Objective To analyze the hypothalamic-pituitary-adrenal axis function in type 2 diabetes mellitus(T2DM) patients combined with depression with different courses.Methods Forty T2DM without depression patients (T2DM without depression group) and 42 T2DM combined with depression patients (T2DM combined with depression group) were divided into 3 groups according to the courses:＜ 5years,5-15 years,＞ 15 years.Thirty healthy person were selected as control group.The levels of serum adrenocorticotropic hormone (ACTH),cortisol (Cor),fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c),24 h urinary-free cortisol (UFC) were determined at 8:00 Am.Results The levels of serum ACTH,24 h UFC in T2DM without depression group were higher than those in control group [(241.7 ±132.6) pg/L vs.(174.1 ± 108.2) pg/L and (96.67 ± 15.92) μg vs.(76.04 ±24.60) μg],and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the levels of serum ACTH,Cor,24 h UFC among ＜ 5 years,5-15 years,＞ 15 years in T2DM without depression group (P＞0.05).The levels of serum Cor,24 h UFC in T2DM combined with depression group were higher than those in T2DM without depression group and control group,and there were significant differences (P ＜ 0.01),but compared with those in T2DM without depression group with the same courses,only ACTH was different in ＜5 years (P ＜ 0.01),Cor,24 h UFC was different in ＞ 15 years (P ＜ 0.01).There was significant difference in the level of serum ACTH between ＜ 5 years and 5-15 years,＞ 15 years in T2DM combined with depression group (P ＜ 0.01),Cor had no difference among different courses (P ＞ 0.05),24 h UFC had difference between ＞ 15 years and ＜ 5 years,5-15 years (P＜ 0.01 or ＜ 0.05).In T2DM without depression group,the level of serum Cor was positively correlated with FPG (P ＜ 0.01),the level of serum ACTH was positively correlated with FPG (P ＜0.05).In T2DM combined with depression group,the level of serum Cor was positively correlated with FPG,HbA1c (P ＜ 0.01),the level of serum ACTH was no relationship with others,the level of serum 24 h UFC was positively correlated with FPG,HbA1c (P＜ 0.01).Conclusion With the prolonged courses of diabetes,the function of hypothalamic-pituitary-adrenal axis gets worse in T2DM patients combined with depression.

Objective To study the gene mutation of the spinocerebellar ataxia(SCA) types 1～3 in the patients with primary dystonia.Methods The CAG triplet repeat expansion of SCA1～3 were detected with the polymerase chain reaction(PCR) in two patients with primary dystonia(father and son) and their 21 health family members.Results The two patients with primary dystonia were found to have the gene mutation of SCA3,the CAG repeat were 80 and 75 respectively.The gene mutations of SCA1,2 were not found in the two patients.The gene mutation of SCA1～3 were not found in the 21 family members.Conclusions The patients with primary dystonia have the gene mutation of SCA3.The gene mutations of SCA3 may be relatived to the incidence of primary dystonia.

Objective Through investigation on hospital infection, to learn the actual status of hospital infection and improve hospital infection management work continuously. Methods Via transect investigation, all hospital-ized patients were investigated by bed-visiting and patients, medical records, checking at the same time. ResultsA total of 3032 cases were enrolled, and the prevalence from 2010 to 2012 were 6. 10%, 5.30% and 4.17%, re-spectively. ICU had the highest prevalence of 39.29%. The lower respiratory tract ranked the first place (45.16%) among infection sites. Invasive operation increased the risk of nosocomial infections. The utilization rates of antibiotics of the hospitalized patients from 2010 to 2012 were 67.7%, 64. 8%, and 54. 1%, respectively. The microbial submission rates for the therapeutic medication were 39 . 00%, 46.99%, and 55 . 01%, respective-ly. The gram-negative bacteria were dominant among the isolated bacterias, accounting for 61.39%. ConclusionThe prevalence survey in the nearly three years shows that the prevalence of nosocomial infections is decreasing,and the microbial submission rate for the therapeutic medication is also increasing by improved hospitalized conditions, strict management of antibiotics and enhanced surveillance.

Polybrominated diphenyl ethers (PBDEs) is a kind of important industrial flame retardants,which widely exists in the environment and biosomes.Some researches have indicated that PBDEs is toxic to the nervous system of animals through affecting the release of neuroendocrine hormone,the signal transduction pathways,the transmission of neurotransmitters,the expression of key proteins in the nervous system,and the apoptosis of neuronal cells.Data from environmental monitoring indicated that environmental exposure to PBDEs in China exists,but the research on the effect of PBDEs on nervous system is very limited,which calls for attention.This article summarized researches on the mechanism of neurotoxic effects induced by polybrominated diphenyl ethers from the aspects such as the release of neuroendocrinal hormone,the signal transduction pathways,the transmission of neurotransmitters,the expression of key proteins in the nervous system,and the apoptosis of neuronal cells,and some ideas about the direction of related researches were presented.

Objective To study tannins of Corylus heterophylla from Heilongjiang Province. Methods The constituents were separated and purified repeatedly by macroporons resin chromatography methods and their structures were identified by 1H-NMR, 13C-NMR, FAB-MS, and 1H-1HCOSY spectra, and chemical methods as well. Results Three tannins were obtained from C. heterophylla. They were heterophylliin D (Ⅰ), roxbin A ( Ⅱ ), and rugosin F ( Ⅲ ). Conclusion Heterophylliin D ( Ⅰ ) is isolated from the extract of C. heterophylla leaves as a new dimmer tannin firstly.

Objective To study dose-response relationship for chromosome translocation and its persistence measured in human lymphocytes exposed to 60Co γ-rays.Methods The chromosome translocations in human peripheral lymphocytes were detected by fluorescence in situ hybridization using 4# and 7# combination of composite whole chromosome-specific DNA probes and Giemsa stain.Results The dose-response relationship for chromosome translocation induced by 60Co γ-rays in vitro could be described by the function:Y=0.0030+0.0134D+0.0165D2.The frequencies of chromosome translocations induced by 0.5 and 2 Gy γ-irradiation did not diminish over time,so it exhibited excellent persistence.Conclusions The results indicate that retrospective dose-reconstruction can be accomplished using chromosome translocation frequency.

Objective To compare the sedative effects and pharmacoeconomic profiles of two kinds of combination of dexmedetomidine in traumatic brain injury patients.Methods94 cases of traumatic brain injury from February 2015 to September 2016 were selected and randomly divided into two groups including A group(47 patients) and B group(47 patients).All patients received the same nursing intervention before and after operation.Patients in group A were given right of dexmedetomidine combined with propofol drug therapy, patients in group B were given dexmedetomidine combined with midazolam drug treatment.To maintain the agitation score (SAS) in the standard state of two~four and efficiency of sedation, the mean arterial pressure (map), respiratory rate (RR), heart rate (HR), oxygen saturation (SpO2), arterial carbon dioxide partial pressure (PaCO2), central venous pressure (CVP) Glasgow Coma Score (GCS) and pharmacoeconomic profiles were tested in all patients.ResultsAll patients in two groups achieved the expected sedative effect and analgesia scores.However, A group showed a greater decrease in MAP, RR and HR after sedation as compared to B group.In two groups, there was no significant difference was observed in pulse oxygen saturation (SpO2),partial pressure of carbon dioxide in artery(PaCO2), central venous pressure(CVP)or GCS score before and after sedation.Dexmedetomidine combined with MI of alprazolam treatment phase compared with dexmedetomidine and propofol regimen is more economical, and the difference has statistical significance (P<0.05).ConclusionThe effects of dexmedetomidine combined with propofol and dexmedetomidine combined with midazolam two regimens can achieve good sedative effect.But combined with propofol group compared to midazolam combined with group of respiratory and circulatory system have better inhibitory effect, also in drug economics angle, midazolam midazolam combined with group than that of propofol combined with group is more economical, patients taking lower cost.

BACKGROUND:Renal ischemia/reperfusion during renal transplant surgery induces the process of apoptosis signaling pathways.Propofol possibly protects kidney from renal ischemia/reperfusion injury.So it is important to investigate propofol's mechanism underlying apoptosis.OBJECTIVE:To investigate the effects of propofol on apoptosis signaling pathways in a rat model of renal ischemia/reperfusion injury and the possible mechanism of action.DESIGN,TIME AND SETTING:An animal experiment,cell morphology observation was performed at the laboratory of the Department of Urinary Surgery,Beijing Friendship Hospital between 2004 and 2005.MATERIALS:A total of 99 male adult outbred Sprague Dawley rats were included in this study.Rabbit anti-rat Bcl-2,Bax,caspase 3,and cytochrome C were produced in Wuhan Boster Bioengineering Co.,Ltd.,China.METHODS:Rats were randomly divided into three groups:control(n = 26),ischemia/reperfusion(n = 35),and ischemia/reperfusion+propofol(n = 38).Rat model of renal ischemia/reperfusion injury was established in each group as follows.Following single intravenous transfusion of 5 mL/kg ringer lactate solution,the right kidney was excised through a median abdominal incision.The left renal pedicle was occluded for 45 minutes using an atraumatic vascular clamp,followed by reperfusion and full-layer suture.At 0,3,12,24,and 72 hours after reperfusion,the left kidney was excised,and simultaneously,rat was sacrificed through bloodletting.In the ischemia/reperfusion+propofol group,propofol(1 mg/kg per minute)was administered from 15 minutes prior to ischemia to 30 minutes after reperfusion,for a total of 75 minutes.In the control and ischemia/reperfusion groups,rats were administered the same amount of ringer lactate solution.MAIN OUTCOME MEASURES:Morphological changes of injured kidney and expression of apoptosis-related protein Bcl-2,Bax,caspase 3 and cytochrome C.RESULTS:Renal ischemia/reperfusion-caused kidney damages could be observed through an optical microscope,and proximal convoluted tubule was severest,followed by distal convoluted and collecting duct,and lastly renal glomerulus.Immunohistochemistry results demonstrated that compared with the control group,Bax,caspase 3,and cytochrome C expression was increased,but no obvious change in Bcl-2 expression was observed in the ischemia/reperfusion group;compared with the control group,Bax,caspase 3 and cytochrome C expression was significantly decreased,but Bcl-2 expression was significantly increased in the ischemia/reperfusion+propofol group(P＜0.05).CONCLUSION:Propofol is likely to exhibit protective effects on cellular apoptosis caused by renal ischemia/reperfusion.Propofol inhibits pro-apoptotic protein Bax,caspase 3 and cytochrome C expression but does not produce effects on Bcl-2 expression.The underlying mechanism correlates with apoptosis signaling pathways in mitochondrion.

Objective To explore the significance on expression of mdr-1, P-gp and DNA heteroploidy in invasive bladder carcinoma. Methods The expressions of mdr-1 and P-gp were detected by RT-PCR and immunohistochemistry(SP) method, and DNA ploidy by flow cytometry method in 26 cases of invasive bladder carcinoma tissues, which were compared with those in 10 normal bladder tissues. At the same time, the flow cytometry was used to determine DNA heteroploidy. Results A of mdr-1 in the neoadjuvant chemotherapy CR, PR, non-respond and control group were (0.61±0.75), (0.71±0.11), (1.68±0.28) and (0.745±0.13),respectively (P＜0.05). Positive rates of P-gp had significant differences between CR, PR and non-respondgroup and control group (P ＜0.05). Positive rates of DNA heteroploid in the above groups were 50 %, 45 %,69 % and 10 %, respectively (P ＜0.05). Conclusion The detections of mdr-1, P-gp and of DNA heteroploid contribute to evaluate neo-adjuvant chemotherapy effects of invasive bladder carcinoma.

Objective To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) 677C ＞ T and unexplained recurrent pregnancy loss (URPL).Methods All patients were recruited from the outpatient department of Obstetrics/Gynaecology & Genetics of Hangzhou First People's Hospital from January 2013 to May 2014.A case-control study was performed.According to the stochastic indicator method,there were 125 subjects with a history of ≥2 times URPL as the case group,and 905 healthy parous women with no history of URPL as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the distributions of the polymorphisms of MTHFR 677C ＞ T,and the results were validated using oligo-chip and direct sequencing.Results The allele and genotype frequencies of MTHFR were 60.0％ for C,40.0％ for T,32.0％ for CC,56.0％ for CT,and 12.0％ for TT in the case group and 67.4％ for C,32.6％ for T,41.4％ for CC,52.0％ for CT,and 6.6％ for TT in the control group,respectively.The prevalence of allele T was significantly higher in the case group than in the control group (OR =1.379,95％ CI =1.051-1.808,P =0.020),the frequency of genotype TT was also significantly higher in the case group than in the control group (OR =2.344,95％ CI =1.220-4.503,P =0.009).Conclusion The fertile women with MTHFR 677T allele and 677TT genotype may be susceptibility to URPL in a Chinese Han population from the Hangzhou area.