[Summary] This retrospective analysis showed that the level of apolipoprotein E was significantly higher in diabetic nephropathy group compared with normal albuminuria group [50.4 (40.8,65.9) vs 46.2 (38.6,56.8)mg/L,P＜0.01].Difference in urinary albumin to creatinine ratio (ACR) among the groups based on the tertile of apolipoprotein E were significant (P＜ 0.01).Multiple linear regression analysis demonstrated that apolipoprotein E was independently associated with ACR (β =0.14,P＜0.05).

Objective To explore the clinical effect of ligament advanced reinforcement system ( LARS) artificial ligament reconstruc-tion of the anterior cruciate ligament ( ACL) in the operation. Methods Sixty patients with ACL injury in our hospital from September 2011 to May 2013 were randomly divided into LARS group and autologous hamstring tendon ( group ST/G) group with 30 cases in each group,the Lysholm score,IKDC score,the difference of clinical effect and bone tunnel of patients in two groups before treatment and at 3rd,6th,9th, 18th months after treatment were compared. Results The time of walking with crutch,ambulation and restore movement in LARS group were obviously shorter than those in ST/G group(P<0. 05). The Lysholm score,IKDC score,the difference of clinical effect and bone tunnel of patients in two groups after treatment were better than those before treatment(P<0. 05). The difference of Lysholm score and IKDC score be-tween two groups before operation was not significant (P>0. 05). The Lysholm score and IKDC score of LARS group at 3rd,6th,9th months after operation was higher than that of ST/G group,and at 18th months after operation,the difference of Lysholm score and IKDC score be-tween two groups was not significant (P>0. 05). At the last follow-up,the distribution effect of LARS group was higher than that of ST/G group (P<0. 05). The excellent and good rate of LARS group (93. 33%) was higher than that in ST/G group(76. 67%),but the difference was not significant (P>0. 05). There were 6 cases of patients with bone tunnel enlargement in LARS group,14 patients had bone tunnel en-largement in ST/G group. The bone tunnel enlargement rate was significantly higher than that of the LARS group (P<0. 05). Conclusion Ligament advanced reinforcement system of artificial ligament in anterior cruciate ligament reconstruction with autologous hamstring tendon re-construction can significantly speed up the recovery of the patients,and improve the postoperative curative effect and reduce the incidence of postoperative bone tunnel enlargement.

Objective To assess the effect of rhein on diabetic nephropathy in rats with type 2 diabetes mellitus. Methods Diabetes was induced by high-lipids and high-sucrose diets (20% sucrose, 10% lard, 2.5% cholesterol, 1% cholic acid and 66.5 % regular chow, w/w) for 1 month and then intraperitoneal injection with 25 mg/kg streptozoticin(STZ) in female inbred Wistar rats. Rhein was continuously given 100 mg?kg-1?day-1 for 6 months 1 week after STZ injection in rhein-prevented group, and 1 month after STZ injection in rhein-treated group. Blood and urinary biochemistry and renal morphology were evaluated at divers times. Results Rhein ameliorated hypertriglyceridemia and hypercholesterolemia, but had few effect on the level of plasma glucose in both rhein-prevented group and rhein-treated group. Excretion of urinary protein reduced markedly and stable-state plasma glucose (SSPG) level decreased in both groups as compared with diabetic group. Examination of kidney sections from both rhein-prevented group and rhein-treated group showed that the structural lesions of glomeruli including mesangial expansion, diffuse glomerulosclersis and thickening of glomerular basement membrane, as well as artery injury such as arteriolar hyalinosis, atherosclerosis were markedly improved as compared with diabetic group. Morphometry of glomeruli from both rhein-prevented group and rhein-treated group showed that glomerular grow and mesangial hypertrophy occurred in diabetic group were ameliorated. The accumulation of fibronectin examined by immunostaining in glomeruli was reduced in both groups. Conclusion Therapeutic intervention with rhein can halt the progression of diabetic nephropathy and prevent the development of glomerulosclerosis and vascular injuries in this animal model of type 2 diabetes mellitus.

20 mm),these three imaging techniques(HAP-MDCT,Lipiodol CT and DSA)had the same sensitivity,for 10~20 mm hepatic nodules,the detecting rate was no significant difference among them,while,for

Objective To investigate the effect of curcumin on chronic pancreatitis in rat.Methods Eighteen one-month old male SD rats were randomly divided into control group,ANP group and curcumin group with 6 rats in each group.After fed by 25％ alcohol for twelve weeks,the rats in ANP group were intraperitoneally injected with lipopolysaccharides ( LPS,2 mg/kg body weight) once a week for 4 weeks.The rats in curcumin group were fed with curcumin when they were intraperitoneally injected with lipopolysaccharides.Seventeen weeks later,the rats were sacrificed.Serum glucose was measured,pancreatic morphology was routinely examined,collagen deposition was determined by Masson stain,and the amylase and lipase in pancreatic tissue were evaluated,TGF-β1 mRNA was determined by using RT-PCR.Results The pathological score of control group,ANP group and curcumin group was 1.17 ±0.41,7.33 ±2.58 and 3.50 ± 1.05,and the score in curcumin group was lower than that of ANP group (P ＜ 0.01 ),but which was higher than that in control group (P ＜ 0.05 ).There was no difference in the serum glucose among the groups.The levels of amylase and lipase in pancreatic tissue were (7348 ± 102 ),( 14135 ± 1272) U/g,which were significantly higher than those in ANP group[( 5428 ± 547 ) and (9123 ± 1250 ) U/g,P ＜ 0.05].The expressions of TGF β1 mRNA in control group,ANP group and curcumin group were 0.618 ± 0.019,0.818 ±0.012,0.745 ±0.088,and the values in ANP group were significantly higher than those in control group and curcumin group (P ＜ 0.01 ).Conclusions On the basis of long term ethanol intake,repeatedly intraperitoneal injection of LPS can induce chronic pancreatitis,and curcumin has anti-fibrosis effect possibly by its inhibitory effect on the expression of TGF-β1.

Background and purpose:Breast cancer is one of the most common carcinoma among female patients with high mortalities. Drug-resistance is the major reason that leads to chemotherapy failure in clinical practice. MCF-7/ADR is a multi-drug resistant cell line that was established on the basis of breast cancer cell line MCF-7. This research aimed to investigate the anti-apoptotic effect of c-fos in resistant breast cancer cell MCF-7/ADR, and to compare with its sensitive counterpart MCF-7.Methods:Doxorubicin with various concentrations was used to treat MCF-7 as well as its MDR- counterpart MCF-7/ADR. The growth inhibitory rate of MCF-7 and MCF-7/ADR wasdetermined by MTT assay. Additionally, RT-PCR was used to test the expression of P-gp and c-fos mRNA in MCF-7 and MCF-7/ADR; The expression of c-fos mRNA was detected by RT-PCR after 3 μmol doxorubicin treatment;We further established cell lines that stably interfered with c-fos, named MCF-7/ADR/si-fos-8B, MCF-7/ADR/si-fos-3D. Flow cytometry and MTT assay were used to investigate the apoptosis rate and inhibitory rate in these above cells under the treatment of 5-FU, CDDP or γ-radiation. At last, RT-PCR and Western blot analysis were used to detect the expression of bax, bcl-2, puma, p53.Results:The expression of c-fos and P-gp (MDR-1) was up-regulated in MCF-7/ADR, compared with its sensitive counterpart MCF-7. Additionally, the resistant fold of MCF-7/ADR to doxorubicin was nearly 40; The expression of c-fos was gradually up-regulated after 3 μmol doxorubicin treatment; The sensitivity to drugs (5-FU and CDDP) was increased after c-fos interference while the apoptosis rate was also increased after 5-FU, CDDP and γ-radiation treatment. RT-PCR and Western blot analysis indicated that up-regulation ofbax,puma,p53 after c-fos interference while the expression of bcl-2 was down-regulated.Conclusion:c-fos may act as an anti-apoptotic protein in resistant breast cancer cell line MCF-7/ADR by regulating the expression of apoptosis related proteins, and may play a vital role in the formation of multi-drug resistance phenotype.

Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy ( NPWT) in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .

Objective To evaluate the effect of suberoylanilide hydroxamic acid (SAHA) on liver injury induced by lethal hemorrhagic shock in rats first entering high altitude.Methods Forty healthy male SpragueDawley rats,aged 2-3 months,weighing 240-280 g,transported from breeding grounds at an altitude of 1520 meters to the experimental station at an altitude of 3780 meters,were randomly divided into 4 groups (n =10each):sham operation group (group S),lethal hemorrhagic shock group (group LHS),normal saline group (group NS),and SAHA group.Anesthesia was induced with inhalation of 3% isoflurane and maintained with inhalation of 0.5%-1.0% isoflurane.Lethal hemorrhagic shock was induced by withdrawing blood from the femoral artery in groups LHS,NS and SAHA.Normal saline 0.25 ml and SAHA 7.5 mg/kg (0.25 ml) were injected intravenously over 2 min after completion of blood-letting in groups NS and SAHA,respectively.The survival rates with 3 h were recorded.Blood samples from femoral veins were taken before blood-letting,immediately after completion of blood-letting and at 3 h after completion of blood-letting (immediately after death if the survival time was less than 3 h) for determination of serum aspartate aminotransferase (AST),alanine aminotransferase (ALT) and lactic dehydrogenase (LDH) activities by the colorimetric method.Liver specimens were taken at 3 h after completion of blood-letting or immediately after death for examination of the pathological changes of the liver and for determination of c-Jun N-terminal kinase (JNK),phosphorylated-JNK (p-JNK) and caspase-3 expression and acetylation of H3K9 in liver tissues by Western blot.Results Compared with group S,the activities of serum AST,ALT and LDH were significantly increased in the other three groups (P ＜ 0.01).Compared with LHS and NS groups,the activities of serum AST,ALT and LDH were significantly decreased,the survival rate within 3 h and acetylation of H3K9 were increased,caspase-3 expression was down-regulated,and p-JNK/JNK ratio was decreased in group SAHA (P ＜ 0.05 or 0.01).The pathological changes of the liver were severe in LHS and NS groups and attenuated in SAHA group.Conclusion Administration of SAHA in early shock can significantly protect the liver after lethal hemorrhage in rats first entering high altitude,and increased acetylation of H3K9 and inhibition of the JNK/caspase-3 apoptotic pathway in liver tissues are involved in the mechanism.

The traditional teaching mode of "subject-centered" has many shortcomings such as knowledge separation and lack of integrity. In order to make up for the deficiencies of this mode, the organ-system integrated medical teaching mode has gradually become the trend of medical teaching reform. Taking "motor system" as an example, this paper discusses the practice of the organ-system integrated medical teaching mode from four aspects: teaching implementation, teaching quality supervision, supporting assessment system and teaching effectiveness.

Objective To explore the effect of the straight line and the auxiliary incision of lip skin on repairing unilateral incomplete cleft lip.Methods 120 cases of unilateral incomplete cleft lip repaired with the straight line method and reconstruction of the orbicularis oris muscle with the auxiliary incision of lip skin.Results 2 cases of cleft relapse by tumble.The wound of 115 children were healed one stage.3 children were healed two stage.All children didn't present vermilion deficiency.The upper lip presented natural labial groove between affected and unaffected side.Both sides of nostrils were symmetry and scars were not ovbious.Conclusion This new method was simple and effective in repairing unilateral incomplete cleft lip.