ObjectiveTo explore the characteristics of traditional Chinese medicine (TCM) syndrome differentiation in chronic complications of type 2 diabetes mellitus (DM).Methods124 patients with chronic complications of type 2 DM were scored by 5 grades according as the severities of their symptoms. There were 5 kinds of patterns such as deficiency of Qi, deficiency of Yin, deficiency of Yang, blood stasis and retention of phlegm and fluid by which the TCM syndrome differentiation was generalized.ResultsThe sequence of TCM patterns was deficiency of Yin, blood stasis, deficiency of Qi, deficiency of Yang and retention of phlegm and fluid, and the syndrome of the two formers were greater than 50%. The proportion of unity of deficient and excessive pattern was 80.5%. Three larger syndrome types were deficiency of both Yin and Yang combined with blood stasis (17.7%), Qi-Yin deficiency with blood stasis ( 16.9 %) and Yin deficiency with blood stasis (16.9%). There was a statistically significant difference in TCM syndromes which were divided into different groups by course of diseases (P<0.05). At onset of DM, the typical symptoms were less observed in the group whose course of disease was less than 5 years, and only 39.1% of patients had the typical symptoms. But at the same time, the prevalences of hypertension and hyperlipidemia were higher in this group than in the others, respectively 63.0% and 87.0%.ConclusionThe primary syndrome is unity of deficient and excessive pattern in chronic complications of type 2 DM and deficiency of Qi and blood stasis are the commonest patterns in course of DM.

Objective To detect point mutations of the PRNP in 10 sporadic Creutzfeldt-Jakob disease (CJD) patients. Methods Priori protein gene open reading frame was amplified by PCR of genomic DNA extracted from peripheral blood leukocytes. Products were sequenced and digested with restriction endonuc lease Nsp I to check the phenotype at codon 129. Results Two CJD patients were confirmed at autopsy. One full sequencing of the PRNP open reading frame revealed normal, but the other revealed a single novel mutation consisting of a cytosine-to-guanine substitution at nucleotide 729, causing asparagine to replace glutamic acid at codon 211. Among 8 probable CJD patients, 2 full sequencing of the PRNP open reading frame revealed anadenine-to-guanine substitution at nucleotide 751, causing lysine to replace glutamic acid at codon 219. The patients were methionine homozygosity at codon 129. Conclusions The E211D mutation was identified in a confirmed CJD patient. The novel point mutation might be associated with familial CJD. However, E219K identified in 2 possible CJD patients was included in polymorphism of the PRNP as well as M129V. Analysis of PRNP plays an important role for diagnose of familial priori disease.

BACKGROUND:The biomechanical properties of naturaly regenerated damaged articular cartilage that belongs to the fibrovascular tissue are far worse than those of the normal cartilage so that they cannot meet the requirements for joint function, leading to traumatic arthritis and loss of joint function.
OBJECTIVE:To evaluate the effects of matrix metaloproteinase-3 (MMP-3) inhibitor I with different concentrations on the early-stage repair of ful-thickness articular cartilage defects in the knee of rats.
METHODS: Twenty-four Sprague Dawley rats were randomized into control, defect (DEF), and defect combined with low-(D+L) and high-dose inhibitor (D+H) groups (n=6 for each group), respectively. Full-thickness articular cartilage defects followed by intraarticular injection of low- and high-dose MMP-3 inhibitor I for 4 weeks was administered in the later two groups. Serum MMP-3 was detected using ELISA method before and after experiment, respectively. Femoral trochleas were collected to observe characteristics of repaired tissue by gross appearance scoring and O’Driscoll histological scoring with Safranine O-Fast Green staining, and to measure type II colagen by immunohistochemistry after experiment.
RESULTS AND CONCLUSION:Rats in the D+H group had obvious repair similarly to hyaline articular cartilage, while creamy white cartilage tissue and fibrous tissue repair were observed in D+L group and in DEF group. D+H group obtained the best repair results according to gross appearance scoring and O’Driscol histological scoring and the highest content of type II colagen (P< 0.05). MMP-3 concentration and the difference value before and after experiment were gradualy decreased in DEF, D+L, D+H, and control groups in sequence(P< 0.05). These findings demonstrate that MMP-3 inhibitor I accelerates the early-stage repair of ful-thickness articular cartilage defects in the knee of rats.

Objective The aim of the present study was to assess the frequency of depression and quality of life(QoL)in lung cancer patients before and after diagnosis , and to investigate the potential related factors. Methods The subjects consisted of 115 consecutive adult patients newly diagnosed for lung cancer in Shanghai Pulmonary Hospital between April 2008 and October 2008. Depression and QoL were evaluated before the diagnosis for baseline; the same evaluation was repeated after surgery. The median interval was 34.6 days (ranged 28-44 days). Patients' biomedical characteristics were noted from patients' medical records, while the demographic factors were obtained during the interview at the out-patients department. Statistical analysis was used to identify the significant predictors. Results The overall incidence of depression before final diagnosis and after surgery was 22.6% and 17.4 %, respectively. No significant change in the prevalence of depression was found in our study. Education, cost of hospitalization, and smoking status were associated with an increased risk of depression before final diagnosis. Age, having confidant, performance status, and type of surgery were found related with postoperative depression. Patients' QoL had a decrease in every subscale after surgery. Changes in role, social functioning scales and fatigue, pain symptom scales were found significantly. In QoL subsc ales, preoperative dyspnea, postoperative role functioning, fatigue , and pain were associated with changes of depression. Conclusion Depression may be present prior to final diagnosis in lung cancer patients and it does not seem to decrease significantly after surgery, indicating the need for psychological screening and appropriate intervention during theperioperative period. A poorer QoL was detected after surgery, which maybe partly contributed to depression symptoms.

Objective:To explore the monitoring value of left ventricular functional parameters obtained by bedside ultrasound combined with clinically relevant indicators in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:A retrospective study was conducted. A total of 24 patients receiving VA-ECMO adjuvant support in Renmin Hospital of Wuhan University from June 2018 to January 2020 were selected. The bedside ultrasound was performed on the first day of ECMO support, the day before weaning, the clinical indicators before weaning were obtained. The differences in clinical indicators and the left ventricular functional parameters between the two groups of whether weaning successfully were compared; univariate Logistic regression analysis was used to screen out the related factors affecting weaning.Results:Sixteen patients were successful weaned and 8 patients failed. Compared with the weaning failure group, patients in the weaning success group required less continuous renal replacement therapy (CRRT, cases: 4 vs. 6, P < 0.05), mean arterial pressure (MAP) before weaning was higher [mmHg (1 mmHg = 0.133 kPa): 84.64±9.55 vs. 62.30±8.79, P < 0.05], and the pulse oxygen saturation (SpO 2) was also higher (0.966±0.670 vs. 0.866±0.061, P < 0.05), while vasoactive-inotropic score (VIS), serum creatinine (SCr) and serum lactic acid (Lac) were lower [VIS score: 7.27±1.42 vs. 16.93±8.52, SCr (μmol/L): 123.60±83.64 vs. 213.10±117.39, Lac (mmol/L): 1.94±0.91 vs. 5.62±5.48, all P < 0.05]. Univariate Logistic regression analysis showed that the MAP, VIS, SCr, Lac, SpO 2 before weaning were the related factors affecting weaning [odds ratio ( OR) were 0.306, -0.740, -0.011, -0.632, -4.069; 95% confidence interval (95% CI) were 1.065-1.732, 0.235-0.899, 0.979-0.999, 0.285-0.992 and 0.001-0.208; P values were 0.014, 0.022, 0.038, 0.047, 0.002]. In the weaning success group, left ventricular ejection fraction (LVEF), velocity of mitralannulus in systolic (LatSa), maximum flow velocity of aortic valve (AV-Vmax), velocity-time integral (VTI), left ventricular global longitudinal strain (LVGLS), left ventricular global longitudinal strain rate (LVGLSr) were all increased on the day before ECMO weaning compared with the first day of ECMO support [LVEF: 0.40±0.05 vs. 0.28±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.62±1.02, AV-Vmax (cm/s): 104.81±33.98 vs. 64.44±16.85, VTI (cm): 14.56±3.11 vs. 7.96±1.98, LVGLS: (-8.95±2.59)% vs. (-5.26±1.28)%, LVGLSr (1/s): -0.48±0.11 vs. -0.29±0.09], whereas the ECMO flow was significantly reduced (L/min: 1.46±0.47 vs. 2.64±0.31), the differences were statistically significant (all P < 0.05). There was no significant difference in left ventricular functional parameters between the first day of ECMO support and the day before ECMO weaning in the weaning failure group. Compared with the weaning failure group, the weaning success group had higher LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr on the day before ECMO weaning [LVEF: 0.40±0.05 vs. 0.26±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.31±1.03, AV-Vmax (cm/s): 104.81±33.98 vs. 67.67±18.46, VTI (cm): 14.56±3.11 vs. 7.75±2.77, LVGLS: (-8.95±2.59)% vs. (-4.81±1.81)%, LVGLSr (1/s): -0.48±0.11 vs. -0.30±0.10, all P < 0.05] and lower ECMO flow (L/min: 1.46±0.47 vs. 2.20±0.62, P < 0.05). Conclusion:Bedside echocardiographic left ventricular function parameters (LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr) combined with clinical indicators (MAP, VIS, SCr, Lac, SpO 2) were helpful to evaluate the therapeutic effect of patients receiving VA-ECMO support and can provide important guiding value in the selection of VA-ECMO weaning timing and the judgment of prognosis.

Objective To explore the effect of carvedilol on ACE2 gene and protein expression in chronic heart failure rats after myocardial infarction.Methods The heart failure model was induced by acute myocardial infarc- tion (AMI) through ligating the left anterior descending coronary artery.One month after operation,rats were randomized to receive placebo or carvedilol 2 mg/(kg?d),by gavage.Sham-operated rats were used as the control group.Hemodynamies,body mass and left ventrieular mass index,plasma and myocardial level of angiotensin Ⅱ were determined.ACE2 gene and protein expression was assessed by using RT-PCR and Western Blot.Results The mortality of placebo and Carvedilol groups were 20%,compared with 0% in sham operated rats.Carvedilol significantly improved LVEDP,LVSP,+dp/dt_(max) and-dp/dt_(min) in CHF rats but all the hemodynamics data were still inferior than that of controls.Plasma and myocardial angiotensin Ⅱ level were increased significantly in CHF placebo rats than those of control rats (plasma Ang Ⅱ:CHF:194?19 vs controls:132?15 ng/L,myocardium Ang Ⅱ:CHF:6.7?0.4 vs control:3.8?0.3 ng/g,P

Objective Severe bronchial stricture due to endobronchial tuberculosis is often accompanied by complex complication,such as obstructiv pneumonia,destroyed lung and bronchiectasis.Its treatment is very diffucult.The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis.Methods Reviewed the clinico-pathological records documenting the surgical outcomes in 81 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 1990 and December 2010.There were 29 male and 52 female.Mean age was(36 ± 12) years (ranged 16-66 years).The three most common reasons of surgery were bronchial stricture accompanied by pulmonary atelectasis,destroyed lung and bronchiectasis(76 cases,93.8％).79 cases had elective operation,whereas one patients required emergency surgery.Pueumonectomy in 51,lobectomy in 16,sleeve resection in 11,segmental resection in 2,and exploratory thoracotomy in 1.If frozen pathological examination showed that endobronchial tuberculosis remained in the bronchial stump,it was covered with muscle flaps,including intercostal muscle flap in 6 cases,latissimus dorsi muscle flap in 5 cases,serratus anterior muscle flap in 5 cases.The mean operative time was 3.2 h (range between 2 h and 5.5 h) and the blood loss averaged 546 ml (range between 100ml and 4 000 ml).The post operative hospital stay averaged(12 ±8)days.Results No intraoperative or early postoperative death occurred.Nine patients developed complications,including BPF in 2,pulmonary infection in 2,empyema in 1,hemorragic shock in 1,hemothorax in 1,incision infection in 1,chylothorax in 1.All 9 cases recovered well after treatment.Pathological examination showed that tuberculosis bronchial remained in the brinchial stump in 13 cases.Neither BPF nor empyema occurred in all the 13 cases.Multivariate analysis revealed that destroyed lung was significant risk factor of postoperative complication.There were 3 late deaths.Five year survival rate was 96.2％.Conclusion Surgical treatment is still the recommeded treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its excellent results.It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed into destroyed lung.

Objective To establish a stem cell life-cycle management information system to realize collection,storage,inquiry,processing and statistical analysis of the stem cell and to provide information for the research on stem cell translation medicine.Methods The functional modules of the system were determined based on the analyses on the requirements of stem cell bank management and its operational flow.The system design was explored from the aspects of technical framework,safety control and fuzzy query.Results The system was gifted with a technical architecture and anallocation scheme based on Spring MVC mode,which proved its efficiency by the trial.Conclusion Stem cell resource library can be used as an important supplement to the clinical sample life-group database,providing data and technical basis support for large-scale clinical samples to transform,integrate,manage and share large data resources.

Objective To investigate the relationship between nerve conduction velocity(NCV)and syndrome differentiation of traditional Chinese medicine(TCM)in patients with diabetic peripheral neuropathy(DPN).Methods 172 patients with DPN were scored by 5 grades according to their symptoms which were classified by 5 kinds of patterns such as Qi-deficiency,Yin-deficiency,Yang-deficiency,Blood-stasis,Phlegm-dampness.NCV of the patients were also tested.Results The frequency of Yin-deficiency and Blood-stasis was more than 50%.The proportion and scores were significantly higher in the elder-age group than in the younger-age group(P<0.05).The scores of Blood-stasis and Yang-deficiency increased in the patients with longer-course(P<0.01).The correlation analysis showed that scores of nervous system were correlated positively with scores of Yin-deficiency,Yang-deficiency and Blood-stasis.There were positive correlation between scores of Qi-deficiency and fasting blood glucose(FBG)as well as between scores of Yin-deficiency and a-lipoprotein(LPa),and between scores of Yang-deficiency and homocysteine(Hcy).The proportion of Yin-deficiency and blood stasis in abnormal NCV group were higher than the normal while the results of Qi-deficiency and Phlegm-dampness were contrary.But the consequence had no statistical significance(P>0.05).Abnormality of NCV was aggravated with the high scores of Yang-deficiency and blood stasis.The analysis with logistic stepwise regression showed that diabetic course,levels of FBG and systolic blood pressure(SBP),be complicated by DN and DR,scores of nervous system sign were the independent risk factors for NCV.Conclusion Yin-deficiency and Blood-stasis are the major TCM syndromes in patients with DPN.The degree of Yang-deficiency and Blood-stasis influenced on the parameters of NCV.Abnormality of NCV can be aggravated with long diabetic course,high levels of FBG and SBP,be complicated by DN and DR,high scores of nerve system sign.

Objective To determine the prognosis and staging non small cell lung cancer (NSCLC) that extends across the fissure into adjacent lobe after surgery.Methods 3752 patients with histopathologically confirmed non small cell lung cancer (NSCLC) received surgical reeessetion from January,1997 to April,2007.Among them,163 patients have a tumor invasion beyond fissure.After matching by pathologic TNM staging (7th),326 patients whose tumor defined in a single lobe were eligible for analysis.Results Histopatholngic staging of matched patients was I a:10 patiens(6.1％ ),I b:79 patients (48.5％),Ⅱa:5 patients (3.1％ ),111:44 patients (27.0％) and Ⅲa:25 patients( 15.3％ ).5 years survival in patients with stage 1 tumors crossing the interlobar fissure was 51％,while in patients not cross the interlobar fissure was 63％ ( P ＜0.05 ).There was no difference in survival for tumors stage Ⅱa and above with regard to importance of interlobar extension.The T2 tumor extending across a lung fissure had a reduction in survival compared with T2 tumor not cross the lung fissure and similar to the T3 tumor without the fissure invasion.Conclusion Our results suggest that TNM staging should be modified for tumor extends the fissure into adjacent lobe.