Objective To compare the expression of serum miR-100 in patients with esophageal cancer and healthy person ,and explore the value of miR-100 in diagnosis for esophageal cancer .Methods Real-time fluorescent quantitative polymerase chain reac-tion was used to detecting miR-100 in 40 esophageal cancer patients(study group) and 50 healthy person(control group) .Results The expression of miR-100 in the study group and control group were 6 .399 ± 3 .541 ,2 .625 ± 1 .515 respective ,the expression in the study group was significant higher than that of the control group(t= 9 .07 ,P< 0 .05) .The under area of receiver operating char-acteristic curve of miR-100 in diagnosis for esophageal cancer was 0 .832(95% confidence interval was 0 .731 - 0 .934) ,when the Cut off value was 5 .285 ,the sensitivity and specificity of miR-100 in diagnosis for esophageal cancer were 65% and 95% . Conclusion Serum miR-100 in esophageal cancer patients is higher than that in healthy person ,which might be a new molecular markers in diagnosis for esophageal caner .

AIM: To explore correlation,consistency and comfort between traditional tear film examination methods and Oculus Keratograph.METHODS: A retrospective study.Totally 101 cases (101 eyes) were diagnosed myopia and then accepted LASEK (laser epithelial keratomileusis).Non-invasive tear film break-up time(NIBUT),lower tear meniscus height(LTMH) were measured with Oculus Keratograph,fluorescein tear film break-up time(fl-BUT) and Schimer Ⅰ test (SⅠt) were performed on all cases.The correlations analysis between NIBUT and fl-BUT,LTMH and SⅠt were performed by Spearman rank correlation,consistency check between NIBUT and fl-BUT by Bland-Altman analysis.Visual analogue scale(VAS) was applied on evaluating the comfort of two kinds of examination methods.RESULTS: LTMH and SⅠt showed positive correlation (rs=0.346,P=0.001).NIBUT and fl-BUT showed positive correlation (rs=0.393,P=0.001),95% consistency limits range-9.62 to 14.18 in Bland-Altman Figure.There was significant difference between VAS of NIBUT and VAS of fl-BUT(z=-2.324,P=0.020).There was significant difference between VAS of LTMH and VAS of SⅠt (z=-8.845,P=0.001).CONCLUSION: Oculus Keratograph can objectively measure NIBUT and LTMH,and was more comfortable than traditional tear film examination methods.It can effectively assess tear film function before corneal refractive surgery.

This study retrospectively reviewed 75 patients with impaired glucose tolerance(IGT)admitted in our hospital from March 2015 to October 2015.All patients underwent Toronto clinical scoring system(TCSS) evaluation.Patients with IGT were further divided into normal score group(TCSS-N, n=50)and abnormal score group(TCSS-A, n=25)according to their scoring results, and 30 healthy volunteers were served as control group.All patients and controls underwent motor and sensory nerve conduction studies, as well as sympathetic skin response(SSR)test using the Keypoint.Net(Medoc Ltd)electromyogram device.The results showed that the SSR amplitude of lower limbs was reduced [(0.61±0.44 vs 1.00±0.33)mv, P<0.05]andlatencyoflowerlimbswas extended [(1 880±282 vs 1 642±256)ms, P<0.05]in IGT group compared with control group.But median, ulnar, tibial, and peroneal nerve sensory and motor conduction revealed no difference between two groups.In TCSS-A group, the SSR amplitude of lower limbs was reduced [(0.47±0.39)mv, P<0.05], latency of lower limbs was extended [(2 062±291)ms,P<0.05]and the sensory nerve action potential(SNAP)amplitude of the tibial nerve was significantly lower compared with control group [(1.83±0.37 vs 2.07±0.30)μv, P<0.05].Compared to TCSS-N group, latency of lower limbs was extended [(2 062±291 vs 1 808±246)ms, P<0.05]in TCSS-A group.The SSR amplitude of lower limbs were reduced[(0.66±0.44)mv,P<0.05]and latency were prolonged(P<0.05)in TCSS-N group compared with control group.Pearson correlation analysis showed that the SSR amplitude and latency of the lower limbs were correlated with the postprandial blood glucose, blood glucose fluctuation, body weight, as well as body mass index.These results suggest that there exists peripheral nerve damage in the patients with IGT, mainly involving the small fiber nerve of the lower limbs.Large fibers may also be mildly affected as the disease progresses.

Objective To evaluate the dosage regimen of sulfasalzine combined with recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR) in the induction and maintenance of remission in active ankylosing spondylitis.Methods This study enrolled 100 ankylosing spondylitis patients with disease duration for less than five years who were treated with sulfasalzine and rhTNFR combination therapy.Patients were randomly assigned to three groups six weeks later:patients in the G1 group received sulfasalzine combined with rhTNFR at a 25 mg dosage twice each week.Patients shifted to monotherapy with sulfasalzine six weeks later:patients in G2 group received sulfasalzine combined with rhTNFR at 25 mg dosage per week.Patients were switched to monotherapy of sulfasalzine twelve weeks later:patients in G3 group received sulfasalzine combined with rhTNFR at 25 mg dosage once every ten days.Patients were changed to monotherapy of sulfasalzine seventeen weeks later.The whole treatment lasted for 24 weeks.All participants were followed up at week 0,6,12,18,24 respectively and were evaluated by BASDAI 50.The primary end-point of this study was the percentage of patients achieved BASDAI 50 remission.Data were analyzed with SPSS version 17.0.Independent t-test and x2 test were adopted to analyze data.Results 90％ of patients treated with combination therapy reached BASDAI50 at the 6th week.All patients in the G1 group achieved BASDAI 50 remission at 12th week,but the percentage dropped to 68.7％ at 18th week,which gradually decreased to 37.5％ at the 24th week.In G2 group,93.9％ patients reached BASDAI50,which declined to 81.8％ at the 18th week.The whole number accounted for 60％ at the end point of 24th week.In G3 group,85.7％ patients achieved BASDAI50 at the 12th week,accounted for 74.3％ at 18th week,and declined to 68.6％ at the 24th week.G3 group of patients presented a significantly higher rate than other groups(P＜0.05).Conclusion Sulfasalzine and rhTNFR combination therapy can gain remission in active AS patients after treated for six weeks.Doctors may extend TNF antagonist treatment in order to achieve long-term remission.

Objective To explore the standard clinical pathway and stratified cost insurance in patients with senile cataract operation. Methods Patients treatment by senile cataract phacoemulsification combined with IOL implantation were selected as research subjects by cluster sample from two hospitals from 2013 to 2014 . Patients were divided into different groups according to the year, chronic diseases, preoperative waiting time. The difference of hospitalization expenses and hospitalization time were compared. Different levels of hospital costs were established by CHAID decision tree used hospitalization cost as target variable. Results The waiting time for operation was 2 days, the total hospitalized time was 5 days and these can be used as reference time in clinical pathway. Patients uninsured or with long waiting time for operation had longer hospitalized time. Chronic disease, terms of payment and waiting time before operation were point factors that effect the hierarchical of decision tree. Conclusion The new standard of clinical path need to adjust constantly. Distinguish different patients condition and pay different clinical path costs.

Objective To investigate the application value of MRS in temporal lobe epilepsy (TLE) without hippocampal sclerosis.Methods A retrospective study was conducted in 23 unilateral TLE patients (TLE group) with absence of hippocampal sclerosis and 20 age-matched normal control subjects (control group).All of them underwent conventional MRI and MRS.N-acetyl aspartate (NAA)/creatine (Cr),choline (Cho)/Cr ratios of bilateral hippocampus in 2 groups were analyzed.Eleven of 23 patients underwent surgical treatment,pathological findings and surgical outcomes were evaluated.Results The NAA/Cr ratios of ipsilateral hippocampus significantly decreased compared with that in the contralateral hippocampus (t=-7.97,P＜0.001) and the control group (t=-9.96,P＜0.001).There was no significant difference between the contralateral hippocampus in patients and the control group (t=-1.21,P=0.12).The Cho/Cr ratios of ipsilateral hippocampus in TLE had no significant difference compared with contralateral hippocampus (t=0.50,P=0.31) and the control group (t=-0.59,P=0.28).The pathological findings of the 11 patients who underwent temporal lobe resection indicated small amounts of neuronal loss and unobvious gliosis.Conclusion MRS is helpful in clinical practice to lateralize and localize the epileptogenic foci in the absence of hippocampal sclerosis in patients with TLE.

Objective To evaluate glycemic control,complication and influence factors of glycosylated hemoglobin(HbA1c) in type 2 diabetic(T2DM) patients with hypertension in retired and veteran of military communities in Kunming.Methods Cross-sectional study was conducted and 216 T2DM patients with hypertension were enrolled in current study.A self-made questionnaire was used to collected information including age,course of the disease,complication,hypoglycemic agents and status of glucose controlling.The levels of HbA1 c,fasting blood-glucose (FBG),2h postprandial blood glucose (2hPBG),total cholesterol (TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),Blood urea nitrogen(BUN),creatinine(Cr) and uric acid(UA) were measured.Relative factors of HbA1c were analyzed.Patients were divided into the standard (HbA1c ＜ 7％) and substandard groups (HbA1c ≥ 7％) according to the level of HbA1c,and divided into the oral-medication,insulin-treatment and oral medication combined insulin groups according to therapeutic regimens.Results The goal attainment rate of HbA1c(HbA1c ＜7％) in retired and veteran of military communities in Kunming was 44.9％ (97/216).The levels of FBG,postprandial plasma glucose(PPBS) and TG in standard group were (6.1 ± 1.2) mmol/L,(9.4 ± 1.8) mmol/L and (1.9 ± 1.3) mmol/L,significant different from those in substandard groups [(7.8 ± 1.6) mmol/L,(11.5 ±2.2) mmol/L and (2.4 ± 1.3) mmol/L],and the differences were significant (t =11.6,9.1,2.2; P ＜ 0.05 or P ＜ 0.01).Meanwhile,the rate of cardiovascular disease,cerebrovascular disease,proteinuria,peripheral neuropathy and retinopathy were 69.8％,34.5 ％,20.5％,20.5％,29.6％,respectively,significantly different between the standard and substandard groups (P ＜ 0.05).HbA1 c level was linear correlated with FBG (r =0.76,P ＜ 0.01),PBG (r =0.61,P ＜ 0.01),TG (r =0.24,P ＜ 0.05) and the frequency of glucose monitoring (r =-0.55,P ＜ 0.01).As the increasing of the stage of diabetes,the selected therapeutic regimen were oral anti-diabetic agents,followed by insulin and insulin combined oral antidiabetic agents.The levels of PBG and serum creatinine in patients with insulin monotherapy were higher than those in other groups (P ＜0.05).Conclusion The level of glucose controlling of retired and veteran of military communities in Kunming is better.The prevalence of diabetic chronic complications is higher in patients with poor glucose controlling.HbA1c level is correlated with FBG,PBG,TG and the frequency of glucose monitoring.Oral antidiabetic agents is the primary therapeutic regimen.

The association between serum fetuin A and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus(T2DM) was investigated.Serum levels of fetuin-A and adiponectin were measured by ELISA and the clinical data were collected in 101 T2DM patients with normal albuminuria (NA group),87 patients with microalbuminuria (MA group),44 patients with overt albuminuria (OA group),and 130 normal control subjects (NC group).Fetuin-A levels increased progressively from NC,NA,MA,to OA groups,and there were significant differences among groups(P＜0.05 or P＜0.01).Fetuin-A level in patients was positively associated with duration of illness,urinary albumin to creatinine ratio (ACR),fasting blood glucose,2-hour postprandial blood glucose,and C-reactive protein(CRP,P＜0.05 or P＜0.01),but was negatively associated with age and adiponectin (all P＜ 0.01).Multiple stepwise regression analysis indicated that duration of diabetes,fetuin-A,CRP,and adiponectin were independent determinants for ACR (all P ＜ 0.01).Fetuin-A may be involved in the development and pathogenesis of DN by proinflammatory effects and repressing adiponectin production.

Eukaryotic expression plasmid pCI-neo-mdr1 which contains human multidrug resistance gene 1(mdr1),was constructed and transferred into human hepatocarcinoma HepG2 cells by use of liposome. G418 was used to screen the cells successfully with mdr1 and the selected cells was named HepG2/mdr1 Morphological and biological properties of HepG2/mdr1 cells were observed. The results show that the constructed HepG2/mdr1 cell line was high efficient and stationary in the expression of mdr1. The work was valuable and desirable for the establishment of multidrug resistant cell models,and for the study of MDR in human hepatoma. Furthermore,the work also provided a perfect model for the research of relationship between insulin resistance and MDR in hepatocarcinoma cells.

Objective To observe the difference in treament of thoracolumbar vertebral bodies fractures be- tween AF nail and Dick nail.Methods From March 1998 to March 2007,85 cases of thoracolumbar vertebral bod- ies fractures were followed up.20 cases were fixed with Dick nail,and 65 cases with AF nail.Results The mean,fol- low-up period was 12 months.By comparison of the operating rime,bleeding amount,the recovery rate of vertebral height,the reduction of Cobb angle and capacity of vertebral canal,AF nail was much better than Dick nail.But there was no marked difference in the recover of nerve function.Conclusion AF nail has more power to reduce vertebral height and is easier to set than Dick nail.It will be worthy of more and wider application in basic level hospitals.