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.

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.

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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 observe the clinical efficacy of stuck-moving needling plus modified Bu Zhong Yi Qi (supplementing qi in the middle energizer) decoction in treating gastroptosis due to qi deficiency in the middle energizer. Method Sixty patients with gastroptosis due to qi deficiency in the middle energizer were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by stuck-moving needling plus the modified Bu Zhong Yi Qi decoction, while the control group was treated with the modified Bu Zhong Yi Qi decoction alone. The two groups were treated once a day, 20 sessions as a treatment course. The lower limit of the stomach was measured before and after the treatment in the two groups, and the clinical efficacy and long-term efficacy of the two groups were compared.Result The height of the lower limit of stomach was significantly changed after the treatment in both groups (P<0.01), there was a significant difference in comparing the height of the lower limit of stomach between the two groups after the intervention (P<0.01), and there was a significant difference in comparing the change of the height of lower limit of stomach between the two groups (P<0.01). The total effective rate was 93.3% in the treatment group versus 73.3% in the control group, and the between-group difference was statistically significant (P<0.01); the clinical efficacy in the treatment group was statistically different from that in the control group (P<0.05). The long-term total effective rate was 76.7% in the treatment group versus 50.0% in the control group, and the between-group difference was statistically significant (P<0.01); the long-term clinical efficacy in the treatment group was statistically different from that in the control group (P<0.05).Conclusion The stuck-moving needling plus modified Bu Zhong Yi Qi decoction can produce a more significant efficacy than the decoction alone in treatinggastroptosis due to qi deficiency in the middle energizer, and its long-term therapeutic efficacy is also consistent.

Objective To reveal the main authors, institutions and countries and analyze their cooperation models by plotting the cooperation network knowledge map of highly cited papers on diabetes mellitus published in 2004-2013 .Methods The cooperation network knowledge map was plotted using the visual software Citespace for the au-thors , institutions and countries that published highly cited papers on diabetes mellitus in 2004-2013 .Results The core authors were Graham Nichol, SM Grundy and Hertzel C.Gerstein, etc.The cooperation in teams was close while the cooperation between teams was rare.The core institutions were Harvard University, Brigham and Womens Hospital, University of Sydney, etc.Universities played the important role in scientific research.The most influential countries were USA, Britain and Canada which had a very close cooperation between each other.Conclusion Single point type, double core type, development type and complete type are the cooperation models of authors, institutions and countries that published highly cited papers on diabetes mellitus in 2004-2013.Geoproperty-and institutional property-based cooperation is still in its infancy, cooperation and exchange should thus be strengthened between cities, between universities, between medical institutions , between general institutions and scientific institutions .

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.

Humic acid (HA) was extracted by NaOH solution from black soil of Heilongjiang in China.Reaction characterization of rare earth elements (La3+,Ce3+,Gd3+and Y3+) with HA was studied by Fourier transform infrared (FTIR) spectroscopy.Results showed that peaks (1600 cm-1 and 1400 cm-1) in FTIR spectra of HA became strength after reaction,implying that carboxyl groups of HA reacted with rare earth elements.

BACKGROUND: Real-time fluorescence quantitative polymerase chain reaction (PCR) refers to join the fluorescence groups into PCR reacting system, and to real-time monitor entire PCR process using the fluorescence signal accumulation, finally to make the quantitative analysis of the unknown template through the standard curve. OBJECTIVE: To study the theory of real-time fluorescence quantitative PCR and to explore its applications and progress in medicine. METHODS: With "real-time fluorescence quota PCR, theorem, application" in English for the search term, PubMed database was retrieved from January 2000 to December 2008. With "real-time fluorescence quantitative PCR, principle, application" in Chinese for the search term, Wanfang Database from January 2000 to December 2008, Tsinghua Tongfang Chinese database from January 2000 to December 2008 ware was retrieved. Literatures were limited to English and Chinese languages. Cell factor and tumor resistance genes served as the evaluation index. The methodology of research on the real-time fluorescence quantitative PCR technology and medical applied research on real-time fluorescence quantitative PCR technology were included. While repetitive research and Meta analysis were excluded. RESULTS AND CONCLUSION: Because real-time fluorescence quantitative PCR technology has not only realized PCR develops from qualitative to quantitative levels, but also has strong specificity, high sensitivity, good duplication, accurate quantization, high automaticity, and entire blocking response compared with conventional PCR, thus it becomes the important tool in the molecular biology research. Real-time fluorescence quantitative PCR technique has been widely applied, such as mRNA expression, detections of DNA copy number and determination of mononucleotide polymorphism, as well as in the clinical medicine including accurate quantitative examination of mycobacterium tuberculosis, Type B and Type C hepatitis, AIDS virus, gonococcus, and chlamydia trachomatis. Its quantitative scope extremely extends, no need of gradient dilution, the specificity is stronger, overcomes the false positivity. Due to the traditional PCR technology cannot give the accurate quantization, it is greatly limited in the practical application. Therefore, the accurate quantization of the PCR product, particularly the dynamic monitoring of viral etiology, becomes the urgent need.