Objective To observe the changes of urine microalbumin (mAlb), renal function and intima-media thickness(IMT) of the carotid artery in prehypertensive patients and investigate whether there are related target organ damage. Methods From August 2009 to May 2010,one hundred and eighty patients were recruited into the study and divided into 3 groups according to the 2005 revised edition of guideline for prevention and treatment of hypertension in China: Sixty normotensive subjects ( NT group,41 males, 19 females,mean age [54. 6 ± 12. 3] years old) ;Sixty prehypertensive patients( PH group,32 males,28 females,mean age [57.0 ± 12.7] years old) and 60 hypertensive patients ( EH group, 28 males, 32 females, mean age [65.0 ±12. 1] years old). Urine mAlb, serum creatinine(Cr) and IMT of the carotid artery were measured and compared among the three groups. The relationships between prehypertension and urine mAlb,serum Cr, IMT of the carotid artery were analyzed. Results In the NT group, PH group and EH group, the urine mAlb concentrations were ( 15.3 ± 7.5 ) mg/L, ( 24. 6 ± 10. 7 ) mg/L and ( 37.3 ± 20. 4) mg/L respectively ;serum Cr were ( 68.0 ± 16. 5 )μmol/L, (81.9 ± 14.9)μmol/L and (95.8 ± 22.5)μmol/L respectively; IMT of the carotid artery were ( 1.46 ± 0. 67 ) mm, ( 1.79 ± 0. 74 ) mm and( 2. 34 ± 0. 78 ) mm respectively. Urine mAlb, serum Cr and IMT of the carotid artery were significantly higher in the PH group and EH group when compared to NT group ( P ＜0. 05 or 0. 01 ); and in the EH group these indices were also significantly higher than those in the PH group( P ＜0. 01 ). Multiple linear regression analysis showed that after adjusted age, body mass index (BMI), blood pressure( BP), serum lipid and serum glucose, in the PH group,the standard partial regression coefficients of correlation between urine mAlb and systolic blood pressure (SBP), diastolic blood pressure(DBP) and serum glucose were 0. 279,0. 259 and 0. 360 respectively ( P = 0. 012, 0. 043 and ＜ 0. 001 ); the standard partial regression coefficients of correlation between serum Cr and SBP, DBP and serum glucose were 0. 317,0. 257 and 0. 377 respectively ( P = 0. 006,0. 049 and ＜ 0. 001 ). The standard partial regression coefficients of correlation between IMT of the carotid artery and age, SBP, DBP, total cholesterol and serum glucose were 0. 381,0. 375,0. 263,0. 265 and 0. 372 respectively( P ＜ 0. 001, ＜ 0. 001, = 0. 033,0. 021 and ＜ 0. 001 ). In the EH group, the standard partial regression coefficients of correlation between urine mAlb and SBP, DBP and serum glucose were 0. 378,0. 258 and 0. 283 respectively( P ＜ 0. 001, = 0. 046, and 0. 009); the standard partial regression coefficients of correlation between serum Cr and SBP, DBP and serum glucose were 0. 294,0. 261 and 0. 464respectively (P =0. 008,0. 042 and ＜0. 001 ) ;the standard partial regression coefficients of correlation between IMT of the carotid artery and age, SBP, high density lipoprotein cholesterol and serum glucose were 0. 262,0. 264, -0. 374 and 0. 306 respectively ( P = 0. 035,0. 023, ＜ 0. 001 and 0. 007 ). We found that both urine mAlb and serum Cr were significantly associated with BP and serum glucose; IMT of the carotid artery was significantly associated with age, BP, serum lipid and serum glucose. Conclusion Urine mAlb, serum Cr andIMT of the carotid artery increased in prehypertensive patients, and these indices were significantly associatedwith the level of the BP. These data indicated there were related target organ damage occurred in prehypertensive patients,the BP level was the risk factor that increased urine mAlb,serum Cr and IMT of the carotid artery.

Objective To investigate the regulatory effects of stachyose through oral administration on the facilitating feces excretion function and its relationship to the intestinal flora in stomach irritation with cool water-induced functional bowel disorder rats. Methodes Stomach irritation with cool water -induced constipation-predominant irritable bowel syndrome model rats were administrated by i.g. with stachyose at intestine were determined within 12 hours on the 7th and 14th day after stachyose administration, and intestine flora was measured on the 14th day after Stachyose administration. Results The feces granules and the moisture contests of feces and the efficiency of the small intestine were increased in stachyose treated C-IBS rats, and the number of intestinal flora was significantly higher than that in the control C-IBS rats [ (38.43±4.57) grain VS (32. 21 ± 3.43) grain, F = 3.892, P ＜ 0.05; (47. 88 ± 3.43)% VS (43. 18 ±6.85)%, F =6.724, P ＜0.01;(1.04±0. 11)radian VS (0. 88 ±0.08)radian, F =4.965, P ＜0.05;(10.77 ±0.44)1g(CFU/g) VS (9.85 ±0.43)1g(CFU/g), F =7.613, P ＜0.01;(10.96±0.35)lg(CFU/g) VS (9. 84 ±0. 35)1g(CFU/g), F = 10. 413, P ＜0. 01 ]. Conclusion The results indicated that the stachyose,an extract of Chinese herbal medicine, had the facilitating feces excretion function and modulation functionon intestinal flora in stomach irritation with cool water-induced functional bowel disorder rats.

There are two phenotypes of microglia, M1 and M2. Microglia in M2 polarization may associate with the phagorytosis of be-ta-amyloid and inhibition of Tau hyperphosphorylation, as well as in other pathology. Electroacupuncture can impact the phenotypes of mi-croglia, which may play a role in the treatment for Alzheimer's disease.

Diabetes Mellitus ; Enterobacter cloacae ; Humans ; Maxilla ; Osteonecrosis

Objective To evaluate the accuracy and feasibility of primary total knee arthroplasty (TKA) assisted by the self-made extramedullary osteotomy template on distal femur alignment.Methods We retrospectively analyzed the clinical data of 40 patients with osteoarthritis or rheumatoid undergoing primary TKA from September 2015 to March 2016.All patients were divided into two groups,extramedullary group and intramedullary group.Extramedullary group had 20 patients (4 males and 16 females) aged 65.1±6.9 years (range 51-75).Intramedullary group had 20 patients (3 males and 17 females) aged 65.7±7.9 years (range 48-75).The blood loss volume,drainage in operation,postoperative range of motion (ROM) at 1 week and 2 weeks,deviation between the ideal value and preoperative hip-knee-ankle (HKA) angle,coronal and sagittal angle of the femoral prosthesis were compared within the two groups.Results The age,gender,body mass index,deviation between the ideal value and preoperative HKA angle,Hospital for Special Surgery (HSS) scoring system,ROM of knee were not significantly different between the two groups.The operation time was 97.4± 14.0 min in extramedullary group and 111.7±9.9 min in intramedullary group (P ＜ 0.05).The blood loss was 71.8± 14.0 ml in extramedullary group and 111.7± 10.0 ml in intramedullary group (P ＜ 0.05),while the drainage volume was 167.0±74.5 ml in extramedullary group and 243.2±91.6 ml in intramedullary group (P＜ 0.05).The postoperative mean deviation of the HKA angle in extramedullary group (2.37°±0.73°) was smaller than that in intramedullary group (3.26°±1.42°).Furthermore,the coronal alignment of the femoral prosthesis in extramedullary group (89.70°±1.91°) was larger than that in intramedullary group (87.69°±2.39°).The sagittal alignment of the femoral prosthesis in extramedullary group (90.03°±2.62°) was also significantly larger than that in intramedullary group (88.07°±2.43°,P ＜ 0.05).The postoperative ROM of knee at 1 and 2 week in the extramedullary group were 101.75°±7.48° and 114.00°±7.88° respectively,while those in the intramedullary group were 101.25°±8.41° and 114.25°±8.78°.There was no statistically different between the two groups.There was no intraoperative and postoperative early complications reported in the two groups.Conclusion Although the primary TKA assisted by the selfmade extramedullary osteotomy template on distal femur alignment can shorten operation time,decrease the blood loss and increase the accuracy of coronal and sagittal alignment,the HSS score and ROM of knee are similar as intramedullary method.

Objective The analysis of correlation between the occurrence of tourette syndrome with one-child family environment. Methods The authors investigated home environment of two groups. One group included 200 patients with tourette syndrome and is the other group included healthy children of the same age in 3 different primary and secondary schools. By comparing with the home environmental factors, parenting styles and parent emotional factors between two groups. Results The instabilities of home environment included bad family relationship, separation between parents, divorce, scolding and even beating children. It showed that anxiety of the direct supervisors among the sickness group were higher than healthy control group as well. Among the ten factors of the Family Environments Scale, the significant differences showed in six factors of affection,cohesion,expressiveness, conflict, intellectual-culture orientation, active-recreational orientation, organization between the two groups. Conclusion So we concluded that ①There is a correlation between the parents relations,parenting styles and the incidence of tourette syndrome; ②An anxiety of the direct supervisor may initiate, even aggravate the incidence of tourette syndrome; ③It is important to convert the education mode and take family overall treatment in order to reduce the incidence and improve the effectiveness of tourette syndrome.

Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in intrathoracic tuberculosis(TB).Methods We retrospectively analyzed patients underwent EBUS-TBNA with a final diagnosis of intrathoracic TB at Shanghai Chest Hospital from October 2009 to March 2013 and observed that the diagnostic efficacy by pathology and microbiology and safety of EBUS-TBNA for intrathoracic TB.Results 75 patients were diagnosed with pulmonary TB or intrathoracic tuberculous lymphadenitis,and accuracy was 80％ (60/75) by EBUS TBNA.A total of 60 patients had pathology,acid-fast bacilli(AFB) staining and mycobacterial culture test results,of whom 52 (86.67％)were diagnosed.Pathological findings were consistent with TB in 77.33％ patients (58/75),in 20.31％ (13/64) the smear were positive for AFB and in 46.67％ (28/60) were positive for cuhure.One hundred and twenty-nine mediastinal or hilar lymph nodes and 10 intrapulmonary lesions were biopsied in 75 patients,the average target number of per patient were 1.85.Pathological findings were consistent with TB in 66.19％ samples(92/139),in 13.91％ (16/115) were positive for AFB and in 38.32％ (41/107) were positive for culture.Multivariate regression revealed that short-axis diameter was an independent risk factor associated with positive pathology,smear and euhure.Additionally,more aspiration times cause higher pathology positive rate,pathology showing necrosis and positive smear were independent risk factors associated with positive cuhure.There were two patients occurred complications during operation.Conclusion EBUS-TBNA was a safe and effective method for the diagnosis of intrathoracic tuberculosis.

BACKGROUND: The cluster of multiple metabolic disorders, namely raised blood pressure, overweight or obesity, raised triglyceride level, reduced high density lipoprotein cholesterol (HDL-C) level were the predictor of type 2 diabetes mellitus (DM). However, similar data especially the old people's data is relatively rare in China.OBJECTIVE: To analyze the relationship between the components of metabolic syndrome (MetS), their clusters and the risk of diabetes among Chinese old population.DESIGN: Cross-sectional study.SETTING :Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Public Health.PARTICIPANTS: The study was carried out from February 2001 until November 2001.4 499 volunteers aged 60 and over were recruited from the academic institutes in Beijing Xicheng, Haidian and Shijingshan districts through cluster sampling methods. They were selected after excluding those who did not have integral data.METHODS: Diabetes was considered when fasting glucose was ≥7.0 mmol/L and was treated for or diagnosed as DM. Chi-square tests were performed to compare the categorical data. Age and sex adjustment were taken in the comparison of the levels of blood pressure, waist circumference (WC), The body mass index (BMI), and lab variables, Multifactor stepwise (backward)Logistic regression analyses were used to select the factors which would have association with the risk of DM. When analyzing the relationship between number of clustering of the traits of MetS and DM, the group without any metabolic abnormalities was set as control group. The dummy variables were set for 1,2,3,4 clusters of metabolic abnormalities. The Logistic regression model was used again to test the relationship and adjusted by age and the family history of DM.MAIN OUTCOME MEASURES: The blood glucose, waist, BMI, blood pressure, triglyceride (TG), HDL-C, and family history of diabetes of subjects.RESULTS: 4 444 people in the mean age of 65±5 were retrieved. 556cases of DM were found in this survey. Age, family history of diabetes,systolic blood pressure, waist and TG were independently associated with the risk of DM, with OR (95%CI) being 1.02 (1.00-1.04), 3.48(2.76-4.39), 1.02 (1.01-1.02), 1.03 (1.00-1.03), 1.13 (1.05-1.21), respectively. When TG was not in the model, HDL-C was also inversely associated with DM (OR=0.67, 95%CI 0.49-0.91). The risk of DM increased with clustering of abdominal obesity, raised blood pressure, raised TG, and reduced HDL-C level in individuals.CONCLUSION: In addition to age and genetic factors, metabolic factors, especially their clusters are closely related to the risk of diabetes. Therefore, the features of MetS are important indicators for the risk of DM in aged people.

BACKGROUND: Stem cell transplantation in repairing infarct myocardium and in improving cardiac function has been widely accepted. However, whether transplanted cells and host cells formed an effective electricity and mechanical couple, whether a relevant independent electrical system with contractile function formed or whether severe malignant ventricular arrhythmia formed, are still unclear.OBJECTIVE: To investigate electrophysiological abnormaltiy and left ventricular remodeling in rats with myocardial infarction following allogenic bone marrow mesenchymal stem cell (BMSC) transplantation.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Experimental Center, Guangxi Medical University from December 2005 to October 2008.MATERIALS: A total of 120 healthy Wistar rats were equally randomized into normal control, sham operation, saline control and cell transplantation groups. Healthy Wister rats aged 1 month were selected to harvest bone marrow.METHODS: At the third passage, rat BMSCs were collected and treated with 5-aza, and differentiated into cerdiomyocytes.BMSCs were labeled with DAPI at 2 hours before transplantation. In the saline control and cell transplantation groups, rat models of myocardial infarction were established by ligating the left anterior descending coronary artery. In the sham operation group, the coronary artery was not ligated, but only braid. At 7 days following ligation, BMSCs in the cell transplantation group at 2×10-1/L were infused into the edge and center of myocardial infarct region by multipoint injection. Rats in the other three groups were subjected to an equal volume of saline.MAIN OUTCOME MEASURES: Electrocardiogram and cardiac electrophysiology were performed. Ultrasonic cardiography was used to detect left ventricular function. Infarct size was determined. DAPl-labeled donor cell migration and distribution was observed with a fluorescence microscope.RESULTS: BMSCs could differentiate into cardiacmuscle cell-like cells which were capable of pulsing spontaneously, expressing cardiactoponin T and forming myofilament in vitro. Compared with the saline control group, PR interval, QRS duration and ventdcular effective refractory period shortened, ventricular fibrillation threshold increased at 4, 8 and 12 weeks (P < 0.05); left ventricular internal diameter at end-systole reduced, and left ventricular ejection fraction and shortening traction was significantly increased (P< 0.05). At 8 and 12 weeks, infarct size was significantly smaller (P < 0.05). At 4 weeks, DAPl-labeled BMSCs could be seen under the fluorescence microscope, and still could he detected at 12 weeks. However, the fluorescence became weak with prolonged time.CONCLUSION: BMSCs have the plasticity of differentiating into cardiac muscle cell-like cells, which can modulate theelectrophysiological abnormality and left ventricular remodeling following myocardial infarction.

BACKGROUND:Buyanghuanwu decoction has excel ent neuroprotective effect and can efficiently suppress nerve cel apoptosis caused by cerebral ischemia-reperfusion injury.
OBJECTIVE:To investigate the effect and mechanisms of Buyanghuanwu decoction on neuronal apoptosis around hematoma in cerebral hemorrhage rats.
METHODS:Seventy-two adult Sprague-Dawley rats were randomly divided into sham operation group, model group, Buyanghuanwu decoction group, and Ginkgo biloba group. Except the sham operation group, rat models of cerebral hemorrhage were established in other three groups. At 2 days after modeling, rats in the Buyanghuanwu group and Ginkgo biloba group were given Buyanghuanwu decoction 26 g/(kg?d)and Ginkgo biloba 3.5 mg/(kg?d) daily by gavage, for 14 consecutive days. Rats in the sham operation group and model group received an equal volume of saline for 14 consecutive days. After the last administration, brain tissue was obtained. TUNEL assay was utilized to detect neuronal apoptosis. Immunohistochemistry was used to detect PI3K, Akt, Bcl-2, and BAX protein expression. Wet and dry weight method was used to detect brain water content. Evans Blue assay was utilized to determine blood-brain barrier permeability.
RESULTS AND CONCLUSION:(1) Compared with the sham operation group, the number of apoptotic neurons, brain water content, Evans blue content and PI3K, Akt, Bcl-2, BAX protein expression increased in the model group (P<0.05). (2) Compared with the model group, the number of apoptotic neurons, BAX protein expression, brain water content and Evans blue content were significantly reduced in the Buyanghuanwu group and Ginkgo biloba group (P<0.05), but PI3K, Akt and Bcl-2 protein expression was significantly increased (P<0.05). (3) Results suggested that Buyanghuanwu decoction inhibited neuronal apoptosis and protected brain tissue by reducing blood-brain barrier permeability, cerebral edema, and by activating PI3K/Akt signaling pathway, regulating Bcl-2 and BAX protein expression ratio.