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Objective:To investigate the serum level of low density lipoprotein cholesterol (sdLDL-C) in elderly patients (age≥65 years) with type 2 diabetes mellitus (T2DM) and the its predictive value in evaluatingthe risk of cardiovascular and cerebrovascularevents in elderly patients with T2DM.Methods:In this retrospective study,386 elderly patients with T2DM were collected from December 2014 to December 2016, the averageage was (72.7±5.4) years old, including 269 males and 117 females; 92 of whom had cardiovascular events during follow-up, the averageage was (72.9 ± 5.2) years old, including 65 males and 27 females, and serum sdLDL-C level was detected. Meanwhile, biomarkers such as lipoprotein (a), apolipoprotein B, apolipoprotein AI and hypersensitive c-reactive protein were analyzedin all the patients.Univariate and multivariate factors were used to analyze the relationship between each variable and the occurrence of cardiovascular and cerebrovascular events. The correlation between LDL-C, sdLDL-C of all subjects with age and other lipid indexes were analyzed. ROC curve was used to determine the predictive value of sdLDL-C elevation for cardiovascular and cerebrovascular events in elderly patients with T2DM.Results:The levels of LDL-c, sdLDL-C, non-HDL-C, GLU, HbA1c and ApoB were significantly higher in theCardio-cerebral vascular event group ( t=3.26, 3.46, 2.91, 2.47, 4.03, 3.00, P<0.05). While the levels of apolipoprotein AI was significantly lower than those in theNon-cardio-cerebral vascular event group ( t=-2.39, P<0.05). Cox regression analysis showed that sdLDL-C per 10 mg/dl was independently correlated with the risk of cardiovascular and cerebrovascular events( HR 1.281, 95 %CI 1.225-16.032, P<0.01)after adjusted for age. SdLDL-C was positively correlated with TG, non-HDL-C and ApoB ( r=0.323, 0.588, 0.623, P<0.01) and was negativelycorrelated correlation with age, HDL-C and apolipoprotein AI ( r=-0.363, -0.301, P<0.01), ROC curve analysis showed that sdLDL-C had a strong ability to predict the occurrence of cardiovascular and cerebrovascular events (AUC=0.736, 95 %CI 0.554 9-0.918 2, P=0.003), while HbA1c also had a strong ability to predict the occurrence of cardiovascular and cerebrovascular events(AUC=0.725, 95 %CI 0.524 3-0.927 3, P=0.006). Combined sdLDL-C with HbA1had the strong ability to predict the occurrence of cardiovascular and cerebrovascular events (AUC=0.837, 95 %CI 0.711 4-0.973 5, P=0.001). Conclusions:The elevation of serum sdLDL-C in elderly patients with T2DM wasa significantly independentrisk factorof cardiovascular and cerebrovascular events. Serum sdLDL-C had a higher clinical value than LDL-C, which was expected to be the most effective predictor of lipid profile in riak assessment of cardiovascular and cerebrovascular events in elderly patients with T2DM.
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Objective:To investigate the levels and the clinical signficance of matrix metalloproteinase 3 (MMP-3) in different activities of rheumatoid arthritis (RA).Methods:Case-control study. A total of 130 patients [24 cases of male, 106 cases of female, age (52.98±13.24)years, the median age was 51 years] with RA diagnosed in the Department of Rheumatology from the Second Affiliated Hospital of Soochow University, Suzhou Hospital of Traditional Chinese Medicine and Suzhou Ninth People′s Hospital from 2017 to 2018, and 100 healthy controls [28 cases of male, 72 cases of female, age (45.04±11.55) years, the median age was 44 years] from the physical examination center of the Suzhou Ninth People′s Hospital. The basic clinical data was used to determine the MMP-3 on groups of RA patients and healthy controls by immunoturbidimetry. The discriminating validity of MMP-3 in disease was evaluated using receiver operating characteristic (ROC) curve analysis.Results:Compared with that in healthy controls[28.0 (21.7-36.1)ng/mL], the MMP-3 in the low groups [51.8(41.8-73.1)ng/mL] increased dramatically ( Z=2.942, P<0.01). However, there was no significant difference between the MMP-3 in remission patients [28.8 (21.9-38.7)ng/mL] compared with the healthy controls ( Z=1.09, P>0.05). The area under the curve (AUC) of MMP-3 for diagnosis of RA was 0.877. the sensitivity was 73.1%, and the specificity was 93%.The AUC of MMP-3 diagnosis of low groups was 0.906, the sensitivity was 77.8%, and the specificity was 88%. In addition, the MMP-3 level was correlated with CRP and ESR ( r=0.242, r=0.243), and it was significantly correlated with DAS 28 ( r=0.361). Conclusions:It was indicated that the level of MMP-3 increased with the severity of rheumatoid arthritis. And the clinically low level of MMP-3 in RA patients could be used to indicate the remission condition. Meanwhile, the serum MMP-3 was closely related to DAS28.
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Objective To analyze the efficacy and safety of CyberKnife combined with temozolomide (TMZ) in treatment of brain metastasis of non-small cell lung cancer (NSCLC). Methods From March 2013 to March 2016, 62 NSCLC patients with brain metastases in department of oncology of the 187th Hospital of PLA were divided into two groups according to the random number table method, the CyberKnife combined with TMZ group (CyberKnife + TMZ group, 31 cases) and simple CyberKnife group (CyberKnife group, 31 cases). Hypofractionated radiation of CyberKnife was given 18-36 Gy in 1-5 fractions of 5-25 Gy. CyberKnife+ TMZ group was given temozolomide 150 mg·m-2·d-1 for 5 days in first cycle, then every 28 days they received temozolomide therapy from the second to the sixth cycles: 200 mg·m-2·d-1 for 5 days. The clinical symptom remission rate after the treatment of CyberKnife in one week, the effective rate after CyberKnife in 3 months, the median intracranial progression-free survival time, overall survival, and the incidences of adverse reaction were comparatively analyzed. Results The clinical symptom remission rates of CyberKnife+TMZ group and CyberKnife group after the treatment of CyberKnife in one week were 93.6 % (29/31) and 96.8 % (30/31). There was no significant difference in the clinical symptom remission rates (χ2= 1.207, P=0.547). The effective rates of the two groups after CyberKnife in 3 months were 93.6 % (29/31) and 90.3 %(28/31). There was no significant difference in the effective rates (χ2 = 0.695, P= 0.706). The median intracranial progression-free survival time in CyberKnife + TMZ group (14.0 months) was significantly higher than that in the CyberKnife group (9 months) (χ2=8.977, P=0.003), and the median overall survival time in CyberKnife + TMZ group (15.0 months) was also significantly higher than that in the CyberKnife group (12.0 months) (χ2 = 5.190, P= 0.023). There was no significant difference in the adverse reaction of the central nervous system between the two groups (χ2=0.746, P=0.689), but the adverse reactions of the digestive system (χ2 = 6.062, P= 0.014) and the hematologic system (χ2 = 6.613, P= 0.010) in CyberKnife + TMZ group were significantly higher than those in the CyberKnife group. Systemic adverse reactions of the two groups were tolerated by most patients. Conclusions CyberKnife combined with TMZ is a feasible therapeutic option for NSCLC patients with brain metastases. This therapy can improve the median survival time to cerebral progression of the disease and the median overall survival time.
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Objective Invasive candidiasis is associated with a significant mortality clinically.The purpose of this study was to observe the T cells immune response to fructose bisphosphate aldolase (Fba), an immunodominant antigen of Candida albicans, and determine whether the antigen has the possibility of priming cellular immune protection in invasive candiasis.Methods Using ELISPOT assay, we determined the frequencies of positive spot-forming cells (SFCs) of Fba antigen-specific T cells secreting IFN-γ, IL-4 and IL-17A in the peripheral blood mononuclear cells (PBMCs) of 26 healthy individuals.Results After Fba stimulation, the frequencies of positive SFCs of IFN-γ, IL-4 and IL-17A in the 26 healthy subjects were 23 (9.75, 42.50), 0 (0, 0.25) and 1.5 (0.75, 8.25), respectively, with statistically significant differences among the three (P<0.01).The response rates of IFN-γ (100% [26/26]) and IL-17A (76.92% [20/26]) were significantly higher than that of IL-4 (15.38% [4/26]) (P<0.01).Fba-induced strong response (SCFs ≥20) for IFN-γ was observed in 57.69% (15/26) of the healthy individuals, that for IL-17A in only 1, while that for IL-4 in none.Responses of both Th1 and Th17 cells to Fba were found in 65.38% (17/26) of the subjects, that of Th1 cells in 19.23% (5/26), but that of Th2 cells in none.Conclusion Fba of Candida albicans can induce immunodominant responses of Th1 and Th17 cells and is a potential vaccine against invasive candiasis.
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<p><b>OBJECTIVE</b>To explore the genotoxicity of bass wood dust.</p><p><b>METHODS</b>Micronucleus frequency in peripheral lymphocytes of workers exposed to bass wood dust in a match factory were examined, solution of bass wood dust emmersion was prepared and the effect on micronucleus frequency in poly-dyeing red blood cell of mice's sternum marrow was also detected. Single cell gel electrophoresis assay was used to detect DNA damage in liver cell, the level of oxygen free radical, lipid peroxidation(MDA) in the liver and the activity of superoxide dismutase(SOD) in red blood cells were also studied.</p><p><b>RESULTS</b>The positive frequency of micronucleus in bass wood-exposed workers with different length of service (0-, 5-, > or = 10 a) were 50.0%, 51.9%, 50.0% respectively, significantly higher (P < 0.01) than that of the control group(4.5%). A dose-effect relationship could also be found in the mice's micronucleus frequency study(r = 0.78, P < 0.01). The activities of SOD[(10.98 +/- 5.74), (15.70 +/- 7.54), (29.63 +/- 14.97) microgram/g Hb] were significantly lower than that of control group[(35.80 +/- 12.92) microgram/g Hb], and the level of MDA[(4.93 +/- 0.90), (4.61 +/- 1.06), (4.33 +/- 0.69) mmol/g liver] were significantly higher than that of the control group[(2.51 +/- 0.34) mmol/g liver]. Single cell gel electrophoresis study showed DNA strand breaks increased with the dose increase and the level of oxygen free radical also increased with the dose increase.</p><p><b>CONCLUSION</b>Bass wood dust may have certain degree of genotoxicity.</p>