Objective To explore the effects of hemodialysis and peritoneal dialysis on microinflammation of chronic renal failure（CRF）uremic patients and its relationship with cardiovascular disease.Methods A total of 120 CRF uremic patients treated in our hospital were divided into hemodialysis group(60 cases) and peritonealdialysis group(60 cases) according to the type of dialysis.After 6 months of treatment,the levels of C reactive protein(CRP)，tumor necrosis factor(TNF)-α，interleukin(IL)-1β，IL-6 btween the two groups were compared.Patients in the two groups were divided into the group with and without chronic heart failure(CHF) according to the presence or absence of combined with CHF,the levels of TNF-α、IL-1β，IL-6 in each group were compared.Results There were no significant differences in the levels of CRP,TNF-α,IL-1β，IL-6 between the two groups before treatment(P>0.05).After treatment,the levels of TNF-α,IL-1β，IL-6 in both groups were significantly reduced than the same group before treatment(P<0.05),the levels of TNF-α,IL-1β，IL-6 in the peritoneal dialysis group were lower than those in the hemodialysis group(P<0.05).In patients with CHF,the levels of TNF-α,IL-1β，IL-6 in patients of the group with heart failure were significantly higher than those in the same group of the group without heart failure(P<0.05).Conclusion Both hemodialysis and peritoneal dialysis can reduce the level of TNF-α,IL-1β，IL-6 in CRF uremic patients,and peritoneal dialysis is better.Microinflammation is correlated with cardiovascular disease.

Objective To explore the changes of thyroid stimulating hormone(TSH) and thyroid hormone(TH) levels in type 2 diabetic patients with different body mass index(BMI) and waist circumference(WC) and the influence of obesity on TSH and TH.Methods A total of 275 hospitalized patients with type 2 diabetes were collected.They were divided into the normal group(18.5kg/m²≤BMI<24kg/m²，88 cases),overweight group(24kg/m²≤BMI<28kg/m²，90 cases) and obesity group(BMI≥28kg/m²，97cases) according to BMI.The blood lipid levels and thyroid function among these three groups were compared.Then,them were divided into M1 group（male WC<85cm）,M2 group（male WC≥85cm）,F1 group（female WC<80cm）,F2 group(female WC≥80cm) according to gender and WC.Make a comparison among the above indexes among these groups.Spearman correlation analysis was used to analyze correlation and multiple linear stepwise regression was used for influence factor analysis.Results Compared with the normal group,TSH levels in the overweight group and obesity group were significantly increased(P<0.05).TSH level in F2 group was obviously higher than those in F1 group and M2 group,and free thyroxine（FT₄） level was lower than that in M2 group(P<0.05).The results of correlation analysis showed that BMI of type 2 diabetic patients was positively correlated with TSH(r=0.25,P<0.05),TC was negatively related with FT₃(r=-0.39,P<0.05),and BMI and WC were negatively related with FT₄(r=-0.31,r=-0.29,P<0.05).The results of multiple linear stepwise regression showed that BMI was an independent correlative factor for TSH,and WC was an independent correlative factor for FT4(P<0.05).Conclusion The TSH level of obese patients with type 2 diabetes is increased,and FT4 is decreased，which are more obvious in female patients with abdominal obesity than those in males.

Objective To explore the predictive value of QT interval after correction（QTc） prolongation in electrocardiogram for delayed neuropsychiatric sequelae(DNS) in patients with carbon monoxide(CO) poisoning.Methods Clinical data of 223 patients with CO poisoning were retrospectively analyzed,the patients were divided into DNS group(31 cases) and non-DNS group(202 cases).Univariate and multivariate logistics regression analysis were used to determine independent risk factors for DNS occurrence,the predictive value of QTc detecting time for DNS was evaluated by ROC curve.Results DNS occurred in 31 cases(13.3%) of the 233 patients with CO poisoning.Univariate logistic regression analysis showed that the Glasgow coma score(GCS)<9 points,transient loss of consciousness,CO exposure to prolonged hospital admission and QTc prolongation were associated with DNS(P<0.05).Multivariate logistic regression analysis showed that the GCS score<9 points,CO exposure to admission time>6h and QTc prolongation were independent risk factors for DNS deveplement(P<0.05).ROC curve analysis showed that QTc detection within CO exposure<2h,2~4h,4~6h had high predictive value for DNS development,and with the best predicted value of within 6 hours of CO exposure.Conclusion QTc prolongation within 6h of CO exposure is a new index for predicting DNS occurrence in patients with CO poisoning.

Objective To investigate the situation of vitamin D level in Chaoyang district of Beijing in recent two years,and explore the influencing factors of vitamin D deficiency and the correlation with blood lipid.Methods A cross sectional study was conducted to include 3905 subjects who underwent physical examination at Beijing first integrated traditional Chinese and western medicine hospital.Venous blood was taken to test 25-hydroxy-vitamin D[25(OH)D] and blood biochemical indexes.Multiple linear regression analysis was used to evaluate the correlation between 25(OH)D and blood lipid.Results The average serum 25(OH)D level of all subjects was(16.22±6.95) ng/ml,deficiency serious was found in 636 cases (16.29 %),deficiency was found in 2372 cases(60.74%),insufficiency was found in 713 cases(18.26%),plenty was found in 184 cases(4.71%).Subjects with different 25(OH)D levels had statistically significant differences in gender,age,weight,BMI,waist circumference,waist to hip ratio,systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG),uric acid(UA),creatinine(Cr),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C)(P<0.05).There were statistically significant differences in 25(OH)D levels among subjects of different gender(P=0.010),different BMI and gender(P=0.030) and physical examination in different season(P<0.001).Age distribution of subjects with different 25(OH)D levels was statistically significant(P＜0.001).The results of multiple linear regression analysis showed that 25(OH)D level was negatively correlated with TC(r=-0.35,P=0.016),TG(r=-0.28,P=0.046),LDL-C(r=-0.33,P=0.022),waist circumference(r=-0.30,P=0.035),waist to hip ratio(r=-0.30,P=0.032),and positively correlated with HDL-C(r=0.27,P=0.049).Conclusion Vitamin D deficiency in Chaoyang district of Beijing is common and should be paid attention.Vitamin D deficiency is associated with age,gender,seasonal variation，waist circumference,waist to hip ratio,BMI and blood lipid.

Objective To explore the efficacy and safety of radiofrequency catheter ablation for ventricular arrhythmias originated from the right ventricular outflow tract(RVOT-VAs)and its influencing factors.Methods According to the success of a single operation or not,256 patients with RVOT-VAs undergoing radiofrequency catheter ablation were divided into successful single operation group(196 cases)and unsuccessful single operation group(60 cases),then general data and operational data of them were compared.Binary logistic regression analysis was performed to evaluate factors that affect the efficacy and safety of operation.Results In 256 patients,immediate success rate,single operation success rate and recurrence rate were 88.3%,76.6% and 13.2% respectively.Proportion of patients combined with hypertension and organic heart disease,QRS waves with various forms,surgical complications and pericardial tamponade in successful single operation group were lower than those in unsuccessful single operation group（P<0.05）.Results of binary logistic regression analysis showed that combining organic heart disease,lack of experience for operators and target site of catheter ablation locating in free wall were independent risk factors for failure of single operation（P<0.05）.Persistent ventricular tachycardial and target site of catheter ablation locating in free wall were independent risk factors for immediate failure of the first operation（P<0.05）.Combining organic heart disease,lack of experience for operators,target site of catheter ablation locating in free wall and QRS waves with various forms were independent risk factors for recurrence after the first operation（P<0.05）.Advanced age and lack of experience for operators were independent risk factors for complications during the first operation（P<0.05）.Conclusion There is high success rate and safety of radiofrequency catheter ablation treating RVOT-VAs.Combining organic heart disease,target site of catheter ablation locating in free wall and the operator’s experience are important factors which affect the efficacy and safety.

Objective To explore the effect of Suramin on Cyclosporine A(CsA)-induced nephrotoxicity in rats and the relevant mechanism.Methods Forty male SD rats were randomly divided into control group,CsA group,CsA+Suramin(low dose) group and CsA+Suramin(high dose)group,with 10 rats in each group.After 5 weeks of administration,24h urine protein,α₁-microglobulin(MG),β₂-MG,N-acetyl-β-D-glucosaminidase(NAG),serum creatinine(SCr),blood urea nitrogen(BUN),uric acid(UA) and cystatin C（Cys C） in 4 groups were detected.The values of creatinine clearance(Ccr) were calculated.Masson trichrome staining was performed to estimate the degree of interstitial fibrosis.The expression of transform growth factor（TGF）-β₁，collagen-Ⅰand fibronectin were determined qualitatively by immunohistochemistry.The corresponding values of average optical density(AOD) of the above indicators were determined.Results The levels of α₁-MG,β₂-MG,NAG,BUN,UA and Cys C in CsA group were higher than those in control group,while the level of Ccr was lower than that in control group（P<0.05）.The levels of α₁-MG,β₂-MG,NAG,BUN,UA and Cys C in CsA+Suramin(low dose) group and CsA+Suramin(high dose)group were lower than that in CsA group,the level of Ccr was higher than that in CsA group（P<0.05）.The degree of interstitial fibrosis and the AOD of TGF-β₁，collagen-Ⅰ，fibronectin in CsA group were higher than those in control group,while the above indicators in CsA+Suramin(low dose) group and CsA+Suramin(high dose)group were lower than those in CsA group（P<0.05）.ConclusionSuramin may probably antagonize the nephrotoxicity induced by CsA.Down regulated expression of TGF-β₁ may probably associated with the mechanism of interstitial fibrosis.

Objective To investigate the characteristics of major adverse cardiovascular events(MACE) and the risk of all-cause mortality in patients with diabetes mellitus and sepsis within 30 days of hospitalization.Methods A total of 720 patients with sepsis were enrolled.According to whether or not with diabetes mellitus,the patients were divided into diabetic group（n=252） and non-diabetic group（n=468）.The occurrence of MACE and all-cause mortality as well as the characteristics of MACE occurred on the 1st to 15th day(D₁₅) and the 16th to 30th day(D₃₀) were compared between the two groups.Results The incidence of MACE in the diabetic group was 36.5%,which was higher than that in non-diabetic group(22.2%，P<0.05),but there was no statistical difference in the incidence of acute cerebrovascular accidents between the two groups（P＞0.05）.The incidence of all-cause death in patients with diabetes was 25.0%,which was higher than that in non-diabetic group（15.6%，P<0.05).The incidences of ACS,acute heart failure,severe arrhythmia and cardiogenic death in D₁₅ of the two groups were respectively higher than those of D₃₀ in the same groups(P<0.05),but there was no statistical difference in the incidence of acute cerebrovascular accidents between D₁₅ and D₃₀ in both two groups（P＞0.05）.Multivariate logistic regression analysis showed that diabetes was an independent predictor of MACE(P<0.05).Conclusion In patients with diabetes mellitus and sepsis,the incidence of MACE and all-cause death during the 30day hospital stay increases significantly.Effective control of blood glucose may reduce MACE and all-cause mortality in sepsis patients with diabetes mellitus.

Objective To evaluate the value of erythrocyte sedimentation rate(ESR)/C reactive protein(CRP) ratio combined with procalcitonin(PCT) in the differential diagnosis of systemic lupus erythematosus(SLE) activity and bacterial infection.Methods A total of 167 patients with SLE were divided into active group(SLE active patients,64 cases) and infection group(SLE patients with bacterial infection,103 cases).Levels of ESR,CRP,ESR/CRP ratio and PCT were compared between the two groups.Value of above indexes in differential diagnosis of SLE activity and bacterial infection was evaluated by receiver operating characteristic(ROC) curve.Results CRP and PCT in patients of active group were lower than those of infection group,while ESR and ESR/CRP ratio were higher than those of infection group(P<0.05).Sensitivity of PCT combined with ESR/CRP ratio in differential diagnosis of SLE activity and bacterial infection was higher than that of PCT,CRP,ESR/CRP ratio and PCT combined with CRP(P<0.05),while there were no significant differences among specificity of above 5 indexes（P>0.05）.Area under ROC curve(AUC) for differential diagnosis of SLE activity and bacterial infection by PCT combined with ESR/CRP ratio was higher than that of CRP,ESR,PCT,ESR/CRP ratio and PCT combined with CRP(P<0.05),and Youden index(YI) of CRP,ESR,PCT,ESR/CRP ratio was 0.36,0.23,0.40 and 0.54 respectively,whose corresponding values were 22.02mg/L,39mm/h,1.69ng/ml and 11.75 respectively.Conclusion Levels of PCT and CRP increase in SLE patients with bacterial infection.ESR/CRP ratio can be used as a new index to identify SLE activity and bacterial infection,and ESR/CRP ratio<11.75 indicates a high possibility of bacterial infection.PCT combined with ESR/CRP ratio can improve the differential diagnosis value of SLE activity and bacterial infection.

Objective To investigate the association between Hb/RDW and RPR to disease activity in rheumatoid arthritis（RA） patients.Methods A total of 102 RA patients(RA group) and 103 healthy subjects（control group） were enrolled.The hemoglobin to red cell distribution width ratio(Hb/RDW) and red blood cell distribution width-to-platelet ratio (RPR) were calculated and compared between two groups.Correlation of Hb/RDW and RPR with disease activity and difference of Hb/RDW and RPR before and after treatment in RA patients were analyzed.According to the Hb/RDW and RPR in RA patients,The receiver operating characteristic（ROC） curve were drawn to evaluate the diagnostic function of Hb/RDW and RPR in RA.Results The levels of Hb/RDW in RA group was decreased than those in control group while the RPR was increased（P＜0.05）.With the increase of DAS28, the Hb/RDW and RPR of RA patients decreased（P＜0.05）.Hb/RDW was negative correlated with ESR,CRP and DAS28 in RA patients(r=-0.381,r=-0.214,r=-0.319,all P＜0.05),whereas RPR was negative correlated with ESR,CRP and DAS28 (r=-0.295,r=-0.282,r=-0.278，all P＜0.05).Furthermore,compare with DAS28 before treatment in RA patients,DAS28 score obviously decreased after treatment,whereas Hb/RDW and RPR obviously increased（P＜0.05）.In addition,the area under the ROC curve of Hb/RDW and RPR for diagnosis of RA was 0.863（P＜0.001）and 0.567（P=0.098）.Conclusion The Hb/RDW has good sensitivity and specificity for the diagnosis of RA.Hb/RDW and RPR may be helpful to assess the disease activity and to evaluate the treatment of RA patients.

Objective To investigate the relationship between serum uric acid level and 25 hydroxyvitamin D₃[25(OH)VD₃] in women in the second trimester of pregnancy.Method A total of 221 women in second trimester of pregnancy were selected and their age,gestational weeks and other general data were collected.The liver and renal function,fasting plasma glucose(FPG),thyroid function and 25(OH)VD₃ levels were measured.According to the 25(OH)VD₃ levels,they were divided into vitamin D deficiency group[25(OH)VD₃<50 nmol/L] and vitamin D appropriate group[25(OH)VD₃≥50nmol/L].The clinical data of the two groups were compared and the factors influencing the level of 25(OH)VD₃ were analyzed.Results In 221 women of second trimester,vitamin D deficiency was present in 147 cases(67%) and Vitamin D was appropriate in 74 cases(33%).Levels of serum uric acid,thyrotrophin (TSH),gestational week in the vitamin D deficiency group were all lower than those in the vitamin D appropriate group,while levels of free thyroxine (FT₄),FPG and total bilirubin (TBIL) were higher than those in the vitamin D appropriate group,with statistically significant differences(P<0.05).Correlation analysis showed that 25(OH)VD₃ level in the second trimester of pregnancy was positively correlated with serum uric acid，TSH and gestational age，while was negatively correlated with FT₄ and TBIL (P<0.05).Logistic regression analysis showed that serum uric acid reduction was a risk factor for the deficiency of 25(OH)VD₃ (OR=1.008,P=0.024).Conclusion Vitamin D deficiency is common in women in the second trimester of pregnancy.The gestational age，serum uric acid,FT₄,TSH and TBIL are associated with the reduction of 25(OH)VD₃.Serum uric acid reduction is the main risk factor for 25(OH)VD₃ deficiency.