To investigate the relationship between plasma level of homocysteine(Hcy) and the methylenetetrahydrofolate reductase ( MTHFR ) gene polyroorphism with non-alcoholic fatty liver in patients with type 2 diabetes mellitus (T2DM). Methods In a case-control study, plasma levels of Hcy, folic acid (FA), vitamin B12 (VitB12), glycosylated hemoglobin Alc (HbAlc), fasting blood glucose (FBG), total cholesterol and triglyceride were measured in 159 T2DM patients with and without non-alcoholic fatty liver ( NAFL), as well as 52 normal controls. Mutation of the C677T of MTHFR gene was determined by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) for all of them. Results Patients of T2DM both without NAFL (96 case) and with NAFL had higher prevalence of hyperhomocysteinemia (Hhcy) (49% and 21%, respectively ) than normal controls did (4 cases, 8% ) (P<0.05), while patients of T2DM with NAFL had higher prevalence of Hhcy than those without it did (P <0. 05). Plasma level of Hey positively correlated to genotype frequency of the MTHFR gene, plasma 0levels of HbAlc and FBG in patients of T2DM, with coefficients of correlation of 0.248, 0.423 and 0.242, respectively (P < 0.05). Results of multiple logistic regression analysis showed that course of the disease, body mass index, plasma levels of FBG and Hcy all were independent risk factors for non-alcoholic fatty liver in patients with T2DM. Conclusions Hhey was an independent risk for non-alcoholic fatty liver and plasma level of Hey was influenced by frequency of the TT genotype of the MTHFR gene, plasma levels of FA and VitB12, as well as metabolic disturbance in patients with T2DM.

Objective To study the impedance detected by the whole blood electrical impedance aggregometry in evaluating the effect of antiplatelet therapy.Methods The imprecision of the two different assays(the whole blood electrical impedance aggregometry and the plasma light transmission aggregometry) was compared.Thirty healthy volunteers and 60 patients with coronary artery disease under antiplatelet treatment were enrolled in the present study,whose anti-aggregated blood were collected for the measurement of electrical impedance in the presence of ADP,arachidonic acid and collagen,respectively.Finally,we analysed the agreement between the results of the two different assays which were used to measured the antiplatelet effect of aspirin and clopidgrel.Results The imprecision analysis showed the CV,(the whole blood electrical impedance aggregometry was 4.8%,superior to the plasma light transmission aggregometry (CV = 7.7%).In healthy control group,the mean impedances were(9.6?3.4)?、(10.4?2.8)? and (13.5?2.2)? in the presence of ADP,arachidonic acid and collagen as in the patients taking aspirin 100 mg/day,the 95% patients' results were 0 ?.Furthermore,the mean impedance of patients taking aspirin 100 mg/day and/or clopidogrel 75 mg/day was significantly lower than that of healthy volunteers(ADP as agonist,t = 2.391,P

Objective To evaluate the safety and efficacy of ultrosonography-guided two-stage ERCP for management of emergent pancreatobiliary diseases during pregnancy.Methods The clinical data of 32 consecutive pregnant women with suspected emergent pancreatobiliary diseases,who were treated with two-stage ultrasonography-guided ERCP from January 2005 to May 2010,were analyzed retrospectively.All patients were treated with ERCP in two stages. In stage Ⅰ,all the patients underwent ultrasonographyguided biliary cannulation,sphincterotomy with small incision and plastic stent placement during pregnancy.In stage Ⅱ,routine ERCP was performed in two weeks after delivery.The success rate of first ERCP,relief of clinical manifestation,improvement of lab indices,maternal and fetal complications were evaluated.Results All patients presented with fever,biliary colic and jaundice.Abdominal ultrasonography or magnetic resonance cholagiopancreatography (MRCP) revealed dilated common bile duct (CBD) in all patients,with CBD stones in 24 and acute cholangitis in 8.Bile duct cannulation and stent placement were successful in all patients.All patients markedly improved after first ERCP,with laboratory indices significantly improved at 1week after the procedure ( P ＜ 0.01 ).In stage Ⅱ,CBD stones were retrieved in 24 patients under ERCP,including 2 cases of mechanical lithotripsy.Bile duct stenosis was found in 3 patients and plastic stents were replaced.Biliary bleeding occurred in 1 case,mild acute pancreatitis in another,with a complication rate at 6.25％.Patients and babies were followed up for 12 months and found to be healthy.Conclusion Twostage ultrosonography-guided ERCP is safe and effective for pregnant patients with emergent pancreatobiliary diseases,which might be regarded as the first choice for such patients to avoid radiation.

Objective To observe the treatment effects of the ultrashort wave diathermy on gentamycin-in- duced acute renal injury of rats.Methods Eighteen Sgrague-Dawley rats were randomly divided into a normal group(6 rats),a model group(6 rats)and a treatment group(6 rats),the treatment group was treated with ultra- short wave diathermy once a day for a total of 20 days.The observed indexes were NAG,RBP,?_1-MG,?_2-MG in the urine of rats;the SCr,BUN in the blood of rats were also tested and the pathological changes of the renal ob- served.Results The pathological injuries of those in the ultrashort wave treatment group was slighter than the con- trol group;the NAG,RBP,?_1-MG,?_1-MG in the urine and the SCr,BUN in the blood of treatment group were low- er than those of the model group(P

Objective To explore the influence of nonylphenol(NP) on the filial generation rats spatial learning and memory capacity which were exposed to the parent rat during its pregnancy. Methods At the first day of the pregnancy, the rats were divided into four groups, which were orally administered with NP at doses of 0,50, 100 and 200 mg/kg,respectively, on gestational days 9～15. Cognitive function was tested by Morris water maze and step-down test. The ultrastructure of hippocampus tissues were observed by electronic microscope.Result The escape latency extended ((61.14±5.92) s) and erroring time increased ((4.57±1.13)times) in Morris water maze, and step down latency extended ((37.5±6.3)s), step through latency shortened((97.8±11.0)s) and erroring time increased ((3.0±1.4) times) in step down test in the N P 200 mg/kg treated groups (P<0 05). The correspond indexes were separately (35.85±4. 29) s, (2.57±0.97) time, (27.1±3.8) s,(172.0±89.2)s and(0.9±0.7)time in control group. Compared to the control group, there were significant differences in the results of the water maze test and step-down test between NP 200 mg/kg and the control group (P <005). The changes of the uhrastructure were found among the hippocampus neurons of NP 200 mg/kg group that characterized with chromatin condensed,clumped in circa-nuclei and mitochondrial tumefaction and vacuolization.Conclusion Exposures to NP during gestation might decreased abilities of spatial learning and memory capacity on F1 rats significantly.

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.

Objective To determine the clinicopathologic characteristics and prognostic factors that may be used to predict the poor outcome of patients with borderline ovarian tumors. Methods All cases with borderline ovarian tumors treated in the West China Second University Hospital from January 2001 to June 2007 were analyzed retrospectively for elinicopathologic features, treatment parameters and outcome of treatment. Univariate and multivariate analyses were used to assess independent prognostic factors using the logistic regression model. Results The median age of 234 patients was 40. 1 years with a range of 14 to 80 years. There were 101 (43.2%), 94 (40.2% ) , 19 (8.1% ), 12 (5.1%) , 8 (3.4%) cases of serous, mutinous, mixed, endometrioid and clear cell tumors, respectively. Out of 234 cases, 182 (77.8%) underwent laparotomy and 45 ( 19.2% ) underwent laparoscopy. Seven women underwent laparoconversion. Fertility sparing surgery was performed on 119 cases (50.9% ) and radical surgery was performed on 115 cases (49.1% ). Totally 161 (68.8% ) patients had stage Ⅰ , 19 ( 8.1% ) had stage Ⅱ, 54 ( 23.1% ) had stage Ⅲ, and none had stage Ⅳ disease. Sixty-four women received postoperative chemotherapy. The median follow-up was 40 months with a range of 8 to 78 months. Recurrence was found in 26 cases (11.1%) during follow-up, and no tumor-related death was reported. The logistic regression model showed that surgery procedure ( OR=2.304, P=0.024), cyst rupture ( OR=2.213, P=0.038 ), stage ( OR= 4.114, P<0.01 ), microinvasion ( OR=2.291, P=0.046) and peritoneal implants ( OR=2.101, P = 0.016) were the five independent prognostic factors affecting recurrence. Conclusions Although patients with borderline ovarian tumors have an excellent prognosis, the risk of recurrence remains in some patients. Emphasis should be put on these patients with high risk factors and preventive strategies should be taken to prevent their progression.

Objective To evaluate the physiological and anatomic basis,indications,surgical skills, prevention of ureter injury and clinic outcomes of using high uterosacral ligament suspension(HUS)for correction of advanced uterine prolapse by the vaginal route.Methods Fifty women with advanced uterine prolapse underwent transvaginal HUS after vaginal hysterectomy with reconstruction of pubocervical and rectovaginal fascia to correct their uterine prolapse between June 2003 and September 2007.The average age of the women was 60.1 years.The mean follow-up period was 24 months(range 4-51 months).The degree of pelvic organ prolapse preoperatively and anatomic outcomes postoperatively were assessed with pelvic organ prolapse quantification system(POP-Q).Results The remnants of the uterosacral ligaments were clearly identified and palpated posterior and medial to the ischial spines by traction with a 24 cm long Allis clamp and used for successful vaginal vault suspension and reconstruction in all 50 consecutive advanced uterine prolapse patients.The ureter injury was avoided by complete knowledge of the ureter's course from the cervix/apex toward its insertion in the sacral region and how far outside of the uterosacral ligament,by uteri palpation and by suturing purposefully placed"deep"dorsally and posteriorly toward the sacrum,as well as by cystoscopy examination of the spillage of urine from both ureters.Mean POP-Q point C improved from 1.5 to-7.5 cm with a median follow-up of 24 months.If the successful HUS was defined as point C≤stage I prolapse,both the objective and subjective cure rates were as high as 100% with a maximum follow-up of 51 months.None of the 50 patients had repeat operation for recurrence of prolapse.There was no major intra-or postoperative complications,such as ureter and other pelvic organ injury.Conclusion HUS with fascial reconstruction seems to be a safe,minimal traumatic,tolerable and highly successful procedure for vaginal repair of advanced uterine prolapse.Because of the use of native tissue as suspension site HUS is more physiologic and cost effective.

Objective To construct adenovirus vector vaccine against H5N1 influenza virus and study on the immunogeuicity. Methods In this study, we amplified hemagglutinin (HA) gene sequence of H5N1 influenza virus (A/Anhui/1/2005), then constructed an adenovirus vector vaccine (Adv-HA), followed by tests in BALB/c mice for the immunogenicity with the vaccine and immunization strategies. Results The recombinate Adv-HA vaccine could effectively induce both humoral and cellular immunity against human H5N1 influenza virus. Conclusion The Adv-HA vaccination against H5N1 influenza is a potential strategy and worthy of further investigation.

Objective To evaluated the clinical results of treatment of osteonecrosis of the femoral head(ONFH)by using bone flap pedicled with gluteal muscle branch of ascending branch of the lateral femo- ral circumflex artery and transversal branch of the lateral femoral cireumflex artery.Methods Bone flap pedicled with double blood vessels was applied in 32 hips with stageⅡandⅢONFH according to the Fieat staging system.Fifteen hips were in stageⅡand 17 were in stageⅢ.All patients were followed up for a mean of 25 months(range,15-38 months)and were assessed clinically and radiologically according to Harris sco- ring.Selective digital subtraction angiography was performed in 9 cases to confirm the blood reconstruction of femoral head.Results Two cases underwent total hip replacement postoperatively.Preoperative and postop- erative Harris score were 55 and 88.6.Clinical success rate was 90.6% and radiological success rate was 87.5%.DSA demonstrated blood supply was found reconstruction in the necrotic femoral head.Conclusion Transplantation of bone flap pedicled with gluteal muscle branch of ascending branch of the lateral femoral circumflex artery and transversal branch of the lateral femoral circumflex artery appears to be a effective treat- ment for osteonecrosis of the femoral head,blood supply of bone flap and blood reconstruction of femoral head was confirmed.Early clinical results were satisfied.