Abstract:Objective To study the difference of eating habits between patients with ankylosing spondylitis (AS) and the healthy controls, and to explore the role of diet as an environmental factor in the pathogenesis of AS. Methods A total of 123 AS patients and 120 matched healthy volunteers were enrolled in the present study from Jul. 2014 to Apr. 2015. The single factor and multivariate analysis were used to compare the differences in eating habits between the patients with AS and the healthy volunteers. According to the Bath ankylosing spondylitis disease activity index (BASDAI), AS patients were divided into active disease group (BASDAI> 4 points) and non-active disease group (BASDAI≤4 points), and the relationship between disease activity and eating habit was studied. The patients were also divided into HLA-B27 positive group and HLA-B27 negative group to study the effects of diet and HLA-B27 interaction on the incidence of AS. Results There were significant differences between the AS patients and the healthy volunteers in eating taste tendency, staple food structure, average daily high cholesterol food, daily soy products, and smoking and drinking frequency(P<0.05). Multivariate analysis showed that spicy taste, moderate daily intake of soy products and moderate drinking were the protective factors for AS, and smoking was an independent risk factor for AS (P<0.05). The disease activity of AS was not related to the eating habits. There were significant differences between HLA-B27 positive patients and the healthy volunteers in eating taste tendency, soy intake, smoking and alcohol consumption(P<0.05, P<0.01). Conclusion The dietary components may be an important environmental influencing factor of AS. HLA-B27 may interact with eating habits in their influence on the pathogenesis of AS.

Abstract:Objective To investigate the role of heparanase (HPSE) in regulating the liver regeneration after major hepatectomy in rats. Methods The HPSE small interfering RNA (siRNA) was designed and synthesized, and was transfected into the rats after 70% hepatectomy by in vivo-jetPEI-Gal vector. Then immunohistochemistry was performed to determine the expression of hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF). Western blotting analysis was performed to detect the expression of matrix metalloprotein (MMP)-2 and MMP-9 protein expression. Immunostaining for Ⅷ factor was done to observe the microvessels, and the microvessel density (MVD) was calculated. Results Compared with control group, the expressions of HGF, VEGF, MMP-2 and MMP-9 were significantly inhibited in HPSE siRNA group, and the MVD was significantly decreased (P<0.01). Conclusion HPSE may regulate liver regeneration via promoting HGF release in ECM, inducing hepatocyte proliferation, increasing VEGF expression to accelerate angiogenesis and upregulating the expression of MMP-2 and MMP-9.

Abstract:Objective To investigate the statuses of hepatitis B virus (HBV) prevalence and hepatitis B vaccination coverage in children of the migrant workers, so as to provide the evidence for HBV control and prevention in Shanghai. Methods An epidemiological survey was conducted with 1 071 children of the migrant workers; the children were from the kindergartens, primary and secondary schools in five urban-rural fringe communities in Pudong New Area of Shanghai. Fasting bloods samples were collected to detect the biomarkers and DNA titer of HBV. Results The hepatitis B vaccination coverage rate was 87.1% (933/1 071); the coverage rate of students under the age of ten was significantly higher than those at 10 years of age or older (P<0.01); the coverage rate in children of the Han nationality was significantly higher than that of the other minorities (P<0.001), and the coverage rate in children whose parents with the college education background and above was higher than that of children whose parents with a lower education background (P<0.001). The positive rate of HBsAg was 0.7% (7/1 071) in this study. We found that age and HBV infected relatives in the family were the main risk factors of HBV infection in children (P<0.05). The positive rate of HBcAb was 1.7% (18/1 071) in the present study, which was positively correlated with the age of children (P<0.01). The positive rate of HBsAb was 33.9% (363/1 071), and the rate decreased with the age increase between 3 to 14 years old and increased with the age increase after 15 years old (P<0.001). The positive rate of HBsAb was significantly higher in other minorities than that in the Han nationality (P<0.001). The proportion of children with low level of HBsAb titer decreased with the increase of age, while the proportion of children with normal and high level of HBsAb increased with the increase of age (P<0.01). Conclusion The hepatitis B vaccination coverage rate in the children of migrant workers is lower than that in the local children of permanent residents. The positive rates of HBsAg and HBcAb witness a great decrease compared with those in 2006. More efforts should be made to strengthen the hepatitis B vaccination for the children of migrant workers.

Abstract:Objective To investigate whether cell lines expressing apolipoprotein E-enhanced green fluorescence protein (apoE-EGFP) can support assembly of infectious hepatitis C virus particles. Methods apoE stably down-regulated Huh7.5.1 cell lines (sh-apoE cell lines) were established by shRNA gene silencing technique, and cell lines expressing apoE-EGFP fusion protein (apoE-EGFP cell lines) were established. The culture supernatants of wild-type Huh7.5.1 cells, control cells (sh-NT cells), sh-spoE cells and apoE-EGFP cells transfected with HCV RNA were collected and the HCV titer of supernatants was determined by TCID₅₀. The interaction of apoE with HCV structure protein E2 was examined by immunofluorescence and confocal microscopy, and the expression of apoE-EGFP on the surface of HCV particles purified by FLAG-specific affinity gel was analyzed by Western blotting analysis. Results The apoE-EGFP fusion protein was highly expressed in sh-apoE cell lines. The infectivity of HCV from apoE-EGFP cell culture supernatant was not significantly different with those of HCV from Huh7.5.1 and sh-NT cells. apoE-EGFP infused protein had fluorescent co-location with HCV structural protein E2, and was detected on the surface of HCV particles purified by FLAG-specific affinity gel. Conclusion The apoE-EGFP fusion protein is an important component of HCV particles and apoE-EGFP cell lines can support the assembly of HCV particles.

Abstract:Objective To study the effect of hydrogen-rich water on lymphocyte gene expression of Beagle dogs exposed to gamma ray (γ ray) using GeneChip technology. Methods Male Beagle dogs were divided into control group, irradiation (IR) group and hydrogen-rich water treatment (HRW+IR) group. GeneChip technology was applied to screen the differentially expressed genes in peripheral blood lymphocyte exposed to 2.0 Gy ⁶⁰Co γ ray for 6 h. Gene ontology (GO) and Kyoto encyclopedia of gene and genomes (KEGG) databases were used to analyze the bioinformatics of the differentially expressed genes, and real-time quantitative PCR was used to validate the results of GeneChip. Results We screened 4 730 differentially expressed genes with over 2-fold changes in IR group and 4 493 genes in HRW+IR group, and identified 1 606 co-differentially expressed genes in the IR and HRW+IR groups. GO terms of biological process, cellular component and molecular function in the IR group were ten, nine and three, respectively, and in HRW+IR group were fifteen, three and four, respectively. The differentially expressed genes were involved in 19 KEGG pathways in the IR group, 24 KEGG pathways in HRW+IR group, and five KEGG pathways in both groups. The PCR results of two genes, selected to validate the GeneChip, were consistent with the GeneChip results. Conclusion Our results indicate that the effect of hydrogen-rich water on lymphocyte gene expression of γ ray-radiated Beagle dogs may involve changes of molecular function, cellular component and biological process, and activation of many signal pathways.

Abstract:Objective To analyze the pulmonary surfactant-associated protein A (SP-A) gene sequence and its bioinformatic characteristics and to observe SP-A mRNA and protein levels in lung injury model of cotton rats, so as to explore the correlation between lung injury and SP-A expression. Methods A total of 32 cotton rats were randomly divided into control (normal saline, NS) group and three lipopolysaccharide (LPS)-induced lung injury groups (the cotton rats were injected intraperitoneally with 2 mg/kg LPS for 24, 48 and 96 hours, respectively). The total RNA was extracted from lung tissue and SP-A gene was amplified by RT-PCR. Then bioinformatic analysis was done for SP-A characteristics. Histopathological changes of lung tissue were observed at different time points by hematoxylin-eosin staining; the mRNA level of SP-A was detected by real time-PCR and the protein level of SP-A was detected by Western blotting analysis. Results The coding region of cotton rat SP-A gene had 744 bp and encoded 248 amino acids, containing six cysteine conserved sites, four α-helices and two predicted N-glycosylation sites. Meanwhile, cotton rat SP-A shared high level of homology in the nucleotide sequences (75.4%-90.1%) and in deduced amino acid sequences (70.6%-87.1%) with other species. Moreover, histopathological changes of lung tissues in three LPS groups were more notable and severe than those in the control group, and the changes were related to LPS treatment time. Compared with the control group, the mRNA and protein levels of SP-A in lung tissues were significantly increased in three LPS groups, with rapid increase starting from 24 h after treatment (P<0.001, P<0.01), with continuous increase at 48 h (P<0.001 and P<0.01), and slight decrease and still keeping at a high level at 96 h (P<0.05, P<0.01). Conclusion SP-A gene of cotton rat is highly conservative; the mRNA and protein levels of SP-A are closely associated with the severity of lung injury.

Abstract:Objective To observe the expression and distribution of insulin-like growth factor-1 receptor (IGF-1R) in orbital adipose tissues of patients with thyroid-associated ophthalmopathy (TAO), and to explore the effect of insulin-like growth factor-1 (IGF-1) on the proliferation and differentiation of orbital preadipocytes. Methods We harvested the orbital adipose tissues from 6 patients with TAO (TAO group) and 5 controls (control group); the patients were treated in Changzheng Hospital, Second Military Medical University from Sep. 2014 to Jan. 2015. The expression and distribution of IGF-1R in the orbital adipose tissues were examined by Western blotting analysis, real-time PCR and immunohistochemistry. The orbital preadipocytes were extracted in two groups, and the effects of different concentrations of IGF-1 (0 nmol/L, 1 nmol/L, 5 nmol/L, 10 nmol/L, and 20 nmol/L) on cell proliferation were examined by CCK8. The differentiation of cells and the expression of IGF-1R were observed by oil red O staining and Western blotting; the effect of different concentrations of IGF-1 (0 nmol/L, 1 nmol/L, 5 nmol/L, 10 nmol/L, and 20 nmol/L) on preadipocyte differentiation was detected by real-time PCR. Results The expressions of IGF-1R protein and mRNA in orbital adipose tissues in TAO group were significantly higher than those in the control group (P<0.01). The proliferation of orbital preadipocytes was promoted in both groups, and the cell proliferation in TAO group was significantly higher than that in control group when treated with 1-20 nmol/L IGF-1 (P<0.05, P<0.01). The expression of IGF-1R in the TAO group was significantly higher than that in the control group before and after differentiation. Compared with IGF-1 absent group, 1-20 nmol/L IGF-1 significantly promoted the expression of PPARγ mRNA in orbital preadipocytes in TAO group (P<0.01). Oil red O staining results showed that the lipid droplet synthesis was significantly increased with the increase of IGF-1 concentration (P<0.05, P<0.01). Conclusion IGF-1R is highly expressed in the adipose tissue and preadipocytes in patients with TAO, and IGF-1 can promote the proliferation and differentiation of preadipocytes in patients with TAO.

Abstract:Objective To use ultrasonic radio-frequency for analyzing the morphologic properties of carotid artery in kidney transplant recipients (KTR), and to evaluate the related factors. Methods A total of 31 KTR patients(KTR group), 31 patients with end-stage renal disease (ESRD) supported by hemodialysis (ESRD group), and 84 age- and sex-matched healthy volunteers (control group) were included in this study and received the ultrasound examination of carotid artery between Mar. 2014 and Dec. 2015. The right common carotid intima-media thickness (CIMT) and right common carotid arteries diameter (CCAD) were measured by ultrasonic radio-frequency in all participants. The independent influencing factors of the CIMT and CCAD were analyzed by multiple linear regression. Results Compared with the ESRD group, the CIMT of KTR group and control group were significantly lower(P<0.05), and there was no significant difference between the KTR and control groups. ESRD group had a significantly wider CCAD than the control group(P<0.01), and there was no significant difference among KTR, control and ESRD groups. The results of multiple linear regression showed the CIMT and CCAD were positively associated with age, body weight, systolic blood pressure (SBP) and some hemodynamic parameters, and they were the independent influencing factors of the CIMT and CCAD. Conclusion After successful kidney transplantation, the morphologic properties of carotid artery of recipients may recover partially. Age, body weight, SBP and some hemodynamic parameters are the independent factors of the morphological changes of carotid artery.

Abstract:Objective To establish a mouse model of chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation using chemotherapy preconditioning regimens. Methods The donor mouse was BALB/c^H-2kd and the recipients mouse was C57BL/6^H-2kb. The pretreatment of recipient mouse was performed using different doses of chemotherapy drugs, busulfan (BU) 20 mg/(kg·d)×4 d+cyclophosphamide (CTX) 150 mg/(kg·d)×2 d, or BU 20 mg/(kg·d)×4 d+CTX 100 mg/(kg·d)×2 d, and then the recipient mouse was injected with different doses of spleen cells (6×10⁷ or 4×10⁷ cells) and/or same dose of bone marrow cells (2×10⁷ cells) to establish the model of chronic GVHD. Hematopoietic chimerism analysis, clinical score and histopathology were used to evaluate the model. Results The high level of recipient-donor mixture chimera was established by pretreated by BU 20 mg/(kg·d)×4 d+CTX 150 mg/(kg·d)×2 d and 2×10⁷ bone marrow mononuclear cells +6×10⁷ spleen mononuclear cells. The onset of GVHD was concentrated at the 30-90 d after injecting spleen cells of the donor mouse. The clinical scores and incidence rate of chronic GVHD were significantly increased in the large numbers of cells and high doses of chemotherapy transplantation group compared with those in smaller numbers of cells and lower doses of chemotherapy groups (P<0.05). Pathological changes such as cellular and structural abnormalities and inflammatory cell infiltration were noted in the intestines, liver, skin and spleen of the model mice. Conclusion Bone marrow mononuclear cells (2×10⁷ cells)+spleen mononuclear cells (6×10⁷ or 4×10⁷ cells) can be used to establish a stable chronic GVHD mouse model via preconditioning with BU and CTX, which paves a way for clinical treatment of chronic GVHD.

Abstract:Hormone therapy (androgen deprivation therapy, ADT) is the first line treatment for advanced prostate cancer. Gonadotropin-releasing hormone (GnRH) agonist is commonly used for ADT, with the risk of flare-up effect at the first dose and testosterone fluctuation, which needs combination of anti-androgen drugs to alleviate the deterioration of the clinical condition. GnRH antagonists directly bind to GnRH receptor, blocking its activity, and they can be used in prostate cancer treatment, without testosterone flare-up effect. This review focused on functional mechanisms of GnRH agonists and antagonists, and history and clinical application of GnRH antagonists, so as to evaluate the clinical safety and effectiveness of GnRH antagonists and to discuss their clinical value and future prospects.

Abstract:Arterial spin labeling (ASL) in perfusion magnetic resonance imaging is based on endogenous contrast (hydrogen proton in arterial blood), and it has drawn widespread clinical attention and application due to its advantages, including noninvasiveness, convenient operation, low cost, quantitative measurement of cerebral blood flow(CBF), and good repeatability. Recently, the craniocerebral disease has become one of the diseases with highest incidence, which has drawn great attention from scientists and clinicians in and outside China; ASL could be helpful in the clinical examination and diagnosis of craniocerebral diseases. This review summarized recent reports on the clinical application of ASL in the cerebrovascular diseases, brain tumors and mental diseases, so as to provide references for future ASL research in craniocerebral diseases.

Abstract:5-hydroxytryptamine (5-HT) receptors are widely distributed in the central and peripheral nervous systems, regulating and controlling various physiologic functions. 5-HT and its analogues can play both inhibitory or promoting roles in the pain signal conduction via interacting with various subtypes of 5-HT receptor at different locations. In the central nervous system, the descending serotonergic neurons exert analgesic effect by activating the inhibitory interneurons, and the analgesic efficiency depends on the quantity and subtype of the 5-HT receptors. In periphery, 5-HT receptors are involved in pain signal conduction and have a close relationship with hyperalgesia. In this review, we focused on the different subtypes of 5-HT receptors locating in the central and peripheral nervous systems, and summarized the regulation mechanisms of 5-HT receptors in the pain signal, hoping to provide a theoretical basis and new target for the therapy and recovery of acute and chronic pain.

Abstract:Exosomes are membrane-derived vesicles of cells, and it can convey information and substances by transporting proteins, lipids and nucleic acids to target cells, thereby affecting the biological activity of target cells. Researches have shown that exosomes play important roles in neurological diseases, such as Alzheimer diseases, Parkinson diseases and prion disease, implying that the study of exosomes may have clinical value for treating central nervous system diseases. In this review, we summarized the generation of exosomes and the recent advances of their roles in neurological disease.

Abstract:Objective To explore the role of a comprehensive teaching method based on a diagnosis-and-treatment simulator for bronchoscopic procedure in the training of high-frequency electrocautery using snare. Methods A prospective self-control study including 20 trainees from the Bronchoscopic Center of Changhai Hospital was designed to evaluate the training outcome of bronchoscopic high-frequency electrocautery snare technique. During the training course, theoretical knowledge teaching was followed by simulator-based practice under the guidance of respiratory endoscopic exports from Changhai Hospital. We recorded and analyzed the procedure accuracy and fluency,operation time, and target tissue excision rate of each trainee before and after the training project. The appraisal of the training effect for each trainee in this study was conducted by questionnaire survey. Results All the 20 trainees successfully completed the whole training project. Compared with the data before the training, the procedure accuracy of excising the target tissue by snare after the training was significantly increased from 5.73±1.37 to 8.50±0.81 (P<0.01); the fluency of operating snare was significantly improved from 5.20±1.61 to 8.27±1.00 (P<0.01); the total operation time-consuming was significantly shortened from (214.9±112.6)s to (88.1±18.2) s (P=0.01); and the target tissue excision rate was increased significantly from (60.0±16.3)% to (76.0±12.6)% (P=0.05). The questionnaire survey showed that all the trainees benefited from the comprehensive simulator-based teaching method. The advantages of this teaching method included repeatability, high simulation degree, safety, operational stability and improved training efficiency. Conclusion The simulator-based comprehensive teaching method has a distinct teaching outcome in bronchoscopic electrocautery snare technique training, and is worth promoting in bronchoscopic training.

Abstract:Objective To design a novel impedimetric immunosensor based on AgI mimic enzyme nanomaterial for detecting carcinoembryonic antigen (CEA) in serum with high sensitivity. Methods A novel chitosan modified AgI (CS-AgI) nanomaterial was synthesized and was characterized by transmission electron microscope (TEM) and Fourier transform infrared spectroscopy (FTIR). Then by utilizing CS-AgI labeled CEA antibody as tags, we prepared a novel impedimetric immunosensor on the gold electrode using the sandwich-type immunoassay. The electrochemical properties of the prepared impedimetric immunosensor were observed by electrochemical workstation and the concentration of CEA in sample was quantitatively analyzed. Results The synthesized CS-AgI nanoparticles were spherical in shape, with the particle size being 100 nm; the particles were employed to construct immunosensor as signal markers. The immunosensor had an excellent electrochemical performance in detection of CEA under PBS base solution of pH=7, and its AC impedance response increased with the increase of the logarithm of CEA concentration, exhibiting a good linear relationship in the range of 0.1 ng/mL to 80 ng/mL (r=0.996), with a detection limit of 0.05 ng/mL. Conclusion Based on AgI mimic enzyme nanomaterial, the impedance immunosensor prepared in this study shows a high sensitivity in detecting CEA; meanwhile, it has acceptable selectivity, repeatability and stability, providing an experimental evidence for early diagnosis and treatment of cancer.

Abstract:Objective To establish an animal model of open craniocerebral injury with seawater immersion and to study the characteristics of the injury. Methods A total of 100 healthy male SD rats were divided into 5 groups:control group, mild injury+seawater immersion group, moderate injury+seawater immersion group, severe injury+seawater immersion group and severe injury+normal saline immersion group. After SD rats had received a controlled cortical impact (CCI) injury, the injured brain tissue was soaked in seawater or normal saline to construct an animal model of open craniocerebral injury. We then observed the characteristics of the model, including the animal behavior, pathological changes, brain water content and the level of blood brain barrier (BBB) opening. Results The animal model could well simulate the characteristics of the open craniocerebral injury with seawater immersion. With the increase of brain injury severity, the cerebral dysfunction, cerebral pathology, cerebral water content, and the damage of BBB became more serious. The pathological changes of brain tissue necrosis and bleeding in severe injury+seawater immersion group were more notable than those in the severe injury+normal saline immersion group. Compared with the severe injury+saline immersion group, the water content of brain tissue and the damage of BBB were significantly increased in the severe injury+seawater immersion group after immersion for 24 h. Conclusion The rat model we established in this study can simulate the open craniocerebral injury with seawater immersion.

Abstract:As it becomes normal for the PLA navy to sail to the open sea for training and the the multiple kinds of offshore military tasks it will face on the sea, the navy officers and soldiers will face more complicated health care problems, which brings greater challenges to the naval medical service support. In this review, we started from the problems in the medical service support; using the spatial analysis functions of geographic information system (GIS), and designed a naval medical service support GIS functional model, which included three functional modules:monitoring of the wounded and diseased, information management of naval medical service resource, and assistant decision-making for military medical service; and we also discussed the application of GIS in monitoring and early warning of the diseases, analysis and evaluation of risk factors, health resource allocation and decision-making support for health service.

Abstract:Objective To rapidly identify the chemical components in a traditional Chinese compound herbal preparation Babao Dan by ultra-high performance liquid chromatography-quadrupole-time of flight mass spectrometry (UHPLC-Q-TOF/MS). Methods A formula database including 547 compounds was developed by Agilent software "Formula-Database Generator". The total ion chromatograms of the Babao Dan extracts were obtained by UHPLC-Q-TOF/MS, and the chemical components were identified by automatic matching method according to the exact mass-to-charge ratio of each chemical component. The chemical components of Babao Dan was further verified using the secondary fragment ion obtained by adjusting the secondary monitor voltage of Q-TOF/MS. The separation was performed on a Waters Xbridge BEH C₁₈ column (2.1 mm×100 mm, 2.5 μm). The mobile phase composing of acetonitrile (A) and 0.5% formic acid aqueous solution (B) was used for gradient eluting (0-5 min, 5% A; 5-25 min, 5%-95% A; 25-30 min, 95% A). The temperature of column was 25℃; the flowing rate was 0.8 mL/min; and the post-column split ratio was 2:1. The Q-TOF/MS and electro spray ion source (ESI) were applied for qualitative analysis under positive and negative ion mode, with the mass scan range being m/z 100-1 500. The capillary voltage was 3 500 V under positive ion mode and 4 000 V under negative ion mode, and the range of collision energy of MS² was 10-40 eV. Results UHPLC-Q-TOF-MS identified a total of 78 chemical components from Babao Dan, including saponins, bile acids, amino acids and so on. Conclusion A rapid and efficient method for identifying the chemical components of Babao Dan by UHPLC-Q-TOF-MS has been established, and the chemical components of Babao Dan has been clarified, which lays a foundation for the quality control and further pharmacological study of Babao Dan.

Abstract:Objective To investigate the expression of sodium-coupled neutral amino acid transporter 1 (SNAT1) in esophageal squamous cell carcinoma (ESCC) tissues, and to evaluate its prognostic value in patients with ESCC. Methods The tissue microarray including 183 ESCC tissues and their corresponding adjacent tissues was subjected to immunohistochemistry detection and Western blotting analysis of SNAT1 expression, and their correlation with the clinicopathological parameters and overall survival time was analyzed. Results SNAT1 was highly expressed in ESCC tissues, with the positive rate being 45.4% (83/183); we also noticed that it was not expressed in normal squamous epithelium tissues. Our analysis results indicated that overexpression of SNAT1 was significantly correlated with tumor size (P=0.023), lymph node metastasis (P=0.007) and tumor stage (P=0.003). The Kaplan-Meier analysis showed that patients with overexpression of SNAT1 had significantly worse outcome than those with negative SNAT1 expression (P<0.001). Cox regression analysis revealed that overexpression of SNAT1 was an independent factor for prognostic of patients with ESCC (P=0.004). Conclusion The expression of SNAT1 is abnormally increased in ESCC tissue, indicating that SNAT1 expression may serve as an important biomarker for prognosis evaluation in patients with ESCC.

Abstract:Objective To know about the epidemiological characteristics and the referral and tracking situation of tuberculosis(TB) patients in Shizhu County, so as to provide a reference for making TB prevention strategies. Methods The clinical data of 5 217 patients with TB in Shizhu County from 2005 to 2014 were analyzed by descriptive epidemiological methods, and the data of referral and tracking of TB patients and suspects reported from non-tuberculosis organizations were also comprehensively evaluated. Results (1) The annual average prevalence of TB was 97.17/100 000 and the annual average smear-positive rate was 58.04/100 000 from 2005 to 2014 in Shizhu County. (2) There were significantly more males than females in our investigation(χ²=21.900 5,P<0.05), with the sex ratio being 2.10:1. The proportion of farmers were the highest among all the professions, accounting for 77.42%, followed by students, accounting for 6.40%. Patients of 35-44 years old was the largest population, accounting for 19.55%, followed by those of 55-64 and 25-34 years old groups, accounting for 16.16% and 16.01%, respectively. (3) Non-tuberculosis organizations reported 2 809 cases from 2005 to 2014, and the overall arrival was 1 673 cases (59.56%), including referral in 1 095 cases (38.98%) and tracking in 578 cases (20.58%). The rate of referral increased from 2.21% in 2005 to 63.33% in 2009, and then decreased from 55.64% in 2010 to 33.88% in 2014. The rate of tracking fluctuated between 13.33% and 30.54%; (4) 1 136 cases did not arrive after tracking, with going out accounting for 43.22%, no tracking information accounting for 36.97% and refusing treatment accounting for 10.48%. (5) Positive rate and confirmed smear-positive rate were 75.13% and 64.84% in 1 673 arrived cases, respectively. Patients diagnosed with active TB (1 257 cases) accounted for 24.09% of the registered during the same period in Shizhu County (5 217 cases), while diagnosis of smear positive TB in 815 cases accounted for 26.16% of the registered during the same period (3 116 cases). Conclusion The main targets of TB prevention in Shizhu County should be males and farmers. Besides, the DOTS should be continually carried out, and the TB prevention and treatment of students should be emphasized. Meanwhile, the key for TB prevention is the combination of treatment and prevention and implementation of referral and tracking.

Abstract:Objective To establish a joint wavelength switching HPLC gradient elution method for simultaneous determination of darutoside, kirenol, darutigenol, fangchinoline and d-tetrandrine in Xixian Fengshi Wan. Methods A Kromasil C₁₈ column (4.6 mm×250 mm, 5 μm) was used with a mobile phase A:acetonitrile-methano (2:1) and mobile phase B:0.05% acetic acid solution with gradient elution. The flow rate was 1.0 mL/min; the injection volume was 20 μL; darutoside, kirenol and darutigenol were detected at 215 nm, and fangchinoline and d-tetrandrine were detected at 280 nm. Results In the given concentration range, the linearity ranges of darutoside, kirenol, darutigenol, fangchinoline and d-tetrandrine were 6.45-129.00 μg/mL (r=0.999 5), 5.61-112.20 μg/mL (r=0.999 9), 4.25-85.00 μg/mL (r=0.999 3), 9.19-183.80 μg/mL (r=0.999 8), and 11.05-221.00 μg/mL (r=0.999 7), respectively; and their average recoveries and RSD were 98.73% (1.43%), 97.63% (1.28%), 99.44% (1.29%), 98.33% (1.38%), and 97.36% (1.37%), respectively. Conclusion The established joint wavelength switching HPLC gradient elution method is simple, accurate and reproducible; it can simultaneously determine the contents of darutoside, kirenol, darutigenol, fangchinoline and d-tetrandrine in Xixian Fengshi Wan and can be used for quality control of Xixian Fengshi Wan.

Abstract:Objective To compare the prognoses of hepatocellular carcinoma (HCC) patients who underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matching methods. Methods We retrospectively analyzed the clinical data of 124 HCC patients who were treated in the First Affiliated Hospital of Nanchang University between Jan.2010 and Dec.2015. The patients included 64 undergoing AR (AR group), and 60 undergoing NAR (NAR group). Propensity score-matching methods were used to assess the overall survival (OS) of the patients in AR and NAR groups while controlling the potential confounders, and the risk factors of prognosis of HCC patients were analyzed by Cox proportional hazard model. Results In the propensity score-matching cohort, the OS of the patients in AR group (n=29) was significantly longer than that in the NAR group (n=45) after propensity score-matching (52[44.83-59.17] months vs 38[31.45-44.55] months, P=0.005). The Cox proportional hazards model revealed that AR was associated with a superior OS (HR=0.54, 95%CI 0.30-0.96, P=0.04). Conclusion Propensity score-matching method has shown that AR can better improve the OS in HCC patients after liver resection compared with NAR.

Abstract:Objective：To study the MSCT findings and clinical value of tendon in previous diabetic foot (Wegener 0 grade). Methods：MSCT data from 63 patients with previous diabetic foot and 33 cases of control group at our department from January 2011 to December 2013 were analyzed retrospectively. All patients were measured the thickness and CT value of the Achilles tendon and plantar aponeurosis, observed the tendon margin and recorded other imaging findings in foot. All patients with previous diabetic foot were further investigated the correlation of the thickness of tendon and the fasting blood glucose, the thickness of tendon and glycosylated hemoglobin, the CT value of tendon and the fasting blood glucose, the CT value of tendon and the glycosylated hemoglobin. Results：The thickness of Achilles tendon and plantar aponeurosis increased, compared to that in the control group (t=3.157, 4.462, P＜0.05). The density of Achilles tendon and plantar aponeurosis were lower than that of in the control group (t=2.176, 2.815, P＜0.05). The majority margin of the Achilles tendon and plantar aponeurosis were indistinct and the swelling foot tissues were showed in previous diabetic foot patients. While smooth-edges and normal foot tissues were demonstrated in the control group. Further correlation analysis showed a positive correlation between the thickness of tendon and glycosylated hemoglobin. The negative correlation was found between the density of tendon and glycosylated hemoglobin. Conclusion：MSCT could evaluate the tendon lesion in previous diabetic foot patients that is available to diagnose and treat the diabetic foot in early stage.

Abstract:目的 评价连续实时血糖监测系统(real-time continuous monitoring system,RT-CGMS)对肠外营养支持患者胰岛素治疗的指导意义。方法:对我院重症医学科胃肠术后行肠外营养支持并采用胰岛素强化治疗的32例患者,进行回顾性总结并分析。根据血糖监测方法不同,分为CGMS组16例,多次末梢血糖监测(MBS)组16例,分析CGMS测定值与指血血糖的相关性,并采用每日血糖的平均值、最高值、最低值、血糖漂移及低血糖情况等指标,评价血糖的控制情况；采用平均住院日,评价两种监测方式对强化胰岛素治疗的病人受益情况。结果 CGMS血糖测定值与指血血糖值的相关性良好,两者的Person相关系数r=0.89(P<0.01)。与MBS相比较,CGMS组血糖最高值显著降低(P<0.05),血糖最低值显著升高(P<0.05),血糖漂移明显降低(P<0.05)；与MBS相比较,CGMS组患者发生低血糖测次数(1次)明显减少(10次),并且患者平均ICU住院日显著缩短(P<0.05)。结论 与多点血糖监测相比,连续血糖监测系统可以更好地的反应患者的血糖变化情况,在接受强化胰岛素治疗的患者中是一种行之有效的监测手段。良好的血糖控制,缩短了ICU患者平均住院日,从而使患者受益。

Abstract:To report one 70-year-old female who developed symptomatic thoracic spinal tuberculosis with asymptomatic right acetabular tuberculosis but was initially misdiagnosed as bony metastasis based on emission computed tomography(ECT) and transverse images of computed tomography scanning at relative regions. The patient had no history of pulmonary tuberculosis, no history of exposure to tuberculosis. Before and from the onset of her intercostal neuralgia, she had nogeneral symptoms of afternoon low-degree fever, night sweets. Blood test results revealed normal blood sedimentation rate and C-protein reaction. Following ECT indicated increased tracer uptake involving T9 vertebral body and right acetabular region, and transverse images of CT scanning at thoracic spine and pelvic region detected bony destruction at T9 vertebra and irregular low bony density at right acetabular region with lesion, she was initially misdiagnosed as bony metastasis. The neglected evidences of narrowed T8-9 intervertebtral disc space and blunt left costophrenic by X-ray also were responsible for the misdiagnosis. The case implied that when spinal lesion happened in an old patient, one should keep in mind that spinal tuberculosis might not be ruled out. Increased tracer uptaking might be found in bony tuberculosis when ECT was done.