BACKGROUND: At present, the relationship between diabetic nephropathy and osteoprotagerin remains poorly understood. OBJECTIVE: To investigate the correlation between bone mineral density (BMD) and serum osteoprotagerin changes in patients with 2 type diabetic nephropathy. METHODS: Totally 104 patients with 2 type diabetes were divided following 5 groups according to glomerular filtration rate: simple diabetes, mild renal injury, moderate renal injury, severe renal injury, and renal failure groups. Additional 20 healthy people were selected as the control group. The level of serum osteoprotegerin was measured by ELISA. Meantime, levels of serum calcium, phosphonium, alkaline phosphatase, creatinine, urea nitrogen, and glycosylatad hemoglobin were measured by. the automatic biochemistry analyzer. The bone mineral density of entopic L_(2-4) was determined by dual X-ray bone density equipment. The whole data was analyzed by multiple regression correlation analysis. RESULTS AND CONCLUSION: The level of serum osteoprotegerin in patients with diabetic nephropathy was obviously greater than that of the healthy people (P < 0.05), but BMD of the mild renal injury, moderate renal injury, severe renal injury, and renal failure groups was obviously lower than that of the healthy people (P < 0.05). Generally, the worse renal function accompanied by higher osteoprotegerin level, and lower BMD. There was a negative correlation between ostaoprotegerin level and BMD in patients with diabetic nephropathy (r=-0.497, P < 0.01). However, the relationships between osteoprotegedn level and diabetic duration (r=0.566, P < 0.01), serum creatinine level (r=0.772, P < 0.01), serum urea nitrogen level (r=0.708, P < 0.01), serum phosphonium level (r=0.329, P < 0.01), or serum intact parathyroid hormone level (F=0.702, P < 0.01) were positive. Meantime, the serum phosphonium level had negative correlation to serum calcium level (r=-0.505, P < 0.01). it demonstrated that when the renal function got worse in diabetic nephropathy patients, the serum osteoprotegerin level was increasing accompanied by BMD decreasing. The osteoprotegerin level presents a negative correlation to BMD and serum calcium level, but positive to diabetic duration, serum creatinine, serum urea nitrogen, serum phosphonium and serum intact parathyroid hormone levels.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Aged ; Cholecystectomy ; Chondrosarcoma ; metabolism ; pathology ; surgery ; Female ; Gallbladder ; chemistry ; pathology ; surgery ; Gallbladder Neoplasms ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Keratin-3 ; metabolism ; S100 Proteins ; metabolism

OBJECTIVE To acquaint pathogen distribution of infection and present drug-resistance conditions of the commonly encountered pathogens.METHODS The statistics of the antimicrobial susceptibility testing of all the clinical isolates from Jan to Nov 2006 in our hospital was condncted.RESULTS Totally 1850 bacteria strains were isolated.From them 620(33.51%) were Gram-positive bacteria,1230(66.49%) were Gram-negative bacteria,25.8% of which were Escherichia coli,8.1% of which were Staphylococcus epidermidis,7.5% were Klebsiella pneumonice and 7.2% were MSSA;Statistics of drug sensibility test suggested,Gram-positive cocci isolated from the clinical issue be highly sensitive to vancomycin,teicoplanin and nitrofurantoin.They were still sensitive to rifampicin.and lower sensitive to other antibiotics.Gram-negatives were high sensitive to imipenem.They were still sensitive to piperacillin/tazobactam and the third-generation cephalosporins.CONCLUSIONS The drug resistance of the isolates is severe.It is suggested that there be ungent need for surveillance of bacterial resistance and rational use of antimicrobial agents be emphasized during clinical therapy.

Objective To investigate the effects of compound radix angelicae sinensis injection on oocyte and segmentation sphere injured by subacute exposure to diesel exhaust particles (DEP) in female mice. Methods Two hundred and ten 21-day-old ICR female mice were randomly divided into 5 groups: the control group (group A), DEP group (group B), DEP+low-dose group (group C),DEP±middle-dose group (group D) and DEP+high-dose group (group E). There were 42 mice in each group. The mice were inoculated with 30 μ1 DEP suspension at 12.0 μg/μl (group B-E) or the same volume of vehicle (PBS, group A) on pharynx posterior wall by sample pipettor beginning at day 21 and repeated every 3 days for 4 times. The mice were sacrificed three days after the last exposure.Compound radix angelicae sinensis injection containing 75 (group C), 150 (group D) and 300 (group E)grams of crude drug, respectively, which was intraperitoneally administered for each mouse daily from the day of the first DEP inoculation till the day before sacrifice, consecutively for 12 days. The general conditions were observed, and the body weight and ovary/body weight ratio were tested. Superoxide dismutase (SOD) activity, malondialdehyde (MDA) and reduced glutathione (GSH) contents in ovarian tissues were assayed. Rates of survival, germinal vesicle breakdown, extrusion of the first polar body and in-vitro fertilization, and quantity of mitochondrial DNA for oocytes were investigated.Ultrastructural changes of oocytes were observed. Results ( 1 ) No significant difference of the body weight was found among all the groups (P＞0. 05). The ovary weight, ovary/body weight ratio, ovary SOD and GSH content were significantly decreased in groups B [( 1.5 ± 0. 6) mg, ( 7.2 ± 2. 5) × 10-5 ,(192. 10±23.67) nU/mg prot and (262.40 ± 31.60) nmol/mg prot], and C [( 1.7 ± 0. 2) mg,(8.9±0.6)× 10-5, (198.92±24.27) nU/mg prot and (271.66±14.58) nmol/mg prot] and D [(2. 1±0. 2) mg, (9. 8±1. 1)×10-5, (214. 37±27. 19) nU/mg prot and (285. 93±9. 55) nmol/mg prot] as comparing to groupA [(3. 3±1. 5) mg, (15.4±7.3)×10-5, (292. 30 ± 40. 03) nU/mg prot and (367.98±24.59) nmol/mg prot (P＜ 0. 05 or P＜0.01); and significantly increased in group E [(3. 7±1.1) mg, (18. 7±5. 4)× 10-5, (279. 10±12. 63) nU/mg prot ]and (353. 59±10. 61) nmol/mg prot]comparing to group B (P＜0. 01). MDA content was signi-ficantly increased for groups B, C and D [(3. 88±0.35) nmol/mg prot, (3. 62 ± 0. 19) nmol/mg prot and (2. 63 ± 0. 34) nmol/mg prot] comparing to group A [(2. 18±0. 44) nmol/mg prot](P＜0. 05 or ＜0. 01, respectively); and significantly decreased for group D and E (2. 35±0. 37 nmol/mg prot) comparing to group B (P＜0. 01). (2) In all observed time points, oocyte survival rate in group B and C, extrusion rate of the first polar body and in-vitro fertilization rate in group B, C and D were significantly lower than in group A (P ＜ 0. 05 or ＜0. 01), and all those in group E were significantly higher than in group B (P＜0. 05). Rates of germinal vesicle breakdown were 100% in all five groups. (3) Logarithmic values of mitochondrial DNA copy numbers in group C, D and E were significantly lower than in group A; whereas significantly higher in group C and D than in group B (P＜0.01). (4) Normal appearance for oocytes in group A was seen. In groups B and C, a number of cytoplasmic organelles were dramatically degenerated in part of the oocytes and some necrotic oocytes were seen. Large body of mitochondria in the oocytes swelled and vacuolized in group D, while such changes dincished to a lesser extent and scope in group E. Conclusions Compound radix angelicae sinensis injection exerts a favorable curative and protective effect on oocyte and segmentation sphere injured by subacute DEP exposure in female mice.

Objective To evaluate the efficacy and adverse reaction of three-dimensional conformal radiation therapy (3D-CRT) combined with chemotherapy of paclitaxel in treatment of brain metastases from breast cancer in the elderly.Methods The 50 patients were randomly divided into observation group (n=26,radiation combined with chemotherapy) and control group (n= 24,simple radiation).In the early stage,both groups received common two-dimesional conformal radiation therapy.The total dose (DT) of whole brain irradiation was 30-40 Gy.In the later stage,the reduced field for the local lesion of brain metastases would be altered to 3D-CRT for the post period with 2 Gy 5 times a week.DT was added from 10-24 Gy up to total DT of 50-64 Gy.The patients were given paclitaxel 65-85 mg/m2 by intravenous drip at 1st and 8th day with synchronization of 2-4 weeks,having paclitaxel chemotherapy of 2-4 circle,28 days a circle.After 2 month treatment,the efficacy and adverse effects of the two groups were observed.follow up for 2 years,the long-term efficacy and survival rate were evaluated.Results The effective rate was 76.9% in observation group and 45.8% in control group,respectively (x2 =5.120,P＜0.05) and the KPS score was 80.8% and 54.2%,respectively.The quality of life was improved in observation group versus control group (x2 =4.059,P＜0.05).Compared with control group,hypoleukemia was significant in observation group (P＜0.05).The complications such as nausea and vomiting,hepatic dysfunction were more in observation group than in control group,but there was no statistical significance between two groups.There was statistic ally significant difference in 2-year survival rate between two groups (x2= 4.7260,P＜0.05).Conclusions The 3D-CRT combined with paclitaxel chemotherapy is a prefered choice for locally advanced brain metastases from breast cancer.More side effects and adverse reaction are observed in observation group.However,all the patients could tolerate them.It is worthy of popularization and application.

Objective To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) in patients with relapsed and refractory malignant lymphoma. Methods The clinical data of 10 patients (6 males and 4 females) with relapsed (4 cases) and refractory (6 cases) malignant lymphomas who received AHSCT in General Hospital of Jinan Military Command from August 2011 to June 2015 were analyzed retrospectively. The median age was 34 years (20 ˉ50 years); 5 cases of Hodgkin lymphoma, 5 cases of non-Hodgkin lymphoma. Before transplantation, all patients received several courses of radiotherapy or chemotherapy. High dose of cytoxan combined with G-CSF were used to mobilize peripheral hematopoietic stem cell, and preconditioning regimen included BEAM, CBV or TBI. Results The median mononuclear cell of 10 patients was 7.385 × 108/kg. Complete remission was achieved in 8 patients after transplantation, and 2 cases relapsed. Median follow-up time was 18 months (20ˉ50 months). The overall survival rate and disease-free survival rate both were 80%(8/10). All patients had nausea, vomiting, diarrhea, oral mucositis and other adverse reactions, which could be tolerated. Conclusion ASHCT is an effective and safe method for treatment of relapsed and refractory malignant lymphomas.

Objective Color doppler ultrasonography of chronic Keshan disease (CKD) was evaluated to provide evidences for clinic diagnosis of the disease. Methods From September to Novermber 2009, according to "Diagnostic criteria of Keshan disease" (GB 17021-1997), 64 cases of CKD were randomly sampled from five Keshan diseased districts in Shandong province, Zoucheng, Sishui, Yishui, Wulian, Jvxian, and Pingyi as patient group. Thirty four healthy volunteers being checked up by Shandong Institute for Endemic Diseases Control and Research were put in control group. All the subjects were examined with Color doppler ultrasonography. The indexes of cardiac structure, left ventricular (LV) systolic function and LV diastolic function were measured.Results Left atrial internal diameter, LV end-diastolic internal diameter, LV end-systolic internal diameter, right ventricular diameter, aorta diameter, right atrial transverse diameter, right atrial long diameter and left ventricle mass of the patient group[(35.38 ± 6.89), (61.57 ± 8.61), (45.39 ± 10.29), (17.22 ± 3.79), (28.69 ± 2.81),(38.00 ± 6.05), (42.68 ± 8.65)mm, (283.22 ± 103.12)g] were higher than that of control group[(26.70 ± 3.27),(45.41 ± 4.93), (26.91 ± 4.35), (13.76 ± 2.27), (24.09 ± 2.89), (31.50 ± 3.32), (35.82 ± 3.14) mm, (156.03 ±39.86)g, t = 6.93, 10.09, 9.98, 4.87, 7.64, 5.81, 4.46, 6.90, all P＜ 0.05]. The LV ejection fraction and fractional shortening of the left ventricular of the patient group[(49.25 ± 14.33)%, (26.11 ± 9.17)%] were lower than that of control group[(73.88 ± 4.04)%, (42.88 ± 3.62)%, t = - 9.79, - 10.22, all P＜ 0.05]. Diffuse hypokinetic motion of the left ventricle reduced in 95% (61/64) of CKD patients, and 5% (3/64) of CKD patients had segmental LV dyskinesia. Seventy five per sent(48/64) of the patients accompanied with mitral regurgitation, and 39% (26/64) of these cases accompanied with tricuspid regurgitation. Meaningful Mitral or tricuspid regurgitation was not found out in control group. Conclusions The CKD patients' bore of atrio-ventricular cavity and LV mass are enlarged, and their motion of ventricle is reduced or partly reduced. They have poor heart function. Mitral regurgitation are more than tricuspid regurgitation. Color doppler Ultrasonography is important in diagnosis of chronic Keshan discase.

BACKGROUND: At present, there is few reports about using middl ecerebral artery obstraction (MCAO) model to determine the repair course of cerebral infarction during functional training.OBJECTIVE: To determine the effect of electro-stimulating therapy on promoting the rehabilitation of cerebral infarction and its mechanism.DESIGN: Randomized controlled study.SETTING: Animal Center and Electron Microscope Laboratory of Zhongshan University.MATERIALS: The experiment was carried out in the Animal Center of Zhongshan Medical College and Neurological Laboratory of the First Affiliated Hospital of Zhongshang University from January 2002 to December2004. A total of 200 healthy males SD rats, aged 3 months and weighing 90-110 g, were selected. According to the following criteria: SBP＞180mmHg (1 mmHg=0.133 kPa), BWT score of MCAO models which were reproduced by RHRSP was 1, totally 180 RHRSP were admitted to the research and divided into electro-stimulating therapy group (n=90) and control group (n=90).METHODS: Electro-stimulating was given to four accupuncture points of the paralyzed limbs of rats. The electro-stimulating treatment was given about 30 minutes once a day. And a therapy course was 6 days, and between two therapy courses there was one-day break. At the end of 1st, 3rd,6th and 9th therapy courses, the brain of motor function and tissue in marginal zone of cerebral infarction were assayed as follow: [1] The beam walking test (BWT, 1 as severe disorder and 7 as normal). [2] Electron microscope. [3] Astrpcyte glial fibriliary acidic protein, neurofilament protein and microtubule-associated protein-2 were assayed with immunohistochemistry. Five fields of each slice in the two groups were randomly selected to add up the positive cell number. Totally 30 positive cells of glial fibriliary acidic protein was selected to assay average absorbency (A) of positive cellular plasm. [4] Apoptosis of neurons were observed with in situ end-labeling (ISEL). [5] Brain-micro vasodilatatio was observed according to the criteria of one complete microvessel account under the field.MAIN OUTCOME MEASURES: [1] Scores of motor function; [2] Ultramicrostructure of cranial neurons and astrocyte; [3] Cranial glial fibriliary acidic protein, neurofilament protein and microtubule-associated protein-2;[4] Apoptosis of neurons; [5] Diastole of cerebral microvessel.RESULTS: Totally 180 rats were eligible while 20 rats were excluded because of their BWT score＞1 after MCAO operation. [1] Results of beam walking test (BWT): Functional recovery of paralysis limbs in electric stimulation group was better than that in control group from the third to the ninth course. In the ninth course, 6 points of rats in electric stimulation group was more than that in control group (42, 46, χ2=15.4, P ＜ 0.01). [2]Positive absorbency of cerebral glial fibriliary acidic protein: That in electric stimulation group was higher than that in control group in the 3rd, 6th,and 9th [(52.97±0.59)% vs (46.40±0.56)%; (49.44±0.80)% vs (46.40±0.56)%;(43.25±0.48)% vs (34.20±0.50)%, P ＜ 0.05]. [3] Assay of neurofilament protein: That in electric stimulation group was higher than that in control group in the 6th and 9th course [(22.9±2.7)% vs (11.9±2.3)%; (26.5±1.7)%vs (11.7±1.5)%, P ＜ 0.05]. [4] Assay of microtubule-associated protein-2:That in electric stimulation group was higher than that in control group in the 6th and 9th course [(21.7±1.3)% vs (11.3±1.1)%; (24.4±2.1)% vs(11.9±2.3)%, P ＜ 0.05]. [5] Apoptosis of neurons: There was not significantly different between the two groups. [6] Results of open number of cerebral microvessel: That in electric stimulation group was higher than that in control group in the 1st, 3rd, 6th and 9th course (33 vs 19; 48 vs 31;45 vs 25; 46 vs 23, Z=-2.309, P ＜ 0.05).CONCLUSION: Electro-stimulating treatment can promote motor function of paralyzed limbs, which was due to that electro-stimulating treatment may promote extinction of the swollen feet of astrocytes, reinforce neurons activity and arouse the dilatation of cerebral capillary which promote the microvascular dilatation in order to improve cerebral blood circulation.

Objective To analyze the antibiotic resistance of the carbapenem no-susceptibility Enterobacteriaceae isolated from pediatric patients and the resistant genes of carbapenemase-producing.Methods In all,46 carbapenem no-susceptibility Enterobacteriaceae strains were isolated from patients at Beijing Children's Hospital between January 2008 and December 2010.Agar dilution method recommended by the Clinical and Laboratory Standards Institute was used to examine the minimum inhibitory concentrations (MICs) of 14 antimicrobial agents.Phenotypic testing for carbapenemase-producing was conducted using Hodge test and double-disk synergy test.PCR was used to detect the expression of the carbapenemase-related genes KPC,GES,IMI/NMC-A,SME,IMP,VIM,GIM,SPM,SIM and OXA.WHONET5.6 was used to perform resistance analysis.Results Among 46 carbapenem no-susceptibility Enterobacteriaceae strains,26 (56.5％) were Klebsiella pneumoniae strains,13(28.3％ ) were Enterobacter cloacae and 7( 15.2％ ) were Escherichia coli.The rates of imipenem and meropenem no-susceptibility Klebsiella pneumoniae were 69.2％ and 80.8％,Enterobacter cloacae were 76.9％ and 100％ and Escherichia coli were 85.7％ and 100％,respectively.40(87.0％ ) strains were positive of Hodge test.41 (89.1％) strains were positive of doubledisk synergy test.38 (82.6％) were positive for the IMP genotype.The carbapenemase-related genes were not found in other 8 strains.Conclusion The prevalence of carbapenem no-susceptibility Enterobacteriaceae strains in Klebsiella pneumoniae isolates is relatively high in children.Resistance to imipenem was lower than that to meropenem from Klebsiella pneumoniae,Enterobacter cloacae and Escherichia coli strains.Many carbapenem no-susceptibility Enterobacteriaceae isolated from pediatric patients carry the blaIMP gene.No the KPC gene was found.

Objective To perform mutation analysis of survival motor neuron gene 1 (SMN1 in two spinal muscular atrophy (SMA) patients and their parents to evaluate the effects of the two SMN1 gene mutations on the transcript levels of the gene and preliminarily predict their effects on the structure and function of SMN protein.Methods Mutation analysis of SMN1 gene was carried out by multiplex ligationdependent probe amplification,reverse transcript-polymerase chain reaction (RT-PCR) and cloning sequencing.Transmission of the mutations was confirmed by the mutation analysis in patients' parents.The full-length SMN1 (SMN1-fl) transcript levels of the patients carrying these subtle mutations were detected using quantitative RT-PCR.Results The two patients were diagnosed as SMA Ⅱ and SMA Ⅲ.They carried p.Val19GlyfsX21 and p.Ala2Gly SMN1 mutations in SMN1 gene,respectively.Both of the two mutations were originated from their fathers.Compared with the healthy individuals (23.5 ± 4.9),the two patients had a significant reduction in the level of SMN1-fl transcripts (t =3.322,P =0.011 (p.Ala2Gly) ;t =6.964,P =0.000 (p.Val19GlyfsX21)).However,compared with the healthy carriers (14.1 ±4.5),the patient with p.Ala2Gly mutation had no significant reduction in the level of SMN1-fl transcripts (13.9 ±3.6,t =0.058,P =0.955) ; however,the patient with p.Val19GlyfsX21 mutation had a significant reduction (4.9± 2.4,t =3.725,P =0.004).Conclusions Two SMN1 gene mutations are identified in our study.The mutation p.Val19GlyfsX21 is a novel mutation and p.Ala2Gly is firstly reported in Chinese SMA patients.p.Val19GlyfsX21 may possibly lead to decreased SMN1-fl mRNA by nonsense-mediated messenger RNA decay,however,p.Ala2Gly has no obvious effects on the amount of the SMN1-fl transcripts,indicating that its deleterious effect may be occurring at SMN protein level or the function of SMN protein.