Objective　To assay serum cortisol concentration in type 2 diabetic patients and evaluate the relationship between serum cortisol concentration and insulin resistance. Methods　Serum cortisol concentrations were measured at 8 am, 4 pm and during oral glucose tolerance test(OGTT) in 60 newly-onset type 2 diabetic patients and 40 healthy subjects using RIA. Results　① Sernm cortisol concentrations were elevated in obese type 2 diabetic patients at 8 am and 4 pm as compared with non-obese patients and normal controls. ② Changes of serum cortisol concentration during OGTT were different between obese type 2 diabetic and non-obese patients: serum cortisol concentrations were decreased after glucose administration in non-obese patients but not in obese patients. ③ In type 2 diabetic patients, serum cortisol concentrations were negatively correlated with insulin sensitivity index (r=-0.34, P<0.01). Conclusion　There is some degree of abnormal in cortisol secretion in obese type 2 diabetic patients.

Objective To investigate the signal mechanism of protein kinase C alpha(PKC-α)participated in enhanced expression of type Ⅰ inositol 1,4,5-trisphophate receptors (IP3 RI) induced by tumor necrosis factor alpha(TNFα),in order to delineate the mechanisms of decreased glomerular filtration rate (GFR) in hepatorenal syndrome caused by TNFα.Methods The glomerular mesangial cells (GMCs)line from rats was chosen as experimental material.GMCs were divided into control (D),TNFα-2 h,TNFα-4 h,TNFα-8 h,and TNFα-24 h groups.Moreover,another two groups were sanflngol-8h (S),TNFα + Sanfingol-8h(TS)groups.The effect of TNFα on the expression of IP3RI was detected by immunocytochemical staining,Western blotting,teal time-polymerase chain reaction (PCR) assays.Results Immunocytochemical staining demonstrated that IP3 RI was mainly distributed in cytoplasm of GMCs.Enhanced positive staining was determined in all TNFα-treated groups,especially in TNFα-8 h group.Western blotting demonstrated that the expression of IP3RI protein was significantly higher in TNFα-4 h,TNFα-8h and TNFα-24 h groups than control group(4 h:1.82 ± 0.63 ; 8 h:2.95 ± 0.66 ; 24 h:2.48 ± 0.72 ; D:1 ±0.02 ; F =9.24,P ＜ 0.05).The expression of IP3 RI protein was the highest in TNFα-8 h and TNFα-24 h groups(P ＜0.05).No difference was found among S,TS,and control groups(S:1.39 ±0.65; TS:1.35± 0.37 ; P ＞ 0.05).Real time-PCR found the expression of IP3 RImRNA was significantly higher in all TNFα-treated groups than control group(2 h:3.35 ± 1.97; 4 h:3.16 ± 1.35; 8 h:3.70 ± 1.76; 24 h:4.49±1.70; D:1 ±0.01; F =6.167,P ＜0.05).No difference was found among all TNFα-treated groups(P ＞0.05).No difference was found among S,TS,and control groups(S:1.53 ±0.79; TS:1.32 ± 0.38 ; P ＞ 0.05).Conclusions IP3 RI was mainly distributed in cytoplasm of GMCs.TNFa could enhance the expression of IP3 RI protein and IP3 RI mRNA,which could be blocked by sanfingol,a PKCα inhibitor.It might be an important signal in the mechanisms of GFR decrease caused by TNFα in hepatorenal syndrome.

Objective To explore the electrophysiological and clinical features of various subtypes of Guillain Barr? syndrome (GBS). Methods The electrophysiological and clinical data of 100 cases with GBS admitted to Xijing Hospital from 1980 to 1999 were analyzed retrospectively. Correlations between varied subtypes and ages were examined by ? 2 test. Results Among the 100 patients with GBS, the demyelinating pattern was present in 51 patients, the axonal pattern in 25 patients, and 8 patients were inexcitable, 12 patients equivocal and 4 patients normal. The demyelinating pattern appeared as a major subtype not only in different age groups, but also in different test times after symptom onset. There was no statistically significant relationship between varied subtypes and ages. In the 100 patients, 32.0% suffered from a preceding upper respiratory infection, and 22.0% had a preceding gastrointestinal tract infection. The cases occurring in rural areas are almost in number equal to those in urban areas. That is, there was no a clear area distribution. Both demylinating and axonal GBS occurred throughout the year with a likely peak from July to September. Conclusion In the 100 patients with GBS admitted to Xijing Hospital, the demyelinating pattern was the major electrophysiological subtype. In addition, the electrophysiological and clinical features of various subtypes of GBS seemed to be different in some ways from those in the studies of both western countries and Li CY in northern China.

Objective To investigate the effects of methylation of p73 gene on pathogenesis of acute lymphoblastic leukemia.Methods The restriction endonuclease enzyme digestion combined with PCR was used to detect p73 gene and methylation in 42 patients with acute lymphoblastic leukemia.Results Methylation of p73 gene was found in 28.6%(12/42).Patients without methylation of p73 gene had a higher complete remission rate of first chemotherapy and a longer survival time than those with methylation of p73 gene.Conclusion Methylation of p73 gene probably plays a role in the pathogenesis of acute lymphoblastic leukemia and may have clinical significance in predicting prognosis of ALL.

5cm hepatic cancer, the effective rate (CR+PR) was 60 8% (62/102), no change (NC) rate 39 2% (40/102), and the 1-, 2-, 3-year survival rates 67 6% (69/102), 49 1% (50/102) and 39 2% (40/102), respectively. The effective rates (CR+PR) in patients with bone tumor and lung cancer were 100%(12/12) and 60%(3/5), respectively. There were no other severe complications found. Conclusions Ultrasound-guided microwave intervention is a safe, effective and feasible method for hepatic cancer, lung cancer and bone tumor.

Objective To analyze and evaluate the precision ,accuracy and linearity of the chemiluminescence method for detec‐ting plasma BNP .Methods According to the experimental schemes of CLSI EP15‐A2 ,EP6‐A files and other relevant documents , the precision ,accuracy and linearity of the Siemens Centaur XP chemiluminescence instrument for detecting BNP ,and the detection results were compared with the performance declared by manufacturer or the quality target formulated by laboratory .Results The imprecision of BNP detected by the chemiluminescence method was less than 1/3 TEa regulated by the Clinical Laboratory Center of Ministry of Health (allowable total error);the variation coefficient index (CVR) of internal quality control data was less than ± 2;the relative bias of the results of external quality control blind samples with the target values were less than Tea regulated by the Ministry of Health ;the linear evaluation results showed that BNP was once linearity in the range of 5 .3‐4696 .7 pg/mL .Conclusion The precision ,accuracy and linearity of the Siemens Centaur XP chemiluminescence instrument for detecting BNP can accord withthe quality objectives requirements and meet the clinical needs .

Objective To investigate the effection of Shenfu Injection (Ginseng-radix aconitum Injection)to the blood coagulation system and its prognosis in the patient of multiple trauma complicated with shock.Methods We prospectively studied 90 patients of multiple trauma complicated with shock,who came from the emergency center of the Second Affiliated Hospital of Medicine' s college of Zhe-Jiang University and emergency department of Lishui People' s Hospital from February 2007 to December 2011,and excluded those suffered with the dysfunction of coagulation system and uncontrolled ongoing bleeding before trauma.And then these eligible patients were randomly divided into two groups:treatment group ( 45 cases ) and control group (45 cases),the control group were received the routine treatment,the treatment group were received Shenfu Injection in early stage based on the routine treatment.The two groups were measured the platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (FIB) before treatment and 3,7 days after treatment.Results The differences of the PLT,PT,APTT,TT,FIB between the treatment group and control group at 3,7 d after the treatment was statistically significant (P ＜ 0.05 ). Conclusions Shenfu Injection has positive regulation to the coagulation system in the patient of multiple trauma complicated with shock.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective: To study the cytocompatibility of nanophase alumina ceramics with osteoblasts. Methods: Alumina ceramics were prepared via wet chemistry techniques. The grain size of alumina of interest in the present study was determined by scanning electron microscopy and atomic force microscopy with image analysis software. Primary osteoblast culture was established from rat calvaria. Protein content, synthesis of alkaline phosphatase(ALP) and deposition of calcium-containing mineral by osteoblasts cultured on nanophase alumina ceramics and conventional alumina ceramics for 7, 14, 21 and 28 d were respectively examined. Results: The average surface grain size of the nanophase and conventional alumina compact formulations was 60 nm and 1.80 ?m respectively.Synthesis of ALP and deposition of calcium-containing mineral were significantly greater by osteoblasts cultured on nanophase than those on conventional ceramics after 21- and 28- day culture. Conclusions: Nanophase alumina may stimulate ALP synthesis and calcium deposition of osteoblasts.

AIM:To analyze curative effect of laser treatment for diabetic retinopathy (DR).METHODS:A total of 100 patients (136 eyes) with DR who were admitted to our hospital during January 2015 to December 2016 were enrolled in the study.All patients were given 532nm laser treatment.Changes of visual acuity and the incidence of complications were statistically analyzed after treatment, and the macula central fovea retinal thickness and hemodynamic changes of affected eyes were compared before and after treatment.The effects of laser treatment were compared among patients with different types of diabetes, patients in different DR stages and patients with different glycosylated hemoglobin (HbAlc) levels.RESULTS:After treatment, the macula central fovea retinal thickness, end diastolic velocity (EDV), pulsatility index (PI) and central retinal artery (CRA), mean flow velocity (Vm) significantly decreased (P<0.05).After treatment, there were 2 cases (2 eyes) of bleeding and 2 cases (2 eyes) of tractional retinal detachment.The effective improvement rate of visual acuity was 83.1%.There were significant differences in the improvement rate of visual acuity among patients with different types of diabetes [type 1 (60.0%) vs type 2 (84.9%)], patients in different DR stages [preproliferative diabetic retinopathy (NPDR) 92.3%, early proliferative stage (PDR) 85.1%, high-risk PDR 54.2%] and patients with different HbAlc levels (< 8% 91.8% vs ≥8% 73.0%) (P<0.05).CONCLUSION:The 532nm laser treatment is effective for DR.It can significantly improve the retinal hemodynamics and visual acuity and relieve macular edema.Types of diabetes mellitus, stages of DR and blood glucose control effect may affect the effects of laser treatment.