Objective To analyze risk factors of vascular disease in the lower limbs in type 2 diabetes patients.Meth- ods Investigating the lower limb vein of 80 type 2 diabetes patients with Siemens G-50 color Doppler ultrasonograph, and recording their age,sex,course of disease,and blood pressure,at the same time,take some tests as follows: FBG,P2hBG,FIN,C-peptide HbA_1c,Tch,UAE.Results Compared to the control group,blood pressure, FBG,P2hBG,Tch,TG,HbA_1c,Tch,UAE of the type 2 diabetes patients with lower limb vascular disease,are all increased significantly(P

Objective　To evaluate the efficiency of low molecular weight heparin(LMWH, fraxiparine) given as a single predialysis bolus injection with reused dialyzers in comparison with standard heparin(SH) administered with a continuous infusion. Methods　30 hemodialysis patients were studied in a radomized crossover fashion. Dialyzers fibrer bundle volumes(FBV), predialysis hemocrit and 2 h clearance of urea, creatinine were observed in the first, the fourth dialysis. The plasma heparin activities(anti-Fxa levels) were measured by the chromogenic substrate assay in 0 h, 2 h, 4 h of dialysis. Results　Significant increase (P<0.05) was seen in the number of dialyzer reuse in LMWH group compared with SH group; there was not significant decrease in dialysis FBV as well as 2 h clearance of urea, creatinine (P>0.05); in addition, the plasma heparin activity(anti-Fxa levels) were comparable in both groups after 2 h of dialysis, however, they were significantly higher after 4 h in the LMWH than those in the SH group (P<0.05). Conclusion　LMWH as a single bolus dose can prevent decrease in dialyzer clearance. It is clinically worthy of further popularity.

Background and purpose:The skeleton is one of the most common sites of metastasis in patients with lung cancer.Bone metastases often cause poor prognosis.It is important to early detect bone metastases.Therefore,we planned a retrospective study to investigate the role of radionuclide bone scanning with 99mTc-MDP in detecting bone metastases in lung cancer patients.Methods:It was a retrospective analysis.400 patients with lung cancer diagnosed in our hospital from 2005.5 to 2007.5 were recruited.Using 99mTc-MDP bone scanning,we analyzed the symptoms,sites,numbers,pathological types and TNM stages of bone metastases.Results:Ostealgia was the most frequent symptom in lung cancer patients with bone metastases.The sites of bone metastases were:thoracic bones(41.52%),vertebras(32.31%),pelvic bones(15.89%),extremities(8.68%),skull(1.60%).126 patients had multiple bone metastases(80.25%).There was a statistical significance of bone metastases in adenocarcinoma patients(48.09%)compared with in squamous cell carcinoma patients(33.33%)(P

Objective To probe into application of clinical pathway on clinical practice teach-ing in thoracic surgery , and evaluate its effect . Methods 76 students were randomized into two groups: 35 students who accepted clinical pathway teaching were the experimental group, they were asked to carry out clinical practice in accordance with the teaching pathway;and the other 41 students were control group. The final examination included four parts: ①theoretical examination account for 20%of the total score. The test paper was randomly combined from the standardized question bank of Xinjiang Medical University, and this test included single choice questions and fill-in questions; ②clinical operational skills test account for 30%of the total score. This part included pleural puncture, dressing change, stitches remove, incision disinfection and surgical draping, and all of these opera-tions were carried out on medical patient simulators; ③clinical case analysis account for 50% of the total score. This part involved history collection, physical examination, humanistic care, case writing, diagnosis and treatment planning for new admission patients. T-test of independent samples was used to analyze all the scores of the two groups. Results The clinical case analysis score and the total score in experimental group [(42.26 ±3.93) points and (81.69 ±6.16) points, respectively]were obviously higher than that in control group[(38.88±4.76) points and(77.39±6.83) points, respectively];There were significant differences between the two groups(P values was 0.001 and 0.006, respectively). Conclusion Application of clinical pathway in clinical practice teaching may improve the effect of clinical teaching. The pathway contents and evaluation methods should be constantly improved accord-ing to teaching practice.

Objective:The study aims to screen chemosensitivity-associated proteins in colorectal carcinoma tissues by using two-dimensional gel electrophoresis (2-DE) and mass spectrometry,then identify some differentially-expressed proteins. Methods:The patients with advanced colorectal carcinoma were confirmed by clinical diagnosis. Fresh carcinoma specimens were collected by biopsy and preserved in liquid N2. The tissues were classified into two groups: high sensitivity group (HS) and low sensitivity group (LS) based on drug sensitivity test. The total proteins were extracted and separated by 2-DE. The images were composed, compared, and differentially analyzed to identify the proteins with differential expression in HS and LS groups. Then the differentially-expressed protein spots were incised from the gels and digested by trypsin. The peptide mass fingerprintings (PMF) was acquired after matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascot database. Two proteins with differential expression were detected by Western blotting.Results:The 2-DE spectrum of HS and LS groups were established. Most protein spots were distributed in the area with pH 4-8 and relative molecular weight of (20-100)×10~3. The average number of the protein spots was 842±23 in HS group and 793±19 in LS group,respectively. The mean matching rate was 90.7%. The number of differentially-expressed dots between HS and LS group was 79.00±13.56. Thirty protein dots were selected for mass spectrum and bioinformatic analysis, and 9 proteins were identified. Conclusion:Colorectal carcinoma with different chemosensitivity had differential protein expression profiles. The differentially expressed proteins may be associated with chemosensitivity and could be used for prediction of chemosensitivity of colorectal carcinoma.

The First Affiliated Hospital of Nanjing Medical University has adopted a strategy of brand development in the process of continuing medical education.Given the different recipients,the First Affiliated Hospital of Nanjing Medical University has established four types of brand-based education modes,namely Jinling high-level forum of clinical medicine,hospital management school,management salon,and clinical case discussion in English.The influence and competitiveness of the brand of hospital continuing education should be elevated through the following methods:adhering to the brand development orientation-to fulfill the public responsibility and cultivate medical talents; establishing appraisal mechanism of continuing medical education; transforming thinking of management department; relying on new media propaganda and expanding domestic and international communication.

Objective:To establish the method validation of microbial limit tests for hospital paste preparations, including com-pound salicylic acid paste, zinc oxide paste and compound pine tar paste. Methods:According to the microbial limit test described in China pharmacopoeia 2010 edition, the method validation of count of bacteria, fungi and yeasts and tests for specified microorganisms was established. Results:Medium dilution method could be used in bacteria, fungi and yeasts count and specified microorganisms ex-amination for compound salicylic acid paste and zinc oxide paste. For compound pine tar paste, bacteria, fungi and yeasts count and the pseudomonas aeruginosa examination could use medium dilution method, while the staphylococcus aureus examination should employ membrane filtration method. Conclusion:The methods of microbial limit tests for the three hospital paste preparations are established, which can be used to control the quality of hospital preparations effectively.

AIM: To investigate the relationship between bone metabolism and serum leptin in type 2 diabetes mellitus (T2DM) postmenopausal female patients. METHODS: Totally 80 postmenopausal female inpatients with T2DM (according to the diagnostic criteria of WHO1999) aged 60-80 years from Yangpu District Central Hospital who gave informed consent were enrolled in the present study from January 2004 to January 2006. Exclusive criteria: Subjects who taking medications such as estrogen, glucocorticoid, or calcium or phosphorus metabolism, having a history of gastrointestinal surgery and other endocrine diseases were excluded. Each subject's age, duration, menopausal period, body mass index (BMI), fasting glucose (oxidation enzyme method), hemoglobin A1c (HbA1c) (microcolumn affinity chromatography) and leptin levels (ELISA) were measured. Ultrasound characteristics of the right heel bone were measured with ultrasound bone densitometer (French UPIS3000) to identify the speed of sound (SOS), broanband ultrasound attenuation (BUA) and stiffness (STI). STI was equal to 0.67?BUA+0.28?SOS-383. Linear correlation analysis was performed in ultrasound index, general index and leptin level. RESULTS: A total of 80 postmenopausal female inpatients with T2DM were involved in the result analysis. BUA, SOS and STI were negatively related with age (r =-0.342 to -0.298,P all

Objective: To discuss the application of BALANCE-FFE sequence in abdominal MRCP.Methods:100 patients of abdominal diseases were examined by BALANCE technique. Results: The signal of BALANCE-FFE sequence was high in abdominal MRCP examination, and BALANCE image of the coronal scan was excellent. Conclusion:The biliary tract had obviously high signal intensity acquired by BALANCE sequence. The gallstone and the stenosis could be seen. The tissue out of the bile duct, the head of pancrease and the lymph could also be seen. The BALANCE sequence could be used as a supplement of conventional MRCP.

Objective To evaluate the interstital MR lymphography using positive lymphotropic contrast agent for differentiation of metastatic lymph nodes from inflammatory lymph nodes hyperplasm.Methods Eighteen New Zealand white rabbits weighted at 2.0-2.5 kg were used.Inflammatory hyperplastic popliteal lymph node model was established in 9 rabbits by injection of complete freund adjuvant into the interdigitial skin of the dorsal aspect of one hind leg,and tumor-bearing popliteal lymph node model was established in another 9 rabbits by injection of VX~2 tumor cell suspension.The popliteal lymph nodes of another hind leg of all 18 rabbits were assigned to the normal contral group.In each group,every rabbit underwent MR lymphography examination before and after the inoculation.Volumes of 0.2 ml of Gd[DTPA-bis(2-aminoethoxy)ethane]polymeric contrast agent(Gd-poly-DTPA-EOEA)injection were injected subcutaneously into the dorsal feet of both hind legs of two groups of rabbits.T_1-weighted 3D gradient-echo images were obtained,and source images were used to reconstruct images of MIP before and after the administration of agent.The maximum short-axis diameter(MSAD)of each popliteal lymph node was measured on the enhanced 3D MIP images,and the signal-to-noise ratio(SNR)measurement was performed in the largest popliteal node of each rabbit at each time point in delayed scan.Independentsamples t test was used to compare the sizes of popliteal nodes in MSADs between inflammatorily hyperplastic and tumor-bearing nodes after the inoculation,and the values of SNRs of popliteal nodes at each time point between inflammatorily hyperplastic,tumor-bearing and normal popliteal lymph nodes.Imaging results of the popliteal nodes were analyzed and correlated with pathological findings.Results All of the rabbits were successfully inoculated except of the 2 rabbits in tumor-bearing nodal group.The size in MSAD of 13 inflammatorily hyperplastic and 11 tumor-bearing nodes was(1.32±0.14)and(1.33±0.12)cm,respectively.There was no significant statistical difference between the sizes of the two groups(t=0.186,P＞0.05).At the time of 5,15,30,60,90,120 minutes after the injection of the agent,the value of SNR of 9 inflammatorily hyperplastic and 9 contralateral normal nodes was 17.31±0.37 and 17.19±0.29,27.42±0.50 and 27.39±0.48,38.44±0.47 and 38.19±0.27,37.10±0.09 and 36.97±0.10,36.32±0.61 and 36.20±0.80,34.60±0.44 and 34.71±0.32,respectively.There was no significant statistical difference between the values of the two groups(t=0.78,0.14,1.43,1.00,0.36,-0.62,respectively,P＞0.05).The value of SNR of seven tumor-bearing and seven contralateral normal nodes was 6.00±0.22 and 17.21±0.28,7.87±0.16 and 27.17±0.23,8.14±0.24 and 38.16±0.19,8.09±0.28 and 36.94±0.30,7.59±0.20 and 35.96±0.72,7.50±0.14 and 34.81±0.27,respectively.There was significant statistical difference between the values of the two groups(t=-84.00,-182.72,-261.27,-186.48,-100.22,-239.00,respectively,P＜0.01).At each time point,inflammatorily hyperplastic nodes had significantly higher values of SNRs compared to tumor-bearing nodes(t=83.97,174.07,158.49,152.71,96.06,154.57,respectively,P＜0.01).A complete or part signal filling defect occurred in the tumor-bearing lymph node on the MR lymphographic images.Conclusions The internal anatomy and function of the lymph nodes were effectively visualized by interstitial MR lymphography with positive lymphotropic contrast agent,which provide a sensitively diagnostic way for the differentiation of benign lymph nodes from malignant ones.