Objective To investigate the risk factors of primary gout.Methods 420 patients with primary gout were analyzed.Results Among the 420 patients,male to female ratio was 21∶1.Average onset age of female was significantly higher than that of the male,whereas,the mean disease duration was significantly shorter in female than that in male.The mean disease duration of patient with positive familial history was significantly shorter than that with negative ones.38% patients had an alcohol abuse history,and 54 percent patients had had high purin food intake.Mean weight of body was (74.7?9.9)kg,and average body mass index(BMI) was (27.3?2.6).Events of inducing acute attack included engorgement,tire,infection,operation and trauma.Conclusion Risk factors of primary gout include age,sex,inherity,food habit,hyperlipemia,renal function failure.Engorgement,tire,infection,operation,trauma and use of diuretics could induce gout acute attack.It should be taken importance to that the onset age shows a young tendency.

Objective To construct insulin B chain DNA vaccine and to perform a vaccinating trial for preventing mice from autoimmune diabetes induced by multiple low dose streptozotocin. Methods RT PCR was used to clone insulin B chain, and insulin B chain DNA vaccine was constructed. DNA vaccine was injected into tibilias anterior muscle of C57BL/6 mice in treatment group (T), prophylactic group (P). The morphology of mice islets was investigated by pathology, blood samples were taken to determine glucose and insulin. Group T and group P were compared with group of normal control mice (C) and group of untreated diabetic mice (D). Results (1) Insulin B chain gene was cloned by RT PCR, which ligated with pcDNA3 plasmid. Insulin B chain DNA vaccine was constructed. (2) In group P, after injection of DNA vaccines, 3 (3/10) and 4 (4/10) mice became diabetic in the second week and the third, fourth week respectively, the incidence was significantly less than those of groups D and T. The insulin level showed no difference between group C and the non diabetic mice of group P. The change of pancreas of diabetic mice in group P was similar to group D. Conclusion Insulin B chain DNA vaccine can prevent pre autoimmune diabetes.

Objective To compare the effort intensities in comprehensive quality development of military medical undergraduates of different sorts and to discuss its improvement.Methods Comprehensive quality of undergraduates of 2010 grade (630 persons including 16 cadres) was assessed by comprehensive quality assessment index system.Based on data envelopment analysis,ratio of actual output (comprehensive quality development) against ideal value was taken as progress effectiveness to reflect the comprehensive development.SPSS 16.0 software was used for statistical processing and analysis.Score of each quality was analyzed and nondimensionalize was performed.Undergraduates' progress effectiveness was compared using analysis of variance.Results In September 2011,progress effectiveness of undergraduates without military status was higher than that of soldiers in comprehensive quality,ideology and morality,science,culture,profession,psychological quality and basic ability (F =34.659,49.234,119.273,12.641,103.814,65.105,P ＜ 0.001).Progress effectiveness in the former was higher than that of the latter in physical fitness.(F =7.363,P ＜ 0.01).In March 2012,progress effectiveness of undergraduates without military status was higher than that of soldiers in comprehensive quality,ideology and morality,science,culture,profession,psychological quality,basic ability and physical fitness (F =28.017,10.847,33.559,24.630,48.767,10.460,38.251,P ＜0.01).Conclusions Comprehensive quality development of undergraduates is a continuous dynamic course.One year's observation shows that at early stage,all qualities of undergraduates without military status improve quickly except physical fitness with more subjective efforts.The two sorts of undergraduates belong to forward effect.

Objective:To investigate the mechanism of inducing immune tolerance of autoimmune diabetic mice by insulin B chain gene vaccine Methods:Insulin B chain DNA vaccine was constructed by genetic engineering techniques DNA vaccine was injected into tibilias anterior muscle of C57BL/6 mice Mice were divided into four groups at random: group control (C), group diabetes (D), group treatment (T), prophylactic treatment (P) Serum was taken to determine insulin, the expression of bcl 2 mRNA was determined by dot blot dehydribation Results:①After prediabetic mice were injected by DNA vaccines, the ratio of incidence of diabetes was 30% in 2 w, 40% in 3 w and 4 w, which were significantly higher than that of groups D and T, and lower than that of group C The level of insulin showed no difference between group C and the non diabetic mice of group P In contrast to non diabetic mice, the change of pancreas of diabetic mice in group P was similar to group D ②AGV of bcl 2 mRNA in thymus cells, spleen cells, and blood monocytes of effective mice in group P showed no difference with group C, but markly lower than those of group D & T Conclusion:Insulin B chain DNA vaccine could recover the balance of the development and activity of thymus cells, spleen cells and lymphocyte in prediabetic mice

Objective To study pathological feature of sacroiliitis of spondyloarthropathies (SpA) in different stages,and improve the threshold of early diagnosis of SpA.Method Samples of sacroiliac joints (SIJ) of 8 patients with ankylosing spondylitis (AS) and 5 patients with undifferential spondyloarthropathies (uSpA) were taken when SIJ steroid injection was performed.The pathological feature was studied.Results Synovitis,including lining cell hyperplasia and inflammatory cell infiltration in looseconnective tissue,local cartilage degeneration,fibrosis and inflammatory cell infiltration in subchondral bony plate and marrow cave were found in 6 (86%,6/7) samples in patients with normal/suspectable SIJ CT scan.In the CT Ⅱ and Ⅲ degree sacroiliitis,marked degeneration and fibrosis of cartilage,inflammatory cell infiltration,pannus formation and subchondral bony plate destruction were increasingly prominent.In the advanced sacroiliitis (CT Ⅳ degree),destruction and calcification of cartilage and subchondral bony plate were the major feature.Eosinopil (EO) was increased in the infiltration cells of synovium and subchrodral bony plate in 3 samples.Conclusion Synovitis,including hyperplasia of lining cell and the infiltration of inflammatory cell in loose connective tissue,and local cartilage degeneration and inflammatory cell infiltration,and destruction of subchondral bony plate are the early changes identified in sacroiliitis.Pathological examination can improve the threshold of early diagnosis of sacroiliitis in case it cannot be confirmed with CT scan.

Objective To report the clinical features and effects of internal fixation with anatomical plate in combination with bone graft in treatment of complicated comminuted fractures of distal femur. Methods There were 11 case of type C2 and 9 cases of type C3 fractures of distal femur according to the AO classification. When they were treated with anatomical plate, bone grafting from ilium or fibula or from both was done to repair their bone defects depending on specific defects of the patients. Results All the patients were followed up for a mean of 20 months (ranging from 10 to 24 months). Bone healed in all the cases. By Schatzker standards, the result was excellent in 14 patients, good in 5 and fair in 1. The excellent and good rate was 95%. Conclusion The authors consider that anatomical plate in combination with bone graft is an ideal treatment for complicated comminuted fractures of distal femur.

Objective To understand the key points of the differential diagnosis between osteitis condensanse ilii(OCI)and early sacroiliitis.Methods From 1997 to 2004,33 cases of OCI were examined with HLA-B27 determination and sacroiliac joint CT scan,and needle biopsy was performed in some cases when needed.Data of clinical history,laboratory,CT scan,as well as pathological examination were collected and analyzed.Results Sacroiliitis was diagnosed in 17(51.5%)cases of the 33 X-ray OCI cases either by CT scan or by pathological examination.Clinical features of these 17 cases included:(1)HLA-B27 was positive in more than 80%of these cases;(2)The age in these cases was younger than that in the OCI cases;(3)About 1/3 of these cases were male,and most of the female were unmarried and nanparous;(4)Most of the cases were with the signs of sacroiliits;(5)? globulin/ ESR/CRP/alkali phosphatase were elevated in most cases.However,among OCI cases,the prevalence of HLA-B27 was similar to general population;all of the cases were female;most of them were pluripara,and few cases were with the signs of sacroiliitis or laboratory abnormalities.Conclusion In X-ray OCI,many cases might be early sacroiliitis.Attention should be paid to avoid misdiagnosis.

Objective To study an effective method for culturing of human vascular smooth muscle cells (hVSMCs) in tissue engineered blood vessels (TEBVs) in vitro.Methods A 3-cm segment of human long saphenous vein was harvested under sterile conditions.The primary culture and subculture were done by modified tissue-piece inoculation and trypsin digestion respectively.The cells were purified by mechanical treatment and differential attachment.PDGF was combined with high concentration of glucose DMEM as the culture medium.The cultured cells were identified by morphology and immunohistochemistry with contrast microscope and SABC kit,and RT-PCR method detected the expression of ?-SMA and calponin 1.Results The cultured cells possessed"peak and valley"characteristics for VSMCs under microscope.Immunohistochemical staining showed positive expression of intracytoplasmic ?-actin,and RT-PCR detected positve expression of ?-SMA and calponin 1.Conclusions Culture medium of PDGF combined with high concentration of glucose DMEM,and with differential attachment method can provide highly purified hVSMCs with good structure and function.

Objective To determine the endothelial function, endothelin-converting enzyme (ECE) activity and ECE mRNA level in patients of diabetes with macroangiopathy, and to investigate the effect of the endothelial function change in type 2 diabetes and diabetes with macroangiopathy. Methods Sixty healthy persons and 40 patients of type 2 diabetes and 60 patients of type 2 diabetes with macroangiopathy were recruited for the study. The activity of ECE in white blood cells was measured by an established method. Endothelial function, ECE activity and expression of ECE mRNA were determined by ELISA, RIA and RT-PCR respectively. Results The expression of ECE mRNA and the ECE activity were increased in patients of type 2 diabetes, especially in diabetics with macroangiopathy. The damage of endothelial function in the diabetic patients was very common. Conclusion High level of ECE activity relates to the damage of endothelial function. High level of ECE activity and up-regulation of expression of ECE mRNA may play a key role in the development of diabetic macroangiopathy.

The purpose of this clinical study was to evaluate the protective effect of continuous potassic warm blood perfusion on myocardium during warm blood extraeorporeal circalation. Warm blood cardiopulmonary bypass and continuous potassic warm blood perfusion for myocardial protection were used in 39 cases undergoing coronary bypass. 15% potassium chloride was mixed with oxygenated warm blood for continuous myocardial perfusion to induce cardiac arrest. The average nasopharyngeal temperature was maintained at 33.5℃. The warm blood was delivered at a rate of 150 to 200 ml/min; 15% potassium chloride was pumped at a high flow rate of 120 to 160 ml/h and then at a low flow rate of 15 to 20ml/h when electrocardiogram showed straight line. The results showed that 38 cases (97.4%) had spontaneous return of normal sinus rhythm shortly after removal of the aortic crossclamp. Myocardial positive inotropic agents were seldom used and hemodynamics kept stable. Cardiac functions showed fast recovery and there were not serious complications such as perioperative myocardial infarction, low output syndrome and arrhythmia. It is indicated that continuous potassic warm blood perfusion for myocardial protection may have a remarkable results to prevent myocardial anoxemia and reperfusion injury during CPB.