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.

[ ABSTRACT] AIM:To investigate the potential role of exogenous hydrogen sulfide ( H2 S) and ATP-sensitive po-tassium ( KATP ) channels in chronic stress-induced colonic hypermotility.METHODS:Male Wistar rats were divided into water avoidance stress ( WAS) group and sham WAS ( SWAS) group.Organ bath recordings were used to test the contrac-tile activity of colonic strips.The effects of H2 S donor NaHS and pretreatment with glibenclamide on the contractions of co-lonic smooth muscle were studied and the IC50 of NaHS was calculated.The localization and expression of the subunits of KATP channels were determined by the methods of immunohistochemistry and Western blotting.RESULTS:WAS increased contractile activity of colonic strips.NaHS concentration-dependently inhibited the spontaneous contractions of strips from the SWAS and WAS rats.The IC50 of NaHS for longitudinal muscle ( LM) and circular muscle ( CM) of the WAS rats was 0.2033 mmol/L and 0.1438 mmol/L, significantly lower than those of the SWAS rats.Glibenclamide significantly in-creased the IC50 of NaHS for LM and CM from the SWAS and WAS rats.In both SWAS and WAS rat colon, Kir6.1, Kir6.2 and SUR2B were expressed on the plasma membrane of the smooth muscle cells.WAS treatment resulted in up-reg-ulation of the expression of Kir6.1 and SUR2B in the colon devoid of mucosa and submucosa.CONCLUSION: The in-creased expression of Kir 6.1 and SUR2B in colonic smooth muscle cells may be a defensive response to chronic WAS.H2 S donors may have potential clinical effect on treating chronic stress-induced colonic hypermotility.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.

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.

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 study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

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 explore the enhancement patterns of pulmonary carcinomas by contrast-enhanced ultrasound(CEUS).Methods Thirty-eight patients with pulmonary carcinomas proven by pathology[28 with peripheral pulmonary carcinomas and 10 central pulmonary carcinoma with obstructive atelectasis(OA)]were examined by baseline ultrasound and contrast-enhanced ultrasound,then the arrival time(AT),time to peak(TTP)were analyzed with time-intensity curve analysis software and the dynamic enhancement pattern of each lesion was assessed.Results Twenty-four peripheral pulmonary carcinomas demonstrated delayed AT about 6-16 s after application of contrast medium,three lesions demonstrated early AT about 4-5 s and one lesion demonstrated absence of contrast enhancement.The lesions exhibited hyper-,hypo- and non-enhancement were 14,13 and 1,respectively.Seventeen lesions were heterogenous enhanced with non-enhanced necrosis areas and enhanced septa,while ten lesions homogeneous enhanced and one lesion no enhanced.Ten central pulmonary carcinoma with OA demonstrated a characteristic pattern:OA appeared a short AT(mean AT 4.8 s)until enhancement and strong contrast enhancement,while the central tumors appeared a delayed AT(mean AT 10.5 s)and faint enhancement.Conclusions CEUS can be useful in differentiation between solid and cystic pulmonary lesions,and detection of the latent lesions underlying the atelectasis.