Objective To investigate the protective effect of Quercetin on kidneys in diabetic rats. Methods STZ induced diabetic rats were given quercetin 100 mg?kg -1 ?d -1 for 8 weeks. Urinary albumin excretion rate (UAER) was measured by radioimmunoassay. The changes of creatinine clearance rate (Ccr) and glomerular protein kinase C (PKC) activities were determined. The expression of TGF ? 1 mRNA of renal cortex in diabetic rats were determined by RT PCR analysis. The glomerular changes were also observed morphologically. Results In untreated diabetic rats, Ccr, UAER, kidney weight/body weight and PKC activity in renal glomeruli were significantly increased, the expression of TGF ? 1 mRNA in renal cortex was elevated, and glomerular hypertrophy existed. After Quercetin treatment, Ccr, UAER, PKC activity and the expression of TGF ? 1 mRNA were markedly reduced as compared with those of untreated diabetic rats in 2 and 8 weeks, no significantly abnormal changes in kidney morphology were observed in Quercetin treated group. Conclusion Quercetin ameliorates early diabetic renal hyperdynamic abnormality via inhibiting PKC activity, in which inhibiting of TGF ? 1 production seems to be involved. Reduction of the PKC activity is important in preventing or delaying the development of diabetic nephropathy.

Objective To observe the clinical effect of percutaneous transluminal angioplasty (PTA)combined with autologous peripheral blood stem cells(PBSC)transplantation in the treatment of lower extremity ischemic disorders.Methods Fourty-two cases of lower extremity ischemic disorders in the treatment group were treated with PTA and autologous peripheral blood stem cells injection and 40 cases in control group were treated with PTA exclusively.Results All the procedures were successful.In treatment group,ABI improved from 0.32 ±0.11 to(at the 3rd month)and 0.49 ±0.13(at the 6th month)(t=-6.765,-6.040,P＜0.05)while TcPO_2 improved from(26.1 ± 2.3)mm Hg to(32.7 ±4.2)mm Hg(at the 3rd month)and(34.5 ±2.7)mm Hg(at the 6th month)(t=-8.901,-14.250,P＜0.05).In control group,ABI improved from 0.30 ±0.12 to 0.47 ±0.15 and 0.47 ±0.130=-5.631,-5.873,P＜0.05)while TcPO_2 increased from(25.9 ±2.4)mm Hg to(28.9 ±2.9)mm Hg(at the 3rd month)and(28.9 ± 2.1)mm Hg(at the 6th month)(t=-5.090,-5.389,P＜0.05).There was significant difference in TcPO_2 on follow-up between the two groups after the treatment(P＜0.05).Conclusion Autologous PBSC transplantation in combination of PTA was effective for the treatment of lower extremity ischemic disorders.PBSC injection helps to increase TcPO_2.

The effects of pioglitazone on the expressions of hypoxia-inducible factor-1 α (HIF-1 α) and vascular endothelial growth factor (VEGF) in renal tissues of diabetic rats were observed. Diabetic rat model was established by feeding high-carbonhydrate-fat diet and injecting streptozotocin. After the treatment with pioglitazone, the kidney index, 24 h urinary albumin, blood urea nitrogen, serum creatinine, fasting blood glucose, fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol,triglycerides, and low-density lipoprotein-cholesterol of diabetic rats were significantly lower than those of untreated ones, high-density lipoprotein-cholesterol was increased, the expressions of HIF-1α and VEGF in renal tissue were decreased ( all P＜0. 01 ). It suggested that pioglitazone may improve renal function and the balance of glucose-lipid metabolism in diabetic rats via down-regulating HIF-1/VEGF pathway.

OBJECTIVE To introduce a new type of tracheal cannula which has the top hole and can seal the outlet for patient with severe brain injury after tracheotomy. METHODS Patients with severe brain injury after tracheotomy were divided into test group using the new type of tracheal cannula(25 cases) and control group using the cuffed Portex tube(25 cases).The incidence,the onset time and the time for control of pulmonary infection were compared between the two groups. RESULTS In the test group,the incidence of pulmonary infection was 52%(13 cases),the onset time was(3?1.3) days and the time for control was(5?1.7) days;in the control group,the above indices were 84%(21 cases),(3?1.5) days and(12?2.2) days separately. CONCLUSIONS The new type of tracheal cannula which has the top hole and can seal the outlrt is better than the cuffed Portex tube in the prevention and treatment of pulmonary infection after tracheotomy.

ObjectiveTo investigate the effects of liraglutide on the differentiation of human bone marrow mesenchymal stem cells (hBM-MSCs) into insulin-producing cells (IPCs).MethodsIn vitro,hBM-MSCs were induced into IPCs by three-stage induction procedure containing high glucose,nicotinamide,and liraglutide.The morphological change of cells was observed by inverted microscope during induction and the induced cells were confirmed by dithizone(DTZ) staining.The protein expressions of pancreatic and duodenal homeobox-1 (PDX-1),glucose transporter 2 (GLUT2),glucokinase(GK),and insulin in each stage of the induced cells were detected by Western blot.Insulin secretion was measured by ELISA.ResultsThe induced effect was pronounced after adding 10 nmol/L liraglutide for 7 days.Cells began to aggregate and get round gradually during induction,and the morphology of most cells appeared as grape-like aggregation and clustered islet-like cells by the end of induction.The number of DTZ positive cells and the protein expressions of PDX-1,GLUT2,GK,and insulin were increased gradually( P＜0.05 ).The basal and glucose-stimulated insulin secretion from induced cells was also increased gradually(P＜0.05).Conclusion BM-MSCs could be induced into IPCs by high glucose,nicotinamide,and liraglutide in vitro.

Objective To investigate the association of chlamydia pneumoniae infection with ankylosing spondylitis (AS).MethodsSerum samples were obtained from 33 AS patients and 22 healthy controls.Enzyme-linked immunosorbent assay (ELISA) was applied to mearsure serum anti-Chlamydia pneumoniae antibodies (IgM/IgG),while immunofluorescence assay (IFA) was used to detect Chlamydia pneumoniae LPS antigen,and polymerase chain reaction (PCR) was used to amplify Chlamydia pneumoniae DNA in peripheral blood cells. Immunohistochemistical technique was applied to examine Chlamydia pneumoniae LPS antigen in synovial tissue from another 9 AS patients who received total hip replacement and 13 patients with comminuted femoral fractures.ResultsThe positive rates of Chlamydia pneumoniae IgM,LPS antigen and chlamydia pneumoniae DNA were higher in AS patients than those in healthy controls (78.8％ vs 22.7％,x2 =16.867,P =0.000; 66.7％ vs 31.8％,x2 =6.431,P =0.011; 33.3％ vs 9.1％,x2 =4.298,P =0.038).Chlamydia pneumoniae DNA positive rate was correlated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (Z =-2.774 and -2.829,P =0.004).In synovial tissues,chlamydial LPS-containing inflammatory cells were observed in 77.8％(7/9) AS patients,while those in fracture patients was 30.8％ ( 4/13 ) ( P =0.08 ).Conclusion Chlamydia pneumoniae infection is common in blood circulation and joint cavity of AS patients and may be associated with the pathogenesis of AS.

Objective To investigate the protective effect of quercetin on diabetic nephropathy and to explore its possible mechanism.Methods Type 2 diabetes mellitus rat model was established by feeding high-carbonhydrate-fat diet and injecting with streptozotocin.At 72 hour after injection,blood samples were collected from the tail veins of all rats.Those rats with blood glucose level ≥ 16.7 mmol/L were considered as the diabetes model been successfully established.The model rats were randomly divided into type 2 diabetic group ( group DM,n =9 ) and quercetin group ( group QUE,n =9 ).Other rats were used as normal controls (group NC,n =8).All rats were performed by intragastric administration for 8 weeks.At the end of experiment,the rats were sacrificed and fasting plasma glucose( FPG),fasting insulin( Flns),serum creatinine (SCr),blood urea nitrogen(BUN),TG,TC,LDL-C,24 h urine protein (24 h UP),and kidney index ( KI ) were evaluated.Pathological changes of kidney were observed by periodic acid-silver metheramine( PASM ).The expressions of ubiquitin and NF-κB p65 on glomeruli w ere examined by immunohistochemical method,and its association with the incidence of proteinuria was analyzed.Results In groups DM and QUE,the level of FPG [ ( 25.45 ± 1.23 ) mmol/L and ( 19.99 ± 1.20 ) mmoL/L],FIns [ ( 25.67 ± 2.58 ) mU/L and ( 19.29 ± 1.80 ) mU/L ],SCr[ ( 44.00 ± 2.53 ) μmol/L and ( 34.43 ± 2.23 )μmol/L],BUN[ ( 11.60 ± 0.39 )mmol/L and (8.20 ± 0.37) mmoL/L],TG [ (3.32 ± 0.22 ) mmol/L and (2.43±0.25)mmol/L],TC[(2.95 ±0.21) mmol/L and (2.24 ±0.17)mmol/L],LDL-C[(2.03 ±0.22 ) mmol/L and ( 1.49 ± 0.13 ) mmol/L ],24 h UP [ ( 46.67 ± 2.50 ) mg/24 h and ( 25.57 ± 2.82 )mg/24 h]and KI[ (9.76 ±0.30) × 103 and (8.44 ±0.26) × 103 ] were significantly increased than the indexes of group NC [ (6.56 ± 0.41 ) mmol/L,( 12.63 ± 1.41 ) mU/L,( 22.88 ± 2.36 ) μmol/L,( 5.45 ±0.51 ) mmoL/L,( 1.64 ± 0.1 1 ) mmol/L,( 1.33 ± 0.17 ) mmol/L,(0.46 ± 0.05 ) mmol/L,( 12.38 ±1.19)/24 h and (6.78 ±0.12) × 103].Moreover,the above indexes in group QUE were obviously lower than group DM.There was evidence of pathological changes associated with diabetes,such as focal and segmental sclerosis and thickened basement and mesangial expansion.The expressions of ubiquitin and NF-κB p65 in renal tissues of group DM increased significantly ( P ＜ 0.01 ).The expression of ubiquitin and NF-κB p65 were positively related with the level of 24 h UP ( r =0.893,0.879,P ＜ 0.01 ).Compared with group DM,all above indexes in group QUE were markedly alleviated ( P ＜ 0.01 ).The expression of ubiquitin and NF-κB p65 was reduced but didn't reach level in group NC ( P ＜ 0.01 ).Conclusion The increased expression of NF-κB induced by ubiquitin-proteasome system may participate in the pathogenesis of proteinuria in diabetic nephropathy.Quercetin has renal protective effects partly through reducing NF-κB p65 expression.

Objective To investigate the association of Mycoplasma pneumoniae(MP) infection with disease activity of ankylosing spondylitis. Methods A total of 158 subjects in our hospital were enrolled in this study, including patients with ankylosing spondylitis(AS, n=66), rheumatoid arthritis (RA, n=31),osteoarthritis(OA, n=25) and normal controls(NC, n=36). MP infection was defined as anti-MP IgM antibody positive. Anti-MP IgM antibodies were determined by a mycoplasma pneumoniae(Mac strain)membrane-based agglutination test. AS patients were divided into two groups: MP infection group and non-MP infection group. T-test was used for statistical analysis of age, blood white cells, ESR, CRP, immunoglobulin, BASDAI index, global assessment on VAS scale, Schober test and chest expansion reflecting spinal mobility.χ2-test was used to compare the positive rate of MP infection in different groups. Gender difference and prevalence of clinical infection in past four weeks between MP infection and MP-free group in AS patients was also compared. Ridit analysis was used to analyze the association of MP infection with degree of sacroiliac damage on CT. Results The prevalence of MP infection in AS (52%, 34/66) was much higher than that in rheumatoid arthritis (RA, 6%, P＜0.01 ), osteoarthritis(OA, 4%, P＜0.01 ) and normal controls (NC, 11%, P＜0.01) . Compared with the non-MP infection group, the MP infection group had more active disease in term of BASDAI(4.0±1.1 vs 3.0±1.9, P=0.017), ESR[(44±32) mm/1h vs (28±23) mm/1h, P=0.029], CRP [(40±38) mg/L vs (22±21) mg/L, P=0.025] serum total IgG level [(18±3) g/L vs (16±5) g/L, P=0.027],but not in serum total IgA and IgM. Regarding to the sacroiliac joint and spinal mobility, MP infection group did not exhibit any association with the sacroiliac grading on CT, Schober test and expansion. In AS patients with MP infection, only 44.1%(15/34) was complicated by clinical manifestations of upper respiratory tract in the past 4 weeks. However, a higher prevalence of MP infection was found in AS patients with clinical manifestation of upper respiratory tract, compared with those with negative clinical manifestation(71% vs 42%,P=0.027). Conclusion Mycoplasma pneumoniae is the most common reported pathogen in ankylosing spondylitis and relates to the disease activity of AS. MP infection is probably a principal triggering factor in the pathogenesis of AS.

Objective To analyze the efficacy and effects of balloon dilation combined with iliac vein balloon dilatation on complications and coagulation function of acute deep venous thrombosis of lower limbs(DVT)complicated with Cockett syndrome.Methods Data of 102 patients with acute DVT combined with Cockett syndrome admitted to the hospital from March 2018 to September 2022 were retrospectively analyzed,including 53 patients treated with catheter thrombolytic balloon dilation of iliac vein(recorded as the study group)and 49 patients treated with catheter thrombolytic therapy(recorded as the control group).Both groups were followed up for 1 year.Thrombosis clearance,edema reduction of affected limb,lower limb hemodynamics,coagulation function,peripheral blood inflammatory factors,complications and thrombosis recurrence were compared between the two groups.Results The thrombus removal grade of the study group was better than that of the control group(P＜0.05).Before and 1 year after surgery,In the control group,the leg circumference diameter difference above the knee between the affected side and the healthy side was(8.02±1.41)cm and(2.89±0.32)cm,respectively.In the study group,the data were(8.19±1.38)cm and(2.57±0.29)cm,respectively.Before and 1 year after surgery,in the control group,the leg circumference diameter difference below the knee between the affected side and the healthy side was(6.84±1.18)cm and(2.13±0.38)cm,respectively.In the study group,the data were(6.63±1.09)cm and(1.76±0.32)cm,respectively.The difference was statistically significant(P＜0.05),and the study group was lower 1 year after surgery(P＜0.05).The average blood flow velocity of femoral vein in control group was(24.75±4.03)cm/s and(28.82±4.29)cm/s before and 3 days after surgery,respectively.In the study group,the data were(24.02±3.86)cm/s and(30.94±4.37)cm/s,respectively.The femoral vein blood flow before and 3 days after surgery in the control group was(13.02±2.12)ml/s and(15.05±2.29)ml/s,respectively,while that in the study group was(13.36±2.09)ml/s and(16.26±2.34)ml/s,with statistical significance(P＜0.05).The study group was higher 3 days after surgery(P＜0.05).The prothrombin time before and 3 days after operation were(22.93±2.04)s and(18.13±1.34)s in the control group,and(23.24±1.99)s and(17.29±1.21)s in the study group,respectively.The thrombin time before and 3 days after operation were(24.86±2.31)s and(21.04±1.75)s in the control group,and(24.13±2.16)s and(19.89±1.53)s in the observation group,respectively.The activated partial thromboplastin time before and 3 days after surgery was(59.21±3.92)s and(49.13±3.02)s in control group,and(60.17±3.85)s and(47.09±2.98)s in observation group,respectively,and the difference was statistically significant(P＜0.05).It was lower 3 days after surgery in study group(P＜0.05).In the study group,preoperative tumor necrosis factor(TNF)-α,platelet activating factor(PAF)and thromboxen B2(TXB2)were(31.91±4.89)ng/L,(14.59±2.36)pg/ml,and(213.12±30.98)pg/ml,respectively.Three days after surgery,the levels were(36.24±4.29)ng/L,(16.12±2.59)pg/ml,and(239.86±32.85)pg/ml,respectively,with statistical significance(P＜0.05).TNF-α,PAF and TXB2 were higher in the study group 3 days after surgery(P＜0.05).There was no significant difference in the incidence of total complications between the two groups(P＞0.05).The recurrence rate of thrombosis in study group was lower than that in control group(3.77％vs 16.33％,P＜0.05).Conclusion Catheter thrombolytic balloon dilation of iliac vein for acute DVT complicated with Cockett syndrome can enhance the thrombolysis effect,improve the swelling of the affected limb,lower limb hemodynamics and coagulation function,and reduce the risk of thrombosis recurrence,which is safe and reliable.However,this treatment plan can mediate the occurrence of inflammation,and reasonable anti-inflammatory therapy should be actively implemented after surgery.

Objective To explore the effect of different blood glucose monitoring frequency on blood glucose fluctuation and control in type 2 diabetes mellitus patients with intensive insulin therapy .Methods One hundred and twenty type 2 diabetes mellitus patients with intensive insulin therapy were chosen and randomly divided into three groups .The three times group received 3 times monitoring including fasting , after breakfast and bedtime , and the five times group received 5 times monitoring including fasting , after breakfast , before supper , bedtime and before dawn , and the eight times group received the 8 times monitoring including before and after every meal , bedtime and before dawn , and the changes of the hemoglobin A 1 c ( HbA1 c) were observed for 4 weeks before and after the treatment .Results The average levels of HbA 1 c in the three groups were decreased 4 weeks after treatment in the three groups , and the difference was not statistically significant ( F=0.301, P>0.05).No difference was found in the fasting blood glucose and blood glucose before supper in the three groups (F=1.450, t=1.760;P>0.05).The levels of blood glucose after breakfast were respectively (8.78 ±0.90), (9.08 ±0.63), (7.49 ±1.01) mmol/L in the three groups, and the level of blood glucose in the eight times group was better than those of the three and five times groups , and the difference was statistically significant (F=23.340,P<0.05).The levels of bedtime blood glucose were respectively (8.07 ±0.59), (8.32 ±0.75), (7.28 ±0.54) mmol/L in the three groups, and the blood glucose fluctuation range in the eight times group was lowest, and the difference was statistically significant (F=32.880, P<0.05).The level of blood glucose before dawn in the eight times group was (6.68 ±0.59) mmol/L, and was better than (7.75 ±0.77) mmol/L in the five times group, and the difference was statistically significant (t=4.170, P<0.01).The average levels of 24 h blood glucose in the three groups were respectively (8.33 ±1.20), (8.26 ± 0.97), (7.84 ±1.15) mmol/L, and the blood glucose control in the eight times group was best , and the difference was statistically significant (F=22.36, P<0.05), and the detection rate of hypoglycemia was 33.3%in the small hours.Conclusions The blood glucose fluctuation range in the eight times group is minimum.The many times blood glucose monitoring in type 2 diabetic patients with intensive insulin therapy , at least 3 times daily, can reduce and prevent the incidence of hypoglycemia .