Objective Serum indicators of oxidative protein damage (OPD) were analyzed to explore the effect on renal MMP/TIMP system of OPD in diabetic nephropathy. Methods AOPP levels and PCO levels were measured by modified Witko-Sarsat's method and 2, 4-dinitrophenylhydrazine spectrophotometric method, expression of serum MMP-2 were determined by ELISA, and MMP-2 activity were detected by zymography . Results AOPP levels of group DN1, group DN2 were higher than those of group DM(78.23±19.30 vs 61.25±12.13,101.59±30.22 vs 61.25±12.13,F＝41.988,P＜0.01). PCO levels of group DN1 and group DN2 were higher than those of group DM (0.84±0.03 vs 0.66±0.02,1.05±0.05 vs 0.66±0.02,F＝205.763,P＜0.01). Pearson correlation analysis indicated AOPP and PCO were positively correlated with the expression (r＝0.460,0.480,P＜0.05) and activity (r＝0.385,0.560,P＜0.05) of serum MMP-2. Multiple stepwise regression analysis showed that AOPP and PCO were major influential factors of serum MMP-2 expression (P＜0.05,P＜0.01) and activity(P＜0.01,P＜0.05). Conclusions OPD might be involved in the imbalance of renal matrix metabolism, which was correlated with the development of diabetic nephropathy.

Objective To observe the expression level of stromal cell-derived factor-1 (SDF-1) in bone marrow stromal cells of acute leukemia at initial diagnosis and complete remission. Method Bone marrow stromal cells were isolated and cultured from five patients of acute leukemia at the time of initial diagnosis (Group A), five patients of acute leukemia at complete remission (Group B), and five healthy individuals or persons with no serious hematopathy (Group C). The content of SDF-1 protein in cultured supernatants was determined with enzyme-linked immunosorbent assay (ELISA). Results The contents of SDF-1 protein in supernatants of groups A, B and C were 2 941?374, 2 891?305 and 1 583?157pg/ml, respectively. The contents in both group A and group B were significantly higher than that in group C. Conclusion The SDF-1 expression level in acute leukemia bone marrow stromal cells was elevated at initial diagnosis, and the abnormality persisted until the stage of complete remission.

Objective To detect the change of the plasma hydrogen sulfide in patients with chronic heart failure (CHF) and explore its clinical significance.Methods A total of 118 patients with CHF was enrolled in this study.According to the NYHA standard,they were classified into grade Ⅱ (34 cases),grade Ⅲ (54 cases),grade Ⅳ (30 cases).The patients were divided into normal treatment group and sodium nitroprusside treatment group with 59 cases each.Another 30 healthy person were selected as control group.The plasma hydrogen sulfide level was detected by spectrophotometer.Results The plasma hydrogen sulfide level in CHF patients and healthy person was (32.45 ± 3.86),(54.26 ± 5.63) μ mol/L,and there was significant difference (P ＜ 0.05).The plasma hydrogen sulfide level in CHF patients of grade Ⅱ,Ⅲ,Ⅳwas (43.26 ±4.73),(31.87 ±4.12),(23.66 ±3.54) μmol/L,and there was significant difference (P＜0.05).The plasma hydrogen sulfide level before treatment in normal treatment group and sodium nitroprusside treatment group was(31.66 ± 3.75),(33.04 ± 4.02) μ mol/L,and there was no significant difference between two groups (P ＞ 0.05).The plasma hydrogen sulfide level after treatment in normal treatment group and sodium nitroprusside treatment group was (36.83 ± 4.32),(44.54 ± 4.68) μ tmol/L,and there was significant difference (P ＜0.05).The plasma hydrogen sulfide level after treatment in two groups was increased compared with that before treatment,and there was significant difference (P ＜ 0.05).The total effective rate in normal treatment group and sodium nitroprusside treatment group was 42.4％ (25/59) and 67.8％(40/59),and there was significant difference between two groups (P ＜ 0.05).Conclusions The abnormal plasma hydrogen sulfide level may be involved in the occurrence and development process of CHF,which could be used as a factor to monitor the disease.The upregulation of plasma hydrogen sulfide level can significantly improve the prognosis of CHF patients.

ObjectiveTo summarize the application experience of laparoscopic totally extraperitoneal prosthetic(TEP) for inguinal hernia in grass-root hospitals.MethodsThe clinical data of 63 cases of inguinal hernia treated by TEP were retrospectively analyzed,and operation scheme suited to the actual conditions of grass-root hospitals was summed up.ResultsAmong the 63 cases,5 cases were treated by transabdominal preperitoneal repair of inguinal hernia(TAPP) to complete the operation because of relatively serious peritoneal rupture.No case was converted to open surgery.11 cases were subjected to continuous epidural anesthesia and the other cases to endotracheal anesthesia.17 cases gained satisfactory result withoutstapling fixation.Among them,a few people had postoperative complications:3 cases of pneumoscrotum,1 case of hematoma of scrotum and 2 cases of early groin pain.No case recurred.ConclusionTEP is a safe and effective operation method in grass-root hospital for inguinal hernia repair.A reasonable selection can be taken according to the individual condition of patients including operation,anaesthesia,mesh style and stapling fixation,to ensure the operation quality,to reduce the medical wst and to reduce the economic burden of the patients.

Objective To study the dynamic imaging changes of the uterine leiomyomas before and after uterine arterial embolization (UAE) treatment and to discuss its therapeutic mechanism. Methods Color Doppler senography and both plain and enhanced MR[scanning were performed in 45 patients with uterine leiomyomas before and after UAE. Plain CT scan was performed in all patients after UAE. All the patients were followed up for 3-16 months (average 10±3.5 months). Results In 41 of the total 45 cases, the color Doppler senography showed rich blood flow signals in leiomyomas and myometrium before UAE and no or less blood flow signals in both leiomyomas and myometrium on the first day after UAE. On the seventh day, the blood flow signal was still absent in leiomyomas while it was restored in myometrium, and the same phenomena remained in the first, the third and the twelfth month after UAE. In the other four eases, color Doppler sonography demonstrated blood flow signals inside leiomyomas on the seventh day after UAE and it remained till twelve months after embolization. The embolic agent (Lipiodol) was found in both leiomyomas and myometrium on CT scan for 45 cases on the first day of UAE. CT scan also showed the deposit of the Lipiodol in myometrium, but Lipiodol gradually vanished in leiomyomas at one, three and the twelve months after UAE. The enhancement was apparent in leiomyomas and myometrium on MRI scan in all 45 cases before UAE. The enhancement was found in the myometrium, but not in leiomyomas, on MRI scan in 39 cases 3 months after UAE. The other six cases demonstrated different degrees of enhancement in leinmyomas after embolization. In two cases the detachment of the leiomyomas were observed after embolization and the desquamating materials were pathologicallyproved to be necrotic tissue. The difference in the measuring data about leiomyoma volume between MPI and color Doppler sonography was of no statistical significance (P > 0.05). Conclusion The therapeutic mechanism of UAE for uterine leiomyomas is selectively embolizing the vascular bed of uterus, leading to subsequent necrosis of leiomyomas. The color Doppler sonography should be the fast choice for the dynamic imaging follow-up after UAE.

A variety of views and approaches were found in the appraisal and judgments of the people's courts in various provinces and cities,on medical disputes involving absence of a hand or foot of newborns,which result in different or event contradictory court decisions.This study made an analysis of the characteristics,nature,and classification of such cases as well as countermeasures of medical institutions,with recommendations on rational and appropriate handling of such cases,for the purposes of legitimate rights maintenance of both doctors and patients,and promotion of mutual understanding between the two parities,and establishment of a harmonious doctor-patient relationship.

Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8%. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardial carcinoma cases in which the esophaged involvement is within 2cm.

OBJECTIVE:To establish a method for the residual simultaneous determination of methanol,alcohol,dichlorometh-ane,n-hexane,tetrahydrofuran and benzene in tosufloxacin tosylat. METHODS:Headspace GC was performed on the capillary col-umn with 6%cyanopropylphenyl-94%dimethylpolysiloxane(DB-624)as fixative lipid,temperature programmed,the inlet temper-ature was 180 ℃,detector was flame ionization detector with temperature of 300 ℃,carrier gas was high purity N2 at a flow rate of 1.5 mL/min,split ratio was 10:1,headspace equilibrium temperature was 100℃,equilibrium time was 40 min,headspace sam-ple volume was 10 mL,and the headspace sample volume was 1 mL. RESULTS:The linear range was 178.3-1782.7 μg/mL for methanol (r=0.9991),301.2-3012.1 μg/mL for alcohol(r=0.9997),33.81-338.10 μg/mL for dichloromethane(r=0.9993), 18.02-180.22 μg/mL for n-hexane(r=0.9991),43.26-432.58 μg/mL for tetrahydrofuran(r=0.9991)and 0.1268-1.2681 μg/mL for benzene(r=0.9991);limits of quantification were 0.31,3.00,0.67,0.02,0.005,0.10 μg/mL,limits of detection were 0.15, 1.51,0.22,0.01,0.001,0.05 μg/mL;RSD of precision test was no higher than 3.1%;RSDs of methanol and n-hexane in stabili-ty and reproducibility tests were no higher than 5%;recoveries were 93.72%-102.20%(RSD=3.1%,n=9),90.10%-101.79%(RSD=4.0%,n=9),97.07%-103.11%(RSD=2.0%,n=9),92.38%-103.83%(RSD=3.9%,n=9),95.44%-103.62%(RSD=2.8%,n=9),and 94.00%-104.73%(RSD=4.1%,n=9). CONCLUSIONS:The method is rapid,sensitive,accurate,and suitable for the residual determination of methanol,alcohol,dichloromethane,n-hexane,tetrahydrofuran and benzene in tosufloxacin tosylat.

Currently,independent clinical medial femoral plate is more needed to apply in more complex C3 distal femoral fractures and knee valgus orthopedic surgery.The doctors always pre-bent the contralateral femoral lateral plate in order to achieve close to the natural shape of the bone.The cold deformation of the plate can change the metallographic structure and the biomechanics,and the position of the screw holes in the plate may also affect the healing of fractures.Compared with traditional manufacturing techniques,3D printing technology as a core technology in third industrial revolution,instead prior manufacture of molds,removing the large amount of material in the manufacturing process and the complex process of forging a final product,it is more suitable for difficult to machine materials,manufacture,inspection shape design,assembly,testing and fast reverse engineering.Therefore,a personalized interior distal femoral plate with 3D printing technology was designed,and the application of the plate,the current situation and prospects of 3D printing technology and other aspects were summarized in this article.

BACKGROUND:Previous studies designed and made titanium metal rubber cervical disc prosthesis, and performed feasible studies on its effect on movement and stress distribution by replicating intervertebral discs. OBJECTIVE:To further observe the changes in the stability of goat cervical vertebra after metal rubber cervical disc replacement. METHODS:Nine goats were randomly divided into experimental group (n=6) and normal control group (n=3). Goats in the experimental group received metal rubber cervical disc replacement at C4/5segment. Goats in the normal control group did not receive any treatment. Radiographic data at anteroposterior and lateral position, hyperextension and excessive flexion were taken to measure intervertebral height, range of motion and intervertebral angle at C4/5 segment before operation, immediately, 4, 8, 12 weeks after operation. Subsequently, slicing and embedding of hard tissue at surgical segment, picric acid-acid fuchsin staining and scanning electron microscopy were conducted.RESULTS AND CONCLUSION:No significant difference in the intervertebral height and spinal range of motion at C4/5 segment at different time points was detected between postoperative results in the experimental group and preoperative results in the experimental group, normal control group. The intervertebral height at C4/5 segment was higher immediately, 4 and 8 weeks after surgery than preoperative result in the experimental group (P < 0.05). No significant difference in intervertebral angle at C4/5 segment was detectable between 4, 8 and 12 weeks postoperatively in the experimental group and normal control group (P < 0.05). At 4 weeks after surgery, bone did not contact with the edge of the prosthesis in the experimental group. At 8 weeks, the gap between bone and the prosthesis became smal, and some new bone attached to the edge of the prosthesis. At 12 weeks, a few osteoblasts were observed on the surface of the prosthesis. New osteogenic tissue grew into the prosthesis. Results suggested that metal rubber cervical disc replacement in the intervertebral space could maintain intervertebral height and range of motion in a short period, and tightly bind to the vertebral body.