Objective To observe the effect of beraprost sodium on elderly patients with type 2 diabetic nephropathy (DN) and to observe the change of the plasma vascular endothelial growth factor(VEGF) and endothelin(ET-1) level.Methods The levels of plasma VEGF and ET-1 in the 27 cases of type 2 diabetes without nephropathy and 48 cases with type 2 diabetic nephropathy were measured.The possible role of VEGF and ET-1 in diabetic nephropathy was explored.48 cases of type 2 diabetic nephropathy patients were randomly divided into 2 groups:the conventional treatment group and beraprost sodium treatment group.The changes of VEGF and ET-1 level in the 2 groups before and after the treatment were measured.Results The plasma VEGF and ET-1 levels were significantly higher in type 2 diabetic nephropathy patients than in type 2 diabetes patients without nephropathy(P ＜0.01).Compared with the control group,beraprost sodium significantly reduced the plasma VEGF and ET-1 levels in patients with diabetic nephropathy(P ＜ 0.05),and also reduced urinary albumin excretion rates (UAER) significantly (P ＜ 0.05).Conclusions The increasing level of VEGF and ET-1 plays an important role in the onset of diabetic nephropathy.Beraprost sodium can correct the balance of the plasma VEGF and ET-1 in treatment of patients with diabetic nephropathy,improves the endothelial function in diabetic nephropathy,decreases urine protein,and plays a protective role in diabetic nephropathy.

Objective:To investigate the efficacy and safety of peginterferon alpha-2a plus ribavirin in the treatment of chronic hepatitis C. Methods:Totally 85 patients with chronic hepatitis C were randomly divided into the observation group and the control group. Each patient in the observation group was injected subcutaneously peginterferon alpha-2a with the dose of 180μg once a week plus ribavirin 900-1 200 mg/d, po, and each patient in the control was treated subcutaneously with 5 MU standard interferon alpha-2b three times a week plus the same used ribavirin. After the 48-week treatment, 24-week fellow-up was carried out. HCV RNA and ALT were detected at the baseline, 4th week, 12th week and 48th week during the treatment, and 24th week after the treatment, respective-ly. The rate of rapid virological response ( RVR) , early virological response ( EVR) , end of treatment virological response ( ETVR) , sustained virological response (SVR), ALT normalization and adverse reactions were respectively assessed. Results: The rates of EVR,ETVR and SVR in the observation group were 76. 7%(33/43), 86. 0%(37/43) and 79. 1%(34/43), respectively, which were significantly higher than those in the control group [54. 8%(23/43), 66. 7%(28/43) and 57. 1%(24/43),respectively] (P<0. 05). The ALT normalization rate at 12th and 48th week after the treatment in the observation group was 81. 4% and 90. 7%, re-spectively, which were higher than those in the control group [64. 3% and 71. 4%, respectively](P<0. 05). The rate of white cell counts and platelet underlying (58. 1% and 39. 5%) in the observation group were also higher than those in the control group (35. 7%and 19.0%)(P<0.05). The decreased rate of neutrophil (58.1%) in the observation group was higher than that in the control group(19. 0%)(P<0. 01). The other adverse reactions in the two groups were similar, and there was no new or unique adverse event related to peginterferon. Conclusion:Peginterferon alpha-2a has better effect than the standard interferon alpha-2b in the treatment of patients with chronic hepatitis C with promising tolerance.

Objective To investigate the effect of rosiglitazone on the epithelial-mesenchymal transition process of renal tubular epithelial cell induced by transforming growth factor-β(TGF-β). Methods The human renal tubular epithelial cell line HK-2 was cultured in vitro and treated with TGF-β at the presence or absence of rosiglitazone, and the morphological changes of HK-2 cells were observed. Then PPARγ,SMAD family number 2/ 3,E-cadherin and Vimentin were detected by western blot, and the mRNA expression of PPARγ, E-cadherin, Vimentin, zinc finger transcription factor Snail and Slug were measured by realtime quantitative PCR. Finally,dual luciferase reporter assay was performed to detect the effect of TGF-β and rosiglitazone on the tran-scription activity of E-cadherin promoter. Results TGF-β could induce the EMT process of HK-2, including morphological changes such as longer pseudopod and broader cell space. TGF-β also activated the SMAD2/ 3 signaling pathway, with expression changes of E-cadherin and Vimentin. Rosiglitazone reversed the morphological changes of HK-2 cells induced by TGF-β, with shor-ter pseudopod and narrower cell space. Rosiglitazone also inhibited the mRNA and protein expressions of Vimentin, and restored the mRNA and protein expression of E-cadherin by up-regulating PPARγ. The activity of E-cadherin promoter was enhanced under the treatment of rosiglitazone. Conclusion Rosiglitazone can antagonize the EMT process of renal tubular epithelial cell induced by TGF-β, through the activation of PPARγ and stimulating transcription and protein expression of E-cadherin.

Objective To investigate the effects of different surgical procedures on clinical outcomes and quality of life(QOL)in patients with breast cancer.Methods The clinical data of 93 patients with breast cancer were retrospectively reviewed.According to the different surgical methods,they were divided into two groups:breast conserving surgery(BCS)group(n =42)and modified radical mastectomy(MRM)group(n =51).Clinical outcomes and QOL score between the two groups were compared.Results Compared with MRM group,the incidence rate of complication in BCS group was significantly lower in subcutaneous exudate[7.1%(3 /42)vs.25.5%(13 /51),χ2 =5.443,P =0.020]and upper limb swelling[14.3%(6 /42)vs.37.3%(19 /51),χ2 =5.443,P =0.020].In the aspect of QOL score,BCS group showed significantly higher score in emotional well -being [(23.14 ±2.71)points vs.(19.98 ±2.69)points,t =5.606,P =0.000],functional well -being[(24.61 ±2.72)points vs.(23.18 ± 2.99)points,t =2.372,P =0.020]and total score of QOL[(116.42 ±12.439)points vs.(111.18 ±10.75)points, t =2.147,P =0.034].BCS group showed significantly lower score in self -rating anxiety scale test[(47.89 ±8.32) points vs.(52.46 ±7.38)points,t =2.767,P =0.007].Conclusion Compared with MRM,BCS can effectively decrease the incidence rate of complications and increase the QOL in breast cancer patients.

Objective To evaluate the effect of direct percutaneous transluminal coronary angioplasty (PTCA) in early stage in acute myocardial infarction (AMI) by acoustic densitometry (AD) technique Methods 40 patients with AMI were divided into 2 groups: 18 patients with direct PTCA (group A),22 patients with medical treatment (group B) The results of 2 D echocardiography and AD examination were studied on both groups at 7 days after admission Results There was no statistical difference in routine echocardiography between the two groups The results of AD examination showed: cyclic variation of integrated backscatter (CVIB) in group A was (4 2?1 3)dB, it was significantly higher than that in group B (2 5?2 4)dB ( P 0 05) Conclusion AD technology can reflect the changes of tissue characteristics in reperfused myocardia early It is a new technology for evaluating the effect of interventional therapy, predicting the improvement of cardiac function, and assessing the myocardia viability

Objective To explore the expression of HIF-2? and VEGF in renal cell carcinoma (RCC) and their correlation with angiogenesis and metastasis of renal cell carcinoma. Methods Expression of HIF-2? and VEGF were assessed by immunohistochemical straining in 48 cases of renal cell carcinomas. Results In 48 cases of renal cell carcinomas, positive rate of HIF-2? was 70.8%. Strong expression of HIF-2? was observed in 12 cases, moderate in 10 cases, weak in 12 cases and no expression in 14cases.There was a significant difference in HIF-2? expression between carcinoma tissues and control tissues (P

Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy (DN).Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table,the control group was treated with the conventional treatment,the observation group was treated with atorvastatin on the basis of conventional treatment,then blood lipids,serum cystatin C,urinary albumin excretion rate (UAER),microalbuminuria( MAU ),α1-microglobulin(MG),β 2-MG between the two groups were compared.Results After intervention,the levels of total cholesterol (TC),triacylglycerol (TG),serum cystatin C,UAER,MAU,αt 1-MG,β 2-MG were significantly decreased compared with those before treatment in the observation group [ (4.32 ± 1.26) mmol/L vs.(5.65 ± 1.38 ) mmol/L,( 1.67 ± 0.64) mmol/L vs.(2.53 ± 0.96 ) mmol/L,( 1.29 ± 0.38 ) mg/L vs.( 1.74 ± 0.51 ) mg/L,(61.09 ± 18.45 ) μ g/min vs.( 86.42 ± 21.34) μ g/min,( 5.73 ±4.81) mg/L vs.(23.16 ±9.73) mg/L,(1.41 ± 1.21) mg/L vs.(4.76 ± 1.24) mg/L,(1.21 ±0.13) mg/L vs.(2.58 ± 0.26) mg/L ] (P ＜ 0.01 or ＜ 0.05 ).In the control group,the levels of TC,TG,serum cystatin C were lower than those before treatment,but there were no significant differences (P＞0.05),but the levels of UAER,MAU,α 1-MG,β 2-MG had significant differences compared with those before treatment (P ＜ 0.01or ＜ 0.05 ) and the same time of the observation group (P ＜ 0.05 or ＜ 0.01 ).Conclusion Atorvastatin can significantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN,which plays an important role in kidney protection.

Objective To observe the effect of tripterygium glycosides combined with prednisone in treatment of purpura nephritis.Methods 51 patients with purpura nephritis were selected and treated by tripterygium glycosides (1.5～2.0mg/kg) combined with prednisone(1.5～2.0mg/kg) ,three times every day.The total course was 6 to 9 months.Before and after the treatment, the five indicators of bleeding and coagulation, urine protein, occult blood changes and drug side effects and recurrence after drug withdrawal were observed.Results The high coagulation of the blood was improved,and the renal function of 94.1%children recovered.Only 6 cases had little complication and only 1 case had recrudescence 1 year after leaving hospital.Conclusion Tripterygium glycosides combined with prednisone was effective in treating children with purpura nephritis.

Objective To understand the implementation of preventive measures for iodine deficiency disorders among residents in Yunnan Province.Methods Iodized salt monitoring database and reports from states (cities) of Yunnan Province from 2011 to 2015 were collected,and the coverage rate of iodized salt,the quality of iodized salt,the rate of qualified iodized salt consumption were evaluated.Results From 2011 to 2015,at the province level,the coverage rate of iodized salt was ＞ 98％.The rate of qualified iodized salt consumption was ＞ 97％ from 2011 to 2012,and kept at higher than 95％ from 2013 to 2015.At the county level,the county (city,district) coverage rate of qualified iodized salt that ≥90％ accounted for 99.22％ (128/129),98.44％ (126/128),91.47％ (118/129),92.25％ (119/129) and 99.22％ (128/129).The constitute ratio of salt containing 18-33 mg/kg iodine increased year by year,from 64.07％ (24 297/37 923) in 2011 to 95.15％ (36 930/38 813) in 2015.Conclusions In recent years,measures for control of iodine deficiency disorders are implemented well in Yunnan Province.After production of new standard iodized salt in 2012,the rate of qualified iodized salt consumption is decreased.After the four-year transition period,the new standard iodized salt has covered over the whole province.To rectify salt market,improve quality of iodized salt and enhance monitoring quality in order to consolidate the control achievements is the focus of prevention work in the future.

OBJECTIVE To investigate the risk factors and to take some useful measures to prevent and reduce infection in order to enhance medical quality,to ensure medical security,to strengthen hospital infection manangement and to prevent hospital infection effectively. METHODS We investigated the prevalence rate of hospital infection among our hospitalized patients in 2001,2003 and 2005, respectively. RESULTS The hospital infection rate was 4.6-6.42% in these years.Risk factors and the abuse of antibiotic were decreasing. CONCLUSIONS In order to control hospital infection rate,mensures should be taken including intensively monitoring the departments with high infection rate,strengthening hospital operation,rationally using the antibiotics,and studying the management for hospital infection.