Diabetic nephropathy is one of the leading causes of the end-stage renal failure, and its major pathologic feature is the renal fibrosis. Transforming growth factor-?_1 is a key factor in the progression of the disease. Two signal pathways, Smads and MAPK following the factor, are closely connected with extracellular matrix accumulation which leads to renal fibrosis. Smads and MAPK also have a cross talk in extracellular matrix accumulation. The relationship between the two signal pathway and ECM accumulation offers us a new therapeutic strategy for renal fibrosis of diabetes.

Objective To formulate the quality standard of Rukang Capsule. Method The TLC of Zhebeimu, Xuanshen, Ruxiang and Tiandong were done separately. The HPLC-ELSD was used to determine the content of Astragaloside in Mongolian Milkretch Root. Result There were the same spots between the controls and samples and an excellent linear relationship for 1.44～4.32 ?g to the content determination of Astragaloside. The average recovery can reach 100.3% with 0.5% of RSD. Conclusion This method is reliable and accurate to application, and can be used for the quality control of the preperation.

Objective To find convenient methods for remote consultation of images of ocular fundus diseases. Methods A remote consultation system composed of internet was set up.The consultation information,including images,words and figures,was published on internet as web pages,so that the consultants would get the notice and the appointment by e mail.After reading the information on line,the consultants gave their opinions back to internet. Results The remote consultation system of images of ocular fundus diseases was setted up and managed successfully,and 23 patients had been diagnosed by this system. Conclusion The system which has clinical practicality is a simple,quick,effective and economic method for remote consultation of images of ocular fundus diseases. [

To detect the soluble Fas (sFas) receptor level in sera from patients with myelodysplastic syndrome (MDS) and acute leukemia (AL), and investigate its clinical significance, the levels of sFas receptor in sera from 18 patients with MDS and 42 patients with AL were detected by using ELISA methods. The results suggested that the sFas receptor levels in sera from patients with MDS-RA were significantly lower than that from normal control (2.89?1.72 ng/ml vs 6.29?1.07 ng/ml, P

Objective·Giving the ovariectomized (OVX) mice exogenous estrogen replace therapy (ERT) so as to explore the inflammatory mechanism of estrogen in the pain modulation of OVX mice.Methods·Twenty-four 12-week-old female C57BL/6J mice were randomized into three groups:sham group (S),ovariectomy+placebo group (P),ovariectomy+estrogen group (E).The ERT began from one week after OVX and last for four weeks.Paw withdraw threshold (PWT) and paw withdraw latency (PWL) were measured at one day before OVX,and three days,one week,two weeks,three weeks,four weeks and five weeks after OVX.Concentrations of inflammatory cytokines in serum were measured at three days and five weeks postoperatively.Five weeks after operation,the lumbar intumescentia of spinal cord was taken and the expression of p38 was analyzed by Western blotting.Results·All the OVX mice's PWTs or PWLs were decreased after operation compared with non-operation mice;PWTs and PWLs were significantly different from group S separately from one week and three days after OVX (P＜0.01).The inflammatory cytokines of OVX mice were significantly higher than group S (both P＜0.01) at three days after OVX.Western blotting results showed that the p38 of group P was significantly higher than that of group S after five weeks postoperatively (P＜0.01).By receiving ERT,both PWTs and PWLs of group E increased slightly and were significantly different from group S (P＜0.01) at four and five weeks after OVX.At five weeks after OVX,inflammatory cytokines of group E were significantly lower than group P (P＜0.01) but still much higher than group S (P＜0.01).Meanwhile the content of p38 in group E was less than that in group P (P＜0.01).The p38 in group E was still more than group S,however it was no longer significantly different from group S (P＞0.05).Conclusion·Estrogen may reduce concentrations of inflammatory cytokines through the p38 MAPK pathway and plays an important role in the pain modulation of OVX mice.

Objective To explore the MRI findings of ovarian cancer peritoneal carcinomatosis (PC).Methods MRI findings of 34 cases with advanced ovarian cancer and PC confirmed by operation and pathology were reviewed retrospectively.MRI protocols included T1 WI,T2 WI,MRH,DWIBS,and gadolinium-enhanced 3D THRIVE sequences.The type of ovarian tumor and MRI manifestations of PC were analyzed.Results All of the ovarian tumors and PC lesions were high signal intensity in DWIBS.All of the ovarian tumors were shown as mixed cystic solid masses,including type Ⅱa in 12 cases,type Ⅱb in 7 cases,and type Ⅱc in 1 5 cases.The MR manifestations of PC were described as follow:linear thickening of the peritoneum (n=2),irregular linear thickening of the peritoneum (n=27);smudged thickening of the omentum (n=1 9),cake-like thickening of the omentum (n=1 1);fouling-appearance of the mesentery (n=4);plaque,nodule and mass in the abdominal cavity (n= 34),cystic mass (n=8).PC lesions were detected in the Douglas’space in 31 cases,paravesical interspace in 24 cases,omentum in 20 cases,paracolic gutter in 9 cases, right subdiaphragmatic / parahepatic space in 1 1 cases,and left subdiaphragmatic / parasplenic space in 10 cases.The primary and PC tumors invaded the rectum in 26 cases,sigmoid in 22 cases,and uterus in 1 6 cases.Ascites and lymphadenectasis in abdomen were seen in 33 and 7 cases,respectively.Conclusion Ovarian cancer PC can be diagnosed accurately by combing DWIBS and con-ventional MRI.

This thesis analyzed the inevitability of medical negligence according to the nature of medical behavior,particularity of medical profession and psychological factors of medical staff.How to control the occurrence of medical errors is an important social problem which is the whole community has been looking forward to solve.This thesis proposed methods to reduce medical negligence from the aspects of service concept,medical education and healthy psychology.

Objective To investigate the feature of Th1 cytokines induced by Mtb-specific antigen in patients with refractory pulmonary tuberculosis.Methods 28 patients with refractory pulmonary tuberculosis,67 patients with first-treated pulmonary tuberculosis,and 25 healthy controls with positive T.spot (LTBI group) were enrolled.IFN-γ,IL-2 and TNF-α in supernatants from PBMCs stimulated with ESAT-6 and CFP-10 were analyzed with Bender Flowcytomix on flow cytometry.Results The levels of the three cytokines were utmost high in patients with first-treated pulmonary tuberculosis.The lowest level of IFN-γ and IL-2 were induced in patients with refractory pulmonary tuberculosis,and were significantly lower than the LTBI group(Mann-Whitney U ＝ 105.5,162.5,P ＜ 0.01).Conclusions The immunotherapy with IFN-γ and IL-2 may play a role in treatment for refractory pulmonary tuberculosis but not for most of first-treated pulmonary tuberculosis.

Objective To evaluate different tigecycline susceptibility testing methods for A.baumannii.Methods Thirty carbapenem resistant A.baumannii (CRAB) and 30 carbapenem sensitive A.baumannii (CSAB) isolates were randomly collected from 30 hospitals during January to December in 2010 in China retrospectively.MIC and inhibitory zone diameters for tigecyclinc were determined by the susceptibility testing methods such as broth microdilution (BMD),agar dilution,E test,MIC Test Strip (MTS),Vitek2.Data were analyzed by comparing the results from each method to those produced by the reference BMD method.The effects of two different susceptibility test media (M-H and ISO-Sensitest Agar) on the MIC of tigecycline were also analyzed.Results For CSAB isolates,the MIC50/MIC90 of BMD,agar dilution,E test,MTS and Vitek2 were as follows:0.125/0.25 mg/L,0.125/0.25 mg/L,0.5/1 mg/L,0.125/0.25 mg/L and 0.5/0.5 mg/L.Compared with BMD method,the categorical agreement rates (CA) of each method were ≥90％,and produced no very major errors (VME) by Food and Drug Administration (FDA)/ European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints.For CRAB isolates,the MIC50/MIC90 of BMD,agar dilution,E test,MTS and Vitek2 were as follows:2/4 mg/L,4/4 mg/L,4/4 mg/L,1/2 mg/L and 2/4 mg/L.Compared with BMD method,MTS produced 3.3％ (1/30)/6.7％ (2/30) VME(FDA/EUCAST breakpoints),and no method CA was ≥90％.The CA between disk diffusion and BMD results were higher by using the criteria of Jones than FDA breakpoints,but only 66.7％ (20/30) were observed in CRAB isolates,and produced no VME.The MIC of tigecycline determined using M-H agar were usually higher than those using ISO-sensitest Agar.Conclusions Agar dilution,E test,Vitek 2 and disk diffusion appear not to be a suitable method for routine susceptibility testing of tigecycline for CRAB strains.Tigecycline intermediate or resistant results determined by these methods require confirmation by BMD,and MTS results also need to be interpreted with caution.