Objective To analyze the incidence and risk factors of microalbuminuria in newly diagnosed and hospitalized type 2 diabetes mellitus patients,and to provide the theoretical basis for therapy of diabetes and diabetic chronic complications.Methods The blood glucose,lipid profile,24h-urinaryalbumin,fasting and postprandial serum insulin and peptid C were measured in 286 newly diagnosed and hospitalized type 2 diabetic patients from Mar.2006 to Sep.2009.Microalbuminuria was defined as the 24h-urinary albumin between 30 to 300 mg twice.Insulin resistance index (HOMA-IR) was recorded and all the patients received fundus examination by ophthalmologists after expansion of the pupil to ensure whether there was retinopathy or not.Results (1)The incidence rate of microalbuminuria in this study was 19.58％ (56/286).(2)Normal albuminuria group and MA group combined DR were 19.57％ (45/230) and 33.93 ％ ( 19/56 ) respectively,and the difference was statistically significant( x2 =5.349,P =0.021 ).Compared with control,the FPG,HbA1c and HOMA-IR were significantly higher in microalbuminuria group ( FPG:[ 11.08 ± 1.76 ] mmol/L vs [9.24 ±1.65]mmol/L,t =-6.148,P ＜0.001;HbA1c:[11.54 ± 1.59]％ vs [9.39 ± 1.64]％,t =-7.533,P ＜0.001 ;HOMA-IR:[3.73 ±0.42] vs [3.50 ±0.30],t =-3.774,P ＜0.001 ).(3) Pearson correlation analysis revealed microalbuminuria was positively correlated with FPG( r =0.460),HbA1 c ( r =0.499),HOMA-IR( r =0.308)and combined DR(r =0.405)(P ＜0.01).(4)Stepwise multiple regression analysis revealed that FPG (ββ =- 0.804,P ＜ 0.01 ),HbA1 c (β =- 0.455,P ＜ 0.01 ) and combined DR (β =1.527,P ＜ 0.05 ) were independently risk factors of microalbuminuria.Conclusion The development of microalbuminuria in newly diagnosed and hospitalized type 2 diabetic patients is associated with FPG,HbA1c and HOMA-IR,and will be easier to merge diabetic retinopathy.

Objective To explore the effect of a training based on instructional video modeling designed from the mirror neuron theory on executive dysfunction after stroke. Methods 40 stroke inpatients with executive dysfunction from July, 2014 to July, 2015 were divided into control group (n=20) and observation group (n=20). The control group accepted executive rehabilitation training, while the observation group were asked to see the video of executive rehabilitation task before training. They were assessed with Behavioral Assessment of the Dysexecutive Syndrome (BADS) before and after intervention. Results The total score and scores of subtests except Rule Shift Cards and Key Search increased more in the observation group than in the control group (t>2.9, P<0.05). Conclusion Rehabilitation video as a visual stimulus for exercise training based on the mirror neuron theory could improve executive function recovery of stroke patients with executive dysfunction.

Objective To study the expressions of matrix metalloproteinases-2 (MMP-2) and its tissue inhibitor-2 (TIMP-2) and microvessel density (MVD) in human endometrial carcinoma tissues and their relations with the invasion and metastasis of endometrial carcinoma. Methods Immunohistochemistry was used to measure the MMP-2, TIMP-2, and MVD protein levels in 33 patients with endometrial carcinoma and 8 normal endometrial samples. Results The MMP-2, TIMP-2 and MVD protein expressed in both normal endometrial samples and endometrial carcinoma. The positive expression proportions of MMP-2, TIMP-2, and MVD protein in endometrial carcinoma tissues were higher than those in normal endometrial samples (P

Objective To explore the susceptibility of Candida albicans biofilms to micafungin. Methods In vitro model of C. Albicans biofilm was established in 96-well microtiter plates with 30 C. Albicans isolates from the Department of Mycology, Changhai Hospital, Shanghai. The susceptibility of C. Albicans biofilms to fluconazole, amphotericine B and micafungin was evaluated by colorimetric XTT-reduction assay. Sessile MIC80 (SMIC80), defined as the lowest antifungal concentration at which an 80% reduction in fungal growth was achieved, was determined. Results Of the 30 C. Albicans isolates grown in sessile states, all were resistant to fluconazole (SMIC80≥64 μg/mL), 4 sensitive to amphotericine B (SMIC80≤1 μg/mL), 26 resistant to amphotericine B (SMIC80 > 1 μg/mL), 27 sensitive to micafungin (SMIC80 < 16 μg/mL), 3 resistant to micafungin (SMIC80 >16 μg/mL). Statistical analysis revealed a significant difference in the activity against C. Albicans biofilms between micafungin and fluconazole (χ2=736.36, P<0.01), micafungin and amphotericine B (χ2=529.95, P<0.01), but not between anphotericine B and fluconazole (χ2=2.29, P>0.05). Conclusion C. Albicans biofilms are resistant to routine antifungal agents such as fluconazole and amphotericine B, but relatively more sensitive to micafungin.

Objective To investigate the pathogenic types and clinical features of children with lobar pneumonia. Methods Eighty children with lobar pneumonia diagnosed from April 2013 to May 2015 were enrolled. Bronchoalveolar lavage lfuid (BALF) of patients were collected. FQ-PCR was used to detect and analyze pathogens in BALF. Results In 80 cases, 59 cases were Mycoplasma pneumoniae, and 2 cases were Chlamydia pneumoniae, 12 cases were Streptococcus pneumoniae, 1 case was Klebsiella pneumoniae, 8 cases were adenovirus, 1 case was respiratory syncytial virus, 14 cases were of mixed infection. The prevalence of MP lobar pneumonia in children of 7-14 years old age group were higher than that of other age groups. Conclusions The pathogen of children with lobar pneumonia varied from Mycoplasma pneumoniae, Chlamydia pneumoniae, bacteria, virus and so on, and Mycoplasma pneumoniae was the common pathogen in lobar pneumonia.

Objective To evaluate the effect of dexmedetomidine on the intestinal mucosal injury in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty patients of both sexes with rheumatic heart disease,aged 32-64 yr,weighing 40-75 kg,of ASA physical status Ⅱ or Ⅲ (NYHA class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and dexmedetomidine group (group D).After induction of anesthesia,the patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with 0.8％-2.0％ sevoflurane inhalation and intermittent iv boluses of sufentanil 0.5-1.0 μg/kg and vecuronium 0.04-0.06 mg/kg.Before routine induction of anesthesia,a loading dose of dexmedetomidine 1 μg/kg was injected intravenously over 10 min,followed by continuous infusion at 0.3 μg · kg-1 · h-1 until the end of surgery in group D,while the equal volume of normal saline was given in group C.Before CPB,at 30 min after aortic clamping,at the termination of CPB,at the end of surgery and at 6 and 24 h after surgery,central venous blood samples were taken for determination of concentrations of tumor necrosis factor-alpha,interleukin-6 (IL-6) and IL-10 and intestinal fatty acid binding protein in plasma (by ELISA),and the plasma concentration of endotoxin (using turbidimetry).The time of postoperative mechanical ventilation and duration of ICU stay were recorded.Results Compared with group C,the concentrations of tumor necrosis factor-alpha,IL-6,IL-10 and endotoxin and intestinal fatty acid binding protein in plasma were significantly decreased,and the time of postoperative mechanical ventilation and duration of ICU stay were shortened in group D.Conclusion Dexmedetomidine infused continuously at 0.3 μg · kg-1 · h-1 (until the end of surgery) after a loading dose of 1 μg/kg before routine induction of anesthesia can reduce intestinal mucosal injury in the patients undergoing cardiac valve replacement with CPB.

Objective To establish a method for the chiral separation and determination of S-isomer in epinephrine hydrochloride injection by HPLC with chiral mobile phase additives. Methods Column of Purospher? STAR RP-18 (4. 6 mm×250 mm, 5 μm) was used. The mobile phase was acetonitrile-10 mmol·L-1 sodium dihydrogen phosphate buffer containing 10 mmol·L-1 sulfobutylether-b-cyclodextrin (pH adjusted to 3. 0 with phosphoric acid) (98. 5:1. 5), detection wavelength was 280 nm, the flow rate was 0. 8 mL·min-1 , and the column temperature was 30 ℃ . Results Good linear relationship was established between the peak area and the concentration of S-isomer over the range of 5. 02-1501. 50 μg·mL-1 (R2 =0. 999 7). The detection limit was 0. 05 μg·mL-1 . Conclusion The proposed method shows high repeatability and durability. It can be employed for the quality control of S-isomer in epinephrine hydrochloride injection.

Objective To identify the pathogenic gene for a Chinese Han consanguineous marriage family with autosomal recessive cerebellar ataxia by homozygosity mapping and mutation analysis.Methods Six members of the family were enrolled in this study,including 3 patients,the unaffected sibling and their parents of first cousin marriage.After excluding GAA repeats mutation of FXN gene,whole-genome single nucleotide polymorphism (SNP) microarray scanning and homozygosity mapping were performed to localize the candidate gene.The coding regions and intronic flanking sequences of the candidate genes were analyzed.Results Four candidate regions were identified,including 2p25.3,9q22.2-34.3,13q12.3-14.3 and 17p13.The SETX gene localizing in 9q22.2-34.3 that is responsible for ataxia with oculomotor apraxia 2 was analyzed at first.There were 4 mutations in exon 10,including three missense mutations (c.3576T ＞ G,p.D1192E ; c.3754G ＞ A,p.G1252R; c.4156A ＞ G,p.I1386V) and a deletion mutation (c.5084_5087delAGTC,p.Q1695_S1696del).Three patients were homozygous of the 4 mutations,an unaffected sibling was normal,and their parents were heterozygous of 4 mutations.Conclusions The pathogenic haplotype comprising four mutations of the SETX gene was identified in the consanguinity family.c.5084_5087delAGTC (p.Q1695_S1696del) is a novel mutation.The affected individuals of this family were characterized by mild phenotype and slow progress without oculomotor apraxia,indicating the clinical variability of the disease.

Objective To observe the effect of low doses of ultrashortwave therapy (USW) on sciatic nerve injury and to deduce its possible mechanism.Methods Fifty-four Sprague-Dawley rats were randomly divided into a USW group,a control group and a normal group with 18 rats in each.Each group was then sub-divided into 1 week,2 week and 3 week subgroups with 6 rats in each.A model of peripheral nerve injury was established by forceps clipping of the sciatic nerve in the USW and control groups.The USW group was then treated with USW exposure.Rats from the appropriate subgroups were sacrificed after 1,2 and 3 weeks of treatment.Sciatic nerve samples were stained using hematoxylin-eosin and toluidin blue.Expression of basic fibroblast growth factor (bFGF) was detected by immunohistochemical methods.Results Degeneration of axons was observed in both the therapy and control groups after 1 week,and regeneration at the end of the 2nd and 3rd weeks.The number of axons with myelin sheaths was significantly higher in the therapy group than in the control group at the end of the 2nd and 3rd weeks.The expression of bFGF was significantly higher in the USW group compared with the control group at all observation time points.Conclusion USW can obviously accelerate the regeneration of the sciatic nerve,probably through increased expression of bFGF.

BACKGROUND:The authors' experiments of the earlier stage proved that the hypocrellin B photodynamic therapy(HB-PDT) can cause selective injuries to choriocapillaries. It is not known whether changing the therapeutic parameters would gain a different result regarding the choriocapillaries after the hypocrellin B photodynamic treatment for a month.OBJECTIVE: To observe the features of Chinchilla rabbit choriocapillaries after HB-PDT treatment and to probe into the research prospect of using HB-PDT to treat choroidal neovascularization (CNV) and of using green light as the light source for PDT.DESIGN: A single sample study.SETTING: Laser Department of the Chinese PLA General Hospital.MATERIALS: The trial was conducted at the Laser Department and the Department of Pathology of the Chinese PLA General Hospital as well as the Department of Photoelectric Engineering of Beijing University of Science and Engineering. The materials included photosensitizing agent hypocrellin B (HB), a green laser transmitter, fundus fluorescence camera and transmission electronic microscope.METHODS: The 532 nm green laser transmitter and slit-lamp microscope were connected by light fiber. Chinchilla rabbits of 2.5 to 3.5 kg was narcotized generally and HB(1. 0 mg/kg) was injected into the marginal ear vein. HB was excited with the green laser of 532 nm. The power density of the light spot on fundus was 300 mW/cm2, and the energy density 30 J/cm2. Laser was applied immediately after HB injection and the diameter of the light spot was 2 000 μm. Direct observation of retina, fluorescein fundus angiography and observation with light microscope and electronic microscope were conducted on the 1st, 7th and 28th days respectively after PDT to find the biological features of retina and the choroid.MAIN OUTCOME MEASURES: Non-selective injury of retina through direct observation of the fundus; obliteration of the choriocapillaries detected through fluorescein fundus angiography; the position and extent of non-selective injury in retina and the structural changes of the choriocapillaries observed through the light microscope; the ultrastructural changes of the fundus observed through the electronic microscope.RESULTS: One day after PDT, photodynamic thrombosis was formed in choriocapillaries being illuminated and the external layer of retina was apparently injured. On the 7th day, injury of endothelial cells of the choriocapillaries was aggravated without obvious changes of the main vessels of choroid. On the 28th days, fibrous tissue appeared where the choriocapillaries had been and the glass membrane became thickened. Repair and proliferation of RPE cells appeared in the laser illuminated area.CONCLUSION: The biological effect in the target area and non-selective injury in the non-target area began to appear from the 1st to the 7th day after PDT and continued to aggravate. That would be repaired by fibrous tissues from the 28th day. It deserves further studies to treat age-related macular degeneration or other diseases in fundus characterized with choroidal neovascularization.