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.

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 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.

[ 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 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

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 compare the clinical outcome of intramedullary nail with locking plate in the treatment of two-part proximal humerus fractures.Methods PubMed,SpringerLink,EMBASE,The Cochrane Library,Medline,Science Direct,CNKI,Wanfang Data and VIP database were searched for relevant studies comparing intramedullary nailing and locking plate fixation of two-part proximal humerus fractures.A meta-analysis of the two methods was conducted using the RevMan 5.0.Differences between the two methods were compared with respect to operation time,intraoperative bleeding,bone union time,Constant score and postoperative complication incidence.Results Seven studies were included in the meta-analysis,with 136 patients treated with intramedullary nail and 159 patients treated with locking plate.Intramedullary nailing showed advantages over locking plate fixation with regards to operation time (WMD =-27.71,95％ CI-36.07--19.35,P ＜ 0.05),intraoperative blood loss (WMD =-114.18,95％ CI-169.91--58.45,P ＜ 0.01) and bone union time (WMD =-2.91,95％ CI-5.80--0.01,P ＜ 0.05).While the two methods showed no significant differences in Constant score (WMD =-2.84,95 ％ CI-5.90--0.22,P ＞ 0.05) and postoperative complication incidence (OR =0.89,95％ CI 0.43-1.84,P ＞ 0.05).Conclusion Intramedullary nail is superior to locking plate in operation time,intraoperative blood loss and bone union time for the treatment of two-part proximal humerus fractures,but the two methods are similar in Constant score and postoperative complications rate.

Objective To investigate the effects of motilin on the voltage dependent potassium channel and L-type calcium channel currents in rat proximal colon smooth muscle cells (PCSM) and to explore its mechanism in increasing colonic motility.Methods PCSM were isolated by collagenase.The voltage dependent potassium channel transit outward current (IKA ) and delayed rectifier current (IKdr) and L-type calcium currents (ICa(L)) were measured by whole cell patch clamp technique.Groups were analyzed by paired t-test.Results There was no significant effect of motilin on IKA and IKdr.L-type calcium channel was dose-dependently activated by motilin from 0.5 × 105 mmol/L to 10.0 ×10-5 mmol/L.At 6 × 10-5 mmol/L motilin and under - 10,0 and 10 mV stimulating voltage,maximum current density increased by 154.61％,62.69％ and 21.02％ respectively and activation kinetics curve obviously left shifted.Half activation voltage decreased from (2.740±1.211) mV prior administration to ( - 25.290 ± 0.614) mV (t =8.534,P =0.007 ) and there was no significant difference in slope factor. Conclusions Motilin increases colonic smooth muscle contraction by promoting calcium influx. However the frequency of colonic smooth muscle contraction could not change with frequency of equilibrium potential and action potential of colonic smooth muscle.

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 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.