We summarized the researches of syndrome differentiation for type 2 diabetes mellitus (T2DM) in this article. According to the constitution feature of obesity and non-obesity and analysis of researches of different medical scholars, we put forward that the easy-suffering constitutions were the basis of the evolution and development of syndromes of T2DM, and the different inducements were the conditions of that courses. The persons whose constitutions were of qi-deficiency of spleen and kidney and excessive stomach often appeared a obese physique, and the people whose constitutions were of yin-deficiency of both the liver and kidney usually showed a non-obese shape. Affected chronically by the inducements, the evolution and development of the syndromes had its own rules respectively corresponding to the different constitutions as the diseases go on. Therefore, to integrate the constitution, disease stage and pathological change with specific zang-fu organs can better grasp its rules of syndrome differentiation.

Objective To investigate the changes and roles of Fc gamma receptors (FcγR) expressed on monocytes in the immune pathogenesis of Henoch-Schonlein purpura(HSP).Methods Thirty children of HSP and 15 health controls were enrolled in this study.The expressions of FcγR Ⅰ and FcγRⅢ on monocytes were determined by flow cytometry,and real-time PCR was performed to detect the transcription levels of FcγR Ⅱ a,FcγR Ⅱ b,cytokines(IL-1 β,IL-6,TNF-α,IFN-α),chemokine(IP-10,RANTES,iNOS),and BLyS/April in monocytes isolated by microbeads.The plasma concentrations of IL-4,IL-10 and TNF-α were analyzed by enzyme-linked immunosorbent assay (ELISA).Results (1) The expressions of FcγR Ⅰ and FcγR Ⅲ on monocytes in patients with HSP were significantly up-regulated compared with healthy controls.Transcription level of FcγR Ⅱ a on monocytes in patients with acute HSP was found to be higher than that in healthy controls while the inhibitory FcγR Ⅱ] b mRNA was significant down-regulated(P＜0.05),which resulted in a higher ratio of FcR Ⅱ a/Ⅱ b in patients with acute HSP.(2) The expressions of cytokine/chemokines factor such as IL-1 β,IL-6,TNF-α,IP-10,RANTES,and iNOS in patients with HSP was detected to be higher than those in healthy controls(P＜0.05).In addition,expression levels of BLyS/April were up-regulated during acute HSP(P＜0.05),the positive correlations were observed between the FcγR Ⅱ a/FcγR Ⅱ b and the cytokine/chemokines factor in monocytes(P＜0.05).(3) Plasma concentrations of IL-4,IL-10 and TNF-α were significantly elevated during acute HSP(P＜0.05),and a negative correlation was observed between concentrations of TNF-α and the mRNA level of FcγR Ⅱb in monocytes.Conclusion The abnormal expression of the cytokines and the imbalance of stimulatory and inhibitory FcγR of monocyte in acute HSP.

Objective To investigate the effects of the intravenous immunoglobulin (IVIG) on the expression of FcγR Ⅱ b and Toll-like receptor 4 (TLR4) in children with Kawasaki disease (KD).Methods 25 children with KD and 15 healthy controls were enrolled in this study.The levels of TLR4 expression on monocytes were assessed by flow cytometry.Real-time PCR was performed to detect the transcription levels of FcγR Ⅱ b,TLR4 signaling molecules(MyD88,TRAF-6,TAK1) and cytokines(IL-1β,IL-6,TNF-α) in monocytes.The concentrations of TNF-α in plasma was determined by enzyme-linked immunosorbent assay (ELISA).Results (1) Compared with healthy controls,the expression of TLR4 and the signaling molecules in the patients were significantly up-regulated but decreased after treatment with IVIG (P＜0.05).(2)The levels of FcγR Ⅱb expression from the patients were higher than those from healthy controls,and decreased after treatment with IVIG(P＜0.05).(3) The levels of cytokine factor expression such as IL-1β,IL-6 and TNF-α in the patients were found to be higher than those in healthy controls (P＜0.05) ; plasma concentrations of TNF-α were significantly elevated during acute KD (P＜0.05).(4)There were significantly correlations to follow between FcγR Ⅱb and the levels of cytokine,TLR4 expression in monocytes (P ＜0.05).Conclusion IVIG can up regulate FcγR Ⅱb expression and down regulate TLR4 expression which might inhibit the inflammatory response.

Objective To retrospectively study the perioperative complications and postoperative function recovery of 93 patients treated with simultaneous bilateral total hip arthroplasty (THA). Methods A total of 93 patients (186 hips) undergone simultaneous bilateral THA from January 1999 to January 2009 in our hospital were involved in this study. There were 70 males and 23 females (at age range of 25-65 years, average 41. 8 years). The preoperative diagnosis included bilateral avascular necrosis of femoral head in 48 patients, rheumatoid arthritis in 11, developmental dysplasia of the hip in 26 and ankylosing spondylitis in 8. The intraoperative blood loss, Harris scores before operation and at final followup as well as perioperative complications were analyzed. Results All the patients were followed up for average 65 months (12-118 months), which showed femur fracture in one patient and infection six months after discharge in one patient. The Harris score was increased from (36.7 ±6.1) points preoperatively to (91.2±6.2) points at the final follow-up. Hip pain disappeared in 92 patients after operation and radiograph showed no loosening. Actebular loosening occurred in one patient 49 months after operation and was revised accordingly. Conclusion Under strict control of operation indications, suitable choice and implantation of the prosthesis and emphasis on perioperative management and postoperative rehabilitation, simultaneous bilateral THA is a safe and effective choice for bilateral hip diseases.

Objective To observe the effects of different quantities of cake-separated moxibustion on blood cells and immunoglobulin in immunosuppressive rabbits; To study the possible mechanism of quantity-effect difference. Methods Immunosuppressive rabbit model was established by intraperitoneal injection of cyclophosphamide. Rabbits were randomly divided into blank group, model group, cake-separated moxibustion 3 Zhuang group, 5 Zhuang group, 7 Zhuang group.Liuwei Dihuang Decoction was used to make herbal-cake, and was put on Shenque (RN8), Guanyuan (RN4), and other acupoints, once for every other day, 10 times in total. Venous blood was taken on the next day after finishing treatment, and the contents of blood cells series and IgG, IgM, complement C3 and complement C4 were detected.Results Compared with blank group, the levels of WBC, NEU, RBC, HGB, HCT, PLT, IgG, IgM, and complement C3 of model group significantly decreased, while the levels of LYM and MONO significantly increased (P<0.01). Compared with model group, the increase of HCT and IgM in the cake-separated moxibustion 3 Zhuang group was not significant, the levels of WBC, NEU, RBC, HGB, HCT, PLT, IgG, IgM, and complement C3 in all treatment groups significantly increased, and LYM and MONO significantly decreased (P<0.01). Compared with cake-separated moxibustion 3 Zhuang group, the levels of WBC, IgG, and complement C3 of cake-separated moxibustion 5 Zhuang group significantly increased, and the levels of WBC, HGB and complement C3 of cake-separated moxibustion 7 Zhuang group significantly increased (P<0.01).Conclusion Cake-separated moxibustion can improve the immune function under immunosuppressive state induced by cyclophosphamide, and different quantities have differences in efficacy.

Purpose To explore the relationship between the mutations of epidermal growth factor receptor ( EGFR) and KRAS genes and clinicopathological characteristics in patients with non-small cell lung cancers (NSCLC). Methods Clinical samples from 431 NSCLC patients were obtained for EGFR and KRAS gene analysis. PCR based direct DNA sequencing was used to investigate mutations in exon 18-21 of EGFR gene and codon 12 and 13 of exon 2 of KRAS gene. Results The overall EGFR mutation rate of primary NSCLC was 53. 6% (231/431) in this study cohort and eight cases showed double EGFR mutations. Mutation rates in female and male were 65. 2% (122/187) and 46. 9% (98/209), respectively. The mutation rate was higher in patients with non-smokers and adeno-carcinoma and adenosquamous carcinoma subtypes than in their counterparts (P<0. 05), with the percentage of 57. 2% (124/216), 60. 3% (199/330), 42. 9% (6/14), respectively. In squamous cell carcinomas and other subtypes, EGFR mutation rates were 11. 6% (5/43) and 11. 1% (1/9), respectively. The EGFR mutation types included exon 18 point mutations (4. 0%, 9/227), exon 19 deletion mutations (4. 5%, 101/227), exon 20 insert or point mutations (9. 7%, 22/227) and exon 21 point mutations (41. 4%, 94/227). Activating mutations of KRAS gene were detected in 7. 8%(31/396) of NSCLC. Twenty-eight patients showed codon 12 mutations ( G>T, G>A, G>C) , and three patients had codon 13 mutations ( G>A, G>T) . Most of these mutations were G to T transversion (64. 5%, 20/31). Conclusion Polymerase chain reaction-direct sequencing is a reliable and effective method for the detection of the EGFR and KRAS gene mutation in NSCLC patients. The mutation rate of EGFR is higher in Chinese patients, especial-ly in non-smoking female patients with adenocarcinoma.

Objective To explore the effects of intensity modulated radiation therapy (IMRT) on lung function in patients with non small cell lung cancer (NSCLC) ,analyze relationship between lung function indexes and radiation pneumonitis (RP) incidence rate ,dose volume histogram (DVH) parameters and incidence degree of RP .Methods 52 patients without operation first radiother‐apy patients were included ,all with Karnofsky score (KPS) ≥ 80 points .Detection of IMRT ,before the end of the end ,first months ,third months of forced vital capacity (FVC) ,forced expiratory volume in one second (FEV1 .0) and diffusion capacity of carbon monoxide (DLCO) change were conducted .The incidence and degree of RP were measured ,and got the V20 and V30 value in DVH .By Spearman correlation analysis ,the relationship between pulmonary function index and the incidence of RP ,V20 ,V30 and RP was analyzed .Results Among the 52 patients ,49 patients were followed up ,the follow -up rate was 94 .2% .In the 49 pa‐tients ,two cases were excluded in the lung recurrence or lung metastasis patients ,thus a total of 47 patients were included in the fi‐nal study .There were 18 cases of RP ,the incidence of RP was 38 .30% .In the third month ,FEV1 .0 and DLCO were significantly decreased than that before radiotherapy (P<0 .05) ,FVC had no significant change (P>0 .05) .Correlation analysis showed that FVC ,FEV1 .0 and DLCO and RP were positively correlated (r=0 .451 ,0 .405 ,0 .635 ,P<0 .05);and V20 ,V30 and RP was posi‐tively correlated (r=0 .689 ,0 .725 ,P<0 .05) .Conclusion the larger the NSCLCV20 ,V30 value ,the more serious the RP would be ,thus they could be predictor of RP degree .

Background and purpose: Primary renal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue(MALT lymphoma) are rare tumors in the kidney.Till now,less than 50 cases have been reported all over the world.This article introduced 2 cases of MALT lymphoma based on the morphological and immunophenotype features,aimed to highlight this rare tumor in terms of clinical characteristics and pathology.Methods:2 cases of renal MALT lymphomas were treated in our hospital.Clinical history were collected,morphological analysis was evaluated based on the HE section,and immunohistochemistry were performed by CD20,CD79a,CD5,CD10,CD43,CD23,BCL10 and cyclinD1 antibodies.Results:2 female patients with the age of 48 and 55,respectively,both of them had a history of chronic pyelonephritis.Under the B ultrasonic and CT scanning,a lump in the kidney was found and whole nephrectomy was performed.In the macroscopic view,tumors were in the renal medulla with dark red color and ill-defined boundary.In the microscopic view,lymphoid cells infiltrate from the pelvis to the medulla of kidney,lymphoid cells mainly consisted of small lymphocytes,centrocyte-like cells,lymphoplasmacytoid and plasma cells.Reactive follicles and lymphoepithelial lesions also could be seen in the tumor.Immunohistochemistry showed that the tumor cells were CD20 and CD79a positive,CD43 was weak positive,but CD5,CD10,CD23,BCL10 and cyclinD1 were all negative.Conclusions:Primary renal MALT lymphomas are very rare diseases.According to the clinical manifestation,it is hard to differentiate from renal cell carcinoma.But the morphological features were consistent with the classic MALT lymphomas in other sites.Immunophenotype profiles were helpful for diagnosis.

Objective:To investigate the suppression effect and apoptosis of the colon cell line HT-29 treated with adenovirus-expressed human hyperplasia suppressor gene(hHSG)and hyperthermia.Methods:Replication-defective recombinant adenovirus containing hHSG was constructed,and then infected into HT-29 cell line to detect its overexpression by western blot.The synergic effect with hyperthermia was observed,cell survival was assessed using Vi-CELL TMXR Cell Viability Analyzer,and cell apoptosis and cell cycle distribution were determined by flow cytometry.Results:After the cells were treated with 100 MOI(multiplicity of infection)Ad5-hHSG and heated at 42 ℃ for 1 h,the number of viable cells decreased sharply,compared with single treatment with Ad5-hHSG or 42 ℃ for 1 h(P

Anti-Bacterial Agents ; pharmacology ; Child ; Humans ; Macrolides ; pharmacology ; Microbial Sensitivity Tests ; Mycoplasma pneumoniae ; drug effects