Objective To investigate the effects of ageing on the expression of peroxisome proliferat or-activated receptor (PPAR)? and explore the relation with insulin resistance (IR).Methods Minimal model technique of Bergman was used to estimate the insulin sensitivity of young (10-12 weeks) and aged (24 months) SD rat. The PPAR?mRNA levels of omental fat were measured by reverse transcription-polymerase chain reaction(RT -PCR) and PPAR? protein level were determined by western blotting respectively . Results The level of IR in the aged group was significantly increased compared with tha t of the young group(IR: 11 49?6 92 vs 5 28?1 94,P

Objective To investigate the relationship of androgen receptor (AR) CAG repeat polymorphism and coronary artery disease (CAD) in elderly men and its potential mechanism.Methods Totally 296 elderly men undergoing coronary angiography were enrolled in this study.Serum total testosterone (TT) and free testosterone (FT) levels were measured.Androgen receptors (ARs) in peripheral lymphocytes were determined by flow cytometry.Genome DNA was extracted from peripheral leucocytes using standard techniques.Gene fragments containing AR CAG repeats were amplified by PCR with specific fluorescent labeled primers.PCR products were separated with agarose gels.CAG repeat number of each sample was obtained by genotyping.Results AR CAG repeats varied from 11 to 28 (P25-P75:18-22; median:20) in elderly male patients.They were divided into the long AR group (CAG repeats≥22,n=82) and the short AR group (CAG repeats＜22,n=214).Compared with the long AR group,serum FT level was much lower in the short AR group [(24.1±23.1) ×10-6mmol/L vs.(31.2±27.8)×10-6mmol/L,P＜0.05].The prevalence of coronary artery disease was higher in the short AR group than in the long AR group [84.1％ (180 cases) vs.69.5％(57 cases),P＜0.05].The FT level was lower in the short AR group combined with CAD than in the control group [(22.4±20.5) ×10-6mmol/L vs.(33.6±32.4)×10 6mmol/L,P＜0.01].There were no significant differences in serum TT and AR levels between the long and short AR groups.No significant correlations were found in the AR CAG repeats polymorphism with FT,TT or AR levels.Age was the main risk factor for FT and AR levels.Logistic regression analysis showed that FT level was negatively correlated with CAD (OR=0.98,95 ％ CI:0.973-0.998,P=0.01),and short AR increased the risk of CAD in elderly male patients (OR=3.44,95％CI:1.887-6.264,P＜0.01).Conclusions Serum FT level is correlated with age and is significantly decreased in elderly male patients with short AR repeats,which may increase the risk of CAD in elderly men.

Objective To analysis the re-hearing expectations and the need for auditory training and the time of adaptation exchanges after cochlear implantation .Methods Sixteen cases of adult postlingual deafness, which were selected, from 2002 to 2011, were treated by cochlear implantation .9 cases participated in speech training right after cochlear implantation , and 7 cases didn ’ t participate in speech training .In the initial stage, the patients were given the tone and input hearing test with voice frequency in the natural environment.The auditory training was for 2 hours a day, which included single and combined training .The training method was comprehensive , including auditory speech perception , writing and verbal expression .The training focused on the coherence and clarity of oral Reading .One training course was 3 -10 weeks .The efficacy of the training with the combination of sound and the ability to adapt to society was analyzed . Results In 10 cases joining the training , 4 cases instantly began to auditory training after cochlear implantation and lasted for more than 5 weeks.1 case discontinuously trained for 4 weeks, and other 5 cases trained transiently ( less than 3 ~4 days ) .6 cases refused to participate in the training process after cochlear implantation .Assessed by the “the lowest auditory function test vocabulary”, the distinguish rate of 5 patients was 90.3%after training for more than 4 weeks, who gradually adapted to working and learning environment after 5-7 months, and gained normal communication after 1.5-2.0 years.The distinguish rate of 5 patients was 36.0%after training for several days , and 2 patients cannot accomplish the test .Besides, the 6 patients without participation the training program cannot finish the assessment for over 2 years after cochlear implantation.Conclusions Cochlear implantation provides patients with the possibility of re-hearing, and the postoperative training can help patients in communicating in social life .A variety of factors can affect the efficacy of re-hearing adult patients with post-lingual hearing after cochlear implantation .

Objective To explore the methods of auditory enlightenment and whole ability training in severe hearing impaired children with inner ear malformations and growth retardation .Methods Eleven severe hearing impaired children with inner ear malformations were chosen , and received the methods of multiple stimuli including auditory, vision, tactile sensation, large and fine motor and so on in order to train their skills including the response and discrimination of sounds , language , and cognition and so on .Results The abilities of hearing and sense were gradually establishment in children 3 months after the training .Seven children could perceive clearly sound , and finish the hearing examination after training 6-13 months so as to lay the foundation for behavioral responses after the cochlear implantation surgery .Two children finished the hearing assessment after the hearing compensation through the audiphone .Conclusions The methods of multiple stimuli in the different sense at the same time can promote the formation of auditory consciousness and auditory nerve loop in infants with inner ear malformations .

Objective To explore children with audition symptom as normal but heterophthongia impacting on the process of their growth , and try to find out the symptom of abnormal speech and hearing to prevent and cure early .Methods Fifty six children were selected at the age of 6 months to 8 years old whose development of audition and speech had not reached the normal norm and known their information relative growth factors such as medical history , present illness , family medical history and environment of growth inside out .We assessed the speech and audition of all cases by clinical objective and subjective audition test and they shown different level of audition damage .We provided different methods to prevent and cure disorders according to inducing factors .Results The characteristic of children , whose right and/or left ear had different damage ( earshot:35 -120 dB ) , usually could not arouse attention especially at early linguistic stage because of inapparent hearing and speech disorders .The delayed diagnosed audition problem already leaded that sixteen children from 4 -8 years old acquired the problems of inappropriate response to voice , simple and vague language and restricted study and twenty cases obtained no response to voice , delayed development of audition comparing with peers , and expressed their demand by body language until 2 to 4 years old until they sought medical advice .Neonatal audition had not passed first and second screen and the level of audition damage were at range of 20-90 dB; however , parents believed neonate could develop naturally when neonate grown up so that they attended training without consistency and worn hearing aid incontinuity .These kind of behavior leaded that neonate acquired medical treatment until 1.5 to 2 years and some reflections had been built up or delayed . Conclusions Children with a similar audition as normal children but heterophthongia are unapparent at early stage, but it will slight show out when they grow up .Parent should comprehend the children ’ s process of hearing and language development and try to find out language and hearing problem as earlier as possible .Early detection could decrease growth gab between children with audition problems and normal children .

Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA) on malignant lesions in gastrointestinal adjacent tissue, and further to analyze the risk factors influencing positive rate of EUS-FNA. Methods The clinical data of 171 patients undergoing EUS-FNA from January 2009 to May 2016 were collected. The lesion location, size and characteristics, the number of needle passes, puncture suction negative pressure, size of puncture needle, and years of operator experience in EUS were retrospectively analyzed. Results The overall sensitivity, specificity, and accuracy of EUS-FNA in the diagnosis of malignant lesions were 78. 3％ ( 83/106) , 100. 0％ ( 65/65) , and 86. 5％( 148/171) , respectively. The univariable logistic regression analysis demonstrated that the risk factors of EUS-FNA were lesion location, lesion characteristics, and lesion size. In multivariate analysis, larger lesion size ( OR=1. 029, 95％CI: 1. 011-1. 047, P=0. 001) and lesion characteristics of solid ( OR=5. 098, 95％CI:1. 324-19. 633, P=0. 018) were independent factors affecting the positive rate of EUS-FNA. Among 171 cases performed by EUS-FNA, the incidence of postoperative complications was 1. 75％ ( 3/171 ) included 2 cases of fever and 1 case of acute pancreatitis, which were improved after conservative treatment. Conclusion EUS-FNA is a safe and effective method of cytological and histological diagnosis with high accuracy and sensitivity, importantly in distinguish malignancy from benign lesion in gastrointestinal adjacenttissue. Positive rate of diagnosis on malignant lesions by EUS-FNA is positively correlated with lesion size, and EUS-FNA positive rate of solid malignant lesions is significantly higher than that of cystic lesions.

Under the background of deepening the medical and health system reform, it is necessary to explore the measures of fine and rational drug use management and strengthen the rational drug use. Through giving full play to the management functions of pharmacy administration and pharmacotherapeutics committee, formulating the performance evaluation index system of pharmacy affairs in the hospital, adhering to the prescription doctor′s advice review and prescription pre audit, continuing to carry out drug dynamic monitoring, implementing standardized-path antimicrobial drug management, the hospital implemented refined and rational drug use management. Before and after the management, the average drug cost, prescription unqualified rate, auxiliary drug amount and antibacterial drugs related indicators were significantly improved, suggesting that fine pharmacy management could promote the rational use of drugs in the whole hospital, promote the transformation of pharmacists′ work, and control the unreasonable growth of drug costs.

Hematologic Neoplasms

The corneal epithelium, an essential refractive interface, plays an integral role in the corneal healing after corneal refractive surgery. All existing corneal refractive surgeries entail a degree of corneal epithelial remodeling; however, excessive epithelial remodeling precipitates adverse outcomes on the refractive correction efficacy of such surgeries. This review summarizes the application of corneal epithelial remodeling in the corneal refractive surgery, and more comprehensively investigates the influencing factors of perioperative epithelial remodeling after corneal refractive surgery, with a view to augmenting the safety, efficacy, predictability, and stability of corneal refractive surgical outcomes.

Donation related vasovagal reaction(DRVR) is the most common adverse reaction during blood donation. It is very important for blood banks to identify, treat and prevent DRVR accurately. At present, it is generally believed that psychological factors are the first major inducement of DRVR. Applied muscle tension (AMT) and salt supplementation have been proved to be effective interventions for vasovagal response; the identification methods of high-risk groups such as State Trait Anxiety Inventory, Medical Fear Inventory and Blood Donor Response Scale have been relatively mature, but the utilization rate is relatively low in China. In this paper, the main clinical manifestations, pathogenesis, research methods, related factors, management and prevention measures of DRVR, as well as the identification of high-risk groups before blood donation are reviewed.