Objective To investigate correlation between cystatin C (Cys C) and target organ damage (TOD) in elderly hypertension and its clinical significance.Methods One hundred patients with TOD in elderly hypertension were selected as an observation group.One hundred patients without TOD in elderly hypertension were recruited as the controll group.And sixty healthy aged persons were recruited as healthy group.Serum concentration of Cys C in all cases was measured by the particle enhanced nephelometric immunoassay.At the same time,serum creatinine (Scr),urine albumin (mALB) and left ventricle mass index (LVMI) via ultrasonography were also detected.Correlation of Cys C with the above measurements were analyzed.Results The Cys C concentration was significantly higher in observation group [(1.84±0.32) mg/L] than in contrast [(0.92±0.36) mg/L] and healtbygroups [(0.85±0.34) mg/L],F=88.43,P=0.000.However,the difference in level of Cys C was not statistically significantly different between controll group and healthy group (P ＞0.05).In observation group,serum concentration of Cys C was positively correlated with Scr,mALBand LVMI (r=0.420,0.526,0.470,P=0.021,0.019,0.034) after adjusting age.Conclusions Serum level of Cys C is markedly elevated and is positively correlated with Scr,mALB and LVMI in patients with TOD in elderly hypertension.It can be considered as one of the useful factors for evaluating TOD in elderly hypertension.

Objective To study the importance of statins in the prevention and treatment of coronary heart disease.Methods167 cases of coronary heart disease in our hospital from December 2013 to November 2014 were chosen as the research object, patients were given different statins such as atorvastatin, rosuvastatin and simvastatin treatment, and total cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol (HDL-C)before and after treatment were statistically analyzed.Results3 months after treatment TC,TG,LDL-C,HDL-C were significantly better than before treatment(P< 0.05);3 months after treatment, 6 months and 12 months, the index value has improved, but the differencehad no statistical significance.ConclusionThe use of statins in coronary heart disease has a significant effect,can improve the clinical indicators.

Behavior Science pays more attention to humanity,and regards the management of people as the key factor of management.Nursing management is the process targeting at the progress of nursing quality and work efficiency.Under the new circumstance,it is very important for the head nurse to supervise the nurses with a scientific management conception in the hospital howadays which will encourage the nurses to fully exert their abilities. and help to improve the nursing quality finally.

Objective To study the changes of antioxidant on ZCLA Mongolian gerbils' sera within different growth period.Methods The gerbils at the age of 1 month,3 months and 24 months were used in the experiment,with each 16(half male and half female),and the sera were collected for determining the MDA,SOD and GSH-Px.Results At the age of 3 months,MDA was the lowest,but GSH-Px was the highest,while the SOD was ascending with growing.Conclusion The changes of GSH-Px showed the direct relation to MDA,while the changes of the SOD was irrespective to the changes of MDA.

Depression is a common complication after stroke.It is often associated with disability,cognitive impairment,and increased mortality.This article reviews the epidemiology,risk factors,predictive factors,and pathophysiology mechanisms of post-stroke depression.

Objective To observe the roh of cytoimmunologic factors,careinoembryonic antigen (CEA),serum ferritin(SF)and prognostic factors in patients with Iung adenous cancer.Methods Eightyone patients with lung adenous cancer were analyzed retrospectively.The clinical features as well as the alternation of T-lymphocyte subsets and its relationship with CEA.SF,disease stage and metastasis of lymph node were studied.Results(1)The percentage of CD4+ T cell decreased and that of CD8+T cell increased,the ratio of CD4+/CD8+ went down accompanied by the increase of disease stage.CEA and SF increased as the dmease stage increased.(2)Thedecrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in patients with metastasis of lymph nodes[LN(+)](p＜0.01).The increase of percentage of CD8+Tcell and CEA,SF level was obvious in LN(+)(P＜0.01 or＜0.05).(3)The decrease of percentage of CD4+T cell and the ratio of CD4+/CD4+ was obvious in CEA (+)(P＜0.01).The increase of percentage of CD8+ T cell and SF level was obvious in CEA (+)(P＜0.01).(4)The decrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in SF(+)(P＜0.01).The increase of percentage of CD3+ CD8+ T cell and the CEA level was obvious in SF (+)(P＜0.05 or＜0.01).Conclusion Disorder of cytoimmunologic situation exists in patients with lung adenous cancer,and it is closely correlatod with the CEA,SF level disease stage and metastasis of lymph node.

Objective To assess the value of exercise treadmill testing (bruce protocol) in diagnosing early atherosclerotic lesions of the lower limb. Methods Between March and September 2008, 173 outpatients with high risks of peripheral arterial disease (PAD) were enrolled randomly from the cardiology clinic of Chinese PLA General Hospital. The patients were subjected to exercise treadmill testing (Bruce protocol) and ankle-brachial index (ABI) determination, as well as lower limb artery ultrasonography within one week. Using ultrasonic findings as diagnostic criteria, the diagnostic sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of exercise treadmill testing for early atherosclerotic lesions of the lower limb were analyzed, and the diagnostic value of exercise treadmill testing was assessed using the ROC curve. Results After exercise, ABI decrement (R value) increased in subjects with high risks for PAD with atherosclerotic lesions of the lower limb aggravating. Using the presence of large atherosclerotic plaques (area > 20 mm2 ), atherosclerotic plaques and atherosclerotic lesions in lower limb arteries as positive diagnostic criteria, the area under curve of ROC was 0. 80 (95% CI: 0.72-0.88), 0.78 (95% CI: 0.71-0.85) and 0. 60 (95% CI: 0.44-0.76), respectively. Using the presence of large atherosclerotic plaques in lower extremities as positive diagnosis, R value was 0.80, with a sensitivity of 54. 0%, a specificity of 96. 7%, a LR+ of 16. 4, and a LR- of 0. 58, meanwhile, R value was 0. 85, with a sensitivity of 70.0%, a specificity of 91.9%, a LR + of 8.64, and a LR- of 0.33. Conclusions Exercise treadmill testing (Bruce protocol) in combination with ABI determination is a safe, accurate, objective tool for detecting early atherosclerotic lesions of the lower limb. Immediately after exercise, 0.85 is the cut-off R value appropriate for diagnosing large atherosclerotic plaques of the lower limb (area > 20 mm2).

Objective To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE MRA) in infrapopliteal occlusive diseases of diabetic patients.Methods A total of 105 patients with known diabetes and peripheral vascular occlusive disease who underwent both CE MRA and DSA examnations were included in this study.They had no obvious stenosis or with stenosis of less than 75％ in iliac,femoral,and popliteal arteries.Every infra-popliteal artery was anatomically divided into 9 vascular segments as tibiofibular trunk artery,proximal and distal anterior tibial artery,proximal and distal posterior tibial artery,proximal and distal peroneal artery,plantar and dorsalis pedis artery.There were 945 segments.The arterial stenosis was accessed with CE MRA and DSA respectively.The segments were scored in 5 categories as＜30％,≥30％ and＜50％,≥50％ and＜75％,≥75％ and＜100％,and 100％ according to stenostic degrees.The Kappa test was used to compare the diagnostic consistency of CE MRA and DSA.Taken DSA as a gold standard for reference,ROC curve was drawn to calculate the diagnostic accuracy of CE MRA in diagnosis of lower limb arterial disease.Results The ratio of statistically valid segments for both CE MRA and DSA were 97.7％ (923/945) in 945 vessel segments of 105 patients,and 390 of 923 arterial segments were both indicated as occlusion by CE MRA and DSA.The diagnostic consistency for the segments was listed in the decreasing order as follows:proximal peroneal artery,proximal posterior tibial artery,distal posterior tibial artery,proximal anterior tibial artery,distal anterior tibial artery,tibiofibular trunk artery,dorsalis pedis artery,plantar artery,distal peroneal artery,and corresponding Kappa values were 0.88,0.86,0.84,0.84,0.81,0.77,0.75,0.75 and 0.73,P＜ 0.05.The AUC(area under ROC curve) of CE MRA was 0.893 with 95％ confidence interval of 0.882 to 0.904.Conclusion CE MRA is an accurate imaging modality in the diagnosis of infrapopliteal occlusive disease s for diabetes.

Objective To study the value of the semiquantitative-parameter analysis of wash out index of time-intensity curve (Swash-out) in evaluating the therapeutic effect of neoadjuvant chemotherapy for locally advanced breast cancer (LABC).Methods Fifty-nine women with LABC underwent dynamic contrast enhancedt MRI examination before chemotherapy,after the 2nd cycle and the 4th cycle of chemotherapy.All patients were divided into major histological response group (MHR) and non-major histological response group (NMHR) according to the final pathologic response.Swash-out and the variancetrends of Swash-out before NAC,after the 2nd cycle of NAC and after the 4th cycle of NAC were compared in each group and between the two groups.According to the gold standard of Miller & Payne criterion,Receiver operating characteristic curve (ROC) analysis was performed to evaluate the predicting effect of Swash-out for NAC response,and to compare it with Semi-quantitative TIC curve indicators Smax (steepest slope) and PPE (peak percent enhancement).Results Fifty-nine patients of LABC patients were divided into a MHR group of 34 patients and a NMHR group of 25 patients.Swash before NAC of MHR group was-16.99 (-56.72-41.20),Swash-out after the 2nd cycle of NAC was 5.66(-69.45-53.08),Swash-out after 4th cycle of NAC was 15.95 (-7.80-54.23).Swash-out before NAC of NMHR group was-23.08 (-64.24-34.39),Swash-out after the 2nd cycle of NAC of NMHR group was-23.01 (-52.72-28.70),Swash-out after 4th cycle of NAC of NMHR group was-11.45 (-50.49-50.93).Swash-out variance rate of MHR group after the 2nd and the 4th cycle of NAC were-1.18 (-31.32-60.86) and 1.50 (-86.27-3.61),respectively.Swash-out variance rate of NMHR group after the 2nd and the 4th cycle of NAC were-0.28(-3.24-9.46) and 0.27 (-5.34-3.11),respectively.Swash-out was not significantly different between the two groups before NAC (Z =-0.97,P ＞0.05).Swash-out and Swash-out variance rate of MHR group after the 2nd cycle of NAC were significant higher than that of NMHR group (Z =-3.97 and-3.02,P ＜0.01).Swash-out and Swash-out variance rate of MHR group after the 4th cycle of NAC were significant higher than that of NMHR group (Z =-3.96 and-3.16,P ＜ 0.01).Area under curve (Az) after the 2nd and the 4th cycle of NAC were 0.805 and 0.804,respectively,and no significant difference was found between them (Z =0.019,P ＞0.05).Diagnostic cut-off points were-8.670 for the 2nd cycle of NAC and 4.105 for the 4th cycle of NAC.Diagnostic sensitivity was 79.42％,specificity was 76.00％ and Youden index was 0.554,for after the 2nd and the 4th cycle of NAC.Conclusion Swash-out of TIC curve before NAC cannot predict the response of NAC,Swash-out of TIC curve after the 2nd cycle of NAC and after the 4th cycle of NAC are efficient in predicting the response of NAC.

Objective To identify PRKAR1A mutations in a pedigree with Carney's complex through clinical investigation and molecular biology research,and to summarize the genetic law,characteristics,and clinical features of this family disease.Methods The family members received a detailed medical examination and related biochemical tests.The hereditary history and clinical features were recorded.DNAs of 12 family members were extracted from blood and 9 exons and adjacent introns of PRKAR1A were sequenced.Results PRKAR1A mutation intron4 c.440+4 delG was identified in 7 family members,including the proband's patient,who presented special signs of pigmentation on the lips,buccal mucosa,and fingertips.Conclusions The deletion mutation (c.440+4del G) in intron 4 of the PRKAR1A gene was found in this family,which is possibly associated with the phenotype skin pigmentation.