Objective To explore the pertinence between the concentrations of seminal leptin (lep) and genital endocrine hormones, such as testosterone(T), follicle stimulating hormone( FSH), luteotropic hormone(LH) and insulin growth factor-1 (IGF-1), as well as the effect of Lep on sperm concentration,motility and genital function indexes.Methods 126 cases of infertility and 30 cases of normal fertility were randomly chosen.The contents of Lep, T, FSH and LH were detected by radioimmunoassay (RIA) and the IGF-1 content were detected by immunoradiometric assay (IRMA).The infertility group was divided into group A (sperm count ≥ 20×109 /L), group B (sperm count ＜ 20×109 /L) and group C of azoospermia.According to the number of white blood cell ( WBC ) in 10 high power fields (HPF), the infertility group was further divided into group WBC (WBC count ≥ 1×109 /L) and group Non-WBC(WBC count ＜ 1×109 /L).According to the sperm vitality and the rate of motility, group A was subdivided into the group of normal spermatic vitality (a + b≥50% ), the group of abnormal vitality( a + b ＜ 50% ) (a refers to the number of sperms with fast forward movement, and b refers to the number of sperms with slow or sluggish forward movement), the group of normal rate of spermatic motility( the rate ≥60% ) and the group of decreased rate of motility( the rate ＜60% ).According to the examination results of the normal contrast group, group A and group B were respectively divided into the following groups: the group of normal sperm penetrating power(≥40 mm), the group of decreased penetrating power( ＜ 40 mm), the group of normal intact acrosome rate(≥80% ), the group of decreased intact acrosome rate( ＜ 80% ), the group of normal terminal swelling rate( ≥60% ) and the group of decreased terminal swelling rate( ＜60% ).Results The concentration of Lep in the infertility group was (2.77±0.80) μg/L, significantly higher than the level of Lep [ (1.14 ± 0.31 ) μg/L ] in the contrast group ( t = 10.943,P ＜ 0.05 ).The contents of IGF-1 and T were ( 17.67±8.09) μg/L and (4.84±2.15) nmol/L respectively, significantly lower than the levels of IGF-1 [(24.79±9.32) μg/L] and T [(6.30±2.53) nmol/L] in the contrast group (t =4.205,3.228,P＜0.01).There existed no significant differences of the concentrations of FSH and LH between the two groups ( t = 1.655,1.378 ,P ＞ 0.05 ).The concentrations of FSH and LH were (32.61±9.14) U/L and (40.57 ± 12.40) U/L respectively in the infertility group and(29.63±7.56) U/L and (37.25±9.19) U/L respectively in the contrast group.The concentrations of Lep and IGF-1 and T showed negative correlation in the infertility group (r = -0.237, -0.316,P ＜ 0.01 ).The concentration of Lep had no correlation to the FSH and LH concentration (r = 0.104, 0.112, P ＞ 0.05 ).The concentration of Lep showed a gradual increase within group A, group B and group C (F = 115.93, P ＜ 0.01 ).The leptin contents in the above mentioned normal subgroups were found to be lower than the abnormal groups.Conclusions There exists pertinence between the Lep concentration and the concentrations of TGF-1, T, FSH and LH.Lep may decrease the sperm density and inhibit sperm vitality and the motility rate through inhibiting androgen secretion and sperm capacitation.

Objective To investigate the significance of MMP-9 and TIMP-1 test for assessing the occurrence and development of chronic heart failure.Methods One hundred and twenty-seven patients with chronic heart failure were enrolled in the observation group,and 40 cases community health people were selected for the control group. The levels of serum MMP-9 and TIMP-1 were detected and the LVEF and E/E ' were evaluated using endocardiography. Results Compared with the control group, the level of MMP-9 was significantly higher (<0.01) but the level of TIMP-1 had significantly decreased ( <0.05) in the observation group. And the ratio of MMP-9 and TIMP-1 had significantly increased compared with the control group ( <0.05) . There were statistically significant differences of LVEF and E/E' between the observation group and control group ( <0.05) . In the observation group,the level of MMP-9, MMP-9/TIMP-1,LVEF and E/E' were increased but the level of TIMP-1 decreased significantly in cases with cardiac functional class III compared with cardiac function class II (<0.05) . There were significant differences between the cases with class IV heart function and class II, III in the levels of MMP-9, TIMP-1 and MMP-9/TIMP-1 ( <0.05) . In the cases of class IV heart function, the LVEF and E/E' have significantly increased compared with the cases of class II ( <0.05) . MMP-9 + TIMP-1 +MMP-9/TIMP-1 combination has higher sensitivity and specificity than the MMP-9,TIMP-1 and MMP-9/TIMP-1 single indicator, and the joint diagnostic value of LVEF + E/E' was less than that of IL-18+ NT-ProBNP. Conclusion The levels of MMP-9 and TIMP-1 and their ratio may have contributed to the early detection and diagnosis for chronic heart failure,and help to determine the disease progression.

Objective To investigate the incidence of the nosocomial infection in patients of Shenzhen district polyclinic,provide solution for controlling the nosocomial infection and give precautionary measures for the future.Methods By prospective and retrospective combinative case-control methods,the incidence of nosocomial infection of the in-patients during May 2002 to December 2004 was investigated and analyzed.Results There were 237 patients and 251 cases of nosocomial infection from 10271 in-patients.The incidence of nosocomial disease was 2.31%.The infection rate was 2.44%.Conclusion In the basis of completely utilizing the third-class network management in nosocomial infection,the precautionary nosocomial infection can be effectually controlled by monitoring and enhancing staff training.

Objective:To study the possible therapeutic mechanisms of triptergium wilfordi in treating glomerulonephritis.Methods:Thirty seven patients with IgA nephropathy were detected urine mononeuclear cells densities with flow cytometry during taking triptergium wilfordi tablets,30 healthy people were used as normal control.Results:The patients urine CD3 +?CD4 +?CD8 +?CD14 + and CD44 + cells densities were much higher than normal control's,but obviously decreased after triptergium wilfordi treatment.CD4/CD8 ratio was much lower in patients than in normal control.It increased markedly after treatment.Patients who reached remission initially had a lower CD4 + cell percentage and higher CD14 + cells percentage than those showed no response to triptergium wilfordi treatment.Conclusion:Triptergium wilfordi could modulate kidney immune cell function and adhesive molecule CD44 expression.Its effects were associated with renal immunity.

To determine the differences in analgesic, hemodynamic and ventilatory effects between epidural and intravenous midazolam (MID), 44 adult patients, ASA grade Ⅰ to Ⅱ, scheduled for elective upper abdominal surgery. were randomly allocated to receiving epidural MID 0.05 mg/kg (group E_1) or 0.1 mg/kg (group E_2). or intravenous MID 0.05 mg/kg (group V_1) or 0.1 mg/kg (group V_2), respectively, The analegic effect was evaluated by pin-prink test, following MID administration. The hemodynamie and ventilatory values were measured by impedance cardiogra phy and side stream spirometry, before and 1.3, 5, 10, 15 and 20 mins after MID administration. Tbe results showed that the segmental spinal analgesia occured with MID in group E_1 and E_2, but no analgesia was produced with WID in group V_1 and V_2. Following MID administration in four groups, HR increased during first 5 mins (P0.05); CI, SI. LVWI, MAP, RPP and indices of myocardial eonstraction, cardiae peak flow and blood ejection velocity decreased slightly(P0.05). After MID administration, SpO_2 and VT were reduced (P0.05), and the inspiratory end-tidal oxygen content difference was elevated transiently (P0.05) and went down in group E_2 and V2(P0.05).

Objective: To compare the clinical effects of postoperative patient controlled epidural analgesia (PCEA) with different combinations of tramadol and/or buprenorphine. Method:The 150 cases of surgical patients were ran domly divided into 6 groups: 0.6% tramadol (group T_1). mixture of 0.6% tramadol and 0.15% bupivacaine (group T_2), mixture of 0.0015% buprenorphine and bupivacaine (group B_1) , mixture of 0. 0015% buprenorphine, bupivacaine and 0.6% tramadol(group B_2). 0.15% bupivacaine(group C_1), 0.0015% buprenorphine(group C_2). With a Graseby- 9300 PCA pump in the loading-continuous-PCA model, the doses were 5mL-0.5ml-1ml respectively. Result: (1)In the first postoperative 24 hours the amount of drugs used in each group was similar; (2)1n these six groups, both visual analog scale scores and the ratios of tatol deliveries to demands were B_2

In order to improve the diagnosis and treatment of severe hemolytic uremic syndrome (SHUS),we summarized the rescuing experiences in 3 children with SHUS.Therefore,close observation of gastro intestinal symptoms,collaborated with repeated examinations of the blood,renal function,urinary output,blood pressure,and manifestations of the central nervous system could help predict to certain extent the occurrence of further hemolysis and renal failure in these patients.Energetic treatment of malignant hypertension and relieving the symptoms of center nervous system could successfully improve renal functions.If urinary output decreased quickly,creatinine (Cr) and blood urea nitrogen (BUN) increased,or severe infection occurred in SHUS patients,hemodialysis should be undertaken as early as possible to prevent caute renal failure and multiple organ failure syndrome (MOFS).Therefore,the treatment of SHUS in children has its peculiarity and complexity.

Objective To investigate the clinical characteristics and classification of diabetic patients with unprovoked ketoacidosis.Methods According to body mass index(BMI),56 patients were divided into 3 groups: low body weight group(LBW,BMI25 kg/m2,n=20).Clinical characteristics,including age,gender,the course of the disease,positive rate of glutamic acid decarboxylase antibody(GAD-Ab) and the function of islet beta-cell,were compared between these three group.Results There were no significant differences in some clinical features(glycemia,and ketosis status) at beginning of disease between 3 groups.The level of serum TG and Insulin was higher in OBW group than that in other groups.Only 3 patients were found GAD-Ab positive in LBW group.Conclusion The clinical and immunological characteristics of OBW and LBW patients were quite different,some of the obese patients should be classified into type2 diabetes,and some into idiopathic type1 diabetes.

0.05).Conclusion VAMT is as effective as VATS,whereas it can achieve a shorter operation time.

Objective To explore whether the inhibited expression of fibrocystin by RNA interference can increase epidermal growth factor (EGF)-induced cell proliferation and its possible mechanism . Methods A stable PKHD1-silenced HEK 293 cell line was established . Cell proliferation rate, intracellular Ca2+ concentration and extracellular signal-reguhted kinase 1/2(ERK1/2) activity were assessed after treatment with EGF, verapamil and Bay K8644 . Results The proliferation rate of PKHD1-silenced HEK-293 cells was found to be significantly higher after EGF stimulation compared to the control HEK 293 cell (231 .5% vs 152 .8%, P＜0 .01) . PKHD1-silencing lowered the intracellular Ca2+ concentration and caused EGF-induced ERK1/2 overactivation in the cells(P＜0 .01 ) . When cells were treated with verapamil for 4 hours to lower the intracellular Ca2+ concentration, the cell proliferation rate was significantly increased after 20 ng EGF for 24 hours . The verapamil treatment increased the level of activated ERK1/2 in EGF-treated cells . An increase of intracellular Ca2 + in PKHD1-silenced ceils repressed the EGF-dependent ERK1/2 activation and the hyperproliferative response to EGF stimulation . Conclusions Inhibition of fibrocystin can cause EGF-induced excessive proliferation through decreasing intracellular Ca2+ resulting in EGF-induced ERK1/2 activation . The loss of fibrocystin may lead to abnormal proliferation in kidney epithelial cells and cyst formation in ARPKD through modulation of intracellular Ca2+ concentration .