microRNA(miR) in body fluids shows good stability and the change in its expression profile and level is associated with cancer and other diseases.Thus,circulating miR has been proposed to be an useful biomarker in diagnosis of the onset,prognosis and risk of diseases.Although great discoveries have been obtained on all aspects of miR,there are some shortcomings existing in the present studies,such as inconsistent specimens,diverse detection methods,lack of standardization on data analysis and other defects,resulting in poor reproducibility of data and inconsistent clinical conclusion,that make circulating miR difficult to be used in clinical laboratory testing.So lots of work is needed for us to implement,such as standardizing sample selection,improving detection reagents and methods,and normalizing test results before we can ultimately establish a fast,easy,low-cost detection of circulating miR in the clinical laboratory.

Humans ; Traumatology

ObjectiveTo investigate the correlation between the level of resistin and the insulin resistance(IR) and the incorporation of microamount albuminuria(MA) of type 2 diabetes mellitus (T2DM).MethodsTwo hundred and twenty T2DM patients and 40 normal subjects (control group) were enrolled in this study.Two hundred and twenty T2DM patients were divided into 4 groups,IR group (group A,79 cases),non-IR group (group B,48 cases),IR complicating MA group (group C,51 cases),non-IR complicating MA group(group D,42 cases).The fasting serum resistin was measured by enzyme-linked immunosorbant assay (ELISA),and the fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) was also determined.ResultsThe level of fasting serum resistin in group A,B,C and D was higher than that in control group [(33.45 ± 1.37),(23.36 ± 1.47),(44.45 ± 1.39),(37.45 ±1.57) μ g/L vs.( 17.44 ± 1.26 ) μ g/L],and there was significant difference among 5 groups (P ＜ 0.01 ).The level of fasting serum resistin in group A was higher than that in group B (P ＜ 0.01 ),and the level of fasting serum resistin in group C was higher than that in group D (P ＜ 0.01 ).The level of fasting serum resistin was both higher in group C and D than that in goup A and B (P＜ 0.01 ).Correlation analysis showed the fasting serum resistin was positively correlated with body mass index(BMI),FPG,HbA1c and FINS in group A(r =0.35,0.46,0.37,0.49,P ＜0.05),and the fasting serum resistin was positively correlated with HbA1c,BMI,systolic blood pressure and diastolic blood pressure in group C(r =0.45,0.32,0.37,0.29,P ＜ 0.05 ).ConclusionsSerum resistin may participate in the process of IR and the formation of MA.It may become one of the diagnostic standard of the IR and one of the important index to estimate the MA.

Objective To study the color digital fundus photography of the fundus in the physical examination in screening and clinical importance to guide treatment.Methods 50 245 cases (100 490 eyes) healthy subjects with Topcon TRC NW100 digital color fundus camera to take pictures after the screening analysis.Results The number of the Inspector General,50 245 cases,45 373 cases of normal,accounting for 90.3％,a general description of those 359 cases,accounting for 0.7％,the positive findings in 4513 cases,accounting for 9.0％.Positive comparison between men and women of all age groups showed no significant difference ( P ＞ 0.05 ).Positive findings of retinal arteriosclerosis in the detection rate of 7.4％,0.1％ of the diabetic retinopathy,macular degeneration,0.1％,0.6％ of retinopathy,optic atrophy 0.1％,the optic nerve C/D greater than 0.7％.Screening of the positive findings of the subjects to give timely and accurate diagnosisandtreatmentrecommendations.Conclusion Digitalcolorfundusphotography objectivity,reproducibility andnon-invasive characteristics of the image data to facilitate thestorage and exchange,andretinalmicrovascular disease couldbetter predictthe effects on cardiovascular and cerebrovascularevents,and therefore have important applications in the field ofhealthy value.

Objective To study the effects of allogeneic blood transfusion on expression of CD40L on peripheral blood monocytes (PBMCs) in patients undergoing radical gastrectomy for gastric carcinoma. Methods Thirty patients classified as ASA physical status Ⅰ- Ⅱ undergoing radical gastrectomy for gastric carcinoma were randomly divided into three groups with 10 patients in each group : group A received no allogeneic blood; group B received leukodepleted blood; group C received allogeneic whole blood during operation or within 12 h after operation. The patients were premedicated with intramuscular phenobarbital sodium 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.06 mg ? kg-1 , fentanyl 2 ?g ?kg-1 , propofol 1.5 mg ?kg-1 and vecuronium 8mg and maintained with continuous infusion of propofol (100?g?kg-1?min-1) and vecuronium (5?g ?kg-1?min-1) and intermittent inhalation of 1l%-2% isoflurane. The patients were mechanically ventilated after tracheal intubation. Blood samples were taken before operation and 2, 5 and 10 days after operation. The PBMCs and plasma were separated from peripheral blood by Ficoll-Hypaque centrifugation. The PBMCs were washed and incubated with the patients own plasma (final-concentration 10% ) and PHA (final concentration 20 ?g?ml-1 ) at 37℃ in a 5% CO2 atmosphere for 48h. CD40Lexpression on PBMCs was quantified by flow-cytometry.Results The demographic data including sex, age, bodyweight and duration of operation and intraoperative blood loss were comparable among the three groups. There was no significant difference in the CD40L expression before operation among the 3 groups. In group A there was no change in CD40L expression after operation. In group B CD40L expression on PBMCs increased significantly on the 2nd postoperative day, but returned to preoperative level on the 5th postoperative day. In group C the CD40L expression on PBMCs kept increasing on the 2nd and 5th postoperative day and did not return to preoperative level on the 10th day. The increase in CD40L expression was significantly larger in group C than that in group B ( P

Objective To investigate the clinical efficacy of hemodialysis (HD) combined with hemoperfusion (HP) versus HD combined with hemodiafiltration(HDF) in treating uremic pruritus .Methods The randomized controlled trials(RCTs) on HD combined HP versus HDF in treating uremic pruritus were retrieved from the electronic databases of Cochrane library ,PubMed , Science ,CNKI ,Chinese Biological Medicine ,Wanfang and CNKI by computer .The domestic medical journals ,monographs ,meeting documents and academic dissertations were manually retrieved .The retrieval time limit was from their establishment to October 2015 .Meanwhile the obtained reference literature indexes were consulted .The two researchers independently screened the collected literatures according to the formulated inclusion and exclusion standards .The visual analogue scale (VAS) ,skin itchy effect judg‐ment criteria ,Dirk R Kuypers score ,PTH ,Ca2+ and P3 - were adopted as the evaluation standards .The Review Manager 5 .3 soft‐ware was used to conduct the meta‐analysis .Results Nine RCTs were finally included ,involving 405 patients .The meta analysis showed that HD+ HP had better effect than HD+ HDF in treating uremic pruritus and clearing blood BUN ,HD+ HDF had better effect than HD+ HP for maintaining Scr and P3 - clearing effect ,while no statistically significant difference was found in terms of PTH decrease and Ca2+ influence (P>0 .05) .Conclusion The dialysis mode of HD+ HP is more effective in treating uremic pruri‐tus .

OBJECTIVE:To observe the short-term efficacy and ADR of tenofovir disoproxil fumarate(TDF)in the treatment of multi-drug resistant chronic hepatitis B(CHB). METHODS:32 patients with multi-drug resistant CHB were analyzed retrospec-tively,and HBV drug-resistant genes were detected before treatment;there were a number of points to resistance;they were gave TDF orally. The recovery rate of serum alanine aminotransferase(ALT),HBV-DNA conversion rate,lactic acid and renal function were observed before and after treatment. RESULTS:The recovery rate of ALT reached 100% at 3 months,and the conversion rate of HBV-DNA reached 96.88%. The lactic acid levels and renal dysfunction was not found during treatment. CONCLUSIONS:TDF take effect quickly on multi-drug resistant CHB,and no obvious ADR is found.

Objective To explore the solution to the secure problem of EMR based upon No.1 Military Medical Project.Methods The existing EMR system provides medical records service and the EMR are stored and managed in ordinary or established file format in the database server.Based upon above database characters related to EMR and the requirement of EMR security,the MRBACKUP system was developed to resolve EMR backup,recovery and dump.Results The MRBACKUP system safeguarded the security of EMR in the lowest cost,the least system resources and the highest efficiency.Conclusion The new secure solution to EMR can better resolve the security problems in the widely-used EMR in hospitals.

Objective To evaluate the feasibility of laparoscopic D2 radical gastrectomy for staging gastric carcinoma.Methods From January 2008 to August 2008,a series of 32 patients with staging gastric tumor underwent laparoscopic D2 radical gastrectomy in our hospital.For distal gastrectomy,groups 1,3,4,5,6,7,8,9,11p,12a,and 14v lymph nodes were resected,while for proximal gastrectomy groups 1,2,3,4,7,8,9,10,and 11 lymph nodes were excised.In the patients who received total radical gastrectomy,the groups 1,2,3,4,5,6,7,8,9,10,11,12a,and 14v were harvested.Reconstruction of the digestive tract was performed after the resected tumor was removed through a mini-incision on the upper abdomen.Results The procedure was completed in all of the patients without conversion to open surgery.The distal gastrectomy was performed on 18 patients,and the proximal surgery was carried out in 2.The operation time and intraoperative blood loss for the two surgeries was 250-390 minutes(mean,325) and 50-250 ml,respectively.Total radical gastrectomy was employed in 12 cases with a mean operation time of 347 min(300-450),and blood loss of 60-350 ml.None of the 32 patients needed blood transfusion.Postoperative pathological examination showed that the edge of the resected samples were negative in all of the cases.They had the gastrointestinal function recovered in 24 to 72 hours(mean,38),and began fluid diet in 2 to 5 days(mean,2.8).No patient had anastomotic leakage or other complications.Thirty of the cases were followed up for 1 to 8 months.During the period,no recurrence,metastasis,or implantations at the incision or puncture sites were found.Conclusion Laparoscopic D2 radical gastrectomy is a safe,feasible,effective and minimally invasive technique with good short-term outcomes for patients with staging gastric carcinoma.

A wide range of uncomfortable symptoms are attributed to menopause.It is also during this time that women are at increasing risk of poor medical conditions such as osteoporosis,cancers and dementia.Most physicians pay attention to the proper selection of effective and reasonable therapeutic methods,unfortunately,no agreement exists on the clinical recommendations and choice.The article reviewed hormone replacement therapy(HRT),common therapy and traditional medical therapy.