objective To investigate the effects of health management on the progress of early diabetic nephropathy (DN).Methods A total of 98 patients with early stage DN were randomly assigned to the study group (n =49 ) and the control group (n =49 ).Questionnaire survey was performed,and urinary albumin to creatinine rate (ACR),body weight,fasting glucose,postprandial 2 h glucose,blood pressure,and lipid profiles were measured.The patients of the study group received health and disease management for 3 years; however,those of the control group received no additional intervention other than essential treatment. At 3 years, all the participants completed the questionnaires and above-mentioned measurements.Results In comparison with the control group,ACR of the study group was significantly decreased at 3 years ( P ＜ 0.05 ).In the control group,urinary protein was found in 15 patients and 3participants developed end-stage renal disease.However,neither urinary protein nor end-stage renal disease was found in the study group.Risk factors of DN,including high blood glucose,high blood pressure,and high cholesterol,were significantly decreased in the study group (all P ＜ 0.05 ).Conclusion Early effective health management of DN may contribute to decreased risk factors of renal disease and delayed disease progression.

Alzheimer’ s disease ( AD) is one of the most common dementia of neurodegenerative disorders, which results from the deposition of amyloid-beta ( Aβ) and there are no curative treatments for this disease at present.It had been proved that prion protein is the receptor for Aβand it plays a key role in the progress of AD with dual-side effects. Prion protein can not only transfer neurotoxicity to neurons but also protect them from neurotoxicity of Aβ.The polymor-phisms of prion protein encoding gene ( PRNP) affect the AD incubation period and clinical symptoms in humans and other animals.The discovery of PRNP mutational mouse fills the gaps of existing AD mouse models in this research area, which is potential for the studies of pathogenesis, new drugs design and testing aspects.The role and effects of prion protein in AD pathogenesis were summarized in this paper, furthermore, the discovery and utility of PRNP gene mutational mouse in research on AD and/or amyloid diseases were reviewed, and in order to provide some guidance for AD animal model study.

Objective To investigate the effectivity of bispectral index(BIS)and auditory -evoked potentials index(AEP index)in monitoring the depth of desflurane anesthesia in the elderly. Methods Sixty patients(ASA gradeⅠ～Ⅱ)without obvious auditory and psychiatric dysfunction undergoing general anesthesia were enrolled in this study,and they were devided into the elderly group (n=30)and the non-elderly group(n=30)according to the age.After the endotracheal intubation,the lungs were ventilated with desflurane in oxygen.End-tidal concentrations of desflurane were maintained at 0.6,1.0 minimum alveolar concentrations(MAC)and 1.3 MAC for 20 minutes, respectively.The changes of BIS,AEP index,mean arterial blood pressure(MAP)and heart rate (HR)were recorded simultaneously.Results In the elderly and non-elderly groups,BIS were 94.14?6.5 and 94.5?4.6(P＞0.05),and AEP index at pre-anesthesia were 87.2?11.7 and 89.2?6.9(P＞0.05)respectively,which showed no statistic difference between two groups.BIS and AEP index decreased significantly in each time point at pre-anesthesia compared with those during anesthesia in two groups (P＜0.05).In the periods of increasing concentration of desflurane,BIS decreased gradually in two groups(P＞0.05),but BIS in the elderly group were higher than in the non-elderly group at the same end-tidal desflurane concentration(P＞0.05),and BIS negatively correlated with the end-tidal desflurane concentration in two groups.In the elderly group,AEP index decreased significantly at the concentration of 1.0 MAC and 1.3 MAC of desflurane compared with that of 0.6 MAC(P＜0.05),but there was no difference in AEP index with increasing end-tidal desflurane concentration from 1.0 MAC to 1.3 MAC(P＞0.05).At every concentration of desflurane,AEPindexintheelderlygroupwaslessthaninthenon-elderlygroup(P＜0.05).Conclusions BIS and AEP indexes correlate well with the end-tidal desflurane concentration,and are valuable for monitoring the depth of desflurane anesthesia in the elderly.AEP index can predict the difference in depth of anesthesia at the same end-tidal desflurane concentration between the elderly and the non-elderly.

Based on the Android platform, a portable electrochemical analyzer was designed for the detection of heavy metal ions. Its output voltage range was ±3 V with accuracy of 0. 1% and resolution of <1 mV. The current acquisition range was±10 mA with accuracy of 0. 1% and the minimum resolution of 10 pA. With the human-computer interaction advantage of Android smart devices, professional and fast detection mode which could meet the needs of professional and ordinary users respectively were developed to simplify the complex process of electrochemical detection and analysis. Some common heavy metal ions including copper, cadmium, lead and mercury were detected with this detector. The results of linearity, repeatability and accuracy were satisfactory.

Objective:To review the treatment of life threatening head and neck space infection.Methods:Retrospective was con-ducted to analyse the patient characterization,signs and symptoms at the time of presentation,presence of concomitant systemic co-morbidities,treatment,prognosis and bacteriology.Results:32 patients from 2007.01 to 2013.01(mean age was 57.71 years)were included.The cases were increased year by year.1 1 (34.37%)patients had breathing difficulty requiring tracheostomy and 19 (59.3%)had concomitant systemic comorbidities.23 cases recovered completely,8 with severe mediastinal infection were trans-ferred to the department of thoracic surgery or the department of respiratory medicine.1 patient died.Pus submission rate was 96.87%,the bacteria detection rate was 37.50%.Pus culture showed mixed infection dominated by streptococci.Staphylococcus au-reus,pseudomonas aeruginosa,enterococcus faecalis,prevotella and neisseria were detected.Conclusion:Annually incidence of life threatening head and neck space infection is increasing.Treatment of the infection should include:①Ensuring the airway patency;②Surgical incision and drainage as early as possible;③ Hypoglycemic control,maintenance of hemodynamic,nutritional support,and multi-disciplinary approach are the key points in the management of such infections;④ Systemic antibiotics.

Aim To screen antibodies of novel purinoceptor as a marker for further study of the purinoceptor. Method BALB/c mice were immunized for 4 times with rat aortic endothelial cell. Then the phage display system was used to construct a single-chain Fv fragment (ScFv) cDNA library from the total RNA of immunized mice. The characteristics of novel purinoceptor not existing on vascular smooth muscle cell but on aortic endothelium were used to enrich the aortic endothelium specific antibodies. Induced with IPTG, these antibodies were secreted into the periplasm of E. coli. The functional experiment of novel purinoceptor named organ bath experiment was used to screen out the positive ScFv from the soluble expressed antibodies. Immunohistochemistry experiment was used for positive ScFv identification. Results The total mouse anti-rat endothelium lgG is 1 ∶16 000. 8?106 mouse anti-rat endothelium ScFv cDNA library was successfully constructed. After 4 times of rat endothelium and rat smooth muscle cells screening, 2 500 ScFv cDNA binding membrane of aortic endothelium was enriched. After 4 times of functional screening, a phage-ScFv named B inhibiting the adenosine induced NO dependent construction by 83.4%?21.6% was selected from the expressed antibodies. Immunohistochemistry experiment showed that ScFv-B combined with aortic endothelium specifically and functional experiment showed that ScFv-B did not have any effect on adenosine induced ileum contraction, indicating that ScFv-B specifically binding to the novel purinoceptor. Conclusions ScFv-B binding specifically to the novel purinoceptor was selected by phage display technique and functional screening experiment which provide a good marker for further study of the novel purinoceptor.

Objective:To compare immune effects of hepatitis B-BCG combined vaccine and hepatitis B vaccine.Methods:The vaccines were administered to the guinea pig at 0, 1, 2 months. The tests were divided into three parts. The immune effects were compared in three kinds of the combined vaccine and hepatitis B vaccine(Part One), in three lots of the combined vaccine and hepatitis B vaccine(Part Two), in the group of combined vaccine and the group of hepatitis B vaccine and BCG(Part Three). After 1 month of each vaccine dose, serum specimens were measured for anti-HBs by ELISA.Results:The several studies have documented the serum anti-HBs concentritious in the group of combined vaccine in first dose were lower than those of the group of control, and the data showed no significantly difference. However, anti-HBs levels of the combined vaccine group in second vaccine dose and third vaccine dose were higher than those of the control group, and this difference was no longer statistically significant in group of combined vaccine and control, and among groups of combined vaccine.Conclusion:The immune efficacy of HBsAg in group of combined vaccine is similar to the group of hepatitis B vaccine in three doses immunization schedules.

OBJECTIVETo set up a venous congested flap model to study the mechanism of necrosis through long-term microcirculation observation.

METHODSA specially deviced chamber was assembled to one side of the ears in an adult white rabbit, about 7 approximately 10 days after the operation the congested flap model was made and the microcirculatory status of the flap was dynamically observed under a vivo-microscope for a long time.

RESULTSThe venous crisis phenomenon of flap was well studied and the microcirculation of the flap was observed carefully, finally the variational rule of the congestion flap microcirculation was made clear.

CONCLUSIONSThe model could well simulate the venous crisis flap in clinic, and the microcirculation could also be observed for a long time.

Animals ; Disease Models, Animal ; Female ; Male ; Microcirculation ; Rabbits ; Surgical Flaps ; blood supply ; pathology ; Veins ; pathology

Objective To explore the predictive values of the levels of blood lipids ,liver function and estrogen for the fetal dis‐tress in intrahepatic cholestasis of pregnancy (ICP) patients .Methods The indicators of blood lipids ,liver function and estrogen of mild IPC group ,severe ICP group and control group were detected respectively ,and the results were analyzed .Results The levels of triglycerides ,total cholesterol and low‐density lipoprotein were positively related to estradiol levels .Multivariate logistic regres‐sion analysis showed that cholyglycine (OR=8 .24 ,P=0 .01) and estradiol(OR=4 .46 ,P=0 .02) were significant for prediction of fetal distress in ICP patients .Conclusion Estradiol and cholyglycine levels may be better indicators for the prediction of fetal dis‐tress in ICP patients .

Objective To explore the correlation between anti-cyclic citrullinated peptide(A-CCP) antibody and tumor necrosis factor(TNF)-?, rheumatoid factor(RF), ESR, PLT count and clinical features in patients with rheumatoid arthritis(RA), and the outcome of unclassified arthritis(arthralgia)patients after six months follow up. The value of A-CCP antibdy in the diagnosis of early RA and its pathogenetic roles is in- vestigated. Methods A-CCP antibody and TNF-?were detected by ELISA and the RF was tested by the rate scatting immunity method in 91 RA patients, 46 unclassified arthritis(arthralgia)patients and 45 other rheumatic diseases patients. Results A-CCP antibody levels in serum correlated significantly with TNF-?levels, PLT count and the degree of joint swelling in RA and unclassified arthritis(arthralgia)patients(r= 0.854, P=0.O00; r=0.882, P=0.000; r=0.318, P=0.002; r=0.486, P=0.001; r=0.291, P=0.005; r=0.731, P= 0.000 respectively). A-CCP antibody levels in serum was weakly negatively correlated with the gripping power in RA patients(r=0.228, P=0.030). And it was weakly correlated with ESR in unclassified arthritis(arthrai- gia)patients(r=0.365, P=0.013). Compared with other rheumatic diseases patients, A-CCP antibody levlels in serum increased significantly in RA and unclassified arthritis(arthralgia)patients(P=0.000). Compared with normal controls, it increased in other rheumatic diseases patients(P=0.011). Twenty-four patients had positive A-CCP antibody in 46 unclassified arthritis(arthralgia)patients. Thirty-two out of 46 unclassified arthritis(arthralgia)patients were early RA after 6 monthes follow up. 95.8%(23/24)unclassified arthritis (arthralgia)patients with positive A-CCP antibody were early RA. Conclusion A-CCP antibody reflects disease activity in certain extent. It's benefit to the diagnosis of early RA. High A-CCPantibody levels com- bined with high levels of TNF-?, ESR, PLT count and joint swelling can help the diagnosis of early RA.