Objective To explore the relation between serum Hcy,Cys C levels and type2 diabetic macro-vascular complications and its clinical significance.Methods The serum levels of Hcy and Cys C were measured with immunoturbidimetry in 80 cases of type 2 diabetic patients with macrovascular complications and 80 cases of type 2 diabetes without macrovascular complications,and in 80 healthy subjects which was seleted as control.Results Serum levels of Hcy and Cys C of type 2 diabetic patients with macrovascular complications were (26.42 ± 5.75)μmol/L and (2.30 ±0.40)μmol/L,which were higher than those of patients without macrovascular complica-tions for (15.31 ±3.13)μmol/L and (1.51 ±0.27)μmol/L(t =15.17,14.64,all P <0.05);Moreover,which were also higher than those in the healthy control group for (8.86 ±1.62)μmol/L and (0.85 ±0.14)μmol/L(t =26.29, 30.56,all P <0.05).The serum levels of Hcy and Cys C of type 2 diabetic patients with carotid arteries increased were (32.53 ±6.46)μmol/L and (2.83 ±0.52)μmol/L,which were higher than those of patients without carotid arteries for (18.46 ±3.63)μmol/L and (1.65 ±0.30)μmol/L(t =11.64,12.06,all P <0.05).In patients of type 2 diabetic with macrovascular complications,Hcy was positively correlated with serum Cys C(r =0.617,P <0.05). Conclusion sCD40L and YKL -40 may have important role in the pathogenesis of type 2 diabetic patients with ma-crovascular complications,which can be used as a valuable reference target in the diagnosis and monitoring of vascular complications in elderly type 2 diabetes,and it may be one of the important independent risk factors of patients with type 2 diabetes.

Objective To study the diagnostic value of single detection and combined detection of serum NSE ,CYFRA21‐1 , CA50 ,SCC and CEA in the patients with esophageal squamous cell carcinoma .Methods The single detection and combined detec‐tion of serum NSE ,CYFRA21‐1 ,CA50 ,SCC and CEA levels were measured in 110 cases of esophageal squamous cell carcinoma and 101 health controls in our hospital from October 2013 to October 2015 .The detection results were statistically analyzed . Results The positive rate and expression levels of serum NSE ,CYFRA21‐1 ,CA50 ,SCC and CEA in the esophageal squamous cell carcinoma group were higher than those in the health control group with statistical significance(P<0 .05) .The sensitivity and diag‐nostic efficiency of combined detection of NSE ,CYFRA21‐1 ,CA50 ,SCC and CEA for diagnosing esophageal squamous cell carcino‐ma were 93 .64% and 86 .73% respectively .Conclusion The 5 tumor markers combined detection of serum NSE ,CYFRA21‐1 , CA50 ,SCC and CEA can improve the sensitivity and diagnostic efficiency for diagnosing esophageal squamous cell carcinoma .

Objective To explore the relationship between serum HBeAg、the qualification of HBV DNA and the liver pathologic change in chronic hepatitis B virus (HBV)carriers with normal liver function.Methods Two hundred and forty-four chronic hepatitis B virus carriers with normal liver function were performed pathology examination by Liver biopsy.Meanwhile liver function,HBV DNA level and serological serum markers of B-hepatitis examination were detected.Results Pathology results showed that,of all 244 cases,7 cases was cirrhosis(2.9％),143 for slight CHB (58.6％),32 for moderate CHB (13.1％) and 9 for severe CHB (3.6 ％).And 53 (21.7％)chronic hepatitis B virus carriers were the normal histology morphology.Fony-eight cases (19.7％) were in inflammation stage G≥2 and 54(22.1％) were with fibrosis stage S≥2.For cases with HBV DNA positive,The inflammation and ftbrosis stages in HBeAg negative group were more severe than that in HBeAg positive group (P ＜ 0.05).The fibrosis stages in patients with low HBV DNA level were severe than that in high HBV DNA levels (P ＜ 0.05).No significant differences were observed in the inflammation stage between subjects with high or low HBV DNA level.Conclusion Most chronic HBV carriers with normal liver function were with different degrees of liver inflammation and fibrosis.HBeAg and HBV DNA associated with liver pathological change.

Objective To investigate the clinical value of medical image-three dimensional visible system (MI-3DVS) in percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) for the treatment of hepatolithiasis.Methods The clinical data of 66 patients with hepatolithiasis (55 were from the First People's Hospital of Shunde City and 11 were from the Zhujiang Hospital) were retrospectively analyzed.The images of computed tomography were three-dimensionally reconstructed with MI-3DVS.The location,number,size,shape of the stones were figured out,and the operation strategies of PTCSL were designed according to the types of the disease.The clinical value of MI-3DVS was evaluated according to the operation results and postoperative recovery of patients.All the patients were followed up via telephone or out-patient re-examination.Results Liver,biliary system,stones and blood vessels were three-dimensionally reconstructed with the MI-3 DVS,and the size,number,shape,location of the stones and location,degree,length of the biliary stricture and its anatomical relationship with adjacent blood vessels were clearly displayed.The coincidence rate of planned and actual operations was 95.5％ (63/66).The mean operation time,intraoperative blood loss,rate of stone clearance,complication rate and duration of hospital stay of 63 patients were (117 ± 9) minutes,(18 ± 1) ml,92.4％ (61/66),6.1％ (4/66) and (15 ± 4) days,respectively.All the patients were followed up till September 2012,the median survival time was 16 months (range,1-69 months),and the recurrence rate of hepatolithiasis was 9.1％ (6/66).One patient died of tumor metastasis and multi-organ dysfunction syndrome postoperatively.Conclusion MI-3DVS could effectively improve the safety and efficiency of PTCSL for patients with hepatolithiasis.

Objective To compare the risk of tumor invasion and metastasis under paravertebral block (PVB) combined with general anesthesia versus general anesthesia in the patients undergoing radical resection for lung cancer performed via video-assisted thoracoscope in terms of plasma concentrations of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for lung cancer performed via video-assisted thoracoscope,were randomly divided into 2 groups (n =20 each) using a random number table:general anesthesia group (group G) and PVB combined with general anesthesia (group PG).PVB of T4-7 was performed successfully with local injection of 0.375％ ropivacaine 5 ml before induction of anesthesia.Double-lumen endotracheal tube was placed after induction of anesthesia,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 1％-2％),and intravenous infusion of remifentanil 0.2-0.3 μg · kg-1 · min-1,and intermittent intravenous boluses of atracurium.Before anesthesia and at 24 h after surgery,the venous blood samples were collected for measurement of plasma concentrations of VEGF and MMP-9.Results The plasma VEGF and MMP-9 concentrations were significantly lower after surgery in group PG than in group G.Conclusion PVB combined with general anesthesia significantly decreases the risk of tumor invasion and metastasis in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope in comparison to general anesthesia.

Adult ; Aged ; Aged, 80 and over ; Anthracosis ; complications ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Lung Neoplasms ; complications ; microbiology ; Male ; Middle Aged ; Pseudomonas Infections ; microbiology ; Pseudomonas aeruginosa ; drug effects

Objective To investigate the level of serum retinol-binding protein 4 (RBP4) and related factors in chronic hepatitis C (CHC). Methods Fifty-six patients with CHC (CHC group) and 35 healthy volunteers (control group) were selected. Serum RBP4 level was measured by ELISA method.Fasting blood glucose ( FBG ), triglycerides (TG), total cholesterol ( TC ), alanine aminotransferase (ALT),γ-glutamyl transpeptidase (γ-GT) were measured, HCV-RNA level was tested by qualitative polymerase chain reaction(q-PCR). Results There were no significant difference in FBG, TC,TG, γ-GT between two groups (P ＞ 0.05 ). Serum RBP4 level in CHC group [(33.38 ± 6.43 ) mg/L] was higher than that in control group [(26.11 ± 3.35) mg/L](P＜ 0.01),the CHC patients with ALT normal (26 cases) had significantly higher RBP4 level [( 38.96 ± 4.09) mg/L] compared with ALT abnormal [30 cases, ( 28.53 ± 3.43 ) mg/L](P ＜ 0.01 ). ALT level was negative with RBP4 in CHC group (r = -0.6368, P ＜ 0.05 ). Conclusion Serum RBP4 level is significantly associated with CHC and negatively correlated with ALT level,but not associated with FBG, TC,TG, γ-GT and HCV-RNA.

As a method of choice in the treatment of ampulary carcinoma,pancreaticoduodenectomy often demands open procedure.With the development of minimally invasive techniques,laparoscopic pancreaticoduodenectomy was realized in recent years.Because laparoscopic pancreaticoduodenectomy is high technique-demanding,its popularization is restricted.With flexible robotic arnls and three-dimensional imaging,Da Vinci surgical system has overcome the shortcomings of traditional laparoscope to some extent.In March 2010.a 60-year-old female patient with ampulary carcinoma underwent Da Vinci surgical system-assisted pancreaticoduodenectomy at the Southwest Hospital.The mean operation time and blood loss were 490 minutes and 450 ml respectively,and no blood transfusion was required.Out-of-bed activity began shortly after the operation.The gastric tube was removed and fluid diet was given on postoperative day 3.The patient was discharged on postoperative day 10 without incidence of complications.The Success of this case preliminarily demonstrats that Da Vinci snrgical system-assisted pancreaticoduodenectomy is safe and feasible.

To examine the relationship between genetic variants in the interleukin-6 receptor gene and obesity. The result showed that the carriers of Asp358 homozygotes had higher risk in developing obesity when compared with Ala358 homozygotes (OR = 1.32,95% CI 1.07-1.68, P = 0. 041). Interleukin-6 receptor gene pulymorphism was significantly associated with obesity.

Objective To observe the clinical efficacy of Wenshen Xiaochuan Paste Recipe (WXPR) in preventing bronchial asthma, and to explore the mechanism. Methods Eighty patients were randomly divided into treatment group and control group. Each group had 40 patients. The control group was treated by conventional western medicine such as inhalation of steroid, and the treatment group was given oral use of WXPR based on the treatment for the control group. Treatment for both groups covered 60 days, and the follow-up lasted 10 months. The clinical outcomes included the clinical efficacy and immune indexes of peripheral blood T lymphocyte subsets CD3+, CD4+, CD8+and CD4+/CD8+ratio, and the serum IgE level. Results (1) After treatment and 12 months later, the scores of asthma control test (ACT ) in the two groups were increased obviously as compared with those before treatment, and there were statistically significant differences (P<0.05 or P<0.01) . The differences of ACT scores between the two groups were insignificant after treatment ( P>0.05) , but were significant ( P<0.05) 12 months later. (2) Within one year after treatment, the frequency of acute asthma attack was decreased in both groups (P<0.05 compared with that before treatment), and the treatment group had better effect on decreasing the attack frequency than the control group (P<0.05). (3) After treatment, the serum IgE, CD4+level, and CD4+/CD8+ ratio were decreased significantly, while CD8+ level was increased in the treatment group, and there were statistically significant differences ( P<0.05 compared with those before treatment). However, the differences of immune indexes in the control group were insignificant before and after treatment ( P>0.05). The improvement of immune indexes in the treatment group was superior to that in the control group ( P<0.05). Conclusion WXPR has good clinical efficacy in preventing and treating bronchial asthma. The mechanism is related with the inhibition of airway inflammation and improvement of immune function probably through regulating T lymphocyte subsets and lowering serum IgE level in asthma patients.