Objective To explore the differences of blood flow parameters of ophthalmic artery by color Doppler imaging in patients with diabetes mellitus with or without retinopathy.Methods 120 patients with diabetes mellitus were collected.According to whether the patients with retinal lesions,the patients were divided into the lesion group and the non lesion group,60 cases in each group.The pulsatility index,systolic blood peak,diastolic blood peak and resistance index in posterior ciliary artery(PCA),ophthalmic artery(OA),central retinal artery(CRA) were compared between the two groups.Results (1)PCA parameters:the pulsatility index[(1.93±0.38) vs.(1.26±0.32),t=10.447],resistance index[(0.92±0.01) vs.(0.58±0.06),t=43.297]of the lesion group were higher than those of the non lesion group(all P＜0.001),and systolic blood peak,diastolic blood peak were lower,the differences were statistically significant(t=11.735,10.762,all P＜0.001).(2)OA parameters:the systolic blood peak[(27.33±8.72)cm/s vs.(35.64±6.88)cm/s,t=5.795],diastolic blood peak[(7.44±3.57)cm/s vs.(10.28±2.92)cm/s,t=4.770]of the lesion group were less than those of the non lesion group(all P＜0.001),resistance index was higher[(1.97±0.34) vs.(1.39±0.18),t=11.678,P＜0.001],but the pulsatility index had no significant difference between the two groups(t=1.732,P=0.086).(3)CRA parameters:the systolic blood peak[(7.91±2.37)cm/s vs.(10.81±2.76)cm/s,t=6.175]and diastolic blood peak[(3.17±1.99)cm/s vs.(5.04±0.66)cm/s,t=6.909]of the lesion group were less than those of the non lesion group(all P＜0.001),the pulsatility index and resistance index were higher than those of the non lesion group(t=54.222,34.293,all P＜0.001).Conclusion The analysis of the parameters of the blood flow parameters in the patients with diabetic retinopathy by fundus artery ultrasound imaging has a certain reference value.

Objective To explore the changes of finger artery hemodynamics of patients with pulmonary heart disease, at the same time to search for the relationship with PaO_2.Methods We used American ACUSON128/xp10 and ATL5000 color Doppler ultrasound diagnostic instrument to detect double middle - finger artery hymodynamics items; VSMANX, VDMIN,TAMX , PI and RI. We used Danish ABL5 artery blood gas analysis to monitor PaO_2 and SaO_2.Results PaO_2 ,SaO_2, VSMAX,VDMIN ,TAMX,and PI in control group,pulmonary heart disease remission stage, active attack stage had significant difference (P

Objective:To study intervenient action of Qixue Bingzhi Prescription on the patient of cervical atherosclerosis(AS). Methods:63 cases of cervical AS were randomly divided into a treatment group(n=33) and a control group(n=30), with 25 cases of same age ranges used as healthy group. The control group was treated with basic treatment of western medicine and the treatment group with the basic treatment plus Qixue Bingzhi Prescription for one month. Changes of blood lipid metabolism, interleukin levels, supersensitive C-reactive protein(Hs-CRP) content and the leukocyte adherence expression rate were observed. Results: The total cholesterol (TC), triglyceride(TG), AS index (TC/HDL-C), interleukin-6 (IL-6), interleukin-8 (IL-8) and Hs-CRP levels and lymphocytes and the neutrophilic granulocyte adhesion molecule expression rate (ICD11b and zCD11b) decreased significantly(P 0. 05), Conclusion: Qixue Bingzhi Prescription can effectively and safely intervene in blood lipid metabolism and inflammatory reaction in the patient of cervical AS, and it has prospect of development in preventing formation of AS and stabilizing plaque.

Objective:The aim of the current study was to investigate the expression of nuclear factor-?B(NF-?B) and metalloproteinase-9(MMP-9) in the small intestine and to explore the potential role of NF-?B and MMP-9 in the damage of gut mucosal barrier after traumatic brain injury.Methods:The trauma was produced by a free-falling weight on the exposed dura of right parietal lobe.The rats were randomly divided into control group and traumatic brain injury groups at hours 3,12,24 and 72,and on day 7.NF-?B binding activity in the small intestine was studied by electrophoretic mobility shift assay(EMSA),and the expression of MMP-9 was studied by immunohistochemistry.Results:The results showed that NF-?B binding activity and MMP-9 expression in the small intestine was progressively increased,reached the maximum at 72 h and kept at high level up to 7 d after TBI.Concomitant upregulation of NF-?B~()and MMP-9 was observed.MMP-9 positively immunostained cells were mainly located at villous interstitium,lamina propria,crypt and submucosal layer,including endothelial cells,lymphocytes and neutrophils.Conclusion:It was concluded that cortical contusion trauma could induce a concomitant and persistent upregulation of NF-?B binding activity and MMP-9 expression in the small intestine which might play a central role in the~()damage of gut mucosal barrier.

Serum creatinine was determined by enzymatic method.99mTc-GFR was measured by 99mTc-DTPA dynamic renal imaging and considered as GFR marker in 210 males and 180 females with type 2 diabetes,eGFR was calculated by Cockcroft-Gault formula,MDRD equation7,abbreviated MDRD equation,modified MDRD equation for Chinese (c-7GFR4 and c-aGFR4),and CKD-EPI equation.They were analyzed by correlation,regression,Bland-Altman analysis and receiver operating characteristic (ROC) curve analysis.The correlation coefficients for Cockcroft-Gault formula,MDRD equation7,abbreviated MDRD equation,c-7GFR4,c-aGFR4,and CKD-EPI equation were 0.79,0.76,0.77,0.76,0.76,0.81 respectively.And the differences were-14.99,-18.85,-23.79,-25.85,-32.07,and-7.16,respectively.The area under ROC curves were 0.91,0.88,0.89,0.88,0.90,and 0.92,respeetively.Kappa values were 0.67、0.52、0.39、0.49、0.46、0.54respectively.The CKD-EPI equation seams to be the most accurate measurement among the six methods when the serum creatinine was determined by enzymatic method in Chinese type 2 diabetic patients.

BACKGROUND: Neuroprotective role of hypothermia on cerebral ischemic-reperfusional impairment has been long acknowledged. Since general hypothermia is complicated and unfit for observing postoperative consciousness and neurological function, it is of important significance to explore novel methods of focal cerebral hypothermia.OBJECTIVE: To study the neuroprotective effect of lateral ventricle infusion of low-temperature fluid on ischemic neurons of middle cerebral artery (MAC) occlusion models established on New Zealand rabbits.DESIGN: A randomized case-control study based on experimental animal models.SETTING: Neurosurgical department and pathological department of a general military hospital of Chinese PLA.MATERIALS: This study was carried out at Neurosurgical Laboratory of Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Altogether 18 healthy New Zealand male rabbits, weighing from 2. 8 to 3.2 kg, were selected 4 - 6 months after birth, and randomly divided into occlusion group, hypothermia group and control group.INTERVENTIONS: Cerebral focal ischemic-reperfusional model was established on the New Zealand rabbits through MCA occlusion for 2 hours followed by reperfusion for 24 hours.MAIN OUTCOME MEASURES: Scores for neurological function, water content in the left and right brain, pathological changes of nerve cells in the left MCA supplying region.pothermia group, significantly higher than that in occlusion group(7.58 ± 0.58 )( P ＜ 0.01 ), but no significant difference could be observed in contrast with brain was(81.64 ± 0.82)% and (79.26 ± 1.30)% in occlusion and hypothermia groups with significant difference between them( P ＜ 0.05), and it was significantly different between the left side [ (81.64 ± 0. 82 )% ] and opyknosis and deep staining could be observed in nerve ganglion cells in occlusion group under optical microscope, but no obvious pathological changes were observed in MCA supplying brain regions in hypothermia group.CONCLUSION: Permanent infusion of low-temperature fluid into the lateral ventricle plays an important neuroprotective role by attenuating cerebral ischemic-reperfusional impairment and improving post-ischemic neurological functions.

Objective To explore the effects and mechanisms of urokinase-type plasminogen activator (uPA) on high glucose-induced rat mesangial cells proliferation and phenotype transformation. Methods Rat mesangial cells were cultured and incubated in media containing either 5 mmol/L D-glucose or 30 mmol/L D-glucose with or without addition of wortmannin, or uPA (105 U/L) for different time periods. At the end of the incubation period, mesangial cells proliferation was assessed by MTT assay and flow cytometric analysis. Cyclin-dependent kinase 2 (CDK2) and p27kip1 expression and activation of Akt were evaluated by Western blotting and Akt kinase assay respectively. Furthermore, the expression and distribution of α-SMA were detected with laser confocal microscopy. Results MTT assay and flow cytometric analysis demonstrated that high glucose induced mesangial cells proliferation (P＜0.05) and an incresed proportion of cells in G2/M+S stage after 24 h incubation (P＜0.01), which were attenuated by uPA or wortmannin (P＜0.01). High glucose induced the enhance of Akt activity after 3 h (P＜0.05), and the effect was inhibited by wortmannin or uPA (P＜0.01). High glucose did not alter CDK2 expression (P＞0.05),but significantly inhibited p27kip1 expression (P＜0.05), which was attenuated by wortmannin or uPA (P＜0.01). High glucose induced the up-regulation of α-SMA expression and perinucleus location in mesangial cells after 24 h (P＜0.01), which were alleviated by wortmannin or uPA (P＜0.01). Conclusion uPA up-regulates p27kip1 expression and counteracts high glucose-induced mesangial cells proliferation and phenotype transformation via blocking PI3K-Akt signaling pathway.

In order to improve the clinical outcomes and promote the development of enhanced recovery after surgery(ERAS),a full-time specialized role of nurse navigator(NN) was established in Department of Surgery in February,2016. Clinical pathway for ERAS was designed,and role functions,core competencies and responsibilities of NN were formulated. According to the functions and the working frame,NN connected and coordinated teamwork activities,monitored the implementation of ERAS during the overall process. After implementation,the NN had dealt with 10 unusual incidents,the execution efficiency of the 14(82.4%) measurements were 100%,1 measurement was 97%,2 measurements were 94.1%,and 33 patients and 42 medical staff thought highly of the NN. This practice effectively promoted the development of ERAS team and specialist nurse role in our hospital.

Objective To elucidate the etiology feature of viral infection in hospitalized children with acute lower respiratory infection. Methods A total of 5 480 children with acute lower respiratory tract infection, hospitalized from September 2007 to September 2009, were studied. Nasopharyngeal aspirates were screened for 8 types of viruses by direct immunofluorescence (DIF) assay. Results At least one type of viral pathogen was detected in 2 710 out of 5 480 patients and the overall positive rate was 49.5%. The most common virus was RSV (51.1%), followed by hMPV (18.9%), PIVⅢ (12.5%), ADV (7.1%), IFA (4.7%), IFB (2.9%), PIV Ⅰ (1.5%) and PIV Ⅱ (1.2%). The positive rate was highest in children under 6 months (43.5%). The seasonal change of RSV, hMPV was more obvious. The peak of RSV, hMPV appeared in the winter and the spring. The prevalence of viral infection in children with pneumonia, bronchitis, asthmatic bronchitis, non asthmatic bronchitis and asthma were 47.4%、63.6%、 50.5%、 30.1% and 43.5% respectively. Conclusions Viruses are the main cause of lower respiratory tract infections in children, especially in infants and young children. RSV and hMPV were the most common viruses in these years.