Objective To analysis the clinical characteristics, treatment and prognosis for patients with cervical cancer with lymph lode of paraaortic and /or supraclavicular metastasis after combined treatment in two years. Methods Data of 20 patients with lymph lode of paraaortic and /or supraclavicular metastasis of cervical cancer were analyzed retrospectively. Results There was no evidence of lymph node of paraaortic and supraclavicular metastasis before the first combined treatments according to the MRI/CT/SPECT scans in these 20 patients. However, lymph lode of paraaortic and/or supraclavicular metastasis were seen in two years after treatments, the shortest is two months. One patient was progressing during treatment whose pathologic diagnosis is mucinous adenocarcinoma, died in 6 months from treatment start. There was only paraaortic metastasis in 15 patients, among these, 4 patients were found lymph lode of left supraclavical metastasis after retreatments in 3-6 months. Both paraaortic and left-supraclavical lymph node metastasis in 4 cases. Among these 20 cases, recurrence and to give up treatment, whose median survival time is 7.50 months, recurrence and to gain treatment, whose median survival time is 18.98 months, there was significant difference (x2=7.23, P<0.01). Conclusion Patients with cervical cancer with lymph lode of paraaortic and/or supraclavicular metastasis after combined treatment will obviously extend survival time after retretments, which has positive therapy significance.

Objective To explore the relation between glucose fluctuation state and diabetic chronic compli-cations in type 2 diabetes mellitus. Methods 169 cases with type 2 diabetes mellitus were divided into two groups: 78 cases with constant high glucose(group Ⅰ) and 91 cases with glucose fluctuation state( group Ⅱ ). The clinical data such as fasting plasma glucose(FBG) ,fasting blood insulin(FINS) ,fasting blood C peptide,2 hours postprandial plasma glucose (2hPG) ,2 hours postprandial blood insuline (2hINS) ,2 hours postprandial blood C peptide, glycosy-lated hemoglobin A1c (HbA1c), and blood pressure (BP), body mass index ( BMI ), urinary albumin excretion rote (UAER) ,triglyeeride(TG) ,total cholesterol(TC) ,high density lipoprotein cholesterol(HDL-C) ,low density lipopro-tein cholesterol(LDL-C) were measured. Results 2hPG in group Ⅱ was much higher than that in group Ⅰ (P<0.01) ,but 2 hours postprandial blood insuline and 2 hours postprandial blood C peptide in group Ⅱ were much lower than those in group Ⅰ (P<0.01). The incidence of diabetic chronic complications was higher in group Ⅱ compared with that in group Ⅰ (P<0.01). Conclusion These findings suggest that glucose fluctuation state with type 2 dia-betes mellitus had increased diabetic chronic complications.

Objective To comprehend the metabolic disorder of the obese patients with type 2 diabetes mellitus(T2DM).Methods According to body mass index( BMI),176 cases of T2DM were divided into 2 groups;obesity(95 cases) and non-obesity(81 cases),the waist circumference(W) ,hip circumference(H) ,fasting plasma glucose(FBG) ,2-hour postprandial plasma glucose(2hBG) ,fasting blood insulin(FINS),2 hours postprandial blood insuline(2hINS), renal function, triglycetide(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C ), glycosylated hemoglobin(HbA1c) and blood pressure(BP) were tested.Results The BMI,the ratio of W/H (WHR), serum uric acid (BUA), FINS, 2bINS, FCP and 2hCP in the obese group were higher than those in non-obese group(P <0.01);systolic blood pressure and diastolic blood pressure in obese patients were higher than those in the non-obese group(P >0.05) ,while the prevalence of abdorminal obesity.Hypertension significantly increased in obese group than those in non-obese group.Conclusion Among the T2DM ,metabolic disorder in obese patients is even more serious.It is very improtant for obese patients with T2DM to be given combined treatment to improve the metabolic disorder,that includes controlling blood glucose, decreasing weight and lightening insulin resistance.

Objective:To explore the therapeutic effect of comprehensive rehabilitation nursing on patients with cere-bral infarction (CI)complicated type 2 diabetes mellitus (T2DM).Methods:According to number table,a total of 118 CI + T2DM patients were randomly and equally divided into comprehensive nursing group and routine nursing group.Comprehensive nursing group received comprehensive nursing based on routine nursing.The evaluating inde-xes included fasting blood glucose (FBG)concentration,limb muscle strength recovery and score of activity of daily living of two groups before hospitalization and discharge.Results:Compared with routine treatment group before discharge,there was significant reduction [(7.9±4.2)mmol/L vs.(5.9±2.8)mmol/L]in FBG concentration in comprehensive nursing group;limb muscle strength recovery of comprehensive nursing group was significantly better than that of routine nursing group (≥ grade III,upper limb 83.1% vs.64.4%,lower limb 76.3% vs.55.9%);percentage of patients with activity of daily living score > 60 scores (33.9%)in comprehensive nursing group was significantly higher than that of routine nursing group (15.2%),P <0.05 all. Conclusion:Comprehensive rehabili-tation nursing could promote the rehabilitation of physical function in patients with cerebral infarction complicated type 2 diabetes mellitus.

Objective:To evaluate the effect of clinical pharmacists in the continued therapy of stroke patients .Methods:Totally 146 cases were selected and randomly divided into the observation group and the control group according to the standard matching meth -od.The observation group was treated with the continued therapy .The control group was given one-month telephone follow-up after the discharge.The differences in the drug compliance (Morisky scale), systolic blood pressure (SBP), diastolic blood pressure (DBP), glycosylated hemoglobin (HbA1C), serum total cholesterol ( TC), low density lipoprotein ( LDL-C), health behaviors ( HPLPⅡscale) and relapse rate were compared between the two groups in the 3rd, 6th and 12th month after the discharge.Results:The differ-ences in the above indices were statistically significant between the two groups ( P <0.05) at the various time points , and those were more significant with time extending (P<0.01).The difference of the relapse rate in the 3rd, 6th and 12th month after the discharge between the two groups were significant .Conclusion: Clinical pharmacists can improve the drug compliance and health behaviors of stroke patients and reduce the relapse rate .It is worthy to be recommended in clinics .

Objective To study the effect of berberine on the lipid metabolism and the expression of ox-LDL,CD36 and PPAR? in the peritoneal macrophage(PM) and alveolar macrophage(AM) from the type 2 diabetic rats. Methods Sprague-Dauley rats were randomly divided into groups of normal control,high-fat diet,type 2 diabetes and berberine treatment.The levels of blood glucose,insulin and lipid were measured biochemically,the content of ox-LDL in macrophage and the protein expression of CD36 and PPAR? in macrophage were assayed by ELISA,the mRNA expression of CD36 and PPAR? in macrophage was disclosed by RT-PCR. Results Compared with the control group, the levels of glucose,insulin and total cholesterol (TC),triglycerides(TG),low density lipoprotein-cholesterol (LDL-C) in blood were increased significantly(P0.05). The content of ox-LDL,the protein and mRNA expressions of CD36 and PPAR? in PM and AM increased in type 2 diabetic group(P

4 mm in diameter, re-operations of ESWL were required until no stones were detected. Results All the patients presented a good tolerability to the treatment and left for home by themselves. With exception of 1 case of failed lithotripsy, the ESWL was successfully accomplished in the rest of 17 cases after receiving 3~9 times of treatment. One or two times of hematuria occurred in 66 times of treatment (66/77, 85.7%). A “stone terrace”, 1.9~5.2 cm in length, was found in 5 cases, 4 of which were cured by re-operation of ESWL and 1 of which underwent ureteroscopic removal of stones. Conclusions Low-energy extracorporeal shock wave lithotripsy is a safe and effective option for patients with renal staghorn calculi.

Aim To investigate the effect of the inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA)reductase enzyme,simvastatin on E-Selectin ex-pression and adhesive function assay induced by CD40L.Methods Human umbilical vein endothelial cell(HUVEC)was cultured from ECV304 cell strain.Then E-Selectin expression and adhesion of lymphocytes to endothelial cells induced by CD40L and interfered with different concentrations of simvastatin or simvastatin(5 ?mol?L-1)+mevalonic acid were determined by RT-PCR and FCM analysis.Results Preincubation of HUVECs with simvastatin(0~10 ?mol?L-1)decreased the expression of E-Selectin induced by CD40L in a concentration-dependent manner.Mevalonic acid(400 ?mol?L-1)inhibited the restrain of simvastatin on E-Selectin expression.Moreover,preincubation with simvastatin,decreased significantly adhesion of lymphocytes to endothelial cells induced by CD40L.Conclusions Simvastatin inhibits activation of endothelial cells induced by the CD40L/CD40 pathway through HMG-CoA dependent effect.

Radiation-induced lung injury (RILI) is a common complication in thoracic cancer patients through radiotherapy, which can be divided into the early-stage radiation-induced pneumonitis (RP) and late-stage radiation-induced lung fibrosis (RILF). At present, glucocorticoids are mainly adopted in the clinical treatment of RP. However, there has been no effective medical treatment for RILF. RILF patients will eventually die from respiratory failure. The exact mechanism of RILI remains unclear. Current studies have proposed that its possible pathogenesis might consist of genetic heterogeneity, oxidative stress and cell damage. In this review, studies related to the pathogenesis of RILI were summarized.

Objective To culture human embryonic germ cells in vitro and identify them by observing the expression of the surface markers SSEA-1 and Oct-4. Methods The gonadal ridges and mesenteries of human embryos at 5～9 weeks post-fertilization were isolated and then cultured in vitro.Flow cytometry and immunocytochemistry were applied to detect whether the cells cultured express SSEA-1 and Oct-4.Immunohistochemistry was also carried out to observe the expression of SSEA-1 on the PGCs which locate in the gonadal ridge. Results Both the cells and the cellular colonies cultured in vitro expressed SSEA-1 and Oct-4.The immunohistology study of gonadal ridges also showed that there were many PGCs which were SSEA-1 positive in it.Conclusion The cells we obtained through tissue culturing are undifferentiated human embryonic germ cells,which originate from hPGCs.