BACKGROUND:Many diabetic patients get microcirculation disturbance due to abnormal hemorheology In a long-term angiopathy,which finally induces severe complications.OBJECTTVE:TO observe the influence of Yishen decoction on hemorheology in patients with diabetes mellitus and diabetic nephropathy and compare with the healthy controls.DESIGN:Controlled observational experimentSETFING:First Clinical Medical College,Harbin Medical University.PARTICIPANTS:Seventy-six inpatients with diabetes mellitus were enrolled at Department of Integrated Traditional and Westem Medicine,First Clinical Medical College,Harbin Medical University from January 1998 to December 2000 as diabetes mellitus group.Sixty-five inpatients with diabetic nephropathy were selected at the same hospital from January 1994 to February 2001 as diabetic nephropathy group.130 healthy subjects,who did body examination,were selected at the same hospital in 1993 as control group,including 98 males and 32 females,with an average age of(42±12)years.All subjects in the three groups knew the program and agreed to participate in the experimont.METHODS:The patients received conventional treatment combined with Yishen decoction containing herba epimedii,herba leonuri,astragalus mongholicus,each 20 g,barbary wolfberry fruit,solomonseal rhizome,gold theragran,dioscorea root,rhubarb,each 15 g,cowherb seed 25 g,as well as sanguisuge 0.8 g(taken medicine after mixing with water).These Chinese herbs were decocted at a simmer(200 mL),taken in the morning and evening respectively for 4 weeks.2 mL venous blood was collected from fasting subjects in the case groups.Hemorheology was measured before and after treatment in the case groups,whereas in body examination in the control group MAIN OUTCOME MEASURES:Hemorheological indexes.RESULTS:A total of 76 subjects with diabetes mellitus,65 subjects with diabetic nephropathy and 130 healthy subjects were involved in the result analysis.①Whole blood viscosity,plasma viscosity and plasma fibrinogen levels were obviouslv higher in the subjects of the diabetes mellitus group compared with the control group before treatment(P＜0.05-0.01). These changes were more significant in subjects of the diabetic nephropathy group(P＜0.01).Hematocrit and erythrocyte sedimentation equation K value were obviously higher in the diabetic nephropathy group than the control group(P＜0.01)Whole blood viscosity level,hematocrit and erythrocyte sedimentation equation K value were markedly hiaher in the diabetic nephropathy group than the diabetes mellitus group before treatment(P＜0 05-0.01). ②Whole blood viscosity and plasma viscosity levels,hematocrit and erythrocyte sedimentation equation K value were remarkably decreased in the case groups and most recovered to normal(P＞0.05).CONCLUSION: Yishen decoction can ameliorate the hemorheology of diabetes mellitus and diabetic nephropathy patients.

Objective To explore the diagnostic value of DDR in synovial sarcoma and compare with the traditional X-ray photography. Methods The DDR manifestation of synovial sarcoma patients which confirmed by operation in our hospital was contrasted with the traditional X-ray photography. Results The DDR performance of synovial sarcoma in soft tissue tumors,small bone destruction around the joints and soft tissue swelling,calcification of tumors are superior to traditional X-ray photography. Conclusion The DDR has better X-ray image quality than traditional X-ray,which can provide more diagnostic information and higher diagnostic value in this disease.

Objective To explore the principle of diagnosis and treatment of intermittent claudication caused by lumbar spine disease combined with lower extremity arteriosclerosis obliterans. Method Eighteen cases of patients with intermittent claudication caused by lumbar spine disease combined with lower extremity arteriosclerosis obliterans, using MRI and MRA, to determine the main reason due to of disease, to take the treatment for the cause. Results The patients were followed up for 7 to 24 months, average (16.0 ± 4.7) months. Assessed according to the modified MacNab criteria of clinical efficacy, excellent in 7 cases, good in 8 cases, general in 3 cases,satisfactory rate was 83.3%(15/18). Intermittent claudication were improved with all patients, walking distance of more than 1000 meters, relief rate was 100%. Postoperative ankle brachial score(0.90±0.54 ) was obviously increased compared with preoperative average(0.58±0.36), there was significant statistical difference(P<0.01). All cases were not amputee due to circulation disturbance. Conclusion The diagnosis and treatment of intermittent claudication caused by lumbar spine disease combined lower extremity arteriosclerosis obliterans,it is necessary to collect a history of serious and careful investigation,combined with imaging, can accurately determine the responsibility of lesions, target to give the appropriate treatment, can get a good effect

BACKGROUND:Currently, there are large numbers of studies related to the association between colagen type I alpha1 (COL1A1) Sp1 polymorphism and bone mineral density and fracture risk, but the results are inconsistent. OBJECTIVE:To evaluate the impact of the COL1A1 Sp1 polymorphism on bone mineral density and fracture by using the Meta-analysis. METHODS:We comprehensively searched the eligible studies for the present meta-analysis through MEDLINE, PubMed, EMBASE databases. Pooled odds ratios and 95% confidence intervals of Sp1 polymorphisms for bone mineral density and fracture risk were obtained, with attention to study quality and publication bias. RESULTS AND CONCLUSION:A total of 32 studies met the inclusion criteria, among which, 22 studies evaluated the Sp1 polymorphism and fracture risk. Significant associations were found in five genetic models. In the stratified analysis by region, the same results were found in the Europeans but not Americans and Asians. Thirteen studies evaluated the Sp1 polymorphism and low bone mineral density risk. A similar result was obtained. However, the analysis of bone mineral density data showed an increased relation between Sp1 polymorphism and low bone mineral density in Europeans and Americans but not in Asians. Overal, the current meta-analysis concludes that the COL1A1 Sp1 polymorphism is associated with low bone mineral density and fracture risk, especialy in Europeans. However, susceptibility to them varies markedly among populations from different regions.

BACKGROUND:Several studies have attempted to apply mouse nerve growth factor to local lesions of peripheral nerve and found that local injection of mouse nerve growth factor can promote nerve recovery, which is superior to systematic application. OBJECTIVE:To evaluate the clinical effects of gelatin sponge infiltrated by mouse nerve growth factor in the repair of peripheral nerve injury. METHODS:Thirty-six patients with single peripheral nerve injury, including 16 males and 20 females, aged 18-48 years, were randomly divided into two groups: 18 patients in case group underwent debridement and neuroanastomosis, and then the injured nerve was wrapped by gelatin sponge which was infiltrated by mouse nerve growth factor and folowed by plaster fixation, anti-inflammatory therapy, neurotrophy and circulation improvement therapy; the other 18 patients in control group were treated only with debridement and neuroanastomosis and other conventional therapies. At 4 weeks after treatment, electrophysiological examination was performed. In addition, sensory and motor function of the distal end of injured nerve was evaluated at 6 months after treatment. RESULTS AND CONCLUSION: Sensory evoked potential and motor evoked potential showed that the recovery rate was 78% (n=14) and 83% (n=15) respectively in the case group, while 57% (n=10) and 66% (n=12) in the control group. There was significant difference between the two groups (P < 0.05). The total effective rate was 94.4% (n=17) in the case group and 83.3% (n=15) in the control group, which were statisticaly better in the case group than the control group (P < 0.05). These findings indicate that it is significantly effective to treat peripheral nerve injury by gelatin sponge infiltrated by mouse nerve growth factor that has good biocompatibility.

10mm in diameter) which were mostly non-functional ones(63.3%), and 12 microadenomas(≤10mm in diameter) which were mostly functional ones(91.7%). Only macroadenonas had abnormal imaging in DR, DSA, while microadenomas had no change in above radiological examinations. Microadenomas appeared in low density on CT or hypointensity in MRI as the direct signs, and CT, MRI contrast enhancement raised its display rate greatly. Macroadenomas showed various contrast in the post enhancement CT or MRI. Contrast enhancement of CT or MRI were capable of delineating size, location, extent of the tumor and the remaining intact pituitary tissue. Conclusion MRI Gd-DTPA contrast enhancement scaning is the first-selecting method to diagnose the pituitary adenomas especially the clinical suspected cases.

Objective To investigate the relationships between genetic polymorphism of CYP2A6 alone or in combination with smoking and hereditary susceptibility to bladder cancer.Methods Based on case-control study,CYP2A6*4 was determined by the nested polymerase chianreaction(nPCR)in 186 patients with bladder cancer and 192 nontumorous controls.The relations between the genetypes of CYP2A6*4 alone or combinated with smoking and bladder cancer was estimated with the X2 test and logistic regression model.Results In the case subjects,the number of the wil/wil genetype was 168,the number of the wil/del genetype was 13,and the number of the del/del genetype was 5.In the control subjects,the number of the wil/wil genetype was 150,the number of the wil/del genetype was 32,and the number of the del/del genetype was 10.The frequency of CYP2A6 del allele was significantly lower in the case Subjects(9.68%)than the controls(21.88%,P＜0.05,OR:0.383).When eombinated with smoking,the risk of bladder cancer in smokers was significantly higher than nonsmoker(P＜0.05,OR=2.322).In smokers,the frequency of CYP2A6 del allele was significantly lower in cases(7.88%)than controls(28.00%,P＜0.05,OR=0.221).In smoking people,the one with CYP2A6 del genotype had a lower risk of bladder cancer than the one with CYP2A6 wild genotype(OR=0.221,95%CI:0.092,0.534).Conclusions Genetic polymorphisms of CYP2A6 are associated with the susceptibility to bladder cancer and have interaction with smoking in carcinogenesis of bladder cancer.Deficient CYP2A6 activity to genetic polymorphism mayreduee bladder cancer risk in smokers.

Objective To study the relationship between cyclooxygenase 2 (COX-2) polymor phisms and the susceptibility of bladder cancer.Methods Polymerase chain reaction restricted frag ments length polymorphism (PCR-RFLP) and the primer introduced restriction analysis (PIRA-PCR)assay were used to genotype the COX-2-765G/C, 1195G/A and 8473T/C polymorphisms in a case control study of 180 bladder cancer cases and 180 cancer free controls in a Chinese population.Re stilts The distribution of the genotype frequencies of 765G/C and 1195G/A were not statisticallydifferent between the cases and controls (P=0.582 for-765G/C and P=0.270 for-1195G/A).Poly morphisms of COX 2-8473T/C were associated with the susceptibility to bladder cancer.The individ uals with the 8473C allele had a decreased risk of bladder cancer (OR=0.56,95% CI=0.35 0.88).Conclusions Polymorphisms of COX-2-765G/C and-1195G/A are not associated with the suscepti bility to bladder cancer.However,COX-2-8473T/C can reduce the risk of bladder cancer.

Objective To analyze the clinical effectiveness of using marginal donor kidney in living kidney transplant. Methods From November 2005 to June 2011,274 cases of living kidney transplant were performed in the First Affiliated Hospital of Zhengzhou University.The cases were divided into the marginal donors group ( Donor ages over 60 years old,suboptimal renal anatomy or physiology) of 66 cases and standard donors group of 208 cases.The clinical data were retrospectively analyzed.The criteria of marginal donors were as follows:36 cases of donors with age over 60 yrs (6 cases with renal cysts and 1 case with renal calculus),22 cases of renal cysts ( with diameter range from 4 mm to 40 mm ),4 cases of renal calculus (with diameter range from 3 mm to 6 mm),4 cases of low GFR (under 35 ml/min.The mean recipients' serum creatinine before surgery and after surgery on day 3,day 7,month 1,month 3,month 6,month 12,related complications,the rate of acute rejection and delayed graft function,1 year,3 year recipient/kidney survival were compared between the 2 groups,respectively. Results The serum creatinine levels in the marginal donor group and standard donor group were (242.7 ± 132.2 vs 185.6 ± 148.4) and ( 156.7 ±86.8 vs 122.2 ± 136.8 ) on day 3,day 7 respectively ( P ＜ 0.05 ).Nevertheless,there were no significant differences between the 2 groups in recipients' serum creatinines before surgery and after surgery on month 1,month 3,month 6,month 12,peri-operative complications,the rate of acute rejection and delayed graft function,1 year,3 year recipient/kidney survival (P ＞ 0.05). Conclusions Healthy old donors and donors with renal cyst (the diameter of renal cysts under 40mm) should not be the barriers to organ donation.To those living donors with low GFR,we should consider of donor age,donor/recipient body weight,donor/recipient body surface area and whether we could deal with the problem by surgical operation.Donor with renal calculus should be carefully evaluated.

We evaluated the patient in the early,advanced or healing phase of the disease by MRI in the treatment of chronic brucellosis spondylitis and to guide the clinical treatment.MRI images of 40 patients with clinically diagnosed chronic brucellosis spondylitis were analyzed retrospectively.The imaging findings of early,advanced and healing patients were summarized.MRI showed abnormal signals in the vertebral body,intervertebral disc,paraspinaI and psoas muscle.It is early stage if the intervertebral space was normal,and advanced stage if combined with interverbral space stenosis.It demonstrated short T1 and short T2 signal or similar to the normal vertebral body,combined with intervertebral space stenosis,for the healing stage.According to the specific imaging manifestations of chronic brucellar spondylitis in the course of disease development,it is possible to evaluate the clinical stage of the disease and guide the rational selection of clinical treatment.