OBJECTIVE:To obverse the efficacy and safety of Liuwei dihuang pill combined with TCM prescription acupoint application in the treatment of type 2 diabetic constipation. METHODS:120 patients with type 2 diabetic constipation were random-ly divided into control group(60 cases)and observation group(60 cases). All patients received controlling blood pressure and regu-lating blood lipids drugs,diet control combined with exercise,and fixed dose of Metformin hydrochloride tablet(0.5 g/times,2 times a day)and Acarbose tablet(100 mg/times,3 times a day);based on it,control group received 5 mg Mosapride citrate tablet, 3 times a day;observation group additionally received 8 Liuwei dihuang pills(3 times a day)combined with TCM prescription acu-point application (in double Tianshu Point,double Yongquan point,double Shenque Point and double Zusanli). 7 d was regarded as a treatment course,and it lasted 3 courses. Clinical efficacy,blood glucose [2 h postprandial glucose(2 h PG),blood glucose (FPG)],the clinical symptom indexes(defecation interval time,each defecation time,weekly defecation frequency)before and af-ter treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than in control group,and the difference was statistically significant (P<0.05). Before treatment, there were no significant differences in the 2 h PG,FPG,defecation interval time,each defecation time and weekly defecation fre-quency between 2 groups(P>0.05). After treatment,2 h PG and FPG in 2 groups were significantly lower than before,and obser-vation group was lower than control group;defecation interval time and each defecation time were significantly shorter than before, and observation group was shorter than control group;weekly defecation frequency was significantly higher than before,and obser-vation group was higher than control group,The differences were statistically significant (P<0.05). During treatment,6 patients showed adverse reactions in control group,and 5 in observation group,and there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Liuwei dihuang pill combined with TCM priscription acupoint ap-plication shows good efficacy in the treatment of type 2 diabetic constipation. It can effectively improve constipation,reduce defeca-tion interval time and each defecation time,increase weekly defecation frequency and have no influence on blood glucose control with small adverse reactions and high safety.

Background:Gastric cancer is the second most frequently diagnosed cancer and the third cause of cancer death in China. Selection of candidates in high risk of gastric cancer by a simple and non-invasive marker with high sensitivity and then undergoing endoscopy is an optimal approach for large scale gastric cancer screening. Aims:To evaluate the clinical value of using trefoil factor 3(TFF3)as a serum biomarker for gastric cancer screening. Methods:Serum samples of 49 gastric cancer patients and 29 healthy subjects were collected for measurements of serum TFFs by ELISA from Jul. 2013 to Jan. 2014 at Ningbo Medical Treatment Center Lihuili Hospital. ROC curve and the area under curve(AUC)were used to verify the diagnostic performance of serum TFF1,TFF2 and TFF3 for gastric cancer. Correlations between TFFs and clinicopathological characteristics of gastric cancer were further analyzed. Results:Serum concentration of TFF3 in gastric cancer group was significantly higher than that in healthy controls[(43. 57 ± 19. 49)ng/ mL vs.(29. 97 ± 14. 20)ng/ mL, P < 0. 01],but no significant differences were found in serum concentrations of TFF1 and TFF2 between the two groups (P > 0. 05). AUC of serum TFF1,TFF2 and TFF3 for diagnosis of gastric cancer were 0. 56,0. 56 and 0. 83, respectively,which indicated that the performance of TFF3 was the best. Taken 33. 0 ng/ mL as the cut off value of TFF3, the sensitivity and specificity were 63. 3% and 82. 8% ,respectively,and the odds ratio for predicting gastric cancer was 8. 27. Significant correlations were existed between serum concentration of TFF3 and TNM stage,differentiation and lymph node metastasis of gastric cancer(P < 0. 05). Conclusions:Serum TFF3 is a promising non-invasive biomarker for gastric cancer screening.

Objective To investigate the relationship between the expressions of serum vascular endothelial growth factor (VEGF), matrix metalloproteinases 9 (MMP-9) before and after chemoradiotherapy and biological behaviors for patients with esophageal cancer. Methods The data of 65 cases with esophageal cancer were analyzed respectively, including 44 cases of primary esophageal cancer and 21 cases of postoperative esophageal cancer. Serum VEGF and MMP-9 before and after chemoradiotherapy were measured, and their relationship with clinicopathological features of esophageal cancer patients was also investigated. Results Serum VEGF level in primary patients [613.50 ng/ml (387.00 - 1127.00 ng/ml)] was significant higher than that in postoperative patients [78.00 ng/ml (40.00 - 196.50 ng/ml)] (Z= -3.493, P= 0.000). There was no difference in serum MMP-9 level with or without surgery, and serum MMP-9 level in primary patients [686.00 ng/ml (434.00 - 1211.25 ng/ml)] has no difference in postoperative patients [637.00 ng/ml (362.00-906.50 ng/ml)] (Z=-0.743, P=0.457). There was no significant correlation in serum VEGF, MMP-9 level with gender, age, tumor pathological type and tumor location in postoperative and primary patients (all P>0.05). There was no significant difference in serum VEGF, MMP-9 level before or after chemoradiotherapy in postoperative patients (P=0.339, P=0.689), but there was a difference in primary patients (P= 0.000, P= 0.001). The changes of serum VEGF, MMP-9 levels were synergistic (r= 0.451, P<0.001). Conclusion The dynamic monitoring and comparison of serum VEGF, MMP-9 levels can predict the efficacy of esophageal cancer and guide the individualized therapy.

Objective To explore the effect of methotrexate packaged by tumor derived microparticles (T-MP MTX) combined with radiotherapy on lung cancer stem cell (CSC) in vitro. Methods T-MP MTX was prepared from non-small cell lung cancer A549 cells. Proliferative changes of A549 cells, bronchial epithelial cells H460 and 16HBE cells treated by T-MP MTX were assayed by MTT method. Cell cycles of A549 cells in blank group and T-MP MYX group were examined by fluorescence activated cell sorting (FACS). The effect of T-MP MTX combined with radiotherapy on CSCs was assessed by tumor sphere formation experiment and animal experiment. The expressions of stemness relative genes (such as β-catenin, Nanog, SOX-2 and KLF4) were measured by Western blot. Results T-MP MTX dose-dependently inhibited the cell growth in A549 cells, but didn't in H460 cells and 16HBE cells. The S cycle ratio of A549 cells in blank group and T-MP MYX group measured by FACS were (15.83±3.14)%and (47.47±6.69)%, respectively. S cycle ratio of T-MP MYX group was notably higher compared with that of blank group (t=7.411, P=0.002). Further study revealed that the number of tumor sphere in blank group, control group, 2 Gy group, 4 Gy group and 6 Gy group was (268.9±22.4), (172.4±18.7), (48.3±5.1), (16.3±3.5) and (5.1±3.1), respectively. The number of tumor sphere in other groups was decreased compared with that in blank group (F=228.291, P=0.000). The numbers of tumor sphere in 2 Gy group, 4 Gy group and 6 Gy groups was also reduced compared with that in control group. Importantly, the number of tumor sphere in these groups were decreased dramatically as the dose of radiotherapy increased (F=95.142, P=0.000). The results of tumor sphere volume were similar with the number of tumor sphere. Western blot experiment showed that T-MP MTX treatment in A549 cells decreased the expression of stemness relative genes (β-catenin, Nanog, SOX-2 and KLF4), and its role was reinforced when radiotherapy was combined. Animal experiment implied that activity of luciferase in T-MP MTX group was decreased compared with that in blank group (P=0.000), and the activity of luciferase in T-MP MTX plus 2 Gy group was reduced significantly (t=6.887, P=0.002). Conclusions T-MP MTX has a potential to sensibilize radiotherapy, and it will synergistically inhibit the proliferation of CSCs when combined with radiotherapy. Moreover, its mechanism may be related with T-MP MTX activating CSCs from hypometabolism state and blocking process of cell cycle.

ObjectiveTo reveal the relation between rhBNP and vascular remodeling,the relation between rhBNP and levels of serum high sensitive C reactive protein (hs-CRP).Methods20 male New Zealand rabbits were randomly divided into two groups.All the rabbits were constructed to be models of angioplasty with BC.After injury,the control group were feed with standard forage,the rhBNP group received standard forage plus sibeutaneous rhBNP [0.1mmg/(kg · day),20 days].The rabbits were killed 4weeks after initial injury.The injured segments were dissected free from arteria iliaca externa,processed for histological and morphological study by TD 2000 analysis system of pathology image.The data of vascular remodeling was determined.The levels of hs-CRP were measured at the beginning and the end of the experiment.ResultsThere was significant difference in AUIEM and AUEEM[ (643.2±134.06) μm2 vs (493.7±139.32) μm2 ; (1495.1±204.98)μm2 vs (1265.9±232.56)μm2,P ＜ 0.05 ],extremely significant difference in residual cavity areas and ratios of stenosis[ (519.1±93.47) μm2 vs (308.6±86.50) μm2;(18.68±7.72) μm2 vs (38.04±8.32) μm2,P ＜ 0.01 ].There was no significant difference between the areas of media (P＞ 0.05).rhBNP reduced the levels of hs-CRP on the 28th day.ConclusionsrhBNP can benefit vascular remodeling after angioplasty which might be through its anti -inflammatory action.

Objective To investigate the effects of DRD1 rs265981,rs4532,rs686 and rs265976 polymorphisms on response to clozapine in resistant schizophrenic patients.Methods DRD1 genotype was determined by SNaPshot SNP technique for 154 patients with resistant schizophrenia.Clinical symptoms were evaluated by Positive and Negative Syndrome Scale (PANSS),and the responder was defined as a reduction of 50％ on PANSS score from baseline after the patients were administered orally clozapine for 8 weeks.Results The frequencies of rs265981 genotypes,alleles and rs265976 genotypes had significant differences between clozapine responder group (88 cases) and nonresponder group(66 cases) in total clinical efficacy ( x2 =10.215,P =0.004 ; x2 =4.082,P =0.041 ; x2 =14.083,P =0.007 ).The frequencies of rs265976 genotypes had significant differences between clozapine response (58 cases) and nonresponse (96 cases) to negative symptom ( x2 =9.805,P =0.046).Conclusion The polymorphisms of DRD1 gene rs265981 and rs265976 may relate with clinical response to clozapine in resistant schizophrenias.rs265981 T/T,allele T and rs265976 genotype A/A are likely to be predictive factors to the improvement of total clozapine therapeutic effects.rs265976 genotype A/A are likely to be predictive factors of negative symptom with treatment of clozapine.

Objective To assess the difference in detection of simulated chest nodules in different lung fields with dual-energy digital subtraction chest radiography by receive operating characteristic curve (ROC) analysis.Methods Dual-energy digital subtraction chest radiography was performed on 20 volunteers with simulated chest nodules. ROC analysis was made in the evaluation results on regular DR images and soft tissue images in different lung fields respectively.Results Az was greater on the soft tissue images than on the regular DR images in the superior lung fields and outer zone of middle lung fields. There were significant differences in the superior lung fields and outer zone of middle lung fields.Conclusion Dual-energy digital subtraction chest radiography is superior to regular DR image on detecting more chest nodule lesions, especially in the superior lung fields and outer zone of middle lung fields. So the two techniques should be united to diagnose.

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.

Background and purpose:Colorectal cancer (CRC) is a malignancy which is the third incidence and the fourth mortality in the worldwide. The main reason for the development of CRC is that the changes of genetic and epigenetic causes the tumor suppressor gene methylation silencing. This study aimed to investigate the plasma and stool GATA5 gene promoter methylation was detected in clinical diagnosis of CRC. Methods: To collect the paired plasma and stool specimens of 34 cases of healthy and 43 cases of patients with CRC. Methylation speciifc PCR (MSP) was respectively detected the GATA5 gene methylation levels of GATA5 gene in plasma and stool. And then separately analyzed their correlations with clinical and pathological parameters in gastric carcinoma. Results: The result of MSP showed that GATA5 gene promoter methylation rates in plasma and stool of CRC patients were 60.74%, 76.60%, respectively, were higher than those of healthy persons (6.47%, 32.35%). And the differences were statistically signiifcant (P=0.006 7, P=0.000 2, respectively). GATA5 gene methylation rates in plasma of CRC patients were closely related to clinical stage (P=0.000 5) and lymph node metastasis(P=0.020), while GATA5 gene methylation rates in stool of CRC patients had no signiifcant with clinical and pathological parameters. Conclusion:Detection of faecal GATA5 gene methylation level and supplemented plasma GATA5 gene methylation level can become a simple, non-invasive, sensitive and speciifc method for clinical diagnosis of CRC.

OBJECTIVE To investigate predisposing factors of candidemia in nosocomial infections.METHODS To retrospectively review the clinical features of 120 cases,including 59 who developed candidemia and 61 cases with bacteremia during the period of 1990-2004.RESULTS The incidence of candidemia was stable over a 14-year period.Candida albicans remained the predominant Candida species recovered(30.5%),followed by C.tropicalis(25.7%),C.glabrata(12.9%),C.parapsilosis(12.9%) and others(17.1%).Of the total 59 cases of candidemia,were administrated by broad spectrum antibiotic therapy for long time,urinary catheters,malignant tumor,etc.Multivariate analysis showed that candidemia was related with many factors.CONCLUSIONS C.albicans was the major pathogen in our hospital during 14 years;the candidemia is related with the use of quinolones,ventilator,central venous catheters and radiation-chemotherapy(P