Recent studies show that the structure integrality and function are more important than the length of telomere in maintaining tumor cells reproduction and proliferation.Mammalian telomeres bound by a specialized six-protein(TRF1,TRF2,TIN2,RAP1,POT1 and TPP1 )complex known as telosome or shelterin,has fundamental role in the regulation of telomere activity,maintaining the length and protecting telomere chromosome terminal.Telosome is involved in the complex regulation of cell mitosis process.The study of the role of telomere binding protein complex in tumorigenesis is very important for searching new methods of tumor diagnosis and treatment.

Fractures of the femoral head (FFH) are mainly seen in young adults,and the majority mechanism is due to dashboard injury in crushing vehicles.FFH can be present with or without posterior dislocation of the hip joint.Except for periarticular pain and hip dysfunction,the typical signs include flexion,adduction and internal rotation of the hip and shortening of involved limb.CT and MRI get their popularity as diagnostic methods for FFH.An emergency open reduction should be indicated in the scenario of failed closed reduction in FFH with posterior dislocation,of FFH with femoral neck fractures,of unmatched head and acetabulum following closed reduction and of deteriorating sciatic nerve damage.Pipkin as well as Brumback classification is still the most popularly used methods,which have great significance for establishment of surgical strategy and prediction of prognosis.More and more clinical evidences show conservative care of FFH should only be indicated for non-displaced fractures or displacement less than 2 mm.These cases must meet the following criteria simultaneously,including stable hip joint,concentric head and acetabulum,no free fractured fragments in the joint space and no labrum entrapment.Operative care is naturally the treatment of choice.Surgical approaches for FFH are hot topics in recent years.In previous control studies to compare Kocher-Langenbeck (K-L) and Smith-Peterson (S-P) approach,it is revealed less operative time,less blood loss and better operative field you can get in S-P approach,however,the incidence of ectopic ossification is higher.Ganz approach,which is characterized by osteotomy of great trochanter,hip capsulotomy and surgical dislocation of the hip,is a novel pattern for operative care of FFH.Ganz approach can show the entire femoral head,while can not damage medial femoral circumflex artery (MFCA) and induce iatrogenic osteonecrosis of the femoral head (ONFH).Various screws are the main implants for the fixation of fractured femoral head.Osteoarthritis and ONFH are two principal complications following FFH,which not only closely associate with severity and mechanism of primary injury,but also correlate with reduction quality and iatrogenic factors.Artificial hip joint replacement is a rational choice for extremely comminuted femoral head and these FFH in the elderly.

Objective To explore a reasonable treatment for intertrochanteric hip fractures in the aged patients by comparing the fixation effects of cannulated compression screws and intramedullary fixation nails. Methods From January 1998 to December 2004, in our department 123 old patients with intertrochanteric hip fracture were fixed with cannulated compression screws or intramedullary nails. They were followed up and their complete clinic data kept. According to the Evans classification, of the 51 patients who received treatment with cannulated compression screws for their anterograde intertrochanteric hip fracture, 14 were type Ⅰ , 24 type Ⅱ , 10 type Ⅲ and three type Ⅳ , while of the 72 patients who received treatment with intramedullary nailing, 10 were type Ⅰ , 12 type Ⅱ , 28 type Ⅲ , 14 type Ⅵ , and eight retrograde intertrochanteric hip fractures. A retrospective comparison was made between the old patients treated with the two different fixation devices in terms of operative time, blood loss, transfusion, average hospitalization time, intraoperative and postoperative complications, functional recovery one year postoperatively and treatment expenses. Results The differences between the two groups in operative time, blood loss, transfusion, treatment expenses were of statistical significance (P0.05). Conclusions Cannulated compression screws should be chosen for old patients with anterograde intertrochanteric hip fractures of Evans types Ⅰ & Ⅱ or of Evans types Ⅲ & Ⅳ who are at a high risk, in a poor health or severely osteoporotic state. For patients with unstable Evans types Ⅲ & Ⅳ or with retrograde intertrochanteric hip fractures, intramedullary nails are suitable.

Objective To investigate the role of ERK1/2 signal pathway in the apoptosis of rat mesangial cells inhibited by TIMP-1.Methods The human TIMP-1 sense and antisense plasmid were transferred into rat mesangial cells through liposome,while mesangial cells transfected with pcDNA3 and non-transfected mesangial cells were used as control.After being stimulated with high glucose(HG 25mmol/L D-glucose)and PD98059(50 ?mol/L)for 24 hours,the apoptosis rate was measured by flow cytometry.The expression of ERK1mRNA was assayed by RT-PCR.The protein expression of p-ERK1/2 in the cell was analyed by ELISA.Results(1)The apoptosis rates of the non-transfected group,transfect pcDNA3 group,sense group and antisense group in the culture medium of high glucose withact PD98059,were(12.10?2.21)%,(11.90?3.34)%,(5.50?0.50)%and(20.70?3.41)%,respectively.The apoptosis rate of the sense group was significantly lower than that without transfection(P

Objective To analyze the factors influencing augmentation index (AI) by examining the AI changes in patients who received continuous ambulatory peritoneal dialysis (CAPD) therapy, and evaluate the artery elastic function situation. Methods The height, weight, blood pressure, blood indicators were detected in 46 CAPD patients (CAPD group) and 42 controls (control group). AI was managed by OMRON HEM-90OOAI, and the influencing factor was analyzed. Results Systolic blood pressure(SBP),diastolic blood pressure(DBP), pulse pressure, central aortic pressure and AIp75 (AI value, when pulse was 75 beats/min) in CAPD group were significantly higher than those in control group. Within CAPD patients,the AIp75, in female was significantly higher than that in nude [(96.67±8.95 )% vs (89.89±6.46)% ,P =0.022]. Simple correlation showed positive relationship in gender, age, SBP, DBP, pulse pressure and central aortic pressure with AI; and negative relationship in height, weight and weight index with AI; while there was no relationship between AI and all kinds of chemical examination indicators or dialysis years.Multiple linear regression analysis evidenced that gender,age, height, DBP and central aortic pressure of CAPD patients had linear regression relation with AI. Conclusions It indicates a decreased artery elasticity and an increased stiffness occurs in CAPD patients. AI has tight correlation with age, height, DBP and central aortic pressure, and is an non-invasive factor thai partially reflects the arterial elasticity. Central aortic pressure is relevant with aortic elasticity and rigidity closely. Measuring central aortic pressure is very imporrant for preventing cardiovascular accident.

Aim To set up a novel animal model of intra-abdominal adhesion and to determine whether the tissue plasminogen activator activity (PAA) in exudate can be taken as an indicator to judge the formation of the adhesion. Methods　Rats were randomly divided into 2 groups. Each animal in both groups was opened the abdominal cavity via midline laparotomy without any disinfectant measures. 2-cm section from the cecal end was clamped and ligated, 1-cm cecum of the section was cut, and another 1-cm end from the ligated site was kept. After the content in the end was extruded, the cecum was put back without using any antibacterial agent. Before the skin closure, an effective combination AMD (allantoin, metronidazole and dexamethasone in combination), was given (ip) according to 1.5 ml per 100 g body weight (60.6 mg·kg-1). The control group was injected (ip) the same volume of normal saline. After 6 h, the exudate was extracted from drainage-tube, with the rats varying posture, and after 1 kw, the rats were killed for examining the intra-abdominal adhesion. The values of PAA of exudate in both groups were analyzed by the relative operating characteristic curve (ROC). Results　In the control group, all 20 rats formed the adhesions, the amount of exudate=(1.25±0.09) ml, the number of WBC(×103)=(23.1±6.6) mm3 and PAA=(0.9±0.4) IU·ml-1 in the exudate of abdominal cavity. In AMD group, however, there was not the adhesion formations (0/20), the amount of exuade was (0.52±0.04) ml (P<0.01), the number of WBC (×103) (10.6±4.2) mm3 (P<0.01), and PAA (23.1±6.6) IU·ml-1(P<0.01) in exuade.ROC analysis indicated that if PAA >1.24 IU·ml-1 in the exuade, the adhesion was difficult to form, and vice versa. Conclusion　This animal model can be taken as an effective tool to evaluate the human adhesion related to multi-links on the pathogenesis, and the PAA in exudate an indicator to judge intra-abdominal adhesion formation.

A 52-year-old female presented with unexplained thrombocytopenia for 29 years and a prunosus plaque on the right cheek for 9 years.She had ever been treated with glucocorticoids,which resulted in a slight improvement of the condition,but the platelet count remained below the normal range.During glucocorticoid tapering,she had administrated traditional Chinese medicines for a long peroid.Recently,the plaque on the cheek became swollen and painful with a progressive decrease in platelet count.Routine blood test showed that the count of white blood cells and platelets was 3.0 × 109/L and 2 × 109/L respectively,and the concentration of hemoglobin was 85 g/L.Computed tomography (CT) scan revealed multiple liver hemangiomas,one of which in the left liver lobe measured 14 cm × 5.7 cm in size.After medical treatment,the giant hemangioma in the left lobe was resected.Thereafter,the platelet count increased to 120 × 109/L with the subsidence of swelling of the right cheek.Postoperative pathological examination confirmed a diagnosis of giant cavernous hemangioma of the liver with extensive intravascular thrombosis and thrombus organization.Based on these findings,the case was diagnosed as adult Kasabach-Merritt syndrome.

Objective To investigate the effect of time from myocardial infarction (MI) onset to percutaneous coronary intervention (PCI) on plasma matrix metalloproteinases (MMPs) level and left ventricle (LV) remodeling in patients with acute ST-segment elevation myocardial infarction of anterior wall,and the relationship between MMPs and left ventricular remodeling.Methods All patients with anterior wall STEMI undergoing PCI were divided into early PCI group (PCI within 18 h after MI onset) and delayed PCI group (PCI between 2 and 3 weeks after MI onset).Plasma MMP-2 and MMP-9 activities were assayed on admission,and at 2 days,1 week after admission.One-year follow-up was finished after PCI.Left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV) and left ventricle ejection fraction (LVEF) were measured by echocardiography at baseline and one year later to elucidate the effects of time from onset to PCI on LV remodeling and the relationship between MMP-2,-9 levels and LV remodeling.Results The MMP -9 activity at 2 days after myocardial infarction was lower in early PCI group than in delayed PCI group [(46±26)μg/L vs.(66±40) μg/L,P=0.000].The changes in LVEDV and LVESV (△LVEDV and △LVESV) were lower and the change in LVEF (△LVEF) was higher in early PCI group than in delayed PCI group [(10.9±6.2) ml vs.(15.0±6.0)ml,(-1.1±5.7) ml vs.(2.9±4.6) ml,(5.5 ±4.0) ％ vs.(3.8±3.4) ％,P=0.000,0.000 and 0.015].MMP-9 had positive correlations with △LVEDV and △LVESV,and a negative correlation with △LVEF at admission and after 1-year follow-up (r=0.32,0.36 and-0.29,respectively,P=0.000,0.000 and 0.001).Conclusions MMP-9 activity at admission is correlated with LV remodeling and LV function.Early PCI can reduce MMP-9 activity and improve LV remodeling after myocardial infarction.

Objective To study the solute clearance effect of the new concentrated anticoagulation hemodiaiysate of citrate for hemodialysis in patients with high risk of bleeding. Methods Forty-two kidney failure patients with high risk of bleeding were divided into two groups (Group A and Group B) according to their hemodialysis manners. Patients in Group A were hemodialyzed with bicarbonate hemodialysate with low-molecular-weight heparin (dalteparin) anticoognlation and those in Group B with the new citrate antieoagnlation hemodialysate prepared in our hospital without any other anticoagulant. Blood urea nitrogen (BUN) and creatinine (Cr) concentrations were measured before and after dialysis, and Kt/V and urea reduction rate (URR) were calculated. In addition, activated clotting time (ACT) and ionized calcium (iCa2+) concentration were also measured at the arterial and venous ends. Results ACT was extended and iCa2+ concentration decreased significantly at the venous end compared with those at the arterial end in Group B (P<0.01). BUN and Cr concentrations were markedly decreased after dialysis compared with those before dialysis in both groups (P<0.01), and no significant difference in solute clearance effect, as indicated by Kt/V and URR, was observed between Group A and Group B (P>0.05). Conclusion The solute clearance effect of the new concentrated anticoagnlation hemodialysate of citrate is excellent during hemodiaiysis in kidney failure patients with high risk of bleeding.

OBJECTIVE: To explore the prevalence, clinical feature and levels of protein carbonyl (PCO) in serum of type 2 diabetes mellitus combining obstrucitive sleep apnea syndrome (OSAHS). METHOD: Two hundred and three patients with type 2 diabetes were taken multi lead sleep detection and their AHI, age, height, body mass index (BMI),waistline, duration of diabetes, fast blood glucose, HbA1c level and level of PCO in serum were recorded. RESULT: The prevalence of OSAHS was 79.2% in 203 patients, serious apnea 30.4%, moderate apnea 45.4%, mild apnea 24.2%. BMI, waistline, fast blood glucose, HbA1c level and level of PCO in serum were higher in patients complicated with OSAHS (P < 0.01). HbA1c was independently and positively correlated with patients with OSAHS risk (P < 0.05, OR 6.11). The independent correlation factors of AHI included HbA1c level,BMI, waistline, duration of diabetes and level of PCO in serum,with HbA1c as the predominant factor (P < 0.05). CONCLUSION The prevalence of OSAHS was higher in patients of type 2 diabetes mellitus combining (OSAHS). Moreover, in these patients poor glucose control and aggravated protein oxidative injury were observed.
Body Mass Index ; Diabetes Mellitus, Type 2 ; blood ; complications ; Humans ; Prevalence ; Protein Carbonylation ; Risk Factors ; Sleep Apnea, Obstructive ; blood ; complications