Aldose reductase ( AR ) belonging to nicotinamide-adenine dinucleotide phosphate ( NADPH ) -dependent aldehyde-keto reductase superfamily, is the key rate-limiting enzyme in the polyol pathway which plays an important role in the body’s high-sugar metabolism. AR is widely present in the kidneys, blood vessels, lens, retina, heart, skeletal muscle and other tissues and organs, converts glucose to sorbitol which easy permeability of cell membranes, cause cell swelling, degeneration, necrosis, and have a close relationship with the development of chronic complications of diabetes mellitus. Diabetic retinopathy ( DR ) is a multifactorial disease, the exact cause is currently unknown, but polyol pathway has been demonstrated to play an important role in the pathogenesis of DR. Clinical risk factors such as blood sugar control, blood pressure and other treatments for DR only play a part effect of remission or invalid, if we can find out DR genes associated with the disease, this will contribute to a better understanding of the pathological mechanisms and contribute to the development of new treatments and drugs. The current research progress of AR, AR gene polymorphism, Aldose reductase inhibitors to DR was reviewed in this article.

Objective To summarize the clinical characteristics of small intestinal stromal tumors(SIST), and evaluate the diagnostic values of various imaging or endoscope examinations for SIST. Methods From July 2004 to June 2009, 74 patients whose operation or endoscopy biopsy tissues pathologically confirmed SIST were collected. The clinical data, imageology including enteroclysis, abdominal ultrasound, spiral computered tomography (CT) and the double-balloon enteroscopy report of the patients were analyzed retrospectively. According to biological behavior, the SIST was divided into four risk degree such as extremely low risk, low risk, moderate risk and high risk. The correlation between pathologic characters and spiral CT feature was analyzed. Results The most predilection site of SIST was jejunum in 43 patients (58.1 %); secondarily duodenum in 17 cases (23%); and 10 cases (13.5%) in ileum. About 94.6 percent of patients (70/74) showed clinical signs, the most common symptom was gastrointestinal bleeding in 46 cases (67. 2 % ), abdominal pain in 23 cases (31.1%). Of various photogrammetry examinations and endoscopy, spiral CT has the highest diagnosis rate and diagnosis coincidence rate, which was 100% and 72. 1% respectively. Among the 74 SIST lesions, 14 cases were extremely low biological risk (18. 9 % ), 21 at low risk (28.4 % ), 15 at moderate risk (20. 3%) and 24 at high risk (32.4%). Spiral CT is helpful for the SIST risk diagnosis. Conclusions The onset of SIST was concealed and early diagnosis was very difficult. Spinal CT which could help to predict the tumor's risk degree and prognosis was noninvasive, convenient and reliable. Therefore, it could be the first choice for SIST examination at present.

ObjectiveTo explore the clinical effect of omeprazole combined with octreotide in treatment of patients with non-variceal upper gastrointestinal hemorrhage.Methods96 patients with non-variceal upper gastrointestinal hemorrhage were randomly divided into two groups.All the cases were received basic treatment of fluid infusion,transfusion and nutritional support.The control group( n =48) was treated with omeprazole alone,and the treatment group(n =48) was treated with omeprazole and octreotide.The course of treatment was 3 days.The vital signs,24h urine output,the number of cases of rebleeding in 72 h and adverse drug reactions was observed and recorded.ResultsThe total effective rate in treatment group and control group was 91.7％ and 72.9％,respectively.The difference between the two groups was statistically significant( x2 =5.79,P ＜0.05 ).The time of hemostasis and blood transfusion volume in treatment group were significantly less than those in control group(t =7.69,9.91,all P ＜0.05).The rebleeding rates after 72 hours of hemostasis between the two groups(8.3％ vs 25.0％ ) was significantly different ( x2 =4.80,P ＜ 0.05 ).In the course of treatment,the side effects weren' t found in both groups.ConclusionOmeprazole combined with octreotide was more effective and safe than omeprazole alone in fast stopping bleeding and reducing rebleeding rate.

This study is to determine the preventive effect and mechanism of targeting IL-17A on pulmonary inflammation and fibrosis after acute lung injury. Mice were treated with anti-IL-17A antibody on the day 7 and sacrificed on the day 14 after bleomycin lung injury. The pulmonary inflammatory status and the deposition of collagen were measured by HE and Sirius stains staining. The contents of hydroxyproline and collagen were measured by using commercial kits. The survival rate of mice was calculated by Kaplan-Meier methods. The inflammatory cytokines in bronchoalveolar lavage fluid were measured by ELISA and the expressions of inflammation-related molecules were detected by Western blotting assay. Targeting of IL-17A could prevent the development of lung inflammation, decrease collagen deposition and the contents of hydroxyproline, and protect against the development of pulmonary fibrosis, which together led to an increase in the animal survival. Moreover, blocking IL-17A decreased the expression ofpro-fibrotic cytokines such as IL-17A, TGF-beta1 and IL-13; increased the expression of anti-fibrotic or anti-inflammatory factors such as IFN-gamma, COX-2, 5-LOX, 15-LOX. Indeed, IL-17A antagonism suppressed the activation of pro-inflammatory p65NF-kappaB but enhanced the activation of pro-resolving p50NF-kappaB. In conclusion, that blockade of IL-17A prevents the development of pulmonary fibrosis from acute lung injury, is because blocking IL-17A may prevent acute inflammation converting to chronic inflammation.

According to the requirement of simulated actual combat,based on the traditional contents of sanitary reconnaissance of water source,this paper introduced some practical knowledge and skills in drinking water under emergency,including water source search,utilization,drinking principles and some measures to reduce the loss of body water.These practices enriched and consum- mated the subject of sanitary reconnaissance of water source.

Objective To study the value of application of histamine provocation test and airway resistance measurement in diagnosis and therapeutic efficacy in preschool children with asthma.Methods Histamine provocation test and airway resistance measurement by the Italian MEFAR MB3 provocating instrument and Germen Microloop lung function instrument for 42 cases who were diagnosed as asthmatic(27 patients with bronchial asthma and 15 cases of cough variant asthma)and 21 healthy cases was compared,and the differences between the 2 groups and the value of therapeutic efficacy were analyzed.Results The resistance ratio of respiratory tract of control group was(97.11?9.09)%,which in asthma and cough variant asthma group was(229.37?57.48)% and(248.80?76.80)%.There was significant difference between the 3 groups(F=48.466 P

Objective To evaluate the effect of combined treatment with gonadotropin-releasing hormone analog(GnRHa)and recombinant human growth hormone(rhGH)on predicted adult height(PAH)in girls with central precocious puberty(CPP).Methods Fifteen girls with CPP,whose growth velocity during GnRHa treatment had been less than 4 cm/year,were given additional rhGH treatment at a dose of 1 U?kg~(-1)?w~(-1),sc, for 4-13 months.Comparisons of growth velocity,height SDS for bone age(HtSDS_(BA))and PAH were performed before and after the combined treatment.Results During rhGH combined with GnRHa therapy,growth velocity increased significantly[(7.4?1.7)cm/year vs (3.2?0.7)cm/year baseline,P＜0.01].In 7 girls treated with rhGH and GnRHa for more than 9 months,growth velocity in the second 6 months[(6.5?1.0)cm/year]was slightly lower than that in the first 6 months[(8.8?1.1)cm/year],being both faster than that of baseline [(3.2?0.8)cm/year].There was a significant increase in rhGH-duration corrected change of HtSDS_(BA) [(0.35?0.15)/6 month vs (0.12?0.18 )/6 month baseline,P＜0.01]and PAH[(3.2_+1.4)cm/ 6 month vs (1.4?1.1)cm/6 month baseline,P＜0.01].Conclusion In girls with CPP showing a marked decrease in growth velocity during GnRHa treatment,the combined rhGH and GnRHa treatment remarkably improves growth velocity and PAH.

Objective To investigate the correlation of blood-brain barrier (BBB) damage and depression in patients with cerebral small vessel disease (CSVD).Methods Consecutive patients with CSVD admitted to hospital were enrolled prospectively.The patients completed head MRI and cerebrospinal fluid (CSF) examination after admission.The BBB damage degree was evaluated by using albumin CSF/serum ratio (Q-Alb).At 3 months after onset,the depression was assessed according to the Hamilton depression scale (HAMD) and the American Diagnostic and Statistical Manual of mental disorders,4th edition (DSM-Ⅳ).The correlation between the BBB damage and depression in patients with CSVD was analyzed,Results A total of 130 consecutive patients with CSVD were enrolled,including 58 (44.62％) had depression within 3 months.There were significant differences in the proportions of patients with lacunar infarction (43.10％ vs.26.39％;x2 =4.008,P =0.045),leukoaraiosis (75.86％ vs.58.33％;x2 =4.408,P =0.036),and cerebral microbleed (27.59％ vs.12.50％;x2 =4.707,P =0.030),and baseline National Institutes of Health Stroke Scale (NIHSS) scores (5.02 ± 2.51 vs.3.60 ± 2.43;t =3.256,P =0.001),Fazekas scales of deep white matter (2.35 ± 1.00 vs.1.56 ± 1.05;t =4.358,P ＜0.001) and the proportion of Q-AIb category (x2 =6.852,P =0.033) between the depression group and the non-depression group.Multivariate logistic regression analysis showed that the baseline NIHSS scores (odds ratio [OR] 1.248,95％ confidence interval [CI] 1.027-1.517;P =0.026),leukoaraiosis (OR 14.786,95％ CI 1.776-123.111;P=0.013),Fazekas scales of deep white matter (OR 1.847,95％ CI 1.210-2.819;P=0.004),and Q-Alb (OR 30.417,95％ CI 3.662-252.643;P =0.004) had significant independent correlation with depression.Conclusions The BBB damage is independently associated with depression in patients with CSVD.

Objective To improve the diagnosis and treatment of ureteral cancer. Methods A retrospective analysis of 24 cases of primary ureteral cancer treated from January 1990 to March 2005 was performed.The diagnostic value of ultrasound,IVU,CT,MRU and the patients' outcomes were reviewed. There were 19 males and 5 females aged 38-72 years(mean,59 years).The tumors were on the left side in 16 cases and on the right in 8.Of the 24 cases,17(71%)had gross hematuria and 7(29%)had micro- scopic hematuria.Urine cytology was performed in 16 cases with a positive rate of 6.3%.B-ultrasonic exami- nation showed hydronephrosis in 19 cases(79%)and low-echo space-occupying disease of middle-inferior ureter in 3(12%).IVU demonstrated hydronephrosis in 20 cases(83%)and filling defect of the diseased ureter in 3(12%).Retrograde pyelography showed filling defect of the diseased ureter in 16(76%)of 21 cases(5 cases had failure of intubation).CT scan was performed in 20 cases,indicating thickening of the ureteral wall and infiltration of the cancer in 14(70%).In 3 cases who had undergone spiral CT thin layer scan and 1 of 3 cases who had undergone MRU,the definite diagnosis was made.Results All the 24 pa- tients underwent surgical treatment.Among them,nephroureterectomy and bladder cuff or partial resection were performed in 18 cases,and nephrectomy and partial ureterectomy in 6 cases.Postoperative pathology showed transitional cell carcinoma in 23 cases,and adenoma in 1.Of the 14 cases during 1990-1999 peri- od,1,5,3,2,2 and 1 cases had survival time of 1,2,3,4,5 and 6 years,respectively.Of the 10 cases during 2000-2005 period,3 were lost to follow-up;2 survived for 3 years and 2,for 1 year;the other 3 who have survived near 5 years have been followed till now.Conclusions IVU and retrograde urography are the most common diagnostic measures for primary ureteral cancer.They can be used in combination with other imaging study to reduce missed diagnosis rate.The 5-year survival rate was lower because of late pathologic stage of the tumors in the patients of this series.

Objective To investigate the clinical and molecular pathological features of dysferlinopathy in China.Methods Four patients with limb-girdle muscular dystrophy2B(LGMD2B)and 4 patients with Miyoshi-type distal muscular dystrophy(MMD)were clinically analyzed, their skeletal muscle were biopsied and immunohistochemical stained.Four cases of each Duchenne-Aran muscular atrophy and myotis were served as controls.Results The clinical situation of dysferlinopathy was characterized by progressive muscle weakness and atrophy, consistent with progressive muscular dystrophy.Histochemical staining revealed muscle fibers degenerating, regenerating and necrosis in a varying degree.Connective tissue was seen proliferated and inflammatory cells infiltrated in the majority of cases.Immunohistochemical staining with anti-dysferlin monoclonal antibody identified the deficiency of dysferlin on the sarcolemma and in the sarcoplasm of 8 cases with dysferlinopathy.Conclusions(1)The clinical and pathological characters of dysferlinopathy are consistent with progressive muscular dystrophy;(2)Anti-dysferlin monoclonal antibody immunohistochemical staining is a reliable method to diagnose dysferlinopathy, which is worth of wide application in clinic.