Background Diabetiretinopathy(DR) icommon ophthalmivasculadisease which can lead to blindness,and itpathogenesiicomplex.C-peptide iby-producin insulin synthesis,and loof studieindicate thaC-peptide iclosely related with diabetimicrovasculacomplications.Objective Thistudy wato explore the clinical significance of the detection of C-peptide to assesthe prognosiof non-proliferative DR(NPDR).Methodretrospective case-observational study wadesigned.The clinical datof 205 casewith NPDwere collected in Wuhan Puren Hospital from January 1,2009 to January 1,2010.The patientwere diagnosed by fundufluorescein angiography (FFA) and the stageof theidiseasewere determined based on the Dstaging developed by the Chinese Ophthalmological Society fundustudy group.Twenty-seven-month follow-up waperformed fothe patientto record the parameterof theiblood biochemistry,changein theiphysical conditions,and changein theiblood pressure and DM.The patientwere assigned to the PDgroup and NPDgroup athe end of the follow-up.The independenrisk factofoNPDwaanalyzed using the univariate analysis,and multivariate logistiregression analysiwaused to evaluate the correlation of varioufactorwith pooprognosiof NPDR.Receiveoperating characteristi(ROC) curve wadrawn to assesthe prediction efficiency of C-peptide fothe prognosiof NPDR.ResultThe clinical datof 205 patientwith NPDwere reviewed,and 15 patientfailed to show up fovisitarate of 7.3％.One hundred and ninety patientwith NPDfinished follow-up with mean age of (41.54± 8.15)years.Of the 190 patients,69 patient(36.3％) advanced to PDR,and 121 patient(63.7％) were NPDduring the follow-up.Significandifferencewere seen in age,hypertension history,smoking history,DM course and C-peptide levelbetween the PDgroup and PDgroup (age:=13.78,P＜0.05 ; hypertension history:x2 =21.57,P＜0.05 ;smocking history:x2 =26.96,P＜0.05;DM course:t=6.89,P＜0.05;C-peptide:t=20.50,P＜0.05).pooprognosiwacorrelated with age (OR:1.04,95％ CI:1.01-1.07),hypertension history (OR:1.05,95％ CI:1.02-1.08),smokinghistory (OR:1.07,95％CI:1.04-1.11),DM course (0R:1.18,95％CI:1.13-1.25) oC-peptide conten(0R:1.09,95％ CI:1.06-1.12).The areundethe ROcurve wa0.835 (P＜0.05,95％ CI:0.818-0.843) when the C-peptide waincluded,buwalarge than 0.769 (P ＜ 0.05,95％ CI:0.754-0.780) when Cpeptide waexcluded.ConclusionThe levelof blood C-peptide are lowein the PDpatientthan those in the NPDpatients,and the lowelevel of blood C-peptide in the NPDpopulation increasetheirisk of developing PDR.Testing foblood C-peptide level can benefithe prognosiof NPDR.

Objective To study the efficacy and adverse reactions of the treatment on different types of infantile hemangiomas (IH) with different doses of propranolol .Methods One hundred and fifty cases of IH without contraindications were randomly treated with different doses of propranolol (low dose group:1 mg?kg -1 ?d-1 ;high dose group:2 mg?kg -1 ?d-1 ) under ECG monitoring inferior half an hour to breastfeeding taking ,and stay in hospital for observation for 6 to 24 hours after the treatment . The patients returned to the hospital for review every month(ECG and blood RT ;lung function in necessary) .Results The curative effect is better on strawberry IH than that on flat IH ,also better on deeply IH than that on superficial IH .The adverse reactions oc‐curred relatively slight in the low dose group and there was no significantly statistical differences on the treatment effects between the both groups(P>0 .05) .Conclusion It is safe and effective to treat IH with propranolol .

Objective To research in correlations between occupational pressure,social support and subjective well-being,in order to explore effective ways to reduce the occupational pressure.Methods Nurses from a certain grade 2A hospital in Wuhan were selected as research objects.Questionnaires were used to investigate the correlations between occupational pressure,social support and subjective well-being.Results Nurses endured a high level burden.The subjective well-being of nurses was negatively correlated with occupational pressure,the higher the occupational pressure,the lower the subjective well-being.The subjective well-being of nurses was positively correlated with social support.The occupational pressure and social support could predict the subjective well-being of nurses.Conclusions There exists potential relationships between occupational pressure,social support and subjective well-being of nurses.This results supports evidence for nursing managers to cultivation and management of nurses,which is helpful to establish effective nursing manage-ment measures.

Objective:To compare the effects of different anesthesia methods on stress hormones and hemodynamic changes in the patients with gynecological laparoscopic surgery. Methods:Retrospective analysis was carried out. Totally 145 patients with gynecolog-ical laparoscopic surgery were divided into two groups according to the anesthesia method, the control group with 72 cases was given routine remifentanyl propofol intravenous anesthesia, and the observation group with 73 cases was given routine propofol isoflurane com-posite anesthesia. Such hemodynamic indices as SBP, DBP and HR, and plasma NE, E, cort and AT II levels at different time points in the two groups were studied and compared, and adverse drug reactions were also observed in the two groups. Results:The BP and HR at T2 and T3 time point in the two groups were significantly lower than those at T0 time point (P<0. 05), and those in the obser-vation group were lower than those in the control group at the same time point(P<0. 05). The levels of NE, E, cort and ATⅡat T2 and T3 time point in the two groups were significantly higher than those at T0 time point (P<0. 05), while the increase in the observa-tion group was lower than that in the control group (P<0. 05). The incidence of adverse drug reactions (ADR), such as respiratory depression, hypertension, bradycardia and so on, and the total incidence of ADR in the observation group were both lower than those in the control group (P<0. 05). Conclusion:Compared with remifentanyl propofol intravenous anesthesia, propofol isoflurane composite anesthesia can keep the hemodynamic stability more effectively and reduce the stress reaction with fewer ADR and promising safety, which is worthy of wider application in clinics.

OBJECTIVE:To analyze the effects of different disinfectants on results of antibiotics skin test,and to improve the accuracy of the judgment results of antibiotics skin test. METHODS:1 500 patients undergoing antibiotics skin test of penicillin and cephalosporin were randomly divided into group A and group B with 750 patients in each group. Group A was given 75% etha-nol disinfection,and group B was given iodine disinfection. The incidence of false positive results were compared after disinfected with 2 kinds of disinfectants. RESULTS:The incidence of false positive result in group B was lower than in group A,with statisti-cally significant difference (χ2=10.004,P<0.05). CONCLUSIONS:For skin disinfection of antibiotics skin test,iodine is better and safer than 75%ethanol.

Objective To compare the clinical efficacy of ilaprazole standard triple therapy with omeprazole standard triple therapy in the treatment of patients with Helicobacter pylori ( Hp ) positive duodenal bulb ulcer. Methods 100 patients with Hp positive duodenal bulb ulcer were randomly divided into the two groups by lottery, given ilaprazole standard triple therapy and omeprazole standard triple therapy respectively.After 5 weeks of the course,take gastroscopy and the enzyme 13C-urea breath test,and the Hp eradication rate,clinical efficacy,ulcer heal-ing rate and adverse reactions were observed.Results The Hp eradication rate is better than the omeprazole group (92%vs 78%,χ2 =3.853,P<0.05),while the ulcer healing rate were no significant (96%vs 90%,χ2 =1.561, P>0.05).Conclusion It is a good method in the treatment of Hp positive duodenal bulb ulcer for ilaprazole stand-ard triple therapy.

Objective To investigate the expression of caveolin-1 in the sera of esophageal cancer patients , and the possibility of caveolin-1 to be the tumor marker of an esophageal cancer .Methods ⑴Western blot was used to detect the expression of caveolin-1 in esophageal cancer cell EC 109 and EC9706;⑵The sera were collected from 43 esophageal cancer patients , 30 benign esophageal lesions, and 50 healthy control men.Enzyme linked immunosorbent assay (ELISA) was used to detect caveolin-1 in serum.Results⑴Western blot showed that caveolin-1 was detected in two types of esophageal cancer cell lines .The level of caveolin-1 in the poor dif-ferentiated EC109 cell line was mush higher than in the well differentiated EC 9706 cell line ( t =3.08 , P =0.035 ) .⑵ ELISA re-vealed that the median level of serum caveolin-1 in 43 esophageal cancers (0.104 ng/ml) was significantly higher than 30 benign e-sophageal lesions (0.075 ng/ml) or 50 healthy control men (0.081 ng/ml) (χ2 =23.16, P =0.001).Conclusions Caveolin-1 may be the tumor marker of an esophageal cancer as its level in esophageal patients was higher than in benign esophageal lesions pa -tients or healthy control men .

Objective To explore the effects of 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3] on memory CD4+T cells of focal proliferative IgA nephropathy (IgAN)patients.Methods (1) Total of twenty incipient focal proliferative IgAN patients (Lee classification:Ⅲ level) were chosen as IgAN group and 20 healthy volunteers were chosen as healthy control group.The level of serum 1,25(OH)2D3 was measured by radioimmunoassay (RIA).Peripheral blood mononuclear cells (PBMCs) were separated by the method of Ficoll density gradient centrifugation and were stimulated with anti-CD3/anti-CD28 in the absence or presence of various concentrations of 1,25(OH)2D3,Dexamethasone(DEX) and 1,25(OH)2D3and DEX combined.PBMCs were cultured for 72 hours and the levels of IFN-γ,IL-4,IL-17A,Foxp3 were measured by flow cytometry(FCM),standing for the levels of Th1,Th2,Th17,Treg.(2) IgAN group was divided into two subgroups (proteinuria ＜ 1 g/24 h subgroup,proteinuria≥ 1 g/24 h subgroup),then the serum levels of 1,25(OH)2D3,IFN-γ,IL-4,IL-17A,Foxp3 were compared.Results Compared with healthy control group,serum 1,25(OH)2D3 level of IgAN group was significantly lower (P ＜ 0.05).Serum 1,25(OH)2D3 level in proteinuria≥ 1 g/24 h subgroup was significantly lower than proteinuria ＜ 1 g/24 h subgroup and healthy control group (P ＜ 0.05).The level in proteinuria ＜ 1 g/24 h subgroup was lower than healthy control group,but the difference was not statistically significant (P ＞ 0.05).(2) The levels of IFN-γ and IL-17A and the ratios of IFN-γ/IL-4,IL-17A/Foxp3 in IgAN group increased significantly compared with healthy control group (all P ＜ 0.05),and the level of Foxp3 decreased significantly (P ＜ 0.05).The level of IL-4 also increased,but the difference was not statistically significant (P ＞ 0.05).The levels of IFN-γand IL-17A and the ratio of IL-17A/Foxp3 in proteinuria≥ 1 g/24 h subgroup increased significantly,and the level of Foxp3 decreased significantly,compared with urinary protein ＜ 1 g/24 h subgroup and healthy control group (P ＜ 0.05).The ratio of IFN-γ/IL-4 in proteinuria≥1 g/24 h subgroup and proteinuria ＜ 1 g/24 h subgroup all increased,compared with healthy control group,and the ratio in proteinuria≥ 1 g/24 h subgroup increased significantly (P ＜ 0.05).There was no significant difference in the level of IL-4 among all groups.(3) After treatment with 1,25(OH)2D3,the levels of IFN-γ and IL-17A and the ratios of IFN-γ/IL-4 and IL-17A/Foxp3 decreased significantly,and the level of Foxp3 increased significantly (P ＜ 0.05),and these effects were more obvious as the increase of the drug concentration.The level of IL-4 did not change significantly.The combination of 1,25(OH)2D3 and DEX had a synergistic inhibition on the production of IFN-γ,IL-4,IL-17A,and the ratios of IFN-γ/IL-4 and IL-17A/Foxp3,and had a synergistic promotion on the production of Foxp3.Conclusions There is a certain extent of vitamin D deficiency in focal proliferative IgAN patients,which may be associated with the severity of proteinuria.The disorder of immunomodulatory effects of memory CD4+ T cell might exist in the patients of focal proliferative IgAN.1α,25-dihydroxyvitamin D3 might have beneficial effects on the immunoregulation of memory CD4+T cells of focal proliferative IgAN patients.

Objective To investigate the characteristics of the author groups in 《Chinese Journal of Geriatrics》,in order to provide references for the future construction and development of the author ranks.Methods Bibliometric method was used to analyze the quantity of papers,region distributions,core authors and cooperative rate in 《Chinese Journal of Geriatrics》 from 2009 to 2013.Results The total amount of papers published in 《Chinese Journal of Geriatrics》》 from 2009 to 2013 was 1636,involving 31 provinces,autonomous regions,municipalities and administrative region.Among these,Beijing,Zhejiang,Tianjin and Jiangsu were the 3 top contributing regions,accounting for 54.0 percent (884/1636 papers).The 1636 papers were contributed by 1435 authors (first authors),of whom 1275 authors published only one paper,accounting for 87.7％ (1275/1435),and their papers accounted for 77.9％ of the total published papers (1275 /1636).27 authors had high yield of 3 or more papers published and deep influence,and they published 95 papers (5.8％).The degree of cooperation was 4.6 (7599 /1636),and the cooperation rate was 93.8％ (1534/1636) within the five years.Conclusions 《Chinese Journal of Geriatrics》is quite influential and attractive in the fields of geriatrics,and a good cooperative relationship is displayed between different authors and authors' institutions.

Objective To establish an expression system of TCRγ9/δ2-Fc protein by baculovirus vector ex-pression system and identify biological function of expressed TCRγ9/δ2-Fc protein. Methods γ9Fc and 82 (OT3) Fc gene fragments were amplified by overlap PCR and inserted into expression vector pBACp10ph. The recombinant plasmid pBACp10ph-γ9/δ2(OT3)-Fc and the baculovirus DNA were co-transfected into st9 cells. The expression position of TCRγ9/δ2 (OT3)-Fc was identified by Western blot and the expression efficiency of γ9Fc and δ2 (OT3) Fc was tested by flow cytometry (FCM). Furthermore, the binding activity of TCRγ9/δ2 (OT3)-Fc protein with SKOV3 ceils and MNS protein was evaluated with laser scanning confocal microslopy and surface plasmon resonance (SPR). Results The recombinant vector pBACp10ph-γ9/δ2(OT3)-Fc was constructed and TCRγ9/δ2(OT3)-Fc protein was expressed in sf9 ceils. However, the expression efficiency of γ9Fc and 82 (0T3) Fc was quite differ-ent. It was proved that purified TCRγ9/δ2 (OT3)-Fc protein can bind with SKOV3 cell and MNS protein. Conclu-sion TCRγ9/δ2-Fc protein is successfully expressed in baculovirus vector expression system and TCRγ9/δ2-Fc protein can simulate the binding activity of TCR in vitro.