Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

Objective To investigate the serum level of C-reactive protein (CRP) in patients with cerebral infarction and its effect on the prognosis of brain infarction.Methods 113 patients (86 with thrombosis and 27 with lacunar infarction) and 48 healthy persons as control were enrolled in this study. The serum level and abnormal rate of CRP were determined. All the patients were scored by clinic neurological function deficit scale (NDS).Results The serum level of CRP in the patients with thrombosis was higher than that in the patients with lacunar infarction. It was also higher in the patients with lacunar infarction than in normal controls (all P

Objective To evaluate preliminary effect of In-Space percataneous interspinous spacer in the treatment of lumbar instability.Methods Data of 18 patients who had undergone interspinous spacer implant for lumbar instability from May 2009 to June 2011 were retrospectively analyzed.There were 10 males and 8 female,aged from 39 to 58 years.All patients suffered from varying degrees of lower back pain induced by lumbar hyperextension,as well as radiating and segmental pain of unilateral lower limb.The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate clinical outcomes.The pre-and postoperative interspinous distance,trailing edge height of intervertebral space,foraminal width,foraminal height,segmental lordotic angle and lumbar range of motion were tested and compared.Results All patients were followed up for 18 to 36 months.The VAS score improved from preoperative 7.9±2.1 to 3.1±1.3 at 6 months postoperatively and 1.5±0.8 at final follow-up.The ODI improved from preoperative 82.1％±13.1％ to 54.7％±14.8％ at 6 months postoperatively and 10.1％±2.5％ at final follow-up.The postoperative interspinous distance,trailing edge height of intervertebral space,foraminal height,foraminal width,segmental lordotic angle and lumbar range of motion were 9.29±1.43 mm,11.28±0.85 mm,21.27±1.01 mm,10.83±0.73 mm,7.62°±0.74° and 6.34°±0.81°,respectively.Wound healed smoothly in all patients,and there were no complications such as spinous process fracture,spinal cord injury,cerebrospinal fluid leakage,device displacement and device dislocation.Conclusion It is easy and safe to use In-Space percataneousinterspinous spacer in the treatment of lumbar instability,and the preliminary effect is satisfactory.

Objective To investigate the difference of short-term clinical efficacy between decompressive laminectomy into In-Space and simple decompressive laminectomy for treatment of lumbar spinal stenosis with vertebral instability.Methods Thirty-three patients with lumbar spinal stenosis with vertebral instability admired from May 2009 to July 2010,were divided into two groups by random number table.Group A of 16 cases was treated with laminectomy decompression and placement In-Space,group B of 17 cases was treated with laminectomy decompression.Lumbar anteroposterior,lateral and flexion-extension X-ray films,preoperatively,and the follow-up were used to measure anterior and posterior disc height,foraminal height,segmental lordotic angle at surgical level.Using Oswestry disability index (ODI) and the visual analogue scale (VAS) to evaluate the clinical efficacy.Results All patients were followed up for (13.20 ± 2.91 ) months (range 6 to 21 months).The anterior disc height after operation of group A was slightly decreased compared with the preoperative(P＞ 0.05 ),the posterior disc height at 1 day after operation and foraminal height after operation of group A were significantly increased compared with the preoperative (P＜ 0.05).The anterior and posterior disc height,foraminal height of group B at 1 day,1 month,3 months after operation were no significantly different compared with the preoperative (P ＞ 0.05 ),at 6 months after operation and the end of follow-up were significantly decreased compared with the preoperative or 1 day after operation (P ＜ 0.05 ).Activity of lumbar vertebra by preoperative 9.86° ± 1.90° decreased to the end of followup 5.60° ± 2.02°in group A,while activity of lumbar vertebra by preoperative 9.89° ± 2.00°increased to the end of follow-up 10.76° ± 3.14° in group B.At the end of follow-up,lumbar back pain VAS,ODI score [ (2.02 ± 1.98 ),( 20.18 ± 18.80) scores ] of group A were significantly lower than those of group B [ (4.15 ±2.36),(30.39 ± 16.62 ) scores ],the differences were statistically significant (P ＜ 0.05 ).No patient suffered In-Space loosening,fracture and emerge.Conclusion The operation of In-Space can maintain spinal mobility and stability as well as avoiding lumbar vertebral instability,and its short-term efficacy is satisfactory.

BACKGROUND: The incompatible reaction may occur after islet transplantation, which affects the survival and functions of cells. OBJECTIVE: To explore the islet cells injury and its causes during islet transplantation. METHODS: The pancreases of voluntary, brain death, donors were isolated by collagenase, and the islet cells injury was measured with different cold ischemia times. The islet cells were cultured with blood as follow: HLA matching group: recipient whole blood + islet cells, recipient whole blood + islet cells + heparin; HLA mismatching group: recipient whole blood + islet cells, recipient whole blood + islet cells + heparin; Control group: recipient whole blood + RPMI1640. The potential injury to islet cells was observed. RESULTS AND CONCLUSION: The pancreases were smoothly obtained. The activity of islets may be more than 80% within 5 hours of ischemia preservation time, which was less than 19% if the cold ischemia preservation time was over 8 hours. When human islets were exposed to human blood, it will induce a rapid consumption of blood cells, no matter HLA matching or HLA mismatching. After adding heparin into the blood, these events were avoided. At 24 hours of in vitro culture, the number of survival islet cells in the HLA matching group was greater than that of the HLA mismatching group (P < 0.05). The results described that cold ischemia time affects islet cells activity, reduce the cold ischemia preservation time within 5 hours and HLA typing are conductive to enhance the quantity of living islets.

Objective To evaluate the precision of BREEZE~(TM) glucose monitor and correlation of glucose measurements between fingertip capillary whole blood glucose(CBG)using BREEZE~(TM) glucose monitor and venous plasma glucose(VPG)using autoanalyzer.Methods All samples of venous plasma and fingertip blood from 188 diabetes or non-diabetes patients were detected for glucose level at fasting,30,60 and 120 min postprandial.BREEZE~(TM) glucose monitor and autoanalyzer measured CBG and VPG respectively.Intra-and inter- coefficients of variations were determined using 10 BREEZE~(TM) glucose monitors with normal,slight high and high glucose levels for the three lots of strips.Results The correlation coefficients between CBG and VPG were all higher than 0.950 at fasting and different postprandial time.98.94% of all measurements were in the A zone when using error-grid analysis.The relevant differences between CBG and VPG were less than 5% at different blood glucose concentrations.The intra-and inter-coefficients of variations of blood glucose values at different blood glucose concentrations using different lots of strips were within 5%.Conclusion BREEZE~(TM) glucose monitor provides high accurate and precise glucose readings on fasting and different postprandial time points over a variety of blood glucose concentrations.

Objective To study whether myeloperoxidase (MPO) can provide prognostic information in patients with acute coronary syndromes (ACS). Methods The study population consisted of 274 consecutive patients with ACS. All patients underwent coronary angiography which showed significant coronary artery disease and blood samples were collected at admission. Follow-ups were scheduled at 1, 3, and 6 months.The end point included cardiac death, acute myocardial infarction (MI), percutaneous or surgical revascularization. Results Patients with elevated MPO serum levels (MPO ≥ 72.2 AUU/L) were more likely to have diabetics and had a history of coronary events. Kaplan-Meier event rate curves with accumulative incidence of end point at 6-month follow-up in the MPO ≥ 72.2 AUU/L group was significantly higher than in MPO＜72.2 AUU/L group. Conclusions MPO may be a powerful predictor of adverse outcome in patients with ACS.

OBJECTIVETo investigate the impact of surgical resection extent and other clinicopathological characteristics on the prognosis in patients with clinical stage I endometrial carcinoma.

METHODSThe data of 135 surgically treated patients with clinical stage I endometrial carcinoma were retrospectively analyzed. Fifty-seven patients (group A) underwent simple hysterectomy and salpingo-oophorectomy with or without pelvic lymphadenectomy. The other 78 patients (group B) received sub-radical or radical hysterectomy and salpingo-oophorectomy with or without pelvic lymphadenectomy. The impact of surgery extent and other clinicopathological characteristics on the prognosis in patients with clinical stage I endometrial carcinoma were retrospectively analyzed.

RESULTSThere were no significant differences between two groups in the pathological stage, pathologic type, tumor grade, depth of myometrial invasion, vascular tumor emboli, ovary invasion, lymph node metastasis, positive peritoneal cytology and adjuvant therapy (P > 0.05). However, the patients in group A had a significantly shorter operating time (105 vs. 145 min), less estimated blood loss (150 vs. 300 ml) and blood transfusion (0 approximately 600 vs. 0 approximately 1200 ml), and a shorter postoperative hospital stay (12 vs. 13 days) than that in group B (all P < 0.05). The overall rates of post-operative complications were 15.8% in group A versus 26.9% in group B (P > 0.05). The recurrence rate in the group A was 14.0% versus 6.4% in group B (P > 0.05). Furthermore, the five-year survival rate in group A was 76.9% versus 85.8% in group B (P > 0.05). Multivariate analysis demonstrated that the important risk factors for clinical stage I endometrial carcinoma were deep myometrium invasion, high pathological grade, positive peritoneal cytology and ovarian metastasis, rather than surgical resection extent.

CONCLUSIONSurgery extent is not an important factor affecting the prognosis in patients with clinical stage I endometrial carcinoma, and extended surgery does not improve their survival. Therefore, excessive resection should be avoided in such cases.

Adenocarcinoma, Clear Cell ; pathology ; surgery ; therapy ; Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Carcinoma, Adenosquamous ; pathology ; surgery ; therapy ; Carcinoma, Endometrioid ; pathology ; surgery ; therapy ; Chemotherapy, Adjuvant ; Endometrial Neoplasms ; pathology ; surgery ; therapy ; Female ; Humans ; Hysterectomy ; methods ; Length of Stay ; Lymph Node Excision ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate

Antiviral Agents ; therapeutic use ; Cytokines ; metabolism ; Dendritic Cells ; immunology ; metabolism ; pathology ; Endotoxemia ; complications ; pathology ; Hepatitis B ; complications ; pathology ; Humans ; Hypoxia ; complications ; pathology ; Ischemia ; complications ; pathology ; Liver ; metabolism ; pathology ; Liver Failure ; etiology ; immunology ; pathology ; therapy ; T-Lymphocytes ; immunology ; pathology

Objective To investigate the safety and efficacy of radiofrequency ablation (RFA) combined with extracting blood from hemangiomas guided with CEUS for treating hepatic cavernous hemangiomas (HCH).Methods Data of 55 patients with 77 lesions of HCH underwent CEUS guided RFA combined with extracting blood from hemangiomas during January 2010 to December 2016 were retrospectively analyzed.Conventional ultrasound and CEUS were performed before therapy,in order to obtain the size and blood supply information of lesions,also performed immediately after treatment and 3 months later to calculate the volume of hemangiomas and the rate of hemangiomas after the treatment,as well as the rate of non-blood supply 3 months after the treatment.Then statistical analysis was done.Results The mean operation time was (31.53±15.89)min,and the blood extracting from hemangiomas was (135.36± 68.13)ml.There was positive correlation between the volume of hemangiomas before treatment and the blood extracting from hemangiomas (r=0.722,P＜0.05).No serious complication occurred among 55 cases,while mild complications happened in 9 cases (9/55,16.36 ％).The volume of hemangiomas decreased immediately and 3 months after treatment (both P＜0.05),and the rate of hemangiomas reducing was (48.76±32.58) ％ and (22.37±35.73) ％,respectively.The rate of non-blood supply 3 months after treatment was 96.10％ (74/77).Conclusion CEUS-guided RFA combined with extracting blood from hemangiomas is an effective and safe method,which has potential to become a first-line therapy.