage; therefore, to seek a kind of artificial corneal scaffold with high biocompatibility is a hot spot.
OBJECTIVE:To explore the biocompatibility of the artificial cornea titanium scaffold with hydroxyapatite surface modification.
METHODS: Twenty-seven New Zealand white rabbits were enroled to make alkali burn models of the right cornea and then randomized into three groups: in experimental group, artificial cornea titanium scaffold with hydroxyapatite surface modification was implanted into the right eye; in control group, artificial cornea titanium scaffold was implanted into the right eye; in blank group, no scaffold was implanted into the right eye. At 2, 4, 16 weeks after implantation, the right corneas were taken out for pathological observation and scanning electron microscope observation.
RESULTS AND CONCLUSION:At 16 weeks after implantation, there was no difference in the number of inflammatory cels and fibroblasts among the three groups. Over time, in the experimental group, the corneal tissues, fibrous tissues and adhered extracelular matrices were increased gradualy. In addition, the experimental group had more adherent corneal tissues, extracelular matrices and better tissue healing than the control and blank groups. These findings indicate that the artificial cornea titanium scaffold with hydroxyapatite surface modification had good biocompatibility that can effectively promote proliferation of corneal cels and corneal vascularization.

Objective To evaluate the effect of 27G pars plana vitrectomy (PPV) and 25G PPV on idiopathic epiretinal membrane (IMEM). Methods Thirty-eight eyes of 38 patients with IMEM were enrolled into this retrospective and comparative study. Eighteen eyes were treated with 27G PPV (group A), 20 eyes underwent 25G PPV (group B) voluntarily. The best corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp microscope, indirect ophthalmoscopy, fundus color photograph, ocular coherence tomography (OCT) and counting of corneal endothelial cells (CEC) were examined before the surgery. BCVA results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. There was no statistically significant difference between two groups in terms of BCVA, IOP, foveal macular thickness (FMT), the counting of CEC and CEC hexagon rate before the surgery (t=1.627, 0.860, 0.293, 1.238, 0.697;P>0.05). All operations were performed by the same doctor. Operation time for vitrectomy and peeling membrane was recorded. BCVA, IOP, OCT, FMT, counting of CEC and the improvement of metamorphopsia were observed on 1, 7 days and 1, 3 months after PPV. Results The mean operation time for vitrectomy in group A and B were (6.7±2.8), (10.5±3.3) min, respectively. The mean operation time for vitrectomy in group A was significantly longer than that in group B (t=3.084, P<0.05). The mean operation time for peeling membrane in group A and B were (10.2±5.2), (11.0±5.9) min, respectively. There was no statistically significant difference between two groups in terms of the time for peeling membrane (t=1.970, P=0.187). On 1, 7 days and 1, 3 months after PPV, the difference of BCVA (t=1.463, 0.683, 0.961, 1.226;P=0.833, 0.509, 0.699, 0.744) and IOP (t=1.314, 1.262, 0.699, 1.116;P=0.763, 0.721, 0.534, 0.712) between two groups were not statistically significant. On 1 day after PPV, there were 2 eyes and 5 eyes with<9 mmHg (1 mmHg=0.133 kPa) IOP in group A and B. On 7 days and 1, 3 months after PPV, the difference of FMT between two groups were not statistically significant (t=1.257, 1.368, 1.437;P=0.735, 0.745, 0.869). On 3 months after PPV, the difference of CEC between two groups were statistically significant (t=2.276, P<0.05);the difference of hexagon rate between two groups were not statistically significant (t=1.473, P=0.889). Conclusion The efficacy of 27G PPV for IMEM appears similar to 25G PPV. But 27G PPV has a shorter operating time for vitrectomy, a more stable IOP and a minimal damage to CEC.

OBJECTIVE:To study the perioperative use of prophylactic antibiotics in a hospital.METHODS:210 surgery patients were sampled randomly from Apr.to Aug.2006 in a hospital and investigated in respect of the perioperative use of prophylactic antibiotics based on the Guiding Principle of the Clinical Application of Antibacterials.RESULTS:Of the 210 cases,the ratio of perioperative use of antibiotics were as high as 98.10%,the application ratio of antibiotics in depuratory operation was 96.97%,and were 100% in other kinds of surgeries.The application ratios of antibacterials 0.5～2 h before surgery,after operation and during operation stood at 25.73%,21.84% and 52.43%,respectively.The average duration of antibiotic use was 3.17 d,with a maximum of 13 d.The duration of antibiotic use in depuratory operation,depuratory-contaminant operation and contaminant operation were 1.40,3.60 and 8.19 d,respectively.Antibacterials used singly totaled 23 kinds,of which,cefuroxime,latamoxef,amoxicillin/potassium clavulanate,cefminox and norvancomycin hydrochloride topped the first 5 places.CONCLUSION:The results show that the rate of application rate of antibiotics in this hospital is on the high side,the preventive medication indications were unclear and the drug use was lack of special aim,the management on which remains to be standardized.