[Summary] Serum cystatin C levels were measured by microparticle enhanced turbidimetry in 114 type 2diabetic patients without retinopathy (group A) and 105 type 2 diabetic patients with retinopathy (group B),as well as 47 normal healthy individuals as controls (group NC).The results showed that the serum cystatin C level of group B was much higher than those of group NC and group A (P＜0.05).However,there was no difference in serum cystatin C level between group NC and group A.Multivariate logistic regression analysis revealed that serum levels of cystatin C and cholesterol,and systemic blood pressure were independent risk factors of diabetic retinopathy in type 2 diabetic patients (all P＜0.05),suggesting that detection of serum cystatin C level may play an important role in early diagnosis and prevention of diabetic retinopathy.

Objective To explore of the color Doppler ultrasound diagnosed choledocholithiasis.Methods 100 cases with choledocholithiasis diagnosed by color ultrasonography and cholangiography were analysed retrospectively.The sensitivity,specificity,accuracy and the inspection time of two methods were compared.Results 90 cases were diagnosed after operation,90％ in 100 patients.The diagnostic accuracy of Doppler ultrasound was 88 cases,2 false negative cases,no false positive.The diagnostic accuracy of cholangiography was 87 cases,3 false negative cases,2 false positive cases.The sensitivity,specificity and accuracy of two groups were not statistically significant (x2 =0.23,1.25,0.57,P ＞ 0.05).The inspection time of color ultrasound was 12 ～ 28 min,the average inspection time was (16.57 ±4.12)min.The inspection time of cholangiography was 12 ～37min,the average inspection time was (21.09 ± 6.24) min.The inspection times of two ways were statistically significant (t =6.53,P ＜ 0.05).Followed up between 5 months and 2 years,there was no residual gallstone patients.Conclusion Color Doppler ultrasound is a noninvasive,safe,time-saving,simple,good repeatability,high successful rate,for common bile duct stones in the main examination methods.

Objective To observe the changes in cerebral microcirculation after subarachnoid hemorrhage(SAH) and to study its correlation with cerebral vasospasm(CVS).Methods Eighty-five SAH patients and 35 controls,enrolled in this study as perspective study subjects,were divided into SAH group and control group,CVS group and non-CVS group(nCVS),symptomatic CVS(sCVS) group and asymptomatic CVS(asCVS) group.All the subjects underwent CT perfusion(CTP) and the associated parameters,including cerebral blood flow(CBF),cerebral blood volume(CBV) and mean transit time(MTT),were recorded for final analysis.Results Compared to the control group,the CBF and MTT were significantly changed in SAH group(P

Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.

Objective To design nursing occupational safety and health curriculum reasonably.Methods With a semi-structured interview outline,focus group interviews among eight clinical nursing and nursing education specialists were conducted to develop the occupational safety and health curriculum design.Results It was important to set up nursing occupational safety and health curriculum.The main object,contents,teaching and evaluation methods were identified.Conclusions Occupational safety and health curriculum can be involved in nursing curriculum system to reduce occupational hazards and maintain physical and mental health of nursing students.

Objective To study the aberrant DNA methylation of H19 and MEST in infertile male sperm.Methods Routine semen analysis and morphological analysis were performed on 15 control individuals and 33 oligoastheno-teratozoospermias.Sperms were purified by density gradient centrifugation and DNA was extracted and treated with bisulfite.After PCR,the purified PCR products were cloned into pMD (R)18-T vector and proceed to chemical transformation,restriction enzyme reaction.For each sample,positive clones were selected for sequencing analysis and DNA methylation analysis.Results Five control individuals had high degree of H19 and methylation rate was 100.0％,while the methylation rate of 93.0％ in 10 oligoastheno-teratozoospermias was significantly lower.Significant difference was found in methylation rate between the control individuals and oligoastheno-teratozoospermias (P ＜ 0.01).As to MEST,10 control individuals had a low degree of MEST and the methylation rate was 1.6％,while the methylation rate in 23 oligoastheno-teratozoospermias was 4.8％.No significant difference was found in the methylation rate between control individuals and oligoastheno-teratozoospermias (P ＞ 0.05).Conclusion Male infertility is associated with aberrant methylation of H19 differentially methylated region,and it may be a biomarker of human spermatogenesis defect.

Objectives To investigate the rational treatment strategy of hepatoblastoma (HB) in children. Methods Clinical data and follow-up of 25 children with HB admitted from February 2009 to March 2013 were retrospectively analyzed. Results Twenty-five children with newly diagnosed HB (14 males and 11 females) were enrolled. The median age on diagnosis was 25 months (3-92 months);In 18 of 25 cases with complete resection of the primary tumor, 17 cases survived. Only 1 of 7 cases with incomplete resection survived. The survival rate in children with complete resection of primary tumor is significantly higher than those without complete resection (P<0.05). The survival rate in children of stage I or II is significantly higher than the children of stage III or IV (P<0.05). Conclusions Complete tumor resection is the cornerstone of therapy for long-term disease-free survival in HB patients. Treatment strategy remains to be further improved for children with recurrent and metastatic HB.

Objective To study the diagnostic value of pencilliosis marneffei (PM)in a non-HIV-infected child with the com-bined detection of aspergillosis galactomannan,fungus Glucan(1-3)-β-D and boold culuture.Methods The venous blood specimen from the child was collected for the quantified detection of aspergillosis galactomannan,fungus Glucan(1-3)-β-D. The growth and colonial morphology of fungus was inspected with the positive blood culture and the characteristics of fun-gus smear were observed under microscope.Results The result of aspergillosis galactomannan was 14.45 μg/L and fungus Glucan (1-3)-β-D 77.14 pg/ml.Penicillium marnrffei was identified using blood culture.It was mycelia form under 25℃ and the salouraud medium produced water soluble claret-red pigment produced.It was mycelia form under 35℃ and the colony was gyri creases,the characteristic broom-like hypha and separation hypha could be found under microscope.Conclusion It is effective for the early diagnosis and therapy of PM with the combination detection of aspergillosis galactomannan,fungus Glucan (1-3)-β-D and boold culuture and have better clinical diagnosis value.

Objective To analyze the basic clinical characteristics,auxiliary diagnostic indexes,bacterial infection spectrum and drug resistance of child urinary tract infection to provide the basis for the prevention,diagnosis and treatment of child UTI.Methods The clinical data in the inpatients with UTI or complicating UTI in our hospital from January 2012 to March 2014 were collected. The repeated strains were excluded.The differences in the pathogens between the patients with complicated UTI and the patients with non-complicated UTI were comprehensively analyzed.Results The onset peak of child UTI for the first time was 0 -0.5 years old.Escherichia coli ,Klebsiella and Pseudomonas aeruginosa are the major pathogens of child UTI,in which 110 strains were Escherichia coli,accounting for 52.9%.The enterobacteriaceae pathogens of UTI had higher sensitivity to carbapenems antibacterial drugs,with the resistance rate of less than 10%;the resistance rate of others detected antibacterial drugs was more than 20%.Con-clusion UTI in the children inpatients of this area has higher drug resistance rate,in the treatment of child UTI,the antibacterial drugs should be rationally used by combining the bacterial drug resistance situation in the local place and the disease severity in or-der to avoid the aggravation of bacterial drug resistance.

Objective To explore the subcellular localization of Galectin-9 and its effect on allogeneic immune response.Methods The plasmid pEGFP-N1 was inserted with Galectin-9 fragment which was amplified from pBKCMV-Galectin-9 by PCR.The recombinant plagmid wag then transfected into CHO cells using JetPEI in vitro.The cells were cultured in G418 selecting mediam to obtain the stably-transfected cells.The transcription and expression of Galectin-9 gene were verified by immunohistochemical staining and RT-PCR.The solid-phase transgenic CHO cells or freshly-cultured supernatant wag added into the mixed lymphocyte response system to detect the inhibitory effect of Galectin-9.Galectin-9 protein wag administered intraperitoneally for 7d consecutively.Results The expression of Galectin-9 wag localized in the cytosol of CHO.The allogeneic mix lymphocyte proliferation was dose-dependently inhibited by the freshly-cultured supernatant from stably-transfected CHO cells.Furthermore,the supernatant from stably-transfected CHO cells dose-dependently inhibited the level of IL-2.The inhibitory effect could be reversed by Tim-3-Fc blocking.Administration of Galectin-9 significantly prolonged the survival of allogeneic cardiac transplants[(22.7±1.2)d vs(7.2±0.4)d)].Conclusion Galectin-9 may be secreted in physical situation to exert its immunomodulatory function on allogeneic immune response.Furthermore.Galectin-9 may be a novel therapeutic drug in transplant medicine.