Table of Content

21 August 2016, Volume 37 Issue 4

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Change of cardiovascular disease risk factors in perimenopausal and postmenopausal women

Sun Yange, Ruan Xiangyan, Alfred O. Mueck

2016, 37(4):  413-417.  doi:10.3969/j.issn.1006-7795.2016.04.001

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Cardiovascular disease(CVD) is the common disease that damage the health of postmenopausal women. To prevent the CVD in the postmenopausal women, the occurrence and the change of CVD risk factors in this term should be understood. Risk factors can be defined as non-modifiable and modifiable. Non-modifiable factors include age, gender and heredity. Modifiable factors include hypertension, dyslipidemia, obesity, glucose intolerance, cigarette smoking, diabetes mellitus and sedentarism. We reviewed the change of modifiable factors in women in perimenopausal and postmenopausal women.

Cell toxicity and cell uptake study of pullulan acetate nanoparticles to BeWo b30 cells

Jiang Ziwen, Zhou Zhimin, Tang Hongbo, Du bo, Zhang Qiqing, Dai Yinmei

2016, 37(4):  418-423.  doi:10.3969/j.issn.1006-7795.2016.04.002

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Objective To provide evidence for application in obstetrics field of drugs during pregnancy and the mechanism of pullulan-base nanoparticles across the placental barrier by investigating the cell uptake of pullulan acetate nanoparticles and the cell toxicity of pullulan acetate nanoparticles to BeWo b30 cells. Methods The fluorescein isothiocyanate labelled pullulan acetate nanoparticles (PA-FITC NPs) were prepared by using dialysis method. The methods to investigate the characteristics involved particle size and distribution, zeta potential and morphology of nanoparticles using dynamic light scattering (DLS) and transmission electron microscopy. The growth curve of BeWo b30 and the cell toxicity of different concentration of PA-FITC NPs were studied by cell counting kit-8. The influence of different NPs concentration, incubation time and incubation temperature on cell up-taking were observed in this study.Results The prepared pullulan acetate nanoparticles are solid and spherical in shape. The mean diameter of PA-FITC NPs by DLS were (348.0±114.3) nm and the Zeta potential was (-26.0±5.1) mV. Cell viability in all concentration groups have no significant difference compared with the control group (P>0.05); higher PA-FITC NPs concentration and longer incubation time showed an increased cell uptake; cell uptake was decreased significantly after the temperature was reduced to 4℃. Conclusion The results demonstrated that there was no obvious toxic effect of pullulan acetate nanoparticles on BeWo b30 cells; There is a positive correlation between cell uptake and the concentration, incubation time and environment temperature of PA-FITC NPs.

Effects of Diane-35 on the glucose and lipid metabolism in patients with polycystic ovary syndrome

Li Yanglu, Ruan Xiangyan, Zhao Yue, Du Juan, Wang Lijuan, Cui Yamei, Alfred O. Mueck

2016, 37(4):  424-430.  doi:10.3969/j.issn.1006-7795.2016.04.003

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Objective To observe the effects of Diane-35 on polycystic ovary syndrome (PCOS), and to investigate its influence on hormone, glucose and lipid metabolism in PCOS patients. Methods Totally 100 patients diagnosed as PCOS were divided into two groups, metabolic syndrome (MS) group (n=64) and non-MS group (n=36), according to the MS criteria formulated by International Diabetes Federation (IDF). Hormone level and parameters of glucose and lipid metabolism were detected and compared between the two groups before and after treatment by Diane-35 for 3 months. Results The body mass index decreased significantly after treatment in MS group, while no obvious change in non-MS group. The serum testosterone and LH/FSH decreased in both groups (P<0.05). The total cholesterol in MS group slightly decreased, but increased significantly in non-MS group. The triglyceride in both groups increased significantly, especially in MS group, and the difference between the groups was statistically significant. HDL-C increased in both group, but only increased significantly in non-MS group (P<0.05). LDL-C decreased in MS group and increased in non-MS group without statistical difference, but the difference of between the groups was statistically significant. Fasting glucose decreased in MS group and increased in non-MS group significantly, and the difference between the groups was statistically significant. Fasting insulin decreased in MS group and increased in non-MS group without significant difference, and the difference between the groups was not significant. Conclusion Diane-35 can modify the menstrual cycle, and improve the hyperandrogenism such as hirsutism and acne, and do not deteriorate the glucose and lipid metabolism. PCOS treatment should combine diane-35 with diet and exercise, helping PCOS patients achieving the best effect.

Letrozole combined with low dose highly purified human menopausal gonadotropin for ovulation induction in clomiphene citrate-resistant infertile women with polycystic ovary syndrome: a prospective study

Zhao Yue, Ruan Xiangyan, Li Yanglu, Du Juan, Alfred O. Mueck

2016, 37(4):  431-436.  doi:10.3969/j.issn.1006-7795.2016.04.004

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Objective To evaluate the efficacy, safety and feasibility of letrozole (LTZ) combined with low dose highly purified human menopausal gonadotropin (Hp-HMG) in clomiphene citrate (CC)-resistant infertile women with polycystic ovary syndrome (PCOS). Methods Totally 120 infertile women with PCOS with CC resistance were enrolled for ovulation induction by LTZ combined with low dose Hp-HMG, together with 237 cycles. The primary study endpoints were the clinical pregnancy rate, the ovulation rate and the percentage of monofollicular development. The secondary efficacy endpoints included the number of ovulated follicles, serum level of estradiol and luteinizing hormone (LH) and endometrial thickness on the day of gonadotropin releasing hormone agonist (GnRH-a) triggering. The main safety parameters were the incidence of adverse events, including the early abortion, ovarian hyperstimulation syndrome (OHSS), and multiple pregnancy. Results The rate of cycle ovulation was 96.2% (228/237), the percentage of monofollicular development was 70% (166/237), cycle cancellation rate was 1.3% (3/237) and anovulation rate was 3.8% (9/237); 237 cycles achieved the periodic single pregnancy rate was 32.9% (75/228), the early abortion rate was 5.3% (12/228). Two twin gestation and 1 ectopic pregnancy; In 120 patients, the rate of cumulative clinical pregnancy was 65% (78/120). No severe OHSS, multiple pregnancy, local or systemic side effects were seen. Conclusion Letrozole combined with low dose Hp-HMG maybe an effective and safe choice for reducing hyperstimulation and increasing pregnancy rate for ovulation induction in CC-resistant women with PCOS.

Effects of Bailing capsules on metabolism in patients with polycystic ovary syndrome

Li Yanglu, Ruan Xiangyan, Zhao Yue, Du Juan, Wang Lijuan, Cui Yamei, Alfred O. Mueck

2016, 37(4):  437-443.  doi:10.3969/j.issn.1006-7795.2016.04.005

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Objective To observe the efficacy of Bailing capsules on polycystic ovary syndrome (PCOS), and to investigate its effects on glucose and lipid metabolism, liver and renal function. Methods A total of 90 PCOS patients were divided into study group (n=50) and control group(n=40). Study group was treated with Diane-35 combined with Bailing capsules, while control group was treated with Diane-35 alone. Parameters of glucose and lipid metabolism, liver and renal functions were analyzed and compared between the two groups before and after treatment. Results ① Total cholesterol significantly increased and HDL-C increased without significant difference after treatment; compared with control group, triglyceride in study group did not increase but increased in control group; Apo AI, Apo B increased and Lp(a) decreased significantly after treatment in both groups, but without significant differences between the two groups. ② Fasting glucose, insulin and HOMA-IR decreased more in study group than those in the control group after treatment. ③ There was no significant difference in creatinine and blood urea nitrogen after treatment, but uric acid decreased more than that before treatment in the study group. The parameters of renal function in control group changed without significant differences. ④ Parameters of liver function between the two groups before and after treatment had no significant differences. Conclusion Diane-35 combined with Bailing capsules can improve the glucose and lipid metabolism and insulin resistance, and protect renal function, and did not have negative effect on liver function. Therefore, Bailing capsules is effective and safe for PCOS patients.

Analysis of serum anti-Müllerian hormone levels in the main phenotypes of polycystic ovary syndrome

Wang Lijuan, Ruan Xiangyan, Cui Yamei, Zhao Yue, Du Juan, Li Yanglu, Yi Yingchun, Alfred O. Mueck

2016, 37(4):  444-448.  doi:10.3969/j.issn.1006-7795.2016.04.006

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Objective To analyze the serum anti-Müllerian hormone (AMH) levels, endocrine and metabolic characteristics in the main phenotypes of polycystic ovary syndrome (PCOS) groups and the controls, and evaluate the correlation between the AMH and these indicators. Methods A total of 174 PCOS cases were divided into four groups according to Rotterdam criteria and NIH recommendations, as follows:Group 1[polycystic ovary morphology (PCO) +oligo-anovulation (OA) +hyperandrogenism (HA)], Group 2 (PCO+OA), Group 3 (PCO+HA) and Group 4 (OA+HA). AMH, endocrine and metabolic levels were measured in serum. Results Serum anti-müllerian hormone levels:Group 1 (8.54±2.40) ng/mL > Group 2 (6.95±1.96) ng/mL > Group 3 (5.64±1.79) ng/mL > Group 4 (4.36±1.74) ng/mL > Controls (2.55±1.15) ng/mL. Conclusion AMH levels were higher in PCOS cases than in controls, with differences comparing the phenotypes. AMH levels correlate best with PCO. AMH has a positive correlation with the testosterone (T), number of follicles 2-9 mm and ovarian volume, has a negative correlation with estradiol (E2).

Effect of polycystic ovary syndrome on pregnancy outcomes

Li Yanglu, Ruan Xiangyan, Alfred O. Mueck

2016, 37(4):  449-453.  doi:10.3969/j.issn.1006-7795.2016.04.007

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Polycystic ovary syndrome (PCOS) is a most common endocrine and metabolic disorder in women of reproductive age. Most studies suggest that insulin resistance, hyperandrogenism and obesity play an important role in the pathophysiology of PCOS. Adverse pregnancy and neonatal outcomes, such as Gestational diabetes mellitus, pregnancy-induced hypertension, are always observed clinically. Therefore, we review the relative factors about adverse outcomes, for example, the development competence of follicles and embryos, the endometrial receptivity in PCOS women, and the relationship between PCOS and pregnancy complications, in order to investigate the effects of preconceptional anti-androgenic treatment on pregnancy outcomes.

Diffusion tensor imaging in brain white matter of AIDS patients with normal appearance on conventional MRI by using tract-based spatial statistics

Li Ruili, Mi Haifeng, Li Hongjun, Ren Meiji, Zhao Jing, Yuan Da, Wang Wei

2016, 37(4):  454-459.  doi:10.3969/j.issn.1006-7795.2016.04.008

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Objective To analyze the microscopic changes of white matter (WM) in acquired immunodeficiency syndrome (AIDS) patients with normal appearance on conventional magnetic resonance imaging (MRI) by diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS). Methods Twenty-two acquired immunodeficiency syndrome (AIDS) patients with normal appearance on conventional MRI (patient group) and 23 healthy volunteers (control group) with matched age and sex were recruited. Siemens 3.0T magnetic resonance scanner was used for DTI data acquisition. DTI parameters of WM, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were compared between the two groups with TBSS. DTI indices with significant difference were further extracted from AIDS patients, correlation analysis was used between DTI indices and CD4⁺ T cell counts. Results Compared with the control group, significantly increased MD were found in several white matter regions including the genu of corpus callosum (GCC), body of corpus callosum (BCC), splenium of corpus callosum (SCC), bilateral anterior corona radiation (ACR), superior corona radiation (SCR), posterior corona radiation (PCR), the left anterior limb of internal capsule (ALIC), external capsule (EC) and cingulate gyrus (CIN-CG) in patient group (P<0.05, corrected by TFEC and FWE); Significantly increased AD were found in the GCC, BCC, SCC, bilateral ACR, SCR, PCR, ALIC, EC and CIN-CG in patient group (P<0.05, corrected by TFEC and FWE). There was more white matter impairment in left hemisphere than that in the right. Corpus callosum and bilateral corona radiata were the larger brain damage regions. The differences of FA values and RD values in every region were not significant between the two groups (P>0.05, corrected by TFEC and FWE). In patient group, significantly negative correlation was found between MD values and CD4⁺ T cell counts in significant clusters (r=-0.457, P=0.034). Conclusion White matter integrity was significantly reduced in extensive regions among AIDS patients with normal appearance on conventional MRI. The pathological features may be the abnormalities in axonal. The involved brain areas mainly related to memory, intelligence and cognitive controls. DTI and TBSS analysis can sensitively discover the white matter microstructure injury in AIDS patients with normal appearance on conventional MRI.

Analysis and comparison of radiographic characteristics of neurosyphilis in patients with and without AIDS

Li Li, Li Hongjun, Ren Meiji, Zhao Jing

2016, 37(4):  460-464.  doi:10.3969/j.issn.1006-7795.2016.04.009

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Objective To analyze and compare radiographic characteristics of neurosyphilis in patients with and without acquired immunodeficiency syndrom (AIDS) radiographic characteristics. Methods CT and MRI findings were analyzed retrospectively in 8 cases of AIDS with neurosyphilis and 23 cases without AIDS neurosyphilis, the differences of imaging findings were compared between the two groups. Results There were 16 cases with encephalitis, 13 cases with brain atrophy, 8 cases with cerebral infarction, 7 cases with meningitis, 1 case with cerebral gumma, 3 cases with normal imaging findings; Fourteen cases showed the coexistence of various forms of lesions, encephalitis was the main change. There was no statistically significant difference in imaging findings between the two groups. Conclusion The imaging appearance of neurosyphilis is various. Imaging appearance of neurosyphilis include encephalitis, brain atrophy, cerebral infarction, meningitis and cerebral gumma.

Comparative study of shear wave velocity and diffusion MRI for hepatic fibrosis in patients with chronic hepatitis B.

Dong Changfeng, Zeng Zheng, Liu Yingxia, Li Hanying, Chen Xin, Luo Yongfang, Shan Lingbo, Huang Hua, Lu Puxuan

2016, 37(4):  465-471.  doi:10.3969/j.issn.1006-7795.2016.04.010

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Objective To compare the value of shear wave velocity (SWV) and intravoxel incoherent motion diffusion MRI (IVIM) in evaluating the stage of hepatic fibrosis in patients with chronic Hepatitis B. Methods Totally 223 patients with HBV infection who underwent liver biopsy were selected into this research, they were divided into four groups:mild hepatic fibrosis (F1), obvious hepatic fibrosis (F2), serious hepatic fibrosis (F3), cirrhosis (F4). Eighty normal subjects were chosen as control group. The SWV of all hepatic segments s5, s6, s7, s8 and their average value were measured; 39 patients of different degrees hepatic fibrosis and 19 normal subjects accepted IVIM, the diffusion parameters (D, f, D^*) were measured. Results Among these 5 groups, the SWV of all hepatic segments had significant difference (P<0.05) except for the segment s5 between control and F1 group (P>0.05), with the development of hepatic fibrosis, SWV increase gradually. The cut-off value of ≥ F1, ≥ F2, ≥ F3 and F4 was separately 1.22 m/s, 1.30 m/s, 1.45 m/s and 1.60m/s, SWV had fine sensitivity of 92.82% and 90.12% for liver fibrosis F1 and F2, as it comes to F3 and F4, SWV get fantastic specificity of 92.27% and 95.93%. The diagnostic accuracy of SWV expressed as area under receiver operating characteristic curve (AUROC) was 0.887, 0.920, 0.952 and 0.954 for the diagnosis of hepatic fibrosis ≥ F1, ≥ F2, ≥ F3 and F4. The mean D, f and D^* values of IVIM measured in patients with hepatic fibrosis were obviously smaller than healthy subjects. As the fibrosis severity progressed, f and D^* values decreased, a trend towards lower f and D^* with the increase of fibrosis stages was statistically significant (P<0.05). f and D^* values had the ability to distinguish different fibrosis stages of F2 between F1, the best cut-off points were 0.135, 9.928×10^-3 mm²/s, respectively. Conclusion SWV could accurately evaluate the stage of obvious hepatic fibrosis in patients suffering from chronic hepatitis B; IVIM could distinguish mild liver fibrosis from obvious hepatic fibrosis, the combination of them were suitable for clinical use.

CT imaging appearances and pathology results of AIDS related lymphoma

Hu Tianli, Liu Jinxin, Zhang Lieguang, Jiang Songfeng, Chen Bihua, Guan Wanhua

2016, 37(4):  472-476.  doi:10.3969/j.issn.1006-7795.2016.04.011

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Objective To analyze and investigate the CT imaging features and pathological results of AIDS related lymphoma, improving the cognition of acquired immunodeficiency syndrome (AIDS) related lymphoma. Methods Data of 39 cases with biopsy-pathologically proved AIDS-related lymphoma (ARL) were retrospectively analyzed, the specific imaging features of ARL were summarized. Results All the pathological types of 39 cases with ARL were non-Hodgkin's lymphomas (NHL); There were 39 lymphomas of lymph node, the main manifestations were enlargement of lymph nodes, including axillary lymph nodes (n=16), cervical lymph nodes (n=9), mediastinal and lung lymph nodes (n=7), abdominal lymph nodes(n=6), inguinal lymph node (n=1); there were 34 extranodal lymphomas, the main manifestations were space-occupying lesions, including soft tissue mass (n=20), liver (n=12), bone/cartilage (n=10), digestive tract (n=8), lung (n=6), adrenal gland (n=4), kidney (n=3), spleen (n=3), pancreas (n=2), muscle (n=2), parotid (n=1), cholecyst (n=1), prostate (n=1), seminal vesicle (n=1) and bladder (n=1), respectively. Conclusion NHL is the primary type of ARL. The main imaging features were extensive lymphnodes involvement and extranodal lesions. Though the imaging manifestations of AIDS complicated with lymphoma were well correlated with pathology findings, the imaging findings still need to be combined with pathological findings to obtain definite diagnosis.

Application value of HRCT in diagnostic imaging and therapy guidance of urinary tuberculosis

Wang Dong, Lu Puxuan, Yuan Hong, Deng Qunyi, Li Jingjing

2016, 37(4):  477-480.  doi:10.3969/j.issn.1006-7795.2016.04.012

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Objective To investigate the 36 cases of urinary tuberculosis on high resolution computed tomography (HRCT) appearances and the value of imaging in guiding therapy, and to improve the diagnostic consistency rate and provide the basis for standard treatment. Methods A retrospective analysis of 36 cases of urinary tuberculosis cases confirmed by pathology and clinical data, to study HRCT scanning technique of urinary tuberculosis, imaging findings of CT plain and enhanced scan and to evaluate HRCT in the role of urinary tuberculosis treatment options.Results (1) Of 36 cases of urinary tuberculosis HRCT scan and enhancement were found in 3 patients with early renal tuberculosis, characterized by small low density lesions in the renal parenchyma. (2) In the renal multiple petal shaped low-density area in 25 cases, renal diffuse calcification that since the cut in 2 cases, renal cortical atrophy thinning in 4 cases, 10 cases of renal atrophy, renal pelvis or light wall thickening in 4 cases; Three cases of retroperitoneal lymph nodes of visible multiple sizes. (3) The HRCT scan and enhancement, infringement on the scope and degree of viscera and the surrounding tissue to evaluate and swollen lymph nodes, according to this decision on operation mode and operation time. Conclusion renal parenchyma in smaller low-density lesions, within multiple petal shaped low-density lesions after enhancement scanning area disc wall showed cricoid moderately delayed reinforcement, and irregular calcification is the imaging characteristics of renal tuberculosis. Based on HRCT imaging performance characteristics can provide objective basis for the choice of clinical treatment.

Review for the HIV-associated neurocognitive disorders by magnetic resonance imaging

Zhan Yi, Shi Yuxin

2016, 37(4):  481-485.  doi:10.3969/j.issn.1006-7795.2016.04.013

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Human immunodeficiency virus (HIV) can infect the brain tissue through the blood brain barrier, causing central nervous system (CNS) disorders, resulting neurocognitive disorders, that is the HIV-associated neurocognitive disorders (HAND). The traditional diagnosis of HAND is though the detailed the neuropsychological test and clinical follow up, however the sensitivity of it is not enough. The magnetic resonance imaging (MRI) is the major the method of detect the abnormality of the CNS, by the high resolution and multiple imaging technique. Related studies showing, MRI related technique contribute to to early detection of neurocognitive disorder, therefore, this article review the current studies.

Analysis on bacterial drug-resistance in the sputum culture of patients with coal worker's pneumoconiosis associated with chronic obstructive pulmonary disease

Yang Pinna, Liu Gang, Tian Jinghua

2016, 37(4):  486-490.  doi:10.3969/j.issn.1006-7795.2016.04.014

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Objective To understand the distribution and drug resistance status of the pathogenic bacteria in patients with coal worker's pneumoconiosis (CWP) associated with chronic obstructive pulmonary disease (COPD). Methods Retrospective analysis was performed on the sputum culture and drug susceptibility test results from 102 patients with CWP associated with COPD who were admitted to Beijing Mentougou Hospital. Results A total of 275 sputum specimens were collected from the enrolled patients, from which 212 pathogenic strains were isolated, including 23 Gram-positive bacterial strains (10.85%), 159 Gram-negative bacterial strains (75%), and 30 fungal strains (14.15%). The pathogenic bacteria were primarily Gram-negative bacilli, with Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Baumanii being the most common; resistance to imipenem was not detected with Gram-negative bacteria, which were susceptible to piperacillin/sulbactam and aminoglycosides; Staphylococcus aureus had the highest detection rate among the Gram-positive bacteria, which were detected with no resistance to vancomycin and low resistance rates to piperacillin/sulbactam and cephalosporins; the fungal infection was primarily caused by Monilia albicans, which had the lowest resistance rate to amphotericin. Conclusion The pathogenic bacteria for CWP associated with COPD are mostly Gram-negative bacilli. There is significant bacterial resistance to the commonly used antibiotics. It is essential to prevent bacterial resistance to antibiotics to promote rational use of antibiotics.

Significance of the detection of anti-neuronal antibodies in the diagnosis of paraneoplastic syndrome of nervous system

Lyu Hong, Wu Yuan, Wang Lijuan, Zhang Guojun

2016, 37(4):  491-494.  doi:10.3969/j.issn.1006-7795.2016.04.015

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Objective To evaluate the significance of the detection of anti-neuronal antibodies in the early diagnosis of paraneoplastic syndrome (PNS) of nervous system (PNSNS). Methods We detected anti-Hu, anti-Yo, anti-Ri, anti-Ma2/ta, anti-CV2, anti-Amphiphysin antibodies of 68 sera by neuronal antigen spectrum of IgG antibody kit (amount medical laboratory diagnostics ag); Results Of the 48 PNS samples, 6 (6/48, 12.5%) were positive for anti-neuronal autoantibodies, among which, 4(23.5%) positive samples were from Group A (demyelinating diseases), 2 (10.0%) positive samples were from Group C (Guillain-Barre syndrome); samples from Group B (motor neuron diseasse) and D (Healthy control) were all negative. There was a trend of higher ratio of anti-neuronal antibodies positive rate in PNSNS group than healthy control group, although the data failed to reach a statistical significance. Conclusion The detection of anti-neuronal antibodies might be a credible method in the early diagnosis of PNSNS.

Evaluation of anti-interference capability of HBV DNA quantitative reagents according to CNAS CL-36 criterion

Fang Fang, Chen Kelin, Chen Yan, Huang Zeyu, Lyu Hong, Liu Shujing, Zhou Jin, Zhang Guojun, Kang Xixiong

2016, 37(4):  495-499.  doi:10.3969/j.issn.1006-7795.2016.04.016

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Objective To evaluate the anti-interference capability of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) quantitative reagents. Methods HBV DNA positive serum samples with critical concentrations, low, medium and high were collected. The analysis of interference was performed in four HBV DNA positive samples with hemoglobin (Hb) ranging from 1.63 to 17.25 g/L or total bilirubin (TBIL) ranging from 26.55 to 497.50 μmol/L by quantitative real-time polymerase chain reaction (q-RT-PCR). According to criterion of China National Accreditation Service for Conformity Assessment (CNAS) CL-36, if the bias is higher than and equal to ±7.5%, there will be interference with the detection of HBV DNA. Results All of the HBV DNA positive sample were subjected to interference with Hb ranging from 7.75 to 17.25g/L, and were not subjected to interference with Hb less than or equal to 3.50 g/L. For TBIL ranging from 274.60 to 399.15 μmol/L, the sample with HBV DNA viral load 2.24×10⁸ IU/mL was the only one without interference. For TBIL=153.55μmol/L, only the sample with HBV DNA viral load 4.62×10² IU/mL was subjected to interference. None of the HBV DNA positive sample were subjected to interference with TBIL less than or equal to 26.55μmol/L. Conclusion The HBV DNA quantitative reagent has certain anti-interference capability:there was no interference effect on HBV DNA results when Hb is less than or equal to 3.50 g/L and TBIL is less than or equal to 26.55 μmol/L.

Fungal pathogens distribution and drug resistance of 399 stains fungi isolated in a hospital

Xu Xinmin, Li Min, Li Ruihong, Zhang Yan, Lu Yao, Wang Huizhu

2016, 37(4):  500-503.  doi:10.3969/j.issn.1006-7795.2016.04.017

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Objective To understand common fungal species and antifungal drug resistance in our hospital and to provide important evidences for rational use of antifungal agents in clinical practice. Methods We performed fungal culture for clinically collected specimens from January 2014 to December 2015, and used CHROMagar Candida chromogenic medium and API 20C AUX yeast identification kit to identify fungal species. ATB Fungus 3 susceptibility kits were used to test drug susceptibility. At last, we counted the composition of fungal species and sensitive rates of 5 kinds of antifungal drugs. Results We obtained a total of 399 strains of fungi. Urine was the main sample of clinical specimen and Candida albicans were the main strain (188 strains, accounting for 47.1%) in Candida. In filamentous fungi, Aspergillus fumigatus were the main strain (25 stains, accounting for 6.3%). The sensitivity of Candida albicans to antifungal drugs was more than 95%, but the sensitivity of Candida glabrata to azole was relatively low and only 65.1% for fluconazole. Aspergillus had a high sensitivity to amphotericin B, itraconazole and voriconazole. Conclusion Candida albicans was the main hospital fungal infection and amphotericin B and 5-flucytosine had high antifungal activity against this fungus. Candida glabrata had a higher resistance to azoles and clinically reasonable use of antifungal drugs according to the results of drug susceptibility is very important.

Common clinical manifestations of AIDS complicated with Pneumocystis pneumonia and the diagnostic value of a plasma 1.3-β-D-glucan test

Huang Shujing, Chen Ming, Dai Fangfang, Yu Yanhua, Ding Xiurong, Feng Xia, Lou Jinli, Li Hongjun

2016, 37(4):  504-508.  doi:10.3969/j.issn.1006-7795.2016.04.018

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Objective To investigate the common clinical manifestations of acquired immune deficiency syndrome (AIDS) complicated with Pneumocystis pneumonia and clinical value of plasma 1, 3-β-D-glucan (G) test in diagnosis of the Pneumocystis pneumonia in patients with AIDS. Methods This was a retrospective study on 83 human immunodeficiency virus (HIV)/AIDS patients with pulmonary infection in the ward of infectious diseases in Beijing Youan Hospital from April to September 2015. The results of G test were analyzed. Results receiver operating characteristic curve (ROC) analysis showed that the areas under the curve of G test was 0.836. The sensitivity and specificity of G-test were 86.36% and 84.61%; the positive predictive value (PPV) and negative predictive value (NPV) were 86.36% and 84.61%. Conclusion The levels of plasma 1, 3-β-D-glucan (G) could provide an effective laboratory diagnostic reference for Pneumocystis pneumonia in patients with AIDS.

Association between hemoglobin and metabolic syndrome: a five-year follow-up

Liu Xiangtong, Tao Lixin, Yang Kun, Li Haibin, Guo Jin, Guo Xiuhua

2016, 37(4):  509-512.  doi:10.3969/j.issn.1006-7795.2016.04.019

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Objective To explore the association between hemoglobin(Hb) and metabolic syndrome (MetS). Methods A total of 3773 individuals in Beijing Tongren Hospital, Dianli Hospital and Xiaotangshan Hospital from 2007 to 2012 were recruited in the study. The subjects were divided into four quartiles according to Hb. Multivariate logistic regression was applied for data analysis. Results There were 2 509 males (average 47.94±15.41 years old) and 1 264 females (average 46.63±12.90 years old). Five-year accumulated incidence of MetS was 14.52%. The average baseline Hb was significantly higher in the subjects with MetS[(144.46±13.47) g/L] than those without MetS[(141.00±14.70) g/L] (t=-5.49, P<0.001). Multivariate Logistic regression analysis revealed that after adjustment of age and sex, elevated baseline Hb was positively correlated to the higher risk of MetS. Compared with individuals with lowest Hb, subjects with highest Hb were more vulnerable to MetS (OR=1.439, 95%CI:1.113-1.859). Conclusion Hb is closely correlated with MetS and its components, and it can be used as a predictor of MetS.

Study on the relationship between individual activities of daily living and self-rated health among elderly people in Beijing

Li Lei, Sun Fei, Tang Zhe, Diao Lijun

2016, 37(4):  513-518.  doi:10.3969/j.issn.1006-7795.2016.04.020

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Objective To investigate both the prevalence of functional disability in each activity of basic activities of daily living (ADL) item and instrumental activities of daily living (IADL) item scales, then the association between each ADL and IADL item and the self-rated health was also explored among the elderly in Beijing. Methods The sample population consisted of 2 411 elderly people over 60, which were taken samples from urban and rural district in Beijing by stratified cluster sampling method. The investigations were completed by trained staff using questionnaires concerning demographic characteristics, living conditions and health status, and activities of daily living. Results In which interviewed, 6.38 percent and 40.21 percent of the subjects regarded themselves to be in very good and good health respectively, while 17.26 percent and 2.01 percent in poor health and very poor health. The dependence rates of basic ADLs and instrumental ADLs (IADLs) among the rural elderly were higher than that of urban elderly. For some items, as bathing, transport, shopping, walking 250 meters, cut own's toenails and up/down one floor, The dependence rates of female elderly were significantly higher than that of male elderly. Multiple logistic regression analysis revealed that items of both basic ADLs and instrumental IADLs were independently associated factors of self-rated health. Feeding (odds rate=7.51, 95% confidence interval:3.55-15.89) and Chair/bed transfers (odds rate=7.36; 95% confidence interval:4.29-12.64) were the leading items correlated with self-rated health. Conclusion Functional disability of daily living activities had significant effect on self-rated health among the elderly.

Analysis of automated chemiluminescent microparticle immunoassay for the screening of syphilis

Wang Kedi, Su Jianrong

2016, 37(4):  519-522.  doi:10.3969/j.issn.1006-7795.2016.04.021

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Objective Compared automated chemiluminescent microparticle immunoassay (CLIA) with conventional methods to analyze the results of CLIA for the screening of syhilis.Methods 36 000 serum samples were tested by CLIA for screening of syphilis, and the positive samples would be subjected to TPPA for furhter confirmation. Then the sensibility, specificity, positive prediction value and negative prediction value were calculated. Results The sensitivity and specificity of CLIA were 100% and 99.7%, respectively. When the value of S/CO value was 1.08, the Youden index reached maximum, the sensitivity and specificity of CLIA were 100% and 94.8%, respectively. Conclusion CLIA is suggested as a screening test for the diagnosis of syphilis.

Evaluation of the preoperative myometrial free margin (MFM) of type Ⅱ submucosal fibroids by transvaginal ultrasonography

Li Jinghua, Huang Wenyan, Zhang Rui, Ma Xuelian, Shi Congning, Li Wenjun, Feng Limin

2016, 37(4):  523-528.  doi:10.3969/j.issn.1006-7795.2016.04.022

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Objective To assess the preoperative myometrial free margin (MFM) of type Ⅱ submucousal fibroids by transvaginal ultrasonography (TVS) that will predict the surgical methods.Methods Charts from hysteroscopic 103 cases (TCRM, Observation group) and laparoscopic 87 cases total laparoscopic myomectomy (TLM), Control group myomectomies were performed between June 2010 and February 2015. We reviewed for preoperative TVS findings. Predictors included myoma number, diameter and the location of type Ⅱ submucosal fibroids at preoperative TVS. The surgical time, intraoperative bleeding, length of stay and hospital costs were recorded after surgery. Results There is no difference between the two groups in the myma number. The mean length of myometrial free margin was (5.88±1.60) mm, the length of the fibroids pseudocapsule to uterine mucosa was (2.78±2.16) mm, surgical time was (52.32±22.48) min, blood loss was (20.28±36.28) mL, the difference between the hemoglobin after and before surgery was (7.98±6.20) g/L, length of stay after surgery was (2.23±1.02) d and the hospital cost was (4 989.52±988.98) yuan in the group of hysteroscopic myomectomies. Meanwhile, in the group of laparoscopic myomectomies the mean length of myometrial free margin was (4.92±2.62) mm, the length of the uterine fibroids psuedocapsule to uterine mucosa was (9.450±6.284) mm, surgical time was (88.34±18.42) min, blood loss was (48.39±32.61) mL, The difference between the hemoglobin after and before surgery was (16.32±4.53) g/L, length of stay after surgery was (5.03±1.10) d and the hospital cost was (12 523.23±2871.08) yuan. Conclusion Hysteroscopic myomectomy of type Ⅱ submucous fibroids may be performed successfully and safely under the condition of MFM no more than 5 mm and the diameter of fibroid less than 65mm.

Aggressive blood pressure management on regional cerebral oxygen saturation in patients undergoing carotid endarterectomy

Wang Yunzhen, Yu Bin, Han Ruquan

2016, 37(4):  529-533.  doi:10.3969/j.issn.1006-7795.2016.04.023

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Objective To assess the effect of aggressive blood pressure management on regional cerebral oxygen saturation (rSO₂) of patients undergone carotid endarterectomy (CEA).Methods A total of 20 patients, aged from 49 to 75 years old, undergone CEA were included in the study. The baseline for MAP was calculated the day before surgery. The strategy of aggressive blood pressure management include that MAP was kept at baseline value during preclamp phase, elevated 10%-20% of baseline value during cross-clamp phase with SBP no more than 160 mmHg (1 mmHg=0.133 kPa) and then decreased 10%-20% of baseline value after clamp removal. Intraoperative bispectral index (BIS), rSO₂ monitoring were applied. The value of MAP, BIS and rSO₂ were recorded at different points of the surgery. Results The MAP was elevated about 11% of baselinevalue during clamping phase (P<0.05) and decreased about 11% of baseline value after clamp removal (P<0.05). The rSO₂ value detected from ipsilateral brain was significantly decreased during the cross-clamp phase (P<0.05), but the decreasing percentage in rSO₂ was less than 20% from preclamp value to cross-clamp value. Then, the rSO₂ was ameliorated to baseline value after clamp removal. Conclusion Aggressive blood pressure management is beneficial to improve rSO₂ for the patients undergoing CEA and prevent incidence of cerebral ischemia.

Influencing factors of hemorrhagic transformation in patients with acute cerebral infarction after non receiving thrombolysis agent

Liu Siwei, Jia Weihua, Zhou Lichun

2016, 37(4):  534-537.  doi:10.3969/j.issn.1006-7795.2016.04.024

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Objective To study the influencing factors of hemorrhagic transformation in patients with acute cerebral infarction after non thrombolytic therapy. Methods From February 2014 to August 2015, 196 cases of patients with acute cerebral infarction who were admitted to our hospital were treated with acute cerebral infarction. According to the occurrence of bleeding in patients with bleeding into the transformation group (54 cases), no bleeding transformation group (142 cases).Statistical data were collected and all indexes were analyzed by single factor. The risk factors of P<0.05 were analyzed by multi factor Logistic regression analysis. Results The two groups of atrial fibrillation, smoking history and drinking history were significantly different, with statistical significance (P<0.05). Two groups of hospital admission fasting blood glucose and low density lipoprotein-cholesterol (LDL-C) levels were significantly different, with statistical significance (P<0.05). Two groups of infarct size were significantly different, with statistical significance (P<0.05). By multivariate Logistic regression analysis, the independent factors that influence the hemorrhage transformation in patients with acute cerebral infarction were atrial fibrillation(OR=4.528, 95%CI:2.035-9.283, P=0.000), admission blood glucose(OR=1.083, 95%CI:1.040-2.243, P=0.000), LDL-C(OR=2.574, 95%CI:1.258-5.279, P=0.000) and large area of infarction (OR=2.728, 95%CI:1.382-6.907, P=0.000).Conclusion Atrial fibrillation, blood glucose, LDL-C and large area of infarction in patients with acute cerebral infarction are the risk factors of hemorrhagic transformation after acute cerebral infarction.

Study about the correlation of NK cell with early onset preeclampsia

Zhao Xiuling, Ma Hongmei, Ma Wei, Shan Zhijuan, Luo Li

2016, 37(4):  538-542.  doi:10.3969/j.issn.1006-7795.2016.04.025

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Objective To study the correlation of natural killer cell (NK) to early onset preeclampsia. Methods This research adopts the case-control study. 44 preeclampsia patients who were regularly checked up in BeiJing LUHE hospital from Jan 2012 to Dec 2014 entered the research. The group included 20 early onset preeclampsia patients and 24 late onset preeclampsia patients. The control group was normal patients at the same period. Collecting maternal peripheral blood umbilical blood and deciduas. We test percentage of NK cell in peripheral and umbilical blood by Flow cytometry. NK cells in deciduas were tested by immunohistochemistry. Results The courts of NK cells in maternal peripheral, umbilical blood and deciduas of early onset preeclampsia and late onset preeclampsia were all higher than those of the normal (P<0.05). It is significantly different. The counts of the NK cells in umbilical blood and deciduas were significantly higher than those of the late onset preeclampsia patients (P<0.05). The NK cell percentage in maternal peripheral blood in early onset preeclampsia patients were higher than in late onset preeclampsia patients. P<0.05. The courts of NK cells in maternal peripheral and deciduas was with negative correlation with course of preeclampsia.(r=-0.397, P=0.040;r=-0.391, P=0.044). It was positive correlation with the degree of elevation of pressure. (r=-0.597, P=0.001;r=-0.416, P=0.031). The courts of NK cells in deciduas was positive correlation with the time of diagnosis. (r=-0.594, P=0.003). Conclusion The counts of the NK cell in maternal peripheral blood, umbilical blood and deciduas in preeclampsia patients were significantly higher than those of the control. Early onset severe preeclampsia increased significantly. NK cell in maternal peripheral blood and deciduas probably play a role in early onset preeclampsia.

Clinical guiding significance of abdominal viscera on the lateral lumbar X-ray in lateral puncture by spinal microendoscopy

Li Nan, Yang Jincai, Hai Yong

2016, 37(4):  543-549.  doi:10.3969/j.issn.1006-7795.2016.04.026

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Objective To explore the clinical guiding significance of trailing edge of abdominal organs on the lateral lumbar X-ray in lateral puncture by spinal microendoscopy.Methods A total of 50 patients who had abdominal enchanced computed tomography (CT) examination in our hospital were included in the present study. We divided the spine from L1 to S1 into 16 axial levels, including the vertebral upper (the cranial endplates), middle and the under margin (caudal endplates). Then we respectively measured vertebral sagittal diameter (L) in every level, and established a coordinate axis (establishing Y axis by the extension of vertebral sagittal diameter and establishing X axis through the midpoint of the rear margin vertebral which was set to be point O). We set the cross point of the parallel line of X axis and the tangent line of post-renal fascia and parietal peritoneum's arc to be point D the projection of which was named D', then we measured the distance between point D' and point O which was called OD'. We set critical puncture point to be point C which is the cross point of the skin and the tangent line of the post-renal fascia and parietal peritoneum's arc through point O and the projection on axis Y of point C was named C'. Then we measured the distance between point C and point O and called OC'. The critical puncture angle (α) which is the crossing angle of the line OC and X axis was measured, and finally we calculated the ratio of OD' and L, and the ratio of OC' and L.Results All of the data show that the location of the projection of the lowest point of the post-renal fascia and parietal peritoneum and the location of the projection of the critical puncture point turns from the back side of the vertebral rear margin to ventral side from L1 to S1, and they are in the same location on the vertebral posterior margin at the middle level of L4. The critical puncture angle is also on declare from L1 to S1, and is about 0° at the middle level of L4. All of the data show that there is no statistical difference between each side of the body in the lowest point of the post-renal fascia and parietal peritoneum, critical puncture point and critical puncture angle.Conclusion This research defines the safe line and the definite range of the puncture point and puncture angle from L1 to S1 according to the projection of the lowest point of the post-renal fascia and parietal peritoneum. It provided an anatomical reference for avoiding intra-operative injury of post-renal fascia or abdominal organs.

Correlation of white blood cell count and prognosis in patients with acute non-ST-segment elevation myocardial infarction

Li Qun, Wang Dezhao, Wang Jun, Hu Hongyu, Fu Qiang, Chen Wei, Guo Caixia, Chen Buxing

2016, 37(4):  550-554.  doi:10.3969/j.issn.1006-7795.2016.04.027

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Objective We aimed to evaluate the relationship between white blood cell count(WBC) and prognosis in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods We retrospectively enrolled 198 patients with NSTEMI and analyzed follow-up data. All patients were admitted to hospital after immediate detection of WBC. Mortality, re-infarction, revascularization, and stroke were the primary end point.Multivariate regression revealed prognostic factors. Results There was no significant difference of the baseline data except of heart rate and creatine kinase isozyme between two groups.We found that patients of WBC>11.0×10⁹/L group had more main adverse cardiovascular and cerebrovascular events(MACCE) at the time in hospital and in the six months after discharge than those of WBC≤11.0×10⁹/L group.In multivariate logistic regression analysis, WBC>11.0×10⁹/L (OR=2.942, 95%CI: 1.333-6.495, P=0.008) was independent predictors for MACCE at the time in hospital. In multivariate cox regression analysis, WBC>11.0×10⁹/L (RR=3.767, 95%CI:1.406-10.089, P=0.008) was independent predictors for MACCE in the six months after discharge.There was no significant differences of the baseline data except of heart rate and creatine kinase isozyme between two groups.We found that patients of WBC>11.0×10⁹/L group had more main adverse cardiovascular and cerebrovascular events(MACCE) at the time in hospital and in the six months after discharge than those of WBC≤11.0×10⁹/L group.In multivariate Logistic regression analysis, WBC>11.0×10⁹/L (OR:2.942, 95%CI:1.333-6.495, P=0.008) was independent predictors for MACCE at the time in hospital. In multivariate cox regression analysis, WBC>11.0×10⁹/L (RR:3.767, 95%CI:1.406-10.089, P=0.008) was independent predictors for MACCE in the six months after discharge. Conclusion The high WBC is an independent predictor of MACCE in patients with NSTEMI.