Objective To evaluate the effect of the Danhong injection combined with irbesartan in treatment ofearly diabetic nephropathy. Methods 64 patients with early diabetic nephropathy were randomly divided into two groups and the control group 32 cases,two groups were given control of blood sugar and ensure water and electrolyte balance,support therapy,in which 32 cases were also observed red Danhong injection,Ecuador irbesartan treatment,2weeks before evaluation. Results The total effective rate in treatment group was higher than the control group( x2 =6.38 ,P ＜0. 05) ,after 12 weeks of treatment,two groups of urinary protein decreased significantly compared with before treatment, including observation of urine protein was ( 0. 6± 0. 1 ) g/24h, the control group was ( 0. 7 ± 0. 3 ) g/24h,and decreased urine protein level of the observation group was better than the control group( t = 2. 74,P ＜ 0. 05 ). And in the course of treatment, side effects and serious adverse events were not found. Conclusion Danhong injection combined irbesartar, could improve the clinical symptoms, reduce microalbuminuria in treatment of early diabetic nephropathy is worthy of wider application.

Objective To investigate the expression of Skp2 and P27kip1 and their relationship with the clinicopathologic characters in basal cell carcinoma(BCC). To explore their expression between with the types of BCC of skin, especially in morpheaform BCC group. Methods Immunohistochemical SP technique was used to examine the expression of Skp2 and P27kip1 in 50 cases of BCC and 30 cases of normal tissues of skin.The expression level was analyzed combined with clinicopathological features of age, sex and types of tumor.Results Skp2 positive products located in cytoplasm or nucleus. P27kip1 positive products located in nucleus.The high expression of Skp2 and the low expression of P27kip1 were observed in BCC, there was statistical significance between the tumor group and the control group (P ＜ 0. 05 ) . The expression of Skp2 and P27kip1 were correlated with clinical types of BCC ( P ＜ 0. 05 ), while which were not correlated with age and sex ( P ＞0.05 ). In BCC tissue, Skp2 expression was negatively correlated with P27kip1 ( - 0.624; P ＜ 0.05), there was no correlated with each other in morpheaform BCC group ( P ＞ 0. 05 ). Conclusion The expression of Skp2 and P27kip1 in BCC are significant differences to normal skin tissues, and they are correlated with each other.They may play an important role in carcinogenesis and the development of BCC, and also make targets to treat it. Compared to nodular and superficial BCC group, the expression of Skp2 are higher in morpheaform BCC group, and the expression of P27kip1 is lower. They may play an important role in the types of the BCC and useful factors to predict the types of the tumor, also determine surgical margin for BCC cases.

As monosaccharide polymers,polysaccharides are widely distributed in nature,they are found in microorganisms,plants and animal cells and tissues.Glycosylation is of importance to maintain the structural stability and biological activity of protein molecules in eukaryotic cells.Polysaccharides represent the most important antigens recognized by immune system.The innate immune system senses invading microbes via their pathogen-associated molecular patterns,using pattern-recognition receptors on the surface of innate immune cells,many of which are polysaccharides uniquely expressed in certain microorganisms.Polysaccharides can also be processed intracellularly and presented to ??-T cells by MHC molecules.Polysaccharides can activate B lymphocytes,with or without T cell help,and induce production of specific antibodies.Amongst the polysaccharide-specific antibodies in human sera,some are products of adaptive humoral responses against microbial infection and others autoantibodies to glycan epitopes of host cells.Patients with autoimmune disorders tend to have higher titers of antibodies against various glycans.Immune clearance of senescence cells depends on the recognition of altered glycan epitopes on cell surface.Modification of glycan epitopes on tumour cell surface is at least partially responsible for activating antitumor immunity.Specific recognition of polysaccharides by the immune system is of importance to immunological defence,autoimmunity,anti-tumour immunity and immunological homeostasis,it will be the new focus of immunology research in the near future.

Objective To investigate the diagnostic significance of combined detection of rheumatoid factor (RF),anti-cyclic cit-rullinated antibody (anti-CCP antibody),glucose-6-phosphatase (GPI)and anti-RA33 antibody in rheumatoid arthritis (RA).Meth-ods One hundred and twenty-six patients with RA,60 patients with other autoimmune diseases and 60 healthy subjects undergoing physical examination were selected as the research subjects.The singled detection of RF,anti-CCP antibody,GPI and anti-RA33 an-tibody,and their combined detection were used to analyze their roles in RA diagnosis.Results Compared with the healthy control group,the four indexes in the RA group were increased,the difference was statistically significant (P<0.05),the RF level in the autoimmune diseases group was increased compared with the control group,the difference was statistically significant(P<0.05). Compared with the the autoimmune diseases group,the four indexes in the RA group were increased,the difference was statistically significant (P<0.05).The sensitivity and specificity of RF to RA were 77.77% and 63.33%;the sensitivity and specificity of anti-CCP antibody to RA were 69.04% and 95.00%;the sensitivity and specificity of GPI antibody to RA were 25.40% and 100.00%;the sensitivity and specificity of anti-RA33 antibody were 27.77% and 99.16%,respectively.The specificity of combined 2 indica-tors was increased from 63.33% to 85.00%,which of combined 3 indicators was increased to 93.33% and which of combined 4 in-dicators even reached to 100.00%.Conclusion The combination of RF,anti-CCP antibody,GPI and anti-RA33 antibody indicators greatly increases with the sensitivity and specificity for diagnosing RA and has clinical significance.

Zebrafish, a new type of model animal , has been widely used in many fields of biological research be-cause of its low cost , ability of external fertilization , high fecundity , allowance of embryo transplant , and ectogenesis .Re-cently, zebrafish and its embryos have been widely used in ecotoxicological studies and environmental monitoring .Further-more, with the maturation of zebrafish transgenic techniques , a new era has come for environmental pollution monitoring .

ObjectiveTo observe the lesions of psoriasis vulgaris by confocal laser scanning microscopy(CLSM).MethodsThe typical lesions of 120 patients with psoriasis vulgaris were observed by CLSM,and scanning results were recorded.ResultsOf the 120 patients with psoriasis vulgaris,all (100％)had dilated and twisted capillaries in dermal papillae,113 (94.17％) acanthosis,106 (88.33％) parakeratosis,86 (71.67％) Munro microabscesses at the level of stratum corneum,71(59.17％) diminished or disappeared stratum granulosum.There were a few(1 to 2) dilated capillary lumens in papillary dermis,with no obvious reduction in the distance between dermal papillae.Some dermal papillary rings lost their integrity or brightness slightly in 24 of the 27 patients with psoriasis guttata.The height of stratum spinosum was 96.85 ± 17.88 μm (ranged:80-150 μm) in patients with psoriasis guttata,lower than that in those with plaque psoriasis (average:143.45 ± 23.19 μm,range:100-190 μm).In lesions of plaque psoriasis,the capillaries in dermal papillae were apparently dilated with hyperemia,showing a characteristic'S' shape or horseshoe appearance; the diameter of dermal papillae was increased and the distance between dermal papillae was reduced,giving a 'transverse section of lotus roots' appearance.Dermal papillary rings completely disappeared in 25 of the 29 patients with plaque psoriasis.ConclusionCLSM may serve as an aid in the diagnosis of psoriasis vulgaris.

Objective To study the therapeutic effects of conservation surgery of laryngeal function for larygeal carcinoma in patients aged 70 years and over. Methods 136 patients aged 70 years and over were collected. Among them, 34 cases underwent vocal cord resection, 28 vertical hemilaryngectomy, 24 horizontal supraglottic hemilaryngectomy, 15 horizontovertical (3/4)laryngectomy, 29 subtotal laryngectomy, 6 total laryngectomy with cricopharyngeal anastomosis.Tissue defects were repaired by use of cervical myocutaneous flap in patients of T3-4 tumor stage. After operation, a special pneumatoeeles was attached on the tracheal cannula when eating.Results All patients had their phonation restored in a week. 92 cases were decannulated. 45 cases had cough and then were improved after respiration training and one case was in failure. No death occurred in the perioperative period. The survival rates were 78.7% at 3 years and 68.5% at 5 years.Conclusions Laryngectomy with reservation of laryngeal function is feasible in senile patients aged 70 years and over under conditions of correct indication, right choice of operation and thoroughly care during perioperative.

Objective To evaluate the effects of small dose of dopamine on the renal blood flow in the elderly patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Sixty elderly patients,of ASA physical status Ⅱ or Ⅲ,aged 65-74 yr,weighing 52-77 kg,scheduled for elective cardiac valve replacement under CPB,were randomized to receive either normal saline (group C,n =30) or dopamine (group D,n =30).After beginning of surgery,CPB was established routinely.In group D,dopamine was continuously infused for 20 min at a rate of 2 μg· kg-1 · min-1 starting from 10 min after the hearts were perfused with cardioplegic solution for the first time,while the equal volume of normal saline was given in group C.The left renal blood flow velocity was measured by transesophageal echocardiography and mean arterial pressure was recorded before and after dopamine infusion.Blood samples were obtained before surgery and at 24 h after surgery for determination of blood urea nitrogen concentrations.Results Blood urea nitrogen concentrations were significantly increased at 24 h after surgery than that before surgery in the two groups.There was no significant difference in mean arterial pressure and the left renal blood flow velocity before and after dopamine infusion between the two groups.Conclusion Small dose of dopamine (2 μg· kg-1· min-1) dose not increase the renal blood flow or improve the postoperative renal function in the elderly patients undergoing cardiac valve replacement under CPB.

To investigate the expression and significance of the ? glucuronidase(? G) gene in the patients with primary hepatocellular carcinoma(HCL), ? G gene was detected in the carcinoma tissue of 54 cases of HCL, 51 cases of cirrhosis tissue of HCL and 10 normal liver tissue by immuno fluorescence, immunohistochemistry and in situ hybridization respectively. The results showed that the expression level of ? G gene in HCL was much higher than that in the normal tissue and the expression level of ? G gene in peri carcinoma tissue was much higher than that in the carcinoma tissue. The data also showed that the expression level of ? G gene was highly correlated with metastasis and differentiation, but not related to tumor size, pathologic type, AFP and serum HBsAg level. It suggested that ? G gene could be used as a predictor for diagnosis and metastasis of hepatocellular carcinoma.

Objective To explore the efficiency of writing admissions records with the electronic medical record system. Methods 16 interns with the same educational backgrounds and residency periods were randomized into 2 groups and wrote admissions records respectively with the electronic system and by hand, the traditional method. 1 week later, the same records were again written by the two groups, now each using the other's method. The time for completing each part of the records was noted down in real time across the entire process. The time taken by the interns to complete the records was changed into marks of speed, the assessments of the records by experts were changed into marks of quality, and composite marks resulted from the two after weighting. Statistical testing was done with the two methods. Results In terms of time, the average total time taken by the electronic and traditional groups was respectively 19. 85 m and 39. 49 m; in terms of quality, the electronic group got higher marks in scores for present, past, personal, and family histories and physical examination and in the overall score; in terms of general efficiency, the electronic group got average marks of 91. 13 while the traditional group got average marks of 65. 72, the difference being statistically significant (P