Objective To investigate the feature of CT perfusion of the lower limb skeletal muscle in patients with diabetic peripheral arterial disease (PAD).Methods It was a prospective study that collected out-patients and in-patients of interventional vascular surgery from January 2008 to January 2013.The patients were divided into three groups,including 27 patients (54 limbs) in diabetic PAD group,27 patients (54 limbs) in common PAD group and 9 patients (18 limbs) in control group.Patients in diabetic PAD group were selected when PAD were diagnosed through CTA and patient had the exact history of diabetes.There were 54 limbs in diabetic PAD group,including 10 limbs in Fontaine Ⅰ class,21 limbs in Fontaine Ⅱ class,14 limbs in Fontaine Ⅲ class and 9 limbs in Fontaine Ⅳ class.Patients in common PAD group were selected when PAD were diagnosed through CTA,patients those had the exact history of diabetes or coronary heart disease were exclusion.Patients in control group were collected with negative CTA results.CT perfusion scans of lower extremities were performed in all patients.Time density curve (TDC),Blood flow (BF),blood volume (BV),mean transit time (MMT) and permeability surface (PS) of skeletal muscle in different pathologic stage were obtained with perfusion software.The differences of perfusion parameters among diabetic PAD group,common PAD group and control group were compared by analysis of variance; and the differences of perfusion parameters among control group and all Fontaine classes in diabetic PAD group were also compared.Results TDC of normal skeletal muscle in control group continued to rise,and raise rapidly at an early stage; TDC of diabetic PAD group and common PAD group continued to rise,but raise slowly; the TDC of ischemia skeletal muscle has smaller slope and lower peak value than that of control group.The values of BF were (10.41±0.92) ml · 100 ml-1 · min-1 in control group,(13.37± 1.15) ml · 100 ml-1 · min-1 in diabetic PAD group and (17.12 ±0.81)ml· 100 ml-1· min-1in common PAD group.The values of BV were (1.04± 0.13)ml/L in control group,(1.23 ±0.16)ml/L in diabetic PAD group and (1.84 ±0.23) ml/L in common PAD group.The values of MTT were (11.63 ± 1.45) s in control group,(7.92±0.35) s in diabetic PAD group and (7.82±0.38) s in common PAD group.The values of PS were (3.46±0.84) ml· 100 ml 1· min-1 in control group,(9.84±0.87) ml· 100 ml-1· min-1 in diabetic PAD group and (12.11 ±0.70)ml· 100 ml-1· min-1in common PAD group.The differences of the values of BF,BV,MTT and PS among the three groups were statistically significant (F values were 10.892,4.492,27.543 and 20.506,P all＜0.05).The differences of the values of BF,BV among control group and all Fontaine classes in diabetic PAD group were not statistically significant(P all＞0.05),the differences of the values of MTT,PS were statistically significant.And the differences of the values of MTT,PS between control group and each Fontaine class in diabetic PAD were statistically significant (P all＜0.05).Conclusions CT perfusion imaging of Lower extremity skeletal muscle can prompt the existence of early skeletal muscle ischemia for diabetic PAD.The method can be valuable for clinical early diagnosis.

BACKGROUND:The effect of body mass index (BMI) on the outcomes ofin vitrofertilization (IVF) is controversial. Some scholars suggested that the higher BMI, the lower rate of pregnancy, and the higher rate of abortion. However, some others got the different results. To data, the effects of BMI on the pregnancy outcomes in females at different ages are rarely reported.
OBJECTIVE:To explore the effect of BMI on the pregnancy outcomes of IVF for infertile women atdifferent ages.
METHODS:A total of 902 cycles undergoing IVF were divided into two groups according to the age:≤ or> 35 years old groups. The patients in each group were then divided into four subgroups according to BMI: low weight, normal weight, excess weight, and obesity subgroups, respectively.
RESULTS AND CONCLUSION: With increasing BMI, the average dosage of gonadotropins was increased gradualy in two both of age groups (P < 0.05). In the≤ 35 years old, the levels of estrogens on the day of injecting human chorionic gonadotropin was significantly lower in obesity group than the other subgroups (P < 0.05); the rates of empty folicle in excess weight and obesity subgroups were significantly higher than that in normal weight subgroup (P < 0.008 23). The fertilization rate and clinical pregnancy rate of in obesity subgroup were significantly lower than those in the other subgroups (P < 0.05). In the > 35 years old group, the empty folicle rate in obesity subgroup was significantly higher than that in normal weight subgroup (P < 0.008 23). Fertilization rate in excess weight and obesity subgroups was significantly lower than that in the normal weight subgroup (P< 0.008 23). There were no significant differences in cleavage rate, cycle cancelation rate, implantation rate, biochemical pregnancy rate and abortion rate between four subgroups (P> 0.05). These findings suggest that in the females at the younger age, BMI not only affects the quality of folicles and fertilization rate; but with increasing BMI, clinical pregnancy rate is decreased obviously. However in the females at the older age, BMI only affects the folicular quality, embryo quality and fertilization rates; there are no significant differences in the outcomes of pregnancy in the four subgroups. BMI have effects on pregnancy outcomes of IVF, and the effects are much greater in the younger female group.

Objective To discuss the preoperative interstitial chemotherapy effect and significance on Ki‐67 and Caspase‐3 in oral squamous cell carcinoma .Methods 60 cases of well‐differentiated oral squamous cell carcinoma were divided into three groups ,non chemotherapy before operation group(n= 30) ,intravenous chemotherapy before operation group (n= 15) and interstitial chemo‐therapy before operation group(n=15) .The expressions of Ki‐67 and Caspase‐3 were determined by immunohistochemical method , then compared between three groups .Results The labelling index of Ki‐67 in tissue of carcinoma were significant differences a‐mong each groups(P< 0 .05) .The labelling index of Ki‐67 in adjacent mucosas of carcinoma were significant differences among three groups(P<0 .05) .The expression rates of Caspase‐3 were significant differences among three groups(P<0 .05) .Conclusion Preoperative interstitial chemotherapy than preoperative intravonous chemotherapy for oral squamous carcinoma more inhibit tumor growth and reduce local recurrence through the inhibition of cell proliferation and induction of cell apoptosis ,thus inhibiting tumor growth .

Objective To explore the relationship of acute myeloid leukemia kayotype with chemotherapeutic effect. Methods Conventional cytogenetic technique of G-band was used to analyze in 222 acute myeloid leukemia patients. Results Eighty-six cases (42. 1%) with cytogenetic abnormalities were found in 204 patients. Excepting for M_3 patients,the favorable,intermediate and adverse groups according for MRC criteria were treated with TA or CAG schema respectively. CR rate of M_3 was obviously higher than non-M_3. The favorable and intermediate group were obviously surpassinger than adverse group in TA schema. CR rate of the intermediate group was highter than that of other groups in CAG schema. CR rate of the adverse group in two schema were all low. CAG was surpassinger than TA schema in intermediate group. Conclusion Cytogenetics is an important chemotherapeutic and prognostic factor to acute myeloid leukemia. CAG schema could be the leader selection in the de novo presby or oligoac-crementional AML patients.

Bilingual teaching is one of education reform in China.The essay analyzed the necessity of bilingual teaching and clarified the reason why it can procced in microbiology.Search after the way in microbiology course according to the character of college in western China.The practice accumulated experience for bilingual teaching.

Background and purpose:Both nature killer cells(NK)and cytoxic T lymphocytes in the body tissues of human are the dominant components of cellular immunity,This study was done to explore the degree of infiltration of NK/T in lung squamous cell carcinoma and its relation to patient survival and prognosis.Methods: CCD8 as the markers cytoxic T lymphocyte(CTL)and CD56 as the markers natural killer(NK)were stained immunohistochemically to detect the distribution and infiltration in the lung squamous cell carcinoma specimens. Results:In 39 of 68 lung neoplasm,whose CTL infiltration was zero or mild,the five-year survival rate was 18%, while in 29 with marked CTL infiltration,the five-year survival rate was 42%.In 46 of 68 lung neoplasm,whose NK infiltration was zero or mild,the five-year survival rate was 14%,while in 22 with marked NK infiltration,the five-year survival rate was 45%.In 48 of 68 lung neoplasm,both the NK and T cells were zero or mild,the five-year survival rate was 33%,while in 20 with marked NK and T cell infiltration,the five-year survival rate was 54%.The five-year survival difference among the patients with NK,T infiltration either marked or zero/mild infiltration were significant(x~2=18.62, P=0.00).Conclusions:The degree of NK and T infiltration is positively correlated with the prognosis and survival time of lung squamous cell carcinoma patients.

Objective To study the effect of propofol intravenous anesthesia on T helper cells of patients with primary liver cancer during perioperative period.Methods A total of 86 patients with primary liver cancer in our hospital from November 2014 to October 2015 were selected,who were divided into observation group and control group according to the method of random numbers,43 cases in each group.The observation group were taken propofol intravenous anesthesia,and the control group were treated with sevoflurane inhalation anesthesia.The Th1 cells percentage,Th2 cells percentage and the ratio changes of the Th1/Th2 cells of two groups before anesthesia and postoperative 1 day were compared.The plasma cortisol levels of two groups before anesthesia,after anesthesia,intraoperative and 1 day after operation were observed.Results The percentage of Th2 cells in observation group and control group 1 day after surgery had no significant difference (P ＞ 0.05).The percentage of Th1 cells and Th1/Th2 cells ratio of the observation group were higher than those of the control group [(16.32 ± 1.76) ％ vs.(14.16 ± 1.03),(8.48 ± 0.92) vs.(7.11 ± 0.72)],the differences were significant (P ＜ 0.05).The plasma cortisol levels of observation group during operation and 1 day after operation were lower than those of the control group[(12.34 ± 1.02) μg/dL vs.(16.13 ± 1.26) μg/dL,(12.01 ± 0.94) μg/dL vs.(15.25 ± 1.08) μg/dL],the differences were significant(P ＜ 0.05).Conclusion The propofol intravenous anesthesia can encourage more Th to differentiate into Th1 cells,which plays a protective role in the patient's immune function.

Successful pain management of perioperative shoulder arthroscopy may allow patients to go home earlier, improve the quality of life in perioperative period, and facilitate rehabilitation. A comprehensive method to perioperative pain control has three stages including preoperative, intraoperative and postoperative phase. Successful pain reduction should begin preoperatively because of an excellent communication between patient and physician, moreover, preoperative analgesia also should be administered. Intraoperative efforts should include local wound infiltration and the administration of anesthetic medication intra-articularly. Postoperative management should include oral analgesics, constant infusion devices, Patient Controlled Analgesia (PCA), sedative-hypnotic drug, continuous cryotherapy and vicarious treatment.
Acupuncture Analgesia ; Analgesia ; methods ; Analgesia, Patient-Controlled ; Arthroscopy ; Humans ; Pain, Postoperative ; therapy ; Perioperative Period ; Shoulder Joint ; surgery ; Transcutaneous Electric Nerve Stimulation

Objective To explore the relationship of acute myeloid leukemia kayotype with chemotherapeutic effect. Methods Conventional cytogenetic technique of G-band was used to analyze in 222 acute myeloid leukemia patients.Results Eighty-six cases(42.1%) with cytogenetic abnormalities were found in 204 patients.Excepting for M3 patients,the favorable,intermediate and adverse groups according for MRC criteria were treated with TA or CAG schema respectively. CR rate of M3 was obviously higher than non-M3.The favorable and intermediate group were obviously surpassinger than adverse group in TA schema.CR rate of the intermediate group was highter than that of other groups in CAG schema. CR rate of the adverse group in two schema were all low. CAG was surpassinger than TA schema in intermediate group.Conclusion Cytogenetics is an important chemotherapeutic and prognostic factor to acute myeloid leukemia. CAG schema could be the leader selection in the de novo presby or oligoaccrementional AML patients.

Objective To investigate the plasma vitamin D3 level and its association with B cell subsets of patients with primary Sj(o)gren's syndrome (pSS).The role of vitamin D3 levels in the pathogenesis of pSS was explored.Methods The expression of plasma vitamin D3 levels of 55 patients with pSS and 32 controls were analyzed by ELISA.Frequencies of peripheral blood CD19+CD27-na(i)ve B cells,CD19+CD27+ memory B cells and CD19+CD27high plasma cells were analyzed by flow cytometry in 34 pSS patients without therapy and 22 controls.The relationship between the vitamin D3 levels and B cell subsets,SSDAI,tear flow rate,saliva flow rate,rheumatoid factor,immunoglobulin was analyzed in pSS patients.Non-parametric test,t test,one-way ANOVA,x2test,Pearman's and Spearman's correlation analysis were used for statistical analysis.Results ① There was significant difference in the levels of plasma 1,25 (OH)2D3 between the pSS patients group and normal control group,1,25 (OH)2D3 was significantly lower in pSS patients than that in the normal control group [24.17(22.20,28.41) pg/ml and 41.25(23.38,62.18) pg/ml,P＜0.05],and that was also obviously lower in the active group [22.64(20.74,24.90) pg/ml] than that in the normal control group (P＜0.05),and that was also obviously lower in the active disease group than that in the inactive disease group [25.39 (23.16,33.09) pg/ml,P＜0.05],but there was no difference between the inactive group and the normal control group (P＞0.05).② The percentage of peripheral blood of CD19+CD27high plasma cells and CD19+CD27+ memory B cells in CD19+ cells was reduced in patients in the pSS group compared with the control group [(0.89±0.30)％ and (1.72±0.43)％,(24±8)％ and (34±5)％; P＜0.05],and that was also significantly lower in the active group [(1.03±0.59) ％ ; (26± 10)％] and inactive group [(1.00±0.16)％,(26± 3)％] than that in the normal controls (P＜0.05).However,there was no difference between the active group and the inactive group (P＞0.05),but the frequency of peripheral blood of CD19+ CD27-naive B cells in CD19+ B cells was increased in patients with pSS compared with normal control group [(75.4±7.5)％ and (63.9±5.2)％,P＜0.05],and that was also significantly higher in the active group [(73.4±9.7)％] and inactive group [(73.3±2.9)％] than that in the normal control (P＜0.05),there was no difference between the active group and the inactive group.③ Significant negative correlation was observed between 1,25 (OH)2D3 and the percentage of peripheral blood CD19+CD27+ memory B cells in CD19+ cells as well as immunoglobulin G(r=-0.627,P=0.039; r=-0.657,P＜0.01) level.Conclusions These results demonstrate that abnormality of vitamin D levels may play an important role in the pathogenesis of pSS.