Objective To analyze risk factors of vascular disease in the lower limbs in type 2 diabetes patients.Meth- ods Investigating the lower limb vein of 80 type 2 diabetes patients with Siemens G-50 color Doppler ultrasonograph, and recording their age,sex,course of disease,and blood pressure,at the same time,take some tests as follows: FBG,P2hBG,FIN,C-peptide HbA_1c,Tch,UAE.Results Compared to the control group,blood pressure, FBG,P2hBG,Tch,TG,HbA_1c,Tch,UAE of the type 2 diabetes patients with lower limb vascular disease,are all increased significantly(P

Background and purpose:The skeleton is one of the most common sites of metastasis in patients with lung cancer.Bone metastases often cause poor prognosis.It is important to early detect bone metastases.Therefore,we planned a retrospective study to investigate the role of radionuclide bone scanning with 99mTc-MDP in detecting bone metastases in lung cancer patients.Methods:It was a retrospective analysis.400 patients with lung cancer diagnosed in our hospital from 2005.5 to 2007.5 were recruited.Using 99mTc-MDP bone scanning,we analyzed the symptoms,sites,numbers,pathological types and TNM stages of bone metastases.Results:Ostealgia was the most frequent symptom in lung cancer patients with bone metastases.The sites of bone metastases were:thoracic bones(41.52%),vertebras(32.31%),pelvic bones(15.89%),extremities(8.68%),skull(1.60%).126 patients had multiple bone metastases(80.25%).There was a statistical significance of bone metastases in adenocarcinoma patients(48.09%)compared with in squamous cell carcinoma patients(33.33%)(P

Objective　To evaluate the efficiency of low molecular weight heparin(LMWH, fraxiparine) given as a single predialysis bolus injection with reused dialyzers in comparison with standard heparin(SH) administered with a continuous infusion. Methods　30 hemodialysis patients were studied in a radomized crossover fashion. Dialyzers fibrer bundle volumes(FBV), predialysis hemocrit and 2 h clearance of urea, creatinine were observed in the first, the fourth dialysis. The plasma heparin activities(anti-Fxa levels) were measured by the chromogenic substrate assay in 0 h, 2 h, 4 h of dialysis. Results　Significant increase (P<0.05) was seen in the number of dialyzer reuse in LMWH group compared with SH group; there was not significant decrease in dialysis FBV as well as 2 h clearance of urea, creatinine (P>0.05); in addition, the plasma heparin activity(anti-Fxa levels) were comparable in both groups after 2 h of dialysis, however, they were significantly higher after 4 h in the LMWH than those in the SH group (P<0.05). Conclusion　LMWH as a single bolus dose can prevent decrease in dialyzer clearance. It is clinically worthy of further popularity.

Objective To probe into application of clinical pathway on clinical practice teach-ing in thoracic surgery , and evaluate its effect . Methods 76 students were randomized into two groups: 35 students who accepted clinical pathway teaching were the experimental group, they were asked to carry out clinical practice in accordance with the teaching pathway;and the other 41 students were control group. The final examination included four parts: ①theoretical examination account for 20%of the total score. The test paper was randomly combined from the standardized question bank of Xinjiang Medical University, and this test included single choice questions and fill-in questions; ②clinical operational skills test account for 30%of the total score. This part included pleural puncture, dressing change, stitches remove, incision disinfection and surgical draping, and all of these opera-tions were carried out on medical patient simulators; ③clinical case analysis account for 50% of the total score. This part involved history collection, physical examination, humanistic care, case writing, diagnosis and treatment planning for new admission patients. T-test of independent samples was used to analyze all the scores of the two groups. Results The clinical case analysis score and the total score in experimental group [(42.26 ±3.93) points and (81.69 ±6.16) points, respectively]were obviously higher than that in control group[(38.88±4.76) points and(77.39±6.83) points, respectively];There were significant differences between the two groups(P values was 0.001 and 0.006, respectively). Conclusion Application of clinical pathway in clinical practice teaching may improve the effect of clinical teaching. The pathway contents and evaluation methods should be constantly improved accord-ing to teaching practice.

Objective: To discuss the application of BALANCE-FFE sequence in abdominal MRCP.Methods:100 patients of abdominal diseases were examined by BALANCE technique. Results: The signal of BALANCE-FFE sequence was high in abdominal MRCP examination, and BALANCE image of the coronal scan was excellent. Conclusion:The biliary tract had obviously high signal intensity acquired by BALANCE sequence. The gallstone and the stenosis could be seen. The tissue out of the bile duct, the head of pancrease and the lymph could also be seen. The BALANCE sequence could be used as a supplement of conventional MRCP.

Aim To investigate the effect of α1-anti-trypsin Z variant (ATZ)overexpression on cell autoph-agy.Methods HEK 293T cells were transfected with pcDNA3.1 zeo+/ATM or pcDNA3.1 zeo+/ATZ,e-qual amount of empty vector was used as control.Cells were treated with NH4Cl for 4 hours and processed for detecting ATZ,LC3 and p62 by immunoblot.Mean-while ,expression and intracellular localization of ATZ, LC3 in 293 T cells were observed with double labeled immunofluorescence.The mRNA levels of autophagy-related genes were measured by real-time PCR.Immu-nohistochemistry was used to observe the morphology of ATZ-positive cells.Results Compared with the control,higher LC3Ⅱ levels and LC3 puncta were observed in ATZ transfected cells.Meanwhile,the levelsof p62 were decreased in ATZ transfected cells,andreversed by NH4 Cl (25 mmol·L -1 )treatment.Overexpression of ATZ increased the mRNA levels of Atg5and Atg12,but had no obvious influence on Beclin1.ATZoverexpressing cells presented abnormal morphologies.The nuclei became reduced,condensed,and even disappeared in ATZpositive cells.Conclusion ATZ overexpression increases autophagy activity whichmay be related to increasing Atg5 and Atg12 levels.

Objective curcumin can suppress the proliferation , induce apoptosis and partial differentiation , and inhibit the migration of many kinds of tumor cells .The aim of this study was to investigate the expressions of mitogen-activated protein kinase (MAPKs) and matrix metalloproteinases (MMPs) when the proliferation of human multiple myeloma RPMI8226 cells was inhibited by curcumin in vitro, and to reveal the antitumor molecular mechanism of curcumin . Methods RPMI8226 cells were treated with various concentrations of curcumin for different periods of times .The inhibitory rate of curcumin on cell proliferation was detected by MTT assay , the cell cycle analyzed by flow cytometry , the protein levels of MAPKs measured by Western blot , and the activity of MMPs analyzed by Gelatin zymography . Results Curcumin inhibited the proliferation of RPMI 8226 cells in a time-and dose-dependent manner , and the cell cycle was arrested in the G 2/M phase ([12.72 ±0.68]%vs [4.79 ±0.15]%).The expressions of JNK and p-JNK showed a con-centration-dependent increase in the RPMI8226 cells treated with curcumin at 6.25, 12.50, and 25.00 μmol/L, respectively (P<0.01) , but the expressions of ERK 1/2 and P38 MAPK did not change significantly compared with the control group (P>0.05).In addition, the activities of MMP-2 and MMP-9 were decreased in a dose-depend-ent manner in the supernatant of RPMI8226 cells ( P <0.01). Conclusion A certain concentration of curcumin could not only acti-vate the JNK signalling pathway of the MAPKs family and induce the apoptosis of RPMI8226 cells, but also inhibit the activity of MMPs and influence the invasion and metastasis of RPMI 8226 cells.

The First Affiliated Hospital of Nanjing Medical University has adopted a strategy of brand development in the process of continuing medical education.Given the different recipients,the First Affiliated Hospital of Nanjing Medical University has established four types of brand-based education modes,namely Jinling high-level forum of clinical medicine,hospital management school,management salon,and clinical case discussion in English.The influence and competitiveness of the brand of hospital continuing education should be elevated through the following methods:adhering to the brand development orientation-to fulfill the public responsibility and cultivate medical talents; establishing appraisal mechanism of continuing medical education; transforming thinking of management department; relying on new media propaganda and expanding domestic and international communication.

Objective:To establish the method validation of microbial limit tests for hospital paste preparations, including com-pound salicylic acid paste, zinc oxide paste and compound pine tar paste. Methods:According to the microbial limit test described in China pharmacopoeia 2010 edition, the method validation of count of bacteria, fungi and yeasts and tests for specified microorganisms was established. Results:Medium dilution method could be used in bacteria, fungi and yeasts count and specified microorganisms ex-amination for compound salicylic acid paste and zinc oxide paste. For compound pine tar paste, bacteria, fungi and yeasts count and the pseudomonas aeruginosa examination could use medium dilution method, while the staphylococcus aureus examination should employ membrane filtration method. Conclusion:The methods of microbial limit tests for the three hospital paste preparations are established, which can be used to control the quality of hospital preparations effectively.

AIM: To investigate the relationship between bone metabolism and serum leptin in type 2 diabetes mellitus (T2DM) postmenopausal female patients. METHODS: Totally 80 postmenopausal female inpatients with T2DM (according to the diagnostic criteria of WHO1999) aged 60-80 years from Yangpu District Central Hospital who gave informed consent were enrolled in the present study from January 2004 to January 2006. Exclusive criteria: Subjects who taking medications such as estrogen, glucocorticoid, or calcium or phosphorus metabolism, having a history of gastrointestinal surgery and other endocrine diseases were excluded. Each subject's age, duration, menopausal period, body mass index (BMI), fasting glucose (oxidation enzyme method), hemoglobin A1c (HbA1c) (microcolumn affinity chromatography) and leptin levels (ELISA) were measured. Ultrasound characteristics of the right heel bone were measured with ultrasound bone densitometer (French UPIS3000) to identify the speed of sound (SOS), broanband ultrasound attenuation (BUA) and stiffness (STI). STI was equal to 0.67?BUA+0.28?SOS-383. Linear correlation analysis was performed in ultrasound index, general index and leptin level. RESULTS: A total of 80 postmenopausal female inpatients with T2DM were involved in the result analysis. BUA, SOS and STI were negatively related with age (r =-0.342 to -0.298,P all