Objective To explore the correlation between adiponectin/leptin(A/L) ratio and metabolic syndrome diagnosis in elderly men. Methods A total of 256 elderly men (≥60 years) were enrolled and divided into metabolic syndrome group(n= 109) and non metabolic syndrome group (n= 147). Serum levels of adiponectin and leptin were measured by radioimmunoassay (RIA) and the A/L ratio was calculated. Metabolic syndrome diagnosis is based on the definition provided by China Diabetes Society (CDS) in 2004. Results (1) In metabolic syndrome group versus non metabolic syndrome group, the serum levels of leptin and adiponectin were (10. 3±7.0) vs (6.8±4.9)μg/L and(7.8±5.6)g/L vs (9.5±5.9)g/L, and A/L ratio was 0. 94±0. 78 vs 2.15±2.13 respectively. (2) A/L ratio was positively correlated with high density lipoprotein cholesterol (HDL-C) and negatively correlated with body mass index (BMI), triacylglycerol (TG) and serum uric acid(P< 0. 001). (3) The higher value of A/L ratio, the lower possibility of metabolic syndrome. When the A/L ratio was more than 5, the incidence of metabolic syndrome was decreased to O(X2 =34. 891 ,P< 0.001). (4) The more components of metabolic abnormality, the lower value of A/L ratio(F= 10. 876,P<0. 001). Conclusions The A/L ratio may be useful in evaluating the extent of metabolic disorder and diagnosing metabolic syndrome in elderly men.

AIM: To establish a quality control method of analysing Lajiao Fengshi Plaster qualitatively and quantitatively. METHODS: Capsaicin was identificated by TLC and menthol,borneol were determinated by GC Lajiao Fengshi Plaster,silica gel as plate,ligarine(60～90?C)-acetoacetate(3(∶)2) as mobile phase,0.5% solution of dichloroquinonechlorimide R in methanol R.as chromogenic agent to identificate capsaicin.The internal standard of GC,naphthalene was employed.10% PEG-20M as the stationary phase,column temperature at 150(?C,) and FID as the detector to determine methol and borneol. RESULTS: There were the same spot corresponding in colour and position sample and reference capsaicin,but negative control had not such colour spot in the same plate of TLC.Menthol,borneol and naphthalene had been separated well under the chromatographic condition.The average recovery of menthol,borneol were 97.44%(RSD=0.93%),98.09%(RSD=1.26%),respectively. CONCLUSION: The method is sensitive,accurate and reproducible and can be used to control the quality of Lajiao Fengshi Plaster.

According to the differentiation of symptamcomplex theory of Spleen Deficiency on myasthenia grvis, with our clinical experience of treatment for some years. Astragalus Saponins and Buzhong Yiqi compound were selected to make phannaceutic experiment for peripheral blood mononuclear cells culture of 14 samples of 10 myasthenia gravis patients. Two controlled groups were given with the treatment of dexamethasone and 60Co respectively. The results showed that liters of nAchR-Ab in cells culture superatants were significantly decreased by watersoluble Astragalus saponias (418.8-2328 fmol/rnl- 0 fmol/ml in 6 cases; 1143 -1235 fmol/ml - 43-157 fmol/ml in 2 cases). Buzhong Yiqi compund could enhance the immunoregulatory action.

Objective To explore the most suitable equation in accessing renal function for the elderly type 2 diabetic patients, and its clinical utility in combination with hypersensitive C-reactive protein (hsCRP). Methods The new Cystatin C-based equations for estimated glomerular filtration rate (Cys-eGFR) and conventional predictive equations were compared with isotopic GFR (iGFR) by linear regression analysis, paired t-test, Bland and Altman procedures and non-parametric receiver operating characteristic (ROC) curves. The new Cys-eGFR equation and hsCRP were also incorporated for detecting renal disease in this population. Results The new Cys-eGFR equation had a better relativity with iGFR (r= 0.767, P＜0.001), a less bias (bias: 0.0007, P＞0.05), a higher conformance (2SD: 21.56), higher sensitivity (90.7%) and specificity (88.6%) for diagnosing moderate decrease in renal function. There was a negative relationship between the new Cys-eGFR and hsCRP (r=-0.655, P＜0.01). When the new Cys-eGFR was 67.06 ml· min-1 ·1.73 m-2 and hsCRP was 5.65 mg/L, the combination of Cys-eGFR and hsCRP was better than the combination of serum creatinine and urine albumin/creatinine ratio in screening stage 3 chronic kidney disease (95%vs.46%). Conclusions The combination of new Cys-eGFR equation and hsCRP may screen an early decrease of moderate GFR.

Objective The aim of the study was to explore the difference between the expression of CDg7 in peripheral blood and bone marrow on acute myeloid leukemia (AML n=30). Methods A flow cytometric quantitative analysis of expression levels for CD87 was performed on fresh blast cells in peripheral blood and bone marrow from patients with acute myeloid leukaemia using CD87, monoclonal antibodies. Analysis the difference between the expression of CD87 using matched t -test. Results The values of CD87 expression in bone marrow of 14 M5 cases are from 9.47 %～80.32 %, and from 11.49 %～87.46 % in peripheral blood. The values of CD87, expression in bone marrow of 8 M4 cases are from 14.27 %～46.28 %,and from 14.79 %～47.19 % in peripheral blood. The values of CD87 expression in bone marrow of 6 M2 cases are from 4.67 %～34.26 %, and from 8.96 %～39.78 % in peripheral blood. The values of CDs, expression in bone marrow of 2 MI cases are from 3.56 %～7.69 %, and from 5.21 %～8.96 % in peripheral blood.The expression of CD87 in peripheral blood and bone marrow from patients with acute myeloid leukaemia had statistical difference (t =3.13, P<0.05). Conclusion The levels of CD87 expression had difference between peripheral blood and bone marrow. The level in peripheral blood was higher than bone marrow. So when we performed quantitative analysis of expression levels for CD87, peripheral blood instead of bone marrow was commended.

Objective:To investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

Objective:To investigate the correlation between lumbar bone mineral density (BMD), musculoskeletal perfusion andmuscle mass.Methods:From May 2019 to August 2020, totally 91 patients who applied for CT perfusion (CTP) examination of abdomen (the scan range included the vertebral body of L1－L3) in Shanghai Tenth People′s Hospital of Tongji University were retrospectively analyzed. The mean BMD of L1－L3 vertebral body was measured by quantitative CT (QCT) at the same time of CT plain scan. According to BMD, the subjects were divided into normal BMD group ( n=33), osteopenia group ( n=41) and osteoporosis (OP) group ( n=17). The L3 level perivertebral muscle mass index and fat fraction were calculated based on QCT examination. The lumbar vertebral and perivertebral muscle perfusion parameters were measured based on CTP images. The parameters of QCT and CTP among three groups were analyzed by Kruskal-Wallis H test or one-way ANOVA. The correlation analysis was conducted between these parameters using Pearson or Spearman analysis. Results:The differences of the perivertebral muscle mass index and fat fraction among three groups were statistically significant ( P<0.05). The differences of the lumbar vertebral perfusion parameters including blood flow (BF), blood volume (BV) and flow extraction product (FE) among three groups were statistically significant ( P<0.05), and BF, BV and FE were positively correlated with BMD ( r=0.444, 0.312 and 0.266 respectively, all P<0.05; adjusted for age and gender r=0.437, 0.340 and 0.337 respectively, all P<0.05). There was no statistically significant difference in perivertebral muscle perfusion parameters among three groups ( P>0.05). Perivertebral muscle mass index was negatively correlated with fat fraction ( r=-0.599, P<0.001; adjusted for age and gender r=-0.404, P<0.001), and there was no correlation between perivertebral muscle mass index and muscle perfusion parameters, as well as perivertebral muscle fat fraction and muscle perfusion parameters. Conclusions:With the changes of BMD, bone mass and perivertebral muscle mass at L3 level are synchronous. Decreased vertebral bone mass is accompanied with reduced perivertebral muscle mass, increased muscle fat and decreased bone perfusion. The changes of vertebral perfusion and perivertebral muscle perfusion at L3 level are asynchronous, which implies that reduced perfusion in OP patients may be confined to the bone.

Objective To study insulin sensitivity and first-phase insulin secretion in obese subjects with impaired glucose regulation (ICR) in Shanghai. Methods A total of 129 subjects [38 lean controls and 91 obese subjects with ICR including 64 isolated impaired glucose tolerance (IGT) ,8 isolated impaired fasting glucose (IFC) and 19 IFC + ICT] underwent 75 g oral glucose tolerance test and insulin-modified reduced sample number (n = 12) of Bergman's minimal model method with frequently sampled intravenous glucose tolerance test (FSIGTT). Insulin resistance was determined from the insulin sensitivity index (S1) of the FSIGTT. Insulin secretion was determined during the FSIGTT by the acute insulin response to glucose (AIRg). The disposition index (DI) , the product of AIRg and S1, was used to determine whether AIRg was adequate to compensate for insulin resistance. Results (1) Compared with normal controls, the value of S1 was significantly decreased in 3 groups with ICR (all P

OBJECTIVETo evaluate efficacy and optimal cut-off-point through cerebral vascular hemodynamic indexes (CVHI) examination to predict stroke.

METHODSA number of 20,333 people at 35 years old and over were checked by CVHI and accumulative score was calculated according to the value of detected indexes. Risk factors of stroke were investigated simultaneously. One hundred and sixty-eight patients with stroke occurred during 4-year following up. Typical syndromes and signs stroke were used as golden standard to evaluate screening efficacy of CVHI.

RESULTSScore of optimal cut-off-point of cerebral vascular hemodynamic indexes was under 75 in ROC curve analyses. Sensitivity, specificity, accuracy, positive and negative predictive values, positive and negative likelihood ratios as well as Youden's index for predicting stroke within 4 years after examination were found to be 87.50%, 67.70%, 67.86%, 2.21%, 99.85%, 2.71, 0.18 and 0.55 respectively. Sensitivity and positive predict values for predicting cerebral vascular thrombosis were superior to predicting cerebral hemorrhage. Positive predicting value in risk exposure population was higher than that of overall population. Coefficiency of variation of cerebral vascular hemodynamic examination was 4.03%. The agreement rate of examination between two physicians was 97.62% and Kappa value was 0.94.

CONCLUSIONThe score of optimal cut-off-point of cerebral vascular hemodynamic indexes examination was 75. Both Efficacy and reliability for predicting stroke seemed to be good, especially for predicting cerebral vascular thrombosis.

Adult ; Aged ; Brain ; physiopathology ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Stroke ; diagnosis ; physiopathology