Pre-disease is a condition in which characteristic symptoms are not prominent.That is to say pre-disease is lack of key proof to be diagnosed as a disease,but has common symptoms as well as signs.It is said in Inner Canon of Huangdi that "prefer prevention to treatment",which needs doctors to find unusual symptoms in early stage of diseases then take positive preventive measures to help patients regain health.Diabetes mellitus(DM) is one of the life style-related diseases which associated with unhealthy habits of human beings.Pre-diabetes mellitus mainly refers to impaired glucose tolerance(IGT).With the help of modern medical technology,doctors and patients should focus on pre-diabetes by combining TCM treatment based on syndrome differentiation and health care,in order to stop DM at early stage.

[Objective]To review our experience in treatine infection after total knee arthroplasty with debridement and component retention to determine To the feasibility,indication,factors related to success and failure,and the main points of technique.[Method]Since 1990 to 2004,9 patients were treated with debridement and component retention at our department.[Result]Four of 9 patients successfully retained their component at most recent follow-up,without ongoing infection(mean 18 months,range 10～25 months).We have not draw the statistically significant factors that related to successful and failure,but the factors such as acute infection,surfacing replacement,immediate debrided after onset of symptoms,and the bacteria sensitive to antibiotic were relate to success.[Conclusion]Debridement and component retention can be used in acute postoperative infection and later acute hematogenous infection after total knee replacement,but timing and indication must be chosen strictly.

The confirmation of maxillomandibular relation is the key step to manufacture complete denture. Certain kind of transformation and shift will lead to the inaccuracy in the progress of the confirmation of maxillomandibular relation, while these problems could be avoided by applying remodified vacuum-formed occlusal pad. In this way, accuracy of the confirmation of maxillomandibular relation and the clinical effect can be enhanced.

Objective: To investigate the expression of MDR1 and GFP in the human hematopoietic cells mediated by adeno-associated virus. Methods: The GFP gene was transferred into the human hematopoietic cells by AAV vectors and created strong visible fluorescence by purely molecular biological means. Using adeno-associated virus vectors, we have transferred human mdr-1 gene into human hematopoietic cells and investigated the drug resistence of human hematopoietic cells modified with mdr-1 gene. PCR analysis confirmed that mdrl cDNA had been successfully transferred into the human hematopoietic cells. An assay of MTT proved that the human hematopoietic cells modified by mdrl gene had resistance to colchicine. Results: It was about 30% of the hematopoietic cells that expressed the green fluorescent proteins. The resistance of hematopoietic cells was increased parently when the cells were infected by the crude virus stocks. Conclusion: It is conducted that the AAV vector could successfully transfer the foreign gene into the human hematopoietic cells. The cells modified with mdrl gene have increased the resistance to drugs.

Objective:Combining with modern medical research progress in a number of target selections,to explore basic biology of different types of syndrome of obese type 2 diabetes.Methods:To research abnormal metabolic status from three levels of anthropometry,blood metabolism and fat factors.Results:The resistin secretion in phlegm-heat syndrome group was significant higher than that in the endogenous heat due to yin deficiency syndrome group,suggesting that resistin could be used as evidence to distinguish phlegm-heat syndrome and endogenous heat due to yin defi ciency syndrome.There was no signifi cant difference of the levels of leptin,IL-6,E-selectin,TNF-?,GLP-1,body mass index,waist-hip ratio,sugar metabolism in the target fasting blood glucose,glycosylated hemoglobin insulin,C-peptide levels,lipid metabolism in the target cholesterol,triglyceride,low-density lipoprotein,very low density lipoprotein,three renal urinary albumin excretion rate in urine,sugar protein and ?2-microglobulin,blood pressure,hematocrit,fibrinogen,C-reactive protein between the phlegm-heat syndrome group and endogenous heat due to yin deficiency syndrome group,but there was marked change tendency.Conclusion:There were differences of different types of syndrome of type 2 diabetes in basic biology from the aspect of spleen heat,and evidence of the possible differences need further study.

Objective:to observe the differential expression of adiponectin in different Chinese medicine syndrome of central obesity and its correlation with obesity character.Methods:To establish xu and shi syndrome of central obesity groups,with normal group as control.The metabolic symptoms and adiponectin expression will be tested and be used to study their correlation with obesity character.Results:The level of adiponectin,ratio of VA/SA,and fast insulin(FIns),HOMA-IR had signifi cantly difference between the xu and shi groups(P

Objective Primitive neuroectodermal tumor (PNET) is a rare malignant small round cell tumor .This paper aimed to study the clinical and pathological features of primary pulmonary primitive neuroectodermal tumor . Methods We collected 2 cases of primary pulmonary PNET to review the clinical and pathological features .Immunohistochemical staining was used to detect immune mark-ers, and fluorescence in situ hybridization (FISH) was applied to detect EWS translocation. Results 2 patients were aged 33 years and 17 years.Microscopically, the tumor cell was composed of single small round cells in diffusion or in distribution of sheets or beams , with scant cytoplasm , oval or spindle-shaped nucleus , high mitotic count .Irregular tumor necrosis scattered in the tumor along with visi-ble rosette structure.Immunohistochemical study showed that the tumor cells were positive for CD 99, FLI-1 and Syn, while CKpan, EMA, Desmin, CgA, TTF1, CD34 were negative.EWS/FLI1 translocations were detected positive in both the cases .2 patients died 7 months and 32 months after operation , respectively . Conclusion Primary pulmonary PNET is rare , so the selection of appropriate im-mune markers (CD99, FLI-1, Syn) and FISH for the detection of EWS translocation helps to improve the accuracy of diagnosis .

Objective To observe the levels of Livin and Caspase-3 in renal tissue of rats following acute paraquat (PQ) poisoning and the intervention effects of ulinastatin (UTI) . Methods Fifty-four Sprague-Dawley (SD) rats were randomly divided into three experimental groups: control group (group A),PQ poisoning group (group B) and UTI group (group C) (n = 18 in each group) . Rats in group B and group C were administered intragastrically with 80 mg/kg PQ, and rats in group C were treated with 100,000U/kg ulinastatin injected intra-psritoneally once a day; and rats in group A were administered intragastrically with the same volume of saline instead of PQ. At 24, 48, 72 hours after poisoning, the levels of Livin in renal tissue were detected by Westen blotting and the levels of Caspase-3 were detected by immunohistochemistry 24, 48, and 72 hours after poisoning, and the histopathological changes of renal tissue were observed at the same time. Results In the group A, the structure of renal tissue was distinct. In the group B, the distinctness of the structure of renal tissue declined significantly, and swelling, edema and vacuolar degeneration were observed 24 h after poisoning, and pathological changes became more and more obvious keeping pace with time elapsing, and sometimes karyopyknosis appeared and celluar structures disappeared with involvement of renal glomerulus and medulla. These pathological changes were significantly lessened in rats of group C. In the group A, there was little Caspase-3 in renal tissue of rats. Twenty-four hours after poisoning, the caspase-3 in renal tissue of rats of group B was found on the membrane and in the kytoplasm of renal tubular epithelial cells of cortical part. Compared with group B, the level of Caspase-3 in renal tissue of rats of group C decreased significantly to lower level (P ＜0. 01 ) . Compared with group A,the levels of Livin in renal tissue in rats of group B and group C increased significantly at all different intervals (P ＜0. 01 ), and as group B was compared with group C, the difference was statistically significant (P ＜0. 01 ) . Conclusions The main pathologyical changes of renal injury induced by PQ are epithelial swelling, vacuole degenerateion and necrosis. Caspase-3 is involved in the process of renal injury. UTI has a protective effect on the renal tissue of rats following paraquat poisoning through up-regulating the level of Livin and down-regulating the level of Caspase-3, however, the regulation mechanism as well as the pathway is still needed to further study.

Objective To evaluate the influence of Peplau interpersonal theory on improvement of nurses communication skills.Methods Totally 50 nurses from a certain level-three hospital in Ningbo were selected as research object using self-control method.These nurses received 8-time Peplau interpersonal theory training.The clinical communication competence was compared before and after the training.Results The clinical communication ability of nurses after training was obviously higher than that before the training.The difference had statistical significance.Conclusions Peplau interpersonal theory training can effectively improve the clinical communication ability of nurses.

Purpose To detect the expression of NKX2. 2 protein in gastrointestinal, pancreatic and esophageal neuroendocrine tumors and the correlation between the expression of NKX2. 2 and the clinicopathologic parameters. Methods 41 cases of gastrointestinal, pancreatic and esophageal neuroendocrine tumors were collected. The expression of NKX2. 2, Syn and CgA in neuroendocrine tumor samples were checked by using immunohistochemical staining. Results The positive expression of NKX2. 2 protein was localized in the nucleus. NKX2. 2 protein showed positive staining in neuroendocrine tumors of the seven original sites. In the four cases of normal pancreatic islet cells also showed strongly diffuse positive nuclear staining. The positive rates of NKX2. 2, Syn and CgA protein in the small intestine, rectum, pancreatic neuroendocrine tumors were 100%, 100% and 46. 7%, respectively. The positive rates of NKX2. 2 in foregut, midgut and hindgut were 30% and 87% (χ2 = 11. 09, P=0. 001). Positive NKX2. 2 protein expression was not associated with gender, age group, grade, tumor size and lymph node metastasis. Conclusion NKX2. 2, as a new type of neuroendo-crine markers, is obviously superior to CgA in the diagnosis of neuroendocrine tumors in the small bowel, rectum and pancreas. NKX2. 2, Syn and CgA, a panel approach may be beneficial to enhance diagnostic accuracy of the neuroendocrine tumors.