Objective To investigate the change of homocysteine level,vascular endothelial growth factor (VEGF) and adiponectin levels in type 2 diabetic patients with diabetic retinopathy and its signicance.Methods 60 patients with diabetic retinopathy ( DR group) and 40 patients with normal fundus ( NDR goup) were selected.30 healthy subjects were used as control group.The serum levels of Hcy,VEGF and adiponectin were detected.Results The serum levels of Hcy and VEGF of DR group and NDR goup patients were higher than that of control group and had statistical significance(all P ＜0.05) ;The serum levels of Hcy and VEGF of DR group were higher than that of NDR group( all P ＜ 0.05 ).The serum level of adiponectin of DR group and NDR goup patients was lower than that of control group ( all P ＜ 0.05 ) ; The serum level of adiponectin of DR group was lower than that of NDR group ( all P ＜ 0.05 ).Hcy and VEGF had a positive correlation with adiponectin( all P ＜ 0.05 ).Conclusion Hcy,VEGF and adiponectin may play important roles in the initiation and sustainment of DR.

While the development and application of gene technology are benefiting human beings widely and deeply, it also arouses people's special attention towards the sustaining of human value and dignity. Ethic problems caused by gene diagnosis, gene treatment and the interpretation of human genome code allow no ignorance. It is an important researching subject in the 21th century to conduct scientific ethical education to personnel of gene technology and medical students according to correct ethic education principles, so as to avoid or reduce the damage caused by it as much as possible.

Background:As a minimally invasive treatment of early gastric cancer,endoscopic submucosal dissection(ESD) proves it could reduce postoperative complications and improve the quality of patients’life. However,ESD-induced gastric ulcer remains a problem. Aims:To evaluate the effect of teprenone combined with rabeprazole on post-ESD ulcer healing and prevention of bleeding after gastric ESD. Methods:One hundred and twenty cases of early gastric cancer or precancerous lesion treated by gastric ESD were divided randomly into group A and group B. Patients in group A were given teprenone combined with rabeprazole,while patients in group B were given rabeprazole alone. The treatment course was 8 weeks. Delayed bleeding rate after ESD and ulcer healing in the two groups were compared. Results:No significant difference was found in rate of delayed bleeding after ESD between the two groups(P = 0. 679). The stage of ulcer had no differences after 7 days of ESD(P > 0. 05),while showed a better healing stage in group A after 30 days and 60 days of ESD(P < 0. 05). The rates of decreased size and area of ulcer were higher in group A after 30 days of ESD(P < 0. 05), while had no statistical differences after 60 days of ESD(P > 0. 05). Conclusions:Teprenone can effectively promote post ESD ulcer healing,especially in the early stage of healing,thus reducing the rate of bleeding after gastric ESD.

Epigenetics is defined as heritable changes in genc expression that are,unlike mutations,not attributable to alterations in the sequence of DNA.The predominant epigenetic mechanisms are DNA methylation,histone modification and microRNA.Exploring the precise roles of epigenetic factors on autoimmunity has become an active research area.Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder with a prevalence of approximately 0.5％ to 1.0％ worldwide.The mechanisms underlying the initiation and progression of RA are still not completely understood.In recent years,the epigenetics of RA have been widely investigated.Alterations in the modification of histones and DNA methylation are the two major epigenetic mechanisms that may potentially cause a breakdown of immune tolerance and the perpetuation of RA.These epigenetic changes may be ideal targets for new personalized treatments.

Objective To detect the genetic diversity and prevalent strains of Mycobacterium tuberculosis isolates from Tibetan patients in Tibet and to analyze factors associated with prevalent strains.Methods A total of 577 Mycobacterium tuberculosis isolates were genotyped by spacen oligonucleotide typing (spoligotyping) and the results were analyzed with BioNumerics software (Version 5.0) and compared with the international spoligotype database of SITVIT2.Results Among the 577 cases of Tibet patients,329 were male and 248 were female.Based on spoligotyping,23 different spoligotypes were identified among 577 Mycobacterium tuberculosis isolates,with a genetic diversity of 3.99 ％.The majority (97.57％,563/577) of the isolates belonged to four known families,such as Beijing family,T family,CAS family and MANU2 family.The remaining 14 isolates had 11 novel spoligotypes.522 (90.47％)isolates belonging to Beijing family presented with 7 spoligotypes,resulting in the genetic diversity of Beijing family of 1.34％.With high similarity,Beijing family strains could be clustered into one genotype;among non-Beijing family strains,strains belonging to T family and MANU2 family were similar and could be clustered into one genotype.Changdu had the highest prevalence (97.83％) of Beijng family strains.In this study,the occurrence of Beijing family strains was not associated with age,sex,bacillus CalmetteGuerin vaccination or treatment history (P=1.00,0.36,0.83 and 1.00,respectively).Conclusions In this study,the genetic diversity of Tibetan Mycobacterium tuberculosis is low and Beijing family strains are highly prevent in Tibet,by classical spoligotyping.

Acupuncture Therapy ; Demyelinating Diseases ; therapy ; Humans ; Male ; Middle Aged ; Sensation Disorders ; therapy

The demands for Traditional Chinese Medicine(TCM)standardization are rising internationally,but the development for TCM intemational standards is confronted with competence.In this context,the authors analyzed the competing status of intemationalized TCM standardization from 3 aspects:1.It is the key point for competition that obtaining leadership in the international organization and dominant position in developing important intemational standards:2.Integrating technical development and intellectual property with intemational standards has been gradually formed;3.Striving to make breakthrough in the development of TCM international standards on the basis of TCM Chinese national standards.The authors recommend that international standards be initiated from TCM service standards.TCM products quality standards and TCM process standards.

Atrial fibrillation (AF) is one of the most common and age-related persistent arrhythmias. With the increase of age, the prevalence of AF and the incidence of atrial fibrillation-related stroke are increased. Due to the decline of cognition and function of various organs, coupled with the increase of comorbities and complications, the types of drug use also are increased in elderly patients, and their anticoagulant therapy has become complex. New anticoagulant drugs increase the choice of treatment in elderly patients with AF. This article reviews the clinical characteristics, necessity, challenge and drug selection of anticoagulant therapy in elderly patients with non-valvular AF to provide information for rational anticoagulant therapy.

Objective:To discuss the relevant factors between occurrence rate of ventilator associated pneumonia (VAP) and sedative therapy of patients adopted mechanical ventilation in intensive care unit (ICU) so as to improve strategy of sedation and reduce occurrence rate of VAP.Methods: The clinical data of 218 patients of ICU who were implemented mechanical ventilation combined with sedative were retrospectively analyzed. All of patients were divided into observation group (61cases) and control group(157cases) according to whether happened VAP. And the differences of sedative time, score of sedation, time of mechanical ventilation and stayed time in ICU between the two groups were analyzed and compared.Results: In observation group, the total sedative time was (7.51±7.86)d, score of sedation was (-2.69±1.09), time of mechanical ventilation was (8.52±17.11)d and stayed time in ICU was (24.44±21.93)d. In control group, all of these indicators were (3.83±2.91)d, (-1.22±1.52), (6.47±5.70)d, and (11.63±7.49)d, respectively. And the differences of them between the two groups were statistically significant (t=6.8850,t=5.0334,t=7.8012,t=6.4368,P<0.05).Conclusion: The sedative time, sedative depth of patient adopted mechanical ventilation are positively relevant with the occurrence rate of VAP, and the occurrence rate can be reduced through improving the strategy of sedation.

Objective To understand the clinical significance of serum immunoglobulins and C3 at the initial episode on the treat-ment and prognosis of childhood primary nephrotic syndrome(PNS) .Methods 426 children patients with first episode of PNS ad-mitted to the nephrology department of our hospital from January 1 ,2003 to December 30 ,2012 were retrospectively analyzed .The clinical data were collected for conducting the analysis on the immuneglobulins and C 3 levels in different age groups ,clinical classifi-cation ,hormone response ,recurrence ,prognosis and correlation among various pathological types .Results (1)Compared with the healthy children ,the peripheral blood IgG level in childhood PNS was significantly decreased ,while the IgM and IgE level were sig-nificantly increased .(2)The IgE level in steroid-sensitive nephrotic syndrome(SSNS) was higher than that in steroid-resistant ne-phrotic syndrome(SRNS);which in frequent recurrence nephrotic syndrome was higher than that in non-recurrence nephrotic syn-drome .(3) The C3 level in the PNS children patients aged over 1 years and nephritis nephrotic syndrome(NNS) was lower than that in simple nephrotic syndrome(SNS) .Conclusion PNS is correlated with the immune dysfunction .Serum IgE level increase clinically manifests by the steroid sensitivity and frequent relapse ;the lower the C3 level ,the poorer the prognosis .