Objective To study the mechanism of diabetic nephropathy(DN) in type 2 diabetes mellitus of blood glucose fluctuation and oxidative stress.Methods 90 patients with type 2 DN were selected,included 30 cases of the normal albuminuria (DM group),30 cases of microalbuminuria (NA group),30 cases of the mass albuminuria (MA group),and during the same period,30 healthy persons in our hospital for medical examination were selected as the control group(NC group).The blood glucose,blood lipid,blood glucose fluctuation and oxidative stress were compared among the 4 groups.Results The blood glucose(FBG),postprandial 2h blood glucose(2hPG),glycosylated hemoglobin(HbA1c) levels had statistically significantly differences among the 4 groups(F=23.088,24.356,43.553,all P<0.05),which in the NC group[(4.03±1.12)mmol/L,(7.11±1.41)mmol/L,(4.11±0.83)%]were lower than the other 3 groups[DM group:(6.34±1.48)mmol/L,(9.13±1.52)mmol/L,(6.67±1.24)%;NA group:(6.58±1.53)mmol/L,(9.78±1.79)mmol/L,(7.53±1.51)%;MA group:(6.84±1.71)mmol/L,(10.23±1.36)mmol/L,(8.11±2.02)%](F=23.088,24.356,43.553,all P<0.05).There were no statistically significant differences in total cholesterol(TC),three acyl glycerin(TG),high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) among the 4 groups(F=1.079,1.732,0.358,1.428,all P>0.05).The mean amplitude of glycemic excursions(MAGE),mean absolute value of blood glucose(MODD),superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the 4 groups had statistically significant differences(F=37.350,216.899,21.003,93.211,all P<0.05).Correlation analysis showed that in patients with type 2 DN,negative correlation was observed between SOD and MAGE and MODD(r=-0.430,-0.523,all P<0.05),MDA and MAGE,MODD was positively correlated(r=0.534,0.624,all P<0.05).Conclusion Blood glucose fluctuation is involved in the occurrence and development of DN,the mechanism may be correlated with oxidative stress.

Objective To investigate the clinical and pathological characteristics, diagnosis and differential diagnosis of uterine intravenous leiomyoma (IVL) , so as to improve the detection of the disease.Methods Five cases of IVL were retrospected, who were treated and diagnosed by clinical gross examination,morphologic features and immunohistochemical staining in Tumor Hospital of Anyang from 2011 to 2015.Results Symptoms of IVL were usually nonspecific, most patients experienced hypermenorrhea, abdominal pain or distension, and pelvic mass.Typical pathological changes were intravenous visible grey weblike or worm-formed nodules, which could be pulled out.Microscopically, the tumors were composed of mild spindle-shaped cells with rare mitotic figure and closely related to blood vessels.The tumors were positive for smooth muscle derived marker, progesterone receptor, estrogen receptor, and negative for S-100, HMB45 and CD34.However CD34 can displayed vascular endothelial cells around the tumor.Conclusion Uterine IVL is a benign tumor with malignant biological behavior, which has different clinical pathological features of leiomyoma ordinary.Surgery is the main treatment method.A satisfactory therapeutic effect can be achieved by selecting the appropriate extent of surgery.Long term follow up of iVL patients after operation is important.

The expressions of survivin and bcl-2 protiens were examined in 8 specimens from normal pituitary tissues and 38 pituitary adenomas by immunohistochemistry. The results showed that the expression of survivin was strongly associated with bcl-2 expression and abnormal expression of survivin resulted in inhibition of cell apoptosis, which might play a role in the pathogenesis of pituitary adenomas.

Methylotrophy is a kind of widespread microbe which can use carbon compound as their only carbon and energy sources.It has been reported that methylotrophy can directly use one carbon com-pound to transform into their own metabolic one carbon unit,then these one metabolic one carbon units can be used as energy and carbon skeleton by organisms,which is a main part in one carbon metabolism.Because this is a novel metabolic system,it can be used in the study of biological metabolism and evo-lution.Based on the previous study about Methylobacterium sp.MB200 in our lab,here we summarized the research improvements about methylotrophy from their taxonomy,metabolism,genomics and ap-plications.

Objective To study the expression of BCSG1 ,S100A4,VEGF in human breast cancer.Methods Immunohistochemistry technique SP method was used to examine breast fibroadenoma in 40 cases,breast invasive ductal carcinoma in 62 cases ( by armpit lymph node metastasis as 2 groups) and corresponding paratumor tissues in 48 cases. Results Among the 4 groups, there was significant difference ( P＜0.05 ) in the positive immunostaining rate of BCSG1 ,S100A4, VEGF. Conclusions In the breast invasive ductal carcinoma, the expression of BCSG1, S100A4 and VEGF increased. This suggested the invasive and metastasis ability of the neoplasm enhanced. The expression were in positive correlation with tumor pathology. Combined detection of BCSG1, S100A4, VEGF expression contributes to the early diagnosis and prognostic assessment of the carcinoma of the breast.

Objective To investigate the relationship between the risk stratification of cardiovascular diseases and the outcome of 64-slice helical computed tomography (MSCT) coronary angiography. Methods A total of 470 cases suspected to have coronary heart disease were enrolled.They all received 64-slice MSCT coronary angiography, and they were divided into groups according to the range of disease, degree of calcium scoring, degree of stenosis and characteristic of plaque. Among them, 80 patients underwent both MSCT and selective coronary angiography (CAG) at one time, and they were grouped according to the range of disease and degree of stenosis. All the 470 cases were classified as five levels according to the risk stratification of cardiovascular diseases. The lesions of coronary artery in different risk stratifications were observed, and the correlations were analyzed.Results In the 80 patients who underwent both MSCT and selective CAG, there were no significant differences in the range of coronary artery diseases(χ2=3.631, P=0.067) and coronary arterystenosis (χ2=1.639, P=0.200) between MSCT and CAG. Along with the increased level of the risk stratification, there were the more ranges of the coronary artery diseases (λvery high risk. multi-vessel disease=1.09,λhigh risk. double-vessel disease=0.91, λlow-risk. single-vessel disease=1.07)and the more degrees of coronary artery stenosis(λvery high risk. severe stenosis=0.96,λhigh risk. moderate stenosis=1.03,λlow-risk. mild stenosis=0.78). The degrees of calcium scoring in different risk stratifications of cardiovascular diseases showed significantly differences (F=256.20,123.76,62.50, 98. 24,52.36,P＜0.01). There was the highest percentage of soft plaque in very high risk patients.Higher percentages of fiber plaque, calcified plaque and mixed plaque were found in moderate risk and low risk patients(λvery high risk. soft plaque=1.01,λlow-risk. calcium plaques=1.17). Conclusions The 64-slice MSCT coronary angiography could provide a basis for assessing risk stratification of cardiovascular diseases. The complicated coronary artery disease, moderate-severe calcification, more severe stenosis, higher percentage of soft plaque are found in the very high risk patients. The lower level of the risk stratification is found in patients with the less range of the coronary artery disease and less severe degree of the coronary artery calcification and stenosis. The calcified plaque and mixed plaque are found in moderate risk and low risk patients.

BACKGROUND: Type Ⅱ collagen has been used as the carrier for chondrocyte transplantation in animal models, but whether type Ⅱ collagen may cause arthritis or mediate cytotoxicity remains unknown.OBJECTIVE: To detect the cellular immune functions of the New Zealand rabbits immunized by porcine type Ⅱ collagen.DESIGN: An exploratory comparative study based on the observations.SETTING: An institute of trauma surgery of a municipal hospital.MATERIALS: The study was conducted in the Institute of Trauma Surgery,Guangzhou Red Cross Hospital from August 1999 to February 2000. Six New Zealand rabbits, whose body mass ranged from 2.0 kg to 3.0 kg, were chosen of either gender.METHODS: The rabbits were immunized by porcine type Ⅱ collagen for 60days, during which the plasma was regularly taken for detection of type Ⅱ collagen antibody. On the 60th day, the peripheral blood as well as the spleens and lymph nodes were taken to separate the lymphocytes, which were subjected to secondary stimulation with type Ⅱ collagen in vitro to observe the reactive cell proliferation. The lymphocytes were randomly divided into two groups, and the first group was treated with phytohemagglutinin(PHA) of different concentrations to serve as the positive control, in which non-specific immunity was examined; The second group was treated with type Ⅱ collagen of different concentrations for examining specific immunity.peripheral blood lymphocytes of normal and immunized rabbits.RESULTS: On the 21st day, the titer of the antibody presented the first peak, and 40 days after the re-injection of the antigen the second peak appeared, which maintained for 20 days and then gradually descended. The lymphocytes of the normal rabbits proliferated in response to PHA stimulation but not to the first stimulation with the type Ⅱ collagen. The lymphocytes of the immunized rabbits exhibited significant proliferation upon stimulations with both PHA and type Ⅱ collagen. At the concentration of 25 mg/L, type Ⅱ collagen stimulation was sufficient to induce lymphocyte proliferation, the peak of which occurred when the collagen concentration reached 50 mg/L.CONCLUSION: Xenogenic type Ⅱ collagen at an adequate concentration may induce the increase of the type Ⅱ collagen antibody in immunized rabbits and proliferation of lymphocytes of the spleens and peripheral blood to cause cellular immune reaction and even immunological arthritis in relation to the transplantation.

Objective To explore the relations of the doctor-patient relationship to psychological security and stress.Methods Totally 430 operation patients were selected and followed-up.A survey was performed using the Security Questionnaire (SQ),the Patient Doctor Relationship Questionnaire 13-Item Version (PDRQ-13),the Hospital Stress Rating Scale (HSRS) Results The average score of SQ was lower than medium value in operation patients.The SQ scores of operation patients with emergency operation were 39.50±10.51,lower than those of selective operation which were 49.02±10.37 and limited operation which were 47.67±10.29 (P ＜ 0.05).The SQ scores of operation patients who didn't provided themselves were 37.33±10.10,lower than those of basically which were 40.10±10.83 and partly provided for themselves which were 43.50±10.51 (P＜ 0.05).The SQ scores of operation patients in severe group according severity of illness were 37.13±10.40,lower than those of them in mild group which were 39.19±10.24 and moderate group which were 41.38±10.01 (P＜ 0.01).The SQ scores of post-operation patients were 44.32±9.96,higher than post-operation patients which were 40.36±10.81 (P ＜ 0.01).The lack of comforts (LC),lack of information (LI) and risks of serious disease (RSD) scores of post-operation patients were 49.23±30.62,30.46±21.42,52.84±31.22,lower than those of post-operation patients which were 52.37±32.06,35.25±20.14,80.12±33.18 (P ＜ 0.05).The path analysis showed that the regression relationship between SQ scores and PDRQ scores,RSD scores was established (β=0.40,-0.26,P ＜ 0.01),and the PDRQ-13 scores was a mediator between the scores of LC,LI,RSD and the SQ scores (β=0.40,P＜0.01).The PDRQ-13 scores was a adjustor between the RSD scores and the SQ scores (β=-0.34,P ＜ 0.01).Conclusions The operation patients have a low level of the sense of security which is statistically significant with surgical types,the ability to care for themselves and severity of illness.The sense of security of post-operation patients were higher than those of pre-operation patients.The recognition of physician-patient relationship may be play a mediating and adjusting role between the sense of security and stress.The surgical stress affect patient security and physician-patient relationship.

OBJECTIVE To study and evaluate the surgical management of cervical anastomotic stricture of the esophagus and its efficiency. METHODS Cervical anastomotic stricture resulted from colon by-pass for patients with esophagus stricture due to corosive in 5 cases,and gastric pull-up in 3 with esophagus carcinoma,one patient suffered serious esophagus stricture at its upper end because of previous radiation,and failed to the anastomoticplasty RESULTS All of them failed to respond to prior dilation. Anastomoticplasty was used in 6 of them,local flap,colon by-pass and jejunal free flap interposition was chosen based on the patient's situation. The operation got succeeded at its first time in seven patients,and at its second time in two cases. Normal oral feeding was restored in seven of them,and semiliguid feeding in the other two. CONCLUSION Surgical treatment is reliable in dealing with patients with problem of anastomotic stricture of the cervical esophagus.

OBJECTIVE To evaluate the clinical features of tumors primarily in the pterygopalatine fossa, and the efficiency of surgical management for these lesions. METHODS The clinical data of 7 cases with tumors primarily in the pterygopalatine fossa were retrospectively studied. Three of them were primary diseases, i.e. fibrous histiocytoma, neurofibroma and cholesteatoma. The other 4 cases were secondary tumors mainly located in pterygopalatine fossa. There were 1 case with epithelial-myoepithelial carcinoma, 1 case with adenoid cystic carcinoma , 1 case with recurrent inverted nasal papilloma, 1 case with recurrent malignant fibrous histiocytoma. Approaches to tumors in pterygopalatine fossa lesions included lateral rhinotomy, and transnasal or transantrum approaches under the nasal endoscope. RESULTS The patient suffered from adenoid cystic carcinoma developed local recurrence 4 months after operation, and extended resection of the recurrent tumor with laser was performed again. No further recurrence was found after following-up for 3 years. Neither local recurrence nor regional metastasis was found in the remaining 6 cases with a follow-up period of 2 to 4 years. The main complication was oronasal fistula. CONCLUSION CT scan or MRI is the main method to the early diagnosis of pterygopalatine fossa tumors. Lateral rhinotomy, endoscopic trasnnasal or transantrum approaches are feasible procedures to resect the tumors.