Objective To explore the relationship between MTHFR gene polymorphism and ~diabetic cardiovascular disease. Methods The MTHFR C677T and MTHFR A1298C gene polymorphisms were detectd by PCR-RFLP to compare MTHFR C677T and MTHFR A1298C genotype distribution and allele frequencies among three groups. Enrolled were 84 healthy individuals (NC) and 158 T2DM subjects who were classified into two groups, i.e. non-diabetes complications (NDC) and ~diabetic cardiovascular disease (DC). Results Patients with diabetic cardiovascular disease had higher frequencies of MTHFR C677T mutation genotype and T allele than control and non-diabetes complications subjects, and had lower folate levels (P<0.001). There were no significant differences in MTHFR A1298C genotype distribution and allele frequencies among three groups (P>0.05). A logistic regression analysis demonstrated that MTHFR C677T and age were the independent predictors of DC. Conclution There is a strong correlation between the polymorphism of MTHFR C677T and diabetic cardiovascular disease.

BACKGROUND: Major psychological problems in patients with carcinoma of large intestine(CLI) were depression and anxiety. Are these bad moods correlated with the pathological stages, the pathological classification and the clinical manifestation of CLI?OBJECTIVE: This study was designed to investigate the relationship between the depression and anxiety state and the clinical manifestations in CLI patients.DESIGN: A comparative observation on patients was conducted in this study.SETTING: This study was conducted at the Department of General Surgery, General Hospital of Shenyang Military Area Command(MAC) of Chinese PLA and the Department of General Surgery, the 307 Hospital of the Chinese PLA. PARTICIPANTS: This study was conducted in the General Surgery Department of the General Hospital of Shenyang Military Area Command of Chinese PLA from February 2002 to February 2003. Totally 79 inpatients and outpatients were diagno sed as CLI by pathological examination. Their informed consents were obtained. Among them, 68 were accordant with the inclusion criteria, 51 males and 17 females; 21 with an age ≥55 years and 47 with an age ＜ 55 years; 39 with an average course of disease≥10 weeks and 29 with an average course of disease ＜10 weeks; 49 in Dukes A-C stages of CLI and 19 in Dukes D stage; 13 with a cancer of anal canal, 55 with a nonanal-canal cancer; 42 with a squamous cell carcinoma and 26 with a nonsquamous carcinoma; 40 with a serum level of carcinoembryonic antigen(CEA) ≥30 μg/L and 28 with it ＜30μg/L; 44 with a serum level of interleukin-8 (IL-8)≥90ng/L and 24 with it＜90 ng/L.METHODS: Sixty-eight patients with CLI received self-rating depression scale(SDS) and self-rating anxiety scale(SAS) testing made by Zung in one week before treatment. Statistical analysis of the scores was performed according to the classifications of age, sex, course of disease, pathological stages, types of carcinoma, and serum level of CEA and IL-8 respectively.MAIN OUTCOME MEASURES: ① The occurrence of depression and anxiety in CLI patients(standard scores of SDS and SAS were ≥50 ). ②The relationship between the standard scores of SDS and SAS and the various variables as age, sex, course of disease, pathological stages, types of carcinoma and serum level of CEA and IL-8.RESULTS: Totally 68 patients with CLI entered the statistical analysis procedure. ① The incidence of depression and anxiety(standard score ≥50) were 48% (33/68) and 43% (29/68) in patients with CLI. ② In patients with an age ＜55, male patients, and patients with a course of disease ≥10weeks, the standard scores of SDS(46.51 ±9.82, 47.74 ± 14.25, 48.38 ± 11.73) and SAS(44.28 ±11.24, 45.06±13.27, 45.78±12.59) were significantly higher than those in patients with an age ≥55,female, and with a course of disease ＜10 weeks(SDS: 43.27 ±10.06, 42.63±10.06, 42.19±14.34;SAS: 41.65±12.77, 41.22±10.89, 42.30±10.21) (t=2.192-2. 329, P ＜0.05). In patients in Dukes D stage of carcinoma, those with a cancer of anal canal and those with a nonsquamous carcinoma, the standard SDS scores(48.04±12.71, 47.23±9.85, 48.06±14.32) and SAS scores (44.96±10.13, 45.17±12.34, 45.28±14.38) were significantly higher than those in patients with Dukes A-C stages of carcinoma, with nonanal canal cancer, and with a squamous cell carcinoma(SDS: 43.42±11.97,44.05±12.14, 44.36±10.57; SAS: 42.23±13.04, 42.39±11.09,43.14±10.60) (t=2.136-2.298, P ＜0.05).In patients with serum level of CEA ≥30 μg/L and with IL-8 level ≥90 g/L,the standard scores of SDS(48.27±11.69, 49.04±12.24) and SAS(44.94±13.34,45.26±12.70) were significantly higher than those in patients with CEA ＜30μg/L and IL-8 ＜90 ng/L( SDS: 43.48±12.76, 44. 15±13.61;SAS: 41.47±10.58, 41.71±14.53) (t =2. 248-2. 314, P＜0.05).CONCLUSION: It is showed that those patients with these variables as a longer course of disease, an older age, male, a more advanced Dukes staging,and higher levels of CEA and IL-8 are prone to depression and anxiety.

Objective:To evaluate the effect of modified Tianma-Gouteng Decoction combined with conventional western medicine in the treatment of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind. Methods:From May 2017 to December 2019, 120 patients of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind were randomly divided into two groups, 60 in each group. The control group was treated with conventional western medicine treatment, and the observation group was with modified Tianma-Gouteng Decoction on the basis of the control group. Before and after treatment, the TCM symptom scores were evaluated. Serum norepinephrine (NE), epinephrine (E), dopamine (DA) were detected by ELISA. Serum MDA was detected by ELISA. Serum homocysteine (Hcy), endothelin (ET) were detected by fluorescence polarization immunoassay, the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment, and Barthel index was used to assess activities of daily living. The rebleeding during the treatment was observed and recorded to evaluate the clinical efficacy. Results:The total effective rate was 90.0% (54/60) in the observation group and 70.0% (42/60) in the control group, with significant difference between the two groups ( χ2=7.500, P=0.006). After 3 and 6 weeks of treatment, the TCM syndrome score of the observation group were significantly lower than those in the control group ( t=10.670, 14.022, P<0.001). After treatment, NIHSS score of treatment group was significantly lower than that of control group ( t=5.736, P<0.01), Barthel index score of treatment group was significantly higher than that of control group ( t=10.559, P<0.01). After treatment, serum NE [(2 897.51 ± 241.65) pmol/L vs. (6 309.25±394.16) pmol/L, t=57.160], E [(1 352.45 ± 234.15) pmol/L vs. (4 131.20 ± 431.55) pmol/L, t=43.839] and DA [(623.59 ± 45.61) pmol/L vs. (950.61 ± 51.39) pmol/L, t=36.866] levels, serum SOD [(4.08 ± 1.05) C/μg·mgHb vs. (3.16 ± 1.02) C/μg·mgHb, t=4.868], MDA [(3.15 ± 1.41) μmol/L vs. (5.86 ± 1.31) μmol/L, t=10.907] levels, serum Hcy [(12.98 ± 2.41) μmol/L vs. (17.68 ± 2.26) μmol/L, t=11.019], ET [(51.36 ± 5.29) ng/L vs. (79.58±7.65) ng/L, t=23.502] in treatment group were significantly lower than those in the control group ( P<0.01); NO [(63.19 ± 3.87) μmol/L vs. (51.26 ± 3.59) μmol/L, t=17.506] in treatment group was significantly higher than that of the control group ( P<0.01). The incidence of rebleeding was 1.7% (1/60) in the observation group and 15.0% (9/60) in the control group, where the difference was statistically significant ( χ2=6.982, P=0.008). Conclusion:Modified Tianma-Gouteng Decoction combined with conventional western medicine therapy can protect the cerebral nerve function of patients with cerebral hemorrhage with syndrome of hyperactive liver yang causing wind, prevent the secondary ischemic brain injury after cerebral hemorrhage, and improve the clinical curative effect.

Objective To investigate the expression of radiation-induced IER5 protein and screen its potential interaction proteins that may participate in DNA repair process.Methods HeLa cells were irradiated with 4 Gy ionizing radiation.IER5 protein expression in whole cell lysate and in nuclear fraction were detected by Western blot at different timepoints after irradiation.3 × Flag-IER5 pCMV plasmid was constrcuted and the Flag tagged-IER5 expression was verified by Western blot.293T cells were transfected with 3 × Flag-IER5 pCMV plasmid.After irradiation the cells were collected and proteins were extracted.The IER5 interaction proteins were purified using immunoprecipitation and separated by 12％ SDS-polyacrylamide gel electrophoresis.Then the binding proteins were cut from the gel and analyzed by Mass spectrometry.Results The expression of IER5 protein began to increase 4 hour post-irradiation and its peak level was observed at 12 hour post-irradiation,and it lasted until 48 hour after irradiation.The expression level of IER5 protein in whole cell lysate and nuclear fraction were both increased.With the mass spectrometry analysis,a total of 347 proteins and 256 proteins were identified in irradiated and nonirradiated groups,respectively.Fourty one differential proteins were obtained,where 10 proteins were associated with DNA metabolic process and DNA rapair in the irradiated group and the poly(ADP-ribose) polymerase 1 (PARP1) protein was further confirmed by Western blot.Conclusions IER5 protein is an DNA damage related protein,and it may participate in DNA repair process.

Objective To study the MR imaging technology and 3D reconstruction of the articular cartilage of knee.MethodsConventional,2D,3D and multiparameter MR imaging scans of knee were performed in ninety patients with trauma(n=34)andosteoarthritis(n=56) of knee and 10 healthy volunteers.The articular cartilages on 3D images were reconstructed using maximum intensity projection(MIP).The mean thickness of articular cartilage was measured and analysed statistically.Results Articular cartilages of knee were clearly depicted by MR imaging technique and 3D.On 2D FSE sequence,about 50% of articular cartilage appeared as three laminar apearance.On 3D imaging,the three-dimensional morphology of articular cartilage was showed clearly.Conclusion MR imaging and 3D reconstruction of the articular cartilages of knee is helpful in early diagnosis and treatment of disordered cartilages.

Objective To assess the risk factors for the occurrence of hypokalemia in patients with hepatic cancer after transcatheter arterial chemoembolizaion (TACE) therapy,and to discuss the corresponding nursing countermeasures.Methods The clinical data of 214 patients with hepatic cancer,who received TACE during the period from August 2014 to February 2015,were retrospectively analyzed.The risk factors causing hypokalemia were analyzed.Results Among the 214 patients,post-TACE hypokalemia occurred in 23 (10.7％).The main risk factors that could cause hypokalemia included anorexia,hydration,vomiting,ascites drainage,sweating.After actively symptomatic treatment,the serum potassium level returned to normal in 22 patients.One patient developed hepatic encephalopathy coma complicated by hepatorenal syndrome,the patient's family members gave up treatment and,according to family members' will the patient left hospital.Conclusion anorexia,vomiting,hydration,ascites drainage,sweating are the risk factors that can cause hypokalemia in patients with hepatic cancer after TACE therapy.The use of low potassium risk scale is helpful for the formulation of nursing countermeasures.

OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
Ear Canal ; surgery ; Humans ; Lasers ; Otosclerosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Stapes ; Stapes Surgery ; Treatment Outcome

Objective To seak a available way of evaluating morphology of filtering blebs after trabeculectomy is very important for forecasting the successful rate of surgery.At the present time,filtering blebs were commonly evaluated by using the slim lamp microscope,but it did not to exactly reflect the filtering passage.This study aimed to evaluate the morphology of filtering blebs after trabeculectomy with anterior segment optical coherence tomography (AS-OCT).MethodsThis was a prospective study.Sixty-nine eyes of 53 patients who had previously undergone trabeculectomy were selected in this study,including 25 eyes with open-angle glaucoma,38 eyes with close-angle glaucoma and 6 eyes with secondary glaucoma.These filtering blebs were classified into functional type (typeⅠandⅡ) and nonfunction type (type Ⅲ and Ⅳ) under the slit lamp microscope based on the van Buskirk grading scales.Intra-bleb morphology and structure were characterized as diffuse-like,cystic-like,encapsulating-like and flatten-like by AS-OCT in reference to the Leung method.The consistency between the two methods was evaluated by the Chi-Square test.Written informed consent was obtained from all the patients before surgery.ResultsThe average follow-up time was 10.78±11.0 months.All the patients finished the examination during the follow-up duration.The average intraocular pressure was(14.9±4.5)mmHg during the observation period.There were 38/69 (55.1%) functioning blebs and 31/69 (44.9%) non-function blebs under the slim lamp microscope.AS-OCT imaging showed diffuse-like blebs in 26 eyes (15.9%),cystic-like blebs in 11 eyes (27.5%),encapsulating-like blebs in 19 eyes (18.8%) and flatten-like in 13 eyes with the intraocular pressure of(13.16±3.77)mmHg,(15.36±2.92)mmHg,(15.77±5.07)mmHg and (16.62±5.33)mmHg,respectively,showing a significant difference among them (F=3.32,P＜0.05).These patterns of different OCT presented a good consistency with the clinical outcome (χ~2=0.03,P=0.86).ConclusionAS-OCT allows the observation of filtering blebs after glaucoma surgery.It is probably to visualize the internal structure of filtering bleb and deep sclerectomy.Functional and dysfunctional filtering blebs delivery gives different OCT patterns.This could be a new way to assess the postoperative healing process.

BACKGROUND:Increasing evidence col ected from animal experiments or laboratories shows that bone mesenchymal stem cel s possess potent immunosuppression and anti-inflammation effects and cartilage regenerative capability. The microenvironment in human knee joint of osteoporosis is more complex and involves lots of bioactive factors and immunologic mechanisms. OBJECTIVE:The analyze the therapeutic effects of intra-articular injection of autologous bone marrow mesenchymal stem cel s on mild-to-moderate osteoporosis, and to investigate the mechanisms for anti-inflammation, immunoregulation and reversion of cartilage degradation. METHODS:About 15 mL bone marrow was aspired from 26 patients with mild-to-moderate osteoporosis and taken to the laboratory where bone marrow mesenchymal stem cel s were isolated and characterized in terms of some surface markers by a flow cytometer, and the ability of osteogenic and adipogenic differentiation was analyzed. The bilateral knees of each patient were divided into two groups at random. The experiment group were treated with autologous bone marrow mesenchymal stem cel s by intra-articular injection (2×107 cel s), while the control group injected the same volume of control medium without bone marrow mesenchymal stem cel s. Western Ontario and McMaster Universities Osteoarthritis Index was used to estimate the function of the knee joints before and after the treatment. We col ected the joint fluid before, 2 and 4 weeks post treatment, and then measured the production of interleukin-1, interleukin-10, tumor necrosis factor-α, cartilage oligomeric matrix protein using ELISA. RESULTS AND CONCLUSION:According to the standardized culture-expansion protocol, a sufficient number of bone marrow mesenchymal stem cel s (more than 2×107 passage 3 cel s) were obtained for intra-articular injection. The bone marrow mesenchymal stem cel s isolated from patients were positive for CD105, CD29 and negative for CD45, CD34, and had the fair osteogenic and adipogenic capacities. The function of the knee joints was improved obviously after treatment. In the experimental group, the secretion of both interleukin-1, tumor necrosis factor-αand cartilage oligomeric matrix protein in the joint fluid was suppressed, while the interleukin-10 level was up-regulated compared to the control group. The results suggest that intra-articular injection of autologous bone marrow mesenchymal stem cel s can exert good effect in mild-to-moderate osteoporosis patients. Furthermore, bone marrow mesenchymal stem cel s via intra-articular injection can function through anti-inflammation and reversion of degradation of the articular cartilage, which is a new promising approach for treating mild-to-moderate osteoarthritis.

Objective:To evaluate the performance of RapidArc technique on cervical cancer patients with various filling status of the bladder. Methods: Conventional fixed field intensity modulation radiated therapy (IMRT) is used as the benchmark. In 10 fe-males suffering from cervical cancer, two CT scans were performed for treatment planning:one with an empty bladder and the other with filled bladder. The prescribed dose was 50 Gy. The images of that with an evacuated bladder and that with filled bladder were planned in the dual-arc RapidArc and the 7-field IMRT, respectively. The implementor of the plan was the Varian TrueBeam linear ac-celerator. Dose-volume histogram was used to evaluate the data from each plan. Results:When the bladder was filled, IMRT and Rapi-dArc homogeneity were 1.05 and 1.04 (P>0.05), respectively. When the bladder was emptied, the homogeneity was 1.04 for both plans (P>0.05). With or without bladder filling, the conformity index was 0.71 and 0.73 for IMRT and RapidArc (P>0.05), respectively. The effect of V30 and V40 (volume for receiving doses of 30 and 40 Gy) on the intestine and the bladder was more favorable in a full than in an empty bladder. No significant difference between the two plans was observed. IMRT exhibited improved V30 on the rectum and on the bladder. RapidArc was much better in terms of monitor unit (MU) and deliver time. Conclusion:No significant differences in the homogeneity and conformity index between dual-arc RapidArc and 7-field IMRT were observed. Filled bladder is better than empty bladder in intestine and bladder protection in both RapidArc and IMRT. IMRT is better on V30 of the rectum and the bladder, whereas RapidArc improved MU and deliver time.