Objective To explore the clinical value of the disposable uterine cavity tissue suction tube in diagnosing abnormal u‐terine bleeding .Methods Seventy‐five patients ,who needed an endometrial biopsy because of abnormal uterine bleeding ,were se‐lected for this study .An endometrial biopsy was performed by a disposable uterine cavity tissue suction tube before the conventional suction dilatation and curettage (D&C) .The sample satisfactory rate and the diagnose accordance rate of the two methods were compared .Results The sample satisfactory rate of the disposable uterine cavity tissue suction tube and of the D&C was 85 .3%(64/75) and 94 .7% (71/75) respectively .The difference was not statistically significant(P>0 .05) .The diagnose accordance rate of the disposable uterine cavity tissue suction tube and the D&C was 90 .3% (56/62) and 93 .5% (58/62) respectively .The differ‐ence was not statistically significant(P>0 .05) .Conclusion To a certain extent ,endometrial biopsy performed by disposable uter‐ine cavity tissue suction tube can be a substitute for D&C as the initial inspection to assess abnormal uterine bleeding ,for its econo‐my ,efficiency and safety .

Objective To ev al uate the genotype distribution of the promoter of leptin gene in Chinese populat ion, and to verify its association with the plasma leptin level and anthropometr ic, metabolic and clinical parameters in type 2 diabetic patients and their non -diabetic first degree relatives. Methods Two hundred and sixty-nine patients with diabetes and 135 non-diabetic first degre e relatives in pedigrees of type 2 diabetes mellitus, and 85 normal controls wer e screened for presence of the polymorphism by PCR-RFLP assay, and body mass in dex (BMI), fasting plasma leptin, insulin, and glucose were measured and HOMA-I R determined. Results (1) In type 2 diabetes gr oup, AA genotype frequency (0.063) and A allele frequency (0.349) were higher th an those in normal controls (0.012 and 0.253, respectively). (2) Diabetic patien ts with AA or AC genotypes showed lower fasting leptin than those with CC genoty pe (P

Objective By simulating a high-glucose condition of peritoneal dialysis (PD)fluid,to explore the effect of high glucose on the expression of leptin and its relationship with peritoneal angiogenesis.Methods Adipocytes differentiated from 3T3-L1 were divided into high glucose group (139 mmol/l glucose) and high mannitol group.Leptin levels in supernatant collected at 0 h,12 h,24 h and 48 h were measured by ELISA.Endothelial cells (ECs) were respectively cultured with normal glouse,high glucose,high mannitol condition,supernatants of adipocyte induced by normal glouse,high glucose and high mannitol,high glucose supernatants+leptin antibody,and high mannitol supernatants + leptin antibody.Tubular structure formation and migration of ECs were detected.Results Adipocytes exposed to high glucose for 48 h produced more leptin as compared with control group,high mannitol group,12 h-high glucose group and 24 h-high glucose group (all P ＜ 0.05).Compared with ECs in normal group,ECs in high glucose had less tubular structure formation and increased migration (all P ＜ 0.01).Compared with those of ECs in high glucose,the tubular structure formation and the migration of ECs in adipocyte supernatants induced by high glucose had increased (all P ＜ 0.01),and these effects were reduced by leptin antibody (all P ＜ 0.01).Conclusion There is an up-regulation of leptin in adipocytes exposed to high glucose,which may be an alternative way to prevent peritoneal angiogenesis.

Objective To investigate the association of CA repeats polymorphism in the promoter region of human IGF-I gene with type 2 diabetes in narthen Han nationality. Methods Gender-age matched subjects with type 2 diabetes and normal glucose tolerance (NGT) were enrolled for this study, 147 subjects in type 2 diabetes group and 159 subjects in NGT group. Genomic DNA was extracted by standard methods. PCR, Genescan,Genotyper, and direct sequencing were conducted to screen CA repeats polymorphism in the promoter region of the human IGF-I gene. Results No significant association was observed between any ( CA), repeat genotype and type 2 diabetes. A lowered serum uric acid was seen in genotypes that included alleles with larger than (CA) 20 repeats [(4.18 ± 1.25 vs 4.63 ± 1.36) mg/dl, P = 0.03]. Conclusion Alleles with larger than (CA) 20 repeats may be a protective factor for type 2 diabetes.

BACKGROUND: Metabolic disorder of blood lipid can be observed in the non-diabetic first-degree relatives.OBJECTIVE: To explore the relationship between the level of blood lipid and insulin resistance in members of type 2 diabetic pedigrees.DESIGN: A retrospective case control study of the non-diabetic first-degree relatives of type 2 diabetic families.SETTING: The department of endocrinology of a university hospital.PARTICIPANTS: This study was carried out in the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical College from June to November 1999. A total of 125 non-diabetic first-degree relatives of type 2 diabetic pedigrees in Chongqing were recruited and divided into hyperlipemia group and normal control group according to their blood lipid level.INTERVENTIONS: Body height, body mass and blood pressure of all the subjects were measured. Their cubital venous blood samples were also obtained for determination of the levels of fasting plasma glucose (FPG), fasting insulin(FINS), fasting C-peptide(FCP), triacylglycerol(TG), total cholesterol(TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C).homeostasis model assessment insulin resistance(HOMA-IR) between the two groups.RESULTS: The level of FINS was markedly higher in the hyperlipemia group [(12.92 ±5.26) μU/L] than in the control group[(9.15 ±4.66) μU/L]( t = 2. 17, P < 0.05) . HOMA-IR was also significantly higher in the hyperlipemia group [ (2.94 ± 1.25 ) ] than in the control group [ (2.01 ± 0.94) ]( t = 2.70, P < 0.01 ) . In the hyperlipemia group, HOMA-IR was positively correlated with TC, TG and LDL-C ( r = 0. 34, 0. 78, 0.42), with TG most closely correlated( r = 0. 78, P < 0. 01), while HOMA-IR had no significant relation with HDL-C ( P > 0.05).CONCLUSION: There is a close correlation between lipid metabolic disorder and insulin resistance in the high-risk diabetic group.

Background and purpose:Human epidermal growth factor receptor-2 (HER-2), a member of epidermal growth factor receptor family, initiates a diverse set of signaling pathways that ultimately affect such fun-damental processes as cell proliferation, cell motility and cell apoptosis. It is reported that HER-2 was associated with epithelial-mesenchymal transition (EMT) process. However, the mechanism needs further investigation. The purpose of this study was to investigate the mechanism of HER-2 on regulating EMT process.Methods:Transwell assay was used to determine the motility of breast cancer cells; Real-time lfuorescence quantitative polymerase chain reaction (RT-FQ-PCR) was employed to determine the expression of genes of interest, and reactive oxygen species production was measured by reactive oxygen species detection kit.Results:HER-2 overexpression in breast cancer cells could promote cell migration and invasion. Mechanistic study showed that HER-2 overexpression could upregulate ZEB1 expression. ZEB1 silencing by siRNA reduced cell motility of HER-2-overexpressing breast cancer cells. Furthermore, reactive oxygen species produced in HER-2-overexpressing breast cancer cells were less than those produced in corresponding control cells.Conclusion:Our study demonstrated that HER-2 overexpression endowed breast cancer cells with EMT related properties by upregulating ZEB1 expression. ZEB1 could be a candidate target for further study of the relation-ship between HER-2 and EMT.

Purpose To evaluate the correlation and consistency of left ventricular ejection fraction (LVEF) obtained by ECG-gated myocardial perfusion SPECT (GMPS) using four formulae (R0-R3) of ECToolbox software and findings on equilibrium radionuclide angiography (ERNA), and to determine the optimal diagnostic thresholds by using the four formulae. Materials and Methods A total of 38 patients with myocardial infarction and 65 patients with suspected coronary heart disease underwent both 99Tcm-MIBI rest GMPS and 99Tcm-RBC ERNA within a week. The LVEF values calculated by ECToolbox R0, R1, R2 and R3 were compared with those obtained by ERNA, and compared with ERNA results, the optimal diagnostic thresholds of the four formulae (R0-R3) were assessed by receiver operating characteristic (ROC) curves. Results The results calculated by the formulae (R0-R3) presented a significant positive correlation with that obtained by ERNA [mean LVEF value by ERNA (54.6±17.5)%, mean LVEF value by formulae R0-R3 (64.1±15.7)%, (56.3±15.1)%, (69.9±17.9)% and (56.7±13.6)%, respectively, r=0.899, 0.898, 0.890, 0.895; P<0.01]. All mean LVEF values calculated by the four formulae were higher than that by ERNA, and the difference was significant (P<0.05). LVEF≥50%obtained by ERNA was considered as normal diagnostic value, the optimal diagnostic thresholds of R0-R3 were 56.5%, 51.5%, 64.5% and 52.5%, respectively. Conclusion The results calculated by R0, R1, R2 and R3 in the ECToolbox software and that by ERNA show significant correlation and difference for the assessment of LVEF. Thus it is advisable to stick to one formula in the follow-up of each patient and select correspondent threshold in the clinical diagnosis.

Objective To determine clinical characteristics and the effects of drug-eluting stents on the occurrence of major adverse cardiac events during percuteneous coronary artery interventional(PCI)and long- term outcomes in patients with chronic renal insufficiency(CRI).Methods Nine hundreds and seventy three patients with angiographically-documented coronary artery disease(lumen inner diameter narrowing＞50%), included 516 patients complicated with experienced renal impairment(CRI group)and 457 with normal renal function(control group).Baseline clinical data and coronary angiographic features were recorded.Results Comparing with control group,patients in CRI group were older with higher incidence of hypertension or diabetes and simultaneously complicated by reduced left ventricular ejection fraction,and more complex coronary lesions(type C).During follow-up(mean 17 months),the mortality was significantly higher in CRI than in control group(6.2% vs 3.3%,P＜0.05),but the former with CRI was significantly lower by using drug-eluting stents in comparing with bare-metal stents(4.1% vs 8.5%,P＜0.05).Conclusion Patients with CRI often complicated with severe coronary artery disease,the mortality after PCI would be significantly reduced by using drug-eluting stents.

Objective To investigate the effect of L-selectin in experimental allergic encephalomyelitis (EAE) of Wistar rats.Methods The rats were randomly divided into four groups;the normal group,the CFA group, the LMS group and the model group;The animal models were established in rats by immunization with myelin basic protein of spinal cord of guinea pig and complete Freund's adjuvant(CFA).The symptom of EAE was observed; pathological feature and myelin of brain and spinal were detected with HE stain and Loyez's stain respectively.The number of positive vessels of L-selectin expression was detected by immunohistochemistry.Results 100% experimental Wistar rats treated with MBP and levamisole developed EAE,but none of the other groups.The number of positive vessels of L-selectin expression was (31.86 ± 1.39) in model group, obviously higher than that of in the normal group (1.38 ±0.18) ,the CFA group( 1.50 ±0.27) and the LMS group(7.25 ±0.59) (all P <0.05) ;The inflammation cells were found around vessels and demyelination were seen in white matter of brain and spinal cords.Conclusion The expression of L-selectin should play an important role in EAE.

Objective To report a case presented with atypical clinical and radiological appearance in the early stage and finally pathologically confirmed as chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids ( CLIPPERS) , aiming to improve the understanding of the disorder. Methods The clinical, imaging, laboratory and pathological features as well as treatment and prognosis of a pathologically confirmed CLIPPERS patient with repeated relapsing-remitting course and stepwise progression in nine years were retrospectively analyzed. Results There were five relapsing-remitting processes in total clinical course of nine years. The clinical and radiological appearance was atypical in the early stage. At the first attack, the patient presented with fever, headache, altered consciousness and epileptic seizure. In the following courses, the patient presented with ataxia, blurred vision and limb weakness. Brain MRI (2006-2009) showed multiple abnormal signals including supratentorial white matter, pons and cerebellum with patchy gadolinium enhancement. Treatment with steroids resulted in a favorable clinical and radiological improvement. The symptoms of this attack included limb weakness, blurred vision, dysdipsia and dysarthria. Physical examination showed cognitive dysfunction, multiple cranial nerves injuries and bilateral pyramidal signs. Brain MRI showed multiple abnormal signals involved pons and cerebellum predominantly as well as supratentorial white matter with punctate gadolinium enhancement peppering the pons and cerebellum. A characteristic predominantly T lymphocytic perivascular infiltration was seen on brain biopsy. Both the imaging and histological findings were consistent with the CLIPPERS features. High-dose steroids treatment was given and obvious clinical and radiological improvements were observed. After discharge, steroids were reduced slowly combined with the use of immunosuppressant to avoid relapse of the disorder. Conclusions There is heterogeneity in clinical manifestations of CLIPPERS with repeated relapsing-remitting course and imaging presentations are sometimes atypical in the early stage, which leads to the misdiagonsis and missed diagnosis. Distinctive pathology is the “gold standard” for definite diagnosis. The nosological position of CLIPPERS is still unclear. Repeated relapse-remitting leads to secondary cerebral atrophy and degeneration, with the risk of progressing to primary central nervous system lymphoma. Early and vigorous steroids treatment with continuing maintenance immunotherapy results in the decreased relapse and best long-term prognosis. The neurologist should strengthen the understanding of CLIPPERS for early correct diagnosis and treatment aiming to reduce the functional disability.