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 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.

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.

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.

The purpose of this study is to investigate the penetration effects and mechanism of N-arginine chitosan (ACS). This novel transdermal enhancer with a mimetic structure of cell-penetration peptides was synthesized by introducing hydrophilic arginine groups to the amino-group on chitosan's side chain. The structure of ACS was confirmed by FT-IR, 1H NMR and element analysis. In addition, attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) was used to study the protein conformation and the water content of stratum corneum, and the result suggested that ACS can change the orderly arrangement of the molecules in the stratum corneum, making the stack structure of keratin become loose. And ACS can increase the water content of the stratum corneurn. Inverted fluorescence microscope and flow cytometry were used to examine penetration effect of ACS on Hacat cell. The result confirmed that the uptake of ACS was enhanced with increased substitution degree of arginine by 4-8 folds compared to chitosan. In vitro penetration studies on three electrical types of drugs were carried out using three model drugs of negatively charged aspirin, positively charged terazosin and neutral drug isosorbide mononitrate by the method of Franz diffusion cells. The results showed that ACS has obviously penetration of the negatively charged drug aspirin, and certain penetration of neutral drug issorbide mononitrate, but inhibition of positively charged terazosin. In vivo imaging technology research results show that the ACS can significantly enhance the fluorescence intensity of morin, which is the auto-fluorescence anionic drug. These obtained results suggested that ACS, as a promising transdermal enhancer, can change the structure of the keratinocytes and analog penetrating peptides promote absorption, but have certain selectivity for the drug.

Objective Design and synthesize short hairpin RNA (shRNA) expression vector of RNA for specific silencing of heparanase (HPA) gene,screened plasmid which silence effects is the best.Observe the function of ceil invasion after inhibiting the expression of HPA in cervical carcinoma cell lines (HeLa).Methods The genomic sequence of HPA gene was retrieved from GenBank database.Designed four pairs of specific oligonucleotide sequences and a negative control according to the shRNA design principles.They were inserted into the vector pYr-1.1,vectors,and transfected into HeLa cells via lipofectamine.Reverse transcription (RT)-PCR and immunofluorescence were employed to detect the expression of HPA gene in the transfected cells at the mRNA and protein levels,respectively.The plasmid were screened and transfected into HeLa cells,then transwell small room stromal invasion experiment were employed to observe the cervical carcinoma cell invasion.Results RT-PCR results of transfected HeLa cells shown that the mRNA amplification multiples were 0.54 ±0.05 in the HPA-592 group,0.89 ±0.18 in HPA-995 group,0.82 ±0.22 in the HPA-1351 group,0.91 ±0.47 in HPA-1658 group.While,they were 1.31 ±0.72 and 1.09 ±0.16 in negative control and blank control group,respectively.Green fluorescence was visible in the cytoplasm,which indicated that the HPA protein was expressed in the cytoplasm,of them the weakest green fluorescence in the HPA-592 group.The relative numbers of invasive cells among the HeLa cells were as follows:182 ±6 in the blank control group,258 ± 17 in the negative control group,and 44 ± 4 in the HPA-592-specific interference group(P ＜ 0.01).Conclusion Successfully screened shRNA vector targeting human HPA,efficiently inhibit expression of HPA gene when transfected into HeLa cells,and significantly reduced the invasion capacity of cervical carcinoma cells.

Objective To assess the factors that influence the accuracy of real-time continuous glucose monitoring system (RT-CGM).Methods A total of 79 diabetic patients wore RT-CGM for three days continuously while calibrating by interphalangeal glucose values 4-8 times a day.We counted matching rate of interphalangeal glucose values and RT-CGM probe value,and analyzed correlation of the matching rate with MAGE,SDBG,MBG,AUC10,AUC3.9,and NGE by Pearson correlation analysis and multiple linear regression analysis.Then we grouped corresponding match rate by MAGE and MBG,compared the difference among groups.Furthermore,we analyzed correlation of RT-CGM probe values of all-day,fasting-postprandial,and nighttime and the corresponding interphalangeal glucose values by Pearson correlation analysis.Results Pearson correlation analysis showed that the matching rate was negatively correlated with the MAGE,SDBG,MBG,and AUC10.MAGE,MBG,and NGE were in the regression equation.MAGE ＜3.9 mmol/L,matching rate was 81％,3.9 ≤ MAGE＜7 mmol/L,matching rate was 67％,MAGE≥7 mmol/L,the matching rate was 52％,the difference among 3 groups was statistically significant (P＜0.01).MBG＜7.8 mmol/L,matching rate was 78％,7.8 ≤ MBG＜ 10 mmol/L,matching rate was 68％,MBG ≥10 mmol/L,the matching rate was 57％,the difference among 3 groups was statistically significant (P ＜ 0.01).When Youden index was 0.409 and MAGE was less than 3.745 mmol/L,the match rate was more than 75％.When Youden index was 0.369 and MBG was less than 8.38 mmol/L,the matching rate was more than 75％.The correlation coefficients of all day,fasting,postprandial and nighttime probe values and the corresponding interphalangeal glucose values were 0.958,0.963,0.944,and 0.965 (all P＜0.01).Conclusions The probe values show good consistency with the interphalangeal glucose values,are able to be used for blood glucose assessment.Blood glucose fluctuations influences accuracy of RT-CGM,the smaller the blood glucose fluctuations,the smaller the mean glucose concentration,the smaller the effective blood glucose fluctuations in frequency,the higher would be the accuracy.It seems to be more effective to do calibration during fasting and nighttime.