OBJECTIVE:To explore the effects of vitamin C in different dosages on the activity of aldose reductase(AR) in renal cortex in rats with streptozotocin-induced diabetes METHODS:50 male Wistar rats(195?20)g were randomly divided into following groups:group C(control rats);group D(diabetic rats);group DT1(diabetic rats treated with vitamin C 30mg/(kg?d);group DT2(diabetic rats treated with vitamin C 90mg/(kg?d);group DT3(diabetic rats treated with vitamin C 270mg/(kg?d);The activities of AR in renal cortex and the concentrations of vitamin C in plasma and renal cortex were assayed 9 weeks after treatment RESULTS:Compared with group C,the levels of vitamin C in plasma and renal cortex decreased significantly(P

Objective To construct insulin B chain DNA vaccine and to perform a vaccinating trial for preventing mice from autoimmune diabetes induced by multiple low dose streptozotocin. Methods RT PCR was used to clone insulin B chain, and insulin B chain DNA vaccine was constructed. DNA vaccine was injected into tibilias anterior muscle of C57BL/6 mice in treatment group (T), prophylactic group (P). The morphology of mice islets was investigated by pathology, blood samples were taken to determine glucose and insulin. Group T and group P were compared with group of normal control mice (C) and group of untreated diabetic mice (D). Results (1) Insulin B chain gene was cloned by RT PCR, which ligated with pcDNA3 plasmid. Insulin B chain DNA vaccine was constructed. (2) In group P, after injection of DNA vaccines, 3 (3/10) and 4 (4/10) mice became diabetic in the second week and the third, fourth week respectively, the incidence was significantly less than those of groups D and T. The insulin level showed no difference between group C and the non diabetic mice of group P. The change of pancreas of diabetic mice in group P was similar to group D. Conclusion Insulin B chain DNA vaccine can prevent pre autoimmune diabetes.

Objective To determine the endothelial function, endothelin-converting enzyme (ECE) activity and ECE mRNA level in patients of diabetes with macroangiopathy, and to investigate the effect of the endothelial function change in type 2 diabetes and diabetes with macroangiopathy. Methods Sixty healthy persons and 40 patients of type 2 diabetes and 60 patients of type 2 diabetes with macroangiopathy were recruited for the study. The activity of ECE in white blood cells was measured by an established method. Endothelial function, ECE activity and expression of ECE mRNA were determined by ELISA, RIA and RT-PCR respectively. Results The expression of ECE mRNA and the ECE activity were increased in patients of type 2 diabetes, especially in diabetics with macroangiopathy. The damage of endothelial function in the diabetic patients was very common. Conclusion High level of ECE activity relates to the damage of endothelial function. High level of ECE activity and up-regulation of expression of ECE mRNA may play a key role in the development of diabetic macroangiopathy.

Objective:To investigate the mechanism of inducing immune tolerance of autoimmune diabetic mice by insulin B chain gene vaccine Methods:Insulin B chain DNA vaccine was constructed by genetic engineering techniques DNA vaccine was injected into tibilias anterior muscle of C57BL/6 mice Mice were divided into four groups at random: group control (C), group diabetes (D), group treatment (T), prophylactic treatment (P) Serum was taken to determine insulin, the expression of bcl 2 mRNA was determined by dot blot dehydribation Results:①After prediabetic mice were injected by DNA vaccines, the ratio of incidence of diabetes was 30% in 2 w, 40% in 3 w and 4 w, which were significantly higher than that of groups D and T, and lower than that of group C The level of insulin showed no difference between group C and the non diabetic mice of group P In contrast to non diabetic mice, the change of pancreas of diabetic mice in group P was similar to group D ②AGV of bcl 2 mRNA in thymus cells, spleen cells, and blood monocytes of effective mice in group P showed no difference with group C, but markly lower than those of group D & T Conclusion:Insulin B chain DNA vaccine could recover the balance of the development and activity of thymus cells, spleen cells and lymphocyte in prediabetic mice

Objective To study the relationship between the (C 106T) single nucleotide polymorphsim of promoter region of aldose reductase gene and type 2 diabetes mellitus with nephropathy in Chinese Han from Chongqing. Methods The (C 106T) allele and genotype of 192 patients of type 2 diabetes were examined by polymerase chain reaction agarose gel electrophoresis and restriction enzyme Bfa Ⅰ. Results The frequencies of both allele C and genotype CC were significantly higher in type 2 diabetes patients with albuminuria than in those without albuminuria. Logistic regression analysis showed that allele C and genotype CC were associated with diabetic nephropathy in type 2 diabetes mellitus patients( P =0.032 and 0.046, respectively). Conclusion This finding suggests that (C 106T) single nucleotide polymorphism in the aldose reductase gene promoter region may be associated with diabetic nephropathy of Chinese Han type 2 diabetes. It may be a functional polymorphism and can serve as an inherited marker for susceptibility of diabetic nephropathy.

Objective To study the effects of electro-acupuncturing points of Yangming meridians on hemiplegia.Methods45 early hemiplegic patients were divided into Groups A,B and C(18 cases in each group).Physical therapy was performed in each group,those in Group B were electro-acupunctured at points of Yangming meridians,while those in Group C at the points according to balancing muscular tension.They were assessed with Fugl-Meyer Assessment and Ashworth Spasm Rating before and 2,4 weeks after treatment.Results2 weeks after treatment,motor function and muscular tension were significantly improved in all the groups,while the efficacy in Groups B and C was superior to Group A(P<0.05).4 weeks after treatment,the Ashworth score of lower extremity in Group B was superior to Groups C and A(P<0.05).ConclusionElectro-acupuncturing at points of Yangming meridians can improve the motor function especially muscular tension in hemiplegic patients,which may be helpful for flaccid paralysis,but adverse for spastic paralysis.

Objective To study the efficacy of T-piece resuscitator on the very preterm infants in the delivery room.Method Very preterm infants (gestational age 28 ～ 31 weeks) who needed positive pressure ventilation during delivery room resuscitation were included in the study between January 2010 and December 2015.Enrolled infants were randomly assigned to self-inflating bag group and T-piece group.Tracheal intubation ratio,duration of mechanical ventilation,continuous positive airway pressure (CPAP),supplementary oxygen through a nasal cannula and total oxygen requirement were compared between groups.The percentages of pneumothorax,sepsis,necrotizing enterocolitis (NEC),bronchopulmonary dysplasia (BPD),retinopathy of prematurity (ROP),intracranial hemorrhage and patent ductus arteriosus (PDA) between groups were also compared.Data were analyzed using independent sample t test and chi-square test.Result A total of 51 preterm infants were enrolled in this study,with 25 infants in the self-inflating bag group and 26 in the T-piece group.There was no statistically significant difference in the gender,gestational age,birth weight,Apgar scores,delivery mode and antenatal glucocorticoids between the two groups (P ＞ 0.05).The ratio of intubation in T-piece group was significantly lower than that in self-inflating bag group (15.4％ vs.44.0％,P ＜ 0.05).Further more,duration of mechanical ventilation and total oxygen requirement in the T-piece group were significantly shorter than those in the self-inflating bag group [(4.2±2.8) dvs.(10.1 ±4.3) d,(36.2±14.7) dvs.(47.2±19.2) d,P＜0.05].However,the duration of nasal CPAP and supplementary oxygen through a nasal cannula,the rate of pneumothorax,sepsis,NEC,BPD,ROP,intracranial hemorrhage and PDA did not differ significantly between groups (P ＞ 0.05).Conclusion Compared with the self-inflating bag group,the use of the T-piece in delivery room decrease the rate of tracheal intubation and the duration of mechanical ventilation and total oxygen requirement.

Objective To improve the knowledge of primary gout in children. Methods Clinical data of a 12-year-old girl with primary gout was collected. Analysis of UMOD gene, REN gene and HNF-1βgene was performed using PCR and di-rect sequencing. Results The girl was admitted for 1-month history of left hallux pain accompanied with elevations of serum uric acid concentration and serum creatinine concentration. Several examinations showed serum uric acid/creatinine ratio was greater than 2.5. The fractional excretion of uric acid was 3.4%-6.6%. The X-ray showed that the proximal phalanxes of halluces were erosion. The diagnosis of renal biopsy was ischemic renal injury and chronic tubulointerstitial nephropathy. Blood uric acid concentrations of parents were normal, and the family history of gout was negative. Two single nucleotide polymorphisms (c.264C>T heterozygous and c.866-71 G>A heterozygous) in UMOD gene, 1 single nucleotide polymorphism (c.373+44C>G heterozygous) in REN gene, and 2 single nucleotide polymorphisms (c.100-50-49ins TCTG heterozygous and c.781-22T>C homozygous) in HNF-1βgene were detected. No pathological mutation was detected in these 3 genes. Conclusions This child is highly suspected to have primary gout caused by familial juvenile hyperuricemic nephropathy.

With the rapid development of tumor subjects and the advance of medical technology,tumor mortality is declining in spite of the increase in tumor incidence.The male survivors pay more and more attention to their prognosis to improve the quality of their life.In the meantime,whether they could produce their own offspring become the main concern of tumor patients with good prognosis.However,until now,male tumor patients,their relatives,different social sectors and even some of our health workers,havent noticed the importance of fertility preservation and long-term fertility desires of male patients with tumor which will lead to declined or even irreversible sterility induced by the lack of fertility preservation before anti-tumor therapy.It's an important way to do fertility counseling,learn the risk of their treatment plans and choose the appropriate technique of fertility preservation which will improve prognosis quality of life of male tumor patients.This article will review the effects of tumor and the treatment on male fertility,their subjective needs and concerns,main methods for fertility preservation and the domestic and foreign research present situation.

Objective To explore the effects of quality improvement in delivery room resuscitation on very/extremely low birth-weight infants (VLBWI/ELBWI). Methods A retrospective analysis was performed to analyze the clinical data of VLBWI/ELBWI who were admitted to the Neonatal Intensive Care Unit (NICU) of Nanjing Maternity Hospital Affiliated to Nanjing Medical University from January to December 2015 (pre-improvement group, n=176) and of those who were admitted from January to December 2016 after the implementation of quality improvement program on delivery room resuscitation (post-improvement group, n=199). Several parameters were monitored, including resuscitation modalities [continuous positive airway pressure (CPAP) , peak inspiratory pressure (PIP)+positive end expiratory pressure (PEEP) with T-piece resuscitator and intubation rate in delivery room], neonatal body temperature and pH on NICU admission, respiratory outcomes, morbidity from intraventricular hemorrhage, necrotizing enterocolitis, retinopathy ofprematurity and hospitalization. Chi-square (or Fisher's exact test), t or rank Sum test was used for statistical analysis. Results There was no significant difference in gestational age, birth weight, gender proportion, delivery mode and Apgar scores between the two groups (all P>0.05). After implementing the quality improvement program, there was an increased overall usage of CPAP [85.9% (171/199) vs 66.3% (112/176), χ2=19.881, P<0.01] and PIP+PEEP with T-piece resuscitator [33.8% (67/199) vs 10.8% (12/176), χ2=19.819, P<0.01], but a decreased usage of balloon catheter ventilation [6.0% (12/199) vs 39.3% (44/176), χ2=53.682, P<0.01]. No significant change in intubation rate was observed(P>0.05). The average admission temperature increased after launching the quality improvement program [M (P25-P75), 36.2 (35.8-36.5) vs 35.6 (35.4-35.7)℃ , Z= - 9.681, P<0.01]. The morbidities of pulmonary hemorrhage within one week after birth [1.5% (3/199) vs 5.1% (9/176),χ2=3.921] and grade Ⅲ / Ⅳ intraventricular hemorrhage [1.1% (2/199) vs 11.9% (21/176), χ2=33.885] decreased along with the improvement in delivery room resuscitation (both P<0.05). The duration of invasive ventilation decreased as well [3 (1-6) vs 4 (2-9) d, Z= - 2.286, P<0.05]. Conclusions Quality improvement in delivery room resuscitation measures standardizes the management of delivery room resuscitation and improves the clinical outcomes of VLBWI/ELBWI.