[Summary] There is growing awareness of the importance of vitamin D beyond maintenance of musculoskeletal health.Vitamin D has been shown to have extensive biological functions,including modulating immune function,inhibiting cellular proliferation,inducing differentiation,promoting apoptosis.Vitamin D deficiency is highly prevalent in critically ill patients,and it may impact the severity of illness and contribute to lessthan-optimal outcomes.Vitamin D plays an important role in preventing the development of critical illness based on its pleiotropic actions,thus holding a profound prospective with respect to an adjunctive therapy in critically ill patients.

Objective To study relationship between Ki67 ,fragile histindine tried (FHIT) and adrenocortical tumors. Methods Ki67 and FHIT was detected by immunohistochemical staining in edrenecortical carcinoma(n=14) ,edrenocortical adenoma(n = 61) and normal adrenocortical tissue adjacent to tumor(n = 10). Results Ki67 was not expressed in normal adrenecortical tissue but highest expressed in adrenocortical carcinoma as well as in adrenocortical adenoma,and however,the expression of FHIT was expressed in a different way to Ki67. Negative correlation was observed between Ki67 and FHIT (r = -0.721 ,P <0.005). Conclusion The correlation of Ki67, FHIT with adrenocortical tumor, suggest that the detection of both Ki67 and FHIT can provide objective and simple diagnosis method to identify adrencortical adenomas from adrencortical carcinomas.

Objectives To investigate the relationship between the insertion and deletion (I/D) polymorphism of human angiotensin converting enzyme (ACE) gene and the vascular complications in type 2 diabetes. Methods The I/D polymorphism of ACE gene was detected by polymerase chain reaction in 120 type 2 diabetic patients and 100 healthy controls. Results The frequency of DD genotype was significantly higher, while frequency of II genotype was lower in diabetic nephropathy patients (DN) than those in control group. The frequency of ID genotype was significantly higher, while frequency of II genotype was lower in type 2 diabetic patients with coronary heart disease (CHD), when compared to those without CHD. The frequencies of ACE genotypes in patients with diabetic retinopathy (DR) or hypertension (HP) were not different from those in control group and non-DR or non- HP patients. Conclusions ① There were relationships between the I/D polymorphism of ACE gene and DN and CHD in type 2 diabetes. ② The DD genotype and D allele of ACE gene might be as markers in predisposing DN, while II genotype and I allele as protective factors for DN in diabetes. The ID genotype might be as a marker in predisposing CHD, while II genotype as a protective factor for CHD in diabetes.③ There was no relationship between I/D polymorphism of ACE gene and HP or DR in diabetes in Guangxi region.

Objective To investigate the expression of human telomerase reverse transcriptase(hTERT),Ki-67 and p27~(kip1) in pheochromocytoma and paraganglioma,and to evaluate whether the expression of hTERT,Ki-67 and p27~(kip1) could serve as diagnostic markers for predicting the biological behaviour of these tumours.Methods Expression of hTERT,Ki-67 and p27~(kip1) was determined by immunohistochemistry in 45 pheochromocytomas/paragangliomas(31 benign,7 suspected malignant and 7 malignant)and 9 normal adrenal medulla samples.Results The hTERT was expressed in 5/7 malignant tumors,5/7 suspected malignant tumours and 3/31 benign tumours.Malignant and suspected malignant tumors expressed more hTERT(P

Objective To investigate the prevalence of vitamin D deficiency in medical intensive care unit (ICU) and its relationship with severity of disease and prognosis.Methods A prospective study was performed to evaluate vitamin D status in 216 patients admitted to the medical intensive care unit.The incidence of hypovitaminosis D was observed.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,days kept in ICU and on ventilator,main laboratory findings,and mortality rate were compared among patients with different serum 25-hydroxyvitamin D [25 (OH) D] levels.Potential risk factors for mortality were analyzed by multivariate logistic regression analysis.Results One hundred and fifty-three patients (70.8％) developed hypovitaminosis D.25 (OH) D deficiency was identified in 95 (44.0％),25 (OH) D insufficiency in 58 (26.8％),and 25 (OH) D sufficiency in 63 (29.2％) patients.APACHE Ⅱ score,positive blood culture,the incidence of multiple organ dysfunction syndrome(MODS),and mortality rate were higher in deficiency group compared with the other two groups [APACHE Ⅱ score:deficiency group 25 (20,28) score,insufficiency group 22 (17,26) score,sufficiency group 19 (18,20) score,P＜0.01 ; positive blood culture:deficiency group 18.9％,insufficiency group 13.8％,sufficiency group 3.2％,P=0.015 ; MODS:deficiency group 48.4％,insufficiency group 43.1％,sufficiency group 25.4％,P=0.025; mortality rate:deficiency group 40％,insufficiency group 24.1％,sufficiency group 15.9％,P =0.003].25 (OH)D levels were negatively correlated with APACHE Ⅱ score and mortality rate (r =-0.325,P＜0.01 ; r=-0.276,P＜0.01,respectively).Analysis by multiple logistic regression demonstrated that 25 (OH) D deficiency (OR =3.005,95 ％ CI 1.321-5.875,P =0.008) was independent risk factor for mortality.Conclusions This study demonstrates that vitamin D deficiency is highly prevalent among patients admitted into ICU.Vitamin D deficiency is associated with disease severity,and seems to be an independent risk factor for mortality.

Based on the comparative analysis of current forms of Chinese medical education evaluation,the authors think that they should learn from each other and Chinese medical education will focus on close integrating self-assessment,government assessment and social assessment.

Objective: To investigate the effects of the cooperative actions of isoflavone, vitamin C and E on the expression of acute C reactive protein (CRP) and interleukin 6 (IL-6) in the patients with typeⅡdiabetic mellitus (DM). Method: Ninety six patients with DM were divided randomly into 4 groups, DM control group(B), and groups receiving low(C), medium (D) , and high (E) dose of the compound antioxidant of isoflavone, vitamin C and E respectively. Another 24 healthy subjects served as normal control group (A). Observe the changes of the levels of CRP and IL-6 during oral glucose tolerance test (OGTT). Results: The peak of serum levels of CRP and IL-6 in the patients of DM control group and lower dosage group appeared 1 h after OGTT and were significantly higher than the 0 h value (P

This paper was to explore the relationship between plasma omentin and obesity and insulin resistance in patients of polycystic ovary syndrome(PCOS).The results showed that there were statistically significant differences in serum omentin levels among control group,PCOS-normal weight group,and PCOS-overweight group [(115.29 ± 33.92),(111.12 ± 34.50),and (42.85 ± 19.39) pg/ml,P＜ 0.05].Omentin were negatively correlated with homeostasis model assessment for insulin resistance(HOMA-IR) and body mass index(BMI).In the multiple stepwise regression analysis,only omentin was negatively correlated with BMI.Omentin may be involved in the development of PCOS by affecting obesity.

Objective High expression of multi-resistant transporter ATP-binding cassette super family G member 2 (ABCG2) is a major cause of drug resistance and chemotherapeutic failure of cancer .This study was to investigate the significance of ABCG2 expression in adrenocortical cancer cells after cyclophosphamide ( CTX) intervention in vivo . Methods Ten male and fe-male BALB/C-nu mice were randomly divided into a cyclophosphamide ( CTX) group and a control of equal number .SW-13 cells were subcutaneously injected into the nude mice to establish a model of subcutaneous transplantation tumor , followed by intraperitoneal injec-tion of CTX and isotonic saline solution into the two groups of mice , respectively .Then the expression of ABCG 2 in tumor tissue and primarily cultured cells was detected by immunohistochemistry and flow cytometry . Results The expression of ABCG 2 in the tumor tissue was significantly higher in the CTX than in the control group ([69.1 ±1.83]%vs [53.4 ±1.65]%, P<0.05), and so was that in the primarily cultured cells ([97.89 ±1.36]% vs [81.88 ±8.31]%, P<0.05). Conclusion The ABCG2 gene is in-volved in the drug resistance of adrenocortical carcinoma and may be a therapeutic target of the malignancy .

The expressions of Ki67 and FHIT were detected by immunohistochemical staining in 15 cases of adrenocortical carcinoma, 42 cases with adrenocortical adenoma,6 cases of adrenocortical hyperplasia, and 10 cases of normal adrenocortical tissue. The results showed that the highest expression of Ki67 and the lowest expression of FHIT were found in adrenocortical carcinoma. There were significant differences in the Ki67 and FHIT between adrenocortical adenoma and adrenocortical carcinoma ( both P < 0. 05 ). There existed negative correlation between the expressions of Ki67 and FHIT( r=-0. 712, P<0.05 ). Ki67 over-expression and loss of FHIT expression may be involved in the occurrence and development of adrenocortical carcinoma. It is suggested that combined detections of Ki67 and FHIT may have reference significance in the differentiation of adrenocortical adenoma from adrenocortical carcinoma.