Objective Toinvestigatethecorrelationofsmallvesseldisease(CSVD)causedacute lacunarinfarctionandurinemicroalbumin.Methods Theclinicaldataof136patientswithacutelacunar infarction admitted to the Department of Neurology,Shengjing Hospital of China Medical University from November 2012 to April 2014 were analyzed retrospectively. They were divided into either a CSVD group (n=72)or a cerebral large vessel disease (CLVD)group (n=64)according to their carotid artery color Doppler ultrasound and head magnetic resonance angiography findings. The levels of urinary microalbumin in both groups were observed and compared. SAS 9. 1 software was used to conduct statistic analysis. A Logistic regression analysis was used to determine the independent risk factors for CSVD caused acute lacunarinfarction.Results TheconcentrationofurinemicroalbuminoftheCSVDgroup(22±13mg/L) was significantly lower than (29 ± 14 mg/L)that of the CLVD group. There was significant difference (P<0.05). There was significant difference in the increased urine microalbumin levels between the CSVD group and the CLVD group (P<0. 01). There was an increasing trend for the proportion of patients with urine microalbumin concentration 10- <30 mg/L (56. 9%[41/72])in the CSVD group compared with the CLVD group (26. 6%[17/64]). Logistic regression analysis showed that the slightly increased microalbuminuria was associated with CSVD caused acute lacunar infarction (OR,3. 130,95%CI 1. 481-6.618;P<0.01).Conclusion Theslightlyincreasedmicroalbuminuriaisanindependentriskfactorfor CSVD caused acute lacunar infarction.

Objective To develop a novel stress fracture animal model system based on dynamic cyclic mechanical loading.Methods Ulnae and tibiae of rats were respectively fixed using differently shaped fixtures (including a fixed holder and a movable holder).The axial mechanical loading was applied via a linear actuator based on LabVIEW control program.During the loading process,a load cell and a laser displacement transducer were used to detect the force and displacement changes in the limbs,respectively.The two signals were sampled at real time by PC-based LabVIEW data acquisition program.A compressive loading test (peak force of 50 N) was conducted to examine the consistency and reliability of cyclic loads after completing the loading system.The loading system and an ElectroForce 3220 mechanical testing machine were respectively used to measure and compare the Young's modulus of a standard ultra-high molecular weight polyethylene (UHMWPE)cylinder to calibrate the loading system.Results The compressive loading test (peak force of 50 N) demonstrated that the mechanical loading system was able to apply consistent loads with controllable intensity and time.The calibration experiment indicated the accuracy of the loading system.Conclusion The novel mechanical loading device has characteristics of precision,scientificity and reliability,and it is approaching the real development situation of stress fracture,which may provide a reliable experimental base for exploring the precautionary measures of stress fracture.

ObjectiveTo compare the sensitivity and specificity of a new index of insulin resistance (IR) derived from plasma triglyceride and glucose with homeostasis model assessment for insulin resistance index ( HOMA-IR) and insulin sensitivity index from frequent sampling intravenous glucose tolerance test (FSIGT-ISI).Methods A total of 1024 subjects (240 normal control,335 with obesity,312 impaired glucose regulation,and 137 type 2 diabetes mellitus) were included in the present study.Standard oral glucose tolerance test,insulin release test,lipid profiles,and other biochemical markers were measured. Among them 540 subjects were selected to undertake FSIGT.TyG index is derived from plasma triglyceride and fasting glucose.TyG2 index is derived from plasma triglyceride and postprandial 2 plasma glucose.ResultsPearson correlation coefficient between TyG and HOMA-IR or FSIGT-ISI was 0.427 ( P＜0.01 ) and -0.100 ( P=0.024 ),respectively,and that between TyG2 and HOMA-IR or FSIGT-ISI was 0.455 ( P＜0.01 ) and - 0.162 ( P＜0.01 ),respectively.The sensitivity and specificity of TyG index for diagnosis of IR was 68.5％ and 63.5％ compared with HOMA-IR,and 68.5％ and49.5％ compared with FSIGT-ISI.For TyG2 index,the slightly higher sensitivity ( 81.7％ with HOMA-IR,75.7％ with FSIGT-ISI),but lower specificity (51.5％ with HOMA-IR,48.2％ with FSIGT-ISI) were found.ConclusionsBothTyGandTyG2 indices could be used as a surrogate for assessing IR in Chinese subjects.However,considering its moderately high sensitivity but low specificity,these two indices are limited in the use of large-scale epidemiological screening.

OBJECTIVETo evaluate the impact of breast density on computer-aided detection (CAD) for breast cancer and the CAD false-positive rate of normal controls.

METHODSTwo hundred and seventy-one histologically proven breast malignant lesions (from Feb. 2008 to Dec. 2009) and 238 randomly selected normal cases were classified by mammographic density according to the American College of Radiology breast imaging reporting and data system (BI-RADS). Mammograms of BI-RADS 1 or BI-RADS 2 density were categorized as non-dense breasts, and those of BI-RADS 3 or BI-RADS 4 density were categorized as dense breasts. Full-field digital mammography (GEMS Senographe) were performed in all patients and controls with craniocaudal (CC) and mediolateral oblique (MLO) views. Then the image data were transferred to review workstation (SenoAdvantage), and the lesions were marked by Second Look Digital CAD system (version 7.2, iCAD). The differences of sensitivity and false-positive rate between dense and non-dense breasts were compared.

RESULTSOverall, the sensitivity of CAD in detection of cancers was 84.1% (228/271), there was a statistically significant difference in CAD of cancers in dense versus non-dense breasts (P = 0.015). The sensitivity of CAD in detection of mass cancers was 76.5% (186/243), in detection of calcification cancers was 79.1% (125/158), there was no statistically significant difference in CAD performance for the detection of mass cancers versus calcification cancers (P = 0.547). There was a significant difference in the CAD performance for the detection of mass cancer cases in non-dense versus dense breasts (P = 0.001), but no significant difference in the CAD for the detection of calcification cancers in non-dense versus dense breasts (P = 0.216). In the controls, the distribution of mass false-positive marks did not differ significantly between non-dense and dense breast tissue cases (P = 0.207), but the distribution of calcification false-positive marks differed significantly between non-dense and dense breast tissue cases (P = 0.001). There was a statistically significant difference of false-positive marks in non-dense versus dense breasts (P = 0.043).

CONCLUSIONSThe sensitivity of CAD in the detection of breast cancers is impacted by breast density. There is a statistically significant difference in the CAD performance for the detection of cancer cases in non-dense versus dense breasts. The false-positive rate of CAD is lower in dense versus non-dense breasts. It appears difficult for CAD in the early detection of breast cancer in the absence of microcalcifications, particularly in dense breasts.

Adenocarcinoma, Mucinous ; diagnostic imaging ; pathology ; Adult ; Aged ; Aged, 80 and over ; Breast ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; diagnostic imaging ; Carcinoma, Ductal, Breast ; diagnostic imaging ; pathology ; Carcinoma, Lobular ; diagnostic imaging ; pathology ; Carcinoma, Papillary ; diagnostic imaging ; pathology ; False Positive Reactions ; Female ; Humans ; Mammography ; methods ; Middle Aged ; Numerical Analysis, Computer-Assisted ; Radiographic Image Interpretation, Computer-Assisted

Objective To explore the incidence rate of people with mild cognitive impairment (MCI) which transferred to Alzheimer's disease (AD) and to study the related influencing factors. Methods 600 MCI aged people were experienced screening test which was conducted by WHO-BCA, MMSE and DCR. A three-year follow-up study was conducted to get the information on the aged people with MCI. Data related to demography, behavior, chronic diseases and perception of the elderly with MCI were collected through face to face interview. Characteristics of the elderly with MCI aged people were tested by 16PF. The content of Apoe was tested by PCR.People with NC were investigated by telephone to get the progression and the time to AD.Methodologies on statistics were log-rank test and Cox proportional hazards regression model.Results The incidence rate of MCI to AD was 6.53% person-years. The incidence rate of the normal people to AD was 1.24% person-years. The hazard of MCI to AD was 5.27 times (95%CI: 3.01-9.82)of the normal people to AD. The result of Cox proportional hazards regression model displayed that: older age (RR=3.14, 95% CI: 2.98-7.46) , hypertension (RR=3.28, 95% CI: 3.02-8.48) ,hyperlipermia (RR = 2.22,95%CI: 1.29-3.82), diabetes (RR=4.87,95%CI: 2.56-9.25), lack of sports (RR=2.02, 95%CI: 1.29-3.14), anxiety (RR=4.46, 95%CI: 3.07-8.14), dread fulness (RR=4.08,95% CI: 3.52-5.25), loneliness (RR= 1.89,95% CI: 1.13-3.16), characteristics of anxiety (RR= 5.07,95%CI: 2.56-10.04, introvert characteristics (RR=2.05,95%CI: 1.33-3.15) and ApoE4 (RR= 1.73,95% CI: 1.15-2.63) were the risk factors of MCI to AD. Higher education (RR=0.29, 95% CI:0.07-0.43), intellectual work(RR=0.14,95%CI: 0.05-0.32), often reading books(RR=0.30,95%CI:0.15-0.58), often taking part in recreational activities (RR=0.41,95%CI: 0.23-0.75) seemed to be the protective of MCI to AD. Conclusion The rate of the elderly with MCI that developing to AD was high, suggesting further study on the cognitive situation among the MCI aged people should be carried out.

In this work, a simple and fast approach for dipeptide detection was developed. AuNPs were decorated onto the surface of indium tin oxide ( ITO ) glass to serve as the working electrode to trigger the electrochemiluminescence ( ECL) of luminol. The property of this electrode was characterized by transmission electron microscopy ( TEM ) , scanning electron microscopy ( SEM ) , electrochemistry and spectroscopic method. Under the optimum conditions, the dipeptide His-Ala could be detected within a linear range from 2. 44×10-11 mol/L to 1. 22×10-7 mol/L, with a detection limit of 2. 42×10-12 mol/L (S/N=3). In human body, the glucagon-like peptide 1(GLP-1) might lose activity during degradation under the enzymatic action of dipeptidyl peptidase IV (PDD-IV), meanwhile release same concentrated His-Ala dipeptide. Thus, the detection of His-Ala dipeptide was of great significance for investigation of diabetes not only for understanding the relation between GLP-1, PDD-IV and its inhibitor, but also the drug discovering because of its potential availability as the target to control the blood GLP-1 level of type II diabetics.

Haizao Yuhu decoction (HYD) is a formula that has been used for approximately 500 years and famous for its efficiency in treating thyroid-related diseases in traditional Chinese medicine (TCM). HYD was first presented by Chen Shi-gong in a famous surgical monograph named Waike Zhengzong during the Ming Dynasty. We conducted the research to investigate the possible pharmacokinetic profile of different prescriptions of HYD in rats, in order to reveal the interactions of Haizao and Gancao drug pair with other herbs in HYD. Liquiritin, naringin, besperidin, peimine, peiminine liquiritigenin, glycyrrhizic acid, hergapten, nobiletin, osthole, glycyrrhetinic acid in blood samples were determined by UPLC-MS/MS. The result revealed tbat Haizao could enhance the peak concentration of glycyrrhizic acid. The other herbs in HYD may promote'the absorption of flavonoids in Gancao in normal rats, but inhibit the absorption of saponins and accelerate their metabolism. Gancao and Haizao drug pair could enhance the bioavailability of hesperidin, peimine, bergapten, nobiletin and osthole and prolong the elimination of peimine and naringin.
Animals ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Magnetic Resonance Spectroscopy ; Male ; Mass Spectrometry ; Plasma ; chemistry ; Rats ; Rats, Wistar

BACKGROUNDInoperable chronic thromboembolic pulmonary hypertension (CTEPH) is a severe clinical syndrome characterized by right cardiac failure and possibly subsequent liver dysfunction. However, whether serum markers of liver dysfunction can predict prognosis in inoperable CTEPH patients has not been determined. Our study aimed to evaluate the potential role of liver function markers (such as serum levels of transaminase, bilirubin, and gamma-glutamyl transpeptidase [GGT]) combined with 6-min walk test in the prediction of prognosis in patients with inoperable CTEPH.

METHODSFrom June 2005 to May 2013, 77 consecutive patients with inoperable CTEPH without confounding co-morbidities were recruited for this prospective cohort study. Baseline clinical characteristics and 6-min walk distance (6MWD) results were collected. Serum biomarkers of liver function, including levels of aspartate aminotransferase, alanine aminotransferase, GGT, uric acid, and serum bilirubin, were also determined at enrollment. All-cause mortality was recorded during the follow-up period.

RESULTSDuring the follow-up, 22 patients (29%) died. Cox regression analyses demonstrated that increased serum concentration of total bilirubin (hazard ratio [HR] = 7.755, P < 0.001), elevated N-terminal of the prohormone brain natriuretic peptide (HR = 1.001, P = 0.001), decreased 6MWD (HR = 0.990, P < 0.001), increased central venous pressure (HR = 1.074, P = 0.040), and higher pulmonary vascular resistance (HR = 1.001, P = 0.018) were associated with an increased risk of mortality. Serum concentrations of total bilirubin (HR = 4.755, P = 0.007) and 6MWD (HR = 0.994, P = 0.017) were independent prognostic predictors for CTEPH patients. Patients with hyperbilirubinemia (≥23.7 μmol/L) had markedly worse survival than those with normobilirubinemia.

CONCLUSIONElevated serum bilirubin and decreased 6MWD are potential predictors for poor prognosis in inoperable CTEPH.

Aged ; Antihypertensive Agents ; therapeutic use ; Bilirubin ; blood ; Exercise Test ; Female ; Humans ; Hypertension, Pulmonary ; blood ; drug therapy ; pathology ; Male ; Middle Aged ; Prognosis ; Prospective Studies

OBJECTIVETo evaluate the long-term efficacy of microwave ablation in the treatment of small renal cell carcinoma (RCC).

METHODSWe retrospectively analyzed 140 cases of small cell renal carcinoma (151 lesions with a mean diameter of 2.8±0.8 cm) treated between April, 2006 and October, 2015 with ultrasound-guided microwave ablation with cooled-shaft needle antenna. One microwave ablation antenna was used for tumors less than 2 cm in diameter and 2 antennas were used for larger tumors. The patients received enhanced ultrasound and CT/MRI examinations at 1, 3, and 6 months after the operation and every 6 months thereafter. The overall survival, disease-free survival, and local tumor progression rate of the patients were evaluated.

RESULTSThe response rate of treatment (complete ablation at one month on enhanced images) was 100% in these patients. The local tumor progression rates at 1, 3, and 5 years were 0.9%, 2.0%, and 7.1%, respectively, and the 1-, 3-, and 5-year distant metastasis rates were 1.6%, 2.5%, and 7.9%, respectively. The overall survival rates of the patients at 1, 3, and 5 years were 98.4%, 94.8%, 89.5%, respectively, with disease-free survival rates of 98.4%, 93.0%, and 83.1%, respectively. No major complications occurred in these cases, and multivariate analysis showed that the tumor number (P=0.015) and tumor growth patterns (P=0.049) were independent risk factors that adversely affected the long-term outcome after surgery.

CONCLUSIONOur data show that microwave ablation is a safe and effective modality for treatment of renal cell carcinoma.

Carcinoma, Renal Cell ; surgery ; Carcinoma, Small Cell ; surgery ; Catheter Ablation ; Disease-Free Survival ; Humans ; Kidney Neoplasms ; surgery ; Microwaves ; Multivariate Analysis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To study the failure tolerance in long bones of lower limbs under dynamic loads. Methods Based on the finite element (FE) model of lower limb for Chinese people, the dynamic three-point bending test on the femur, tibia, leg and thigh was conducted , and the FE model was validated against the cadaveric experiment. Results The force-displacement curves between FE simulation and cadaveric experimental results for bending tests were correlated. The contact forces on femur, tibia, thigh and leg with failure tolerance were 4.29, 3.94, 4.81 and 4.086 kN, respectively，and the displacements from the impactor were 17.78, 34, 52.1, and 47.06 mm, respectively. The simulation results were correlated well with those in dynamic cadaveric experiments. Conclusions This study validated the effectiveness of the FE model, which would lay a good foundation for the further research on validation of FE model of knee joint and whole lower limb, and provide the theoretical references for the protection of pedestrians in crashes.