Objective To study the effect and possible role of recombinant human erythropoietin(rhEPO) on the proliferation and apoptosis of endothelial progenitor cells (EPCs) from patients with diabetic nephropathy (DN). Methods Various concentration of rhEPO was added to the culture system of EPCs from 20 DN patients (DN group) and 20 normal people (control group). MTT assays were used to detect the proliferative rate, Annexin V/PI stains to detect the apoptotic rate, and Western blot assays to detect the expression level of Akt protein kinase. Results Proliferative ability of EPCs from control group and DN group was improved when concentration of rhEPO was 0.3, 0.6 and 1.2 kU/L, and it was dose-dependent. The effect from the latter was more obvious. The apoptotic rate of DN group was lowered and the expression levels of Akt protein kinase were upregulated when the concentration of rhEPO was 1.2 kU/L, while this kind of effect was blocked after Wortmannin was added to the culture system. Conclusion rhEPO can improve the number and function of EPCs from both healthy volunteers and patients with DN. PI3K/Akt pathway may play an important role.

OBJECTIVE To investigate the resistance status of pathogens from surgical incision infection.METHODS The secretion of infected wounds was cultured to detect pathogens by routine methods from Jan 2001 to Dec 2006.The identifications and antimicrobial-susceptible tests of pathogens causing incision infection were determined by Full Automated Analyzer.All data were analyzed retrospectively.RESULTS A total of 246 pathogen strains were cultured from the secretion of surgical incision infection in 6 years,of which Gram-negative bacilli,Gram-positive cocci and fungi accounted for 57.7%,34.1% and 8.2%,respectively.The first place of isolates was Escherichia coli,followed by Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,etc.74.5% of S.aureus isolates and 83.3% of S.epidermidis isolates were resistant to oxacillin.45.1% of E.coli of the isolates and 35.0% of isolates of K.pneumoniae were extended-spectrum ?-lactamases producing.Almost all of the detected resistant strains showed serious multiple resistance.Vancomycin and imipenem still had better activity for antimicrobial multiple resistant bacteria.CONCLUSIONS Surgical incision infection is serious.Infection surveillance should be taken to control surgical infection.Pathogens infected surgical incision are multi-resistant to antibiotics.

AIM: This study aimed to observe the effects of high-glucose on proliferation and apoptosis of endothelial progenitor cells (EPCs) in type 2 diabetes mellitus patients, and tried to elucidate their possible role. METHODS: Various concentrations of glucose were added to the culture system of EPCs from 25 cases of type 2 diabetes mellitus patients (DM group) and 25 cases of healthy volunteers (control group). MTT assays were used to detect the proliferative rates. Annexin-V/PI stains were used to detect the apoptotic rates, and RT-PCR to detect the expression level of bcl-2 and bax. RESULTS: Proliferative activity of EPCs in both control group and DM group were attenuated when concentration of glucose was 33 mmol/L, while apoptotic rates increased. No significant change of proliferative rate and apoptotic rate of EPCs in DM group and control group in the presence of 5 mmol/L glucose was observed. The expression level of bax of EPCs in both DM group and control group increased while expression level of bcl-2 did not change much in the presence of 33 mmol/L glucose. CONCLUSION: High-glucose attenuates proliferative activity of EPCs and increases the apoptotic rate. Upregulation of bax may be its possible role.

The construction of harmonious doctor-patient relationship is an important project in social medicine .The influen-cing factors about doctor-patient relationship are analyzed from three aspects which are responsibility ethics , bottom-line ethics and clin-ic ethics.Based on the discussion , certain countermeasures are proposed to reconstruct harmonious doctor -patient relationship .

AIM: To explore the effect of different corneal incision size on change in tear function after phacoemulsification cataract surgery in type 2 diabetics.
●METHODS:One hundred and fifty patients with type 2 diabetes (150 eyes) from Jan. 2015 to Oct. 2015 in our hospital were enrolled. The patients were randomly divided into two groups. Seventy-five patients (75 eyes) in group A: coaxial 2. 2mm micro - incision phacoemulsification cataract extraction and intraocular lens (lOL) implantation; seventy-five patients (75 eyes) in group B:the conventional coaxial 3. 0mm small incision phacoemulsification cataract extraction and lOL implantation. The difference of demographic characteristics between two groups were insignificant. The ocular surface disease index ( OSDl ) , corneal sensation, break up time (BUT) and Schirmer′sltest(Slt) were examined preoperatively and 1wk, 1, 3 and 6mo postoperatively.
●RESULTS:At 1wk, 1 and 3mo postoperatively, the OSDl score in two groups increased and the OSDl score of group B was significantly higher than those of group A and the differences were statistically significant ( all P<0. 05 ) . The corneal sensation in two groups decreased after operations and the corneal sensation of group B was significantly lower than those of group A and the differences were statistically significant (all P<0. 05). The Slt in two groups decreased after operations and the Slt of group B was significantly lower than those of group A and the differences were statistically significant (all P<0. 05). At 1wk and 1mo postoperatively, the BUT in two groups decreased after operations and the BUT of group B was significantly lower than those of group A and the differences were statistically significant (all P<0. 05). At 6mo postoperatively, no significant change was found in the OSDl score, corneal sensation, BUT and S l t of group A compared with preoperatively (all P>0. 05). At 6mo postoperatively, the differences of OSDl score and corneal sensation in group B were statistically significant compared with preoperatively ( all P< 0. 05 ) while no significant change was found in the BUT and S l t of group B (all P>0. 05).
●CONCLUSION:Phacoemulsification surgery with 2. 2mm corneal micro-incision has less effect on change in tear function comparing to the 3. 0 mm incision control, which can be applied particularly in patients with type 2 diabetes.

Objective To study the influence of HBV replication regulator,enhancer I and Pre- S2,on the immune response of HBV DNA vaccine.Methods DNA fragments of HBsAg,PreS2 HBsAg,HBsAg-enhancer I and PreS2-HBsAg-enhancer I region of HBV were amplified by PCR using the complete genome DNA of HBV adr subtype,and inserted into VR1012 vectors,respective- ly.The recombinant plasmids were transfected into HepG2 cells,and injected into Balb/C mice.The expression of HepG2 cells and the cellular and humoral immune response of mice were tested by cell immuno-chemistry,ELISA and ELISPOT.Results The target protein were expressed by transfected HepG2 cells,enhancer I and Pre-S2 can promote the expression of HBsAg in transfected cells.The HBsAb and the HBsAg specific CTL in inoculated mice were found in the second week after injection, PreS2 but not enhancer I can promote the immune response in inoculated mice.Conclusions When inserted into HBV DNA vaccine,enhancer I and PreS2 can promote the expression of HBsAg in transfected HepG2 cells,PreS2 can promote the immune response in inoculated Balb/C mice.

Background The establishment of diabetic animal model is a crucial step for the study about diabetic eye diseases. At present,the main modeling method include the injection of streptozotocin and alloxan. But the shortcoming of the former is an expensive price, and that of the later is high death rate of animals. Objective This experiment was to discuss the way which decrease the death of alloxan-injected animal and explore the effects of high blood glucose on the posterior capsular opacification (PCO). Methods Forty clean healthy male New Zealand white rabbits were randomly divided into 2 groups. 90mg/kg of alloxan were injected via ear vein once in 20 rabbits to create the diabetic animal models,and the equivalent amount of normal saline solution was injected at the same way as normal blood glucose group. The successful models were selected in the animals with the blood glucose level over 12. 0 mmol/L two weeks later, and PCO of lens were graded based on the method of Odrieh under the slit lamp. Extracapsular lens extraction was then performed on the right eye of rabbits in both groups, and the posterior capsules were obtained from these eyes at the 6th, 10th and 14th days after operation. The expression of proliferating cell nuclear antigen ( PCNA ) in posterior capsular lens epithelial cell was detected by immunohistochemistry. Results The modeling successful rate was 70% after injection of alloxan. The body weight of rabbits in high blood glucose group was significantly lowed and the blood glucose was significantly elevated in comparison with normal blood glucose group ( all P<0. 05). Two weeks after surgery ,2 eyes occurred 2 grade of PCO and only one eye showed the 1 grade of PCO in the high blood glucose group. However, 1 grade of PCO was found in 3 eyes in the normal blood glucose group. Biopsy revealed that PCNA was positively expressed in the cell nuclei of LECs in high blood glucose group rather than the normal blood glucose group from the 10th day after surgery. The proliferation index of PCNA was 0. 86±0. 04 and 0. 25±0. 03 respectively in high blood glucose group and normal blood glucose group, showing a significant difference between them (t = -16. 171 ,P = 0. 000). Conclusion Stable diabetic models of rabbits can be created by intravenous injection of 90 mg/kg alloxan. High blood glucose level is one of the important factors for the development of PCO.

OBJECTIVETo evaluate the effect of lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle.

METHODSFrom May 2009 to October 2013,12 patients with soft tissue defects combined with tendon and bone exposure in the foot and ankle were treated by lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle, including 9 males and 3 females with an average age of 37.5 years old ranging from 19 to 58 years. Ten cases had the soft tissue defects in the dorsum of foot and 2 in the ankle. The defect area of soft tissue was from 11 cm x 9 cm to 8 cm x 5 cm.

RESULTSTwelve patients were follow-up for 3 to 12 months (averaged 7.3 months). The flaps of 9 cases were survived,the flaps edges of the other 3 cases were necrosis,and healed after dressing change. The flaps were slightly swelling without ulcer occurrence.

CONCLUSIONLateral supramalleolar artery descending branch antidromic flap can repairing the damage by one-stage operation with advantage of dissection easy,rich blood supply without sacrifice of major artery.

Adult ; Ankle ; blood supply ; surgery ; Arteries ; surgery ; Female ; Foot ; blood supply ; surgery ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Young Adult

Objective To compare the serum levels of transforming growth factor (TGF)-beta 1,bone morphogenetic protein (BMP)-4 in patients with rheumatoid arthritis (RA) and RA with interstitial lung disease (RA-ILD).Methods Twenty-eight RA-ILD patients,32 patients with RA but without ILD and 20 normal controls were enrolled.The RA-ILD group was further divided into early group and late group.All the observed subjects were analyzed using enzyme linked immunosorbent assay (ELISA) for the determination of serum TGF-β1 and BMP-4 levels.The relationship between the serum levels of TGF-β1,BMP-4 and laboratory examinations were investigated.Comparisions between groups were tested by one-way ANOVA analysis and ttest.Correlation of indexs were observed by Spearman method.Results Patients in the RA-ILD group were older than RA group in disease onset age,in addition,patients with ILD had better joint function and higher serum rheumatoid factor titers.The occurrence time of interstitial lung disease was 2-6 years after the onset of arthritis,with an average time of (3.0±1.2) years.The TGF-β1 levels in the RA-ILD group were slightly higher,but not statistically significant than other groups (P＞0.05).The TGF-β1 serum levels in the early RA-ILD patients were significantly increased than those of the late RA-ILD group and the RA group.BMP-4 levels in patients with RA-ILD group were less than RA without ILD group and healthy control group,and the difference was statistically significant (P＜0.05).BMP-4 level in early RA-ILD group was significantly decreased than those of the late RA-ILD group and RA group.No correlation between the serum BMP-4,TGF-β1 level (P＞0.05) no assay result correlated with laboratory parameters including ESR,CRP,RF and anti-CCP antibodies (P＞0.05).Conclusion TGF-β1 serum levels are increased and BMP-4 levels are decreased in early RA-ILD patients.The serum levels of TGF-β1 and BMP-4 may be indicatior for asymptomatic ILD and reflect disease progression.

This study was purposed to investigate the expression of RPL36A (ribosomal protein 36a) in the newly diagnosed acute myeloid leukemia (AML) cells and its mechanism at the molecular level. The RPL36A mRNA expression in the newly diagnosed AML cells, U937 cells and normal MNCs was determined by RT-PCR. Small interfering RNA (siRNA) targeting to RPL36A was transfected into U937 cells by Lipofectamine 2000 system. Proliferation, cell cycle, apoptosis of U937 were observed through MTT assay, flow cytometry, acridine orange/ethidium bromide (AO/EB) double staining, TUNEL and Annexin V/FITC respectively. RPL36A mRNA and protein expression levels were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot analysis respectively. The results showed that RPL36A expression in the newly diagnosed AML cells and U937 cells was significantly upregulated. The average OD value of U937 cells transfected with RPL36A siRNA was significantly lower as compared with 3 control groups. The cell percentage in G2-and S-phase increased, which indicated the inhibition effect of RPL36A siRNA on cell proliferation. Remarkable cell apoptosis in U937 cells treated with RPL36A siRNA was observed by AO/EB, TUNEL analysis and Annexin V/FITC assay; RPL36A mRNA and protein expression level of U937 cells treated with siRNA were significantly declined in a time-dependent manner (r=0.9813 and 0.9537). It is concluded that the RPL36A expression in the AML cells is significantly enhanced and the RPL36A gene may be involved in regulation of cell cycle and cell apoptosis of AML, which promotes proliferation of AML cells and inhibits apoptosis of cells.
Adolescent ; Adult ; Aged ; Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Female ; Humans ; Leukemia, Myeloid, Acute ; pathology ; Male ; Middle Aged ; RNA Interference ; RNA, Small Interfering ; genetics ; pharmacology ; Ribosomal Proteins ; genetics ; pharmacology ; U937 Cells ; Young Adult