Objective To explore the related risk factors of stroke in progression(SIP)and establish discriminant models to predict the incidence.Methods 31 possible related factors were compared between progressive group(n=110)and non-progressive group(n=336),and the related factors were analyzed in discriminant models.Results Discriminant models were established by 16 factors,including arterial stenosis,OCSP subtype,blood glucose,low density lipoprotion,creatinine,the sign of early cerebral infarction on CT,the temperature increasing and the rapidly decreasing of blood pressure in 48 hours after admittion.The evaluation to the models by interview data and prospective data showed a satisfied result.Conclusion Arterial stenosis,OCSP subtype and other significant factors selected by model will be helpful in prediction of SIP.

Objective To summarize the age-related changes and the risk factors of renal tubular function in the elderly male cases.Methods Totally 229 cases without chronic kidney disease were divided into two groups:group aged ＜80 years and group aged ≥80 years.We measured the urine routine,serum creatine,serum urea,urine β2-microglobin (β2-MG),urine α1-microglobin (α1-MG)and calculated the eGFR based on Cockcroft-Gault equation.Logistic regression was used to analyze the risk factors which may accelerate the progression of the renal tubular impairment.Results The average age of 229 cases was (76±10)years.There were 142 cases in the group of ＜80 years old and 87 cases in the group of ≥80 years old.The level of eGFR in the group of ≥80 years old was (55.0±12.7) ml/min,which was lower than that of the group of ＜ 80 years old (80.3 ± 18.0 ml/min) (t =9.882,P＜0.01).The level of urine SG was decreased in the group of ≥80 years old versus in the group of ＜80 years old(1.016±0.006 vs.1.013±0.006).The value changes of urine pH,urine β2-MG and urine α1-MG were of statistical differences between the two groups [(6.2±0.8) vs.(6.6±0.8),(0.96±1.02)mg/L vs.(2.08 ±3.56)mg/L,(6.67±3.57) mg/L vs.(8.71±6.59)mg/L].The correlation analysis showed that age correlated negatively with eGFR and urine SG(r =-0.692and r=-0.280,both P＜0.01)and positively with urine pH(r=0.255),urine β2 MG(r=0.262),urine α1-MG(r=0.228)(all P＜0.01).The Logistic regression analysis showed that coronary heart disease was an independent risk factor for the progression of renal tubular impairment (OR=4.251,P=0.002).Conclusions Renal tubular functions is decreased with ageing age in the elderly male,especially in the advanced elderly.The coronary heart disease is an independent risk factor of the progression of renal tubular impairment.

Radiation?induced heart disease ( RIHD) is a common type of radiation?induced damages in chest radiotherapy. There are no obvious short?term symptoms in patients with RIHD. However, RIHD causes irreversible permanent damages to the heart over time, which undermines the quality of life. Patients with severe RIHD even have a risk of death from myocardial infarction caused by coronary atherosclerosis. This paper summarizes the research advances in epidemiology, diagnosis, mechanisms of radiation?induced injury in various parts of the heart, radiotherapy techniques, and treatment. Reduction in radiation range and dose, early diagnosis, and early treatment are recommended for patients to reduce heart injury and improve the quality of life.

Objective:To study the changes of the NKT like cells after HIV infected. Methods:We collected peripheral blood from 47 untreated HIV infected individuals and 31 healthy controls,and analyzed the expression of Annexin-V,Ki-67,HLA-DR and other surface molecules in NKT like cells by flow cytometry. Results:The NKT like cell percentage of untreated HIV infected group was (3. 03±1. 61)%,the NKT like cell percentage of normal control group was (8. 30±7. 42)%,the percentage of NKT like cells in HIV infected individuals was significantly lower than the healthy controls ( P<0. 05 );the NKT like cell HLA-DR expression of untreated HIV infected group and normal control group were (5. 40±4. 10)% and (0. 89±0. 83)%,the NKT like cell Annexin-V expression of untreated HIV infected group and normal control group were (30. 21±13. 15)% and (5. 40±8. 05)% ,and the activation and apoptosis of NKT like cells was significantly higher after HIV infection compared with health individuals (P<0. 001,P<0. 01),the degree of activation was negatively correlated with CD4 count (r=-0. 885 7,P<0. 05);and the NKT like cell Ki-67 expression of untreated HIV infected group and normal control group were (11. 15±4. 76)% and (27. 63±18. 31)%,the proliferation ability was significantly lower after HIV infection compared with healthy controls(P<0. 05). Conclusion:HIV infection can significantly reduce the number of NKT like cells and its ability to proliferate,and increase its ability to activation and apoptosis.

Objective:To better understand the changes of the NKT like cells after HIV infection and HAART treatment.Methods: Peripheral blood from HIV-infected individuals, HAART-treatment AIDS patients and healthy controls were collected, the expression of CD57 and the proliferation ability of NKT like cells before and after HAART were analyzed by flow cytometry.Results:We found that the percentage of NKT like cells before HAART was significantly lower than the healthy controls ( P<0.01 ) , and recovered after HAART treatment ( P<0.05 );the aging of NKT like cells was significantly higher before HAART compared with health individuals (P<0.01),and recovered after HAART treatment(P<0.05)the proliferation was significantly lower in vitro before HAART compared with healthy controls,and partial recovered after HAART.Conclusion: After HAART treatment,the number of NKT like cells,CD57 expression and the proliferation ability of HIV infected patients were restored.

Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P<0. 05). The refraction at 1 month ( -0. 56 ± 0. 42)D and 6 months ( -0. 58 ± 0. 22)D after treatment were of no significant difference (P>0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P<0. 05),but there were no significant difference between 1 month and 6 months after treatment (P>0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.

Objective To evaluate the function of IRISiQ200 full automated urine analyzer and its clinical application of user re-classification function.Methods The reproducibility,linearity and mutual infection rate of IRISiQ200 were detected.116 fresh urine specimen were obtained from outpatient and inpatient at random.After the specimen were detected with IRISiQ200,the doubtful urine sediment images were discriminated repeatedly by user reclassification.The microscopic quantitation in uncentrifuged samples was used as reference.Results IRISiQ200 showed good reproducibility,linearity and lower mutual infection rate.The performances by using iQ-200 were: erythrocytes Y=0.596X+11.353,R2=0.834;leukocytes Y=0.468X+5.745,R2=0.708;epithelial cells Y=0.524X-2.649,R2=0.815.The performances after reclassification: erythrocytes Y=0.895X-3.328,R2=0.997;leukocytes Y=0.786X-1.880,R2=0.976;epithelial cells Y=0.911X-5.502,R2=0.992.Conclusion IRISiQ200 full automated urine analyzer shows excellent performance.There is fine correlation between iQ-200 and microscopic quantitation in uncentrifuged samples,and the urine sediment can be observed intuitively by using reclassification function.The doubtful urine sediment images can be discriminated.It can degrade the instrument error and increase the detection accuracy greatly.[Chinese Medical Equipment Journal,2008,29(2):82-83,85]

Clostridium difficile is a gram-positive,anaerobic spore-forming bacillus commonly found in the environment and human gut.Excessive use of antibiotics,immunosuppressive agents and chemotherapy drugs may lead to overgrowth of the toxic strain of Clostridium difficile with high resistance,which are supposed to be the major contributing factors leading to Clostridium difficile associated diarrhea(CDAD).The globally increasing incidence of CDAD,especially the outbreak of nosocomial infection caused by the hypervirulent strain in North America,arouse worldwide attention.For providing new ideas to the early diagnosis and treatment of CDAD,this review summarize the latest development on pathogenesis and rapid laboratory diagnosis of Clostridium difficile.

Objective To test thyroid-stimulating hormone (TSH) suppress GLUT4 expression and translocation by stimulating TNF-α secretion in 3T3-L1 adipocytes via a cAMP-PKA pathway.Methods 3T3-L1 preadipocytes were induced to differentiate into adipocytes.The adipocytes were treated with bovine TSH,Forskolin,H89 and Rapamycin,respectively.The concentration of TNF-α in the cell culture medium was measured by ELISA.The level of GLUT4 mRNA in adipocytes was assessed by real time polymerase chain reaction.Protein levels of GLUT4 in total cell lysates and plasma membrane lysates were quantified by Western blotting.Results Incubating 3T3-L1 adipocytes with TSH markedly increased the concentration of TNF-α in medium in a time-and dosedependent manner (P ＜ 0.05); meanwhile,the levels of GLUT4 mRNA and total and plasma membrane GLUT4 protein were decreased in a dose-dependent manner (P＜0.05 or ＜0.01).H89 and rapamycin could block the above effects respectively (326.7±43.2 vs.341.9±12.0,P＞0.05).However,there was no statistical difference in the TNF-α levels between stimulation with 1 μmmol/L forskolin versus 0.04 μmmol/L bovine TSH (481.9± 28.4 vs.522.7± 36.2,P＞0.05).Conclusions TSH can down-regulate GLUT4 expression and translocation in 3T3-L1 adipocytes by stimulating TNF-α secretion through a cAMP-PKA pathway.

3T3-L1 adipocytes transfected with TSH receptor (TSHR) shRNA were incubated with bovine TSH.The concentration of tumor necrosis factor (TNF)-α in culture medium was measured by enzyme linked immunosorbent asssy.Protein level of insulin receptor substrate 1 (IRS-1) was quantified by Western blotting.Tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation.The results showed that 1 mIU/ml TSH significantly sitmulated TNF-α release in 3T3-L1 adipocytes [(341.85 ± 12.00 vs 522.67 ± 36.22) ng/L,P＜0.01],along with the decreases in IRS-1 protein expression and its tyrosine phosphorylation (P＜ 0.01).These effects disappeared when TSHR expression was down-regulated with RNA interference in 3T3-L1 adipocytes.In addition,WP9QY,a TNF-α antagonist,blocked TSH-decreased IRS-1 expresssion.These results suggest that TSH downregulates IRS-1 protein expression and its tyrosine phosphorylation through stimulating production of TNF-α,and thus contributes to the development of insulin resistance.