Arteriosclerosis Obliterans ; surgery ; Graft Occlusion, Vascular ; therapy ; Humans ; Lower Extremity ; blood supply ; Stents

Objective To investigate the association of insulin dose with clinical factors of type 2 diabetes. Methods We reviewed the data of 214 type 2 diabetic patients who received insulin regimens.We compared the insulin dose and period at the targeted blood glucose levels among 6 groups according to different type of oral hypoglycemic agents. Results There existed statistically significant correlations of the glucose-targeted insulin dose with course,FPG,BMI,combination therapy with oral hypoglycemic agent(P<0.1,test level P=0.1).Merely metformin failure group took less insulin than the group admitted due to combination therapy failure (P=0.016, 0.53(0.35～0.62)U/kg and 0.63(0.51～0.75)U/kg respectively).The longest targeted period existed in the later. Relationship between the targeted bedtime insulin NPH dose and FPG level can be demonstrated by equation Y=0.255X+7.8. Conclusions The targeted insulin dose is influenced by synthetic factors. Patients admitted due to combination oral hypoglycemic drug failure have the maximal targeted insulin dose and the longest titration period. The final bedtime insulinNPH dose can be predicted by FPG level.

Objective To investigate the influence of lentivirus mediated short hairpin RNA(shRNA)target to human papilloma virus(HPV)16 E6 on invasive ability of cervical cancer Caski cells.Methods Lentivirus was produced after shRNA target to human papilloma virus(HPV)16 E6 and to nonsense was cloned to lentivirus work vector.Infection ratio was assessed by assay of EGFP positive cells of Caski.Total mRNA of E6 was determined by RT-PCR after Caski cells were infected by lentivirus.The change of E6 protein expression was analyzed by Western blot.The invasive ability of Caski cells was assayed employing Transwell.Results The optimal MOI (Multiplicity of infection)of lentivirus to Caski was 2.5.Total mRNA and protein of E6 were decreased (by 70%and 63%)in interfering group compared with control group.The invasive ability of Caski cells also reduced after infected by lentivirus.Conclusion shRNA mediated by lentivirus can inhibit expression of HPV16 E6 and invasive ability of cervical cancer cells.

Objective To investigate the expression of μ-opioid system in the epidermis of patients with atopic dermatitis and its role in the pathogenesis of atopic dermatitis. Methods Thirty-two mice were equally divided into 4 groups, negative control group, pre-treatment group, naloxone group, and physiological saline group. Ovalbumin was used to sensitize mice in pretreatment group, naloxone group, and physiological saline group for 7 weeks, then, mice in naloxone group and physiological saline group were treated with intracutaneous naloxone or physiological saline solution for 1 week, respectively. Mice were killed in negative control group and pre-treatment group at the end of sensitization, and in naloxone group and physiological saline group after 1-week injection with naloxone or physiological saline, skin tissues were obtained from the back of killed mice and subjected to histological examination with HE staining and quantitative fluorescent PCR for the detection of mRNA expression of μ-opioid receptor (MOR) and its ligand (β-endorphin) in epidermis. The atopic dermatitis severity index of lesions and histological changes were assessed before and after the treatment. Results In comparison with the negative control mice, the epidermal expression level of MOR was signifieantly decreased (t = 2.549, P ＜ 0.05 ) in pre-treatment group, but increased in naloxone group and showed no statistical difference from the negative control group (t = 0.671, P ＞ 0.05). No significant difference was observed in the epidermal β-endorphin mRNA expression between negative control group and pre-treatment group or naloxone group (both P ＞ 0.05 ). The improvement of lesions could be visualized after treatment with naloxone (t = 8.338, P ＜ 0.01 ), which was concordant with the histological changes in naloxone group. Conchusions As an antagonist of MOR, naloxone can restore the expression of epidermal MOR in mice model for atopic dermatitis, and shows a certain efficacy in the treatment of atopic dermatitis, which proves that μ-opioid system is somewhat associated with the pathogenesis of atopic dermatitis.

Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.

Objective To develop a Chinese military psychosomatic health scale(CMPHS) and examine its reliability and validity. Methods Based upon the previous researches, the Scale was compiled according to open-ended inventory survey. The data was collected from 1050 subjects chosen by random cluster sampling. 60 of them were tested with the CPSHS at the same time, while 61 of them were retested with the CMPHS after two weeks. The reliability and validity were examined by exploratory factor analysis ( EFA) and correlation analysis. Results According to the factor analysis results, 11 factors were extracted, namely espiratory apparatus, alimentary system,skeletal and musculature,integument,regeneration and endocrine,nervous system, anxiety, depression, psy-choticism and family history. There were 91 items in the formal scale when one lie subscale was added. The correlation between subscales were 0. 103 ～ 0. 778 (P < 0. 01) , the correlation between subscales and total scale were 0.600 ～0.859(P<0.01). The test-retest correlation coefficients of total scale and subscales were 0.427 ～0.901 (P < 0.01); the Cronbach (α) coefficients were 0. 643 ～ 0. 935 (P < 0. 01) ; and the split-half correlation coefficients were 0. 349 ～ 0. 855 (P < 0. 01 ). The correlation coefficients were 0. 425 ～ 0. 979 (P < 0. 05 or 0. 01 ). Conclusion The Chinese military psychosomatic health scale has acceptable psychometrics properties on reliability and validity.

ObjectiveTo investigate the expressions of folate receptor alpha (FOLR1) in 40 esophageal cancerous tissues and its relevance of ABO blood group.MethodsABO blood groups were analyzed in 40 patients.Immunohistochemistry (IHC) and real-time quantitative reverse transcription PCR detection were used to detect the expression of folate receptor in cancer and adjacent tissues.Results20％of esophageal cancer was suspected positive (+), 50％ of cancer adjacent tissue was suspected positive (+), 10％ were positive (+), the difference was statistically significant (x2 = 14.48, P ＜0.01).Real Time RT-PCR analysis showed FOLRI low expression in esophageal cancer and adjacent tissues, compared to normal esophageal mucosa, the differences were statistically significant (F1 =53.247, F2 = 116.500, P ＜0.01).ABO blood type and FOLRi in esophageal cancer patients were not significant correlated (P =0.647, P ＞0.05).ConclusionsFOLRI expression was decreased in the esophageal lesions compared with adjacent tissues.Detection of FOLRl expression level in esophageal cancerous tissues and the paired adjacent tissues was helpful for judging the extent of disease and guiding surgery treatment.The FOLRI expression level in esophageal carcinoma tissues had no relationship with ABO blood types.

Objective To investigate the effect of persistent hypoglycemia on the cerebral oxidative stress and matrix metalloproteinase-2 (MMP-2) activity of newborn rats and to explore the potential mechanism of hypoglycemia-induced brain injury of newborn.MethodsSeven-day-old rats were injected insulin subcutaneously to induce persistent hypoglycemia.Cerebral cortex,hippocampus and thalamus were collected after 36 hours' observation and stored in -80 ℃.Glutathione (GSH)and glutathione disulfide (GSSG) were detected by commercial kit and GSSG/GSH was calculated.MMP-2 activity was detected by gelatin zymography. The data were analyzed by t test,one or two-wayanalysis of variance and Pearson correlation analysis.Six rats were set as the normal glucose group. ResultsThirty-six hours after induction of hypoglycemia, the cerebral GSSG and GSSG/GSH of hypoglycemic pups elevated about 1.5 times higher than those of control group [GSSG:(15.89 ± 5.46) vs (6.15 ± 3.42) mg/g protein,t =3.704,P =0.004; GSSG/GSH:(5.58± 1.79) ％ vs (2.79±1.76) ％,t =2.712,P=0.022].The GSSG and GSSG/GSH in thalamus of hypoglycemia were significantly higher than those of control [GSSG:(15.93 ± 5.75) mg/g protein vs (5.03±5.14)mg/g protein,P＜0.05; GSSG/GSH:(6.50±3.25) ％ vs (2.41±3.12) ％,P＜0.05],whereas there were no significant differences in the cortex ard hippocampus.The total MMP-2 activity of hypoglycemic animals (2.22±0.59) was significantly higher than that of control (1.21± 0.17)(t=4.064,P=0.002),and significant differences were found between the two groups in cortex (2.14 ± 0.5 vs 1.17± 0.27),hippocampus (2.31± 0.72 vs 1.22 ± 0.37) and thalamus (2.22±0.68 vs 1.24±0.18) with all P＜0.01].The activity of MMP-2 was positively related to GSSG (r=0.575,P=0.0002) and GSSG/GSH (r=0.484,P=0.0003).ConclusionsOxidative stress might play an important role in the persistent hypoglycemia induced brain injury of 7-day-old rat pups and thalamus might be most vulnerable to hypoglycemia.Hypoglycemia might also elevate MMP-2 activity which is positively related to GSSG level and GSSG/GSH of the brain.

Objective To investigate the expression of apoptosis-related proteins in rat cerebral cortex following traumatic brain injuries(TBI)and discuss the role of oxygen free radical-mitochondria signal pathway in Edaravone treating TBI.Methods A total of 180 male adult Sprague-Dawley rats were randomly divided into TBI group,Edaravone treatment group and control group.Each group was divided into six subgroups at 1,3,6,24,48 and 72 hours after TBI.Edaravone treatment group was injected with Edaravone(10 mg/kg)and the other two groups injected with the same volume of 0.9%normal saline.The pathological change in the rat cortex following TBI was observed with HE staining.At different time points,the expressions of Cytc,Bcl-2 and Bax in rat cortex as well as cell apoptosis and MDA change were observed by means of immunohistechemistry,TUNEL and TAB.Results HE staining showed scattered degenerated and necrotic neurous in cerebral cortex six hours after neuron injury,which peaked at 24 hours.Compared with control group,intermediate product MDA of free radical was increased six hours after TBI and peaked at 48 hours in Edaravone treatment group,which was lower than TBI group especially at 24,48 and 72 hours(P＜0.05).Compared with control group,the immunity reaction of Cytc positive cells inereased at six hours and peaked at 24 hours in TBI group,with statistical difference at 3,6,24,48 and 72 hours(P＜0.05).Compared with TBI group,the immunity reaction of Cyte positive cells was decreased obviously at 24,48 and 72 hours in Edaravone treatment group.Hyperexcitability of Bcl-2 after TBI reached peak at 3 hours and decreased gradually.But the expression of Bax was increased gradually after TBI and peaked at 48 hours,when Bax/Bcl-2 reached peak too.Folowing TBI,TUNEL positive cells increased gradually and reached peak at 48 hours,with mainly type Ⅰ TUNEL cells before 24 hours and typeⅡTUNEL cells after 24 hours.Conclusions There exist necrosis and apoptosis of nerve cells in cortex after TBI,especially apoptosis.Oxygen free radical mitochondria is one of the signal transduction pathways of nerve cell apoptosis following TBI.Edaravone exerts certain therapeutic effect on TBI.

OBJECTIVE To investigate nosocomial infection and antibiotic resistance of Pseudomonas aeruginosa among geriatrics patients and to instruct clinical monitoring and control infection.METHODS P.aeruginosa isolates from geriatrics patients were identified and the resistance to antibiotics was determined by K-B method.RESULTS The risk factors of nosocomial infection were underlying diseases,low immunological function,long time hospitalization,invasive treatment,and prolonged antibiotic therapy.The resistant rates to trimethoprim/sulfamethoxazole and cefotaxime in PA were 74.8% and 60.2%,respectively.The resistance rate to imipenem was 3.9%.CONCLUSIONS It is suggested to carry out proper measurement to control the spread of multiresistant strains in order to improve the treatment of PAE infection in geriatrics patients.