ObjectiveTo investigate the relationship of HLA-DRB1 allele polymorphism and antineutropil cytoplasmic antibody ( ANCA ) with the susceptibility to antithyroid drug ( ATD ) -induced leucocytopenia in the patients with Graves' disease (GD) in Anhui Han Chinese.MethodsThe HLA-DRB1 * 08032,DRB1 * 1501,and DRB1 * 0901 allele frequencies were determined by the polymerase chain reaction-based sequence-specific primer (PCR-SSP) method in 76 patients with Graves' disease who had ATD-induced leucocytopenia and 98 patients with Graves' disease treated with ATD,who were free from leucocytopenia.The other230 healthy subjects served as controls.Indirect immunofluorescence assay (IIF) was used to detect ANCA positive rate.Result( 1 ) Compared with the controls and the GD patients without leucocytopenia,the allele frequencies ofDRB1 * 08032 and DRB1 * 1501 in patients with ATD-induced leucocytopenia were significantly increased ( OR were 3.06,1.77,4.03,and 2.28,all P＜0.05),while that of HLA-DRB1 * 0901 was decreased ( OR were 0.33 and 0.43,both P＜0.05 ).(2)The ANCA frequencies were significantly increased in the GD patients with methimazole-induced leucocytopenia compared with those without leucocytopenia (x2 =4.878,P＜0.05 ).( 3 ) Compared with the GD patients not carrying DRB1 * 08032,DRB1 * 1501,and DRB1 * 0901 alleles,the ANCA positive rates were significantly increased in the GD patients carrying these alleles(x2 were 5.682,5.429,4.009,and 4.549,all P＜0.05).ConclusionsThe DRB1 * 08032 and HLA-DRB1 * 1501 alleles may be susceptible to ATD-induced leucocytopenia in Anhui Hans,while HLA-DRB1 * 0901 alleles may be protective or resistant gene.Immune response may be involved in the development of leucocytopenia.The occurrence of immune response is based on the genetic susceptibility.

Objective To observe the therapeutic effect of exenatide combined with metformin therapy in type 2 diabetes with nonalcoholic fatty liver disease.Methods 50 patients with type 2 diabetes and nonalcoholic fatty liver disease were randomly divided into experimental group and control group with 25 cases in each.The control group were treated with metformin, the experimental group were treated with exenatide on the basis of metformin.Before treatment and at the end of 12-week treatment, patients height, weight, body mass index(BMI), waistline(WC), glycated hemoglobin(HbA1c), fasting blood glucose(FBG),fasting C-peptide(FCP), triglyceride(TG), cholesterol(TCH), high density lipoprotein(HDL), low density lipoprotein(LDL),systolic pressure(SBP), diastolic pressure(DBP), alanine aminotransferase(ALT), superoxide dismutase(SOD), liver lipid contents(LFC) were detected.Results Baseline data were not significantly different between the two groups.Compared to baseline, WC, HbA1c, FBG and LFC in experimental group and control group were obviously improved after treatment(P<0.05), and the experimental group improved more significantly than control group(P<0.05).Conclusion Exenatide combined with metformin has an obvious therapeutic effect on BMI, WC, HbA1c, FBG, FCP, SBP, TG, TCH, HDL, LDL, LFC than mere metformin treatment in treatment of type 2 diabetes with nonalcoholic fatty liver disease.

Purpose:To evaluate the effects of p53 overexpression on the balance of in situ T helper cell 1 with T helper cell 2 in colorectal adenomas and carcinomas, with further study of the immunological mechanism of p53 overexpression stimulating colorectal cancer formation.Methods:Endoscopic colorectal mucosal biopsies were taken from 68 patients with colorectal tumors,including adenomas(n=30) and carcinomas(n=38),and their normal mucosas served as control(NS,n=68).Paraffin sections were examined immunohistochemically for p53 protein overexpression and four cytocine(IL-2,IL-4,IL-10,IFN-r) levels were detected by enzyme linked immunosorbent assay(ELISA) with the culture supernatants of colorectal tissue.Results:IL-2 and IFN-r levels in culture supernants of the positive group were significantly lower (P0.05).Conclusions:p53 overexpression induced inbalance of in situ Th1 with Th2 levels,shown as a drift from Th1 toTh2.p53 gene inactivation may play an critical role in immunological mechanism of colorectal carcinoma carcinogenesis.

Objective To explore the relationship between neutrophil‐to‐lymphocyte ratio (NLR) and early‐stage diabetic nephropathy in patients with newly diagnosed type 2 diabetes(T2DM ). Methods A total of 160 patients with newly diagnosed T2DM were enrolled in this study and divided into two groups:early‐stage diabetic nephropathy (EDN ) group and non‐DN group (T2DM group). The clinical and biochemical data were collected. Results NLR ,neutrophia cell count ,2 hPG ,HbA1 c ,age were significantly higher in EDN group than in T2DM group[NLR (2.27 ± 0.92)vs(1.81 ± 0.56) ,neutrophia cellcount(4.35±1.47)vs(3.78±1.08)109/L,2hPG(21.98±4.30)vs(20.37±4.40)mmol/L,HbA1c (11.06±2.02)% vs (10.22 ± 1.89)% ,age(49.22 ± 12.71) vs (44.41 ± 10.81)years] (P< 0.05).Logistic regression analysis showed that NLR (OR= 6.529 ,95% CI:1.946 ~ 21.873 ,P= 0.002)and 2 hPG(OR = 1.213 ,95% CI:1.002 ~ 1.467 ,P= 0.047 ) were independent risk factors for EDN.Conclusion Increased NLR is significantly associated with EDN. High NLR level may be a reliable predictive marker for EDN.

Objective To assess the effect of levothyroxine , lipoic acid and their combination therapy on improving the cognitive deficit and on the level of oxidative stress in the serum and hippocampus tissue of adult hypothyroid rast .Methods Fifty male SD rats were randomly divided into five groups:normal group , hypothyroidism group [ propylthioaracil ( PTU ) group], the levothyroxine sodium (L-T4) treatment group (PTU +L-T4 group), the lipoid acid(LA) treatment group (PTU+LA group), and the two-drug combination group (PTU+LT-4+LA group).After 8 weeks of treatment, the learn-ing and memory abilities of the rats were evaluated by Morris Water Maze ( MWM ) .The content of malondialdehyde ( MDA) and the activities of superoxide dismutase ( SOD) in the serum and hippocampus were respectively measured using thiobarbituric acid ,and xanthine-xanthine oxidase methods .Results Compared with the normal group , the escape latency was longer(P<0.01), the MDA level was increased and the SOD activity was decreased in the serum and hippocampus in the PTU group (P<0.001).Compared with PTU group, the SOD activity was increased and the MDA level was decreased in the PTU +L-T4 group, PTU +LA group and PTU +L-T4 +LA group(P<0.05).There was significant difference in MWM test score .Conclusion The L-T4 and LA combination therapy can significantly improve the cognitive function of hypothyroid rats.

Objective To compare the effect of treating hyperglycemia on insulin pump therapy in newly diagnosed type 2 diabetes mellitus(T2DM) and the patients with failure to oral antidiabetic therapy. Methods Selecting 32 patients with newly diagnosed T2DM(NDM group)and 64 T2DM patients with failure to oral antidiabetic therapy(ODM group),which were treated by insulin pump,having no significant difference of the level of blood glucose,body mass index(BMI),age,proportion of sex between NDM group and ODM group. Results (1)The mean time and the maximal dosage of insulin for blood glucose to be targeted in NDM group were all lower than those in ODM group(P all

Objective To investigate the oxidative stress status and cardiac myocyte apoptosis in rats with propylthiouracil-induced hypothyroidism and to examine the effect of levothyroxine ( LT4 ),vitamin E ( VitE ),and both supplementation on this experimental model.Methods Male Sprague Dawley rats were divided into normal control group( NC),propylthiouracil group( PTU ),LT4 treatment group( PTU + LT4 ),VitE treatment group ( PTU +VitE),LT4 and VitE combination therapy group (PTU + LT4 + VitE).Serum T3,T4,TSH levels,serum and myocardial superoxide dismutase ( SOD ) activity and malondialdehyde ( MDA ) content were determined.Cardiac myocyte apoptotic index was made with TUNEL.Results ( 1 ) Compared with NC group,T3 and T4 levels were significantly lower and TSH level was significantly higher in PTU group and PTU+VitE groups( P＜0.05 ).Compared with PTU group,T3 and T4 levels were significantly higher and TSH level was significantly lower in PTU + LT4 group and PTU + LT4 + VitE group( P＜0.05 ).There were no statistical differences in T3,T4,and TSH levels between PTU group and PTU + VitE group( P＞0.05 ).( 2 ) Compared to NC group,serum and myocardial MDA levels in PTU group increased significantly( P＜0.05 ),serum SOD activity decreased significantly ( P＜0.05 ),while myocardial SOD activity showed no significant difference( P＞0.05 ).( 3 ) Compared with NC group,myocardial apoptosis index was significantly higher in PTU and PTU + VitE groups( P＜0.05 ).Compared with PTU group,myocardial apoptosis index was significantly lower in PTU + LT4 group and PTU + LT4 + VitE group( P＜0.05 ).Conclusion LT4,VitE,and their combined treatment of hypothyroidism in rats reduce the myocardial cells apoptosis,which may be related to the improvement of thyroid function and amelioration of oxidative stress.

Objective To explore the etiology and pathogenesis of Hirschsprung disease(HD) and the role of nitric oxide in pathophysiology of HD. Methods The whole amount preparations of dilative and transitional segments were stained by NADPH\|diaphorase histochemistry mothod,and colonic walls were digested by dispase. Then the NOS positive nervous structure were observed by light and scanning electron microscope. Results In dilative segment, under light microscope, ganglion and neuron were bigger and more darkly stained. Intraganglionic neurons distributed mostly in peripheral area of ganglion and basal part of ganglionic fiber bundles. Under scanning electron microscope, the neurons were denser, more nerve fibers from them and connected with each other in all dimensions. And more transverse connected fibers between neurons which were arranged along muscle fibers. Myenteric plexus even connected with the submucosal plexus by nerve fibers which passed through circular muscle layer. In transitional segment, under light microscope, intraganglionic neurons cytoplasm were lightly stained and also variedly. The ganglion and neurons of the segment were smaller, and the fibers from them were thinner and paler than those of the dilative segment. Under scanning electron microscope, neurons' density was lower, the fiber connection between neurons and muscle fibers/neurons was lesser. In the transitional segment, neurons and nerve fibers were distributed linearly along the longitudinal muscle fibers. Conclusion Our results indicated that an intimate relationship existed between the development of Hirschsprung disease and abnormal distribution and metabolism of NOS positive neuron in colonic wall. [

Objective To detect the expression and correlated significance of inducible nitric oxide synthase and p53,Bax in benign and malignant diseases of gallbladder. Methods In 16 cases of chronic cholecystitis,11cases of chronic cholecystitis with adenomyoma and 24 cases of gallbladder adenocarcinoma,the expression of iNOS,p53 and Bax in gallbladder's wall was detected by SP immunohistochemistry. Results 1^Inducible NOS and Bax expressed in both benign and maligmant diseased gallbladders' wall,compared with benign diseased gallbladders,the expression of iNOS and Bax in adenocarcinoma was decreased(P

Objective To detect the expression of inducible nitric oxide synthase (iNOS) and heme oxygenase-1(HO-1) in human colon of irritable bowel syndrome(IBS), aim at finding out the role of gas messenger molecule such as nitric oxide(NO) and carbon monoxide(CO) in the pathogenesis of IBS. Methods The expression of iNOS and HO-1 in human colonic tissue specimen of enteroscope was detected by En vision and SABC immunohistochemistry each in 34 cases of IBS and 16 cases of normal control group. Results The expression of iNOS and HO-1 expressed mainly in the colonic mucous membrane epithelia, and the expression in IBS group was higher than that in normal control group(P