Objective To investigate the relationship between diabetic retinopathy(DR) and the state of diabetes mellitus(DM) control.Methods The factors for the occurrence and development of DR were analyzed by non conditional Logistic regression model.Results 5 significant factors were screened out,which were urinary microalbumin excretion index(ALB/Cr),blood glucose before breakfast,glycosylated hemoglobin(HbAlc),diabetic neuropathy and course of DM.And the sugestible threshold value of blood glucose before breakfast is 7.90mmol/L at which we can prevent the occurrence of DR,and at 7.15mmol/L,occurrence of DR can be strictly controlled.Conclusion The state of controlling blood glucose and other complications in DM patients influences the occurrence and development of DR.

Objective To evaluate the efficacy of percutaneous laser hypothermia in the treatment of lumbar discogenic pain. Methods From June 2006 to March 2008,35 patients with lumbar discogenic pain were treated by low-frequency laser hypothermia in our hospital with 1 second impulse time,1 second interval time,3.5 w power,and 30 minutes duration. The effectiveness of the therapy was evaluated afterwards. Results Among the cases,15 patients were treated by one operation,20 patients received a second therapy,and 6 underwent the therapy for totally 3 time; the treatment was effective in 32 cases (excellent in 7,good in 24,and fair in 1). The therapy is ineffective in 2 cases. One case was converted to open surgery for unsatisfying outcomes of the laser hypothermia. The total effective rate was 91.4%(32/35),and fineness rate was 88.6%(31/35). Conclusions Percutaneous laser hypothermia is an effective treatment for lumbar discogenic pain. The indications for the procedure should be selected strictly.

Objective To investigate the changes of Na~+,K~+-ATPase activity in the proximal tubules (PT) of type 2 diabetes mellitus(T2DM) and the correlation of PT Na~+,K~+-ATPase activity and endogenous digitalis-like substance (EDLS). Methods Female Wistar rats were developed a rat model of T2DM and then divided into 3 groups after injected stretozotocin, that is, 5 weeks group, 7 weeks group and 9 weeks group. The PT were microdissection by freehand. Na~+,K~+ -ATPase activity of PT were determined by liquid scintillation counter. Serum EDLS and insulin were determined using radioimmunoassay. Results Compared with control group, T2DM rats were associated with hyperglycemia, hypertriglyceridemia, dyslipidemia, and insulin resistance; Na~+,K~+-ATPase activity of PT in T2DM rats was significantly increased, and there was no significant difference among 3 sub-groups. Serum EDLS level was significantly enhanced in T2DM, however, EDLS levels were no significant difference among 3 sub-groups. Na~+,K~+-ATPase activity of PT had negative relation with EDLS level in serum. Conclusion Na~+,K~+-ATPase activity of PT in T2DM rats is increased and EDLS level in serum decrease may play a important role.

BACKGROUND:Restenosis and lumina loss limit further application of balloon extension and stent implantation.Effect of tunica intima proliferation and apoptosis in restenosis and the intervention method are exploring.OBJECTIVE:To investigate the influence of Rosuvastatin on the vascular smooth muscle cells proliferation and apoptosis in rats with carotid artery injury established by Medtronic balloon.METHODS:The male SD rats were randomly and equally divided into injury group and treatment group.Each rat was subjected to balloon injury on the lift common carotid artery,and control artery without balloon injury on the right artery served as control group.Treatment group rats were given Rosuvastatin(dissolved in Nacl)5 mg/kg per day 3 days before injury,while the injury group rats were given 9 g/L NaCl.At 7 and 14 days after injury,the common carotid arteries were harvested for HE staining.SM α-actin and proliferating celI nuclear antigen were detected by immunohistochemistry.In addition,smooth muscle cells apoptosis was detected by TUNEL.RESULTS AND CONCLUSION:The neointimal area and the area ratio of neointimal/media were decreased in treatment grouP significantly at 14 days compared with injury group(P<0.05),and neointimal area increased by 26%:positive cell rate of proliferating cell nuclear antigen was decreased,but apoptosis cells were increased cornpared with the injury group(P<0.05).Results showed that Rosuvastatin prior to balloon injury inhibited neointimal proliferation and neointimal celI proliferation following balloon Injury,promoted smooth muscle cells apoptosis,ultimately reducing neointimaI formation and inhibiting restenosis.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To explore the association between the 5-HTR2A (-1438A/G)promoter region gene polymorphisms and unipolar depression and effcacy of antidepressant drugs in northwest Chinese Han population.Methods Polymerase chain reaction (PCR) was used to detect the distributive frequency of serotonin 2A receptor promoter region polymorphisms of 136 unipolar depression patients( patient group) and 160 normal people tween the patient group and the control group.The frequency of AG,GG genotypes; and G allele in patients was phisms of 5-HT2AR promoter region were correlated with SSRIs treatment response(F= 6.317, P= 0.013 ).There was significant difference of the effective power at the end of week 2 ( x2 = 5.878, P= 0.015 ).The effective power of AA, AG genotype was much higher than that of GG genotype and the effective power in the group with AA genotype was higher than that with AG genotype( each 87.8% ,57.6% ,53.7% ).Conclusion The frequency of GG genotype of 5-HTR2A( 1348A/G)may be associated with episode of unipolar depression in northwest Chinese Han population and A allele may be correlated with well response to paroxetine.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.

Objective To evaluate the significance of sonographically detected thyroid calcification in the diagnosis of thyroid carcinoma.Methods Five hundred and twenty-two patients with thyroid disease,including 119 with thyroid cancer,were included in the study.Each patient underwent preoperative,highresolution sonography to evaluate the thyroid gland for the presence of calcification.Calcifications were classified:type Ⅰ,microcalcification;type Ⅱ,coarse calcification;type Ⅲ,annular or"egg-shell"calcification;typeⅣ,calcified nodules within a cyst.Results The incidence of calcification and microcalcification was significantly higher in thyroid cancer than in benign nodules(P＜0.001).The appearance of microcalcifications was highly specific for malignancy with a sonographic specificity of 88%.The sensitivity was 60%,and the odds ratio(0R)was 11.28.The incidence of calcifications of type Ⅱ and type Ⅲ did not differ significantly between the benign and malignant groups.Calcifications of type Ⅳ were showed totally in benign groups.Patients younger than 45 years with calcified nodules constituted a highrisk group,with a OR of 11.33 versus 2.96 in patients older than 45 years with calcified nodules.In the group of solitary thyroid nodules,the incidence of cancer in the calcified nodules was higher than in the nodules without calcifications,with a OR of 20.48.Conclusions The detection of thyroid calcifications by sonography is diagnostically valuable,especially in eases involving a solitary nodule or a young person.The presence of calcifications in these cases should raise the suspicion of malignancy,especially microcalcification.

Objective·To investigate the incidence, risk factors and treatment of the catheter-related thrombosis (CRT) in breast cancer patients after implantation of totally implantable venous access port (TIVAP) in chemotherapy. Methods·A total of 190 cases after implantation of TIVAP were investigated. Color Doppler ultrasound was used to monitor the neck blood vessels to find whether there was CRT before chemotherapy and before taking out the port. The incidence of CRT, occurrence time, risk factors and treatment efficacy were observed. Results·There were 112 (58.9%) cases with CRT and 108 (56.8%) patients with asymptomatic thrombosis, and only 4 cases had symptomatic thrombosis, the incidence of which was 2.1%. Most thrombosis developed on the 21th day after catheterization, and the patients over the age of 60, with clinical stage Ⅲ - Ⅳ and chemotherapy regimens TEC (docetaxel combined pirubicin and cyclophosphamide) were the risk factors for thrombosis. All the patients with asymptomatic thrombosis accepted anticoagulant treatment with low molecular heparin, earthworms enzyme or aspirin, respectively, but there was no significant difference in efficacy in the three groups (P=0.743). Conclusion·Port catheter related symptomatic thrombosis incidence is low but the incidence of symptomatic thrombosis is high in the breast cancer patients after chemotherapy. Age, tumor stage and TEC chemotherapy regimens are the risk factors for catheter-related thrombosis.

Objective:To characterize the memory B lymphocytes activalion by nonspecific antigen of different phylogeny antigen.Methods:Three groups were immunized by same quantity different antigens,which were ovalbumin,milk and ostrcean extract to intitule A,B,C,respectively,as basic immunity.After one week,across immunity was performed with A,B and C antigen as secondary immunity,the subgroups were divided.Basic antibodies were determined with ELISA before and after secondary immunity.Results:Antibodies after secondary immunity increase 10%～25% than that before secondary immunity in subgroups which antigens were different when basic and secondary immunity.There were significant difference compare with control groups (P