10mm, the PLG lie in the neck of gallbladder.(3)PLG complicated with clinical symptoms.(4)The PLG diameter increases or complicated with stones.But surgical treatment should be prudent for non-neoplasm PLG, especially cholesterol polys.

Objective:To observe the effect of blood glucose lfuctuation and the sustained high blood glucose on renal pathological change and collagen IV (Col IV) expression in diabetic rats.
Methods:hTe 60 male Sprague-Dawley (SD) rats were randomly assigned into a normal control group (NC) and a model group (DM). hTe rats in the normal control group were fed with normal diet, while the rats in the model group were fed with high-sucrose-high-fat diet for 6 weeks. Atfer that,streptozocin (STZ, 30 mg/kg) was injected to induce diabetic model. The model group was then randomly divided into 2 subgroups:a sustained high blood glucose group and a fluctuation blood glucose group (animals in the latter group were subcutaneously injected with insulin twice daily). Rats were sacriifced atfer 3 months and kidney tissues were dissected for HE and PAS staining, Col IV immunohistochemistry and Western blot.
Results:Compared with the normal control group, the renal glomeruli and capillary basal membrane in the diabetic rats was getting larger and thicker, respectively;the capsular space and ground substance was extended and increased, respectively;the volume of renal tubule, kidney hypertrophy index, glomeruler sclerosis index and Col IV content were all increased in the diabetic rats (P<0.01). Compared with the sustained high blood glucose group, the above mentioned pathological changes were more serious in the blood glucose lfuctuation group.
Conclusion:The capillary basal membrane of kidney in diabetic rats is thicker and the ground substance is increased. The degree of glomeruler sclerosis is more serious in the blood glucose lfuctuation group compared with the sustained high blood glucose group, which is conifrmed by the increased level of Col IV.

Objective:To analyze the important controllable factors which affect the glycemic control of diabetes.
Methods:A cross-sectional study was carried out to examine the role of relevant characteristics in glycemic control by a sampling investigation of 430 diabetic patients in Hunan, China. A questionnaire was designed for personal interviews to collect data. Univariate regression analysis and multiple linear regression analysis were used to evaluate the effects of various factors on glycated hemoglobin A1c (HbA1c) control.
Results:hTe level of HbA1c in 430 patients was (8.7±2.6)%, and the value in 34%patients among them was ≤7.0%. Base on univariate regression analysis some factors were associated with good HbA1c control, including age, diabetic education, self monitoring of blood glucose, knowledge of blood sugar control standard, living environment, and self-owned glucometer. However, the upgraded treatment was associated with poor control. Based on multiple linear regression analysis, the ifrst four factors mentioned above were protective factors for HbA1c while upgraded treatment was risk factor for HbA1c.
Conclusion:Knowledge of blood sugar control standard, diabetic education and self monitoring of blood glucose are important controllable factors for better glycemic control of diabetes.

Talents are core competitiveness of a hospital.In view of the nature of long and slow development cycle of medical talents,Wuxi No.2 People' s Hospital has innovated aTalent-tree program.This program develops talents by categories and stages,in the model oftree root-tree trunk-tree crownto fit different stage needs of these people.The program features a categorized education mode to establish hierarchical individualized plan for the whole career.The hospital has explored a special pathway for talents development,for the purpose of providing talents to ensure sustainable and innovative growth of the hospital.

Objective To evaluate ascending venography in the diagnosis of iliac vein compression syndrome.Methods From April 2011 to April 2013,we have had 556 patients with varicose veins suspected of Cockett syndrome.The degree of varicose veins by the International Union of Venous Clinical Classification (CEAP classification) was as following[1]:shallow varicose veins of lower limb (C2) in 190;varicose veins with limb swelling (C3) in 149 cases ; with body skin changes,such as pigmentation,eczema or lipid hard skin disease (C4) in 130; with healed ulcers (C5) in 17; with active ulcer(C6) in 70.Deep vein anterograde contrast and femoral venous cannula angiography were performed on 760 times.Results Iliac vein compression syndrome (Cockett) was detected by ascending venography in 154 patients,the diagnosis was established by following femoral venous cannula angiography.In the other 48 patients in whom Cockett syndrome was suspected by ascending venography,final diagnosis was reached by femoral venous cannula angiography.Altogether there were 202 iliac vein compression syndrome cases,with a positive rate 38.19％ (202/529).The narrowness was larger than 50％ in 173 cases.In 145 cases there were visible collateral vessels.Conclusions Deep vein ascending angiography is a useful screening method in the diagnosis and treatment of Cockett syndrome.

[Objective] To detect the expression of CD137L mRNA and protein in colorectal cancer tissues and discuss its possible clinical significance.[Methods] To detect the expression of CD137L mRNA in colorectal cancer tissues and adjacent noncancerous tissues by real-time RT-PCR and immunohistochemistry and to analyze the relationship between CD137L expression and clinical features.[Results] The mean level of CD137L mRNA in colorectal cancer tissues is significantly higher than that of adjacent noncancerous tissues (0.035 ± 0.013 vs.0.008 ± 0.005,P ＜ 0.05 ).CD137L mRNA expression in colorectal cancer show no significant differences among different age,sex,tumor location,Dukes classification,histological differentiation,and serum levels of CEA.We selected 8 colorectal cancer tissues and 3 adjacent tissues randomly to analyze the expression of CD137L by immunohistochemistry.CD137L was expressed on tumor cells in colorectal cancer tissues.The expression of CD137L was observed only in colorectal cancer tissues (6/8),but not in adjacent noncancerous tissues (0/3).[Conclusions] The expression of CD137L Mrna in colorectal cancer tissues is higher than that of adjacent noncancerous tissues and CD137 is expressed on tumor cell surface,it might be of biological importance for the progression of colorectal cancer.

Objective To investigate the clinical characteristics of childhood anaphylactoid purpura.Methods Seven hundred and sixty children with anaphylactoid purpura were included in this retrospective study.The clinicopathological features of childhood anaphylactoid purpura were analyzed,including age at onset,gender,season at onset,clinical and pathological manifestations,and complications such as purpura nephritis.Results Childhood anaphylactoid purpura commonly affected preschool and school-age children,and usually occurred in winter or spring.Of these patients,265 (34.87％) had gastrointestinal symptoms,298 (39.21％) had joint involvement,and 223 (29.34％) had renal impairment.Purpura nephritis mainly manifested as haematuria,proteinuria and nephritic syndrome,and was diagnosed in 91.91％ (91) of the patients receiving renal biopsy.The pathological grade of purpura nephritis varied from Ⅱ to Ⅲ in these patients.The distribution pattern of purpura was associated with complications.Conclusions Anaphylactoid purpura has age and season predilection.Purpura in both lower and upper extremities is likely to be complicated by gastrointestinal haemorrhage and joint involvement,and lower extremity purpura is more frequently to be complicated by nephritis than purpura in both lower and upper extremities.In general,childhood anaphylactoid purpura is a mild condition with a good prognosis.

At present , the death anxiety of people in mainland China presents the main characteristics of col -lective avoidance , instantaneous outbreak , the vulnerability of death anxiety buffer system , and load social prob-lems of death anxiety .The taboo of death is linked to collective avoidance of death anxiety , and the avoidance to death causes the extrusion and deformation of most people ' s death anxiety .When people ' s death anxiety encoun-ters serious "death reminder", it will instantly break out .Due to the vulnerability of death anxiety buffer system and the impact of current social problems in mainland China , people ' s death anxiety presents a characteristic of brutal want on spread .

Objective To discuss the surgical and interventional treatment of vascular injuries. Methods Clinical data of 85 patients with vascular injuries were retrospectively studied by grouping. Location of injury included jugular vein, vertebral artery, main extremity vessels and superior mesenteric artery. There were 25 patients with traffic injury and 60 with stah injury, of whom 62 patients underwent surgical operation (vascular grafting were performed in 37 and vascular repair in 25) and 23 received in-tervention therapy. Results There were one death and one amputation. Fifty-eight patients were fol-lowed up, which showed that all patients had good vascular patency. Conclusions Prompt and correct diagnosis is very important for treatment of vascular injury. Interventional treatment had merits of minor trauma, short operation duration, simple manipulation and quick postoperative recovery. Surgical opera-tion and endovascular intervention can be used together in treating vascular injury.

Objective To discuss the methods and the efficacy of interventional treatment of vascular injuries. Methods From January 2006 to March 2008, interventional therapy was performed in 13 cases of vascular injuries including injuries of internal jugular vein, subclavical artery, axillary artery,inferior vena cave, abdominal aorta, superior mesenteric artery, arteria iliaca, vena iliaca and femoral artery.Types of these injuries included arteriovenous fistula in 3, vascular rupture complicating haematoma in 4,pseudoaneurysm in 3 and arterial stenosis ensuing from injury repair in 3. Covered stent-grafts were used in 9 cases (10 stent-graft), mesh stem in 1, sealed with balloon in 2 and introcoil embolism in 1.Result Interventional procedure was successful in all these 13 cases, there was no mortality nor severe complications. Small amount of endoleak developed in thoracic aorta pseudoaneurysm and contrast leaked from internal jugular vein in left subclavical arteriovenous fistula after stent-graft insertion, these were healedconservatively. Twelve cases were followed up from 1 to 26 months. Hemoptysis occurred in patient with thoracic aorta pseudoaneurysm 12 months after intervention but without abnormality in CTA. There were no stem break, shift, deformation or stennsis and there were no recurrence of primary disease.Conclusion Interventional therapy is of less invasion, short performation duration, simple manipulation and quick postoperative recovery for vascular injuries.