Reactive oxygen species(ROS) resulting from oxidative stress plays a significant role in the pathogenesis of diabetic nephropathy.It induces cell apoptosis and accelerates the development and progression of diabetic nephropathy through mitochondrial activation,DNA oxidative injury and influence on gene expression.Reducing ROS formation and blocking the pathway of cell apoptosis activated by ROS may become a new target in the treatment of diabetic nephropathy.

Colorectal cancer stem cells are a small part of cell population with features of stem cell in the colorectal cancer tissues. Tumor stem cells have the self-renewal capability and have been considered as the root of tumor recurrence. They play an important role in the development, progression, relapse, metastasis, and resistance to chemoradiotherapy of tumors. The long-term clinical practice has proved that traditional Chinese medicine has particular advantage on the aspect of resisting tumor recurrence and metastasis. In recent years, with the deep understanding of the theory of colorectal cancer stem cells, the clinical and basic researches of traditional Chinese medicine compound, single herb and active ingredient become hot spots.

Objective To investigate the thyroid hormone changes and their relationship with the state of severity in critically ill patients. Methods Ninety-two patients with no thyroidal illness syndrome admitted to the ICU from January ,2009 to December,2009 were enrolled in this study. The common situations and the score of acute physiology and chronic health evaluation Ⅱ were assessed on addmission. We measured the thyroid hormone levels on the day after admission and analysed whether thyroid hormone levels were related to disease severity. Results The thyroid hormone levels in septic shock group [TT3 (1.16 ± 0.24) nmol/L, TT4 (68.93 ± 24.11) nmol/L, FT3 (3.76 ± 0.21) prnol/L, FT4 (16.40 ± 2.74) pmol/L, TSH (1.58 ± 1.01) mU/L] were significantly lower than those in non-septic shock [TT3 (1.50 ± 0.25) nmol/L, TT4 (91.70 ± 21.90) nmol/L, FT3 (4.24 ± 0.45) pmol/L, FT4(17.98 ± 3.28) pmol/L, TSH (2.43 ± 2.76) mU/L] (P ＜ 0.05). The serum thyroid hormone levels of free triiodothyronine (FT3) ,free thyroxine (FT4) were related to the score of APACHE Ⅱ in septic shock(P ＜ 0.05).Conclusions The levels of thyroid hormone were significantly lower in critically ill patients than the control group and had positive correlation with the disease severity.

Objective To find out an optimal anesthesia and the d osage used in painless gastroscopy, and to evaluate its efficiency. Meth ods 200 patients undergoing painless gastroscopy were divided into 4 gr oups randomly. 2?g/kg iv of propofol was used in group Ⅰ, fentani 1?g/kg + pr opofol 2?g/kg in group Ⅱ, rimifentani 0.5?g/kg + propofol 1.5?g/kg in grou p Ⅲ, and rimifentani 0.75?g/kg + propofol 0.75?g/kg in group Ⅳ. Observed o bjects induced starting time and depth of anaesthesia, HR, R and SpO2 during o peration, side effects such as cough reflex and larynx spasm, time of regaining consciousness, postoperative side effects such as nausea and vomiting. R esult Significant differences (P≤0.01) were found between group Ⅳand the other 3 groups in starting time and depth of anaesthesia, side effects , time of regaining consciousness and suppression of respiration during operatio n. Conclusion Combined rimifentani 0.75?g/kg + propofol 0.75 ?g/kg are optimal anestheties in painless gastroscopy if side effects are preve nted.

AIM: To establish a method for detecting the residual solvents in protopanaxdiol. METHODS: Capillary GC with HP-PLOT-Q column (30 m ? 0. 53 mm ? 1. 0 ?m) was used to determine residual in protopanaxdiol. N,N-dimethyl-acetamide as solvent media,FID detector and nitrogen as the carrier gas. RESULTS: There was a good linearity at the experimental concentration (r = 0. 999 96-0. 999 99),the RSD of precision was less than 6. 0 % . The spotting recovery of the 3 residul,including methol,ethyl acetate and n-butanol,was in the range of 98. 2%-102. 2% ,and its’RSD was 1. 1%-2. 4% . CONCLUSION: The method is simple,accurate and of high sensitivity,can be used for the determination of residual solvents in protopanaxdiol.

Objective:To analyze the reasons of early failure of the PHILOS in proximal humerus frac-tures.Methods:From Nov.2010 to Nov.2014,there were 117 patients with humerus fractures treated with PHILOS locking plate in Department of Orthopaedics,Xuanwu Hospital.All of the patients were treated with the plate by open reduction internal fixation,and we analyzed these cases retrospectively. After the operation,we removed the drainage tube within 48 h,and the patients were allowed to do the passive motion 3 days after the surgery if the X-Ray showed the plate and screws were reliable.Eight ca-ses failed within 4 weeks after the operation.We analyzed the reasons of the failure.Results:The rate of the failed cases was 6.83%(8 /117).The average age was 72.4(66 -82)years.In the 8 failed cases, 3 were on the right side,and the other 5 on the left side.As for the reason of the fractures,2 cases were because of car accidents,and the other 6 because of daily life injury.According to the Neer classifica-tion,3 cases were 2-part fractures,and the other 5 3-part fractures.Three cases were total failure,and the other 5 partial failure.All the 8 failed cases failed within 4 weeks after the operation,of which 1 was on the sixth day after surgery,the other 7 2 to 4 weeks after the surgery.The 3 totally failed cases were treated by removing the screws and plates,the other 5 by conservative methods.All of the cases were malunion at the end.Conclusion:The early failure of the PHILOS locking plate in proximal humerus fractures is related to the bad reduction during the operation,the loss of medial cortex support,the limi-tation of screw length,the osteoporosis and the improper rehabilitation after operation.It is very important to do good preoperative plan for a surgeon.During the operation,we should try our best in the fracture reduction,use the appropriate plate and screws,and then pay attention to the rehabilitation after the operation.After all of this,the rate of failure may be decreased.

The hardship and differentiation degrees are important judgments about test questions.The key purpose about analyzing hardship and differentiation degrees is not only to keep the qualified test questions,eliminate the unqualified and refine the test questions,but also to accumulate valuable data to make exams more scientific,standardized and specified.

Many active measures,such as setting up an interesting group in microorganism laboratory,enhancing students' enthusiasm for study by letting them play the important role to make them have more developing space,are provided so that the students can generate the most creativity and comprehensive ability.The result of the activity shows that the students benefit from the interesting group activity.

Objective:To study the time-course effect and postoperative residual curarization of rocuronium(ROC) in patients with obstructive jaundice.Methods: Forty patients(with normal renal function and without muscle or nerves diseases) receiving elective surgery under general anesthesia were divided into 2 groups: trial group(group Ⅰ) included 20 ASA(American Society of Anesthesiologists) Ⅲ patients with obstructive jaundice and control group(groupⅡ) included 20 ASA Ⅰ-Ⅱpatients without obstructive jaundice.All patients received total intravenous anesthesia with pentothal sodium,fentainyl and propofol.Neuromuscular blockade was evaluated with train-of-four(TOF) stimuli of the ulnsar nerve during operation.The 3?ED_(95)((0.9 mg/kg)) of ROC was given during anesthesia induction.As TOF rate(TOFR) reached 25%,1?ED_(95)(0.3 mg/kg)of ROC was added.Postoperation neuromuscular blockade was continuously evaluated until TOFR reached 90%.Tracheal extubation trigger was defined as that patient was able to open his/her eyes and to raise his/her arm or head for 5 s.The onset time,effect time of ROC,the time of TOFR from 0 to 70% and from 70% to 90%,and the TOFR at the time of tracheal extubation were observed.The blood gas analysis was done at the same time.Results: The effect duration in groupⅠwas longer than that in group Ⅱ(P