Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.

To promote establishment of local reference values r ange system of human serum lipid, using proposing methods, weve determined 909 healthy adults in Kunming Area about their levels of serum triglyceride, total cholesterol, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol, and acquired original data of serum lipid levels with age and sex．

Objective To evaluate the effect of clinic-pathological variables on prognosis and recurrence of the aged women suffered from borderline epithelial ovarian tumors. Methods The clinical and follow-up data of 102 cases were analyzed retrospectively. Univariate and multivariate logistic regression analysis were used to assess independent prognosis and recurrence factors.Results The postoperative accessory treatment, peritoneal implantation and lymph nodes metastasis could influence the 5-year survival rate(χ2=19.311, 11.054, 18. 559, all P＜0.01). The surgery procedure, peritoneal implantation, lymph nodes metastasis and microinvasion could influence the recurrence rate(χ2=23.606, 23.583, 25.774, 23.583, all P＜0.01). The logistic regression model showed that the postoperative accessory treatment and peritoneal implantation were the two independent prognosis factors (OR=0.060, 35.319, all P＜0.01). The surgery procedure,peritoneal implantation and microinvasion were the three independent factors affecting recurrence(OR =0.001, P＜0.05;OR=60.952, P＜0.05;OR=88.874, P＜0.01). Conclusions The early standard treatment on borderline epithelial ovarian tumors of the aged women have an excellent prognosis, the risk of recurrence remains in some patients. We emphasize that these patients with highrisk factors should be main surveillance population.

Objective To observe the positional relationship of lumbar nerve roots and its main adjacent structures with CT data, and to conduct 3D construction and measurement,so as to provide anatomical basis for percutaneous lumbar diskectomy(PLD).Methods CT serial tomography dataset of 30 healthy adults' lumbosacral portions were imported into Mimics 17.0 software to segment related structures and obtain the layers of different structures.The structures were 3D reconstructed and virtually demonstrated.The lumbar nerve roots and their main surrounding structures were observed and measured.Results The minimum distances between the lumbar nerve roots and the superior articular processes increased gradually from L3 to L4 intervertebral disc layer to L5 to S1 intervertebral disc layer.The 3D model clearly displayed the morphology and spatial relationship of the lumbar nerve roots and their adjacent structures in lumbosacral portion.The lower the lumbar intervertebral discs were,the thicker they were.The distances from the middle point of the back of lumbar intervertebral disc to the end of the superior spinous process of lumbar vertebra increased at first and decreased then,and the distance in L3 to L4 intervertebral disc layer was the farthest.Conclusion The relationship between lumbar nerve roots and superior articular processes,the intervertebral disc thickness variance and the change of the distances from lumbar intervertebral disc to the end of the superior spinous process have been analyzed in this study,and the clinic basis has been laid for percutaneous lumbar diskectomy.

Objective To evaluate the status of lymph node micrometastases in "non-metastatic" No11P lymph nodes as judged by conventional pathology in the lower third of gastric cancer. Methods In this study 43 No11P lymph nodes harvested from 43 patients which was histologically free of metastasis were examined by consecutive sections and TRAP( telomeric repeat amplification protocol)-ELISA (enzyme linked immunosorbent assay). The data were statistically analyzed according to the clinicopathological features of the patients. Results Micrometastasis was discovered in 4 lymph nodes from 4 patients by consecutive sections. The micrometastatic rate of the conventional pathologic non-metastatic No11P lymph nodes was 9%. The micrometastatic rate of the conventional pathologic non-metastasis No11P lymph nodes detected by TRAP-ELISA was 44%, including 4 lymph nodes observed by consecutive sections It revealed that lymph nodes micrometastases were correlated with the size of the tumor( x2 = 8. 488, P < 0. 05 )、and tumor stage (x2 = 12. 022,P < 0. 05 ). It also showed that the micrometastatic rate increased proportionally to tumor infiltration depth(x2 =6. 473, P <0. 05), not correlated with patients' demographic features, general type and histological differentiation of the tumor. Conclusions There was a high rate of micrometastasis in No11P lymph nodes. This lymph nodes micrometastasis was correlated with the size of the tumor, invasion depth of primary tumor and patients' clinical stage.

Objective To establish a method focusing on regulation of CNN3 gene in the rat hippocampus and help to explore the role of CNN3 gene played in the brain physiology and pathology.Methods One cDNA sequence and three shRNAs targeting CNN3 gene were designed and synthesized.The recombinant lentivirus-mediated expressing and three short hairpin RNA ( shRNA) vectors targeting CNN3 gene in the rats were constructed with engineering technology.All recombinant vectors were intravenously injected into rats hippocampi guided by stereotaxic apparatus.Western blot was performed to explore the best shRNA and to study the changes of CNN3 gene in the rat hippocampus after transfection with the silence and over-expressed vectors.Results The lentivirus-mediated vector expressing CNN3-OE and three shRNA vectors targeting CNN3 gene were successfully constructed.Within eight weeks after transfection, the vectors of CNN3-OE and three CNN3-shRNAs changed the expression of CNN3 gene in the rat hippocampus, in particular, all the protein levels of calponin-3 encoded by CNN3 gene were significantly down-regulated along with the time, with the highest inhibitory rate of 73.6%in the CNN3-shRNA2 group.Significant up-regulation of calponin-3 protein level by 93.88%, was found only on the 14th day after transfection.Conclusions Lentivirus-mediated vectors of CNN3-OE and CNN3-shRNAs may regulate in vivo the CNN3 gene level in the local brain region of rats via stereotactic injection.The study lays a foundation for disease prevention and treatment in the future.

Objective To investigate brain function alteration in early onset schizophrenia by amplitude of low-frequency fluctuation (ALFF) based on resting-state functional MRI (fMRI). Method Twenty patients with early on?set schizophrenia and 20 sex, age, education years matched healthy controls underwent resting-state functional MRI. The difference in ALFF was compared between patients and controls. Result Compared with control group, the ALFF values in patient group increased in the left frontal gyrus, precuneus, cingulate cortex, occipital lobe, parahippocampal gyrus and calcarine (P<0.05, AlphaSim revised), while decreased in the right superior temporal lobe and the posterior lobe of cerebellum (P<0.05, AlphaSim revised). Conclusion There are abnormal ALFF in multiple regions in early onset schizo?phrenia, suggesting that early onset schizophrenia may have altered in resting-state brain activity.

Background and purpose: When patients have positive sentinel lymph node (SLN), axillary lymph node dissection (ALND) is usually performed, but most of them have no metastasis in the non-sentinel lymph node (nSLN). It is of great significance to predict metastasis of nSLN precisely. The aim of the study was to establish a nomogram for the intraoperative prediction of nSLN metastasis in breast cancer patients using one-step nucleic acid amplification (OSNA) techniques and to direct the subsequent therapy for breast cancer effectively. Methods: Of 552 breast cancer patients who underwent SLN biopsy in the 2010 OSNA clinical trial, 103 with SLN metastasis treated with ALND were assessed to establish a nomogram for intraoperative prediction of nSLN based on the molecular diagnosis. A validation cohort of 61 patients who met the similar criteria in the 2015 OSNA clinical trial subsequently validated it. Results: Primary tumor size, total tumor load, the number of positive SLNs and negative SLNs were associated with the presence of nSLN metastasis based on the multivariable logistic regression results, and a nomogram was established with these variables. Its area under the ROC curve was 0.814 for the predictive model and it was 0.842 in the re-validation cohort. The tumor size assessed by the postoperative histological examination was replaced by the size evaluated by the imaging examination, and the area under the ROC curve was 0.838. There was no statistically significant difference in the accuracy compared with the former validation data (P=0.7406). Conclusion: The predictive nomogram based on the molecular diagnosis can predict the nSLN metastases intra/post-operatively. It appears to be obviously superior to other predictive models and may help to guide the axillary management and to make decisions about radiation target region.

Objective To investigate the influencing factors for knowledge,attitude and practice(KAP)of the Three-manager mode about hierarchical medical system of Chronic diseases of the community residents in Xiamen,and provide references for the implementation of hierarchical medical system.Methods Multi-stage random sampling method was adopted,and 400 residents were randomly sampled from 5 communities of Xiamen for questionnaire survey.The survey features the dependent variable of the community residents′ knowing and joining-in the Three-manager mode,the internal factors(social demographic characteristics),and the external factors(medical expenditure and healthcare insurance).On such basis,four logistic regression models were built for analysis of such influencing factors.Results 41.10% of the surveyed were aware of the Three-manager mode,and 39.71% of the hypertension/diabetes patients among them joined in the hypertension network or diabetes network.Age,education,medical expenditure and referral experiences were significant influencing factors for KAP level of the Three-manager mode,while the residents of older age,higher education and referral experiences were high in their KAP;those of lower per capita monthly income,hypertension or diabetes,with coverage of medical insurance and satisfied with medical consultation in community were high in their awareness of Three-manager mode.Conclusions The KAP level of Three-manager mode of the community residents in Xiamen is acceptable,yet expected of further improvement.Room of further improvement includes enhancement of synergy of the Three-manager mode,enhanced motivation of government financial support and medical insurance,better service functions of community institutions,and especially the construction of hierarchical medical system.

Objective To explore the clinical variables associated with the shrinkage modes of primary breast tumor in women after neoadj uvant chemotherapy (NAC ), and to develop a nomogram for predicting non-concentric shrinkage mode(NCSM).Methods Sixty-one women with pathologically proven solitary invasive ductal carcinoma (ⅡA-ⅢC)were recruited. Breast specimen was prepared with PMSS, and residual tumors were microscopically outlined,scanned and registered by Photoshop CS 5 software.The 3D model of residual tumors was reconstructed with 3D-DOCTOR 4.0 software to evaluate the shrinkage mode.17 factors such as age and body mass index and menopausal status were chosen as independent variables,and the clinic-pathologic shrinkage mode was considered as dependent variable. A Logistic regression model was used to construct the nomogram. Results Primary tumor stage,lymph node down-staging, PR and mammographic malignant calcification before NAC were independent predictors of clinic-pathologic shrinkage mode (β:1.538,OR:4.656,95%CI:1.414-15.328,P=0.011;β:1.555,OR:4.735, 95%CI:1.082-20.722,P=0.039;β:-1.707, OR:0.181, 95%CI:0.044-0.741,P = 0.017;β:- 1.405, OR:3.808, 95% CI:0.06 - 0.998,P = 0.048, respectively ). The nomogram predicting the risk of NCSM showed a good concordance index(0.869),and its conformity of mean absolute error was 0.039. Conclusion Based on the clinicopathological findings of primary breast tumor, a nomogram to predict shrinkage modes after NAC in breast carcinoma patients is constructed.The statistical tool is helpful for individually selecting the patients who can be treated with BCT after NAC.