Objective To develop a model of type 2 diabetes with early renal injury on spontaneously hypertensive rats (SHR). Methods The 6-week old SHR were fed with the diets enriched with sucrose (20%, W/W), lard (10%, W/W), cholesterol (2.5%, W/W) and chleolate (1%, W/W) to induce insulin resistance. Hyperglycemia was developed by intraperitoneal injection of streptozotocin (STZ, 35 mg/kg). Wistar-Kyoto rats (WKY) were used as normal controls. Rats with plasma glucose (PGL) ≥ 16.7 mmol/L were diagnosed as diabetes. Eight weeks after the induction of diabetes, plasma triglyceride (TG), cholesterol (CHO), glucose, systolic pressure(SP), 24-h urine protein excretion (Upro) were examined in all the rats, and the homeostasis model assessment of insulin resistance (HOMA-IR) was analyzed. Renal pathological changes were studied by immunohistochemical staining and electron microscope. Results After 2 weeks on the high sucrose and fat diets, the model rats exhibited significant increase in basal PGL, TG and CHO levels as compared to control rats (P<0.05, respectively). The insulin resistance was developed in model rats demonstrated by the higher HOMA-IR (5.03±0.38 vs 2.61±0.34, P<0.05). At the end of the experiment, model rats were associated with hypertension. Upro level was significantly increased in model rats compared with that in controls [(57.58±16.54) mg/24 h vs (5.35±1.90) mg/24 h, P<0.01]. The kidney hypertrophy index (KWI) was significantly increased in the model rats compared to controls (P <0.05). Moreover, the diabetic model rats showed glomerular hypertrophy, foot process effacement, micro villous transformation, glomerular basement membrane (GBM) thickening. Conclusion A rat model is successfully established, which presents typical features of human type 2 diabetes and can be served as an ideal model to study the diabetic nephropathy.

Objective To investigate the clinical characteristics and the optimal time of delivery in pregnant women with severe preeclampsia complicated with ascites. Methods A retrospective study was conducted on 179 severe preeclampsia mothers and their 195 neonates,presented in the First Affiliated Hospital of Wenzhou Medical College from Jan.2003 to Dec.2005,who were divided into two groups:32 complicated with ascites(ascites group)and 147 without(non-ascites group). The general conditions,mode of delivery and complications including eclampsia,hemolysis,elevated serum level of 1iver enzymes,and low platelets(HELLP syndrome),liver failure,renal failure,heart failure,hypoproteinemia,placental abruption,postpartum hemorrhage and puerperal infection,were also analyzed.Clinical data of all infants(38 from ascites group and 157 from non-ascites group)were analyzed.The incidence and mortality rate of small for gestational age(SGA)in both group within the same gestational age group and those between different gestational age groups in the ascites group were compared. Results (1)The average gestations at admission and delivery in the ascites group were earlier than the other[admission:(32.5±2.1)weeks vs(36.1±3.5)weeks;delivery:(34.1±2.3)weeks vs(37.2±1.5)weeks,P＜0.053.The rate of systemic antenatal care in the ascites group waslowcr than that of the non-ascites group(25.0%vs 53.7%,P＜0.05).More complications werefound in the ascites group than in the non-ascites group(hypoproteinemia:100.0%vs 47.0%;liver and renal failure:31.2%vs 8.2%;HELLP syndrome:9.4%vs 2.0%;postpartum hemorrhage:18.8%vs 2.0%;all P＜0.05).(2)The incidence of SGA in the ascites group was all higher than that in the non-ascites group,however,significant differences was only found between the tWO groups at＞36 weeks(7/9 vs 30.2%,P＜20.05).The perinatal mortalily rates of SGA in the ascites group at＜32 weeks and 32～34 weeks were significantly higher than that in the non-aseites group respectively(＜32 weeks:69.2%vs 19.2%,P＜0.05;32～34 weeks:2/7 vs 0,P＜0.05).(3)The highest perinatal mortality rate and the highest incidence of SGA in the ascites group were found in the groups of＜232 weeks and＞36 weeks,respectively. Conclusions The early onset of ascites and higher rate of complications in severe preeelamptie women implies the adverse maternaI and fetal outcomes.Ascites in severe preeclampsia cases should alert the clinicians.The optimal time for delivery might be at 32～36 weeks of gestations.

Objective To study 6 type Ⅰ interferon (IFN)-inducible genes (IFIT4, IFI44, Ly6e,OAS1, OAS2 and OAS3) in patients with lupus nephritis (LN) and analyze its correlated expression levels with disease activity and/or clinical manifestations. Methods Total RNA was obtained simultaneously from kidney tissues and peripheral blood cells of 12 patients with diffuse proliferative lupus nephritis and 10 normal controls. Moreover, peripheral blood cells were obtained from 119 LN patients and 35 normal controls. Total RNA was extracted and reversely transcribed into complementary DNA. Gene expression levels were measured by real-time polymerase chain reaction by comparing to a housekeeping gene, and IFN score was calculated. Disease activity was determined by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Results The 6 genes were highly expressed in diffuse proliferative lupus nephritis patients compared with normal controls. IFN scores were positively correlated with SLEDAI score, the concurrent presences of anti-double-stranded DNA (anti-dsDNA) antibodies (P<0.05) and hypocomplementemia (P<0.01). Conclusion The 6 IFN-inducible genes are highly expressed iri LN patients. IFN scores are elevated in active lupus nephritis patients, in patients with positive anti-ds-DNA antibody and hypocomplementemia. IFN scores may be a useful biomarker for lupus nephritis therapy.

Adolescent ; Diagnosis, Differential ; Humans ; Male ; Sturge-Weber Syndrome ; pathology

Objegtlve To study the effect of lipexins on the proliferation and secretion of peritoneal macrophages from patients with preeclampsia in vitro.Methods Peritoneal macrophages were obtained from 24 patients with preeclampsia(preeclampsia group)and 24 normal pregnant women(normal pregnant group)who were treated in the First Affiliated Hospital of Wenzhou Medical Coilege from March to July 2007.Enzyme linked immunosorbent assay (ELISA) was used to detect the concentration of tumor necrosis factor-α(TNF-α)in the supernatant of macrophages which were pulsed with lipoxins at different concentrations(0,10,100 nmol/L)in both groups after 48 hours.Methyl thiazolyl tetrazolium (MTT)assay was used to detect the inhibition rate of cell proliferation of macrophages which were pulsed with lipoxins at different concentrations(0,10,100 nmol/L)in both groups after 24 hours.Results (1)The concentration of TNF-α:the levels of TNF-α were(1867.5±47.3),(1836.9±4.5) and (1800.5±2.7)ng/L after treatment with differed concentrations of lipoxins(0,10,100 nmol/L)in preeclampsia group vs normal pregnant group[(791.3±62.2),(789.4±2.3),(781.5±1.9)ng/L].The levels of TNF-α in preeclampsia group were significantly higher than that in normal pregnant group(P＜0.05).Lipoxins significantly inhibited the concentration of TNF-α in a dose-dependent manner in preeclampsia group (P＜0.05),while it had no significant effect in normal pregnant group(P＞0.05).(2)Cell proliferation inhibition:Incubation with lipoxins produced a dose-dependent(0,10,100 nmol/L)inhibitory effect on proliferation in preeclampsia group,[(14.8±6.3)%,(32.9±3.6)%,(36.7±3.8)%],vs normal pregnant group[(16.8±6.9)%,(16.7±5.4)%,(15.9±2.1)%].The rate of cell proliferation in preeclampsia group was significantly hisher than that in normal pregnant group.Lipoxins significandy inhibited this growth(P＜0.05),while it had no significant effect in normal pregnant group(P＞0.05).Conclusion Lipoxins can inhibit the proliferation of macrophage and secretion of TNF-α in preeclampsia in a dose-dependent manner.Lipoxins may be potentially useful in prevention and treatment of preeclampsia.

This paper presents a novel x-ray dose testing water tank used for the stereotactic radiation therapy system, including its constitution, structure and the method of using it. The water tank has a simple structure of inner and outer sleeves which are connected through a drowned pump and a water pipe in order to control the water level of the tank. The water tank featuring autoregulation and easy use is worthy of clinical application and popularization.
Equipment Design ; Radiosurgery ; instrumentation ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; instrumentation ; methods

Objective To investigate the value of adenosine triphosphate(ATP)bioluminescence assay for assessing object surface contamination degree in intensive care unit(ICU).Methods 30 groups of high frequency contact object(including ventilator panel,bedside table and computer keyboard)in ICU from January to December 2016 were enrolled for the study. Each object was sampled and evaluated before and after disinfection,and their surface was divided into two areas,whose sur-face contamination degree was evaluated by ATP bioluminescence assay and bacterial culture method that were classified as ATP group and control group.The fluorescence detection value and colony number were compared between two groups be-fore and after disinfection.The correlation between the fluorescence detection value and colony number was analyzed by Pearson correlation in the same sample,and the Kappa consistency test was used for the qualification rates of two detections. Results ①The fluorescence detection value and colony number of ventilator panel,bedside table and computer keyboard af-ter disinfection in two groups were significantly lower than that before disinfection(t=8.107~26.393,all P<0.05).②Pearson analysis result showed that both before and after disinfection,the fluorescence detection value had no significant cor-relation with colony number of ventilator panel,bedside table and computer keyboard(r=0.199~0.338,all P>0.05).③There were no significant differences in the qualification rate between two groups of ventilator panel,bedside table and com-puter keyboard before and after disinfection(χ2=0.000~1.404,all P>0.05).The qualification rate before the disinfection of ATP group and control group were 0 and 8.9%,and that after disinfection were 86.7% and 91.1%,whose Kappa consis-tency test result showed that the Kappa value was 0.776(95%CI:0.575~0.978)>0.75,so the consistency was quite sat-isfied.Conclusion ATP bioluminescence assay could be used as a rapid and handy preliminary screening to assist bacterial culture method to evaluate the object surface contamination in ICU,and the result was satisfactory and it would be worthy of clinical application.

Objective:To evaluate the safety and effectiveness of tranexamic acid in the treatment of spontaneous intracerebral hemorrhage.Methods:Patients with spontaneous intracerebral hemorrhage admitted to the Departments of Emergency and Neurology, Nanjing Drum Tower Hospital from December 2015 to December 2018 were enrolled prospectively. The patients were randomly divided into two groups according to a random number table: tranexamic acid group and control group. All patients received conventional treatment. On this basis, 1 g of tranexamic acid injection was given to the tranexamic acid group, dissolved in 100 ml of normal saline, intravenous injection for 10 min; then 1 g of tranexamic acid was given, dissolved in 250 ml of normal saline, intravenous drip for 8 h. The control group was given an equal volume of normal saline. The main outcome measures were good outcome (defined as modified Rankin Scale score0-2) and mortality at 90 d after treatment. The secondary outcome was hematoma enlargement at 24 h after treatment and the National Institutes of Health Stroke Scale (NIHSS) score at 7 and 30 days after treatment. Platelet count and fibrinogen level were measured before treatment and 4 h after the infusion of tranexamic acid. Various adverse events were monitored.Results:A total of 150 patients were included, including 83 males (55.3%). There were 73 patients in the tranexamic acid group and 77 in the control group. There was no statistically significant difference in baseline data between the two groups. The rate of good outcome in the tranexamic acid group at 90 d was significantly higher than that in the control group (57.5% vs. 40.3%; χ2=4.476, P=0.034), while there were no significant differences in mortality rate (0% vs. 1.3%; Fisher's exact test P=1.000) and the proportion of patients with hematoma enlargement at 24 h (6.8% vs. 15.6%; χ2=2.845, P=0.092). The NIHSS score at 7 d (9.26±3.35 vs. 11.68±4.25; t=3.859, P<0.001) and at 30 d (5.45±2.52 vs. 7.38±3.28; t=4.030, P<0.001) in the tranexamic acid group were significantly lower than those of the control group. Fibrinogen in the tranexamic acid group increased significantly after treatment compared with baseline (4.20±0.56 g/L vs. 3.33±0.60 g/L; t=8.997, P<0.001), and was significantly higher than that in the control group after treatment (4.20±0.56 g/L vs. 3.30±0.55 g/L; t=9.906, P<0.001). No adverse events such as venous thromboembolism, ischemic events, and seizures were observed. Conclusion:Tranexamic acid can promote the recovery of neurological function, and improve the outcome of patients with acute spontaneous intracerebral hemorrhage, and the safety is good.

Objective To analyze the clinical characteristics and gene mutations of 56 patients with congenital hyperinsulinism(CHI)and to provide a theoretical basis for clinical diagnosis and treatment of CHI.Methods Fifty-six children who were diagnosed as CHI between February 2002 and January 2016 in Beijing Children's Hospital Affiliated to Capital Medical University were selected as research subjects.A retrospective study was done about the clinical data and the treatment procedures of the 56 patients,such as perinatal conditions,clinical manifestations,laboratory data,treatments,prognosis and so on.Polymerase chain reaction(PCR)-DNA technology or next-generation sequencing technology was used to analyze the CHI relevant genes of the 56 patients.Results Thirty of the 56 patients carried CHI gene mutation.(1)Twenty-three of 56 patients(41.0％)carried ABCC8/KCNJ11 gene mutations:4 of 23 patients carried complex heterozygous mutation,1 of 23 patients carried both ABCC8 and KCNJ11 gene mutation,1 of 23 patients carried maternally inherited ABCC8 gene mutation,12 of 23 patients carried paternally inherited ABCC8 gene mutation,1 of 23 patients carried paternally inherited KCNJ11 gene mutation,3 of 23 patients carried de novo ABCC8 gene mutation,1 of 23 patients had unknown genetic way,19 of 23 patients were treated with Diazoxide,2 of 19 patients were responsive to Diazoxide,7 of 19 patients were unresponsive to Diazoxide and 10 of 19 patients were uncertain to Diazoxide.(2)Five of 56 patients(8.9％)carried GLUD1 gene mutation,4 of 5 patients were treated with Diazoxide and they were all responsive to Diazoxide.(3)One of 56 patients(1.7％)carried de novo GCK gene mutation,responsive to Diazoxide treatment.(4)One of 56 patients(1.7％)carried maternally inherited SLC16A1 gene mutation,responsive to Diazo-xide treatment.Conclusions The ABCC8 gene and GLUD1 gene mutation are the main causative genes of CHI.The GCK gene and SLC16A1 gene mutation are in the minority.Most ABCC8 gene and KCNJ11 gene mutation are unresponsive to Diazoxide treatment.

OBJECTIVETo compare data from an epidemiological survey on injuries with a survey conducted in hospitals on injuries in the same areas and to find out the differences and shortcomings of hospital data in describing the feature of injuries in an area.

METHODSComparing the causes and age distributions of injuries from the two surveys.

RESULTSThe first 4 leading causes of injuries from the population-based survey were mechanical injuries, falls, burns/scalds and traffic accidents while the first 4 leading causes of hospital-based survey were traffic accidents, assault, mechanical injuries and burns/scalds. The differences of the age distributions of these leading causes between the two surveys were significant except mechanical injuries.

CONCLUSIONDifferences were noticed between population-based survey and hospital-based survey. It should be cautions when using hospital data to describe the features of injuries in a certain area.

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Burns ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hospitalization ; Humans ; Incidence ; Male ; Middle Aged ; Rural Health ; Wounds and Injuries ; epidemiology