Objective To analyze the prevalence and risk factors related to the diabetic patients with hypertension in the Kailuan group workers.Methods A total of 9 498 type 2 diabetic patients were followed up for 5 years,regarding myocardial infarction,stroke,and death incident.The cumulative incidence of hypertension in diabetic patients and the evaluated risk factors of hypertension were analyzed.Results The prevalence of hypertension in 9 489 subjects with diabetes was 63.3％,higher than that in subjects without diabetes(42.0％,P＜0.01).Aging,smoking,obesity,high blood levels of triglycerides,total cholesterol,and low-density lipoprotein-cholesterol were the risk factors of diabetic patients with hypertension,in whom the morbidity of myocardial infarction,cerebral infarction,cerebral hemorrhage,and renal dysfunction was 3.3％,6.0％,0.9％,and 18.8％,respectively,all higher than those (2.1％,2.6％,0.3％,and 10.9％) in diabetic patients without hypertension (P＜0.01).By the end of follow-up for 5 years,incidences of cerebral infarction,cerebral hemorrhage,and death in diabetic patients with hypertension were higher than those with normal blood pressure (P＜0.05),but no difference in incidences of myocardial infarction between the 2 groups (P＞0.05).The 5-years cumulative incidence of hypertension in the diabetic population was 40.1％.Male sex,smoking,snoring,obesity,and hypertriglyceridemia were the risk factors of hypertension in diabetic patients (P ＜ 0.05).Conclusion The prevalence and the 5-years cumulative incidence of hypertension in diabetic patients increased significantly.Diabetic patients with hypertension may have higher risk of cerebrovascular events and kidney dysfunction.

Objective: To study the influence of contractual medical association on inpatient service performance. Methods:The data came from“Database of Inpatient Record” administered by Department of Medical Insurance. Using diagnosis related groups ( DRG) as the tool of risk-adjustment, the third-tier general hospitals and second-tier general hospitals in medical alliance as the intervention group, and the average level of the same grade local hospitals as the control group, the influence of medical alliance on inpatient service performance was evaluated. The difference in difference ( DID) method was used for the data analysis. The assessing indicators included the number of DRG group, case mix index ( CMI) , the total weight, cost efficiency index and time efficiency index. Results:After the establishment of medical association, compared with the average level of the same grade local hospitals, in the third-tier general hospitals of medical alliance, the growth rate of the total weight had declined, and cost efficiency index had increased, while in the second-tier general hospitals of medical alliance, the CMI value had de-clined, and the cost efficiency index had increased. Conclusion:Contractual medical association played a role of triage patients, and improved the service levels and management efficiency of the second-tier general hospitals.

The expression of C-myc, K-ras and H-ras oncoproteins in lymphocytesand monocytes, and NK subsets were studied in 21 patients with Behcet's syndrome (BS)and 40 healthy individuals. CD16~+,57~- cells of NK from BS patients were much decreasedwhen compared to the control. The positive percentages of three kinds of oncoprotein in BS lymphocytes and C-myc and K-ras oncoproteins in BS monocytes were significantly higher thanthat of the control. Positive correlations were found not only between C-myc expression oflymphocytes and serum ?-globulin%, IgM and IgG levels in BS, but also between C-mycexpression of monocytes and ESR. Expression of K-and H-ras oncoproteins in lympho-cytes and monocytes from BS patients were found to be negatively correlated with serumIgA level. Negative correlation was also found between C-myc expression in monocytesand CD16~+,57~- subset of NK. The significance of these results and the possible correlationsbetween BS and autoimmunity were discussed. It was suggeted that autoimmunity mightbe an important mechanism underlying BS.

Humans ; Hydrocarbons, Brominated ; analysis ; metabolism

OBJECTIVE:To observe clinical efficacy and safety of rhBNP combined with levosimendan in the treatment of acute heart failure,and to investigated the effects of drug combination on serum UA and BNP levels. METHODS:68 patients with acute heart failure were randomly divided into observation group and control group,with 34 cases in each group. Both groups re-ceived routine treatment;control group was additionally given Levosimendan injection 5 ml added into 0.9% Sodium chloride in-jection 45 ml with persistent micropump injection:at pump rate of 12 μg/(kg·min)within first 1 h,and then at pump rate of 0.5μg/(kg·min)for consecutive 23 h;observation group was additionally given rhBNP 1.5 μg/kg for intravenous shock,and then giv-en consecutive intravenous injection of rhBNP at rate of 7.5 ng/(kg·min)continuous 3-7 days on the basis of control group. Clini-cal efficacy of 2 groups were observed,and serum levels of UA and BNP,heart function index,the safety of drug use were ob-served before and after treatment. RESULTS:After treatment,total effective rate of observation group(94.11%)was significantly higher than that of control group (70.59%),with statistical significance (P<0.05). The improvement of serum levels of UA and BNP in observation group was more significant than in control group,with statistical significance (P<0.05). The stroke volume and left ventricular ejection fraction of observation group were significantly better than those of control group,with statistical signif-icance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (2.94%) and control group(5.88%)(P>0.05). CONCLUSIONS:rhBNP combined with levosimendan have significant clinical efficacy and high safety in the treatment of acute heart failure.

AIM: To provide scientific references for leeches by means of the antithrombin,antitrypsin and antichymotrypsin activities of the four kinds of leeches. METHODS: Using antithrombin,antitrypsin and antichymotrypsin activity analysis methods,the four kinds of leeches,they were,Whitmania pigra Whitman,Hirudo nipponia Whitman,Hirudo medicinalis Linnaeus,Hirudinaria manillensis Lesson,were detected. RESULTS: The blood-sucking leeches except whitnania pigra whitman had high antithrombin activity,and these four kinds of leeches were the same antitrypsin and antichymotrypsin activities. CONCLUSION: These three biological activity methods could be considered as reliable indexes in assessing the qualitity of leeches.

Flow cytometry analysis of DNA ploidy level and S-phase fraction (SPF) was carried out in 24 snap-forzen tissue specimens of ovarian carcinoma. The relationship of DNA ploidy level and SP-F with age,clinical stage, ascites, histologic type,pathological grade,lymphocyte infiltration and psammoma bodies was analyzed.Results showed that the relationship of DNA ploidy level and SPF with ascites and pathological grade was significant. Aneuploid portion and SPF in patients with ascites or pathological grade Ⅲ or Ⅱ were higher than those in patients with no ascites or pathological grade I. The author considers that DNA ploidy level and SPF of ovarian carcinoma can serve as a relatively independent objective index which reflects tumor's biological behaviours,and will be of great auxiliary value to early diagnosis and therapy of ovarian carcinoma.

Objective To evaluate the safety and efficacy of mesohepatectomy for large and centrally located hepatocellular carcinoma.Methods A retrospective study was carried out on 136 pa tients who underwent mesohepatectomy for large and centrally located hepatocellular carcinoma at Xiangya Hospital,Central South University,from 2001 to 2007.Intraoperative/post operative data and long-term survivals were analyzed.Results Vascular occlusion time,operative time,intraoperative blood loss,intraoperative blood transfusion and hospital stay were (13.3 ± 9.1) min,(173.1 ±41.1)min,(548.7±320.5)ml,(511.4±231.7)ml and (18.6±8.8)d,respectively.Four patients developed major complications.There was no in-hospital death.The 1-,3-,and 5-year overall survival rates and disease-free survival rates were 71％,46％,29％ and 65％,40％,24％,respectively.Conclusions Mesohepatectomy for large and centrally located hepatocellular carcinoma preserved the maximum amount of functional liver parenchyma.It is safe and reliable and may be used as the treatment of choice.

Objective To evaluate the feasibility of a low-dose contrast medium protocol for 64-slice CT angiography (CTA) of head using a low-tube-voltage setting.Methods ① Phantom study:64-slice spiral CT respectively sets 80,100,120,140 kV and 100,200,300,400,500 and 600 mA as scanning parameter lines.Analysis of the best Signal-to-noise ratios (SNR) and contrast to noise ratios (CNR).②Clinical study:to prospectively continuous select sixty-six patients with suspected intracranial aneurysm and arteriovenous malformation and so on from April to October of 2012 to perform hand CTA inspection.The random number table method for A,B two groups,33 patients in each group.Group A (conventional group)scanning parameters:120 kV,400 mA and amount of contrast agent:1 ml/kg; Group B(test group) scanning parameters:80 kV,600 mA,amount of contrast agent 0.5 ml/kg.Using independent samples t test for each group radiation dose,SNR,CNR were statistically analyzed.By two experienced radiologists to 5 points on two groups of image quality subjective evaluation.Mann-Whitney U test was used for statistical analysis of subjective evaluation.Results Group A and B group CTDIvol respectively is 59.1,27.5 mGy.Group B than in group A,CTDIvol decreased by 53.5％.A,B groups of the SNR,CNR were 71.5 ± 10.7,92.0 ± 7.4; 58.5 ± 10.5,79.6 ± 7.7,Group B than in group A SNR,CNR were enhanced by 22.3％,26.4％,differences were statistics significance (t =584.0,388.6,P ＜ 0.01).The subjective image evaluation of group B was bigher than group A (Z =31.2,23.4,P ＜ 0.05),differences were statistics significance.Two physicians on CTA images to assess the consistency of uniform height(Kappa =0.904,P ＜0.05).Conclusion In the head CTA examination,use of low tube voltage combined with low contrast dose not only can improve the image quality but also radiation dose were significantly lower.

Objective To explore the effect of enalapril combined with folate acid on endothelial function and urine microalbumin(UMA) in patients with hypertension.Methods 120 patients with hypertension were randomly divided into two groups:control group (n =60) was given enalapril 10.0mg/d,observation group (n =60) received enalapril 10.0mg + folic acid 0.4mg/d.The total treatment period was 8 weeks.Blood pressure,plasma homocysteine (Hcy),flow mediated dilation (FMD) and UMA were examined.Results The efficacy of pressure releasinghad no significant difference between two groups.Hcy[(10.2 ± 5.8) μmol/L vs (16.6 ±-8.1) μmol/L,t =3.641],FMD[(14.8 ±5.4)％ vs (8.2±3.5)％,t =7.325] and UMA[(14.8 ±5.4)mg/L vs (31.6 ±9.5)mg/L,t =8.221] of two groups were significantly different after treatment.Conclusion Combination therapy of enalapril and folate acid can decrease plasma Hey and UMA,restore vascular endothelium function in patients with hypertension.