BACKGROUND:Many diabetic patients get microcirculation disturbance due to abnormal hemorheology In a long-term angiopathy,which finally induces severe complications.OBJECTTVE:TO observe the influence of Yishen decoction on hemorheology in patients with diabetes mellitus and diabetic nephropathy and compare with the healthy controls.DESIGN:Controlled observational experimentSETFING:First Clinical Medical College,Harbin Medical University.PARTICIPANTS:Seventy-six inpatients with diabetes mellitus were enrolled at Department of Integrated Traditional and Westem Medicine,First Clinical Medical College,Harbin Medical University from January 1998 to December 2000 as diabetes mellitus group.Sixty-five inpatients with diabetic nephropathy were selected at the same hospital from January 1994 to February 2001 as diabetic nephropathy group.130 healthy subjects,who did body examination,were selected at the same hospital in 1993 as control group,including 98 males and 32 females,with an average age of(42±12)years.All subjects in the three groups knew the program and agreed to participate in the experimont.METHODS:The patients received conventional treatment combined with Yishen decoction containing herba epimedii,herba leonuri,astragalus mongholicus,each 20 g,barbary wolfberry fruit,solomonseal rhizome,gold theragran,dioscorea root,rhubarb,each 15 g,cowherb seed 25 g,as well as sanguisuge 0.8 g(taken medicine after mixing with water).These Chinese herbs were decocted at a simmer(200 mL),taken in the morning and evening respectively for 4 weeks.2 mL venous blood was collected from fasting subjects in the case groups.Hemorheology was measured before and after treatment in the case groups,whereas in body examination in the control group MAIN OUTCOME MEASURES:Hemorheological indexes.RESULTS:A total of 76 subjects with diabetes mellitus,65 subjects with diabetic nephropathy and 130 healthy subjects were involved in the result analysis.①Whole blood viscosity,plasma viscosity and plasma fibrinogen levels were obviouslv higher in the subjects of the diabetes mellitus group compared with the control group before treatment(P＜0.05-0.01). These changes were more significant in subjects of the diabetic nephropathy group(P＜0.01).Hematocrit and erythrocyte sedimentation equation K value were obviously higher in the diabetic nephropathy group than the control group(P＜0.01)Whole blood viscosity level,hematocrit and erythrocyte sedimentation equation K value were markedly hiaher in the diabetic nephropathy group than the diabetes mellitus group before treatment(P＜0 05-0.01). ②Whole blood viscosity and plasma viscosity levels,hematocrit and erythrocyte sedimentation equation K value were remarkably decreased in the case groups and most recovered to normal(P＞0.05).CONCLUSION: Yishen decoction can ameliorate the hemorheology of diabetes mellitus and diabetic nephropathy patients.

Objective To discuss the application value of aer-barium sulphate double contrast radiograph in digestive tract diseases diagnosis. Methods The author analyzed 197 cases' images retrospectively which had positive performance in radiograph and had been clinical defined in our hospital from January to June 2008. Results In all these cases, there are 83 cases origin from mucous membrane which include inflammation, tumor and anabrosis; 24 cases origin below mucous membrane which include interstitialoma, lymphoma and scleroderma; 38 cases mainly changed in the shape, structure and position of organs which include hiatus hernia, Oblique inguinal hernia, diverticulum, malrotation of intestine and megacolon; 29 cases mainly changed in the power and function of organs which include functional disorder of esophagus, mesentery-compressed syndrome funtional disorder of small intestine and irritable colon; 17 cases' performance caused by the factor outside intestinal canal which include mesentery shift, stomach shift and small intestine shift, and other cases which include fistula between esophagus and mediastinum, rectovaginal fistula, foreign body in esophagus and small intestine ascariasis. Conclusion Aer-barim sulphate double contrast radiograph is the best method to diagnose the digestive tract diseases because it has forte as follow: convenient, easy prepared, less painful, large-scale examine limit and reliable diagnosis.

Professional education of nursing is an important means to bring up practical type of nursing talents.Combined with the existing problems in nursing profession's anatomy teaching of our college,we put forward some thoughts on modifying nursing anatomy course.

Objective To investigate the relationship between genetic polymorphism of N-acetyltransferase 2(NAT2) and susceptibility to bladder cancer.Methods Based on case-control study,NAT2 mutation alleles(NAT2*5,*6 and*7) were determined by ASPCR and PCR-RFLP in 78 patients with bladder cancer and 80 nontumorous patients.In addtion,the relationships between the genotypes and tobacco smoking,occupational exposure,high dose intake of meat or pathological characteristic of bladder cancer patients were analyzed.Results In the blood samples from 158 cases,the 4 alleles NAT2*4,NAT2*5,NAT2*6 and NAT2*7 were detected.The frequency of NAT2 slow genotypes was 29.5%(23/78) in patients with bladder cancer,which was significantly higher compared with 16.3%(13/80) in control patients(P

Objective To investigate the change of quality of life and urodynamics after the enterocystoplasty combined with clean intermittent self-catheterisation (CISC) in nonparalytic spinal cord dysfunction (NSCD) patients with neurogenic underactive bladder by the Medical Outcomes study 36-item short-form general health survey (SF-36). Methods The quality of life of 72 NSCD patients with NUB were measured by SF-36 questionnaire, who had been taken enterocystoplasty combined with CISC or only CISC according to urodynamic results. In total, 58(81% ) patients were successfully followed for one year by SF-36 questionnaire and urodynamic examination, including 30 men (mean age 27±5 year) and 28 women (mean age 26±4 year). The normal volunteers without lower urinary tract symptom were set as control group, including 20 men (mean age 28 ± 4 year) and 20 women (mean age 29±4 year). Results At the follow-up, physical role, vitality and social function of men and women were 55±14 and 45±15, 76±19 and 74±15, 52±19 and 59±13 respectively, significantly higher than those before the treatment (35 ± 10 and 32 ±11, 27 ± 18 and 33 ± 17, 40 ±12 and 34 ±15). The bladder compliance and maximum cystometric capacity were (320 ± 44 ) ml and ( 338 ±50)ml,(55±15)cm H2O and (60±17)cm H2O respectively, also significantly higher than those before the treatment (131±30ml and 140±35ml,5±3 cm H2O and 6±4 cm H2O). However, detrusor leakage point pressures were (6±2)cm H2O and (6±3)cm H2O respectively, significantly lower than those before the treatment (28 ±9 cm H2 O and 25 ± 6 cm H2O). Except for physical function and bodily pain, the all domains of quality of life in both men and women patients were significantly lower than those in control group. Only 17 % of men and 7 % of women believed "their health is better than that one year ago". There was no significant difference in the remission rate between men and women (89% vs 76%) in the patients with RUUTD before treatment. Conclusions It is suggested that urodynamic parameters are significantly improved. Many domains of quality of life were not improved and the reduced quality of life still occurred in NSCD patients with NUB using enterocystoplasty and CISC.

Objective To analyze the value of multi-slice spiral CT (SCT) scan in staging and subtyping of renal cell carcinoma (RCC). Methods The preoperative kidney SCT data and postoperative pathology results of 64 patients with RCC were retrospectively analyzed. The patients′ ages ranged from 33-78 years (average 54 years). There were 44 males and 20 females in the study group. According to the CUA Guidelines, the staging and subtyping of RCC were performed through the combined information of preoperative SCT attenuation in unenhanced, corticomedullary phase and enhancement pattern. The results were compared with the postoperative histopathological results. Results The SCT results showed 38 cases were clear cell RCC, 14 cases were papillary RCC and 12 cases were chromophobic cell RCC. Histopathological results showed that 40 cases were clear cell RCC, 16 cases were papillary RCC and 8 cases were chromophobic cell RCC. According to the standard of 40 HU of CT attenuation value, the sensitivity, specificity and accuracy were 75%, 79% and 78% for diagnosis of papillary RCC in the unenhanced phase. The sensitivity, specificity and accuracy by the standard of 90 HU of CT attenuation value was 90%, 88% and 89% for diagnosis of clear cell RCC in the corticomedullary phase. In chromophobic RCC, homogeneous enhancement was more common than in papillary RCC and clear cell RCC. There was no significant difference of staging and subtyping of RCC between SCT and pathological results (P>0.05). The accuracy of SCT in staging and subtyping of RCC was 88% in staging, and 89% in subtyping. Conclusions SCT is a useful preoperative tool to stage and subtype RCC

Objective To investigate clinical and pathologic features of hypertension patients with adre -noeorticotropic hormone ( ACTH)-independent adrenal hyperplasia , and to analyze the relationship between them . Methods The data of patients with ACTH-independent adrenal hyperplasia and hypertension was collected in Department of Urology , the First Affiliated Hospital of Zhengzhou University from Jan .2012 to Dec.2012.The clinical manifestations , endocrine examination results , imaging findings and the pathological changes of adrenal gland were retrospectively analyzed .Results 75 cases were followed-up.Among them, 39 cases were male and 36 were female.Their ages ranged from 20 to 74 years(with 47 as the average).Pathological results showed that diffusive hyperplasia was observed in 42 cases, tubercle hyperplasia in 26 cases, mixed corticomedullary patho-logical changes in 6 cases, and medullary hyperplasia in 1 case.No significant difference was found among diffu-sive, tubercle and mixed corticomedullary hyperplasia in clinical manifestations except for headache , endocrine examination results, or imaging findings(P>0.05).Conclusion There is no relation between clinical manifes-tations, endocrine examination results , imaging findings and pathological changes in adrenal gland for patients with ACTH-independent adrenal hyperplasia and hypertension .

AIM: To determine the distribution and frequency of functionally important allelic variants in the cytochromes P450 (CYP) 2C19, arylamine N-acetyltransferase 2 (NAT2), and thiopurine S-methyltransferase (TPMT) genes in the Han Chinese population and compare them with those of other ethnic populations.METHODS: Genotyping was carried out in a total of 210 unrelated Han Chinese volunteers derived from He-nan area. CYP2C19 variants ( * 2 and * 3), NAT2 variants ( * 6 and * 7), and TPMT variants ( * 3A, * 3B, and * 3C) were detected using polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP)assays. Detection of NA T2 * 5 and TPMT * 2 were performed using allele-specific polymerase chain reaction assays. RESULTS: Allele frequencies of CYP2C19 * 2 and * 3 occurred with 34.76 % and 6.4 %, respectively.Thirty-one persons ( 14.8 % ) carried two of these CYP2C19 alleles responsible for poor metabolizing activity.The frequencies of specif ic NAT2 alleles were 59.1%, 4.1%, 26.4 %, and 9.5 % for * 4 (wild-type), * 5(341C), * 6 (590A), and * 7 (857A), respectively. Genotyping of three different single nucleotide polymorphisms in the NA T2 gene revealed that the frequency of slow acetylators was 19.5 %. TPMT * 3C had an allelic frequency of 1.2 %. TPMT* 2, TPMT * 3A, or TPMT* 3B was not detected in the analysed samples. CONCLUSION: The overview of allele distribution for drug-metabolizing enzymes CYP2C19, NAT2, and TPMT among a Han Chinese population shows obvious difference to Caucasians. The data will be useful for clinical pharmacokinetic investigation and drug dosage administration to Han Chinese population.

Objective To assess the outcome of de-epithelialied ileocystoplasty combined with strengthened pelvic floor in patients with neurogenic bladder.Methods Twelve patients (9 male,3 female) aged from 18 -27 years (averaged 25 years) with neurogenic bladder received de-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor,and were evaluated by urodynamic parmeters,upper urinary tract image appearance,and serum creatinine before and one year after operation.Results After operation,the max cystometric capacity (412 ± 32 ml),bladder compliance (26.2 ± 4.0ml/H2O),relative safety cystometric capacity (368 ±26 ml) and max flow rate (20 ±3 ml/s) were respectively significantly higher than those preoperation(247 ±27 ml,4.4 ± 1.2 ml/cm H2O,206 ±24 ml,11 ±2ml/s,P ＜ 0.05).Moreover,the post voided residual (26 ± 8 ml) and detmsor leakage point pressure (17.8 ±3.6 cm H2O) were significantly lower than those of preoperation (136 ± 25 ml,63.1 ± 4.9cm H2O,P ＜0.05).The vesicoureteral reflux disappeared in five (63％) cases,and was relieved in the remaining three cases.Of the five cases with renal insufficiency,three (60％) cases had normal serum creatinine level,none had increased serum creatinine levels.After operation,late healing occurred in two ( 17％ ) cases,intestinal obstruction in one (8％),vesicoabdominal fistula in one (8％),and no cases had mucous urine.Clean intermittent self-catheterization was performed in one case (8％) to empty the bladder due to a fever resulting from urinary tract infection,the remaining 12 (92％) cases could empty their bladders through abdominal pressure.Conclusions De-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor results in a good outcome for the patients with neurogenic bladder.

Objective To investigate the relationships between genetic polymorphism of CYP2A6 alone or in combination with smoking and hereditary susceptibility to bladder cancer.Methods Based on case-control study,CYP2A6*4 was determined by the nested polymerase chianreaction(nPCR)in 186 patients with bladder cancer and 192 nontumorous controls.The relations between the genetypes of CYP2A6*4 alone or combinated with smoking and bladder cancer was estimated with the X2 test and logistic regression model.Results In the case subjects,the number of the wil/wil genetype was 168,the number of the wil/del genetype was 13,and the number of the del/del genetype was 5.In the control subjects,the number of the wil/wil genetype was 150,the number of the wil/del genetype was 32,and the number of the del/del genetype was 10.The frequency of CYP2A6 del allele was significantly lower in the case Subjects(9.68%)than the controls(21.88%,P＜0.05,OR:0.383).When eombinated with smoking,the risk of bladder cancer in smokers was significantly higher than nonsmoker(P＜0.05,OR=2.322).In smokers,the frequency of CYP2A6 del allele was significantly lower in cases(7.88%)than controls(28.00%,P＜0.05,OR=0.221).In smoking people,the one with CYP2A6 del genotype had a lower risk of bladder cancer than the one with CYP2A6 wild genotype(OR=0.221,95%CI:0.092,0.534).Conclusions Genetic polymorphisms of CYP2A6 are associated with the susceptibility to bladder cancer and have interaction with smoking in carcinogenesis of bladder cancer.Deficient CYP2A6 activity to genetic polymorphism mayreduee bladder cancer risk in smokers.