Diabetes mellitus (DM ) was the third largest chronic disease in the world and the number of patients in China ranked first. Diabetic nephropathy (DN ) as one of the most serious complications of DM was the main cause of death in DM patients along with the incidence of DM gradually increasing. The complex pathogenic mechanism of DN was composed of many factors such as the disorder of glucose metabolism ,inflammation and immune response. Under the special environment of the DM , autoimmunity was an important factor for the occurrence and development of DN. Immune cells ,cytokines and autoantibodies influenced each other resulting in impairment of renal function and affected the progression of DN. Further research on the immune related factors in DN and DM has important value for the prevention and treatment of these diseases.

Objective To investigate the effect of one day method in endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy (LC) in treatment of cholecysto lithiasis and combined.Methods A retrospective analysis was carried out for fivety-seven cases of cholecystolithiasis combined with choledocholithiasis were peformed EST combined with LC as one day method (Conducted EST firstly and then took LC within 24 hours) from September 2007 to September 2012.Results Fifty-six cases completed LC,the surgical success rate was 98.24％,transit operation rate was 1.76％.Two cases performed abdominal pain and serum amylase rised the other 1 case was transited operation because of the inflammation of triangular parts of the gallbladder and discharged after 9 days.All patients total bilirubin fell to normal level within 72 hours.Conclusion The one day method in EST combined with LC treatment of cholecystolithiasis and choledocholithiasis can effectively reduce patients trauma,achieve good effect with fewer complications and shorter recovery time.

Objective To explore the clinical effects of high frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) on neonatal meconium aspiration syndrome (MAS).Methods Data of 53 newborns with MAS admitted into the Neonatal Intensive Care Unit of Ning Bo Women and Children's Hospital from June 2008 to June 2011 were retrospectively analyzed.According to different therapeutic measures,they were divided into three groups:conventional mechanical ventilation (CMV) group (n=23),HFOV group (n=18) and HFOV+PS group (n=12).The oxygen index,arterial oxygen/alveolar oxygen ratio (a/ApO2) and inspired oxygen fraction (FiO2) were monitored at 2,12,24 and 48 h after mechanical ventilation.The mechanical ventilation time,duration of hospital stay,change of symptom,complications and clinical outcomes of the three groups were compared by analysis of variance and Chi-square test.Results The parameters of the three groups at 2 and 48 h after mechanical ventilation were as followed:CMV group [oxygen index:(23.79±7.27) and (15.04±4.76) mm Hg; a/ApO2:0.11±0.04 and 0.31 ±0.07; FiO2:0.74±0.16 and 0.47± 0.21],HFOV group [oxygen index:(21.13±6.29) and (11.73±4.54) mm Hg; a/ApO2:0.14±0.06 and 0.35±0.06; FiO2:0.68±0.14 and 0.41±0.11] and HFOV+ PS group [oxygen index:( 18.35 ± 5.68 ) and ( 7.85 ± 5.06 )mm Hg; a/ApO2:0.17±0.03 and 0.40±0.02; FiO2:0.59±0.13 and 0.29±0.16].Compared with CMV group,the parameters of HFOV group and HFOV+ PS group were different at different time points,and the parameters (duration and extent) of HFOV+ PS group were better than those of HFOV group (all P＜0.05).The mechanical ventilation time was (7.2±0.6) days in CMV group,(4.2± 1.4) days in HFOV group and (2.9±0.5) days in HFOV+PS group; the hospital stay was (22.2±4.5) days in CMV group,(15.6±3.4) days in HFOV group and (11.8±4.3) days in HFOV+PS group; and the oxygen treatment time was (15.4± 2.4) days in CMV group,(11.8±5.3) days in HFOV group and (7.4±2.2) days in HFOV+PS group.The mechanical ventilation time,oxygen treatment time and hospital stay time were the longest in CMV group,the shortest in HFOV+ PS group (P＜ 0.05,respectively).Conclusions Early HFOV combined with PS might be a better therapeutic method for infants with MAS than HFOV or CMV alone.

Objective To provide reference for expanding the employment positions of graduates in medical infor-mation management and information system of Chongqing Medical University by analyzing their employment situa-tion and trends.Methods The jobs of 171 graduates from Chongqing Medical University Medical Information School in 2008-2013 were registered according to the agreements of graduates, Chongqing Medical University Medical In-formation School, and employing units.Results The employment rate of graduates in medical information manage-ment and information system was relatively high .Their main employing units were medical and health organizations and associated enterprises in the City of Chongqing and Sichuan Province.The employment rate was low in coastal regions.The number of employed graduates in medical and health organizations reached its peak in 2013, and re-mained unchanged in medical and health associated enterprises.Conclusion Although the employment situation of graduates in medical information management and information system is good., the number of employing units and regions is relatively less.The literacy and ability of graduates in medical information management and information system should be improved, their employment channels should be expanded, and their professional education should be further perfected with gradual saturation of demand for graduates in employing units.

The goal of this work was to explore the prospect of standardized application of an in-vitro bioactivity assay for recombinant human follicle-stimulating hormone based on a reporter gene. The relative accuracy, intermediate precision, linearity and applicable range of the method were validated according to the General Rules of Chinese Pharmacopoeia 2020 edition Volume IV (9401). Three laboratories used this method to determine the in-vitro biological activities of six batches of drug product and three batches of drug substance manufactured by two different companies. The consistency of the potency determined by three laboratories, the intra-laboratory precision and inter-laboratory precision were analyzed. The method was optimized during the collaborative validation. The results of method validation meet the requirements of the General Rules of Chinese Pharmacopoeia 2020 edition Volume IV (9401). Aiming to resolve the problems found in the collaborative validation, the medium for cell seeding, the pre-diluted buffer solution of standard and sample, and the means of removing and discarding supernatant after stimulation were optimized. After optimization, there was no significant difference in the bioactivity among the different laboratories (P > 0.05), indicating statistical equivalency. Intra-laboratory and inter-laboratory precision were good and the geometric coefficient of variation (GCV%) were both less than 15%. In conclusion, the reporter gene assay has good intra-laboratory repeatability and inter-laboratory reproducibility and is suitable for analyzing recombinant human follicle-stimulating hormone drug product and drug substance by different manufacturers. It is expected to be used as a standardized method for the determination of the in-vitro bioactivity of such products.

Objective To assess the dose reduction potential of adaptive statistical iterative reconstruction(ASiR)and model-based iterative reconstruction(MBIR)in pelvic CT with a standard male phantom.Methods A Fluke Biomedical RANDO standard male phantom was scanned with discovery CT750 HD using different tube currents.CT images were reconstructed with FBP,50％ASiR and MBIR.The CT value,the image noise and the contrast-to-noise ratio(CNR)for the sacral vertebra relative to muscle were measured.The volume CT dose indexes(CTDIvo1)and dose-length product(DLP)were recorded.Results Compared with FBP,using 50％ASiR and MBIR had significant reduced image noise and greater CNR.The effective minimal tube currents for displaying sacral vertebra were 250 mA(FBP),180 mA(50％ASiR),and 100 mA(MBIR).With the similar image quality using FBP,the dose was reduced by 28.0％ and 59.9％ using 50％ASiR and MBIR,respectively.Conclusions Using advanced iterative algorithms can reduce image noise,improve CNR,and reduce the radiation dose in pelvic CT examination.

Objective To investigate the blood-saving effect of controlled low central venous pressure (CLCVP) in different types of hepatectomy.Methods Ninety ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 37-76 yr,weighing 40-75 kg,undergoing elective hepatectomy,were divided into 6 groups according to the surgical approach and whether CLCVP was used during surgery (n =15 each):CLCVP1-3 groups and nonCLCVP1-3 groups (NCLCVP1-3 groups).The standard hepatectomy,half liver resection and irregular hepatectomy were performed in CLCVP1-3 groups,respectively,with CLCVP.The standard hepatectomy,half liver resection and irregular hepatectomy were performed in NCLCVP1-3 groups,respectively,without CLCVP.In CLCVP1-3 groups,from skin incision to the end of liver resection,CVP was maintained ≤ 5 cm H2 O through adjustment of the position,fluid restriction and iv infusion of nitroglycerin,and norepinephrine was infused simultaneously to maintain mean arterial pressure ≥ 60 mm Hg.In NCLCVP1-3 groups CVP was maintained at 6-12 cm H2O.Intraoperative blood loss and blood transfusion were recorded.Results Compared with NCLCVP1-3 groups,intraoperative blood loss was significantly decreased in CLCVP1-3 groups (P ＜ 0.05).Compared with NCLCVP3 group,the amount of blood transfusion was significantly decreased,the constituent ratio of intraoperative blood loss ＜ 200 ml was increased,and the constituent ratio of intraoperative blood loss ＞ 1000 ml was decreased in group CLCVP3 (P ＜ 0.05).Conclusion CLCVP can decrease the intraoperative blood loss and blood transfusion in patients undergoing irregular hepatectomy.

Objective To study the prevalence and variation of influenza B viruses of Shenzhen. Methods Fifty strains influenza B viruses in Shenzhen from 1994 to 2006 were selected. HA1 gene were amplified by RT-PCR and sequenced. Phylogenetic analysis of HA1 was conducted by MEGA program. Results The influenza B viruses of Shenzhen were divided into Yamagata and Victoria lineage. The two lineages prevailed respectively in different years from 1994 to 2006. The variance of glycosylation site and some mutations of antigenic determinants were detected in the two lineages. Conclusion The viruses of Yamagata and Victoria lineage prevailed respectively in different years in Shenzhen but the mutation rates of the two lineages were slowly.

BACKGROUND: The in vitro amplification is a primary method for harvesting endothelial progenitor cells (EPCs) due to its simple operation and low cost.OBJECTIVE: To isolate EPCs from rabbit bone marrow to further observe the effects of autologous EPCs on promoting vascular endothelial repair.DESIGN, TIME AND SETTING: An open experiment was performed at the laboratory of Department of Internal Medicine, Changzheng Hospital, Second Military Medical University of Chinese PLA between March 2005 and February 2006. MATERIALS: Eight New Zealand rabbits of either gender, aged 6-8 months, weighing (2.5:L-0.5) kg, were included in this study. Rabbit bone marrow was taken for isolation of bone marrow mononuclear cells by density centrifugation. METHODS: Bone marrow-derived mononuclear cells were inoculated at 1×106/cm2 and cultured for 7 days in M199 medium containing vascular endothelial growth factors and basic fibroblast growth factors. EPCs were identified by Dil-labeled acetylated low-density lipoprotein (Dil- Ac-LDL) and FITC-labeled lectin BS-1 staining. Cells that phagocytized Ac-LDL displayed red fluorescence, cells that combined with lectin BS-1 showed green fluorescence, and cells that were labeled with both exhibited orange fluorescence. Expression levels of CD133, CD134, and Flk-lwere detected using immunofluorescent staining and through the use of flow cytometer.MAIN OUTCOME MEASURES: ① Cellular morphology observation. ② Proliferative capacity of EPCs.③EPCs identified by Dil- Ac-LDL and FITC-labeled lectin BS-1. ④ lmmanohistocbemical identification of EPCs. ⑤Flow cytometry identification of EPC surface marker.RESULTS: ① Cellular morphological observation: the newly isolated bone marrow-derived mononuclear cells exhibited a round appearance. Following 72-hour culture, adherent cells grew in colony cluster, presenting with round or irregular appearance, and nuclear division was obvious. By day 7, flaky cell colonies mutually connected together, presenting with shuttle-shaped endothelioid cells.② Proliferative capability of EPCs: in the 2-4 days of culture, EPCs proliferated fast, and the proliferation slowed down thereafter, exhibiting a typical "S" -shaped appearance. By days 6 and 7, EPC proliferation accelerated again, with the absorbance values of 0.58±0.15 and 0.62±0.23, respectively. ③ Over 95% of EPC cytoplasm exhibited red fluorescence after stained with Ac-LDL, appropriately 100% of cytoplasm exhibited green fluorescence after stained with FITC-labeled lectin BS-1, and over 90% of cytoplasm exhibited orange fluorescence after double staining. ④ Immonohistochemistry and flow cytometry results revealed positive expression of EPC surface markers CD133, FIK-1, and CD34.CONCLUSION: Cell population with EPC characteristics can be successfully isolated from rabbit bone marrow by in vitro amplification.

BACKGROUND: Studies have shown that basic fibroblast growth factor has effects on stimulating vessel regeneration and collateral reconstruction. However, administration was performed mostly by peripheral vein, left atrium or percutaneous coronary intervention, and it is difficult to achieve an effective therapeutic concentration in the local myocardium. OBJECTIVE: Based on the property of poly(D, I-lactic-coglycolic acid) (PLGA), to investigate outcomes of inducing neovascularization in the myocardium in combination of basic fibroblast growth factor (bFGF) by ensuring target release of protein growth factor in local tissue. METHODS: PLGA and bFGF were dissolved in dichloromethane. This liquid mixture was rolled into the form of a hollow tube (3.0 mm outer diameter, 2.8 mm inner diameter, 0.1 mm thick, 10 mm length) for further use. The middle third of the left anterior descending coronary artery of mini-swines was ligated, and the local myocardium became dark purple. After the successful establishment by abnormal regional wall motion in the cardiac apex at anterior wall using ultrasound, the mini-swines were assigned to channels and bare scaffolds (BS) group and channels and bFGF-incorporating scaffolds (FS) group. The scaffold was implanted in the myocardium using self-made hollow bit. At 6 weeks, the number of proliferative cells was quantified by immunohistochemical staining. New vessels were quantified utilizing Image-Pro Plus software package in both groups. Quantitative analysis of changes in mass defect percentage was performed by Emory Cardiac Toolbox software combined with single-photon-emission computed tomography. RESULTS AND CONCLUSION: At 6 weeks, number of proliferative cells and the density of new vessels were significantly increased in the FS group compared with BS group(P<0.001). Single-photon-emission computed tomography illustrates that MDP was significantly lower in the FS group compared with the BS group (P < 0.001). Results have suggested that PLGA scaffolds that incorporate bFGF were able to induce angiogenesis and enhance blood-flow perfusion.