Objective To explore the influence of type A character on early renal impairment in elderly patients with essential hypertension and the protective effect of benazepril. Methods According to the type A behavior measuring scale, 80 cases with type A character and 80 cases without type A character were screened out from the elderly patients with essential hypertension. The patients received benazepril intervention with incipient dose of 10 mg daily, which increased gradually to the largest does of 20 mg daily within 1 month, The treatment lasted 6 months in order to make the patients achieve the normal blood pressure (BP). The general data, plasma angiotensin Ⅱ (AngⅡ )> urinary albumin excretion rate (UAER) and urinary β2-microglobulin (β2-MG) were measured at pretherapy and post-treatment respectively. Results There were no statistically significant differences at pretherapy between the two groups in age, gender, body mass index (BMI), blood urea nitrogen (BUN), creatinine (Cr), systolic pressure and diastolic pressure (all P>0.05). Ang Ⅱ [(60.3±11.6)mg/Lvs (55.8±10.2)mg/L], UAER[(83.3±23.3)μg/min vs. (75.7±16.3)μg/min] and β2-MG [(75.6±24.5)mmol/L vs. (66.0±19.4)mmol/L] were significantly higher in type A character group than in non-type A character group (t=2.598, 2.603, 2.742; P= 0.016,0.012, 0.008). TypeA character value of the two groups showed a positive correlation with Ang Ⅱ (r= 0.361, P=0.002), UAER (r=0.198, P=0.015) and β2-MG (r=0.202, P = 0.021). Only Ang Ⅱ (β=0.291, t=2.793, P= 0.008) was correlated to type A character value independently by multiple stepwise regression analysis. Before treatment in both of the type A character group and the non-type-A character group, there was a positive correlation between Ang II and UAER, (β2-MG, and obvious correlation in type-A character group. The systolic pressure, diastolic pressure, Ang Ⅱ , UREA and β2-MG were all decreased obviously in two groups post treatment. And the variable value of AngⅡ was also positively correlated with UAER (r=0.373, P=0.005; r=0.282, P=0.032), fr-MG (r= 0.385, P=0.003; r= 0.279, P=0.039) before and after treatment. Conclusions Type A character can aggravate injury of early renal function by certain stress systems in the elderly patients with essential hypertension and benazepril has better protective effect for it.

Objective To report two cases of Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and to assess their clinical features,diagnosis and treatment.Methods A medical history including medication history and therapeutic response was carefully collected from two male patients.Physical examination was carried out with a focus on skin lesions.Diagnosis was made according to medical history as well as physical,mycological and histopathological examination findings.Antifungal agents were given at a high enough dose in time.After lesions improved,the doses of antifungal agents were tapered gradually,and drugs were withdrawn until patients completely healed.Compound preparations containing both antifungal agents and glucocorticoids were also topically applied in the early period of treatment.Results Both patients were diagnosed as Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and cured after 100-day supporting treatment and antifungal treatment with oral itraconazole,etc.Conclusions Candida parapsilosis-caused candidiasis should be managed with combination therapy mainly including antifungal agents.To achieve a satisfying efficacy,antifungal agents should be given early at a high enough dose for a long enough period.

Objective: To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions. Methods: All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed. Results: A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ). Conclusions Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

Objective To investigate the vision-related quality of life （VRQL） in patients with glaucoma and to explore the intervention. Methods 260 patients with primary open angle glaucoma (POAG) were investigated with questionnaire of VRQL and self-evaluation before and after health education. 100 health adults with similar age and vision was selected as controls. Results There were significant decrease on VRQL and self-evaluation in patients with glaucoma. Systematic health education can significantly improve their VRQL and self-evaluation. Conclusion The in patients with Glaucoma may result in decrease of VRQL， and systemic health education can improve the quality of life.

Objective To compare effect of three therapies( modified constraint-induced movement therapy (mCIMT), constraint-induced movement therapy (CIMT) and Bobath therapies)on the recovery of motor function in upper-extremities of patients with apoplexy hemiparalysis. Methods Fifty-seven patients with apoplexy hemiparalysis were randomly divided into CIMT treatment group ( n = 19), mCIMT group (n = 19) and Bobath group (n = 19). Patients in Bobath group exercised 2 h/d, 5 d/week for 6 weeks. CIMT group and mCIMT group had restriction of movement at the unimpaired upper extremity by placing it in a sling a whole day for training using impaired extremity. Patients in CIMT treatment group exercised 6 h/d,5 days a week for 2 weeks in a row; mCIMT treatment group exercised for 1 h/d, 3 days a week, and also exercised in daily life at least 2 hours every day, for ten consecutive weeks. The patients in all three groups were assessed for upper-extremities motor function using FMA of Fugl-Meyer, for recovery of upperextremities motor speed using STEF and for recovery of daily ability at respective time-points of pre-treatment and the second week, sixth week and tenth week of post-treatment. Results In 3 assessments in the 3 groups there was no obvious change before treatment, while the FMA score was 45. 2 ± 5.1 (F = 1. 107 ,P =0. 382), BI score was 63. 1 ± 10. 3 ( F = 0. 930, P = 0. 401 ), STEF score was 63.4 ± 8.6 ( F = 1. 843, P =0. 168). At the second week, sixth week and tenth week of the treatment, the difference of assessment in the three groups was significant. The improvement in CIMT group was better after 2 weeks treatment compared with Bobath and mCIMT group, while the Bobath group showed better results than mCIMT group did after 6 weeks treatment. After 10 weeks treatment, the FMA, STEF in mCIMT and CIMT groups were improved better than Bobath group, while the BI score in mCIMT group was better than that in Bobath and CIMT group. Conclusions The mCIMT and CIMT therapy are better in improving the upper limb function in stroke patients compared with Bobath, while the mCIMT therapy is more effective in improving the abilities of daily life in stroke patients compared with the other two treatments.

Objective To investigate the feasibility of a novel molecular probe 99Tcm-3P4-RGD2 in evaluating arterial plaque stability after atorvastatin intervention in rabbits with SPECT/CT. Methods Eighteen male New Zealand rabbits were randomly divided into group A (stable plaque), group B (vulnerable plaque), and group C (vulnerable plaque with statin intervention). All rabbits were fed with high-fat food for 12 weeks. After high-fat feeding for two weeks, sham surgery was performed on group A. In the meantime, abdominal aorta injury was performed on group B and group C. After that, rabbits of group C were given oral atorvastatin (2.5 mg·kg-1·d-1). 99Tcm-3P4-RGD2 SPECT/CT imaging was performed on each group at the end of 4, 8 and 12 weeks. T/NT ratios were calculated. Animals were sacrificed at the end of 12 week after imaging studies. The abdominal aortas were collected, imaged with SPECT/CT, and evaluated by pathological HE staining and immunohistochemical analysis. MVD was calculated. Differences among 3 groups were analyzed using one-way analysis of variance. Results There was no significant radioactive uptake in the abdominal aortas of three groups on the 4th week′s imaging. The radioactive uptake in abdominal aortas increased slightly on the 8th week, with the highest radioactive uptake in group B. The radioactivity in abdominal aortas of the 3 groups maintained increasing on the 12th week, with T/NT ratios of 1.579±0.217, 1.873±0.226 and 1.524±0.237, respectively (F=8.984, P<0.05). In ex vivo abdominal aorta images, especially images of group B, radioactivity in lesion sites was higher than that in normal tissue. Accordingly, results of HE staining showed that artery plaques of group A and group C were grade Ⅱ and group B was grade Ⅳ. The MVD of group A, B and C was 8.17±1.17, 15.86±1.07 and 7.17±1.60, respectively (F=9036, P<0.05). Conclusion 99Tcm-3P4-RGD2 SPECT/CT imaging has a high sensitivity in the evaluation of arterial plaque stability after statin intervention in rabbits.

[Summary] Four patients with hyperthyroid-associated exophthalmos, myxedema, acropachy ( EMA ) syndrome, including three male patients and one female patient were diagnosed with Graves′diseases and treated by 131 I therapy. Complaints of thyrotoxicosis were presented at the onset. Tibia myxedema and acropathy appeared, and eye symptoms aggravated in two patients after anti-thyroid drug therapy and 131 I therapy. Four cases were all given clobetasol propionate, miconazole nitrate, neomycin sulfate and urea cream alone or in combination with compound betamethasone local injection treatment, and three cases were given low-dose oral prednisone treatment. Complaints of tibia myxedema and eye symptoms were significantly improved after the treatment. Therefore, we should be wary of the occurrence of hyperthyroid-associated EMA syndrome after 131 I therapy. Corticosteroid might be the effective therapy for myxedema and eye symptoms of EMA syndrome.

Objective To evaluate desmopressin stimulated inferior petrosal sinus sampling in diagnosing Cushing′s disease.Methods Sixteen ACTH-dependent Cushing′s disease patients underwent bilateral desmopressin stimulated inferior petrosal sinus ( IPS ) sampling because of negative or equivocal magnetic resonance imaging.Cortisol response to high-dose dexamethasone suppression test was also evaluated.ACTH sampling was taken from a peripheral vein and bilateral IPS before and both 5 and 10 min after injection of desmopressin.Diagnosis was based on the ratio of ACTH level in between IPS to peripheral vein by desmopressin test.Diagnosis was confirmed after surgery.Results High-dose dexamethasone suppression test showed suppressible in 9 of 16 patients with Cushing′s disease.An IPS gradient ＞2 was found in 14 of the 16 cases (87.5％ )with Cushing′s disease after desmopressin injection,while before injection the respective figure was 12 of 16 (75.0％).No severe adverse effects were observed during or after the procedure.Conclusion Desmopressin test during bilateral IPS sampling is a safe and effective diagnostic procedure in Cushing′s disease.

AIM:To study the effect of astragalus polysaccharides(Aps)on cholesterol efflux in THP-1 macrophage-derived foam cells.METHODS:After exposed to Aps at different doses,cholesterol efflux and ABCA1 protein levels in cultured THP-1 macrophage-derived foam cells were determined by a ? counter and flow cytometry,respectively.RESULTS:Aps increased cholesterol efflux in THP-1 macrophage-derived foam cells with dose dependent pattern and resulted in an increase in the expression of ABCA1 protein in THP-1 macrophage-derived foam cells.CONCLUSION:The increase in cholesterol efflux by Aps might be related to the up-regulation of ABCA1.

Objective:To investigate the relationship between serum lipocalin-2 level and the risk of cardiovascular disease(CVD) in patients with type 2 diabetes.Methods:A total of 279 type 2 diabetic patients were enrolled in this study. Basic information and clinical data were collected. These patients were divided into CVD group and non-CVD group according to their cardiovascular disease status. Serum lipocalin-2 level was assessed by enzyme linked immunosorbent assay.Results:Compared to non-CVD group, serum lipocalin-2 level was significantly higher in CVD group( P<0.01). The Spearman correlation analysis showed that serum lipocalin-2 level was positively correlated with waist circumstance, diastolic blood pressure, uric acid, triglyceride, and HbA 1C( P<0.05), while negatively correlated with high density lipoprotein-cholesterol level( P<0.01). In addition, the univariate and multivariate logistic regression analysis revealed that serum lipocalin-2 was an independent risk factor for CVD( P<0.01)after adjustment for potential confounders. Moreover, receiver operating characteristic curve analysis demonstrated that the area under curve value of lipocalin-2 was 0.74, with the optimal cutoff value of lipocalin-2 66.84 ng/mL. Conclusion:Serum lipocalin-2 is closely associated with CVD in patients with type 2 diabetes, which might be considered as one of the predictors for CVD in type 2 diabetes mellitus.