Objective To explore the relationship among plasma cytokines’ level, adhesion molecules expression and skin damage in patients with chronic venous insufficiency (CVI) of lower extremities.Methods In 32 patients with CVI and 8 normal individuals as control, blood TNF ?, IL 1? and IL 2R were assayed with ELISA method; serum endothelial cell intercellular adhesion molecule 1(EC ICAM 1), polymorphonuclear CD 18 (PMN CD 18 ) and polymorphonuclear CD 11b (PMN CD 11b ) were assayed with immunohistochemical method; and ultrastructure of diseased veins was examined by electroscope.Results The results showed that the level of plasma TNF ? and IL 1? increased remarkably in Class 2-3 compared with Class 1 and control ( P 0.05) . The index of EC ICAM 1 and PMN CD 11b positively expression increased remarkably in Class 2-3 compared with that in Class 1 and control. The index of PMN CD 18 expression in Class 2-3 and Class 1 was greatly higher than that in control ( P

Objective　To study the relationship between cell apoptosis and vascular disease.Methods　The paper reviewed the concept, character, gene control and signal transduction of apoptosis associated with vascular disease.Results　Cytokine, radiation could induce apoptosis of endothelial cells, and caused vascular damage.The apoptosis of smooth muscle cells was related to the atherosclerosis and restenosis of vessels.Conclusion　Cells apoptosis is related to vascular disease significantly.

Objective:To investigate the clinical effect of hydromorphone combined with ropivacaine and its effect on stress response after laparoscopic myomectomy.Methods:From March 2017 to March 2020 in Shangyu Hospital of Traditional Chinese Medicine, Zhejiang Province, 100 patients who were performed laparoscopic hysteromyoma were randomly divided into observation group (50 cases) and control group (50 cases). Both groups were treated with plane block of transverse abdominal muscle after anesthesia induction. The control group was injected with ropivacaine, and the observation group was injected with hydromorphone and ropivacaine. The changes of hemodynamics at the time of entering operation room (T 0), 1 h after operation (T 1) and after surgery (T 2) were compared between two groups. The visual analogue scale (VAS) score at postoperative 3 h, 12 h and 24 h, Ramsay sedation score during operation, and serum stress level at preoperative and postoperative 24 h were compared between two groups. Results:The levels of heart rate, systolic and diastolic blood pressure between the two groups at different times had no significant differences ( P>0.05). The VAS scores of the observation group at postoperative 3 h, 12 h and 24 h were lower than those in control group [(3.05 ± 0.32) scores vs. (3.42 ± 0.39) scores, (2.16 ± 0.38) scores vs. (2.73 ± 0.43) scores, (1.43 ± 0.29) scores vs. (2.28 ± 0.35) scores], and there were significant differences ( t = 5.186, 7.024, 13.223, P<0.05). The scores of Ramsay sedation score in observation group was higher than that in control group [(3.79 ± 0.45) scores vs. (2.54 ± 0.39) scores], and there was significant difference ( t = 14.843, P<0.05). The levels of noradrenaline, interleukin-6, and cortisol in observation group at postoperative 24 h were lower than those in control group [(254.18 ± 14.35) pmol/L vs. (328.73 ± 18.69) pmol/L, (26.89 ± 4.10) ng/L vs. (35.27 ± 5.46) ng/L, (214.30 ± 21.28) pmol/L vs. (296.53 ± 32.19) pmol/L], and there were significant differences ( t = 22.371, 8.678, 15.068, P<0.05). Conclusions:The combination of hydromorphone and ropivacaine in abdominal transverse plane block after laparoscopic myomectomy has good analgesic and sedative effects and can reduce stress response.

Objective To investigate the relationship between the serum ghrelin level and β-cell function after treatment of patients with newly diagnosed type 2 diabetes mellitus.Methods 34 patients with newly diagnosed type 2 diabetes mellitus were divided into three groups of pre-treatment(DM0),two weeks after treatment(DM1)and six months after treatment(DM2).Intravenous glucose tolerance tests(IVGTT)were performed and blood glucose,HbA1C,ghrelin,insulin were measured during the study.Insulin sensitivity was assessed by homeostasis model assessment(HOMA).Results(1)Compared with DM0 group,beta-cell function and the mean AUC of insulin were dramatically improved in groups of DM1 and DM2(all P<0.05).(2)Compared with DM1 and DM2,ghrelin levels and the mean AUC of ghrelin in DM0 groups were lower(all P<0.05).(3)Only positive correlation between ghrelin and HOMA-β(r=0.446,P<0.05),and negative correlations of ghrelin with glucose(r=-0.274,P<0.05),insulin(r=-0.35,P<0.05)and BMI(r=-0.276,P<0.05)were found after six months of treatment.Conclusions Ghrelin might play an important role in the pathogenesis and progress of type 2 diabetes mellitus.

AIM: To access the difference of the efficacy between terbinafine and itraconazole in the treatment of dermatophyte onychomycosis. METHODS: The Medline, Science Direct On Site (SDOS), and Springer database were searched in detail on the data of the mycological cure rates of the two antifungal agents for treatment of dermaphyte onychomycosis occourring in patients aged from 18 a to 60 a with the published double blind randomized clinical trials and then pooled. The odds ratio (OR) and its 95 % confidence interval (CI) were calculated. RESULTS: Six treatises of double blind randomized clinical trials were selected for this analysis according to the screening criteria. The mycological cure rate of continuous terbinafine 250 mg per day was higher than that of either therapeutic effect of itraconazole pulse 400 mg per day (OR = 5.01, 95 % CI (3.42 - 7.33)) or continuous itraconazole 200 mg per day (OR = 2.58, 95 % CI (1.91 - 3.49)) . CONCLUSION: Terbinafine is more effective than itraconazole in the treatment of dermatophyte onychomycosis.

Objective: To investigate the inlfuence of different blood pressure (BP) circadian rhythm on cardiac function in hypertensive patients.
Methods: A total of 180 hypertensive patients with well controlled day-time blood pressure were divided into 3 groups. Dipper group, n=30, Non-dipper group, n=99 and Reverse dipper group, n=51. The relationship between cardiac function, relevant clinical index and blood pressure circadian rhythm were analyzed.
Results: The mean systolic and diastolic BP, BP classiifcation and the antihypertensive medication were similar among 3 groups.①The ratio of peak mitral E wave to peak mitral annulus E' wave (E/E') increased accordingly from Dipper group, Non-dipper group and Reverse-dipper group as (8.1 ± 2.4), (8.6 ± 2.5) and (9.6 ± 3.2), P<0.05. ②Left atrial volume index (LAVi) in Reverse-dipper and Non-dipper groups were higher than that in Dipper group as (43.8 ± 11.8) ml/m2, (40.7 ± 9.8) ml/m2 and (36.6 ± 8.5) ml/m2, P<0.05 or P<0.01. ③E/E' was positively related to nocturnal systolic BP and age, negatively related to nocturnal BP decline rate (nocturnal BPR); E/E' was independently related to age and BPR. LAVi was positively related to nocturnal systolic BP, pulse pressure, age and hypertension course, negatively related to the mean diastolic BP, day-time diastolic BP and BPR; LAVi was independently related to BPR, pulse pressure and hypertension course. Left ventricular ejection fraction had no statistic differences among 3 groups.
Conclusion: Abnormal blood pressure circadian rhythm was associated with the cardiac injury in hypertensive patients. The cardiac injury increased accordingly from Non-dipper group to Reverse-dipper group and the main damage was in diastolic function.

Objective To investigate the relationship between the serum ghrelin level and ?-cell function after treatment of patients with newly diagnosed type 2 diabetes mellitus.Methods 34 patients with newly diagnosed type 2 diabetes mellitus were divided into three groups of pre-treatment(DM0),two weeks after treatment(DM1)and six months after treatment(DM2).Intravenous glucose tolerance tests(IVGTT)were performed and blood glucose,HbA1C,ghrelin,insulin were measured during the study.Insulin sensitivity was assessed by homeostasis model assessment(HOMA).Results(1)Compared with DM0 group,beta-cell function and the mean AUC of insulin were dramatically improved in groups of DM1 and DM2(all P

Objective To investigate the comparative roles of the pathologic changes of gastrocnemius on the pathologic process of varicosis of the lower extremity(VLE). Methods By means of electron microscopy and light microscopy, image analysis and the capillary basement membrane and gastrocnemius muscle cell in 30 patients with VLE and 10 contrast subjects were studied. Results (1) Light microscopically, smearing of cross-striation, sarcolemmal proliferation, fibrinoid degeneration, fatty degeneration, and haemorrhage were seen in muscle of patients with VLE. (2) Electron microscopically, increase in thickness of the capillary basement membrane, increase in lipid droplets and glycogen, swelling of mitochondra, myelin figure, lipofusin, disruption of the myofibrils, and myopathic changes were seen in muscle cells of patients with VLE. The area and thickness of the capillary basement membrane in patients with varicosis were higher than those in the control subjects ( P 0.05). Conclusions (1) It is suggested that the ultrastructure changes of gastrocnemius muscles result from ischemia and hgpoxia. Among the changes, the capillary basement membrane plays an important role in the induce insuficiency of the calf muscle pump function which result in VLE extremities. (2) It is suggested that degeneration of gastrocnemius muscle cell may relate to the insufficiency of calf muscle pump function. (3) In early pathologic process, insufficiency of the calf muscle pump function can be compensate by muscle cells hypertrophy. The transverse areas of muscle cells in early period were bigger than that in later period, so that the compensation was limited, chronic ischemia and hypoxia can affecte the calf muscle pump function.

Objective To evaluate the value of preoperative spiral CT (SCT) scanning in the diagnosis and staging of middle-late stage rectal carcinoma. Methods The results of SCT scanning of 34 patients with middle-late stage rectal carcinomas were compared with the pathological examination results and the findings of surgical operation. Results SCT could display the manifestations of middle-late stage rectal carcinoma, such as rectal wall thickening, local tumor mass, tumor invasion of rectal circumference, narrow rectal cava, lymph node enlarging (diameter≥10mm) and tumor distant metastasis. According to Duke's staging, the overall accuracy of SCT staging was 70.6%, and for the stages B1, B2, C, and D the sensitivity was 83.3%, 50%, 66.7%, 78.5%, and the specificity was 62.5%, 44.4%, 57.1%, 100%, respectively. According to TNM staging, the overall accuracy of SCT was 73.5%, and for the stages T2, T3, T4 the sensitivity was 85.7%, 61.5%, 78.6%, and the specificity was 54.5%, 66.7%, 100%, respectively. Conclusion Preoperative SCT could display the invasive range of middle-late stage rectal carcinoma and the tumor lymph nodes metastasis, especially distant metastasis, and had a definite diagnostic value.

Objective To discuss the endothelial cell which was modified by exogenous anticoagulant genes contribute to the increase of antithrombosis activity of lined vascular prosthesis and the influence to other physiological functions of endothelial cells. Methods This summarized paper was made on literature review of recent years.Results The transfection of genes, including plasminogen activator (t-PA, u-PA, Urokinase), thrombomoduline (TM) and hirudin, etc, to endothelial cells resulted in not only the increase of antithrombosis activity of local vascular, but also the decrease of endothelial cell function in adherence and proliferation.Conclusion The increase of antithrombosis activity of lined vascular prosthesis has been done by exogenous genes. However, this technique ought to be studied, intensively.