Epidemic investigation was made in 2080 diabetic cases in Henan Province. Results showed that TCM Xiaoke syndrome is not only related to the pathological changes of the Lung in Upper - jiao, Spleen -stomachin middle - jiao and kidney in lower - jiao, but also closely related to pathological changes of the liver. During the early stage when mild hyperglycemia is present, the manifestations of deficient liver ( of liver blood and liver Yin) are especially conspicuous with a frequency of occurrence only less than Qi -deficiency syndrome. This important new discovery reminds us that " liver" is not to be overlooked clinically. It also proves that application of nourishing, softening, converging, and soothing the liver are reasonable and scientific methods for diabetes treatment.

Objective To explore the appropriate time to block adrenal androgens in endocrine therapy of prostate cancer.Methods An human androgen-dependent prostate carcinoma xenograft model in SCID mice was established with LNCaP cells.Firstly,the serum PSA and tumor volume of 2 groups (castrated and not castrated) were measured on the 1,4,7,10,14,17,21,28,35,42,49 and 56 day to determine the recurrent time of prostate cancer after castration.Secondly,3 different groups of castration and adrenalectomy at the same time,adrenalectomy in recurrence after castration and sham adrenalectomy in recurrent after castration,were set to measure the serum PSA and tumor volume on the 1,4,7,10,14,17,21,28,35,42,49 and 56 day.The tumor tissues of 5 groups were harvested to measure testosterone concentration,and tumor progress in these groups was compared.Results The recurrence time was 14 days in castrated group,21 days in group with castration and adrenalectomy at the same time and 35 days in group with adrenalectomy in recurrence after castration.The testosterone concentration in tumor tissues was (2.69± 0.21) pmol/g in the group with castration and adrenalectomy at the same time,and (2.16±0.13) pmol/g in the group with adrenalectomy in recurrence after castration,and the difference was significant (P＜0.05).Conclusion Compared with the therapy of castration and adrenalectomy at the same time,the therapy of adrenalectomy in recurrence after castration may have slower progress course in prostate cancer.

Objective To investigate the characteristics of strains of AmpC β-lactamase(AmpC enzyme)production in Dathogenic bacteria in blood stream and clinical presentations of the cases, and study the related ampC and ampD genes.Methods One hundred and eighty-one strains of gram negative bacillus in blood stream were collected,Cefoxitin screening test and three-dimensional test were performed for screening of strains of AmpC enzyme,production and those of AmpC enzyme hyperproduction retrospective analysis was condected in the strains with positive results.ampC and ampD gene PCR ampliftcation, sequencing and sequence analysis of positive strains were performed, and gene homology of ampC positive strains was analysed bv Rep-PCR. Results Among 181 strains in blood stream,strains of AmpC enzyme production were detected in 39 isolates by Cefoxitin screening test,with the detection rate of 21.5%(39/181).The detection rate of strains of AmpC enzyme hyperproduction by three-dimensional test was 43.6%(17/39).PCR revealed that the positive rates for ampC and ampD genes were 41%(16/39)and 56.4%(22/39),respectively.The ampC gene sequencing of 16 positive strains indicated that the homology was 98%to 100%by comparison with the GenBank,while the ampD gene sequencing of 2 strains of Enterobacter cloacae demonstrated that the suspected gene mutations existed in the carboxy-terminal of ampD gene. Conclusion The prevalence of drug-resistant pathogenic bacteria in blood stream in this study is due to nosocomial infection.The mutation of ampC gene is rare in the pathogenic bacteria in blood stream with production of AmpC enzyme,while the rate of gene mutation in Enterobacter cloacae is higher, and the deletion and amino acid substitutions in the carboxy-terminal of ampD is highly relevant to the depressed expression of AmpC enzyme.

Objective: To isolate Mycobacterium tuberculosis H37Rv and H37Ra genes especially,and to construct two cDNA libraries by using suppression subtractive hybridization (SSH).Methods: We used suppression subtractive hybridization (SSH) to clone the differential genomic genes between Mycobacterium tuberculosis virulence strain H37Rv and attenuated strain H37Ra.After two times of subtractive hybridization and two times of PCR,the products of last PCR amplification were inserted into pGEM-T Easy vector and be transformed into the E.coli DH5α and screened of blue and white clones of the transformants.The subtracted cDNA library of differentially expressed genes were identified by RT-PCR.Results:High or especially expressed genes as tester had been obtained by SSH in correctitude reaction (H37Rv as tester) and reverse reaction (H37Ra as tester),the cDNA libraries of A and B of Mycobacterium tuberculosis H37Rv and H37Ra were successfully constructed.90% of the colonies were white clones,the single band of the colonies was 75% and 80%.Conchision:The cDNA libraries of Mycobacterium tuberculosis H37Rv and H37Ra were successfully constructed using SSH technique,which lay a solid foundation for screening and cloning new specific differentially expressed genes in them.

Objective To investigate the status of social support and job satisfaction of community nurses and their relationship in Wuhan. Methods A total of 230 community nurses from 20 community health service centers in Wuhan were investigated by general information questionnaire, job satisfaction scale of community nurse and social support scale. Results The total score of job satisfaction was (96.14±14.76) points, the highest score of dimension was leadership and management (23.64±4.60) points, and the lowest was pay and welfare (10.83±3.00) points. The total score of social support was (37.17±7.05) points, the highest score of dimension was perceived social support (20.15 ± 4.48) points, the lowest was availability (8.05±1.57) points. There was a positive association between community nurses′social support and job satisfaction (r=0.248, P<0.05). Conclusions Social support is one of the predictors of job satisfaction. In order to make sure the sustainable development of community health services, it is necessary to know the status and take corresponding measures to improve the levels of social support and job satisfaction.

[Objective] To design anatomical steel plate for internal fixation of scapular neck fracmre.[Method]By observing the scapular structure and scapular fracture type,imaging a form of anatomical steel plate for internal fixation of scapular neck fracture,the needed relative measurement datum of scapula were obtained.Forty pairs of scapular spechnens of men and women were measured,relative datum were obtained.Based on the measurement,scapular neck fracture plate was designed.The steel plates were applied in patients with scapular neck fracture or scapular body fracture,patients were followed up after operations,the results were observed.[Result]Seven patients with scapular neck fracture or scapular body fracture were operated with the anatomical steel plates,the steel plates were obedient to the scapulas greatly,the fixations were strong,the operations were easy,the time of operations were short,seven patients were followed up for 12-18 months showing satisfactory results.[Conclusion]The design of anatomical scapular neck fracture steel plates is satisfactory,when using tile plate to fix scapular neck fracture.The fixation is strong,using the steel plate can be benificial to patient's early exercise.It has advantages of preventing complications,promoting fracture to heal,making the scapular operation easy,shortening the time of operation,lessening the blood in operation.This type of anatomical steel plate has the value to be popularized.

Objective To study and to analyse the cause of laparoscopic adrenalectomy failure and its complications. Methods 8 of 19 laparoscopic adrenalectomies were converted to open surgery .The cause of failure and its complications were analysed. Results The causes to convert to open surgery were:bleeding of right middle suprarenal vein in 1,adrenal tumor was sheltered of cauda pancreatis in 1,left adrenal cyst was sheltered by spleen in 1,CO 2 pneumoperitoneal pressure can not be maintained during the procedure in 2,tumers could not be found in 2,the telescopic port was inserted into musculus psoas major in the retroperitoneal approach and the bleeding influenced the operation field in 1.3 patients had high fever after operations and 1 had an abscess in the adrenal bed.Reactive pleuritis occurred in 1. Conclusions Fine technique and experiences were needed for laparoscopic procedures and good team work between the operators was very important.Complications were often associated with the initial cause that led to the laparacospic adrenalectomy failure.Laparoscopic adrenalectomy via the retroperitoneal approach has been easier than that via the transperitoneal approach.

Objective To study the diagnosis, treatment, and prognosis of implantation metastasis to abdominal incision after open operation for bladder carcinoma. Methods 10 cases of implantation metastasis to abdominal incision after open operation for bladder carcinoma encountered from 1985 to 1999 were retrospectively studied,nine being male and 1 female.The average age was 52.7 years. Results These were 6 transitional cell carcinoma (all were grade G 3),2 transitional cell carcinoma with squamous carcinoma or adenocarcinoma,1 squamous carcinoma,and 1 adenocarcinoma.The diameter of the metastasis lesion was 1.4～11.5 cm?1.0～6.9 cm.The treatments included total cystectomy with resection of metastasis,TURBt with resection of metastasis,urinary diversion with chemotherapy and/or radiotherapy, resection of metastasis with chemotherapy and/or radiotherapy, and chemotherapy and/or radiotherapy alone.7 of the 10 died of the carcinoma,the survival times being 4～41 months (average 13 months).Only 1 patient survived for 41 months.Whereas the others died within 14 months.3 patients are still alive for 5～9 months with no recurrence. Conclusions The differentiation of the cancer cells of implantation metastasis is usually bad and often accompanied by squamous followed by carcinoma or adenocarcinoma.Total cystectomy with resection of the metastasis followed by chemotherapy and/or radiotherapy might prolong the survival time, but the prognosis is usually poor.

Objective To examine the efficacy and safety of Urocalun in treatment of calculus in ureter. Methods Sixty patients with calculus in the ureter were treated.The diameters of the stones were less than 1 cm.The patients were assigned to receive Urocalun orally,450 mg each time,3 times a day. Results Five weeks after Urocalun administration,the calculi were eliminated in 45 cases (75%).The calculi descended in 10 cases (17%).The positions of calculi remained unchanged in the rest 5 cases (8%).Four patients (7%) had mild uncomfortableness in stomach,nausea or thirsty after Urocalun administration. Conclusions Urocalun is effective for eliminating the calculus in ureters.

Objective To investigate the relationship between the levels of total serum IgE and IL-4 in patients with seasonal contact dermatitis. Methods Total serum IgE was tested by immunoradiometric assay(IRMA) in 29 cases of seasonal contact dermatitis, 35 cases of allergic contact dermatitis and 24 cases of healthy controls. Production of IL-4 was detected by ELISA from peripheral blood mononuclear cells (PBMC) cultured with PHA for 48 hours. Results The levels of IL-4 secreted by PBMC and total serum IgE were significantly higher in patient with seasonal contact dermatitis than those in control group (P