The hemoglobin A1c(HbA1c) results can reflect the average level of blood glucose over the past 2-3 months,its clinical application value is transforming from evaluation indicator to diagnosis indicator.The application of HbA1c as a diagnostic indicator of diabetes is limited by many factors,such as multi-factor influence on measurement and its late start on standardization process in our country,optimal cut-point and the defect of HbA1c existing in the molecular level,etc.Therefore,clarifying the limitations of HbA1c in the practical application is of great significance for its clinical application.

Objective To explore an algorithm to define the threshold value for tumor contouring on 18F-fluorodexyglucose (FDG) PET imaging. Methods A National Electrical Manufacturing Association (NEMA)NU 2 1994 PET phantom with 5 spheres of different diameters were filled with 18F-FDG. Seven different sphere-to-background ratios were obtained and the phantom was scanned by Discovery LS 4. For each sphere-to-background ratio, the maximum standardized uptake value ( SUVmax ) of each sphere, the SUV of the border of each sphere ( SUVborder ), the mean SUV of a 1 cm region of background (SUVbg) and the diameter (D) of each sphere were measured. SPSS 13.0 software was used for curve fitting and regression analysis to obtain the threshold algorithm. The calculated thresholds were applied to delineate 29 pathologically confirmed lung cancer lesions on PET images and the obtained volumes were compared with the volumes contoured on CT images in lung window. Results The algorithm for defining contour threshold is TH% = 33.1% + 46.8% SUVbg/SUVmax + 13.9%/D ( r = 0.994) by phantom studies. For 29 lung cancer lesions, the average gross tumor volumes ( GTV ) delineated on PET and CT are ( 7.36 ± 1.62 ) ml and (8.31 ±2.05) ml, respectively (t = -1.26, P＞0.05). Conclusion The proposed threshold algorithm for tumor contouring on PET image could provide comparable GTV with CT.

Objective To investigate the effects of atorvastatin on the experimental autoimmune encephalomyelitis(EAE)and the underlying mechanism of immunoregulation.Method The Wistar rats were used to establish EAE model.After oral administration of 2, 8 mg? kg~(1)?d~(1)of atorvastatin, the rats were examined for the development of neurological signs, changes of histopathology and the expression of IL-4 and MMP-9.Result Though high dose treatment with atorvastatin, the frequency of EAE attacks degreased from 76.67% to 33.33%(P=0.008);the extent of inflammation degreased from 3.2?1.1 to 1.3?0.4(P=0.01);and the number of MMP-9 positive cells degreased from 37?7 to 26?5(P= 0.001), the expression of IL-4 could be increased from(0.35?0.12)ng/ml to(0.68?0.23)ng/ml (P=0.05).Conclusion Atorvastatin can reduce the inflammation and produce the recover of the neurological harm because of the changes of MMP-9 and IL-4.

Objective To evaluate the clinical efficacy of transcatheter renal sympathetic denervation(RDN)in the treatment of resistant hypertension.Methods Clinical data of 10 patients with resistant hypertension treated by transcatheter renal sympa-thetic denervation were retrospectively analyzed.The blood pressure and complications were analyzed.Results In all of the 10 pa-tients,systolic and diastolic blood pressure decreased significantly after two weeks compared with preoperative,and further de-creased after 3 months (P <0.05 ).There were no statistical difference of systolic and diastolic blood pressure between 3 and 6 months(P >0.05).Before the RDN,the mean number of antihypertensive drugs was 5.3±0.9.After 6 months which was 3.2±0. 6,and which was decreased significantly compared with the preoperative (P <0.05).No adverse reactions were found.Conclusion The RDN can be quickly and sustained decrease the blood pressure in patients with resistant hypertension.

Objective To analyze the clinical pathological characteristics of achalasia patients complicated by esophageal cancer.Methods From January 2005 to May 2013,among 658 patients with achalasia,the clinical data,pathological characteristics of tumor and the treatment of those complicated by esophageal cancer were collected and analyzed.At the same time,receiver operating characteristic (ROC) curve analysis was performed to analyze the relationship between the course of achalasia and esophageal cancer.Results Among the 658 patients with achalasia,297(45.1％) cases were male and 361(54.9％) cases were female.A total of 62 cases (9.4％) were lost to follow-up and of 596 cases who completed the follow-up,26 cases (4.4 ％) were complicated with esophageal cancer.Among the 26 patients complicated with esophageal cancer,69.2％ (18/26) were male;the course from achalasia diagnosed to esophageal cancer was (16.5±8.2) years.The patients with a disease duration more than 10 years accounted for 88.5％(23/26),and 80.8％ (21/26) underwent previous balloon dilatation or Heller surgery.The predilection site of esophageal cancer was in the middle esophagus of patients complicated by esophageal cancer (69.2％,18/26),the main type was squamous carcinoma (88.5％,23/26),65.4％(17/26) of the lesions invaded to muscular layer (stage T3 to T4),61.5％(16/26) had the late stage tumor (stage Ⅲ to Ⅳ),and 23.1％(6/26) had distant metastasis.The results of ROC curve analysis showed that when the duration was 10.5 years,the Youden index reached the maximum value (0.71).And 38.5％ (10/26) of patients with esophageal cancer could not be treated with esophageal cancer radical surgery,and their average survival time was (11.4±6.6) months.Conclusion The patients with the duration of achalasia over 10.5 years are required for regular endoscopic examination to improve the prognosis.

Astragalus polysaccharide has been widely used in food and medicinal industry owing to its health-promoting properties. In order to characterize better the relationship among molecular weight, structure-activity and activities, a simple method was used different concentration of ethanol including 30% (PW30), 50% (PW50), 70% (PW70), 75% (PW75), 80% (PW80) and 90% (PW90) to precipitate Astragalus polysaccharides into different molecular weight. As a result, PW90 showed smooth surface and the strongest antioxidant activity among these six fractions (P < 0.05). In conclusion, graded ethanol precipitation was a simple method to separate Astragalus polysaccharides into different molecular weight with different antioxidant activity fractions.
Antioxidants ; pharmacology ; Astragalus Plant ; chemistry ; Chemical Precipitation ; Ethanol ; chemistry ; Polysaccharides ; chemistry ; pharmacology

Objective To explore the optimal HbAlc diagnostic cutpoint in different glucose tolerance populations in the plateau region.Methods (1) 472 diabetes mellitus (DM) patients and highrisk groups accepting diabetes screening in the First Affiliated Hospital of Kunming Medical College (217 males and 255 females,≥20 years old,median age 54 years old) were collected,oral glucose tolerance test (OGTT) and HbAlc were tested.(2) the research subjects were divided into normal glucose adjustment group (NGT),Impaired fasting glucose group (IFG) and (or) Impaired glucose tolerance IGT group and diabetes mellitus (DM) group.The receiver-operating characteristic curve (ROC) was explored to determine the optimal HbA1c diagnostic cut point for IFG,IGT and DM status respectively.Results The average HbA1 c values of NGT,IFG and (or) IGT,DM groups were (6.06 ± 0.11) ％,(6.63 ± 0.11) ％,(8.70 ± 2.08)％ respectively,for IFG and IGT groups,the optimal HbA1c diagnostic cut points were 6.7％ and 6.6％,respectively; If use either FBG or 2 h PG to diagnose DM,the corresponding optimal HbA1 c diagnostic cut point was 7.1％ ; If use anyone of FBG or 2hPG to diagnose DM,the corresponding optimal HbA1c diagnostic cut point was 7.0％ ; If both FBG and 2hPG were used to diagnose DM,the corresponding optimal HbA1 c diagnostic cut point was 7.1％.Conclusion Preliminarily confirm the optimal HbA1c diagnostic cut point in different glucose tolerance populations in the plateau region of Kunming,and provide the evidence for further clinical application of HbA1c.

OBJECTIVETo investigate the correlation of the deleted azoospermia (DAZ) gene copy related to gr/gr and b2/b3 deletions in the AZFc region with male spermatogenic impairment.

METHODSThis study included 121 infertile men with different de- grees of spermatogenic impairment and 95 healthy donors from the sperm bank. Using PCR, PCR-RFLP, and Y chromosome specific sequence tagged sites (STS) , we analyzed the association of DAZ gene copy deletions related to gr/gr and b2/b3 deletions in the AZFc region with spermatogenic impairment.

RESULTSThere were 15 cases of gr/gr deletion (12. 40% ) and 6 cases of b2/b3 deletion (4.96%) in the infertility group as compared with 13 cases of gr/gr deletion (13.68%) and 1 case of b2/b3 deletion (1.05%) in the control. Analysis of the DAZ-specific single nucleotide variant (SNV) loci revealed 11 gr/gr-DAZI/DAZ2 deletions (9.09%), 4 gr/gr-DAZ3/DAZ4 deletions (3.31%), and 6 b2/b3-DAZ1/DAZ2 deletions (4.96%) in the infertile men in comparison with 3 gr/ gr-DAZ1/DAZ2 deletions (3.16%), 10 gr/gr-DAZ3/DAZ4 deletions (10.53%), and 1 b2/b3- DAZ3/DAZ4 deletion (1.05%) in the control.

CONCLUSIONPartial deletions of gr/gr and b2/b3 exist in both healthy men and male patients with different degrees of spermatogenic impairment and cannot be considered as a risk factor for spermatogenesis impairment. However, deletions of different DAZ duplicons in gr/gr and b2/b3 deletions have different effects on spermatogenesis. DAZ1/DAZ2 instead of DAZ3/DAZ4 deletions might be associated with spermatogenesis impairment.

AIM:To investigate the application of retinal nerve fiber layer (RNFL) thickness detected by OCT in the diagnosis of primary open angle glaucoma (POAG) and its relationship with the mean defect of visual field.METHODS:A retrospective study was carried out.Totally 158 cases (158 eyes) of patients with POAG were selected as POAG group, including 81 cases in early stage, 47 cases in middle stage and 30 cases in late stage.At the same time, 50 cases of persons without eye related diseases were selected as the control group.The upper, lower, nasal and bitamporal RNFL thickness and mean defect of visual field were detected, and the patients with POAG were followed up for 3mo.RESULTS:The upper, lower, nasal and bitamporal RNFL in POAG group were thinner than those in the control, and the mean defect of visual field was higher than that in the control group at different time (P<0.05).There was no significant difference in RNFL thickness and mean defect of visual field between patients with early POAG and the control group (P>0.05).The RNFL thickness of various parts was higher than that in patients with middle and late POAG, and the mean defect of visual field was lower than that in patients with middle and late POAG (P<0.05).There was no significant difference in RNFL thickness of various parts and mean defect of visual field in POAG group at different time (P>0.05).Pearson correlation analysis showed that the upper, lower, nasal and bitamporal RNFL thickness was negatively correlated with the mean defect of visual field (r=-0.719,-0.615,-0.681,-0.518, P<0.05).CONCLUSION:OCT can monitor the change of RNFL thickness in patients with POAG, and has a negative correlation with mean defect of visual field, which can be used for early diagnosis of POAG.

Forty type 2 diabetic patients with diabetic peripheral neuropathy (DPN) were assigned to two groups and treated respectively with?-lipoic acid or mecobalamin for 2 weeks.The results suggested that?-lipoic acid could accelerate the nerve conduction velocity and decrease the plasma level of endothelin and C reactive protein as well as microalbuminceria with a effect similar to mecobalamin therapy on DPN.