Objective To investigate the value and limitations of ultrasound determination-evaluated brachial artery endothelial function in elderly diabetic patients. Methods High-resolution two-dimensional ultrasound was used to determine brachial artery(BA) flow-mediated vasodilation(FMD) during reactive hyperemia. Endothelial function was evaluated by FMD in 67 elderly patients with type 2 diabetes. Results In diabetes versus normal control group,the BA diameter and flow velocity showed no significant difference (P＞0.05) at basal state,but showed significant decreases (P＜0.05) after reactive hyperemia. Single-factor correlation analysis showed that FMD was in negative correlation with disease course, TG, ISI and age (r=-0.2357,-0.2215 and -0.3256, -0.2415,(all P＜0.05～0.01),and showed no correlation of FMD with BMI, TC, FBG, HbA1c, FIns. Conclusions FMD has a value in evaluating the flow-mediated endothelial dysfunction in older T2DM patients, while our analysis of the results should consider the patient's age, gender, race, disease course, blood lipids and other factors.

ObjectiveTo detect the mRNA expression levels of RORγt and Foxp3 genes in peripheral blood mononuclear cells(PBMCs) of children with atopic dermatitis(AD),and to explore their possible roles in the development of AD.MethodsSixty-three children with AD and 54 age-matched normal children were eligible for this study.Real-time fluorescence-based quantitative PCR was carried out to measure the mRNA expressions of RORγt and Foxp3 genes in PBMCs of these subjects.ResultsThe relative expression levels of Foxp3 and RORγt mRNA were significantly higher in children with AD compared with the normal controls (2.4060 ± 0.3355 vs.1.1852 ± 0.4189,t =17.50,P＜ 0.01; 6.9130 ± 0.2046 vs.2.7501 ± 0.2518,t =98.63,P ＜ 0.01 ).A statistical increase was observed in the level of RORγt mRNA in children with severe AD compared with children with mild and moderate AD(7.1203 ± 0.1056 vs.6.8046 ± 0.1731 and 6.8655 ± 0.3671,t =6.61,5.23,both P ＜ 0.01).No significant difference was noted in the expression of RORγt mRNA between children with mild and moderate AD,or in the Foxp3 mRNA expression among children with mild,moderate and severe AD.The severity of AD was positively correlated with the level of RORγt mRNA (r =0.62,P ＜ 0.01 ),but uncorrelated with the level of Foxp3 mRNA(r =0.04,P ＞ 0.05).ConclusionsThe high expressions of RORγt and Foxp3 genes may be involved in the pathogenesis of AD,and the severity of AD is positively correlated with the expression intensity of RORγt gene.

Objective To compare the effects of transcranial and trans-spinal low frequency magnetic stimulation (MS) on the expression of growth-associated protein-43 (GAP-43) in the spinal neurons of rats after spinal cord injury (SCI). Methods Forty-five Sprague-Dawley female rats were divided randomly into a transcranial magnetic stimulation (TMS) group,a trans-spinal cord magnetic stimulation group and a model control group with 15 in each group.Another 6 rats served as a normal control group.Spinal cord injury at the T9-10 level was modeled according to the modified Allen's method.The rats in the two MS groups received magnetic stimulation at 0.5 Hz and 75％ of the maximum output intensity ( 1.9 T) of the magnetic stimulator beginning 24 h post injury.They received 30 pulses daily for 28 days while the rats in the model control group were not exposed to MS.Basso-Beattie-Bresnahan (BBB) scale scores and motion evoked potentials (MEPs) were measured at the 1st,7th,14th,21 st and 28th day post injury.The expression of GAP-43 protein was studied using immunohistochemical methods and semi-quantified by Western blotting. Results At the 4th week post injury the average BBB scores in the model control group,the TMS group and the trans-spinal cord magnetic stimulation group were all significantly different. MEP amplitudes decreased significantly in all groups after the injury,and the latency was prolonged,but there were no significant differences among groups at any time point.GAP-43 expression also increased after SCI,and it was significantly higher in the MS groups than in the model control group at 4 weeks. Moreover,the expression of GAP-43 in the trans-spinal cord MS group was significantly greater than in the TMS group.Conclusion Magnetic stimulation can promote nerve regeneration and improve locomotor recovery after spinal cord injury,at least in rats.The effect of trans-spinal cord magnetic stimulation is superior to that of TMS.The mechanism may be related to the activation of central pattern generators.

ObjectiveTo observe the clinical efficacy of superficial needling in treating senile intractable constipation.Method The recruited patients were randomized into a treatment group and a control group, 40 in each group. The treatment group was intervenedby superficial needling, while the control group was by oral administration of Phenolphthalein tablets. The two groups both received the treatments for 4 weeks.ResultThe therapeutic efficacy increased with the treatment; patients showed improvements indefecation frequency, stool constitution, and effort in defecation (P<0.05); there was a significant difference between the treatment group and the control group (P<0.05); the residual marker counts of 48 h and 72 h after treatment were significantly lowered in both groups compared to that before treatment (P<0.05).ConclusionSuperficial needling can obviously improve the symptoms of senile intractable constipation, promoting the gastrointestinal transit motility.

Objective To investigate the changes of serum and pleural effusion inflammatory indexes in chil-dren with mycoplasma pneumoniae complicated with pleural effusion.Methods Enzyme linked immunosorbent assay (ELISA)double antibody sandwich method was used in the three of pleural effusion group,mycoplasma pneumonia group,control group and other groups to detect serum and pleural effusion human interleukin 6 (IL -6).human inter-leukin 2 (IL -2)and TNF -(human tumor necrosis factor alpha)etc.Inflammation index levels were detected and compared.Results The group of patients with mycoplasma pneumonia mycoplasma pneumonia patients was (9.93 ± 1.05)pg/mL for the IL -6 level,IL -2 levels for (4.93 ±0.55)μg/mL,(1.45 ±0.17)ng/mL for the TNF alpha level,which were significantly higher than those of the control group,the IL -2 was significantly lower than that of the control group,with statistically significant difference (t =6.25,5.88,4.63,5.95,3.69,5.95,all P <0.05).Compa-ring pleural effusion group and mycoplasma pneumonia group,we found serum IL -6,TNF alpha levels of pleural effu-sion group were significantly higher than that of mycoplasma pneumonia group,while IL -2 was lower than that in group mycoplasma pneumonia,with statistically significant difference (t =4.02,3.06,3.06 and 2.88,all P <0.05). The levels of serum IL -6,IL -2 and TNF -in the serum of patients with different effusion levels were significantly different from the other two groups (all P <0.05).Pleural effusion IL -6 and TNF level of pleural effusion group and mycoplasma pneumonia patients was significantly higher than those of the control group and IL -2 were significantly lower than that of the control group,the difference had statistical significance (t =5.69,3.69,602,4.11,2.94,3.67, all P <0.05).Pleural effusion pleural effusion IL -6 and TNF levels were significantly higher than those in the myco-plasma pneumonia group and IL -2 were significantly lower than that in mycoplasma pneumonia group,the difference had statistical significance (t =3.58,4.13,3.21,all P <0.05).The inflammatory indexes of patients with different effusion volume could be found in the pleural effusion,in patients with a large number of pleural effusion,the IL -2, IL -6 and TNF -levels compared with the other two groups showed significantly different (t =6.11、5.44、4.82,all P <0.05).Conclusion IL -6,IL -2 and TNF alpha in the occurrence and development of mycoplasma pneumoniae pneumonia play an important role.Suffering from mycoplasma pneumonia in patients with pleural effusion,whoseTNF-and IL -6 inflammatory index and serum indexes are abnormal,is of certain clinical practical value for clinical diagnosis,treatment and prognosis,as the indicator of the development and prognosis of pneumonia and pleural effusion.

Chronic lymphocytic leukemia (CLL) remains an incurable disease.Rituximab and fludarabine are two of the most effective agents in CLL update.Despite the widespread use of highly effective chemoimmunotherapy,fludarabine-refractory CLL remains a challenging problem associated with poor overall survival.Approved therapeutic options for these patients remain limited.Fortunately,allogenetic stem cell transplantation (allo-SCT) and several novel targeted therapeutics in clinical trails hold promise of significant benefit for these patients' population.This review discusses the activity of available and novel targeted therapeutics besides allo-SCT in fludarabine-refractory or fludarabine-resistant CLL.

Objective To explore the treatment of neuropathic pain,the combined use of parecoxib sodium after treatment based ontheuseoffentanyl on transparent paste.Methods In the period from August 2014 to August 2015 by the neuropathic pain patients in our hospital were selected in 38,they were divided intotwogroups,1groupsusingonlyfentanyltransparent paste treatment,2 group based on the use of fentanyl transparent paste on the combined use ofparecoxibsodium,comparingtwotreatmentsoftreatment effect.Results After five days,fifteen days and twenty-five days after treatment,the vas of the patients in the two groups was lower than that before the study,and there was a significant difference between the two groups(P<0.05).There is a big gap between the two groups(P<0.05).Conclusion Fentanyl transparent dressing in treating neuropathic pain can play an ideal therapeutic,for the use of a drug when the poor efficacy of the patient alone combined with parecoxib sodium can significantly improve the therapeutic effect.

Objective·To investigate the correlation between the serum haptoglobin (Hp) level and the metabolic parameters in patients with polycystic ovarian syndrome (PCOS), and explore the distribution of Hp genotype and allele frequency in PCOS patients and their correlations with PCOS. Methods·A total of 106 patients with PCOS and 86 cases of patients with non-hyperandrogenic and regular menstruation (control group) were enrolled. Serum Hp level was measured by enzyme-linked immunosorbent assay (ELISA); Hp genotype and allele frequency were determined by polymerase chain reaction (PCR), respectively. Results·The serum Hp level in PCOS group was significant higher than that in the control group (P=0.000). Correlation analysis reveals that serum Hp level was positively related to body mass index (BMI) (P=0.000) and homeostatic model assessment insulin resistance (HOMA-IR) (P=0.000). Compared with control group, proportion of Hp2-2 genotype (Hp2/Hp2) increased significantly in PCOS group (P=0.006), and the frequency of Hp2 allele was also higher (P=0.002). Conclusion·Serum Hp level was positively related to BMI and HOMA-IR, which maybe associated with the occurrence and development of obesity and insulin resistance. Patients with Hp2-2 genotype might have genetic predisposition to PCOS, and high frequency Hp2 allele was found in them.

Neurotrophin 3(NT-3) is required for proprioceptive neuron survival and physiological function.During embryonic development,NT-3 deficient in developing muscle dues to loss of proprioceptive neurons in dorsal root ganglia or their axons by apoptosis,and then to the absence of muscle spindles.The chemoattractant effect of NT-3 on dorsal root ganglion axons has been improved that NT-3 is a key requirement for the development of proprioceptive projection to motor neurons.Depletion of NT-3 in the period of adult educes to the decline of the function of proprioception.NT-3 has extensive protective effect on proprioceptive neuron and enhances them to restore the normal physiological function under the pathological state.

The metastases status of internal mammary lymph node(IMLN) is an independent prognostic factor for breast cancer and it also is an important reference for neoplasm staging.The patients with IMLN metastases consistently have worse outcomes.The overall risk of IMLN metastases is 18 ％-33 ％.Metastases exclusively situated in the IMLN,without concurrent axillary metastases,occur in 2 ％-11％ of patients.Factors related to IMLN metastases include the status of axillary node,the age of patients,the localization and characteristics of primary tumor.Recently,with the development of sentinel lymph node biopsy(SLNB), internal mammary-SLNB may access the status of IMLN with a minimal risk. Internal mammary-SLNB procedure can improve the system for nodal staging of breast cancer,and it will contribute to the individualized treatment for breast cancer patients.