Objective To study the safety of tilt table test (TTT) in elderly patients. Methods Among the 785 subjects examined for TTT, 110 were elders with an average age of( 65?4) years, ranging from 60 to 82. Out of the 110 elder subjects, 39 syncope patients were due to unknown reasons, 13 due to heart or brain diseases and 58 were non syncope subjects. We conducted base tilt table test (BTTT) in all patients and additional isoproterenol tilt table test (ITTT) in 18 patients. The BTTT protocol included 60～80 degrees upright tilt for 25 minutes and the ITTT protocol included isoproterenol infusion at 2-4 ?g/min for 10 minutes. Results 13 out of 39 patients with unknown reasons had a positive BTTT and 6 out of 10 patients had a positive ITTT, respectively; Among the 31 out of 110 positive TTT patients, 17 (54.8%) showed a vasodepressor response, 4 (12.9%) a cardioinhibitory response and 10 (32.3%) mixed response. Serious abnormal responses were not observed. Conclusions (1) TTT is a safe and effective method for diagnosing the vasovagal syncope (VVS) in elderly patients; (2) Because of its safety, BTTT could be chosen for identifying the VVS in the elderly heart or brain disease patients complicated with syncope.

Objective To establish a determining method for the content of berberine hydrochloride in Coptis chinensis Franch.and Xianglian pills.Method The sample was extracted and developed,the berberine hydrochloride was determined by thin layer chromatograph-fluorescence of spectrophotometry with Benzen-ethylaceate-isopropanol-methanol-ammonia water(6:3:1.5:1.5:0.5) as the developing system and Ex=365 nm,Em=409 nm.Result The calibration curve was linear in the range of 0.473～ 3.784 ?g,r=0.999 3.The recovery rate in Coptis chinensis Franch.was 99.03%,RSD=1.86%,and in Xianglian pills was 97.10%,RSD=1.09%.Conclusion The method is simple and accurate.

Adolescent ; Adult ; Aged ; Bloodletting ; Child ; Child, Preschool ; Combined Modality Therapy ; Dermatitis ; therapy ; Female ; Humans ; Infant ; Insect Bites and Stings ; therapy ; Lymphangitis ; therapy ; Male ; Middle Aged ; Moxibustion ; Young Adult

ObjectiveTo evaluate the suitability of Nordtest guideline in estimating measurement uncertainty of routine tests in clinical laboratory.MethodsData of clinical laboratory of Beijing Tongren Hospital were collected,which came from 176 days of Internal Quality Control ( IQC ) from July 2010 to December 2010 and 6 times of External Quality Assesment ( EQA ) of NCCL from 2009 to 2010.The combined and expanded uncertainties of 21meaurements (sodium, potassium, chlorine,calcium,phosphrous,glucose,urea nitrogen,creatinine,uric acid,total protein,albumin,total bilirubin,direct bilirubin, alanineaminotransferase, aspartateaminotransferase, alkalinephosphatase, lactate dehydrogenase,glutamyl transpeptidase,creatine kinase,triglyceride and total cholesterol) were evaluated according to Nordtest guideline.ResultsOf all the measurements,expanded uncertainty of direct bilirubin ( 17.69％ ) was the highest.For some enzymes such as ALT,AST,ALP and LDH,expanded uncertainties were all over 10％ markedly influenced by the calibrator uncertainty.Expanded uncertainty of triglyceride was 12.7％,also largely influenced by calibrator uncertainty,while that of total cholesterol was 6.96％.ConclusionsNordtest guideline is suitable to evaluate the measurement uncertainty of routine assays in clinical laboratory.However,calibrator uncertainty should be taken into account in the process of evaluation.

Objective To investigate the correlation between diabetic distress and coping styles among patients with type 2 diabetes. Method One hundred inpatients with type 2 diabetes were engaged in the investigation of their diabetes distress and coping styles by the diabetes distress scale (DDS) and medical coping modes questionnaire (MCMQ) and the correlation between them. Results The average score of diabetic distress was (2.17 ± 0.71), which was at mild level. 57%of them were at the higher level of diabetic distress. Confrontation and avoidance dimensions were lower than the norm in coping styles, and the acceptance dimension was higher than the norm (all P<0.01). The average scores of diabetic distress, regimen-related distress and physician-related distress subscales were negatively correlated with confrontation (all P<0.05). The average score on diabetic distress and the subscales were positively correlated with avoidance and acceptance dimension (all P<0.01). Conclusions Diabetic distress is prevalent in type 2 diabetic patients and the degree of positive coping is still not insufficient. The diabetic distress is negatively correlated to the confrontation, and positively correlated to the avoidance and the acceptance dimension. The medical staff should instruct the patients to adopt positive coping styles, and avoid negative coping styles to reduce diabetic distress. It will be conductive to the physical and mental rehabilitation of the patients as well.

Objective:To investigate the expression and clinical significance of PD-L1 in colorectal cancer (CRC). Methods:A total of 210 CRC patients who accepted radical surgery in our hospital from January 2015 to January 2016 were divided into three groups, namely, high-frequency microsatellite instability (MSI-H), low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS). The expression of PD-L1 was detected by immunohistochemistry, and the expression characteristics of PD-L1 in different types of CRC were analyzed. Results:CRC cases with low differentiation had a higher expression of PD-L1 than CRC patients with high differ-entiation (P<0.05). PD-L1 had a positive rate of 75.8%in the MSI-H group and a rate of 9.3%in the MSI-L and MSS groups, wherein the difference between the two groups was statistically significant (P<0.05). Conclusion:PD-L1 was positively expressed in some CRC tu-mor tissues, and its positive rate was significantly higher in MSI-H than in MSI-L and MSS. The therapeutic effect of a PD-L1 blocker for patients with MSI-H CRC might be preferable.

Retinal damage has been found in atypical parkinsonian syndromes (APS) which include multiple system atrophy, progressive supranuclear palsy, and corticobasal syndrome. Optical coherence tomography (OCT) is a noninvasive, noncontact, repeatable bioimaging technique that can be used to evaluate the structural changes in the retina. We reviewed the recent progress of OCT technology in APS for reference in clinic.

Magnetic resonance imaging ( MRI ) findings were studied in 19 patients with non-dementia Parkinson′s disease ( PD) Hoehn-Yahr Stage 1 and 1.5 and 38 healthy subjects.The width and area of pars compacta of substantia nigra ( SNc) , substantia nigra ( SN) and midbrain were measured.The width and area ratios of SNc to SN were calculated.Compared with controls, the widths of right SNc was narrower, bilateral ratios of SNc to SN width were decreased in PD group.As to the area of substantia nigra, there was no significant difference between PD and controls.The width of left SN and the ratio of right SNc to SN width was negatively correlation with age of patients.The ratio of left SNc to SN width, the area of bilateral SNc and left SN, as well as the ratio of right SNc to SN area had negative correlation with the disease duration;however, there was no correlation with gender, Hoehn-Yahr Stage, the Unified Parkinson disease rating scale score, mini mental state scale, education years, levodopa equivalent daily dose, Hamilton Depression Scale or Hamilton Anxiety Scale in PD group.The results indicate that there are bilateral structural changes of SN in unilateral PD patients, which may be more significant with increasing disease duration.The measurement of SNc width and SN area can be used as an objective indicator for diagnosis and disease progression monitoring of PD.

Naringin is mainly present in Rutaceae Citrus Pomelo,grapefruit,lime,and its variants of the peel and fruit,which belongs to dihydrogen flavonoids.Studies have shown that naringin has anti-type 1 and type 2 diabetes pharmacological effects,the mechanism of action by inhibiting diabetes-related oxidative stress injury,inflammation,abnormal metabolism of glucose,and other aspects,while a certain degree of delay in diabetes complications (including diabetic cardiomyopathy,diabetic nephropathy,diabetic retinopathy,and diabetic neuropathy).The mechanism of naringin on the mechanism of diabetes mellitus and its complications was studied in order to provide the basis for the development of antidiabetic drug.