Objective To explore the clinical significance of urine trace albumin in early diagnosis of diabetic nephropathy(DN). Methods A total of 35 patients with DN in DN group,32 patients with type 2 diabetes mellitus (DM)in DM group and 36 people accepted physical examination in control group.The urine trace albumin,blood urea nitrogen,serum creatinine were detected and compared.Results Urine trace albumin level in DN group was significant higher than those of DM group and control group,the differences were statistical significant(P <0.05),blood urea nitrogen and serum creatinine levels were slightly higher than those of DM group and control group,but there were no statistical significant differences (P >0.05).The urine trace albumin,blood urea ni-trogen and serum creatinine between DM group and control group had no statistical significant differences (P >0.05).Conclusion Urine trace albumin could be used as an early diagnostic index for early diagnosis of DN.

Objective To explore the effects of insulin-like growth factor-l (IGF-l),insulin-like growth factor binding protein-1 (IGFBP-1) and growth hormone (GH) on the generation, development and treatment of diabetes chronic complications. Methods 20 healthy controls,10 type 1 diabetes mellitus patients and 62 type 2 diabetes mellitus patients were enrolled into the study. IGF-1, IGFBP-1, GH, HbAlc. serum insulin (INS) and serum C-peptide (C-P) were measured. Results ①Serum level of IGF-1 was obviously lower in the diabetes mellitus group than that in controls (type 1 P＜0. 05,type 2 P＜0. 05). ②Serum level of IGFBP-1 was significantly higher in type I diabetes mellitus than that in controls (P＜0. 05),and it was obviously lower in type 2 diabetes mellitus with obesity and hyperinsulinism than that in contris (P＜0. 05). ③Serum level of GH was higher in type 1 diabetes mellitus than that in controls (P＜0. 05 ) and was not significantly different from that in controls (P＞0. 05). ④The level of IGF-l was higher in diabetes nephropathy (DN) patients and diabetes retinopathy (DR) patients than that in controls (P＜0. 05). ⑤The level of IGF1 was negatively correlated with HbAlc (P＜0. 01, type 1r=- 0.73, type 2r=-0. 62). Conclusion Measurement of IGF-1, IGFBP-1 and GH may play an important role in diabetes chronic complications,especially in the generation,development of diabetic microvascular.

Objective To explore the relationship between endothelial dysfunction and insulin resistance (IR) during reduction of body weight in obese subjects. Methods 260 obese subjects without metabolic disorders, cardiovascular disease and other clinically detectable diseases were enrolled in this study. Among them 157 patients were found to have impaired endothelial function and 103 with normal endothelial function. They were randomly divided into body weight reduction intervention group and nonintervention group. The measures of intervention included food restriction, exercise, and drugs for weight reduction, and they were continued for two years. 87 subjects with normal weight and without endothelial dysfunction served as normal control. IR index (HOMA-IR) and flow-mediated endothelium-dependent dilatation function were measured before and after the study period. Results After two years, it was found that the endothelial function was markedly improved (4.56?4.79 vs 15.17?5.80, P

MicroRNAs( miRNAs)are a family of endogenous noncoding small RNA molecules that are approximately 20 nucleotides in length. Aberrant expression or dysfunction of miRNAs and subsequent dysregulation of their target genes might be involved in the occurrence and development of various cancers. Gastric cancer is a leading malignant disease worldwide. Recent studies have shown that some miRNAs are closely associated with the proliferation,migration,invasion, apoptosis and chemosensitivity of gastric cancer cells by regulating their target genes. Advances in study on gastric cancer-related miRNAs,their target genes,and the use of miRNAs-targeted therapy in gastric cancer were reviewed in this article.

BACKGROUND:Nanohydroxyapatite/polyamide 66 composite is very close to the human cortical bone in terms of mechanical properties, and has osteogenic activity, which is a safe and reliable bone material. OBJECTIVE:To investigate the effect of nanohydroxyapatite/polyamide 66 composite bioactive supporting material on the restoration of vertebral structure and height. METHODS: Totaly 177 patients with spinal diseases, 116 males and 61 females, aged 17-81 years, were enroled, including 97 cases of spinal fractures, 5 cases of primary tumors of the spine, 17 cases of spinal tuberculosis and 58 cases of cervical spondylosis. The nanohydroxyapatite/polyamide 66 composite bioactive supporting body was filed into the bone grafts of patients and then subjected to anterior decompression and internal fixation. After 36 months of folow-up, imaging analysis, Frankel spinal cord injury classification, bone graft fusion, visual analog scale scores,Short Form 36 and Japanese Orthopedic Association scores were evaluated. RESULTS AND CONCLUSION:During the folow-up, except one patient with cervical spine fracture appeared to have slight supporting body displacement, there was no supporting body prolapse or rupture phenomena. The bone graft fusion rate was 96.0%, the average supporting body sinking distance was 1.7 mm. After treatment, 97 patients with spinal fractures had different degree of improvement in the neurological function (P < 0.05); the visual analog scale scores, Short Form 36 and Japanese Orthopedic Association scores were improved significantly in al the 177 patients compared with before treatment (P < 0.05). These results demonstrate that the use of nanohydroxyapatite/polyamide 66 composite bioactive supporting material for spinal reconstruction can improve the bone fusion rate, and restore the vertebral structure and height effectively.

BACKGROUND: The authors have studied the porosity, pore size, mechanical strength, in vitro biological activity,ectopic osteogenic activity of porous biphasic calcium phosphate enhanced by recombinant bone morphogenetic protein-2/silk fibroin sustained-release microsphere (BCP/rBMP-2/SF). However, further investigation on the osteogenic ability of the composite bone graft material is warranted based on a reliable animal model, which will provide experimental data for the clinical application of the composite material in the spinal fusion.OBJECTIVE: To investigate the osteogenic efficacy of BCP/rBMP-2/SF in a sheep lumbar interbody fusion model.METHODS: Sixteen healthy adult sheep were divided into two groups randomly. All sheep were operated on the left extraperitoneal approach and intervertebral discs of L1/2, L3/4, and L5/6 were exposed respectively. Three of the following four materials were randomly implanted into the L1/2, L3/4, and L5/6 of each animal: autologous iliac, BCP/rhBMP-2/SF,BCP/rhBMP-2 or BCP/SF.RESULTS AND CONCLUSION: The group of BCP/SF/rhBMP-2 achieved a similar fusion rate compared with the group of autologous iliac at 12 and 24 weeks after operation, and they were significantly better than the other two groups. These findings indicate that the novel new artificial bone, BCP/rhBMP-2/SF, can obtain similar lumbar fusion results compared with the autologous iliac. It is expected to be applied to clinical practice in the future by further improving its properties.

Objective To compare the clinical efficacy of Rivaroxaban and Warfarin in the treatment of lower extremity deep vein thrombosis.Methods From January to December 2015,51 patients of deep vein thrombosis of the lower limb divided into.Warfarin group (21 cases) and Rivaroxaban group (30 cases).The time of each therapy lasted for 3 months or longer.The characteristics and the change of lower limb venous patency rate in two groups of patients were analyzed to evaluate the curative effect.Results Rivaroxaban group had shorter therapy time than Warfarin group.The lower limb venous patency rate in Rivaroxaban group were higher than that in Warfarin group (85.7％ vs.60％,P ＜0.05).Ultrasonography showed partial patency in 5 mixed thrombus patients of Warfarin group,while complete patency in 2 and partial patency in 3 of Rivaroxaban group.Normalized rate in peripheral venous thrombosis patients of Rivaroxaban group were higher than Warfarin group (84％ vs.25 ％ P ＜ 0.001).Conclusions Rivaraxaban is superior to Warfarin in the complete recanalization of DVT,while safe and reliable.

Objective To build clinical nursing pathway for artificial abortion operation and explore the effect of this method. Methods The nursing pathway was designed and carried out. The satisfaction degree with nursing, status of patients' awareness about contraception and artificial abortion operation was compared before and after the nursing pathway was implemented. Results Before and after the nursing pathway was implemented,the proportion of missing item of operation record was 0.636 and 0.013, the satisfaction degree with nursing was 77.0% and 92.3%, rate of patients' awareness about contraception and artificial abortion operation was 47.6% and 96.1%. Conclusions The clinical nursing pathway for artificial abortion operation may improve the degree of satisfaction- and the status of patients' awareness about contraception and artificial abortion operation, and decline the proportion of missing item of operation note, it ensures high nursing quality and safety surgery, which is worthy of popularizing.

[Summary] During recent years, increasing evidences have indicated that type 2 diabetes mellitus(T2DM) might increase the risk of certain tumors; the process might be not only related with the chronic pathologic status of T2DM such as hyperglycemia, hyperinsulinemia, insulin resistance, dyslipidemia, status of chronic inflammation but also associated with the long-term use of anti-diabetic drugs (i. e. sulfonylureas, biguanides, glitazones, dipeptidyl peptidase-4 inhibitors, glucagon-like peptitide-1 receptor agonists), as well as the use of insulin and insulin analogues. Herewith a system review was made about the recent progress in studying T2DM and tumor risk.

Objective To analyze clinical manifestation,diagnosis and treatment of 8 patients with gas gangrene in Wenchuan earthquake.Methods Eight patients with gas gangrene in Wenchuan earthquake were selected for analysis on their clinical manifestations.We finally diagnosed gas gangrene based on patients'clinical manifestation and the cultured ciostridium in the focus of infection.All the patients were treated with antibiotics,repeated surgical debridement,hyperbaric oxygen and nutritional support.Results Most patients had no erepitation of the extremities but found gas in interstice of tissues identified by X-ray,B-ultrasound and CT scanning.Film preparation of efflusion of all patients showed clostridium and bacterial culture manifested mainly perfringens.Most patients were demonstrated to be with polyinfection.In addition,all patients were characterized by pitchy necrotic tissues,effusion,systemic decrease of red blood cells,increase of white blood cells and platelet.No death or amputation occurred under active combined therapy.Conciusions Earthquake induces mainly open trauma often combined with mixed infection,when gas gangrene is one of main special infections.The predominant combined therapies include utility of antibiotics and thorough surgical debridement,while hyperbaric oxygen and nutritional support are important and effective adjunctive therapies.