Objective To investigate the relationship between polymorphisms of candidate genes 〔glucokinase (GCK) gene, NIDDM1(D2S140) gene, fatty acid bindingprotein2(FABP2)gene〕and type 2 diabetes mellitus (DM) in Shandong Chinese Han population. Methods Short tandem repeat (STR) region polymorphisms of GCK gene, NIDDM1 gene and FABP2 gene were analyzed with the polymerase chain reaction and polyacrylamide sequencing gel in 107 patients with type 2 diabetes mellitus and 105 normal subjects. The subjects studied were unrelated and they are Chinese Hans living in Shandong province and no diabetes family history was revealed. Results A5 allele of GCK gene and B2 allele of NIDDM1 gene were positively related with type 2 diabetes (RR=15.70, P0.05). Logistic regression analysis showed that A5 allele and B2 allele were among the risk factors of type 2 diabetes. Conclusion Polymorphic microastellite repeat markers at the glucokinase gene and the NIDDM1 (D2S140) gene locus are associated with type 2 diabetes in Chinese. The polymorphism at the FABP2 locus is not a genetic marker for type 2 DM in Chinese Hans.

Objective To determine the relationship between the polymorphism of D2S140 gene and type 2 diabetes mellitus.Methods D2S140 region polymorphism were analyzed with the polymerase chain reaction and short tandem repeat methods in 103 subjects with type 2 diabetes mellitus and 105 nondiabetic subjects.All subjects were biologically unrelated Chinese without a family history of DM.Results There were 7 alleles ranging from 151bp to 163bp in all subjects.The frequencies were 0.01 to 0.37,2 alleles were more common in diabetic patients than in nondiabetic subjects (RR=16.04, P

Animals ; Endotoxemia ; metabolism ; pathology ; Female ; Liver ; metabolism ; pathology ; Male ; Mitochondria, Liver ; metabolism ; Rats ; Reactive Oxygen Species ; metabolism

Objective To investigate the change of renal tubular function in elderly patients after use of β lactam antibiotic. Methods The elderly patients with pulmonary infection were treated with β lactam antibiotic,the dosage was 50%-70% of normal use. The renal tubular function indicated by urine α1-MG, β2-MG, pro/Cre, NAG/Cre and glomerulus function marked by eGFR, serum creatinine (Cre)), cystatin C were detected during drugs treatment and 7 days after stopping medications. Results The infection was controlled well in 3-7 days after treatment. Urine α1-MG, β2-MG, pro/Cre and NAG/Cre were abnormal before treatment, were elevated in 3, 14 days after using antibiotic, and came down to the level before treatment on 7 days after stopping treatment. The level of Cre and eGFR was (89.0±25.97) μmol/L and (26.39±8.17) ml/min before treatment, then elevated and decreased in 14 days after treatment, respectively, and down to the level before treatment on 7 days after stopping of antibiotic. Cystatin c was abnormal before treatment and did not change significantly after treatment and after stopping antibiotic. Conclusions It is important to protect renal tubular function and to adjust antibiotic dosage according to eGFR during using antibiotic in elderly patients to control infection.

Objective:To analyze the association of clinical characteristics and laboratory indicators at initial maintenance hemodialysis(MHD)with long-term prognosis in advance-aged patients, and to find influencing factors for the prognosis in advance-aged MHD patients.Methods:This retrospective study was conducted at the Nephrology Department of Beijing Hospital between April 2007 and January 2018.A total of 61 patients receiving first-time hemodialysis at ≥ 80 years of age and undergone regular dialysis for 3 months or longer were enrolled.All patients were followed-up until death or the end of July 1, 2018.Patients were divided into the survivor and non-survivor groups, and differences in clinical characteristics and laboratory indicator values were compared between the two groups.Influencing factors for prognosis in advance-aged MHD patients were analyzed by using multivariate Cox regression.Results:For the 61 subjects, the median follow-up time was 25.8 months.During the follow-up, 32 patients died(52.5%). The main death causes were infectious diseases(40.6%, n=13)and cardiovascular and cerebrovascular diseases(37.5%, n=12). The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 75.4%(46/61), 54.1%(33/61), 37.7%(23/61), 22.9%(14/61)and 16.4%(10/61), respectively.The median survival time was 25.8 months for all patients, 27.5 months for patients aged 80-84 years, and 14.9 months for patients aged 85 years and over.The non-survivor group had a higher male ratio(65.6% or 21/32 vs.37.9% or 11/29, χ2=4.678, P=0.031)and lower levels of hemoglobin(85.4±13.0 vs.95.0±17.6 g/L, t=2.867, P=0.019)and albumin(30.3±5.0 vs.34.6±4.8 g/L, t=3.039, P=0.001)than the survivor group.Kaplan-Meier curves indicated that the survival rate decreased with age, and subjects aged less than 85 years had a higher survival rate than subjects aged 85 years and older(the median survival time: 14.9 months vs.27.5 months, Log Rank P=0.006); patients who received continuous renal replacement therapy(CRRT)before dialysis had lower survival rates than patients who did not receive CRRT(the median survival time: 7.8 months vs.29.2 months, Log Rank P=0.002); patients with high serum levels of albumin(≥33 g/L)had higher survival rates than patients with low serum levels of albumin(<33 g/L)(the median survival time: 29.2 months vs.18.9 months, Log Rank P=0.003). Multivariate Cox regression analysis showed that age at initial dialysis( HR=1.136, 95% CI: 1.005-1.285, P=0.041), female( HR=0.409; 95% CI: 0.169-0.994, P=0.048), serum albumin level( HR=0.836, 95% CI: 0.772-0.906, P<0.001)and CRRT before dialysis( HR=6.161, 95% CI: 1.848-20.538, P=0.003)were independent predictors of all-cause mortality in advance-aged patients. Conclusions:Advance-aged patients undergoing hemodialysis have complicated clinical conditions and poor prognosis.Age, gender and serum albumin level at initial dialysis and CRRT before dialysis are independent predictors of prognosis in these patients.

Objective To study the success rate of ventilator weaning in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients influenced by bobbed endotracheal intubation. Methods One hundred and sixteen AECOPD patients who were given invasive mechanical ventilation and reached the standards of off-ventilator were divided into control group (general endotracheal intubation group) and experiment group bobbed (tracheal intubation) by random digits table method with 58 cases each. The respiratory rate (RR), heart rate (HR), rapid and shallow breathing index (RSBI), oxygenation index (OI), pulse blood oxygen saturation (SpO2), tidal volume and success rate of ventilator weaning were compared. Both groups were implemented of extubation if they reached the standards of the extubation time by observing their ability in spontaneous breathing test (SBT). Results The RR, HR and RSBI before extubation in experiment group were significantly lower than those in control group:(19.7 ± 2.3) times/min vs. (23.5 ± 2.3) times/min, (91.2 ± 6.3) times/min vs. (93.4 ± 8.1) times/min and 80.2 ± 6.7 vs. 90.5 ± 9.6, P<0.05, and the OI, SpO2, tidal volume and success rate of ventilator weaning were significantly higher than those in control group: (269 ± 9) mmHg (1 mmHg = 0.133 kPa) vs. (245 ± 16) mmHg, 0.929 ± 0.014 vs. 0.870 ± 0.037, (6.1 ± 1.2) ml/kg vs. (5.1 ± 0.8) ml/kg and 91.38%(53/58) vs. 77.59%(45/58), P<0.05. Conclusions The bobbed endotracheal intubations can improve the success rate of ventilator weaning in patients with AECOPD.

Based on summarizing the international experiences and reviewing the historical evolution and current situation of the physicians'compensation system of public hospitals in China,this paper clarified the existing problems of the current compensation system.Such problems namely included lack of security on the source of the physicians'compensation,low level of sunshine salary which caused thecompensatory mechanism,lack of scientific design of the salary structure and allocation,as well as other underlying causes.Drawing lessons from reform practices at home and abroad,the basic principles and reform directions were put forward,as well as 4 route selections,namely establishing an security investment system to guarantee a stable and higher level salary under the current compensation system, implementing a high level of flip-type annual compensation with locking the current salary into files, establishing an appropriate compensation system referring to an innovated evaluation system of physicians in public hospitals,and coordinating closely with public institution reforms to promote physicians' compensation system reform.

Objective To investigate the expressions of Pokemon and c-myc in colorectal cancer,colorectal adenomas and normal colorectal mucosa tissues,and demonstrate its relationship with clinicopathological features and prognosis in patients with colorectal cancer.Methods The specimens were taken from colorectal cancer tissue of 86 patients,colorectal adenomas tissue of 60 patients,and 40 normal colorectal mucosa tissue.The expressions of Pokemon and c-myc protein were detected by immunohistochemistry,and the expressions of Pokemon and c-myc gene were detected by reverse transcription polymerase chain reaction (RT-PCR).The correlation between the expressions of Pokemon and c-myc,and clinicopathological features was analyzed.Results The positive expression rates of Pokemon and c-myc protein in colorectal cancer tissue were significantly higher than those in colorectal adenomas tissue and normal colorectal mucosa tissue:69.8％ (60/86) vs.13.3％ (8/60) and 5.0％ (2/40),73.3％ (63/86) vs.15.0％ (9/60) and 2.5％(1/40),and the expression levels of Pokemon and c-myc gene in colorectal cancer tissue were significantly higher than those in colorectal adenomas tissue and normal colorectal mucosa tissue:0.915 ±0.247 vs.0.358 ±0.102 and 0.277 ±0.085,1.272 ±0.360 vs.0.398 ± 0.153 and 0.255 ±0.097,there were statistical differences (P ＜ 0.05).The expression levels of Pokemon and c-myc gene in colorectal cancer tissue had a close correlation with the degree of infiltration,histological differentiation,lymph node metastasis,distant metastasis and Dukes stage,there were statistical differences (P ＜ 0.05),but had no correlation with the sex,age,and tumor diameter (P ＞ 0.05).Conclusions The expression levels of Pokemon and c-myc are higher in colorectal cancer tissue,and the expressions are related to the clinicopathological features of colorectal cancer.The expression levels of Pokemon and c-myc may predict the prognosis in patients with colorectal cancer.

Objective To explore the effect of Xiongbiyihao mixture in the treatment of coronary heart disease with angina pectoris.Methods 90 coronary heart disease patients with angina pectoris were divided into the treatment group( 60 cases) and control group( 30 cases).The control group was given routine westerm medicine therapy,and the treatment group was administered with Xiongbiyihao mixture at the base of the control group.Ater treatment,the heart disease attack frequency,duration,and degree,clinical symptoms and electrocardiogram changes of the two groups were observed.Results The total efficiency symptoms of and electrocardiogram of the treatment group was 95.0％,90.0％,respectively,and was higher than that of the control group(76.7％,73.3％ ) ( x2 =9.7,x2 =7.8,all P ＜ 0.05).Conclusion Xiongbiyihao mixture could effectively improve the coronary blood,reduce myocardial ischemia,and alleviate the symptoms of angina pectoris,chest tightness,chest pain.It is safe and effective in the treatment of angina pectoris,and worthy of clinical application.

Objective To screen the risk factors of liver metastasis in patients with postoperative colorectal cancer and to set up a mathematic model.Methods One hundred and sixty-eight patients received radical surgery were retrospectively analyzed.Logistics model regression was used to identify the risk factors and ROC test to complete a mathematic model.Results The 3 and 5-year incidence rate of liver metastasis was 25.0％ and 33.3％,respectively.The risk factors of liver metastasis were lymph node metastasis (LNM),tumor invasive depth (TID),histological grading (G) and preoperative serum tumor markers (PSMs).The mathematic model was:logit (P) =-0.931 + 0.973 × LNM + 0.302 x TID + 0.637 x G + 0.042 x PSMs.Conclusion The risk factors of liver metastasis were LNM,TID,G and PSMs,and the mathematic model could be set up.