Objective　To explore the method of chemical synth esis of L-alanyl-L-glutamine dipeptide. Methods　 L-alanyl-L -glutamine dipeptide was prepared by condensation and ammoniation reaction of L -glutamine and 2-D-chloropropionyl chloride. The physico-chemical properties of this dipeptide were identified with melting point determination, amino acid analysis, elements analysis and MS and its purity was determined with HPLC. Results　This dipeptide was confirmed good in quality by physico-chem ical determination. Conclusion　Dipeptide synthetized by this me thod is simple, convenient and with good guality.

Objective To evaluate the effects of nutritional education by "knowledge,attitude and behavior" on health improvement in patients with type 2 diabetes.Methods One hundred and sixteen patients with type 2 diabetes were selected with nutritional education intervention by "knowledge,attitude and behavior",and another 100 diabetic patients as control group with regular education for six months,to follow up their changes in awareness of diabetes-related nutritional knowledge and biochemical examinations. Results Ninety-eight patients in intervention group completed follow-up.Awareness of diabetes-related nutritional knowledge,intake of nutrients and indices of metabolism in intervention group were significantly different from those in control group,including serum level of glycosylated hemoglobin A1c(HbA1c)[(6.1 ?0.9)% vs.(7.7?2.3)%,t=6.421,P

Objective To discuss the clinical manifestations, diagnosis and treatment of solidpseudopapillary tumor of the pancreas (SPTP) in children. Methods Clinical data of 12 cases of SPTP admitted to Beijing Children's Hospital from Mar 2001 to Mar 2007 were collected and analyzed retrospectively. Result There were 7 females and 5 males among the patients. The mean age was 13.6 years. The main symptoms were abdominal pain and mass. Tumors located in the head in 4 cases, in the body and tail of the pancreas in 8 cases. Five cases underwent tumor enucleations, one case underwent body resection of the pancreas, two cases underwent Whippple's procedure including one recurrent case, five cases underwent body and tail resection of the pancreas plus splenectomy. All these 12 cases were followed up for 6 months to 6 years. One case lost follow-up 6 months after body and tail resection of the pancreas plus spleneetomy. Another one suffered from live tumor one year after operation and refused surgical exploration and lost follow-up. The other 10 cases were still alive. Conclusion SPTP are predominantly seen in adolescent females. For its benign clinical behavior and relatively good prognosis, surgical resection is the main choice of therapy.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Receptor, EphB4 ; genetics

[Summary] Diabetic nephropathy is one of the major chronic microvascular complications of diabetes ,which is the leading cause of end‐stage renal disease ,as well as the main cause of death in diabetic patients. Glomerular endothelial cell is an important component of the glomerular filtration barrier ,which is directly related to the materials of circulation ,and it can be easily damaged by glucose ,lipid and inflammatory factors. Under the hyperglycemia ,the PKC pathway ,the polyol pathway and oxidative stress were activated ,producing an excess of advanced glycation end products and reactive oxygen species ,which damage the endothelial nitric oxide synthase ,reduce the generation of nitric oxide ,while produce a large number of Ang Ⅱ. Ang Ⅱ damage the endothelial cell. In addition ,there are crosstalk between glomerular endothelial cells and endothelial cells ,which also cause endothelial cell injury. Here ,we reviewed the role of endothelial cell injury in the pathogenesis of diabetic nephropathy.

Objective:To clone the RC-RNase gene and prepare its recombinant prokaryotic construct, and then to express RC-RNase protein using Escherichia coli system. Methods: RC-RNase cDNA was obtained by RT-PCR from liver of Rana catesbeiana, and cloned into pUCm-T plasmid for nucleotide sequencing. Its expression construct was prepared using the 6?His vector pRSET-A, and induced to express by IPTG in Escherichia coli BL21(DE3). Western blotting identified the expression product. Results: A 380 bp long cDNA was obtained from liver of Rana catesbeiana, restriction sites and sequence being consistent to those reported for RC-RNase. After introducing the gene into Escherichia coli and through the induction by IPTG, it was observed a new peptide at the expected position (Mr 16000) on SDS-PAGE gel. This product was proved to be the target protein via Western blotting. It existed in a form of inclusion body and its efficiency reached 12.5% of total bacterial proteins. Conclusion: RC-RNase gene was cloned and expressed in Escherichia coli. The protein could be used for characterizing the biological activities and function of RC-RNase.

Objective:To investigate surgical methods and clinical effects of tibial pseudarthrosis due to neurofibromatosis type I (NF1) in adult using Ilizarov technique combined with intramedullary nail.Methods:A total of 12 adult with tibial pseudarthrosis due to NF1 treated by Ilizarov technique combined with intramedullary nail from October 2009 to December 2017 were retrospectively included. There were 6 males and 6 females with an average age of 27±8.3 years (range 17-44). All cases presented severe anterior arch in varus or valgus deformity with shortening in an average of 10.8±3.7 cm (range 5.6-16.5 cm). The in-volved levels were at the middle and lower part of tibia. All cases suffered from more than one treatment with failed surgery. One male patient with 5 times of unsuccessful operations. There were 4 cases with severe limping gait and 8 cases with walking with the help of brace (or single crutch) preoperatively. Regarding the family history, seven cases were inherited by father and 5 cases by mother. During surgery, the part of tibial pseudarthrosis and thickened fibrous tissue surroundings like periosteal were removed. The contracture achilles tendon was elongated in open way, and intramedullary nailing cross the ankle joint was applied when the tibial medullary cavity opened. Further, iliac bone grafting and proximal tibial osteotomy were performed with Ilizarov fixator application finally. The tibia was lengthened at a rate of 0.5-1 mm/d at 7 days postoperatively. The healing rate of pseudarthrosis and the length and alignment of limb were evaluated by X-ray routinely. The lower limb function and complications were assessed by self-made table for lower limb deformity correction and functional reconstruction.Results:All patients were followed up for 31-80 months with an average of 47.6±14.7 months. Bone union of pseudarthrosis in all cases was eventually achieved. The tibia was lengthened 5-12 cm with an average of 8.4±2.5 cm. There were 9 cases underwent second surgeries to promote bone healing and to correct residual deformities. The external fixator was used for 25-37 months with an average of 31.5±3.7 months. There was no complication, including neurovascular injury, severe soft tissue or bone infection affecting the clinical effects. All intramedullary nails were not removed finally. The limb function and gait in full weight bearing in 12 patients recovered at the latest follow-up. The evaluation score was 2.4±0.3 (range 2.1-2.8), of which 9 cases were excellent 3 were good. Thus, the excellent and good rate was 100%.Conclusion:The satisfactory clinical effects, including angular deformity correction, pseudarthrosis healing and short limb lengthening, can be achieved in adult with tibial pseudarthrosis due to NF1 by using the combination method of Ilizarov technique and intramedullary nail. However, the treatment duration could be longer.

ObjectiveTo estimate the cognitive function of subarachnoid hemorrhage patients with negative digital subtraction angiography(DSA),and analyse its relevant factors and clinical characteristics.Methods 96 subarachnoid hemorrhage patients were selected,and the disease condition were classfied into different grades by Fisher scale,Hunt-Hess scale and the cognitive function were estimated by mini-mental state examination (MMSE),then calculated its incidence,analysed the relationship between the classification and cognitive impairments.ResultsThe incidences of cognitive impairment in subarachnoid hemorrhage patients with negative DSA were 51.04％.Cognitive impairment was closely related to Hunt-Hess and Fisher grade (P＜ 0.01 ).ConclusionSubarachnoid hemorrhage patients with negative DSA exist different extent of cognitive impairment.The higher Hunt-Hess or Fisher grade,the more serious cognitive impairment.

Objective To evaluate the effectiveness of intravenous immunoglobulin (IVIG) in critical hand-foot-mouth disease (HFMD).Methods The data from PubMed, MEDLINE, EMBASE, EBSChost, Cochrane Library, Cochrane Central Register of Controlled Trials, Ovid, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, Chinese Citation Database, and other references and grey literatures were retrieved, screening out all those related to clinical trials on treating critical HFMD by IVIG.Standard methods of the Cochrane Collaboration were employed to evaluate the methodological quality of the trials.Meta analysis was performed with Rev man 5.3 software.Results Eleven trials including 967 cases were investigated.The meta analysis showed that IVIG had significantly clinical efficacy (OR =6.84,95％ CI:3.74-12.52 ,P ＜ 0.05).IVIG could significantly decrease duration of fever (MD =-1.94,95％ CI:-3.07--0.81 ,P ＜0.05) ,hospitalization time (MD =-4.56,95％ CI:-8.95--0.17,P ＜0.05).There was no significant difference in duration of fever (MD =-0.28,95 ％ CI:-0.59-0.03, P ＞ 0.05), duration of herpes (MD =0.18,95％ CI:-0.22-0.59, P ＞ 0.05), hospitalization time (MD =-0.12,95％ CI:-0.47-0.23, P ＞ 0.05) when the dosage of injection was adjusted.Conclusions IVIG is recommended for treating critical HFMD because it is effective in decreasing the duration of fever and hospitalization.Well designed studies with more sample in multi-center are required in further study to explore the efficacy and safety of IVIG on critical HFMD.