Objective To explore the levels of serum adiponectin(APN)and homocysteine(Hcy)in elderly patients with type 2 diabetes metlitus(T2DM)complicating retinopathy and the relation between these two indicators.Methods Sixt-eight cases of complicating retinopathy(T2DM+DR group)were screened from the elderly inpatients with T2DM in our hospital from January 2012 to December 2014.Their general data were investigated.The routine biochemical indicators were tested.The enzyme-linked immunosorbent assay(ELISA)was employed to measure the serum total APN,high molecular weight APN and Hcy levels.Mean while the correlation among total APN,high molecular weight APN and Hcy was evaluated by adopting the Pearson correlation analysis.Contemporaneous 65 cases of elderly T2DM and 70 elderly people undergoing the healthy physical examination were chosen as the T2DM group and NC group respectively.Results The WHR,FBP,TC,TG,LDL-C,HbA1c,FINS and HOMA-IR in the T2DM+DR group and T2DM group were higher than those in the NC group,while the HDL-C level was lower than that in the NC group(P＜0.05);the duration and BMI of the T2DM-4-DR group were higher than those of the T2DM group,the difference was statistically significant(P＜0.05);the levels of total APN and high molecular weight APN in the T2DM+DR group and T2DM group were lower than those in the NC group,while the Hcy level was higher than that in the NC group(P＜0.05);moreover the levels of total APN and high molecular weight APN in the T2DM+DR group were lower than those in the T2DM group,and Hey level was higher than that in the T2DM group,the difference was statistically significant(P＜0.05);the levels of total APN(r=-0.654)and high molecular weight APN(r=-0.562)were negatively correlated with the Hey level in the T2DM+DR group(P＜ 0.05).Conclusion The serum APN level is decreased and Hcy level is increased in elderly patients with T2DM complicating retinopathy,which may be associated with the progression of retinopathy in T2DM.

Dating of injury and the discrimination in trauma and disease is always an important hot topic in the field of forensic medicine. Lumbar disc herniation is a kind of physiological degeneration. To seek a method for deducing the occurrence time of traumatic LDH exactly, this article reviewed the correlation between humoral, celllur immunity and the occurrence time of LDH. It is suggested that some characteristic changes of the expression of IgG,IgM,macrophages may be a helpful method for the occurrence time deduction of traumatic LDH.

Objective To investigate the causes of diarrhea during autologous peripheral blood stem cell transplantation (APBSCT )and summarize the nursing strategies.Method The histories of 23 APBSCT patients suffering from diarrheas were retrospectively reviewed to find out the causes of diarrhea and summarize the nursing strategies.Results The main causes of the diarrheas included the toxicity of pretreatment chemotherapy drugs in 15 cases,antibiotics in 2 cases,gastrointestinal motility drugs in 2 cases,intestinal infections from decreased immunity in 2 cases and other diseases in 2 cases,all recovered by corresponding managements.Conclusions APBSCT-associated diarrheas may be caused by chemotherapy drug toxicity,infections,drugs and other factors.So the nurses should evaluate them correctly,adopt corresponding nursing measures,strengthen the observation of patients' condition and raise awareness of prevention for the purpose of reducing the incidence of diarrhea,promoting the recovery of patients and improving the quality of life.

Objective To evaluate the application of Sigma stent in treatment for esophagn-tracheal fistula. Methods Clinical data of 22 cases of esophago-tracheal fistula treated with Sigma stent were retrospectively analyzed, including 17 cases of esophageal cancer and 5 cases of benign esophageal diseases, with length of 4 days to 2 months. One single stent was placed in 5 cases, two stents ( both in trachea and esophagus each) in 15 cases, and three stents in 2 cases, and 18 eases with tube-type trachea stent, 3 with obtuse angle L-type and 1 with Y-type. Placement of stent was by interventional method or/and endoscopy. Results Forty-one stents were successfully placed in 22 patients with no death in the procedure. And, all patients with fistula were healed successfully and could have normal eating 2 to 4 days after operation, except 1 patient who received a tracheal stent inserted first, but an esophageal stent inserted again due to incomplete seal of the fistula and another benign case who received surgical operation 1 year after stent placement due to protracted unsealed fistula, with an overall cure rate of 91% (20/22). Conclusions Placement of Sigma stent in the esophagus or/and trachea could effectively heal esophago-tracheal fistula. All the patients can eat normally after the procedure. Stent can be recycled and formation of secondary esophago-traeheal fistula can be prevented effectively with such procedure.

Objective To study the effect of endothelial progenitor cells(EPCs) transplantation on chronic deep venous thrombosis.Methods Bone marrow-derived mouonuclear cells (BMMNCs) were isolated from rat bone marrow by ficoll and cultured with EGM-2MV medium.A rat model of chronic deep vein thrombosis was established by partial ligation of the inferior vena cava and intravenous injection of thrombosin.Model rats were randomly divided into three groups:A(n =25),EPCs group,1 ml 10~6 EPCs transplantation;B(n = 25),EGM-2MV medium group,1 ml EGM-2MV medium transplantation;C (n =25),control group,without any treatment.After transplantation,HE staining and immunohistochemical staining was conducted to detect recanalization of the inferior vena cava.Western blotting of inferior vena cava thrombosis was used to detect VEGF,bFGF protein expression changes.SPSS13.0 software was used for analysis.Results Compared with group B and C,VEGF,bFGF protein significantly increased in group A.The recanalization capillary density was significantly higher in group A than that in group B,and C (P ＜0.05).The neovascularization was identified by immunohistochemical staining using vWF antibody,as endothelial cells.Conclusions EPCs were the precursor of endothelial cells,when transplanted into the deep vein thrombos,initiating angiogenesis and accelerating organization and recanalization of vein thrombus.

Objective To investigate the effect of bone marrow derived endothelial progenitor cells (EPC)transplantation on microenvironments in a murine model of chronic vein thrombosis.EPCs transplantation was evaluated whether it can up-regulate thrombus organization and recanalization associated cytokines(VEGF,ANG-1 and MCP-1). Method EPCs from immature Wister rats' bone marrow were isolated using a Ficoll density gradient centrifugation,and cultured in fibronectin-coated plate in EGM-2M Vmedium.EPCs were harvested on the 10th day,then were transplanted into chronic inferior vens cava thrombus of adult Wister rat through the femoral vein.Rats were divided into three groups:blank control group(group A,sham operation),the control group(group B,the medium injected)and the experimental group(group C,EPCs injected).The rats were sacrificed after 28 days.VEGF,ANG-1 and MCP-1 mRNA was measured by real-time quantitative PCR and protein expression change by Western blotting from IVC and thrombus tissue. Results EPCs were identificated successfullv by immunohistochemistry,immunofluorescence and function,then were transplanted into chronic inferior vena cava thrombus of adult rats.After EPCs transplantation,the VEGF,ANG-1 and MCP-1 mRNA expression in group C expression was significantly up-regulated with statistical significance(P＜0.01)compared with group A and group B in IVC and thrombus tissue by real-time PCR.There was no significant difference between group A and group B (P＞0.05).VEGF,ANG-1 and MCP-1 protein expression were similar to mRNA expression.There was significant increase in group C compared to group A and group B(P＜0.01)and no statistical significance between group A and group B(P＞0.05).Conclusion EPCs deriving from bone marrow may change the microenvimnment of chronic vein thrombus through up-regulating thrombus organization and recanalization associated cytokines(VEGF,ANG-1 and MCP-1).

Objective To set up the trimester-specific reference ranges of thyroid hormones for normal pregnant women to provide reference criteria for diagnosis, treatment and monitoring or screening of thyroid disease during pregnancy and related research. Methods A cross-sectional survey was conducted in pregnant and non-pregnant women in iodine sufficient areas. A total of 505 normal pregnant women and 153 normal non-pregnant women (as control) were selected for establishing trimester-specific reference ranges of thyroid hormones after rigorous screening through the survey questionnaire and laboratory tests. Thyroid hormones were measured by Bayer automated chemiluminescence immunoassay, and the reference range of each hormone was calculated as median (the 50th percentile value) and two-sided limits (the 2.5th and 97.5th percentile values). Results All women investigated were in iodine sufficient status within optimal urine iodine level. The serum TSH level during the 1st trimester was obviously declined compared with that in the non-pregnant individuals (P < 0.01), and started to rise during the 2nd trimester, but was still not restored to non-pregnant level until the 3rd trimester. Serum FT4 and FT3 levels gradually decreased from the 2nd trimester to the 3rd (P < 0.01), and the TT4 and TT3 levels were markedly elevated since early pregnancy (P < 0.01) and reached peak levels at the 2nd trimester approximately making up to 1.5 times of those in the non-pregnant individuals. Conclusion The thyroid hormone levels during pregnancy differ completely from those of the non-pregnant individuals, and also differ during different gestation periods. Therefore, to establish trimester-specific reference data of thyroid hormones during normal pregnancy may be important for clinical practice.

Objective To investigate the role of miR-208b-3p in dexmedetomidine(DEX) alleviating rat myocardial ischemia reperfusion injury(MIRI).Methods Eighty adult male Wister rats were divided into the sham operation(Sham) group,I/R group,DEX group and miR-208b-3p+ DEX group.In the Sham group,a 6-0 silk suture was only placed without ligation,and other 3 groups were treated by I/R model.Before ischemia reperfusion,the DEX group received a loading dose of DEX(5 μg/kg) via the femoral vein followed by a continuous infusion of 5 μg · kg-1 · h-1 for 1 h.In the miR-208b-3p+ DEX group,rats received intramuscular injection of miR-208b-3p analogue at 24 h before ischemia reperfusion.The cardiac function indexes were monitored at 120 min after reperfusion,including heart rate(HR),left ventricular systolic blood pressure(LVSP),left ventricular end diastolic pressure(LVEDP) and left ventricular rate maximum(dp/dtmax).The serum levels of cTn-Ⅰ and CK-MB were detected and the apoptosis rate(AI) was measured by in situ apoptosis assay.The levels of oxidative stress related indicators were detected and Western blot was used to detect the level of myocardial apoptosis protein.Results Compared with the Sham group,the cardiac function in the I/R group was decreased,but the levels of CTn-Ⅰ,CK-MB,AI,MDA,Bax and Caspase-3 were increased(P＜0.05);compared with the I/R group,the above indexes in the DEX group were improved(P＜0.05);compared with the DEX group,the above indexes in the miR-208b-3p+DEX group were deteriorated(P＜0.05).Conclusion Overexpression of miR-208b-3p can eliminate the protective effect of DEX on MIRI.

Objective To analyze the median urinary iodine(MUI)level in normal pregnant women based on World HeMth Organization(WHO) recommended criterion,and to provide the MUI reference values for monitoring and evaluating iodine nutrition during pregnancy and related studies.Methods Total 604 normal pregnant and 192 non-pregnant women(as a comparison)were selected from a cross-sectional survey.These women were all healthy,iodine sufficient,with normal thyroid function,and negative anti-thyroid antibodies.The iodine content in drinking water,edible salt,and urine was determined by standard methods,and serum TSH,FT4,FT3,thyroid peroxidaseantibody(TPOAb),and thyroglobulin antibody(TgAb)were measured using chemiluminescent immunoassay.Resuits (1)The iodine in drinking water was 3.0μg/L indicating such small amount of iodine could be neglected for daily iodine intake.(2)All women consumed iodized salt with the median iodine in salt of 31.7 mg/kg.The daily iodine intake of at least 240 μg could be roughly estimated if an average of 10 g salt was taken per person per day and further subtracted by 20%iodine lost during cooking,which could meet the iodine needs during pregnancy.(3)The MUI of 173.1μg/L was calculated from 604 pregnant women having 174.5,167.0,and 180.7 μg/L during the first,second,and third trimesters,respectively,reaching the optimal level of 150-249 μg/L recommended by WHO for pregnant women.However,our data showed relatively lower levels,not reaching 200μg/L.The MUI of 240.2μg/L was calculated from 192 non-pregnant women,reaching the level of"above requirement"(200-299μg/L) recommended by WHO for adults.(4)All women were euthyroid and antibody-negative,but the TSH level in pregnant women was lower than that in non-pregnant women,in particular during the first trimester,while FT4 and FT3 were considerably decreased compared with the non-pregnant(with an exception of FT4 in the first trimester),and both gradually declined with the gestational age.Conclusions The optimal MUI level of 150-249 μg/,L recommended by WHO can be applied to pregnant Chinese women,but our data provided a relatively low range of 150-200μ/L throughout pregnancy.The higher MUI of 240.2μg/L in non-pregnant women indicated that iodized salt with different contents should be supplied on market to meet the requirement of different groups of population.