Objective To elucidate the role of insulin receptor and its ?-subunit autophosphorylation in evoking insulin resistance in non-obese type 2 diabetes. Methods 14 patients with non-obese type 2 diabetes and 12 healthy subjects were enrolled in this study. Insulin receptor numbers and its insulin affinity in erythrocytes were measured using radio-labelled ligand binding assay described by Comi et al. Insulin receptor autophosphorylation in erythrocytes membrane was initiated by adding insulin and ?- 32 P ATP. Then the membrane proteins were resolved on 7 5% SDS-PAGE and subjected to autoradiography. Results The numbers of high and low affinity receptors in erythrocytes of type 2 diabetes were 21?13 and 955?427 per cell respectively, and they showed no significant difference as compared with control. The high affinity constant(K 1) and low affinity constant(K 2) of insulin receptors in erythrocytes of type 2 diabetes were (1 70?0 93)?10 -9 LM -1 and (1 44?0 86)?10 -7 LM -1 respectively, also displaying no significant difference in comparison with the control. Insulin-induced receptor ? subunit autophosphorylation was 8 02?5 6△A/mg protein in type 2 diabetes, which was lower than that (28 38?15 24)△A/mg protein) in control(P

This study was aimed to evaluate the number of acute exacerbation of chronic obstructive pulmonary disease (COPD) and quality of life with family pulmonary rehabilitation exercise. Randomized controlled method 584 was used in the study. The COPD patients in the stability drug treatment were divided into the treatment group and control group. The treatment group A was given health education and pulmonary rehabilitation training in the family. And the treatment group B was given health education and treatment of pulmonary rehabilitation training in the family with acupoint application therapy. Health education was given in the control group. Changes on the number of acute exacerbation of COPD and quality of life were observed. The intervention time was one year. The results showed that patients after one-year pulmonary rehabilitation exercise in the family, the acute exacerbation (AECOPD) times of treatment group A and group B were obviously decreased (P < 0.01) compared to pre-treatment. The OR value was (0.79, 2.02) and (0.59, 2.11), respectively. The quality of life of treatment group A and group B was obviously improved (P < 0.05). The OR value was (3.39, 10.11) and (4.23, 9.57), respectively. Compared to the control group, the quality of life in treatment group B was obviously improved (P < 0.05). The OR value was (0.59, 7.78). It was concluded that the pulmonary rehabilitation exercise in the family can decrease the number of AECOPD and improve the quality of life of patients, reduce the risk of COPD patients in the future. This method is worth popularizing in the clinical and community practice.

Objective To observe the changes of serumγ?glutamyl transpeptidase(GGT)levels before and after the patho?gen treatment in patients with subclinical schistosomiasis,and explore its clinical value in the diagnosis and treatment of sub?clinical schistosomiasis. Methods Totally 109 patients with subclinical schistosomiasis,who were found in the endemic inves?tigation of schistosomiasis in Ezhou City,were selected as the investigation subjects,and then they were treated with praziquan?tel. The serum GGT levels of the subjects before and after the treatment were detected and compared. Results Before the treat?ment,the average value of the GGT levels of the 109 patients was(48.1 ± 45.9)IU/L,among which,the GGT levels of 69 cases (63.3%)were normal,and the levels of 40 cases(36.7%)were increased. After the treatment,the average GGT level of the pa?tients was(32.1 ± 23.4)IU/L,which decreased by 33.3%comparing with that before the treatment,and the difference had a statistical significance(U=2.17,P=0.01). The GGT levels of 65 patients decreased in different degrees. Among the 40 pa?tients whose GGT levels had increased before the treatment,the GGT levels of 31 ones returned to the normal. Conclusion The GGT level detection can accurately reflect the liver function in the patients with subclinical schistosomiasis ,and also it has certain clinical application value to judge the liver function damage and recovery of the patients before and after the pathogen treatment.

Objective To investigate the effect of ultrasound combined with intravenous terbutaline sulfate for external cephalic version and the impact of this therapy on maternal and neonatal complications.Methods 126 singleton pregnant women who were diagnosed by B-ultrasound breech pregnancy at 34-36 weeks in regular antenatal examination from January 2014 to June 2016 were randomly divided into an observation group (n =70)and a control group (n =50).The observation group was treated with intravenous drip of terbutaline sulfate after epidural anesthesia,and then received external cephalic version under B-ultrasound monitoring.The control group received traditional knee-chest position for correcting breech presentation.The success rate of breech correction,breech version rate,cesarean section rate,vaginal delivery rate,adverse reactions,postpartum hemorrhage volume,neonatal asphyxia,and neonatal birth injury were noted and compared between the two groups.Results As compared with the control group,the observation group had a higher success rate of breech correction and a higher rate of vaginal delivery while a lower rate of cesarean section,with a significant difference (x2 =20.210,8.564;P ＜0.05).The rate of postpartum hemorrhage,neonatal asphyxia,or neonatal birth injury did not differ significantly between the two groups (P ＞ 0.05).Conclusions Application of ultrasound combined with intravenous terbutaline sulfate in external cephalic version is easy to operate and has a higher success rate and greater safety,significantly reducing the rate of cesarean section and improve the success rate of vaginal delivery.

Objective To investigate the actualities about bladder management in patients with spinal cord injury. Methods 76 spinal cord injured patients were investigated with questionnaire. Results 61 patients adopted the bladder management methods recommended by their doctors, the other 15 refused the doctor's suggestion. In frequency order, bladder management methods used by spinal cord injured patients were intermittent catheterization (43.4%),triggering voiding or bladder expression(34.2%),indwelling catheter (2.6%), urine collection device 3.9% and others (15.8%). The female were more likely to adopt intermittent catheterization. The general satisfaction was 77.63%. Conclusion Medical staffs should recommend appropriate bladder management method for spinal cord injured patients not only considering their medical conditions bur also their psychological and social conditions.

The expression vector of SmIg scFv fragment was constructed in patient with B cell chronic lymphocyte leukemia (B-CLL) and expressed in E. coli to obtain scFv fragment, and the effect of the protein on the proliferation of stimulated peripheral blood mononuclear cells (PBMC) was investigated in vitro. Two pairs of primers were designed, and variable region genes of light chain and heavy chain were amplified by PCR respectively from the pGEM-T vectors previously constructed in our laboratory which containing light chain gene or Fd fragment of heavy chain gene. The PCR product was digested, purified and inserted into pHEN2 vector to construct the soluble expression vector pHEN2-scFv. After the induction by IPTG, the scFv protein was identified by SDS-PAGE electrophoresis and purified by Ni-NTA-Chromatography. MTT was used to determine the effect of purified protein on the proliferation of stimulated PBMC in vitro. Plasmid PCR and restriction enzyme digestion of pHEN2-scFv revealed the pHEN2-scFv vector was constructed successfully. Id-scFv protein was expressed in positive clone after induced by IPTG. SDS-PAGE analysis showed that the relative molecular weight of fusion protein was about 30 kD (1 kD= 0.9921 ku), which was consistent with the theoretically predicted value. Proliferation of PBMC could be induced by purified Id-scFv. It was suggested that the expression vector of SmIg scFv fragment was constructed successfully, and scFv protein was expressed and secreted from E. coli, which could induce proliferation of PBMC. This may lay an experimental foundation for further research of Id-HSP complex vaccine for B-CLL.

Objective To study the role of Lugol staining for detecting early esophageal cancer and precancerous lesions.Methods 2% Lugol solution was adopted to stain esophageal mucosa in 45 cases with esophageal suspicious lesions,observed and multiple biopsies were taken for pathological study.Results Thirty-nine cases were light or non-stained among the 45 cases with Lugol staining.Which revealed 8 esophageal cancers(5 early cancer,3 advanced cancer),5 Barrett esophagus,,11 mild-moderate dysplasias.The rate of detecting early esophageal cancer and precancerous lesions with Lugol staining was 46.7%.Conclusion Lugol staining is helpful for diagnosis of early esophageal cancer and precancerous lesions,and it is simple in operating.The role of Lugol staining in detecting early esophageal cancer and precancerous lesions has important clinical value.

Objective To analyze clinicopathologic features and malignant transformation of spiradenoma (SA).Methods Clinicopathologic data on 25 cases of SA were retrospectively analyzed.An immunohistochemical study was conducted on 5 of the 25 patients.Clinicopathologic features of SA were summarized based on clinicopathologic data,immunohistochemical results and relevant literature.Results The average age of these patients was 40 years.Lesions were acquired and solitary in 24 cases (96％,24/25),and occurred most frequently in the extremities.The diameter of tumors was less than 2 cm in 20 cases (87％,20/23).Twenty-three cases were benign SA with various histological manifestations,including 15 cases (65％,15/23) of typical SA,8 cases (35％,8/23) of cylindroma.VarTing numbers of mitotic figures were observed in different cases.The immunohistochemical study showed epithelial and myoepithelial differentiation.Two cases of SA experienced malignant transformation into poorlydifferentiated basal cell adenocarcinoma and well-differentiated adenocarcinoma respectively.Lymphocytes decreased significantly in number or disappeared in the malignant area,and both the malignant tumors exceeded 2 cm in diameter.Conclusions SA is a kind of neoplasm with distinct histological characteristics and nonspecific clinical manifestations.Most SA cases have a benign clinical course,but malignant transformation should be considered in some cases with longterm clinical course and large size.

Objective To investigate the feasibility of a small amount of water intake at the early stage after general anesthesia in children.Methods Five hundred and seventy children underwent operations under general anesthesia were randomly divided into 2 groups:control group ( n =288) and early postoperative drinking group ( n =282).The children received routine water deprivation after operation in control group.After recovery from anesthesia and recovery of coughing and swallowing reflexes,the children were allowed to drink a small amount of water in early postoperative drinking group.The incidences of crying,bucking,aspiration and hyoxemia were recorded before water intake and at 5 min after water intake.Results Compared with control group,the incidence of crying was significantly decreased and no significant change was found in the incidence of bucking in early postoperative drinking group.No patients exhibited aspiration and hyoxemia in the two groups.Conclusion It is feasible that children drink a small amount of water at the early stage after general anesthesia.

Objective To explore the strategies and effectiveness of perioperative fluid administration during pediatric kidney transplantation.Methods In our study,we evaluated the heart function and compliance of pediatric patients preoperatively,and then formulated perioperative fluid management strategy according to children’s circulation feature.The electrolytic balance was kept and complications were prevented.Results Twenty-nine out of all 48 children experienced electrolyte disturbance to different extents on day 1 postoperatively,which improved on day 2 after prompt management.There were five cases of oliguria,three cases of delayed graft function(DGF),one case of heart failure and multiple organ failure respectively.Conclusion Such nursing strategies like formulation of reasonable fluid infusion plan according to the physiological features of pediatric recipients,keeping the electrolytic balance and careful management of fluid at polyuria,oliguria and anuria,care critical for the children to live through the perioperative periods.