Objective　To study the changes of the four active substances endothelin(ET),calcitonin gene related peptide (CGRP),thromboxane B2(TXB2) and 6-Keto-prostaglandin F1α(6-Keto-PGF1α) in plasma when they acted on each other in the formation and development of diabetic retinopathy.Methods　Using the method of radio-immunity,the levels of ET,CGRP,TXB2,6-Keto-PGF1α in plasma were measured in four groups of patients with type 2 diabetes (group 1∶40 cases without retinopathy;group 2∶40 cases with primary retinopathy;group 3.40 cases with hyperplasia type of retinopath;group 4∶40 cases normal controls).Results　The results showed that ET increased progressively (P＜0.01) with the prolonging of the duration of DM and the worsening of retina damage、CGRP showed a decreasing tendency (P＜0.05,P＜0.01) in the advanced stage of DM retinopathy.Rectilinear regression analysis showed that the association of ET/CGRP with TXB2/6-Keto-PGF1α became closer with the worsening of deabetic retinopathy (r=0.44,P＜0.05;r=0.596,P＜0.01).Conclusion　The four active substances acted on each other in the formation and development of diabetic retinopathy.It had a significent meaning in the initial mechanism of DM,in the development of disease and in the direction of medication usage to understand their relationship.

Objective To study the changes of the four active substances endothelin(ET),calcitonin gene related peptide (CGRP), thromboxane B2 (TXB2) and 6-Keto-prostaglandin F1? (6-Keto-PGF1?) in plasma when they acted on . each other in the formation and development of diabetic retinopathy. Methods Using the method of radio-immunity,the levels of ET,CGRP,TXB2, 6-Keto-PGF,. in plasma were measured in four groups of patients with type 2 diabetes (group 1: 40 cases without retinopathy; group 2: 40 cases with primary retinopathylgroup 3. 40 cases with hyperplasia type of retinopath; group 4: 40 cases normal controls). Results The results showed that ET increased progressively (P

Objective To evaluate results of reconstructing thumb opposing function by transfering the extensor carpi ulnaris and the extensor pollicis longus muscle tendons. Methods Forty-nine patients with dysfunction of thumb opposing were admitted to this study. Twenty-nine had median nerve injury in the wrist, twenty complicated ulnar nerve injury at the same time. Thumb opposing function of all patients was reconstructed by transfering the extensor carpi ulnaris and the extensor pollicis longus muscle tendons. Results All patients with median nerve injury got satisfactory results. 80% of patients complicated ulnar nerve injury got fine therapeutic effect. Conclusion It is a convenient and efficient procedure that reconstructing thumb opposition function by transfering the extensor carpi ulnaris and the extensor pollicis longus muscle tendons.

Background:Detection and removal of colorectal polyp by colonoscopy is of great importance for prevention of colorectal carcinoma. Aims:To investigate whether the clinical symptoms of patients undergoing colonoscopy may hint colorectal polyp and carcinoma,and provide reference for candidate selection in colonoscopic screening. Methods:A total of 2 366 patients undergoing colonoscopy were recruited and the history information such as symptoms at outpatient visits, site and nature of the lesions was collected for analyzing the detection rates of colorectal polyp and carcinoma and the correlations of clinical symptoms with the risk and site of the disease. Results:The overall detection rates of colorectal polyp and carcinoma were 20. 5% and 5. 4% ,respectively,in 2 366 patients. The detection rates were significantly higher in symptomatic patients than those in asymptomatic patients(24. 2% vs. 4. 5% for polyp and 6. 4% vs. 0. 9% for carcinoma,P all = 0. 000). Moreover,when patients were classified by major symptoms,the detection rate of colorectal polyp was significantly increased in patients with diarrhea(OR = 1. 213),hematochezia(OR = 2. 076),and changing of stool consistency(OR = 1. 503)(P all < 0. 05),and the detection rate of colorectal carcinoma was significantly increased in patients with abdominal pain( OR = 1. 568),hematochezia( OR = 2. 837),changing of stool consistency( OR =2. 206),and tenesmus( OR = 1. 735)( P all < 0. 05). The major symptoms being hematochezia,changing of stool consistency and tenesmus were associated with lesions locating at rectum or left hemicolon(P all < 0. 05). Conclusions:Diarrhea, hematochezia and changing of stool consistency hints risk for colorectal polyp, while abdominal pain, hematochezia,changing of stool consistency and tenesmus hints risk for colorectal carcinoma. Colonoscopy is strongly recommended for patients with these symptoms.

Background:Screening of colorectal cancer (CRC) and colorectal adenoma (CRA), the precursor of CRC, is crucial for CRC prevention.It is believed that opportunistic screening of CRC in high risk population would narrow down the screening scope and save the health resources, and is suitable for the present status in China.Aims:To analyze the performance of high risk factors in predicting CRC/CRA, for exploring the feasibility of opportunistic screening for CRC in high risk population.Methods:A total of 1 862 outpatients and health examination subjects undergoing colonoscopy from Feb.2015 to Aug.2016 at the PLA 281 Hospital were recruited and asked to complete a questionnaire of high risk factors for CRC and CRA before colonoscopy.The questionnaire was designed based on the updated consensus on the screening and management of early colorectal cancer and precancerous lesion in China.Using the results of colonoscopy as gold standard, the predictive performance of high risk factors for CRC/CRA was analyzed.Results:Four hundred and sixty-eight (25.1%) individuals with high risk factors for CRC/CRA were screened out by the questionnaire.The detection rate of CRC in individuals with high risk factors was significantly higher than those without (17.5% vs.0.9%, P=0.000).The sensitivity, specificity, positive and negative predictive values of high risk factors in predicting CRC were 87.2%, 78.2%, 17.5% and 99.1%, respectively, and the missed diagnosis rate was 12.8%.For CRC/CRA, the corresponding figures were 83.2%, 87.0%, 57.3%, 96.1% and 16.8%, respectively.The risk ratios (RR) of high risk factors for CRC and CRC/CRA were 20.35 and 14.78, respectively.Conclusions:Opportunistic screening of CRC in high risk population is feasible and applicable in China under present condition.

Objective To introduce Checklist Individual Strength(CIS)into China,and evaluate its reliability and validity.Methods CIS was translated into Chinese language and the reverse translation was done by several experts.Validity and reliability were implemented in 214 cases with cerebral infarction.Results 4 components were extracted in factor analysis,and the total cumulative contribution was 78.984%.By correlation analysis,the twenty items were divided into 4 domains:subjective feeling of fatigue,concentration,motivation and physical activity,it was same as in the English version.Cronbach α of four domains were 0.9256,0.9072,0.7598,and 0.9157,respectively.Conclusion Psychometric properties(reliabilities and validities)of CIS Chinese version is met with satisfaction and seems to be adaptable to Chinese cerebral infarction patients.

Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.

Objective To explore the application of quantitative DNA analysis in differential diagnosis of benign and malignant breast masses to aid the surgery plan formation.Methods Four hundred and eighty-eight patients with breast mass were enrolled into this study.Tissues of breast mass in patients were gained by fine-needle aspiration puncture.Two sections were made from each sample,one was stained by Papanicolaou for regular cytology analysis and another was stained with Feulgen for quantitative DNA analysis.Pathological results were confirmed in each case after surgery.Results One hundred and sixty-four cases were classified as patients with benign neoplasm,while the other 324 cases were classified as malignant neoplasm,according to the pathological examination results.The sensibility and specificity were 91.4%(296/324) and 92.7%(152/164) for regular cytological method,90.1%(292/324) and 100.0%(164/164) for quantitative DNA analysis method.Meanwhile the positive predictive and negtive value of quantitative DNA analysis was 100.0%(292/292) and 83.7%(164/164),of which regular cytological methods were 96.1%(296/308) and 84.4%(152/180).Conclusion The quantitative DNA analysis might assistant differential diagnosis of benign and malignant breast tumor.

Objective To detect the expression of TGF-β1 mRNA and ERβwt mRNA in peripheral blood monoanclear cells (PBMCs) in patients with chronic fatigue syndrome (CFS), and their relationship with pathogenesis of CFS. Methods Fluorescence quantitative RT-PCR (FQ-RT-PCR) was used to examine TGF-β1 mRNA and ERβwt mRNA expression of peripheral blood monocytes in 63 cases with CFS,50 cases with other diseases, and 50 healthy controls. The gene expression levels were calculated with the formula △Ct=Ct(target gene) - Ct(internal control). Results The mean TGF-β1 mRNA expression of CFS patients (△Ct = 3.27 ± 0. 58) was higher than that of disease controls (△Ct = 4. 54 ± 1.05, t = 8. 11, P <0.01) and that of healthy controls (△Ct = 4. 37 ± 1.00, t = 7. 02, P < 0. 01). The mean ERβwt mRNA expression of CFS patients (△Ct =9. 34 ±0. 92) was lower than that of disease controls(△Ct =7.12±0. 47, t = 15.44 ,P < 0. 01) and that of healthy controls(△Ct = 7. 10 ±0. 48, t = 15.47, P < 0. 01). Conclusions The TGF-β1 mRNA and ER βwt mRNA expression levels of PBMCs are siguificantly elevated in patients with CFS. It may be implicated in the pathogenesis of CSF.

Objective: To investigate the relationship between expression of FoxM1 and BCRP in invasive breast carcinoma of no special type (IBC-NST) tissues and the clinical pathological characteristics and prognosis of the patients. Methods: Seventy-eight cases of IBC-NST with excision were included. The expression of FoxM1 and BCRP was assessed by immunohistochemistry and its relationship with the clinical pathological characteristics and prognosis was evaluated. Results: FoxM1 was expressed in 71.8%(56/78) of IBC-NST, and the expression was related to tumor diameter, TNM staging, ER, PR and HER2. BCRP was expressed in 53.8% (42/78) of IBC-NST, and the expression was related to age, tumor diameter, lymph node metastasis, ER and HER2. Kaplan-Meier survival analysis showed the survival time was related to tumor diameter, TNM staging, lymph node metastasis and the expression of FoxM1, BCRP, ER, PR and HER2. Cox multivariate analysis showed that TNM staging, FoxM1, BCRP, HER2 were determinants of patient survival time. Conclusions The expression of FoxM1 is associated with tumor diameter, TNM staging, ER, PR and HER2 while BCRP is associated with age, tumor diameter, lymph node metastasis, ER and HER2. Both FoxM1 and BCRP have prognostic significance in IBC-NST patients.