Objective To investigate the changes of Na~+,K~+-ATPase activity in the proximal tubules (PT) of type 2 diabetes mellitus(T2DM) and the correlation of PT Na~+,K~+-ATPase activity and endogenous digitalis-like substance (EDLS). Methods Female Wistar rats were developed a rat model of T2DM and then divided into 3 groups after injected stretozotocin, that is, 5 weeks group, 7 weeks group and 9 weeks group. The PT were microdissection by freehand. Na~+,K~+ -ATPase activity of PT were determined by liquid scintillation counter. Serum EDLS and insulin were determined using radioimmunoassay. Results Compared with control group, T2DM rats were associated with hyperglycemia, hypertriglyceridemia, dyslipidemia, and insulin resistance; Na~+,K~+-ATPase activity of PT in T2DM rats was significantly increased, and there was no significant difference among 3 sub-groups. Serum EDLS level was significantly enhanced in T2DM, however, EDLS levels were no significant difference among 3 sub-groups. Na~+,K~+-ATPase activity of PT had negative relation with EDLS level in serum. Conclusion Na~+,K~+-ATPase activity of PT in T2DM rats is increased and EDLS level in serum decrease may play a important role.

Objective To evaluate the efficacy of percutaneous laser hypothermia in the treatment of lumbar discogenic pain. Methods From June 2006 to March 2008,35 patients with lumbar discogenic pain were treated by low-frequency laser hypothermia in our hospital with 1 second impulse time,1 second interval time,3.5 w power,and 30 minutes duration. The effectiveness of the therapy was evaluated afterwards. Results Among the cases,15 patients were treated by one operation,20 patients received a second therapy,and 6 underwent the therapy for totally 3 time; the treatment was effective in 32 cases (excellent in 7,good in 24,and fair in 1). The therapy is ineffective in 2 cases. One case was converted to open surgery for unsatisfying outcomes of the laser hypothermia. The total effective rate was 91.4%(32/35),and fineness rate was 88.6%(31/35). Conclusions Percutaneous laser hypothermia is an effective treatment for lumbar discogenic pain. The indications for the procedure should be selected strictly.

Objective To investigate the relationship between diabetic retinopathy(DR) and the state of diabetes mellitus(DM) control.Methods The factors for the occurrence and development of DR were analyzed by non conditional Logistic regression model.Results 5 significant factors were screened out,which were urinary microalbumin excretion index(ALB/Cr),blood glucose before breakfast,glycosylated hemoglobin(HbAlc),diabetic neuropathy and course of DM.And the sugestible threshold value of blood glucose before breakfast is 7.90mmol/L at which we can prevent the occurrence of DR,and at 7.15mmol/L,occurrence of DR can be strictly controlled.Conclusion The state of controlling blood glucose and other complications in DM patients influences the occurrence and development of DR.

Objective To evaluate the significance of sonographically detected thyroid calcification in the diagnosis of thyroid carcinoma.Methods Five hundred and twenty-two patients with thyroid disease,including 119 with thyroid cancer,were included in the study.Each patient underwent preoperative,highresolution sonography to evaluate the thyroid gland for the presence of calcification.Calcifications were classified:type Ⅰ,microcalcification;type Ⅱ,coarse calcification;type Ⅲ,annular or"egg-shell"calcification;typeⅣ,calcified nodules within a cyst.Results The incidence of calcification and microcalcification was significantly higher in thyroid cancer than in benign nodules(P＜0.001).The appearance of microcalcifications was highly specific for malignancy with a sonographic specificity of 88%.The sensitivity was 60%,and the odds ratio(0R)was 11.28.The incidence of calcifications of type Ⅱ and type Ⅲ did not differ significantly between the benign and malignant groups.Calcifications of type Ⅳ were showed totally in benign groups.Patients younger than 45 years with calcified nodules constituted a highrisk group,with a OR of 11.33 versus 2.96 in patients older than 45 years with calcified nodules.In the group of solitary thyroid nodules,the incidence of cancer in the calcified nodules was higher than in the nodules without calcifications,with a OR of 20.48.Conclusions The detection of thyroid calcifications by sonography is diagnostically valuable,especially in eases involving a solitary nodule or a young person.The presence of calcifications in these cases should raise the suspicion of malignancy,especially microcalcification.

Objective To investigate the influence of heme oxygenase-1 (HO-1) on rat renal tubular epithelial cell apoptosis induced by albumin and the possible mechanism. Methods The renal tubular epithelial cells (NRK-52E) were cultured in DMEM/F12 1:1 medium as normal control group; NRK-52E cells were cultured with 30 g/L fat-free bovine serum albumin (BSA) as the BSA control group; NRK-52E cells were cultured with CoPP (Cobalt pretoporphyrin Ⅸ) 5 μ mol/L for 24 hours as the treatment group. MTT assay was used to observe the effects of CoPP on growth inhibition induced by BSA in NRK-52E cells. The effect of CoPP was observed in BSAinduced apoptosis with the fluorescence microscope dyed by AnnexinV-FITC PI. The levels of HO-1, and expression of Bcl-2 and Bax mRNA were detected by reverse transcript polymerase chain reaction (RT-PCR). Results Compared with normal control group, BSA inhibited the growth of NRK-52E cells (P<0.05) and increased cell apoptosis rate (P<0.05). The CoPP pretreatment partially inhibited the BSA-induced apoptosis(P<0.05). Compared with normal control group, HO-1 mRNA expression increased (0.44±0.06 vs 0.39±0.05, P<0.05) in BSA control group. Compared with the BSA control group, the expression of HO-1 mRNA significantly increased after CoPP pretreatment(0.50±0.06 vs 0.44±0.06, P<0.05 ). Meanwhile, BSA increased the expression of Bax mRNA (0.87±0.04 vs 0.67±0.03, P<0.05)and reduced the expression of Bcl-2 mRNA (0.25± 0.04 vs 0.42±0.02, P<0.05 ). CoPP could inhibit the effect of BSA (Bax mRNA: 0.75±0.07, Bcl-2 mRNA: 0.36±0.03, P<0.05, respectively). Conclusions BSA can increase the apoptosis rate significantly and regulate the expression of apoptosis associated proteins in mRNA level directly. CoPP inhibits these changes, which provides evidence to support the essential role of HO-1 in cytoprotective function .

Objective To assess the pubvaginal fascia sling cystourethropexy (PV sling) technique and outcomes of the treatment of female type Ⅲ stress urinary incontinence. Methods From October 2005 to January 2008, 9 women presenting with type Ⅲ stress urinary incontinence were treated with Pubvaginal fascia sling cystourethropexy. All the patients underwent 1 h pad test before discharge and were tested with maximum uroflow rate, volume of postal residual urine, maximum urethral close pressure (MUCP) and abdominal leak point pressure (ALPP) after 3 months. Results The operative time ranged from 60 to 90 min (mean, 75 min). Estimated blood loss ranged from 60 to 100 ml (mean, 76 ml). Intraoperative unilateral bladder perforation occurred in 2 cases. One patient with infection of abdominal incision was cured by changed dressings. The urinary catheter was removed 5 days post-operation. 4 patients had normal urination and 1 patient had urine retention. The recovery following intermittent catheterization was 3-12 days. 8 patients got 3-28 months' follow up. 7 patients were cured with 1 h pad test decreased from preoperative 58 g (45-75 g) to postoperative 1 g (0-2 g), mean residual urine was less 65 ml (0-80 ml). The values of Qmax (ml/s),MUCP (cm H2O) and ALPP (cm H2O) were 10. 5±2. 7, 15. 5±3. 4 and 40. 4±8.2 pre-opreative,and 26.5±3.9, 49.8±6.7 and 98.6± 12.2 3 months post-operative. There were significant differences of these parameters between pre-and post-operation (p＜0.01). Conclusions PV sling could be a safe and effective surgical procedure fortreatment of type Ⅲ female stress urinary incontinence.

Objective To explore the association between the 5-HTR2A (-1438A/G)promoter region gene polymorphisms and unipolar depression and effcacy of antidepressant drugs in northwest Chinese Han population.Methods Polymerase chain reaction (PCR) was used to detect the distributive frequency of serotonin 2A receptor promoter region polymorphisms of 136 unipolar depression patients( patient group) and 160 normal people tween the patient group and the control group.The frequency of AG,GG genotypes; and G allele in patients was phisms of 5-HT2AR promoter region were correlated with SSRIs treatment response(F= 6.317, P= 0.013 ).There was significant difference of the effective power at the end of week 2 ( x2 = 5.878, P= 0.015 ).The effective power of AA, AG genotype was much higher than that of GG genotype and the effective power in the group with AA genotype was higher than that with AG genotype( each 87.8% ,57.6% ,53.7% ).Conclusion The frequency of GG genotype of 5-HTR2A( 1348A/G)may be associated with episode of unipolar depression in northwest Chinese Han population and A allele may be correlated with well response to paroxetine.

The correlated proteome of Penicillium marneffei resistant to fluconazole was investigated in the present study, in which 11 strains of P. marneffei of both the mycelial and yeast forms sensitive to fluconazole were cultivated in Sabouraud's liquid medium containing 8 g fluconazole and the MICs of fluoconazile to P.marneffei before and after inducing cultures were tested by E-test method. The strains of the mycelial and yeast forms showing the most significant increase in MIC value were selected and the protein clip CM10 was used to detect the proteome differences before and after inducing cultures. It was found that 11 strains of the mycelial forms and 2 strains of the yeast forms could tolerate the action of fluconazole and could grow at a drug concentration of 8 μg/mL. Furthermore, the MICs of fluoconazole to the mycelial forms were significantly increased after 7 days of inducing culture and the geometric means of MICs were increased from 1.22 μg /mL to 55.56 μg/mL. After the mycelial forms had been induced to be resistant, 16 proteins were highly expressed with specific expression of the 4581.1 Da and 6109.7 Da proteins; whereas 22 resistant yeast form were highly expressed with specific expression of the 3575.2 Da, 8507.0 Da and 8563.3 Da proteins. These results suggest that the mycelial form of P.narneffei seems to be more tolerant to the action of fluconazole than the yeast form. The resistance of these organisms to fluconazole may be associated to some specific proteins.

Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.