Objective To investigate the value and limitations of ultrasound determination-evaluated brachial artery endothelial function in elderly diabetic patients. Methods High-resolution two-dimensional ultrasound was used to determine brachial artery(BA) flow-mediated vasodilation(FMD) during reactive hyperemia. Endothelial function was evaluated by FMD in 67 elderly patients with type 2 diabetes. Results In diabetes versus normal control group,the BA diameter and flow velocity showed no significant difference (P＞0.05) at basal state,but showed significant decreases (P＜0.05) after reactive hyperemia. Single-factor correlation analysis showed that FMD was in negative correlation with disease course, TG, ISI and age (r=-0.2357,-0.2215 and -0.3256, -0.2415,(all P＜0.05～0.01),and showed no correlation of FMD with BMI, TC, FBG, HbA1c, FIns. Conclusions FMD has a value in evaluating the flow-mediated endothelial dysfunction in older T2DM patients, while our analysis of the results should consider the patient's age, gender, race, disease course, blood lipids and other factors.

Objective To investigate the anatomical characteristics and clinical application of the distal musculocutaneous perforators derived from the descending branch of lateral circumflex femoral artery in the anterolateral thigh flap transplantation. Methods From July 2007 to December 2009, the anatomic variations of musculocutaneous perforator were investigated in 96 cases who received anterolateral thigh flap and 10 preserved cadavers. Thirty-five cases who received the anterolateral thigh flap using the distal musculocutaneous perforators were included in the study. There were 19 males and 16 females. The age ranged from 28-55 years old, with an average of 38.5 years old. Single flap was used in 20 cases while lobulated flap in 15 cases. Single flap area ranged from 7 cm×15 cm to 9 cm×25 cm, lobulated flap ranged from 5 cm×7 cm to 8 cm×20 cm. Results The cadaver study found that the most musculocutaneous perforators were concentrated in the far fourth of the anterolateral thigh region. The musculocutaneous perforators commonly arose from the the lateral femoral circumflex artery. The perforator arose directly from the femoral artery or the deep femoral artery in one case separately. In the clinical study, 2-5 musculocutaneous perforators were found in 94 cases but not in the other 2 cases. The descending branch of lateral circumflex femoral artery became the direct m musculocutaneous perforator. The proximal intermuscularseptum perforator was found in 2 cases. Postoperative follow-up time ranged from 6-11 months. All flaps survived in the follow-up.Marginal necrosis was found in 3 cases. Only 1 case had complained of knee joint instability. Conclusion The results of this study suggest that the vascular anatomy of the distal musculocutaneous perforator was reliable. The perforator may serve as an option for proximal one in anterolateral thigh flap transplantation.

Objective To compare the effects of transcranial and trans-spinal low frequency magnetic stimulation (MS) on the expression of growth-associated protein-43 (GAP-43) in the spinal neurons of rats after spinal cord injury (SCI). Methods Forty-five Sprague-Dawley female rats were divided randomly into a transcranial magnetic stimulation (TMS) group,a trans-spinal cord magnetic stimulation group and a model control group with 15 in each group.Another 6 rats served as a normal control group.Spinal cord injury at the T9-10 level was modeled according to the modified Allen's method.The rats in the two MS groups received magnetic stimulation at 0.5 Hz and 75％ of the maximum output intensity ( 1.9 T) of the magnetic stimulator beginning 24 h post injury.They received 30 pulses daily for 28 days while the rats in the model control group were not exposed to MS.Basso-Beattie-Bresnahan (BBB) scale scores and motion evoked potentials (MEPs) were measured at the 1st,7th,14th,21 st and 28th day post injury.The expression of GAP-43 protein was studied using immunohistochemical methods and semi-quantified by Western blotting. Results At the 4th week post injury the average BBB scores in the model control group,the TMS group and the trans-spinal cord magnetic stimulation group were all significantly different. MEP amplitudes decreased significantly in all groups after the injury,and the latency was prolonged,but there were no significant differences among groups at any time point.GAP-43 expression also increased after SCI,and it was significantly higher in the MS groups than in the model control group at 4 weeks. Moreover,the expression of GAP-43 in the trans-spinal cord MS group was significantly greater than in the TMS group.Conclusion Magnetic stimulation can promote nerve regeneration and improve locomotor recovery after spinal cord injury,at least in rats.The effect of trans-spinal cord magnetic stimulation is superior to that of TMS.The mechanism may be related to the activation of central pattern generators.

ObjectiveTo detect the mRNA expression levels of RORγt and Foxp3 genes in peripheral blood mononuclear cells(PBMCs) of children with atopic dermatitis(AD),and to explore their possible roles in the development of AD.MethodsSixty-three children with AD and 54 age-matched normal children were eligible for this study.Real-time fluorescence-based quantitative PCR was carried out to measure the mRNA expressions of RORγt and Foxp3 genes in PBMCs of these subjects.ResultsThe relative expression levels of Foxp3 and RORγt mRNA were significantly higher in children with AD compared with the normal controls (2.4060 ± 0.3355 vs.1.1852 ± 0.4189,t =17.50,P＜ 0.01; 6.9130 ± 0.2046 vs.2.7501 ± 0.2518,t =98.63,P ＜ 0.01 ).A statistical increase was observed in the level of RORγt mRNA in children with severe AD compared with children with mild and moderate AD(7.1203 ± 0.1056 vs.6.8046 ± 0.1731 and 6.8655 ± 0.3671,t =6.61,5.23,both P ＜ 0.01).No significant difference was noted in the expression of RORγt mRNA between children with mild and moderate AD,or in the Foxp3 mRNA expression among children with mild,moderate and severe AD.The severity of AD was positively correlated with the level of RORγt mRNA (r =0.62,P ＜ 0.01 ),but uncorrelated with the level of Foxp3 mRNA(r =0.04,P ＞ 0.05).ConclusionsThe high expressions of RORγt and Foxp3 genes may be involved in the pathogenesis of AD,and the severity of AD is positively correlated with the expression intensity of RORγt gene.

Objective To carry out the risk assessment on health effects of viruses in reused wastewater in city.Methods During May-November in2002,the concentration of total coliform and fecal coliform in water sample s collected from waste water after secondary treatment of wastewater treatment plant and reused waste water treated by conventional wastewater-reuse technical process in Xian Baishiqiao Wastewater Treatmen t Center were determined,and the hypothesis testing on the normal distribution of monitoring data was carried out.Meanwhile the removal efficacy of coliform in wastewater with chlorine disinfection was ob-served.The beta-Possion model,the model for evaluating the infection probability of pathogenic microorganism in drinking water,and Monte Carlo simulated method were used for the risk assessment on health effects of viruses in reused wastewater in city.Re sults The monitoring data on concentrations of fecal coliform in water samples collected from secondarily treated wastewater and reused wastewater showed log-normal distribution.The removal efficacies of coliform from wastewater were4log at condi-tions of7mg /L chlorine and20-minute contact time,and5log at conditions of15mg /L chlorine and20-minutes-contact time.The means of annual risk value of health effects of viruses in reused wastewater were1.21?10 -6 for the reuse of wastewater in greening and4.31?10 -8 for the reuse in irrigation of farmland respectively,the highest risk values for these two reuse methods were all below10 -4 ,the acceptable annual risk value for drinking water ruled by Surface Water Treatment Rules published by USEPA.The probability of annual risk value

The problems, such as non-full utilization of media, low interesting and participation of users, in read-ing extension service provided by the WeChat public platform in Library of China Medical University were summa-rized by literature analysis and comparative analysis with the reading extension service provided by the WeChat plat-form in other academic libraries as examples, and suggestions were proposed for the application WeChat public plat-form in future reading extension service.

Chronic lymphocytic leukemia (CLL) remains an incurable disease.Rituximab and fludarabine are two of the most effective agents in CLL update.Despite the widespread use of highly effective chemoimmunotherapy,fludarabine-refractory CLL remains a challenging problem associated with poor overall survival.Approved therapeutic options for these patients remain limited.Fortunately,allogenetic stem cell transplantation (allo-SCT) and several novel targeted therapeutics in clinical trails hold promise of significant benefit for these patients' population.This review discusses the activity of available and novel targeted therapeutics besides allo-SCT in fludarabine-refractory or fludarabine-resistant CLL.

Objective To explore the treatment of neuropathic pain,the combined use of parecoxib sodium after treatment based ontheuseoffentanyl on transparent paste.Methods In the period from August 2014 to August 2015 by the neuropathic pain patients in our hospital were selected in 38,they were divided intotwogroups,1groupsusingonlyfentanyltransparent paste treatment,2 group based on the use of fentanyl transparent paste on the combined use ofparecoxibsodium,comparingtwotreatmentsoftreatment effect.Results After five days,fifteen days and twenty-five days after treatment,the vas of the patients in the two groups was lower than that before the study,and there was a significant difference between the two groups(P<0.05).There is a big gap between the two groups(P<0.05).Conclusion Fentanyl transparent dressing in treating neuropathic pain can play an ideal therapeutic,for the use of a drug when the poor efficacy of the patient alone combined with parecoxib sodium can significantly improve the therapeutic effect.

Objective·To investigate the correlation between the serum haptoglobin (Hp) level and the metabolic parameters in patients with polycystic ovarian syndrome (PCOS), and explore the distribution of Hp genotype and allele frequency in PCOS patients and their correlations with PCOS. Methods·A total of 106 patients with PCOS and 86 cases of patients with non-hyperandrogenic and regular menstruation (control group) were enrolled. Serum Hp level was measured by enzyme-linked immunosorbent assay (ELISA); Hp genotype and allele frequency were determined by polymerase chain reaction (PCR), respectively. Results·The serum Hp level in PCOS group was significant higher than that in the control group (P=0.000). Correlation analysis reveals that serum Hp level was positively related to body mass index (BMI) (P=0.000) and homeostatic model assessment insulin resistance (HOMA-IR) (P=0.000). Compared with control group, proportion of Hp2-2 genotype (Hp2/Hp2) increased significantly in PCOS group (P=0.006), and the frequency of Hp2 allele was also higher (P=0.002). Conclusion·Serum Hp level was positively related to BMI and HOMA-IR, which maybe associated with the occurrence and development of obesity and insulin resistance. Patients with Hp2-2 genotype might have genetic predisposition to PCOS, and high frequency Hp2 allele was found in them.

The activity of erythrocyte membrane Na-pumping K~+-activated pera-nitro-phenylphosphatase (K~+-pNPPase) and red cell deformability (RCD) were stndied in 50adult patients with non-insulin-dependent diabetes mellitus (NIDDM). RCD was expressedas red blood cell filtration index (RBC-IF). In comparison with the healthy subject, theactivity of erythrocyte membrane Na-pumping K~+-pNPPase was significantly decreased,and RBC-IF was significantly increased. The above-mentioned changes were more severein NIDDM with retinopathy than those without. There was a very close negative corre-lation between Na-pumping K~+-pNPPase and RBC-IF. These results indicated that thedecrease of erythrocyte membrane Na-pumping K~+-pNPPase activity might be an importantfactor fot the decrease of RCD.