Objective To investigate the clinical significance of serum P-selection,TNF-α,hs-CRP,IL-1β, ICAM in patients with diabetic renal microangipathy, and the therapeutic mechanism of Simvastatin combined with aspirinon in treating renal microangipathy. Methods The serum levels of P-selection,TNF-α, hs-CRP, IL-1β, ICAM were determined by ELISA in all groups. Patients with diabetic renal microangipathy treated with simvastatin and as-pirinon. Results ① The serum levels of P-selection,TNF-α,hs-CRP,IL-1β,ICAM in DM groups were higher than those of normal controls(P<0.01). ②After treatment with simvastatin and aspirinon for 8 weeks in patients with di-abetic nephropathy,the serum levels of P-selection, TNF-α, hs-CRP, IL-1β, ICAM were all decreased significantly compared with those before treatment respectively (P<0.01). After treatment for 16 weeks the above indices re-mained decreased until treatment for 21 weeks (P<0.01). Conclusion ①The plasma levels of Poselection,TNF-α and hs-CRP, IL-1β, ICAM are correlated to the occurance and development of diabetic renal microangiopathy, becom-ing predicted factors in early stage of diabetic renal microangiopathy. ②The therapeutic mechanism of simvastatin and aspirinon in patients with diabetic nephropathy lies probably in the inhibition of these factors expression, thus di-rectly or indirectly affecting the prolffer-ation of mesangial cells and mesangial matrix.

r cirrhosis. NO and ET-1 are involved corporately in the development of liver cirrhosis, but not the main factors facilitating hypoxemia of liver cirrhosis.

Objective To study the influence of interleukin(IL)-1β,intercellular adhesion molecule(ICAM)on diahetic renal microangiopathy.Methods Sixty-two patients with type 2 diabetic mellitus were divided into three groups:normal albumin urine group(20 patients),microamount albumin urine group(22 patients),and dominancy albumin urine group(20 patients)according to their urinary albumin excretion rate(UAER).IL-1β,ICAM was measured by enzyme-linkedimmuno sorbent assay(ELISA)method in the type 2 diabetic mellitus and the healthy persons.Results The concentration of IL-1β,ICAM in the three groups with type 2 diabetic mellitus was higher than that of the twenty healthy persons(P＜0.05),higher in the dominancy albumin urine group than that in the microamount albumin urine and normal albumin urine groups(P＜0.01).The concentration of IL-1β in the microamount albumin urine group was higher than that in the normal albumin urine group(P＜0.05),the concentration of ICAM in the microamount albumin urine and normal albumin urine groups was equal(P＞0.05).Higher serum IL-1β and ICAM was associated with higher UAER(P＜0.05).The concentrations of IL-1βwas positively correlated with ICAM.Conclusion ICAM,IL-1β is probably correlated to UAER of diabetic renal microangiopathy,80 it has very important meaning and clinic value to measure the concentration of IL-1β,ICAM in serum earlier.

Objective To study the relationship between expression of multidrug resistant 1 ( MDR1) gene encoded P-glycoprotein ( P-gp) and multidrug resistance relation protein ( MRP) in ulcerative colitis and the disease behavior. Methods Sections of endoscopic biopsy samples from patients with ulcerative colitis were studied by immunohistochemistry with monoclonal antibody of MDR1 gene encoded P-gp and MRP. Results Expressions of MDR1 gene encoded P-gp and MRP in the 12th month and 18th month of ulcerative colitis were 40. 5% , 45.9% , 48. 6% and 51.4% , respectively, which were all significantly higher than those of early phase ( P < 0.05). P-gp and MRP expressions in active stage and remission stage of ulcerative colitis were 36.4% , 18. 6% , 46. 1% and 25.4% , respectively, which was significantly different between the two stages (P < 0.05 ). At active stage of ulcerative colitis there was no significant difference in expressions of P-gp and MRP among mild, moderate and severe patients (P > 0. 05 ). Conclusion Examination of P-gp and MRP expressions is feasible and dependable in presenting evidence of drug insistence. However, it is not suitable to be an indicator of severity because of its poor differentiation ability in active stage.

Objective To detect the levels of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and investigate its relationship with liver function, ascites and heart structure in patients with liver cirrhosis. Methods The levels of plasma NT-proBNP and various clinical and biochemical parameters were determined in 60 patients with liver cirrhosis and 30 healthy controls. Meanwhile Child-Pugh liver function was classified. All people underwent color Doppler echocardiography. Results The level of plasma NT-proBNP was significantly elevated in patients with liver cirrhosis [(38.63±36.05)pmol/L], compared with that of the controls [(7.50±8.25)pmol/L],P<0.01. There was no significant difference in different Child-Pugh class and aseites amount of liver cirrhosis. E/A < 1 and E wave decelerate time (EDT) was in-creased in liver cirrhosis. Conclusion The levels of plasma NT-proBNP in liver cirrhosis are significantly elevated, and related to early impairment of diastolic function. But it does not correlate with liver function and aseites.

Objective To investigate the relationship between pancreatic cancer and diabetes mellitus (DM). Methods Two hundreds and twenty patients with pancreatic cancer and 300 controls, who suffered from non-digestive tract, non-neoplastic or non-hormone-related disorders, were enrolled from 1997 to 2007. The incidence of diabetes between the two groups and the relationship between pancreatic cancer and diabetes were compared, pancreatic cancer patients with DM were compared with patients without DM for their gender, age, location and differentiate degree of the cancer. Results The incidence of DM in the two groups were 33.1% and 9.67%, respectively, and the difference was significant (P < 0.05). In the pancreatic cancer group, the proportion of patients with DM diagnosed within 2 years or for more than 10 years were 25.91% (57/73) and 3.18% (7/73), which were significant higher than those in the control group 6.0% (18/29) and 0.67% (2/29)) (χ2=46.15, P<0.01, 0R=6.07; χ2 =4.72, P<0.01, OR=4.90). In the pancreatic cancer group, the proportion of patients with DM diagnosed within 2～5 years or 5～10 years was not significant different when compared with that of the control group, and there was no significant difference in terms of gender, age and cancer location between the pancreatic cancer patients with DM and without DM. The majority of pancreatic cancer patients with DM had corpora mammillaria or well differentiated adenocarcinoma, and the majority of pancreatic cancer patients without DM had differentiated adenocarcinoma. Conclusions DM was closely related with pancreatic cancer and DM may be one of the presentations of pancreatic cancer, as well as a possible risk factor for the tumor.

AIM: To evaluate the changes of serum total prostate specific antigen (T-PSA), free prostate specific antigen (F-PSA) and the ratio of F-PSA to T-PSA (F/T) in patients with prostate cancer (PCa) and its clinical significance. METHODS: The concentrations of T-PSA and F-PSA in serum were measured by micropartical enzyme immunoassay (MEIA) using AxSYM System, and the F/T ratio was calculated. RESULTS: Before operation, the concentrations of T-PSA and F-PSA in patients with PCa were much higher and F/T ratio was significantly lower than that in patients with benign prostate hyperplasia (BPH). T-PSA and F-PSA levels decreased, but F/T ratio increased after operation in PCa and BPH. F/T ratio in 83.5% PCa and 6.5% BPH was less than 0.16. To diagnosis PCa, the sensitivity of F/T ratio was 83.5%, and the specificity was 86.7%. CONCLUSION: Serum T-PSA, F-PSA and F/T ratio are important parameters for the early diagnosis of prostate cancer. [

Objective To investigate the expression of melatonin MT1 receptor in rats with acute necrotizing pancreatitis (ANP) and the protective effects of melatonin (MT) pre-intervention for the pancreas. Methods Fifty-four male Sprague-Dawley (SD) rats were randomly divided into three groups:sham-operation group, ANP group and MT-pretreated group. The models of ANP were induced by retrograde injection sodium taurocholate into the bili-pancreatic duct. MT group undergoing intraperitoneal injection 50 mg/kg 30 minutes before the establishment of ANP models. Four, 8 and 12 hours after the onset of operation, the levels of serum amylase and pathological changes of the pancreas were observed. The contents of malondialdehyde (MDA), superoxide dismutase (SOD) and tumor necrosis factor-alpha (TNFα) in the pancreas were measured. The expression of MT1 protein and MT1 mRNA in pancreas were separately analyzed by immunohistochemistry and real-time PCR. Results (1) Pancreatic pathological damage in ANP groups was progressive exacerbated. It was obviously ameliorated in MT group as compared with ANP group ( P ＜ 0.05 ); (2) Compared with SO group, the levels of serum amylase, MDA and TNFα in the pancreas were significantly increased in ANP group (P ＜0.05 or P ＜0.01 ). They were markedly decreased in MT group as compared with ANP group [ 12 h, (2348.00 ±278.90)U/L vs (3194. 83 ±538.10)U/L,(2.255 ± 0.472 ) μmol/L vs ( 2.960 ± 0.722 ) μ mol/L, ( 102.929 ± 29.399 ) ng/L vs ( 378. 544 ±183.454)ng/L, P ＜ 0.05 ]. The level of SOD was decreased in ANP group compared with SO group (P ＜0.05) and increased in MT group[ 12h, (11.448 ± 1.594)U/L vs (8.427 ± 1.950)U/L, P＜0.05] ;(3)Compared with SO group, the expression of MT1 protein and MT1 mRNA in ANP group were down-regulated as the severity of the disease increased ( P ＜ 0.05 ). They were significantly higher in MT group than ANP group. Conclusions Melatonin pre-intervention is able to increase SOD level and decrease MDA, TNFα levels, thereby reducing pancreatic injury. The MT1 might play an important role in the pathogenesis of ANP. MT might exert protective effects for the pancreas in ANP rats through increase the expression of MT1.

Objective To investigate changes of esophagogastric varicosis,and portal hemodynamics in cirrhotic portal hypertensive patients after Hassab surgical operation. Method The changes of esophageal varicosis and gastric varices incidences at different phases of cirrhotic patients after the Hassab surgical operation were examined by electric endoscope.Hemodynamics of portal vein system was measured by Doppler color imaging and color Doppler ultrasound after operation. Results Mild esophageal varicosis incidences on the 6th,12th and 18th month after the Hassab surgical operation were respectively 44.1%,34.7% and 28.4%,higher than that before operation (7.5%) (P＜0.05).Severe esophageal varicosis incidences on the 6th,12th and 18th month were respectively 25.1%,30.0% and 35.0%,lower than that before operation (65.2%) (P ＜ 0.05).Mild esophageal varicosis with gastric varices incidences on the 6th,12th,18th and 24th month before and after operation were respectively 16.6%,and 7.4%,9.2%,9.1%,10.3% respectively.Severe esophageal varicosis with gastric varices incidences in the 6th,12th,18th and 24th month were respectively 43.8%,and 45.8%,45.2%,47.4%,48.8% (P＜0.05).Inner diameter of portal vein and the right branch of portal vein on the 6th and 12th month before and after operation were respectively (13.5±1.7) mm,(9.8±2.0) mm,(10.5±2.2) mm,(11.2±1.2) mm,(8.1 ± 1.3) mm and (8.2 ± 2.2) mm (P ＜ 0.05).Maximum flow rate and blood flow of portal vein,velocity of the left of portal vein in the 6th and 12th month were respectively (13.6 ±2.6) cm/s,(1095 ±290) ml/min,(13.3±2.6) cm/s,(11.5 ±1.6) cm/s,(11.8 ±1.8) cm/s,(847 ±249) ml/min,(907 ± 310) ml/min,(11.0 ± 1.9) cm/s and 11.1 ± 1.9 cm/s (P ＜ 0.05).Velocity of the right of portal vein in the sixth month were (11.6 ± 2.6) cm/s,which was significantly slower than preoperative level of (13.2 ± 2.9) cm/s. Conclusion After the Hassab surgical operation the degree of esophageal varices lightens during 18 months and aggravates after 18 months.There is obvious relation between gastric varices and the degree of esophageal varices.Velocity of portal blood flow becomes slow,blood flow diminishes and inner diameter reduces after the Hassab surgical operation.

Objective To analyze the changes of varicosis and hemodynamics in cirrhotic patients with portal vein hypertension at different stages after Hassab devascularization, and to evaluate the outcome.Methods Hassab devascularization was performed in 161 patients with portal vein hypertension, who were all evaluated by means of endoscopy, Doppler color imaging and Child-Pugh grading before and 6, 12, 18,24 months after the procedure, respectively.Results The rates of mild esophageal varicosis were 44.0%,34.8% and 28.3% at 6, 12 and 18 months after Hassab devascularization, respectively, which were all significantly higher than that before the operation(7.5%, P ＜ 0.05), while the rates of severe esophageal varicosis were 25.2%, 29.7% and 34.9% at 6, 12 and 18 months after the procedure, which were significantly lower than that before(65.2%, P ＜ 0.05).The incidence of varices in gastric fundus was correlated with the severity of esophageal varices.At 12 months after the operation, the inner diameters of portal vein and its right branch significantly decreased when compared with those before(P ＜ 0.05), the maximal flow rate,volume of portal vein and average flow rate of the left branch also significantly decreased(P ＜ 0.05).At 6 months after the operation, the average flow rate of the right branch slowed down(P ＜ 0.05).Child-Pugh Grade A accounted for 63.5%, 60.6% and 57.9% at 6, 12 and 18 months after the operation, respectively, which were significantly higher than that before(48.4%, P ＜0.05).When evaluated at 24 months after the procedure, all variables were getting close to those before.Conclusion The severity of esophageal varices mitigates in 18 months after Hassab.Hemodynamics of portal vein system decreases in 12 months.The overall liver function improves in 18 months after the operation.