[Efficacy and safety of a combined oral contraceptive containing drospirenone 3 mg and ethinylestradiol 20 µg in a 24+4-day regimen in China].

OBJECTIVE: To assess the efficacy, bleeding pattern, cycle control and safety of a combined oral contraceptive (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 µg in a 24+4-day regimen in China. METHODS: This is a multi-center, open, one-label study. Healthy females aged 18-45 years received YAZ for 13 cycles. Following-ups were scheduled during the treatment phase on Day 12-19 of Cycle 1, 4, 7 and 10 and 10-17 days after completing the study. The efficacy variables were the number of unintended pregnancies, bleeding pattern and cycle control. The safety variables were adverse events (AE), lab examinations, physical and gynecological examinations, vital signs and body weights and questionnaires. RESULTS: Four pregnancies occurred among 675 women for 603.78 women-years, resulting in a Pearl index (PI) of 0.7 and adjusted PI of 0.6. The cumulative 1-year pregnancy rate was 0.66%. The mean number of bleeding/spotting days was (26.3 ± 12.4) days in reference period 1 and (15.4 ± 5.5) days in reference period 4. 94.2% (582/618)- 96.8% (538/558) subjects experienced scheduled bleeding. The mean duration of scheduled bleeding decreased from (5.9 ± 3.2) to (5.0 ± 1.6) days. The percentage of women with intermenstrual bleeding decreased from 14.5% (90/621) at Cycle 1 to 2.3% (13/558) at Cycle 12. The common AE relating treatment include nausea (3.4%, 23/675), breast tenderness (1.2%, 8/675), dizzy (1.2%), vagina bleeding (1.2%). No serious AE relating treatment occurred. 85.6% (542/633) subjects were satisfied or very satisfied with the study treatment. CONCLUSION: YAZ is highly effective, acceptable and safe for Chinese women.

Expression and clinical significance of phosphoglycerate dehydrogenase and squamous cell carcinoma antigen in cervical cancer.

OBJECTIVE: To determine the expression patterns of phosphoglycerate dehydrogenase (PHGDH) and serum squamous cell carcinoma antigen (SCC-Ag) in cervical cancer andtheir clinical significance and to explore their relationship with clinicopathological parameters. METHODS: The expression of PHGDH was detected in 75 cervical cancer tissues and 21 normal cervical epithelium by immunohistochemistry. The SCC-Ag level was tested in 64 serum samples of the 75 squamous cervical cancer cases by immunoradiometric assay. The correlation of PHGDH and SCC-Ag with clinicopathological parameters was analyzed. RESULTS: Phosphoglycerate dehydrogenase was more moderate/strong expressed in cervical cancer than in normal cervical epithelium (72% vs 28.6%, respectively; P < 0.05); furthermore, PHGDH and serum SCC-Ag expression in squamous cervical cancer were positively correlated (r = 0.310, P < 0.05). Phosphoglycerate dehydrogenase and serum SCC-Ag were both associated with International Federation of Gynecology and Obstetrics stage and tumor size (P < 0.05). CONCLUSIONS: The overexpression of PHGDH is found in cervical cancer, in particular, in bigger tumors and with advanced stages; and its expression is positively correlated with serum SCC-Ag level and implies that PHGDH may useful for prognosis, prediction, and treatment of cervical cancer.

Investigation on the precipitate morphology and fraction characterization by atomic force microscopy.

Precipitate was typically characterized by the transmission electron microscopy (TEM) or scanning electron microscopy (SEM) to analyze the relationship between material property and precipitate fraction. However, these procedures tend to be are always time consuming because of the complicated sample preparation process involved and the observation course. Particularly, sometime the precipitate can't be highlighted solely from the images easily. In this study, atomic force microscopy (ATM) was performed to characterize the morphology and fraction of the precipitate in this paper. Five kinds of materials were selected and prepared by electropolishing or vibration polishing method to display the precipitates on the sample surface. The experiment results prove that different types of precipitates with higher values for height on a sample surface could be clearly observed by AFM, and the images quality is highly relied upon the surface quality. The precipitate fraction can be calculated using the AFM micrographs and image photo post treated software (IPP). It was turned out that AFM is found suitable for observation almost all kinds of precipitates, and the precipitates can be easily separated from the images. Not only vibration polishing but also electrolytic polishing could offer a smooth surface for observing nanosized precipitates by AFM. A comparison of the fraction result obtained by AFM and precise microchemical analysis proves that the fraction measurement result obtained by AFM is acceptable.

The expression and significance of Dickkopf-1 in epithelial ovarian carcinoma.

The aim of this study was to investigate the presence and prognostic value of Dickkopf-1 (DKK1) in epithelia ovarian carcinoma. The expression of DKK1 was determined in 56 epithelial ovarian carcinoma tissues, 35 benign ovarian cystadenoma tissues, and 12 normal ovarian tissues by quantitative real-time PCR and immunohistochemistry. The DKK1 mRNA level in the carcinoma tissues was upregulated (5.5+/-2.7-fold increase) compared with that in the normal tissues (p<0.0001). The mRNA level of DKK1 in the cystadenoma tissues (1.1+/-0.4-fold increase) was not statistically different from that in the normal tissues (p=0.486). DKK1 protein expression in the carcinoma tissues was also higher (89.29%) than in cystadenoma (65.71%) and normal tissues (58.33%) (p=0.006 and p=0.009, respectively). In epithelial ovarian carcinoma, DKK1 gene and protein overexpression was associated with advanced FIGO stage (p=0.007, p=0.004) and poor differentiation grade (p=0.027, p=0.010). Elevated DKK1 protein levels in ovarian carcinoma samples were associated with a poor outcome in univariate and multivariate analysis (p<0.0001 and p<0.0001, respectively). The study indicated that DKK1 maymbe a useful prognostic and diagnostic indicator for epithelial ovarian carcinoma.

Inhibition effect of Guizhi-Fuling-decoction on the invasion of human cervical cancer.

AIM OF THE STUDY: Guizhi-Fuling-decoction (GZFLD), a traditional Chinese medical formulation, exerts an anti-tumor effect, but the mechanisms of its action on invasive tumor inhibition have not been documented. The aims of this study were to identify the inhibitory effect of GZFLD on the invasive of cervical cancer and to elucidate the extensional mechanisms of its action. MATERIALS AND METHOD: The invasive ability of HeLa cells was tested with Transwell chamber. The expressions and activities of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) were measured by zymography/reverse zymography, RT-PCR and Western blot analysis. Establish tumor-bearing mice model to assess the ability of GZFLD to inhibit tumor growth and angiopoiesis in vivo. RESULTS: We have found that GZFLD suppressed the invasive ability of HeLa cells, inhibited MMPs expressions and activities, increased TIMPs expressions and activities, and furthermore restored the MMPs-TIMPs balance in HeLa cells in a concentration-dependent manner. Meanwhile in vivo, GZFLD had significantly inhibited tumor growth and angiopoiesis. CONCLUSION: In general, our results showed that GZFLD had inhibited the invasion of cervical cancer both in vitro and vivo. The inhibitory effects may be associated with restoring the MMPs-TIMPs balance, and then suppressing the degradation of extracellular matrix.

Preliminary study on the clinical application of four cytokines in serum of autoimmune diseases / 中华检验医学杂志

Objectives:the purpose of this study was to systematically evaluate the clinical value of cytokines in autoimmune diseases (AID). It was a kind of complex disease, and its pathogenesis involved cytokines, autoantibodies, immune cells and other immune factors. Especially some AID, such as Adult still′s disease (AOSD) and Takayasu arteritis(TA), had no specific biomarkers at present. This study was a retrospective case-control study.Methods:the data of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8(IL-8) and interleukin-10(IL-10) in 834 AID patients from January 2019 to August 2022 were collected, and the serum levels of those cytokines in 30 healthy controls (HC) were detected at the same time. And AOSD, TA, systemic lupus erythematosus (SLE) and Behcet′s syndrome (BS) were divided into active group and inactive group. In addition, we also made a subgroup analysis of two important organs involved in SLE (kidney and nervous system). GraphPad Prism 9 and R 4.2.2 software were used. Nonparametric tests (Kruskal-Wallis H test, Mann-Whitney U test) were used to compare the differences among groups, and Dunn′s method was used to correct the false positive caused by multiple tests. Results:To compare the level of IL-6 in each group, except Behcet syndrome (BS) group and antiphospholipid syndrome (APS) group, the serum IL-6 level of AID group was higher than that of HC group, with antineutrophil cytoplasmic antibodies associated vasculitis(AAV) [3.85(2.00,8.55) pg/ml], idiopathic inflammatory myopathies(IIM) [7.80(2.50,6.50)pg/ml], IgG4-related disease(IgG4RD) [3.65(2.08,12.83) pg/ml], rheumatoid arthritis (RA) [5.50(2.20,16.10) pg/ml], SLE[4.70(2.75,16.55) pg/ml], Sj?gren syndrome(SS) [3.20(2.00,8.90) pg/ml], systemic sclerosis(SSc) [2.70(2.00,8.90) pg/ml], TA[3.40 (2.00,6.50) pg/ml], other AID diseases[4.40(2.00,11.10) pg/ml], especially AOSD [15.20(2.10, 39.20) pg/ml]. After correction, the differences were statistically significant ( P c<0.05). At the same time, the levels of serum TNF-α [7.40(5.60,10.95) pg/ml]and IL-10 [5.00(5.00, 7.58) pg/ml] in AOSD group were significantly higher than those in HC group[7.15(5.93,8.00) pg/ml,5.00(5.00,5.00) pg/ml] after correction ( P c<0.05). At the same time, the levels of serum TNF-α and IL-10 in AOSD group were higher than those in HC group. The serum levels of IL-6 and IL-8 in patients with active AOSD, BS, SLE and TA were significantly higher than those in patients without active disease (all P<0.05). In addition, the level of serum IL-8 in lupus nephritis group was significantly higher than that in non-lupus nephritis group ( P<0.05). At the same time, the serum levels of IL-6, IL-8 and TNF-α in neuropsychiatric lupus erythematosus group were significantly higher than those in non-neuropsychiatric lupus erythematosus group ( P<0.05), but there was no significant difference in IL-10 between neuropsychiatric lupus group and non-neuropsychiatric lupus erythematosus group. Conclusions:there was a close relationship between AID and cytokines. At present, the change of serum IL-6 level was the most classic one in clinical routine.

Value of subtypes of antimitochondrial antibodies in primary biliary cholangitis / 中华风湿病学杂志

Objective:To investigate the distribution and clinical significance of subtypes of antimitochondrial antibodies (AMA)-M2, M4, M9 in primary biliary cholangitis (PBC).Methods:A total of 1 367 patients were detected with AMA-M2, M4, M9 in Peking Union Medical College Hospital (PUMCH) from Jan 2014 to Dec 2019 and the clinical parameters were collected. The distribution patterns of AMA subtypes in different groups were analyzed and the diagnostic sensitivity and specificity of AMA subtypes in PBC were calculated. Chi-square test was used for statistical analysis.Results:In 1 367 patients, 236 of whom were positive for AMA subtypes. The positivity of AMA subtypes in female was significantly higher than in male (20.34% vs 9.41%, χ2=23.792, P<0.01). In addition, the positivity of AMA subtypes was significantly higher in 30-65 years old patients than in patients younger than 30 years old or older than 65 years old [(20.00%(193/965) vs 10.97%(17/155) vs 10.53%(26/247), χ2=17.209, P<0.01]. 110 patients with positive AMA subtypes were diagnosed with PBC. The diagnostic sensitivity and specificity of AMA-M2 were both desirable [94.64%(106/112) and 92.35%(1 159/1 255)]. Although the specificity of AMA-M4 was as high as 99.12%(1 244/1 255), its sensitivity was very low [15.18%(17/122)]. Combined detection of different AMA subtypes could not improve the diagnostic sensitivity and specificity significantly. Diseases other than PBC can be positive for AMA subtypes, predominantly for AMA-M2. Conclusion:Female and 30-65 years old patients were more frequently positive for AMA subtypes. AMA-M2 was the most valuable AMA subtype for diagnosing PBC.

Downregulation of phosphoglycerate dehydrogenase inhibits proliferation and enhances cisplatin sensitivity in cervical adenocarcinoma cells by regulating Bcl-2 and caspase-3.

Phosphoglycerate dehydrogenase (PHGDH) is the key enzyme of de novo serine biosynthesis. Previous reports have demonstrated that PHGDH plays an important role in some malignancies. However, the biological role of PHGDH in human cervical adenocarcinoma has not been explored. We examined the expression of PHGDH in 54 cervical adenocarcinoma samples by immunohistochemistry and evaluated the association with clinicopathological parameters and prognosis. We performed shRNA transfection to knock down PHGDH gene expression in HeLa cells. A cell proliferation test, cisplatin cytotoxicity test and apoptosis test examined the HeLa cell line after PHGDH knockdown in vitro. In vivo tumorigenesis was assessed using a mouse xenograft model. Moreover, we examined the effects on Bcl-2 and cleaved caspase-3 expression after knockdown of PHGDH and treatment of cisplatin for 48h by Western blot. In this study, we demonstrated that elevated PHGDH expression was found in cervical adenocarcinoma and was associated with tumor size and prognosis. Knocking down PHGDH in HeLa cells significantly inhibited cell proliferation and increased cisplatin chemotherapy sensitivity. Silencing PHGDH resulted in inhibition of tumorigenesis in vivo. Furthermore, PHGDH knockdown reduced Bcl-2 and increased cleaved caspase-3 expression. Collectively, our study indicates the novel roles of PHGDH in cervical adenocarcinoma and identifies PHGDH as a new anticancer target.

Effect of left atrioventricular interphase on cardiac function after dual-chamber pacemaker implantation in patients with high-degree atrioventricular block / 中国医师进修杂志

Objective:To study the effect of left atrioventricular interphase (LAVI) via esophageal electrocardiogram on cardiac function after dual-chamber pacemaker implantation in patients with high-degree atrioventricular block.Methods:Using a prospective approach, 40 patients with high-degree atrioventricular block who would undergo dual-chamber pacemaker implantation from January 2017 to March 2018 in Department of Cardiovascular Medicine, Dalian Municipal Central Hospital Affiliated of Dalian Medical University were enrolled. All patients accepted esophageal electrocardiogram tests at 3 months after the implantation, to exam the interatrial conduction time (IACT) of sinus rhythm and pacing rhythm, and interventricular conduction time (IVCT). Then based on the outcome of the echocardiography test, the optimal atrioventricular delay (AVD) of the pacemaker of each patient was determined while the LAVI differed from 100 ms to 150 ms. The left ventricular ejection fraction (LVEF), peak speed of blood flow velocity in early mitral orifice diastole (E), E peak deceleration time (EDT), peak speed of early mitral annular diastolic movement (e′), isovolumic relaxation time (IVRT) and left atrial volume (LAV) were tested by echocardiogram before implantation, before AVD adjustment at 3 months after implantation, after AVD adjustment at 3 months after implantation, and 6, 12, and 18 months after implantation. Then, the left atrial volume index (LAV/body surface area) and E/e′ were calculated.Results:Among the 40 patients, the IACT of sinus rhythm was (55.55 ± 10.33) ms, the IACT of pacing rhythm was (93.95 ± 12.77) ms, and the mean IVCT was (63.20 ± 17.84) ms; the optimal LAVI was 110 to 150 (132.00 ± 10.43) ms, and notably, the optimal LAVI between 120 and 140 ms was 82.5% (33/40). The LVEF, EDT, IVRT, left atrial volume index and E/e′ from before AVD adjustment of 3 months after implantation to follow-up endpoint (18 months after implantation) were significantly improved compared with those before implantation, and there were statistical differences ( P<0.01); the EDT and IVRT after AVD adjustment at 3 months after implantation were significantly improved than those before AVD adjustment at 3 months after implantation: (142.15 ± 35.58) ms vs. (125.94 ± 31.13) ms and (119.52 ± 22.15) ms vs. (133.92 ± 23.87) ms, and there were statistical differences ( P<0.05); the IVRT and left atrial volume index 18 months after implantation were significantly improved compared with those before AVD adjustment at 3 months after implantation: (122.07 ± 16.99) ms vs. (133.92 ± 23.87) and 32.94 ± 3.22 vs. 35.43 ± 5.76, and there were statistical differences ( P<0.05). Conclusions:Optimizing the LAVI after dual-chamber pacemaker implantation via esophageal electrocardiogram can improve the long-term prognosis of patients with high-degree atrioventricular block.

Anti-mutant citrullinated vimentin antibody in the diagnosis of rheumatoid arthritis / 中华检验医学杂志

Objective This study aimed to assess the diagnostic value of anti-mutated citrullinated vimentin (MCV) antibodies in rheumatoid arthritis (RA) and its correlation with disease progression, extra-articular manifestations and overlap syndrome. Methods Retrospective Studies. Clinical data of 837 patients in PekingUnionMedicalCollegeHospitalfrom June to August 2017 were collected, including the result of anti-MCV, anti-cyclic citrullinated peptide (anti-CCP) antibodies, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and High-sensitivity-C-reactive protein (CRP). According to the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis, there were 323 patients diagnosed with RA, including 59 males and 264 females with the average age of 51 years. According to whether the RA patients have overlap syndrome with other autoimmune disease (AID) or have extra-articular manifestations, 258 cases were categorized into RA group, including 47 males and 211 females with the average age of 50 years; 14 cases were categorized into the group of overlap syndrome, including 1 male and 13 females with the average age of 36 years;51 cases were categorized into the group of extra-articular manifestations, including 11 males and 40 females with the average age of 59 years.According to 2010 rheumatoid arthritis classification criteria for destruction in joints, the radiographic changes were divided into 4 stages. There were 203 casesenrolled in our study, 88 caseswere fitted into early stage group (stage I)including 21 males and 67 females with the average age of 48 years; 115 caseswere fitted into progressive stage group, which compromisedstageⅡ (interim stage), stage Ⅲ (severe stage) and stage Ⅳ(final stage) cases, including 19 males and 96 females with the average age of 53 years. Mann-Whitney U test, x2 test, Receiver operating characteristic (ROC) curves and Spearmancorrelation coefficientwere used in Statistical analysis. Results Ⅰ Amongdiagnosed RA patients, 199 (61.6％) cases were positive for anti-MCV, anti-CCP and RFsimultaneously, 42 (13％) cases were positive for anti-MCV, which was higher than anti-CCP positive (1 cases, 0.3％) or RF positive (7cases, 2.2％). The difference was statistically significant(P<0.001, P<0.001). ⅡROC was calculated and MCV=35.95 U/ml was used as best-fit cut-off value. The AUC for anti-MCV was 0.867, while the sensitivity was 80.5％and specificity was 80.9％.ⅢThe detection levels of anti-MCV (682.8 (106.4-1000.0)), anti-CCP (407 (4.0-1536.0)) and RF (82.8 (21.1-244.9)) in the group of progressive stage were higher than those in the group of early stage (114.5 (28.5-1000.0), 62.5 (5.0-1020.7), 50.1 (6.7-127.1)), which showed a significant difference(P<0.05, P<0.05, P<0.05). The anti-MCV, anti-CCP and RF were positively related to the degree of joint destruction (r=0.229, P<0.05;r=0.187, P<0.05;r=0.167, P<0.05);anti-MCV and anti-CCP were positively related to extra-articular manifestation (r=0.152, P<0.05;r=0.136, P<0.05). Conclusion Anti-MCV antibodies are more sensitive in patients with RA, and have complementary diagnostic value for anti-CCP and RF-negative patients; high levels of anti-MCV and anti-CCP in RA patients are associated with RA progression and extra-articular involvement.

Prozone effect on indirect immunofluorescence assay for anti-nuclear antibody testing / 国际检验医学杂志

Objective To explore the influence of prozone effect on anti-nuclear antibodies (ANA) testing by indirect immunofluorescence assay (IIFA).Methods The samples with high titer of ANA (≥1∶1 000) were selected from 880fresh serum samples, and were subsequently diluted in 1∶100, 1∶1 000and 1∶10 000ratio.Prozone effect was defined as fluorescence intensity from 1∶1 000dilution was stronger than that from1∶100dilution.The samples with prozone effect were determined manually or by Sprinter XL and EUROPattern.The samples with prozone effect were further characterized by combinations of fluorescence patterns, fluorescence intensities and autoantibody specificities.Results A total of 880samples were tested.Importantly, 34samples displayed prozone effect (3.86％in total and 29.57％in samples with ANA≥1∶1 000).Interestingly, prozone effect was identified by manual detection as well as by Sprinter XL with similar fluorescence patterns and fluorescence intensities.Notably, EUROPattern can only select the central area for identification.Among all samples with prozone effect, 74.42％samples exhibited fluorescence intensities of≥1∶10 000.Speckled pattern was the most prevalent fluorescence patterns in samples with prozone effect (46.51％).In addition, anti-RNP antibodies (62.79％) were the most popular autoantibodies in samples with prozone effect, followed by anti-dsDNA antibodies (51.16％) and anti-SSA antibodies (51.16％).Conclusion Prozone effect was present in ANA testing, especially in samples with high titers, resulting in underestimating the titers.The study highlighted that special attention should be paid to the prozone effect in clinical practice.

A multi-center clinical study for ANA specific autoantibodies detection by chemiluminescent immunoassay / 中华检验医学杂志

Objective To evaluate the clinical performance of chemiluminescent immunoassay (CLIA) on anti-nuclear antibody(ANA) specific autoantibodies testing.Methods A multi-center clinical study A total of 811 Sera samples were collected from 6 collaborating hospitals during the period of April to July 2016, and tested with CLIA and line immunoassay (LIA) in parallel for autoantibodies to ribonucleoprotein(RNP), smith antigen(Sm), SSA/Ro60,SSB/La, centromere protein B(CENPB), double-stranded DNA(dsDNA), nucleosome(Nuc), and ribosome P protein(Rib-P).The positive rate,specificity and qualitative coincidence rate for each antibody between CLIA and LIA methods were analyzed.All discrepant samples for systemic lupus erythematosus (SLE) highly specific autoantibodies (including anti-Sm, dsDNA, Nuc and Rib-P) were retested by enzyme linked immunosorbent assay (ELISA) and further analyzed with SLE disease cohort using McNemar test.Results The positive rate and specificity of CLIA and LIA for antibodies to ANA specific antigens were comparable.Excellent qualitative coincidence were found between CLIA and LIA for the detection of anti-RNP, SSA/Ro60, SSB/La and CENPB (Kappa>0.75), while the coincidence rate foranti-Sm, dsDNA, Nuc and Rib-P detection were moderate (0.4

Clinical application and standardization of antiphospholipid antibodies tests / 中华检验医学杂志

According to the consensus criteria of antiphospholipid syndrome (APS),the diagnosis of APS requires the persistent presence of antiphospholipid antibodies (aPLs),indicating the critical role of aPLs in the diagnosis of APS.During the last decade,great efforts have been made to improve the laboratory detection and standardization of aPLs testing.Unfortunately,the heterogeneous nature of aPLs,lacking of standardization in aPLs test,and significant inter-laboratory variation have hampered the clinical application of aPLs test.In this commentary,the clinical application and standardization of aPLs test are focused on,and how to establish the standardization system in aPLs test in order to improve the performance of aPLs test in clinical practice are discussed.

Analysis of treadmill exercise test on patients with left main coronary artery or proximal anterior descending obstruction / 中国综合临床

Objective To explore the significance of treadmill exercise test (TET) in identifying left main coronary artery(LMD) obstruction from proximal left anterior descending(LAD) obstruction.Methods Patients with positive in the TET of the Central Hospital of Dalian from Jan.2008 to Dec.2013 were enrolled in this study and they were divided into LMD group with 21 cases and LAD group with 35 cases according to the results of coronary angiography.Retrospectively study was conducted to analyze the exercise time,the start time of ST segment change,the lead of ST segment between groups.Results Lead aVR ST segment elevation(≥0.10 mV) was 85.7％ (18/21) in the LMD group and 62.9％ (22/35) in the LAD group.Lead aVR ST segment elevation in the LM group was ((0.16 ± 0.07) mV,higher than in the LAD group ((0.11 ± 0.07) mV ; t =2.614,P ＜ 0.05).Accompany ST segment depression of leads and cumulative ST segment depression were (5.7 ±1.7) pcs and (1.13 ±0.42) mV in LMD group,significantly higher than those of LAD group((4.6 ± ± 1.8) pcs and (0.87 ± 0.32) mV ; t =2.314,2.634,P ＜ 0.05).The occurrence rate of ST segment depression (≥0.10 mV) in leads V2 and V6 were 33.3％ (7/21) and 90.5％ (19/21) in LM group,significantly higher than that in LAD group (11.4％ (4/35) and 62.9 ％ (22/35) ; x2 =3.990,5.105 ;P ＜ 0..05).The start time of ST segment deviation of LM group was significantly earlier than that of LAD group ((199.8 ± 70.8) s vs.(273.7 ± 127.3) s;t =-2.787,P ＜ 0.01).The differences were not statistically significant in terms of the exercise time between groups ((315.0 ± 120.0) s vs.(376.1 ± 110.0) s;t =-1.948;P ＞ 0.05),the rate for achieving target heart rate(33.3％ (7/21) vs.48.6％ (17/35) ; x2 =1.244 ; P ＞ 0.05) and the Duke score ((-11.8 ±7.2) vs.(-8.4 ±6.8) ;t =-1:772;P＞0.05).Conclusion Compare with patients with the LAD disease,ST segment elevation of lead aVR is significantly higher induced by treadmill exercise test in patients with left main disease.Meanwhile,the lead accompanied with ST segment depression is significantly higher,and the start time of ST segment deviation is significantly earlier.

Clinical analysis of 21 cases of pediatric bridging bronchus / 临床儿科杂志

Objective To explore the clinical diagnosis and treatment of pediatric bridging bronchus deformity and brid-ging bronchus with pulmonary artery sling. Methods The clinical data of the 21 cases of diagnosed bronchial bridge deformity and bronchial bridge with pulmonary artery sling, the imaging findings of all the echocardiography, MSCT chest scan, enhanced CT and reconstructive image were retrospectively analyzed. Results In 21 cases, 10 were diagnosed as bronchial bridge only, among which three cases had other types of congenital heart disease;11 cases were diagnosed of pulmonary artery sling with pulmonary artery sling, among which 8 cases had other types of congenital heart disease;their average age of the 8 cases were all younger than 2 years old, except one case;most of them had the symptoms of recurrent respiratory tract infections and parox-ysmal dyspnea. According to Wells, bronchial bridge was divided into type I and typeⅡ;15 cases were type I, 6 cases were typeⅡ, 10 patients with bronchial bridge only were all type I, 5 cases of typeⅡwere associated with pulmonary artery sling. All of the 6 cases were diagnosed as typeⅡassociated with pulmonary artery sling. Conclusions Infants and young children with clini-cal recurrent respiratory tract infections should be considered the possibility of bronchus bridge deformity, and should be paid more attention to the possibility of pulmonary artery sling. MSCT plain chest scan, enhanced CT and airway reconstructive im-age are the important ways to diagnose the disease.

Current status and prospects of antiphospholipid antibodies tests / 中华检验医学杂志

Antiphospholipid antibodies (APLs) are important for the diagnosis of antiphospholipid syndrome (APS),especially for predicting the risk of thrombosis and pathological pregnancy.However,the heterogeneity of antiphospholipid antibodies,lacking of standardization and significant interlaboratory variation binder the clinical application of APLs and better understanding of APS diagnosis and treatment.Therefore,it is urgent to establish a standardize system for antiphospholipid antibodies test and to improve the performance of the test and perform well-designed clinical evaluation.

The relationship between pulse pressure and urine microalbumin in patients with essential hypertension / 中国医师进修杂志

Objective To observe the influence of pulse pressure on renal injury in patients with essential hypertension (EH).Methods Two hundred and twenty-nine patients with mild-to-moderate EH completed 24 h ambulatory blood pressure monitoring.The patients were divided into 2 groups according to 24 h mean pulse pressure (MPP):EH 1 (24 h MPP ≥ 60 mmHg,1 mmHg =0.133 kPa) group (128 cases) and EH2 (24 h MPP ＜ 60 mmHg) group (101 cases).According to 24 h urine microalbumin and biochemical determination of renal function,the influence of pulse pressure on kidney function was observed and compared.Results The 24 h mean systolic blood pressure (MSBP) and 24 h MPP in EH1 group were significantly higher than those in EH2 group [(156.20 ±6.11) mmHg vs.(143.67 ±5.46) mmHg,(69.09 ±5.87) mmHg vs.(51.15 ±7.15) mmHg] (P ＜0.01),the 24 h mean diastolic blood pressure (MDBP) in EH2 group was significantly higher than that in EH1 group [(92.52 ±5.93) mmHg vs.(87.11 ± 5.52) mmHg](P＜ 0.01).The 24 h urine microalbumin in EH1 group was significantly higher than that in EH2 group [(104.80 ± 24.25) mg vs.(91.29 ± 24.03) mg] (P ＜ 0.01).There was positive correlation between 24 h MPP,24 h MSBP and 24 h urine microalbumin (r =0.259,0.201,P ＜ 0.01),and there was negative correlation between 24 h MDBP and 24 h urine microalbumin (r =-0.180,P＜ 0.01).Conclusion The 24 h MPP is closely related with the renal injury which is caused by high blood pressure in patients with EH.

Analysis of the Prevalence and Economic Burden of Diabetes in Guandu District of Kunming / 昆明医科大学学报

Objective To analyze the prevalence and economic burden of diabetes in Guandu district of Kunming. Methods We used probability proportional to size (PPS) sampling method to select representative sample of 4595 residents aged 18 or over from this district. Each participant received face to face questionnaire interview and physical examination. We applied different methods to measure the direct,indirect and intangible costs of diabetes. Results In the study population, the overall prevalence of diabetes was 6.2%,and females had higher prevalence of diabetes than males (6.2%vs. 5.6%, <0.05) . The DALY/1000 population of diabetes was 3.52, among which males and females were 5.18 and 6.70, respectively. Mean unit direct costs, indirect costs and intangible costs of diabetes were 3464.49 Yuan,84.48 Yuan and 4 045.97 Yuan,respectively. The total economic burden of diabetes was 401.84 million Yuan. Intangible costs represented the largest component of economic burden of diabetes,followed by direct costs. Conclusion The huge economic burden of diabetes has become the cause for concern in Guandu district. Effective measures are needed to reduce the economic burden of diabetes.

Clinical significance of different antiphospholipid antibody isotypes in systemic lupus erythematosus / 中华检验医学杂志

Objective To investigate the prevalence and clinical significance of different subtypes (IgG,IgM and IgA) of anticardiolipin antibodies (aCL) and anti-β2-glycoprotein Ⅰ antibodies (aβ 2GP1),as well as lupus anticoagulant (LA) in systemic lupus erythematosus (SLE).Methods IgG/IgM/IgA,IgG,IgM,IgA aCL and anti-β2GP1 were tested by enzyme-linked immunosorbent assay (ELISA) in 100 patients with SLE (42 patients were diagnosed as secondary antiphospholipid syndrome),44 healthy controls and 32 patients with other connective tissue diseases excluding SLE and antiphospholipid syndrome (APS).Meanwhile,LA was tested by modified Dilute Russell's viper venom time (dRVVT).The correlation between antiphospholipid antibodies and clinical manifestation was analyzed by Spearman correlation analysis.The postiverate of antiphospholipid antibodies in SLE patients,health controls and patients with other connective tissue diseases were compared by chi square test.The concentrations of antiphospholipid antibodies in different groups were compared using independent sample Kruskal Wallis test.The diagnostic efficacy of antiphospholipid antibodies in SLE patients was analyzed by crosstable using clinical diagnosis of APS as gold standard.P ＜ 0.05 was considered statistically significant.Results The prevalence of IgG aCL (x2 =15.031,P ＜ 0.001),IgA/G/M (x2 =11.678,P =0.003) and IgA (x2 =6.17,P =0.036) antiβ2GP1 were significantly higher in patients with SLE than in the other two groups.IgA/G/M (r =0.207,P=0.039),IgG (r=0.230,P=0.021) and IgA (r=0.217,P=0.030) aCL,IgA/G/M (r=0.218,P=0.029) and IgA (r =0.255,P =0.01) anti-β2GP1,as well as LA (r =0.233,P =0.02) were associated with thrombotic events.IgA/G/M anti-β2GP1 (r =0.22,P =0.029) and LA (r =0.254,P =0.011) were associated with pathological pregnancy.23.1％ (6/26) aCL positive SLE patients were IgM and/or IgA aCL positive.53.6％ (15/28) anti-β2GP1 positive SLE patients were IgM and/or IgA antiβ2GP1 positive.In SLE patients,the specificity and sensitivity of IgA/G/M aCL for APS were 98.3％ and 26.2％,respectively.The specificity and sensitivity of IgA/G/M anti-β2GP1 were 84.5％ and 40.5％,respectively.The specificity of at least two isotypes positive for APS (both aCL and anti-β2GP1 were 98.3％),was higher than IgG aCL (94.8％) or anti-β2GP1 (93.1％).The sensitivity of at least one isotype of aCL (47.6％) or anti-β2GP1 (42.9％) positive for APS were higher than IgG aCL (40.5％)and anti-β2GP1 (21.4％).Conclusions IgG and IgM aCL together would be better than IgA/G/M aCL for APS screening.IgA/G/M anti-β2GP1 would be better for APS screen due to higher sensitivity and strong association with thromboembolic events and pathologic pregnance.IgA aCL or anti-β2GP1 was associated with thromboembolic events.IgA aCL or anti-β2GP1 would be useful for APS diagnosis in IgG and IgM aCL or anti-β2GPl negative patients.

Influence of interbody fusion intervertebral fixation on adjacent joint degeneration in patients with lumbar diseases / 中国基层医药

Objective To explore the influence of interbody fusion intervertebral fixation on adjacent joint degeneration in patients with lumbar diseases .Methods 56 patients with lumbar diseases who were taken interbody fusion intervertebral fixation were selected as the research subjects ,and the adjacent intervertebral joint degeneration in patients were followed up .Results 56 patients were followed up for 24-72 months,the average time was (41.2 ± 8.3)months.The new clinical symptoms were occurred in 12 cases(21.4%),including 8 cases of low back pain, 3 patients with leg pain,1 case of lumbocrural pain.Radiographic changes occurred in 9 cases(16.1%),9 cases of patients with new clinical symptoms ,including 5 cases of osteophyte formation or exacerbation ,2 cases for adjacent segment instability ( I degree of vertebral spondylolisthesis ) ,1 case of small joint hyperplasia stage spinal stenosis , 1 case of protrusion of intervertebral disc .In 9 patients with imaging performance ,internal fixation of upper adjacent segment degeneration in 7 cases,internal fixation of the adjacent segment degeneration in 2 cases.Conclusion Inter-body fusion intervertebral fixation in the treatment of lumbar diseases ,adjacent joint is prone to degeneration ,so the destruction of adjacent joint operation should be reduced .