Diabetes mellitus is particularly prevalent among aging people in recent years.Compared with diabetes in young and middle aged,geriatric diabetes has specific pathophysiology.Macrovascular complications of Type 2 diabetes including coronary heart disease,myocardial infarction,heart failure,stroke and peripheral artery disease,cause increased disability and mortality in aged populations.In order to prevent macrovascular complications,management strategies should be taken in treating hyperglycemia,hypertension,dyslipidemia,and hypercoagulability.

Objective To optimize the CT pulmonary angiography (CTPA)using right atrium (RA)CT value monitoring to determine the accurate time to peak CT value of pulmonary artery.Methods Sixty patients were randomly divided into two groups and 30 patients for each.Group PT:CTPA acquisition was triggered by pulmonary trunk monitoring,holding breath and 70 mL contrast agent (CA).Group RA:CTPA was performed using triggering from RA with spontaneous respiration and 40 mL CA.Imaging quality, average CT values of pulmonary arteries and veins,as well as their density difference were compared.Results The imaging quality, average CT values of pulmonary arteries and artery-veins density difference were significantly higher in group RA (P <0.05),while the CT values of pulmonary veins were significantly lower in group RA (P <0.05).No significant differences were showed in the proportion of subjects where sixth grade pulmonary arteries were opacified between the two groups (P >0.05).Conclusion CTPA imaging is optimized by triggering from RA CT value monitoring.This technique provides the optimal enhancement of pulmonary artery and minimal contrast filling of pulmonary venous with reduced doses of CA.

Adefovir dipivoxil (ADV) is commonly used as an anti-viral agent in the treatment of chronic hepatitis B,with a dose-and time-dependent nephrotoxicity.Clinical analysis was made in 4 patients with chronic hepatitis B who developed Fanconi syndrome and hypophosphatemic osteomalacia after long-term use of ADV (10 mg/d).

ObjectiveTo analyze the imageology appearance and clinical characteristics of primary squamous cell carcinoma of the breast.MethodsFeatures of MRI(4 patients)and B-type ultrasonic inspection(5 patients)of nine patients with primary squamous cell carcinoma of the breast pathologically confirmed were retrospectively reviewed. Compared with postoperative pathological appearance, the correlation between imageology appearance and clinical, pathological characteristics was analyzed. ResultsImageology appearance:In MRI:The tumor diameter was around 50 mm;The tumors were located at nearby papillae;There were two patients with pachymenia at the same time;The tumor margin was unclear,which has clear tumor wall structure and heterogeneous pachymenia,and without corpora mammillaria shadow which was toward interior;The tumors were low signal on T1WI and partially high signal on T2WI;The image with enhancement scanning showed that parenchymatous part of tumor were enhanced,while enhancements were not obviously at the centre of tumor with necrosis.In B-type ultrasonic inspection:The average diameter of tumors was around 40 mm, there were NT=0 mm in 4 cases. NT=19 mum in 1 case. The tumors presented as shape of clump or sublobe,which had unclear margin and high echoic region behind the tumor.There were also normal echo at the tumor lateral in 2 cases at the same time,and 4 cases showed blood supply was abundant, and 2 cases showed that there were colliquation and necrosis which had cystic hypoechoic signal at the tumor interior.MMG:There were class-4 in 2 cases,and Class-3 in 1 case.The tumor with little calcification which had no obvious veining showed uniformly high densities.All patients were treated with entire mastectomy. The patho-staging showed 3 cases were in ⅢB, 1 case was Ⅱ B, and 1 case was in Ⅱ A. Theresults of ER and PR with all patients were negative by using immunohistochemistry. 3 cases were also treated with chemotherapy after surgery; other organs (brain and lung) were found metabasis by follow-up visit of post-operation.ConclusionFor patients with primary squamous cell carcinoma of the breast,MMG inspection before surgery did not have specific imageology characteristics, while MRI has. The combination of MRI, B-type ultrasonic inspection and CNB can detect pathologic types and invasive circumscription,so it may have great applications for choose of surgery style and directions of therapy in the future.

Objective To optimize the enzymolysis condition for Acaudina leucoprocta to research lencoprocta the antioxidant activity of its hyoholysate in vivo.Method Response surface methodology (RSM) was employed to optimize the hydrolysis conditions with protamex.The ICR mice were given ig the hydrolysate of Acaudina lencoprocta obtained under optimal conditions.The activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and the content of MDA in blood serum and liver in mice were analyzed.Results and Conclusion The best hydrolysis conditions were:the amount of enzyme was 2.02%;enzymolysis temperature was 51.18 ℃;enzymolysis time was 127.81min,hydroxyl radical scavenging rate was 73.10%.The activities of SOD,GSH-Px in hydrolysate were significantly enhanced and the content of MDA was significantly lower,which showed that this hydrolysate had remarkable antioxidation activity.So the enzymolysis technology for Acaudina leucoprocta was optimal.

OBJECTIVEBy using orthogonal design method to optimnize prescription of pulsed electric field at Jiaji (EX- B 2) points for spinal cord injury (SCI).

METHODSFifty six patients of SCI were selected, in which 36 cases were divided into orthogonal design trial and 20 cases were into clinical verification. With 36 patients who received orthogonal design trial, Frankel grading scale was used as observation index to screen optimal prescription of pulsed electric field. Pulse frequency (factor A) included low frequency (factor A(I), 10(2) Hz). moderate frequency (factor A(II), 10(4) Hz) and high frequency (factor A(III), 10(3) Hz); pulse amplitude (factor B) included 0-30 V (factor B ), 0-60 V (factor B(II)) and 0-90 V (factor B(III)); pulse width (factor C) included 0.1 ms (factor C(I)). 0.6 ms (factor C(II)) and 0.9 ms (factor C(III)); acupuncture time (factor D) included one month (DI), three months (D(II)) and five months (D(III)). Twenty patients were used for clinical efficacy observation and the effects of screened optimal pre scription of pulsed electric field at Jiaji (EX-B 2) points combined with regular rehabilitation training on spasm se- verity, score of sensory and motor functions, Barthel index and Frankel score were observed.

RESULTS(1) As results of orthogonal design trial, the optimal prescription was A(III) B(III), C(I), D(III), which were high frequency (10(3) Hz), 0-90 V of pulse amplitude, 0.4 ms of pulse width and 5 months of treatment time. (2) As results of 20 patient clinical verification, Ashworth score, tendon reflex and clonus were all significantly improved (P<0.001, P<0.01), the scores of sensory and motor functions were evidently improvedtl (P<0.001, P<0.05), and Barthel in dex and Frankel score were also enhanced (P<0.001, P<0.05).

CONCLUSIONThe optimal prescription of pulsed electric field at Jiaji (EX-B 2) points for spinal cord injury is high frequency (10& Hz), 0-90 V of pulse amplitude, 0.4 ms of pulse width and 5 months of treatment time. The optimal prescription of pulsed electric field at Jiaji (EX-B 2) points combined with regular rehabilitation could obviously improve spasm severity, enhance senso- ry and motor functions, and ameliorate activity of daily life and Frankel score.

Acupuncture Points ; Adult ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; rehabilitation ; therapy ; Treatment Outcome

Objective To observe the effect on Foxg1 gene expression in the subgranular zone (SGZ) of cerebral tissue from neonatal rats with hypoxic-ischemic brain damage (HIBD) after transplantation of neural stem cells (NSCs) derived from umbilical cord blood.Methods Mononuclear cells separated from umbilical cord blood by density gradient centrifugation were cultured with orientated induction to differentiate the NSCs.The neuronal phenotype was identified using immunocytochemical methods.A total of 150 Sprague-Dawley rats were randomly divided into a sham-operation group,an HIBD group and an HIBD-NSCs group.Rats in the HIBD group and the HIBD-NSCs group were subject to ligation of the left carotid artery and then kept in a box under 8％ oxygen and 92％ nitrogen for 2.5 hours to establish the HIBD animal model.The artery was separated but not ligated in the sham operation group,which was not subjected to hypoxia.Twenty-four hours after the operation,the cultivated NSCs were transplanted by caudal vein injection into the rats in the HIBD-NSCs group.Rats were then sacrificed on the 3rd,7th,14th,21st and 28th days after the operation.Foxg1 gene expression in the SGZ was examined using in-situ hybridization methods.Results The number of Nestin-positive cells peaked on the 6th day of cultivation and then decreased by the 9th day.The Foxg1 gene was expressed in the SGZs of each group.The expression increased by the 3rd day after surgery in the HIBD and HIBD-NSCs groups,and peaked on 7th day after the operation,then declined gradually.The average expression level of Foxg1 in the HIBD group was significantly lower than that in the HIBD-NSCs group on the 7th day and thereafter.Conclusions Human umbilical cord blood mesenchymal stem cells can be induced and differentiated into neural stem cells.Foxg1 genes can still be present in the SGZ after birth.HIBD can induce the expression of Foxg1 genes.Transplanting NSCs can promote the expression of Foxg1 genes and improve morphological and functional recovery after HIBD,at least in neonatal rats.

Objective To observe the changes of serum superoxide dismutase (SOD) levels in typeⅡdiabetic patients with peripheral arterial disease (PAD) before and after interventional therapy, and to investigate the effects of oxidative stress level and interventional treatment on serum SOD level. Methods During the period from July 2011 to December 2012 at authors’ hospital, a total of 40 patients with type Ⅱ angiography together with balloon dilation and/or stenting was carried out in 24 patients (group B, with Fontaine stage of Ⅱb - Ⅲ). Of the 24 patients in group B, lower limb arterial angiography together with balloon dilation was employed in 16 (group B1) and lower limb arterial angiography together with balloon dilation and stenting was adopted in 8 (group B2). Twenty healthy clinical subjects were used as control group (group C). Before interventional treatment, elbow venous blood samples of patients in group A and B were collected to determine serum lipid, HbA1c and SOD levels. The same tests were also carried out in the subjects of group C. During percutaneous lower extremity arterial intervention , through arterial sheath 3 ml arterial blood specimen was collected in all patients of both group A and B before intervention started. Twenty-four hours after the treatment, venous blood specimen was also collected in all patients to determine serum SOD levels. The results were statistically analyzed. Results Lower limb arterial angiography showed that no obvious arterial stenosis was seen in the patients of group A. The interventional procedures were all successfully completed in all patients of group B. SOD levels of group A, B and C were (46.1 ± 3.13)U/ml, (35.37 ± 3.58)U/ml and (60.50 ± 6.99)U/ml respectively. SOD levels of both group A and B were significantly lower than that of group C (t = 8.420, P < 0.01; t = 14.324, P < 0.01). The level of SOD in group A was significantly higher than that in group B (t = 10.092, P < 0.01). The ankle-brachium indexes (ABI) of group A, B and C were (0.70 ± 0.12), (0.58 ± 0.13) and (1.15 ± 0.07) respectively. ABI of group A and B was significantly lower than that of group C (t = 14.324, P < 0.01; t = 17.392, P < 0.01). ABI of group B was significantly lower than that of group A (t=3.027, P<0.05). SOD level bore a negative correlation with HbA1c level (r=-0.541, P<0.01). In both group A and group B, no significant difference in SOD level existed between the venous blood and arterial blood. The preoperative arterial SOD levels in group B1 and group B2 were (35.70 ± 3.04)U/ml, and (36.07 ± 2.14)U/ml respectively, and the difference between the two groups was not statistically significant. The preoperative SOD levels in the ischemic arterial region in group B1 and group B2 were (32.95 ± 3.52)U/ml and (33.59 ± 2.64)U/ml respectively, and the difference between the two groups was not statistically significant although these levels were significantly lower than the preoperative arterial SOD levels(t=2.741, P<0.05; t=2.704, P<0.05). After the interventional treatment, the SOD levels in the ischemic arterial region in group B1 and group B2 were (29.40 ± 5.49)U/ml and (26.68 ± 2.31)U/ml respectively, and the difference between the two groups was not statistically significant although these levels were significantly lower than the preoperative SOD levels in the ischemic arterial region (t = 2.536, P < 0.05; t = 5.005, P < 0.01). No statistically significant differences in SOD levels at each corresponding site existed between group B1 and group B2. Conclusion No significant difference in SOD level exists between the venous blood and the arterial blood. Serum SOD level carries a negative linear correlation with HbA1c level. Before interventional treatment , the SOD level in ischemic region is low, which becomes lower after the interventional procedure, which may be caused by the enhanced oxidative stress reaction that is resulted from the damage of the vascular wall due to interventional manipulations. The enhanced oxidative stress reaction may play an important role in the occurrence of restenosis.

Background and purpose: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is of advantage in treating non-small cell lung cancer (NSCLC) patients with EGFR mutations. However, their clinical effects vary individually. This study aimed to evaluate whether the EGFR ligand, plasma transforming growth factor α (TGF-α), could act as a predictor for the EGFR-TKI treatment e?ciency in NSCLC patients with EGFR mutations and the association between TGF-α and prognosis in these patients. Methods: Seventy-five NSCLC patients with EGFR gene positive mutation were included in the current study from May 2012 to Jul. 2014 in Ruikang Hospital A?liated to Guangxi University of Chinese Medicine. Plasma TGF-α was measured using enzyme-linked immunosorbent assay (ELISA) in all of the patients before EGFR-TKI treatment. The radiographic evaluation was performed 2 months after the therapy. The association between TGF-α and clinical outcome and its prediction e?ciency were determined, followed by the further analysis of the association between TGF-α and overall survival (OS) as well as progression-free survival (PFS). Results: After EGFR-TKI treatment, there were 20 patients with partial response (PR), 25 with stable disease (SD) and 30 with progression disease (PD) in all 75 NSCLC patients harboring EGFR positive mutation. The disease control (DC) rate reached 60%. Patients in PD group presented statistically significant higher plasma TGF-αthan patients in the DC group (P<0.01). Multivariate COX model indicated that smoking status, lymph node metastasis and plasma TGF-α levels were independent risk factors for prognosis in these patients. The ROC analysis revealed that baseline plasma TGF-α showed good prediction e?ciency [area under the curve (AUC)=0.926] and the cut-off point of TGF-α was 16.75 pg/mL. Higher level of TGF-α (≥16.75 pg/mL) was associated with smoking history, clinical stage, lymph node metastasis and clinical outcome of the patients (P<0.05). In comparison to patients with low TGF-α, the patients with high TGF-α concentration presented significantly reduced median OS and PFS (log-rank P<0.05). Conclusion: Higher plasma TGF-α (≥16.75 pg/mL) had a predictive role in EGFR-TKI resistance and poor prognosis.

OBJECTIVE:To summerize the characteristics and variability of chest X-ray manifestations in SARS patients treated with compound glycyrrhizin.METHODS:60cases of SARS were equally divided into2groups:groupⅠreceiving compound glycyrrhizin,groupⅡ(as control)receiving conventional treatment.The appearing time,site,scope and dynamic changes of the pulmonary lesions on chest radiograms were compared between2groups.RESULTS:The average period from peak to50%improvement of lesion in X-ray manifestations was shorter in groupⅠthan that in groupⅡ.In restoration stage,more patients had their X-ray findings absorbed in groupⅠcompared with the patients in groupⅡ.Compound glycyrrhizin had little influence on WBC,blood sugar and electrolytes.CONCLUSION:Glycyrrhizin may be a promising drug against SARS with less side effects.