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.

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 evaluate the impact of epidural anesthesia with levobupivacaine combined with general anesthesia on colon surgery. Methods Sixty patients undergoing elective radical procedure for colon carcinoma were randomLy divided into four groups: saline group (group S), 0.125% levobupivacaine group (group L1), 0.25% levobupivacaine group (group L2), and 0.5% levobupivacaine group (group L3). Group S received normal saline of 10 mL epidurally and then infusion of 5 mL·h-1 until the procedure was finished; groups L1, L2, and L3 received levobupivacaine instead. Anesthetic induction was performed after epidural puncture. Mean blood pressure and heart rate were recorded at 8 time points including 5 min after entering into the operation room, 1 min after intubation, skin incision, abdominal exploration, 1 h after skin incision, completion of operation, extubation, and leaving PACU; meanwhile blood glucose and cortisol were detected, anesthesia time, time to PACU stay, bleeding, transfusion volume, adverse reaction, and doses of propofol, remifentanil, ephedrine, and fentanyl were noted. Results Time to PACU stay was longer in S group than in other 3 groups. Doses of remifentanil and fentanyl were larger in L1 group than in L2 group and L3 group. Ephedrine dose in L3 group was larger than in other 3 groups. Blood sugar in L1 group was higher than L2 group and L3 group. Cortisol in S group was higher than in other 3 group. Cortisol in L1 group was higher than in L3 group. The number of patients with hypotension was greater in L3 group than other 3 groups. Conclusions Continue epidural infusion of 0.25%levobupivacaine can reduce stress response and opioid uses, shorten PACU stay, whereas it does not increase use of ephedrine.

The aim of the current study was to investigate the spectra in the different organs of the rats which died of massive hemorrhage; to explore their spectral changes 15 days postmortem and the best mathematical model with different band absorption ratio changes to postmortem interval(PMD; and to compare the spectral changes of different temperature.Thirty male Sprague-Dawley rats were sacrificed by cutting abdominal aorta,and the cadavers were divided equally and kept at 4 ℃,20℃ and 30℃ in the control chamber.From the same rat,seven different organs were sampled at intervals of 1-15 days postmortem,and then measured by Fourier transfom infrared (FTIR)spectrometer.Six mathematical model functions were explored.The absorbance of bands and band absorbance ratios of absorption peak in each organ showed a time-dependent increase or decrease,most band absorbance ratios remaining stable for 7-15 days postmortem.Cubic model functions of the various bands absorbance ratios against PMI showed a stronger related coefficient.The absorbance bands with obvious changes at 20 ℃ showed stabilized tendencies at 4 ℃ and significant changes at 30 ℃ within 15 days postmortem.In addition,FTIR spectroscopy revealed a time-dependent metabolic process,with potential of being used to estimate PMI during 7 days postmortem,which merits further investigation.

To evaluate the efficacy of HbA1C in diagnosing diabetes in subjects with primary hypertension.The results demonstrated that the area under the reciever operating characteristic ( ROC ) curve was 0.895,with corresponding sensitivity of 85.4％,and specificity of 82.2％,when the optimal cutpoint of HbA1C in diagnosing diabetes was 6.0％.Our study suggested that HbA1C ≥6.0％ can be used efficiently in diagnosing diabetes in patients with primary hypertension.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective:To summarize and analyze the clinical characteristics of hyperuricemia in adolescents, and improve the awareness of diagnosis and treatment among clinicians.Methods:Four adolescent cases of hyperuricemia with a clear family history were admitted to the Department of Endocrinology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from November 2015 to August 2021. Their clinical manifestations, laboratory tests, gene sequencing, and therapeutic effects were analyzed.Results:Among the 4 patients, there were 2 cases with mutation in uromodulin(UMOD)gene(c.453C>T, 1 homozygous mutation in p. C151C; c. 453C>Y, 1 heterozygous mutation in p. C151C); 1 case with compound heterozygous mutation in adenosine triphosphate binding cassette transporter G2(ABCG2)gene(c.421C>A p. Q141K; c. 34G>A p. V12M); and 1 case with homozygous mutation in the ABCG2 gene(c.421C>A, p. Q141K). The blood uric acid levels of 4 patients decreased significantly after medical treatment and lifestyle interventions.Conclusions:In addition to primary etiology, the cause of hyperuricemia in the adolescent can be associated with certain acute and chronic diseases as well as genetic conditions. Genetic testing is recommended for patients with a family history. Medication safety should be stressed in the treatment of adolescents.