Objective To observe the characteristics of glycemic excursion and to evaluate the therapeutic effects on blood glucose in new dignosed type 2 diabetes mellitus after being given continuous subcutaneous insulin infusion(CS Ⅱ).Methods Thirty-eight new dignosed type 2 diabetes mellitus patients were randomly divided into group CS Ⅱ(n=18) and group many-times subcutaneous insulin infusion(MS Ⅱ,n=20).The blood glucose lasted for three days were monitored by continuous glucose monitoring system(CGMS).Results The abnormal glucose metabolism in two groups were markedly released after two weeks treatment,the mean blood glycemic(MBG),mean amphtude of glycemic excursions(MAGE),means of daily differences(MODD) and the percentage of blood glucose beyond 7.8 mmol/L and 11.1 mmol/L after therapy were all significantly decreased compared with those of before therapy (P＜0.001);the average levels of blood glucose before and after diet were decreased obviously as well(P＜0.05,P＜0.01).All index in group CS Ⅱ were lower than that of group MS Ⅱ (P＜0.01,P＜0.001).Conclusion Continuous glucose monitoring system can assess the changes characteristics of blood glucose effectively,continuous subcutaneous insulin infusion was an effective means of controlling blood glucose.

Objective To establish appropriate correction models of serum marker α -fetoprotein (AFP) multiple of the median (MOM) for prenatal screening on patients with neural tube defect (NTD) at the second trimester to replace the foreign data currendy used in Beijing with a higher sensitivity.Methods A sample of 5815 mid-gestation pregnant women with normal pregnancy outcome were selected including 5557 cases of age ＜ 35 years and 258 cases of age ≥35 years.The regression relationship between AFP median and gestational age was builded by exponential model and the regression relationship between MOM and weight was builded by power model in age ＜ 35 years.The regression relationship between AFP median and gestational age was builded by S model and the regression relation ship between MOM and weight was builded by quadratic model in age ≥35 years.The normal reference values in two age sections were estimated approximately by percentiles method.Results Corrected AFP MOM values with mean value (age ＜ 35 years:1.001; age ≥35 years:1.113) and median value (age ＜ 35 years:0.934;age ≥35 years:0.990) obtained by regression analysis were more close to 1.00 than the data from the software[mean value(age ＜ 35 years:1.164; age ≥35 years:1.254) and median value (age ＜35 years:1.093; age ≥35 years:1.149)].There were significant differences (age ＜35 years:t =65.120,P =0.000;age ≥35 years:t =9.812,P =0.000).Conclusion Correction model for maternal serum marker is more applicable for Beijing population at the second-trimester prenatal screening.

A total of 105 patients with ketosis-onset diabetes were divided into four groups (A+B-,A + B +,A - B -,A - B +) based on the results of islet-associated autoantibodies (A +,A - ) and β-cell function (B +,B - ).Nearly 94％ patients in the A -B + group and 1/10 patients in the A - B - group were non-insulin dependent.While in the A + B - and A + B + groups,the detection rates of subsequent non-insulin dependency were 20％ and 58％,respectively.Among the four groups,patients in the A - B + groups had a lower level of IL-6 and a higher level of TNF-α. Patients in the A + B - and A + B + groups had a higher level of IL-18.Our study indicates that patients with ketosis-onset diabetes may present different clinical characteristics. Evaluate the islet-associated autoantibodies and pancreatic β-cell function may be helpful to the clinical diagnostic and therapeutic strategies in diabetes.

Objective:CD4+CD25+regulatory T cells (Treg) may contribute to tumor progression by suppressing antitumor im-munity. The function of Treg in antitumor immunity regulation in the peritoneal microenvironment of ovarian cancer (OC) was investi-gated and compared with the circulating Treg to elucidate OC immune escape. Methods: Flow cytometry was used to determine the proportion of CD4+CD25+T cells in CD4+T cells in ascites of 27 patients with OC and in peripheral blood lymphocytes of 28 patients with OC. The samples were analyzed and classified in three stages:primary disease (PD), after chemotherapy (AC), and recurrence dis-ease (RD), according to the clinical conditions of the OC patients upon donating the samples. The percentage of Treg in the three groups was determined in ascites and blood. CD4+CD25+T cells were isolated from ascites and peripheral blood of patients with OC us-ing magnetic sorting (MACS) system. The cells were then tested for regulatory function through coculture with carboxyfluorescein diac-etate succinimidyl ester-labeled autologous CD4+ CD25- responder cells. Results:The proportion of CD4+ CD25+T cells in CD4+T cells significantly increased in ascites (28.25%± 14.06%) compared with that in blood (14.6%± 4.74%;P<0.0001). The Treg in ascites and blood in AC showed higher proportion (P<0.0001) than those in the PD and RD;the proportion in RD was higher than that in PD (P<0.0001). Moreover, the Treg in ascites mediated a significantly higher suppression compared with the Treg in peripheral blood (P<0.001). Conclusion:The frequency and suppressor function of Treg were significantly higher in ascites than in peripheral blood. This finding suggests more possibility for escape immune surveillance in the peritoneal microenvironment. Moreover, the proportion of Treg in AC was higher than that in PD or RD;the proportion in RD was higher than that in the PD. Chemotherapy may favor the expansion of Treg, which may promote the recurrence of cancer.

Objective:The objective of this research is to study the serum level of the high-mobility group protein B1 (HMGB1) in human ovarian tumor (OvCa) and in a healthy control. This study also aims to identify different HMGB1 levels before and after sur-gery and to explore the inhibitory effect of HMGB1 gene silencing in the proliferation and invasion ability of OvCa. Methods: En-zyme-linked immunosorbent assay was used to measure the serum level of HMGB1 in OvCa patients and healthy subjects. Lentivirus vector with HMGB1 shRNA was constructed and used to infect OvCa cells. The expressions of HMGB1 mRNA and protein were test-ed by real-time PCR and Western blot. Cell proliferation was detected using the Cell Counting Kit-8 assay, whereas cell invasion and migration were detected by Transwell assay. Results:The serum level of HMGB1 was more elevated in patients with malignant diseas-es compared with individuals with benign diseases and the control groups. In the malignant group, the serum level of HMGB1 de-creased noticeably after therapy. Down-regulation of HMGB1 expression resulted in the inhibition of the biological behavior and metas-tasis of ovarian cancer cells. Conclusion: HMGB1 is closely associated with clinicopathologic features of OvCa. Knockdown of HMGB1 expression can significantly inhibit cell proliferation, cell migration, and cell invasion of OvCa. These findings indicate that HMGB1 can function as a therapeutic target for ovarian neoplasm in the future.

Objective: This research explores the relationship between the immuno-suppression function of regulatory T cells (Treg) in the ascites of ovarian cancer (OC) patients, the clinico-pathologic features of these patients, and the correlation of the function of Treg with initial treatment and relapse status of the patients to further investigate the specific mechanism of immuno-regulatory func-tion of CD4+ CD25+ Treg in the ascites of OC. Methods: Immuno-magnetic activated cell sorting (MACS) was conducted to sort CD4+CD25+Treg and autologous CD4+CD25-Treg from the ascites of 28 OC patients. Carboxyfluorescein-diacetate succinimidyl ester (CFSE) was used to label the autologous CD4+CD25-Treg. These labeled cells were then used as controls and co-cultured with autologous CD4+CD25+Treg at the ratio of 1∶1 or 1∶2. The mean inhibition ratio of Treg in specimens to the proliferation of autolo-gous CD4+ CD25-Treg was calculated after the flow cytometry of the CFSE expression and Modfit software analysis of the CD4+CD25-Treg proliferation index (PI) were performed. Anti-IL-10 and/or anti-TGF-β1 antibodies were neutralized to investigate whether the CD4+CD25+Treg-mediated immuno-suppression escaped through the ascites can produce a marked effect by the inhibitory cyto-kine IL-10 or TGF-β1. Results: The mean inhibition ratio of CD4+ CD25- Treg in the ascites of stage Ⅲ to Ⅳ OC patients was (75.72±17.04)%, which is significantly higher than that of stageⅠtoⅡOC patients (59.61±16.97)%;P<0.05. In addition, Treg in the as-cites of OC patients with recurrent disease showed a significantly higher inhibition ratio than that of patients with primary disease;P<0.001. Moreover, Treg in groups added into neutralizing anti-IL-10 and/or anti-TGF-β1 antibodies displayed significantly lower depres-sant effect than the control group;P<0.05. Conclusion:The immuno-suppression of CD4+CD25+Treg in the ascites of OC patients is correlated with the tumor staging and status of the primary or recurrent diseases. Moreover, Treg may indicate a suppressor function by secreting cytokine IL-10 and TGF-β1.

OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with imipenem and cilasta-tion in the treatment of severe abdominal infection,and its effects on plasma endotoxin and inflammatory factors. METHODS:Dur-ing Apr. 2013-Apr. 2016,100 patients with severe abdominal infection in our hospital were divided into observation group and control group according to random number table,with 50 cases in each group. Both groups were given Imipenem and cilastation sodium for injection 0.5 g added into 0.9% Sodium chloride injection 500 mL,ivgtt(≥40 min),q12 h. Eight hours later,ob-servation group was additionally given Xuebijing injection 100 mL added into 0.9% Sodium chloride injection 500 mL,ivgtt, bid;Both groups were treated for 5-7 d. The levels of plasma endotoxin and inflammatory factors(TNF-α,IL-6,IL-6/IL-10) were compared in 2 groups before after treatment,and clinical efficacies and the occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in plasma endotoxin or inflammatory factor levels between 2 groups(P>0.05). After treatment,plasma endotoxin and inflammatory factor levels of 2 groups were decreased significantly,and the obser-vation group was significantly lower than the control group,with statistical significance(P<0.05). The excellent and good rate of observation group was 98.00%,which was significantly higher than 78.00%,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Xuebijing injection combined with imipenem and cilastation show significant therapeutic efficacy for severe abdominal infection,can effectively control the release of endotoxin and inflammatory factors with good safety.

Objective To explore the value of brain CT scanning for distinguishing tumor-like inflammatory demyelinating diseases (TIDD) from glioma or primary central nervous system lymphoma.Methods The brain CT features in 20 patients with TIDD(10 female,10 male;mean age (35.6±14.0)years;range,6-51 years)and 32 gliomas(16 female,16 male;mean age(42.0±19.8)years;range,12-75 years)and 6 lymphomas(3 female,3 male;mean age(53.8±11.8)years;range,32-68 years)were retrospectively reviewed and compared between brain tumors and TIDD.Results (1)Among the 38 primary brain tumors,there were 19 cases(50%,14 gliomas,5 lymphomas)with hyperdense lesions,10 cases(26.3%,9 gliomas,1 lymphomas)with isodense lesions,and 9 glionms (23.7%)with hypodense lesions.In contrast,the brain unenhanced CT manifestation of 20 TIDD all showed with hypodense lesions.(2)On unenhanced CT the lesions of 6 lymphomas all were hyperdense or isodense,like 90% of 20 high grade gliomas(WHO grade Ⅲ and Ⅳ),but this rate for grade Ⅱ was only 41.7%.(3)According to the shape of hyperdense lesions of the 19 primary brain tumors with,7 cages(6 gliomas,1 lymphomas)manifested with asymmetric hyperdense small-patches,4 cases(1 gliomas,3 lymphomas)with symmetric hyperdense large-patches,4 cases(3 gliomas,1 lymphomas)with diffused hyperdensed lesions,and 4 cases(4 gliomas)with ring-shaped hyperdensed lesions.Furthermore,4 primary brain tumors(4 lymphomas)underwent CT enhanced scanning and all the cases showed strong enhancement(3 cases with hyperdense lesions and 1 with isodense lesions on unenhanced CT),but only 3 cases of 7 TIDD showed mild enhancement in contrast.(4)By Spearman's relevant analysis,hyperdense and isodense on unenhanced CT was proved to have significant positive correlation between the grade of gliomas(r=0.435,P=0.013).Therefore,the frequency of hyperdense and isodense lesions in lymphomas and WHO grade Ⅲ and Ⅳ astrocytoma was higher in contrast with low grade astrocytoma.Conclusions Brain CT as a simple,economical and practical examination method has significant meaning for differentiating TIDD from glioma or PCNSL and could be used as an adjuvant method for MRI and magnetic resonance spectroscopy.Patients with hyperdense or isodense on unenhanced CT or strong enhancement could be excluded from TIDD.

Objective: To compare the inhibitory effect of carmustine(BCNU) and bleomycin on craniopharyngiomas in vitro. Methods: Cells were successfully cultured in vitro from the fresh specimens, then the culture medium with bleomycin or BCNU at different concentration was added. The tumor inhibitory curve-line was drawn based on the cell number at different time points. After cultured for 144 h, ATP-luminescence assay was applied to test the antitumor effect. Results: The cell number decreased rapidly when the medium was added. The decreasing speed was faster in BCNU medium than that in bleomycin medium at the same concentration. The bleomycin medium showed no significant inhibitory effect except for the one at 1.00 g/L. However, regardless of the concentration, BCNU medium inhibited the cells effectively. Conclusion: BCNU has stronger inhibitory effect on craniopharyngiomas cells than bleomycin, it can be used to treat this tumor

Objective:To explore the trajectory of breast reconstruction in patients with breast cancer at different stages of treatment and to provide reference for medical staff to intervene in breast reconstruction and improve breast reconstruction rate.Methods:During February 2017-October 2017, 192 female patients with breast cancer (aged 20-64 years, mean 49.7 years) were selected by self-designed breast reconstruction demand questionnaire. They were checked up in the diagnosis period, after chemotherapy without chemotherapy, after chemotherapy, and after the completion of chemotherapy.Results:The demand rates for breast reconstruction during the diagnosis period, the period without chemotherapy after mastectomy, the middle period of chemotherapy and after chemotherapy were 10.4%, 13.4%, 16.7% and 17.7% respectively. The main reasons why patients were unwilling to choose breast reconstruction were that patients were worried that breast reconstruction would affect the integrity of cancer resection and worried about cancer recurrence and metastasis. Patients who were unwilling to breast reconstruction planned to choose breast prosthesis, and the difference was statistically significant ( P<0.05). Menopause was the influencing factor of breast reconstruction demand. Conclusions:After chemotherapy, patients have the highest demand rate for breast reconstruction, and more patients are willing to choose the breast reconstruction method of prosthesis implantation. This period is the best period for medical staff to recommend breast reconstruction treatment.