Objective The purpose of this study was to observe the effects of bumetanide on elderly type 2 diabetic patients with middle and advanced stages nephropathy. Methods Forty cases with diabetic nephropathy (DN) were divided into two groups:control group (20 cases) and treatment group (20 cases) . The control group accepted furosemide (20 mg, once a day) and the bumetanide was orally administrated at the dose of 1.0 mg, twice a day to the treatment group for 3 months. The assessment of transferrin (TRF) and urine microalbumin (UALB) was performed at the time points at the end of 1, 4, 8, 12 weeks after treatment. Results (1) The levels of BUN, SCr and UA after treatment were lower than before treatment, but there were no significant differences. (2) In the treatment group, the levels of TRF and UALB have decreased after treatment for 1 week, with no statistically significant. But at the end of 4, 8 and 12 weeks,the differences were statistically significant ( <0.05) . Especially, during the three months follow-up,the levels of TRF and UALB at 12 weeks have decreased obviously. Conclusion The therapeutic effect of bumetanide on DN might be better than that of furosemide.

Objective To evaluate the efficacy and adverse effect of brachial plexus block with morphine and ropivacaine for postoperative analgesia in children. Methods Forty-five children undergone upper extremity surgery were randomly divided into three groups (n = 15) , ie, Croup A (brachial plexus block with ropivacaine), Croup B (brachial plexus block with ropivacaine and subcutaneous injection of morphine) and Croup C (brachial plexus block with morphine and ropivacaine). The analgesic effect and the analgesia maintenance time were recorded by FLACC method at 1, 2, 4, 6, 8, 12, 24 hours after operation. The adverse reactions were observed 48 hours after operation. Results There was no statistical difference between Croup A and Croup B in the analgesia maintenance time and the number of cases without analgesic therapy at each time point (P > 0. 05). Compared with Croup A or Croup B, the analgesia maintenance time in Croup C were significantly extended and the number of cases without analgesic therapy at 4, 6, 8, 12, 24 hours after operation were significantly increased (P < 0.05). The adverse effect was fairly light in three groups. Conclusion Brachial plexus block with morphine and ropivacaine may extend analgesia maintenance time effectively and safely in children undergone upper extremity surgery.

Objective To estimate the value of diffusion weighted imaging with background body signal suppression(DWIBS)in tumors of intestinal tract and metastasis.Methods 15 cass with tumors of intestinal tract underwent MRI and DWIBS examinations.Four of them underwent CT scan.Results All primary tumors were showed by conventional MR sequences and DWIBS.DWIBS showed that 4 cases had the invasion of placenta percreta,5 cases had transcoelomic metastasis in abdominal cavity and 5 cases had lymphatic metastasis,while the conventional MR sequences showed the invasion of placenta percreta in 10 cases,the invasion of fat interspace in 8 cases,transcoelomic metastasis in abdominal cavity in 3 cases and lymphatic metastasis in 3 cases.Conclusion DWIBS is better than the conventional MR sequences and CT in detecting the primary tumor of intestinal tract,transcoelomic metastasis in abdominal cavity and lymphatic metastasis.However,the conventional MR sequences and CT is better than DWIBS in detecting the invasion of placenta percreta and fat interspace.

Objective To study the epidemiological characteristics of diabetes mellitus and to provide effective prevention and intervention methods in rural area in Kunming.Methods A cross-sectional study was conducted among 3 440 permanent residents aged 20～74 years in kunming rural districts.Results The general prevalence rate of diabetes was 4.01% and the standardized rate was 2.90%.The standardized prevalent rate for male(3.55%) was higher than that for female(2.61%),and the prevalence rates varied among different groups of rural inhabitants.Conclusion It is necessary to take effective methods to prevent and control diabetes in rural area.

The development and influencing factors of compliance behavior of investigators in clinical trials were explored. According to literature review, a hypothetical model of development of compliance behavior of investigators in clinical trials was established, and the influencing factors of compliance behavior of investigators and their interrelationships were studied based on questionnaire survey of five hundred investigators sampled randomly from one hundred clinical trial institutions in China. Cronbach's alpha coefficient and structural equation modeling were adopted to empirically analyze the results. Six variables in the hypothetical model were included: compliance behavior of investigators, credibility of clinical trial, capability of government regulation, quality control of sponsor, quality control of clinical institution and compliance intention of investigators. Empirical analysis showed that the compliance behavior of investigators in clinical trial was directly affected by compliance intention of investigators, quality control of sponsor and quality control of clinical institution. In addition, credibility of clinical trial and capability of government regulation indirectly affected the compliance behavior of investigators in clinical trial through influencing the compliance intention of investigators, quality control of sponsor and quality control of clinical institution. Quality control of sponsor was affected by credibility of clinical trial and capability of government regulation while quality control of clinical institution was only influenced by capability of government regulation.

Objective To isolate and identify the causative agent in an incident with crowd fever of adults in Henan province.Methods The cells was inoculated by the throat swabs of the patients and followed by neutralization assay and other molecular methods.Then indirect immunofluorescence assay was performed to detect the specific IgM/IgG antibodies against virus in the serum of the patients.Results We have isolated 2 strain adenoviruses from 10 swab samples,which were both identified as Ad11 by sequence analysis and neutralization test.6 of 10 samples were positive fer IgM specific for adenovirus and 3 positive for IgG.The remaining sample was negative for both.Conclusion The causative agent in this incident with crowd fever of adults was Ad11 in group B.

AIM: To study the influence of injection agent of pidotimod on function of the immune-system in normal and immune-depressed mice, and to investigate the mechanisms of the immunomodulating action of pidotimod. METHODS: The expressions of TNF-? and IL-6 in mice spleen was detected by RT-PCR method. The effects of pidotimod on phagocytosis functions of mice peritoneal exudate cells was investigated by neutral red phagocytosis. The lymphocyte proliferations induced by Con A or LPS were detected by MTT method. Adopt the serum haemolysis to measure the production of serum antibody. RESULTS: The normal and immune-depressed mice were treated for 14 days with different dosages of pidotimod by injection. Pidotimod can significantly increase the expressions of TNF-? and IL-6 of spleen, potentiate phagocytosis of the peritoneal exudate cells, potentiate the lymphocyte proliferations ability induced by Con A or LPS. CONCLUSION: Pidotimod can potentiate amelioration normal and immune-depressed mice immunesystem function and increase expressions of TNF-? and IL-6 of spleen.

ObjectiveTo study the MR Imaging features of breast phyllodes tumor (PT),and to correlate it with pathological results.MethodClinical and MRI findings were retrospectively reviewed in twenty-seven women with 28 PTs lesions confirmed by surgical pathology.Statistical analyses were one-way ANOVA for size analysis,Fisher exact test for analysis of MR appearances and Spearman correlation to study the relationship between MRI findings and BI-RADS categories.Results( 1 ) The histologic findings were benign,borderline and malignant PTs in 14.3％ (4/28),53.6％ (15/28) and 32.1％ (9/28) of lesions,respectively.(2) The mean maximum-diameter were (6.4 ± 3.9) cm,(5.7 ± 2.2) cm in borderline type and (4.8 ± 1.8)cm in benign type respectively.The results showed differences in lesion's size among the three type (F = 287.541,P =0.000),especially between malignant and benign type (P = 0.033 ).(3)Internal non-enhanced septations and silt-like changes on enhanced images,as well as time-signal curve on MRI correlated significantly with the histological grade ( P ＜ 0.05 ).( 4 ) If the category BI-RADS ≥ 4a was considered to be a suspicious sign for malignant lesion,the diagnostic accuracy of MRI would be 96.4％ (27/28),and the BI-RADS category of the MRI could reflect the PT's histological grade with a low correlation coefficient ( r = 0.382,P = 0.045 ).Conclusion The findings of PT on MRI have some characteristics,with tumor size and several MRI features correlating with the histological grade of breast PT.

Objective To investigate the relationship between serum cholinesterase(ChE) and acute-phase proteins in patients with multiple trauma, then to evaluate their significance to judge prognosis. Method It's a prospective observation study. Patients with multiple trauma admitted to emergency intensive care unit,Second Af-filiated Hospital, Zhejiang Universieg, school of medicihe within 24 h after trauma from Oct. 2005 to Oct. 2007 were enrolled. And those with chronic liver disease, touching orgnaophosphorus, active tuberculosis, tumor, in-fection of major organ before trauma, liver injury or age < 18 year were excluded. Among 81 patients, 57 were male and24 female. The average age was (46±18) years, and the average injury severity score was (34.0±11.9).Seventy six healthy were selected as controls, 53 male and 23 female, with an average age of (44±16)years. The exclusion standards were the same as those in patients. Both groups had same gender proportion and age. Senum ChE and acute-phase proteins(APP) including albumin(ALB), prealbumin(PAB), transferrin(TRF),C-reactive protein(CRP) in patients were detected at 1, 3, 7 d after trauma. The acute physiology and chronic health evaluation Ⅲ (APACHEⅢ) was recorded simuhancously. Serum ChE, ALB, PAB, TRF, CRP in the controls were also detected. All of these indexes in the controls were compared with thoses in patients by t test or rank surn test. The dynamic changes of serum ChE and APPs in patients were analyzed by one way repeated mea-sures ANOVA. The relationships between serum ChE and those APPs and the relationships between APACHE Ⅲ and these indexes were analyzed by Pearson correlation analysis. We also compared these indexes between patients with different outcomes by t test or rank sum test. The values of serum ChE and those APPs to judge prognosis were evaluated by logistic regression analysis. Results Patients had lower serum ChE, ALB, PAB, TRF and higher CRP than the healthy at 1, 3, 7 d post trauma. Serum ChE activity in patients was reducod over 25% (42.3%～50.2%) than that in the healthy, and showed a tendency to decrease after trauma, which resembled PAB and TRF. Serum ChE was positively correlated with ALB, PAB and TRF at 1, 3, 7 d, and negatively correlated with CRP at 3, 7 d. At 1, 3, 7 d post trauma, APACHEⅢ in patients was negatively correlated with serum ChE and TRF, but negatively correlated with ALB only at 1 d, and negatively correlated with PAB only at 1,7 d, and posi-tively correlated with CRP only at 7 d. Non-survivors had lower serum ChE activity and TRF than survivors at 1,3,7 d after trauma, but had lower ALB only at 7 d after trauma and had lower PAB only at 1,7 d after trauma than survivors, and had higher CRP than survivors only at 7 d after trauma. Logistic regression analysis showed serum ChE and PAB were the only two independent risk factors to judge prognosis. Conclusions Serum ChE may be in-cluded as negative acute-phase protein, and is better than other APPs in reflecting injury severity and prognosis in patients with multiple trauma.

Objective To explore the mechanism by which the anti-human P185erbB2 scFv-Fc-IL-2(HFI)modulates tumor surface molecules and activates immune effector cells in vitro. MethodsMTT assay was used to test the proliferation and the LAK-like cytotoxicity. Flow cytometry assay was used to test the expression of ICAM-1, Fas and erbB2 receptors in tumor cells and the expression levels of CD molecules FasL and LFA-1 in human PBMC. Antibody-dependent cell-mediated cytotoxicity(ADCC)mediated by HFI against SKOV3, MCF-7 and SGC-7901 tumor cells was explored hv LDH release assay. Results The expression levels of ICAM-1 and Fas on SKOV3 cell treated with HFI were upregulated, from 24.85％ and 0.53％ to 85.36％ and 59.19％ respectively, while the expression levels of erbB2 on SKOV3, MCF-7 and SGC-7901 tumor cells treated with HFI were downregulated, from 98.48％, 42.60％ and 36.66％ to 94.01％,30.95％ and 12.36％ respectively. HFI could significantly enhance the proliferation activity of human PBMC, and CD3+ CD8+ T cells and CD3- CD16+ CD56+ NK cells were elevated, from 24.37％ and 6.90％ to 38.80％ and 13.45％ respectively. The expression levels of CD25, LFA-1 and FasL were significantly enhanced from 3.99％, 86.52％ and 5.02％ to 12.96％, 99.06％ and 16.19％. The LAK-like cytotoxicity of human PBMC treated with HFI against SKOV3, MCF-7,SGC-7901 tumor cells was significantly improved:HFI was effective in mediating ADCC against SKOV3,MCF-7 and SGC-7901 tumor cells which expressed high,medium and low levels of erbB2,respectively,and HFI-induced ADCC was correlated with the degrees of erbB2 expression on the tumor cells. Conclusion The expression levels of ICAM-1 and Fas on SKOV3 cell treated with HFI are significantly upregulated. The expression levels of erbB2 on SKOV3, MCF-7 and SGC-7901 tumor cells treated with HFI are downregulated. HFI can significantly enhance the proliferation activity of human PBMC. The LAK-like eytotoxicity of human PBMC treated with HFI against tumor cells is significantly enhanced. HFI iS effective in mediating ADCC and the activity of HFI-induced ADCC is correlated with the degrees of erbB2 expression on the tumor cells.