Objective To investigate the reasons for the inconsistent results between the vertical auto profile(VAP)method and bio-chemical homogeneous phase(BHP)method in detecting plasma low-density lipoprotein cholesterol(LDL-C),and provide experimen-tal basis for the accurate and quantitative detection of plasma LDL-C levels.Methods A total of 360 plasma samples from diabetes mellitus patients combined with carotid plaque admitted to the Department of Endocrinology of Ningbo Yinzhou Hospital of Traditional Chinese Medicine during January,2022 and January,2023 were collected.The LDL-C levels of these samples were detected by the VAP method and BHP method,respectively.The VAP method uses software to automatically calculate the area under the LDL-C curve after centrifugation of the sample as the LDL-C level(LDL-CVAP)and the BHP method directly detects the LDL-C level(LDL-CBHP)by the special surfactant method.360 samples were divided into the consistent group(group A)and inconsistent group(group B)ac-cording to the relative deviation between the LDL-CBHP and LDL-CVAP methods.Group B was further divided into the LDL-CBHP on the high side group(Group B1)and LDL-CBHP on the low side group(Group B2).Groups B1 and B2 were divided into B1-1,B1-2,B1-3 and B2-1 groups based on the degree of relative deviation.The percentages of samples and levels of lipoprotein a cholesterol[Lp(a)-C],intermediate-density lipoprotein cholesterol(IDL-C),Lp(a)-C and IDL-C[Lp(a)-C+IDL-C],very low-density lipo-protein cholesterol(VLDL-C),total cholesterol(TC)and total triglyceride(TG)in each group were compared.Results The LDL-CBHP levels of 360 samples were significantly higher than that of LDL-CVAP(P＜0.01).The percentage of samples in group B was significantly higher than that in group A,and that of group B1 was significantly higher than that of group B2(P＜0.05).The levels of Lp(a)-C,IDL-C and Lp(a)-C+IDL-C in groups B1-1,B1-2,and B1-3 were significantly higher than those in group A(P＜0.01).The relative deviation between LDL-CBHP and LDL-CVAP in 360 samples was significantly positively correlated with the levels of Lp(a)-C,IDL-C,and Lp(a)-C+IDL-C(P＜0.01).The maximum correlation coefficient was found in Lp(a)-C+IDL-C.Conclusion The results of plasma LDL-C in diabetes mellitus patients combined with carotid plaque detected by the BHP method are significantly different from those detected by the VAP method,which mainly shows that the results of the BHP method are on the high side.The higher the level of plasma Lp(a)-C+IDL-C,the greater the relative deviation between the BHP method and VAP method.The reason for the high results of LDL-C detected by the BHP method may be related to the fact that LDL-CBHP contains irremovable Lp(a)-C and cholesterol carried by IDL-C.The VAP method can be used as an accurate method for detecting real LDL-C without Lp(a)-C and IDL-C.

Objective To explore the relationship between glycemic instability index(GLI),peripheral blood CD4+/CD8+,neutrophil-to-lymphocyte ratio(NLR),red blood cell distribution width(RDW),neutrophil gelatinase-associated lipocalin(NGAL),and the occurrence,condition and prognosis of stroke-associated pneumonia(SAP).Methods According to the occurrence of SAP within 7 d after onset,550 patients with acute cerebral infarction were divided into the study group(129 cases with SAP)and the control group(421 cases without SAP).GLI,peripheral blood CD4+/CD8+,NLR,RDW and NGAL levels were measured.The differences in the above indicators were compared between the study group and the control group,as well as SAP patients with different conditions and prognoses.The relationship between above indicators and the occurrence,condition and prognosis of SAP was discussed.The prognostic values of each indicator and combination of indicators were analyzed.Results GLI,NLR,RDW and NGAL levels were higher in the study group,the medium to high risk group and the poor prognosis group than those in the control group,the low-risk group and the good prognosis group.CD4+/CD8+was lower than that in the corresponding group(P＜0.05).Multivariate Logistic regression analysis showed that higher GLI and NLR were independent risk factors for acute cerebral infarction complicated with SAP,and higher GLI,NLR,RDW and NGAL were independent risk factors for the medium to high risk conditions in SAP patients,while higher levels of CD4+/CD8+were protective factor for high-risk diseases in patients with concurrent SAP and SAP(P＜0.05).Higher GLI,NLR and RDW were independent risk factors for poor prognosis in patients with SAP(P＜0.05).ROC curves indicated that the AUC of the combination of GLI,NLR and RDW for evaluating poor prognosis in patients with SAP was better than that of GLI or RDW.Conclusion Changes in GLI,CD4+/CD8+and NLR are influencing factors for the occurrence of SAP.GLI,CD4+/CD8+,NLR,RDW and NGAL are influencing factors for the severity of SAP patients.GLI,NLR and RDW are associated with poor prognosis in SAP patients,and all three have certain predictive effective in predicting the prognosis of SAP patients,and NLR has the highest predictive efficacy.

Objective:To investigate the clinical efficacy, safety and tolerance of different enteral nutritional therapy in the treatment of moderately severe acute pancreatitis (MSAP).Methods:From January 2018 to January 2019, 65 patients with MSAP who were hospitalized in Beijing Chao-Yang Hospital, Capital Medical University were prospectively enrolled. According to random number table, the patients were divided into the nasogastric tube enteral nutrition (NGEN) group (35 cases) and the nasojejunal tube enteral nutrition (NJEN) group (30 cases). All the patients received enteral nutrition solution through continuously pumping at a constant speed for 24 h. The two groups were compared in the relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, computed tomography severity index (CTSI) score 1 week after enteral nutrition, nutrition status, infection parameters, hospitalization time, hospitalization expenses and complications. Independent sample t test and rank sum test of two independent samples were used for statistical analysis. Results:There were no significant differences in age, gender, body mass index (BMI), CTSI score and Ranson score at admission, relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, CTSI score one week after enteral nutrition or hospitalization time between NGEN group and NJEN group (all P>0.05), and there was no death in both groups. The cost of hospitalization, catheterization time, cost of catheterization of NGEN group were all lower than those of NJEN group ((40.0±10.0) thousand yuan vs. (40.4±9.0) thousand yuan; 2.00 min (1.50 min, 2.50 min) vs. 11.50 min (9.50 min, 12.75 min); 135.42 yuan (135.42 yuan, 135.42 yuan) vs. 1 313.30 yuan (1231.20 yuan, 1 823.72 yuan)), and the differences were statistically significant ( t=2.342, Z=6.737 and 7.687, all P<0.01). The albumin levels of MSAP patients of the NGEN group at admission and 1 week after enteral nutrition were both higher than those of NJEN group ((43.5±5.1) g/L vs. (41.0±4.0) g/L, (42.1±4.1) g/L vs. (39.5±4.4) g/L), and the differences were statistically significant ( t=2.135 and 2.486, P=0.04 and 0.02), however there was no statistically significant difference in the decrease of albumin level between the two groups ( P>0.05). There were no statistically significant differences in the incidence of nutrition-related complications (abdominal distension, diarrhea, gastric retention and lumen obstruction) or the incidence of severe complications (transient organ failure and pancreatic necrosis complicated with infection) between NGEN group and NJEN group (all P>0.05). Conclusions:The efficacy and safety of NGEN are equivalent to NJEN in MSAP. Moreover, it can reduce the medical expenses of patients, and it is convenient to carry out in primary hospitals because of its easy operation.

Objective:To explore the effects of continuing nursing mode based on theory of use and satisfaction in patients with peripherally inserted central catheter (PICC) .Methods:From August 2017 to June 2018, this study selected 400 patients with PICC as subjects in the First Affiliated Hospital of Wenzhou Medical University.All of patients were divided into control group and intervention group with the method of random number table, 200 cases in each group. Control group carried out the routine nursing. Intervention group analyzed the needs of patients for content and form of continuing nursing, and built the PICC continuing nursing intervention plan based on the theory of use and satisfaction. This study compared the incidence of catheter-related and unplanned extubation, self-management ability, nursing satisfaction of patients between two groups after intervention.Results:After intervention, the incidences of catheter-related complications and unplanned extubation of intervention group were 1.5% and 0 respectively lower than those (16.0% and 5.0%) of control group with statistical differences ( P<0.05) . In intervention group, the scores of the daily catheter observation, maintenance compliance, catheter management confidence, exception handling of catheter, information acquisition, motion with catheter, daily life with catheter and total score of self-management ability, and nursing satisfaction of patients were higher than those in control group with statistical differences ( P<0.05) . Conclusions:Continuing nursing mode based on theory of use and satisfaction can reduce the incidence of catheter-related and unplanned extubation in patients with PICC, improve patients' catheter self-management ability as well as nursing satisfaction which is worthy of being widely used in clinical application.

Objective To analyze the controlled risk factors of osteoporotic vertebral fractures, and determine the clinical value for the management of risk factors. Methods 626 cases of postmenopausal women were selected, age, height, weight and bone mineral density(BMD) of patients were collected.The Tetrax balance test system was used to assess the fall risks.Vertebral changes of patients were evaluated through X ray of thoracolumbar lateral. The clinical data were analyzed and compared between vertebral fracture group and non-vertebral fracture group. Spearman test was used to analyze the correlation between vertebral fracture and age, height, weight, body mass index(BMI), the risk of fall, body fat and BMD. Results 328 patients presented with osteoporotic vertebral fractures, while the other 298 cases did not suffer from osteoporotic vertebral fractures. There were 426 vertebral bodies involved. Comparing to non-vertebral fracture group, the vertebral fracture group showed higher age [(68.67±9.29)years vs.(63.04± 9.30)years], lower height[(151.10 ± 4.39)cm vs.(154.90 ± 5.86)cm], lower bone mineral density[lumbar spine BMD (0.85 ± 0.16)g/cm2 vs.(0.93 ± 0.17)g/cm2, hip spine BMD (0.72 ± 0.18)g/cm2 vs.(0.81 ± 0.13)g/cm2],higher body fat [(41.30 ± 5.20)％vs.(36.30 ± 5.90)％] and higher fall risk (41.38 ± 25.79 vs. 36.20 ± 26.22) ( P<0.001). While there were no statistical differences in weight and BMI between the two groups, age, height, BMI, body fat, fall risk, lumbar spine and hip BMD were significantly correlated with vertebral fracture (r=0.358,-0.323, 0.169, 0.186, 0.135,-0.398,-0.364, respectively, all P<0.001). Conclusions Decreased bone mineral density, increased age, abdomen fat content and increased fall risk, are the risk factors of osteoporotic vertebral fractures.

Objective To investigate the impact of motilin(MTL), neurotensin(NT)and nitric oxide synthase(NOS)on Oddi sphincter(SO)motion after cholecystectomy. Methods Oddi sphincter manometry(SOM)was performed on both Guinea pig model group(cholecystectomy)and control group (laparotomy)12 weeks after operation. Sphincter of Oddi dysfunction(SOD)group was determined by receiver operating characteristic(ROC)curve analysis and area under curve(AUC). Protein expression of MTL, NT and NOS in SO was also detected through integral optical density method. Meanwhile,the contents of MTL and NT in patients′ plasma of both SOD group(SO pressure> 40 mmHg)and control group were compared. Results AUC of 0.75 and SO pressure of more than 29.8 mmHg was determined as the standard of SOD group.MTL and NT contents(193.16±29.2 pg/mL and 104.57±19.52 pg/mL,respectively)of the model group(n=10)in plasma were significant higher than those of control group(n=11)(154.24 ± 27.69 pg/mL and 79.65±11.24 pg/mL,respectively),and same trend of MTL and NT protein expression in SO was detected(3 556.71±455.80 and 6 321.74±203.54 of the model group;3 075.92±350.06 and 5 843.57±344.00 of the control group).While NOS protein expression in model group was lower than that of the control group(2 954.21± 173.54 VS 3 314.91± 246.67, P<0.05). In clinical research, the plasma contents of MTL(350.98 ± 24.31 pg/mL VS 319.56 ± 23.54 pg/mL)and NT(102.39 ± 19.56 pg/mL VS 80.45±12.35 pg/mL)in SOD group(n=15)were higher than those of the control group(n=15)(P<0.05). Conclusion MTL and NT contents in plasma and protein expression of MTL, NT and NOS in SO may be related to SOD. MTL and NT examinations may assist diagnosing SOD after cholecystectomy.

Endothelial dysfunction was closely related with AS , NO bioavailability ( production and utilization of endothelial NO ) was decreased by oxidative stress , lipid infiltration , inflammatory factor expression , vascular tone alteration and so on , which play an important role in endothelial dysfunction .Enhanced arginine , activityand asym-metric dimethylarginine together with increased hyperhomocysteinemia all promote AS by intervening NO bioavail -ability.Diabetes mellitus, obesity, chronic kidney disease , smoking and so on also involved in AS via influencing NO bioavailability and NO level .

Objective To observe the curative effect of clinically equivalent doses of Xuesaitong and ginaton injections on cerebral ischemia reperfusion (I/R) injury of rats.Methods Male rats were randomly divided into five groups:normal control group,sham-operation group,model control group,Xuesaitong group and ginaton group.The cerebral ischemia rat model was established by middle cerebral artery occlusion (MCAO).Rats in the Xuesaitong group were given 20 mg·kg-1 of Xuesaitong injection,and rats in the ginaton group were intravenously injected with 7.5 mg· kg-1of ginaton immediately after I/R injury and once daily for 7 days.Rats in the sham-operation group and model control group were given the same volume of 0.9％ sodium chloride solution.The score of ethology,volume of cerebral infarction,mortality,superoxide dismutase (SOD),malondialdehyde (MDA),xanthine oxidase (XOD),nitrogen oxide (NO) and NO synthase (NOS) in seruu were examined.Results Compared with model control group,Xuesaitong and ginaton effectively reduced behavioral score 96 h (P ＜ 0.05),120 h (P＜0.01),144 h (P＜0.01) and 168 h (P＜0.01) after I/R injury,the volume of cerebral infarction 168 h after I/R injury and NO content (P ＜ 0.05).But they had no effects on NOS,SOD,MDA,and XOD contents.Conclusion Curatively injecting Xuesaitong and ginaton can effectively reduce cerebral I/R injury,but no significant difference in curative efficacy is observed between Xuesaitong and ginaton at clinically equivalent doses.

OBJECTIVETo evaluate the predictive accuracy of the SurgiCase CMF software in surgical simulation and prediction for mandibular asymmetry with 3-dimensional simulation and measurement.

METHODSCBCT data of 27 patients with mandibular asymmetry were observed in CMF, and postoperative soft tissue physiognomy were predicted by simulating sagittal ramus osteotomy with or without genioplasty. The measurement parameters representing the symmetry of soft tissue were selected and the horizontal, coronal and sagittal planes were established. The results were analyzed by SPSS 19. 0. The overlap compared color grading charts were observed.

RESULTSAngles between cheilions and the horizonta plane (Ch-Ch-FH) in the simulation and postoperative soft tissues are (2. 35 ± 1. 81)° and (1. 44 ± 1. 13)°. The angles constructed among subnasale, upper lip and lower lip (Sn-UL-LL) are (4. 02 ± 3. 05)° and (2. 59 ± 1. 64)°, showing statistically different (P < 0. 01, P < 0. 05), which means that predictive accuracy of the lip canting and lip vertical deviation is relatively low. Distance between gonioi and sagittal plane (Go'-MS), distance between gonion and pogonion (Go'-Pog') and angle betweer subnasale to menton and the horizontal plane (Sn-Me'-MS) are not statistically different, which mean! high predictive accuracy of mandibular angle and chin. By observing the overlap compared color gradin-) charts, the predictive accuracy is not good in the cheek, especially in the deviate side.

CONCLUSIONSThe predictive accuracy of CMF system for patients with mandibular asymmetry is relatively high, but it is not good in the lip and cheek. The software improvement is still necessary.

Cephalometry ; methods ; Chin ; anatomy & histology ; Cone-Beam Computed Tomography ; methods ; Face ; Humans ; Lip ; anatomy & histology ; Mandible ; abnormalities ; surgery ; Osteotomy ; methods ; Software ; Surgery, Computer-Assisted ; methods

Objective To assess right ventricular (RV) regional and global volume and systolic function in patients with right coronary artery disease by real time three-dimensional echocardiography(RT-3DE).Methods RT-3DE images were acquired in 20 normal controls (Group A),30 patients with right coronary artery stenosis(Group B) and 10 patients with RV myocardial infarction(Group C).Volumetric RT-3DE images were analyzed by use of TomTec software,which provided regional (inflow,body and outflow) and global end diastolic volume(EDV),end systolic volume(ESV),stroke volume(SV) and ejection fraction(EF).RT-3DE quantitative data were analyzed to test repeatability.Results Compared with group A and group B,EDV and ESV of body and global were larger in group C;ESV of inflow and outflow were larger (P ＜0.05).EDV of group C was larger than group B(P ＜0.05).Compared with group A and group B,the EF of inflow,outflow and global in group C were lower(P ＜0.05).The EF of body in group C were lower than group B(P ＜0.05).There was no significant difference in regional and global volume and EF between group A and group B(P ＞0.05).The intra-observer and inter-observer's variability was low and consistency was high.Conclusions In patients with RV myocardial infarction,RV regional and global volumes were enlarged and systolic function was impaired.Evaluating right ventricular regional and global volume and function in patients with right coronary artery disease by RT-3DE has high repeatability.