Objective To explore the relationship between HbA1 c and carotid artery intima‐media thickness (CIMT) ,carotid arterial stiffness in diabetic patients with peripheral neuropathy. Methods A total of 220 subjects were enrolled in this study and divided into three groups:T2DM group (n=60) ,DPN group (n=100) ,and healthy individuals as NC group (n=60). Serum HbA1c ,CIMT and carotid arterial stiffness were measured. Results HbA1c [(8.62 ± 2.71)% ] ,CIMT [(1.01 ± 0.11)mm] and carotid arterial stiffness [(827.6 ± 123.7)]was significantly higher in DPN group than in NC group [(4.20 ± 0.47)% ,(0.70 ± 0.07) mm ,(521.2 ± 89.3)] and T2DM group [(7.95 ± 1.98) % ,(0.81 ± 0.09) mm , (629.3 ± 113.5)] respectively (P< 0.05).The duration was significantly longer in DPN group than in T2DM group(P<0.05). CIMT [(1.11 ± 0.09)mm] and arotid arterial stiffness [(901.5 ± 241.5)] was higher in patients with HbA1 c≥10.0% than in patients with HbA1 c between 8.0% ~10.0% [(0.94 ± 0.07)mm ,(724.5 ± 159.9)] and patients with HbA1c between 7.0% ~ 8.0% [(0.73 ± 0.06)mm , (574.1 ± 145.3 )] respectively ( P< 0.05 ).Association analysis showed that HbA1 c had a positive correlation with CIMT and carotid arterial stiffness (r= 0.107 ,0.213 ,P< 0.05). Conclusion CIMT and carotid stiffness are positively correlated with HbA1 c in DPN patients.HbA1 c is a risk factor for CIM T and carotid stiffness.

[ ABSTRACT] AIM:To investigate the effect of tripterygium hypoglaucum Hutch ( THH) on collagen-induced ar-thritis ( CIA) in rats and its possible mechanism.METHODS:SD rats were randomly divided into normal group and CIA group.The rat model of type II CIA was successfully established and the model rats were randomly divided into 4 different groups:model group, dexamethasone group, THH (200 mg/kg) group, and THH (400 mg/kg) group.The contents of IL-12, IL-23 and IL-37 in the serum and foot paws of the CIA rats were detected by ELISA.The histopathological changes of the skin of the food paws were observed by HE staining.The protein expression of MMP-13 was determined by Western blot.The MMP-13 activity in the foot paws was detected by fluorescence labeling method.RESULTS:Compared with CIA group, THH at dose of 400 mg/kg significantly reduced the weight loss in typeⅡCIA rats ( P<0.01 ) .THH at dose of 400 mg/kg obviously decreased the contents of IL-12 by 28.31%, IL-23 by 41.57%in the serum and IL-12 by 30.78%, IL-23 by 39.46%in the foot paws, while IL-37 was significantly increased by 79.43% in the serum and 75.78% in the foot paws ( P<0.01) .The pathological changes of the subcutaneous tissues were improved by treating with THH (400 mg/kg).The protein expression of MMP-13 was significantly decreased by 31.82%(P<0.01), and the MMP-13 activity was also reduced.THH at dose of 200 mg/kg had no obvious improvement on the above indexes.CONCLUSION:THH has significant inhibitory effect on rat CIA by reducing the content of proinflammatory cytokines IL-12 and IL-23, increasing the content of anti-inflammatory factor IL-37, inhibiting inflammatory cell infiltration and vascular proliferation, and attenuating the protein expression of MMP-13 and MMP-13 activity in rats.

Objective To investigate the etiology, pathology, pathogenesy and treatment in patient with rhabdomyolysis (RM) complicated with acute renal failure(ARF). Methods Analysis of clinical and muscle pathological data combined with literatures were made for a patient with RM-ARF.Results The patient who had experienced exercise induced RM for 5 years. Alcohol drinking and infection were led to RM with ARF for this time. There was non-special inflammatory feature in light microscope by biopsy. The principle of RM management was prevention of hypovolemia and acidification of urine. Hemodialysis (HD)was chosen for treatment of ARF and basic recovery was obtained.Conclusions The etiology of this patient may be the alcohol drinking, particularly the infection which developed on the basis of recurrent RM. Muscle biopsy is useful not only for observing the pathological features of RM, but also for differentiation of etiological factors. The HD therapy used in time may be the key to get favorable effect for this case.

Objective To study the complexity of S region qusispecies in various disease stages of chronic hepatitis B virus(HBV) infection and its relation to disease activity. Methods Serum samples were obtained from 112 patients with chronic hepatitis B virus infection;22 with chronic carries(ASC),30 with chronic mild or moderate hepatitis(CH),60 with fulminant hepatitis failure(FHF). HBV qusispecies populations were separated by the single strand conformation polymorphism (SSCP) method targeted the S region and DNA sequencing analysis. Results The number of SSCP bands detected in the patients with ASC、CH and FHF was 1.45?0.13,3.70?0.22 and 5.93?0.24, respectively. There was a statistically significant difference in the number of quasispecies among various disease stages ( P

Objective:To investigate the role of FASL and TRAIL in the AICD (activation induced cell death) of PBLs in patients with chronic hepatitis B.Methods:The PBLs of 20 nonnal control,24 patients with chronic hepatitis B and 24 patients with chronic severe hepatitis B were isolated and cultured with or without phytohemagglutinin( 10 pig/ml) for 48 hours in vitro. After incubation,the cells were harvested by centrifugation and the expression of FASL.,TRAIL in PBLs was assayed by reverse transcriptase-polymerase chain reaction (RT-PCR) and im-munohistochemical staining (SABC Method) .Results-.The expression of FASL mRNANTRAIL mRNA was undetectable in the resting PBLs of three investigated groups, but it was obviously increased after PHA stimulation in vitro. In comparison with the group of normal controls, the expression of FASL mRNA,TRAIL mRNA in PBLs was significantly higher in the group of patients with chronic hepatitis B( P

In order to study the affection of neutralizing antibody on the therapeutic effect of IFN? -2b,NBA was used to detect the neutralizing antibody to against IFN in the sera from 27 patients with chronic hepatitis B.The results indicated that neutralizing antibody against IFN was present in 15 of 27 patients who had been treated with IFN?-2b,and the overall frequency of neutralizing antibody was 55.6%(15/27).At the end of IFN therapy,HBV DNA was undetectable in 4 of the 15 patients(4/15, 26.7%)with neutralizing antibody.By contrast.HBV DNA became undetectable in 10 of the 12 patients (10/12,83.3 % ) without neutralizing antibody (P

Objective To investigate difference of NKG2D receptor expression level on the surface of natural killer (NK) cells in the patients with hepatitis B and its clinical significance.Methods This was a four-arm study with different types of subjects,including patients with chronic hepatitis B (CHB,n =22),HBV carriers (HBVC,n=10),patients with acute hepatitis B (AHB,n=18) and healthy donors (HD,n=18).NKG2D protein and mRNA levels on the surface NK cells in the peripheral blood were examined by reverse transcription-polymerase chain reaction assay.The relationship between NKG 2D expression and serum hepatitis B virus (HBV) DNA level was analyzed.The data were compared by analysis of variance and linear regression.Results NKG2D mRNA expression levels in groups of HBVC, HD, AHB and CHB were 0.96±0.17, 1.03±0.12,1.53±0.30 and 1.51 ± 0.35,respectively; the differences among groups were statistically significant (q=7.586,7.485,7.920 and 7.880,respectively; all P＜0.01).NKG2D protein expression levels in groups of AHB,HD,CHB and HBVC were 0.87±0.14,0.89±0.17,0.67±0.09 and 0.59±0.13,respectively; the differences among groups were statistically significant (q=6.92,7.67,7.53and 8.16,respectively; all P＜0.01).The NKG2D mRNA expression levels on NK cells were negatively correlated with serum HBV DNA viral loads in patients with CHB,AHB or HBVC (r=-0.75,-0.66 and-0.69,respectively; all P＜0.01).The NKG2D protein levels on NK cells from patients with AHB and CHB were negatively correlated with serum HBV DNA levels (r=-0.47 and -0.45,respectively; both P＜0.05).Conclusion NKG2D mediated NK cytotoxicity may play a role in viral clearance in hepatitis B.

Objective To study the relationship between genotypes and phenotypes,geographical distribution,and the sites of infection of Trichophyton rubrum(T.rubrum).Methods The genotypes were determined by Southern blotting with a probe amplified from the small-subunit rDNA and adjacent internal transcribed spacer(ITS)regions.The phenotypes of T.rubrum were determined by conventional method.Results Twenty genotypes(DNA type A to T)and5phenotypes(villous,furrowed,granular,powdery,and woolly)were recognized among49strains of T.rubrum.Genotype A prevailed in all phenotypes except granu-lar type.Type B represented the most common genotype among the strains of villous type and furrowed type.Type A took the first place in powdery type and woolly type.All of the type A strains were from Dalian.Seven of9type B strains were from Nanjing.Six type C strains were all from Nanjing.The majority strains of21strains isolated from tinea unguium were type C,most of the16strains isolated from tinea cruris and tinea corporis were type A,8strains from tinea pedis were type B,and4strains from tinea capitis were type C.Conclusion There are certain possible relationships between genotypes and phenotypes,geographical distri-bution and sites of infection of T.rubrum.

Objective To evaluate clinical effects of integrated traditional Chinese and western medicine therapy for epilepsy after stroke. Methods Literatures about the treatment of epilepsy after stroke with the combination of traditional Chinese medicine and western medicine which come from the database such as CNKI, VIP, WanFang and Pubmed, were studied and all the randomized controlled trials on comparing therapeutic effects of treating epilepsy between combined treatment of TCM and western medicine and western medicine were enrolled. The Cochrane Collaboration's software RevMan 5 was used for meta-analysis. Results 7 articles were included in the study, there is homogeneity among these articles(P>0.05), The fixed effect model was used for the meta analysis. the combined results were OR=5.17, 95%CI(3.02, 8.82), the overall effect of test Z=6.01, P<0.01, the difference between the treatment group and the control groups was significant, that means the overall effect of the combination of traditional Chinese medicine and Western medicine treatment was better than western medicine treatment; Funnel plot graphic displayed asymmetrically, which indicated the literatures publication bias. Conclusion The current data indicate that the curative effect of TCM and west medicine combined treatment is better than pure western medicine therapy for epilepsy after stroke, but as the literature publication bias, clinical studies need more high quality large samples to prove this conclusion.

Morphea complicated by Hashimoto's thyroiditis is reported in two sisters.Case 1:a 64-year-old female presented with skin rashes on the anterior neck,trunk and bilateral anterior shins for 5 years,itching skin rashes on the perineum for 4 years,and Hashimoto's thyroiditis for 9 years.Physical examination revealed grade 1 enlargement of firm thyroid gland without exophthalmos or pretibial myxedema.Dermatological examination showed pink patches on the neck and breast,sclerosis and atrophy of skin over the back,porcelain-white patches on the perineum.Histopathological findings suggested the diagnosis of morphea on the breast and lichen sclerosus et atrophicus on the perineum.Case 2:a 55-year-old female,who was the younger sister of case 1,suffered from gradual sclerosis and atrophy of skin in the left inframammary region and abdominal region for 4 years,as well as Hashimoto's thyroiditis for 3 years.Similarly,physical examination revealed grade 1 enlargement of firm thyroid gland without exophthalmos or pretibial myxedema.Hypopigmentation,sclerosis and atrophy of skin were observed in the left inframammary region,abdominal region and central back region.Histopathological examination suggested a diagnosis of morphea.According to the clinical and histopathological manifestations,periodic acid-Schiff staining and thyroid gland function test results,the 2 cases were both diagnosed as morphea complicated by Hashimoto's thyroiditis.