Opjective To study the prevalence of diabetic nephropathy of type 2 diabetes and its correlated risk factors. Methods 1 059 cases with type 2 diabetes in our university hospital during the period of 1997-2000 were screened for diabetic nephropathy,and its correlated risk factors were analysed. Results The prevalence of diabetic nephropathy and end stage of renal disease were 9.73% and 5.47%, respectively. Hypertension and dyslipidemia characterized with hypertriglycemia and low leve1 of HDL were the main risk factors of type 2 diabetic nephropathy. There was no significant relationship between single-determining HbAlc level and UAER. Conclusion The prevalence of diabetic nephropathy of this study was slightly lower than that reported by other authors in western countries,and the risk factors were consistent with those papers.

Objective To evaluate the effect of transverse position and numbers on the stability of the spinal pedicle screw fixation during the pedicle cortex perforation. Methods The vertebral compression fracture was performed in the L1 vertebral body using the Chiba's method from 60 fresh thoracic and lumbar vertebrae samples of sheep(T13-L3),which were randomly divided into 6 groups(A,B,C,D,E,and F)using a lottery method. Bilateral pedicles of vertebral arch of T14 and L2 were inserted pedicle screws,connecting titanium rods to fix T14-L2 segments. Then the samples of groups B,C,D,E,and F were removed a quarter of right side of lateral T14 thoracic pedicle cortical,which were considered the pedicle cortex perforation model. Finally,each group was fixed on different numbers of crosslinks:group A(0 crosslink,Intact),group B(0 crosslink,NCL),group C(1 crosslink,1/2 of the rods,MCL),group D(1 crosslink,1/3 of the rods close to T14,PCL),group E(1 crosslink,2/3 of the rods away from T14,DCL)and group F(2 crosslinks,1/3 and 2/3 of the rods respectively,TCL). After all samples were subject to 10 000 times of fatigue test with biomechanics test machines,the axial compressive stiffness,range of the motion(ROM)of the 6 directions(flexion,extension,lateral bending,and axial rotation),and the maximum pullout of the screws of the T14 pedicle cortex perforation were measured and compared among these 6 groups. Results The axial compressive stiffness in groups A,C,D,E,and F was significantly higher than that in group B(all P<0.05),and group A was significantly higher than group F(P<0.05) . The maximum pullout in groups A,C,D,E,and F were significantly higher than that in group B(all P<0.05),and group A was significantly higher than group F and groups C,D,and E were significantly lower than group F(all P<0.05). ROM of flexion,extension,lateral bending,and axial rotation in groups A,B,C,D,E,and F were significantly lower than that in group B(P=0.000),and ROM of left and right axial rotation in groups C,D,and E were significantly higher than in that group F(P=0.000). Conclusions During the pedicle cortex perforation,adding of one crosslink can improve the stability of the pedicle cortex perforation,and adding of two crosslinks can approximately achieve the same stability as the pedicle screw fixation with no pedicle cortex perforation. The location of the crosslink has no obvious effect on the short segment of spinal fixation.

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.

Objective The effect of lead exposure on children is consistently associated with intellectual and other neurologic deficits.However the exact mechanism by which Pb~(2+) exerts toxic effects on developmental central nervous system remains unknown.Our group has found by gene-chip test that the expression of metabotropic glutamate receptor subtype 5 (mGluR5) mRNA was changed by lead exposure.The present study aimed to examine the effects of different level of lead exposure on the expression of mCluR5 in gestation and lactation.Methods Sprague-Dawley rats were exposed to lead acetate during gestation and lactation.Three concentrations of 0.05%,0.2%,and 0.5% lead acetate were applied and considered as low,middle and high exposure group respectively.The Pb levels of blood and hippocampus of pups were analyzed at weaning to evaluate the actual lead content at the end of the exposure.The impact of lead exposure on the expression of mGluR5 mRNA and protein in hippocampal tissue of pups was investigated by quantitative real-time polymerase chain reaction (PCR) and Western blot.The potential role of the expression of mGluR5 mRNA and protein in lead neurotoxicity were discussed.Results The levels of lead in blood and hippocampus from lead-exposed rats were significantly higher than those in the controls and positively related to the degree of lead exposure.The results of real-time PCR and Western blot showed that exposure to lead acetate decreased the expression of mCluR5 mRNA and protein with a dose-dependent manner.Conclusions Hippocampal mGluR5 might be involved in lead-induced neurotoxicity.

Objective To study the effect and its possible mechanism of p66shc on endothelial dysfunction induced by hydrogen peroxide(H2O2).Methods Human umbilical vein endothelial cells (HUVEC) were used and cultured.H UVEC cells were untreated(control group)or treated with four groups of H2O2,H2O2 plus protein kinase C (PKC) inhibitors,H2O2 plus PKC activator,H2O2 plus P38 inhibitor for 30 minutes respectively,and cells were collected after 24 hours.The apoptosis,viability,proliferation of HUVEC were detected with immune fluorescent staining,MTT and Ki-67 respectively.P66shc and ser36 p66shc (p-p66shc)protein expressions were assessed using Western blotting.P66shc mRNA expression was measured with real-time quantitative polymerase chain reaction (RT-PCR).Results H2O2 induced HUVEC dysfunction which decreased HUVEC proliferation and increased the apoptosis of HUVEC.The expressions of p66shc,p-p66shc protein and p66shc mRNA were significantly increased after treating with H2O2.PKC inhibitor inhibited a H2O2 induced HUVEC dysfunction through increasing HUVEC proliferation activity and reducing cell apoptosis.The expressions of p66shc,p-p66shc protein and p66shc mRNA were significantly decreased after treating with H2O2 plus PKC inhibitor.PKC activator enhanced H2O2-induced HUVEC dysfunction and increased the expressions of p66shc.P38 inhibitor had no obvious effect on H2O2-induced HUVEC dysfunction and the expressions of p66shc.Conclusions p66shc may play an important regulatory rote in endothelial dysfunction caused by H2O2.P66shc may regulate a H2O2-induced endothelial dysfunction through PKC signal pathway.

Objective To evaluate the safety and efficacy of Centurion Vision System for subhixated cataract surgery.Methods Clinical data of 15 eyes with lens subluxation treated with Centurion Vision System were retrospectively reviewed.Ocular variables including visual acuity,intraocular pressure,corneal endothelial cell counts (CEC),central foveal retinal thickness (CFRT),intraocular lens (IOL) position,as well as intraoperative and postoperative complications were observed.Results The best corrected visual acuity (BCVA) was 0.6 or better in 10 eyes (66.7％) 3 months after surgery,while the BCVA of the other 5 eyes was between 0.2 and 0.6 mainly due to pre-existing macular degeneration caused by high myopia or trauma.CEC and CFRT values demonstrated a statistically significant difference between the preoperative and all postoperative follow-ups (all P ＜ 0.05).Three months after surgery,no serious surgeryrelated complications,such as retinal detachment,IOL dislocation,suprachoroidal hemorrhage,macular edema,were observed.Conclusion Centurion Vision System can facilitate phacoemulsification in eyes with subluxated lenses,and this technique is safe and effective due to providing excellent outcomes and avoiding vitreoretinal complications.

Objective To investigate and analyze the current status of adult unplanned endotracheal extubation in China,understand the preventive strategies of unplanned endotracheal extubation,and supply reference for future research.Methods All publications concerning unplanned endotracheal extubation from CBMdisc,CNKI and Wangfang Database were analyzed by establishing the reference manage and appraisal databases with Noteexpress and SPSS software.Results The publications concerning unplanned endotracheal extubation grew steadily year by year.The major study type was case series report(36.4％)followed by review(16.7％) and experience introduction(14.6％).Most literature focused on risk factors,preventing strategies,patients' outcomes and so on.Lacking of effective physical restraint and patients' anxious were the most common factors leading to unplanned endotracheal extubation.Conclusions Unplanned endotracheal extubation has got much attention from the clinical faculties recently.However,the domestic researchers focused on this topic lacked strict research design and efficient statistical methods.So it is imperative to develop the best practice information sheet for preventing unplanned endotracheal extubation by evidenced-based and scientific method.

Objective To explore the lethal action and possible mechanism of RI-1, a RAD51 inhibitor, on MSH2 deficient colorectal cancer cells.Methods The expression of MSH2 protein level was assessed by Western blot, and the sensibility of human colorectal cancer cells to RI-1 (10, 20, 30, 40 and 50 μmol/L)was measured by MTT method.Lentivirus vectors MSH2-shRNA and Neg-shRNA (negative control) were constructed and transfected into HT29 cell.Apoptosis and DNA damage of cells treated with RI-1(40 μmol/L)were detected by flow cytometry and Single cell gel electrophoresis respectively.In addition, the formation of γ-H2AX foci was analyzed by immunofluorescence.Results Compared with control, MSH2-deficient HCT8 cells had obviously apoptosis(P<0.01);in HCT8 and HT29 Shmsh2 cells, tail DNA%, tail length, tail moment and olive tail moment were markedly increased(P<0.05),and the number of γ-H2AX focus were increased(P<0.01).Conclusions RAD51 inhibitor RI-1 selectively kills MSH2 deficient colorectal cancer cells by increasing DNA damage.

Objective To observe the effects of lycopene on fibrinolytic activity and nitric oxide in atherosclerosis rabbits. Methods 30 New Zealand rabbits were randomly divided into three groups. They were individually housed in metal cages. Throughout the experimental period, they were given restricted amounts of food. Control group was fed with normal diet,model group was fed with 1% cholesterol,10% lard and 89% normal diet, lycopene group was fed with 1% cholesterol,10% lard and normal diet plus 6% lycopene.At the time of the first day and the 8th week, blood samples were drawn from ear edge vein of rabbits. The activity and content of plashaa tissue type plasminogen activator(t-PA)and plasminogen activator inhibitor(PAI-1)were detected. The levels of serum Nitric oxide (NO)were determined.At the end of the study, the plaque areas were measured. SPSS 10.0 software was used to evaluate the differences among the three groups. Results Compared with control group, atherosclerosis rabbits had lower content and activity of t-PA, higher content and activity of PAI-1 and lower content of NO. Compared with model group, lycopene group had no significant difference about the content and activity of tPA and PAI-1.But lycopen increased the levels of serum NO, significantly diminished the area of lipid plaque. Conclusions The experimental results suggested that lycopene had antiatherogenic effects. The possible mechanisms might be that lycopene could decrease lipid peroxidation injure, maintain the concentration of NO and protect vascular endothelium. The antiatherogenic effects of lycopene had no correlation with the fibrinolytic activity.

Objective To analyze the reasons of non-planned decannulation (NPD) of peripheraly inserted central catheter (PICC) and explore the applicable prevention strategies.Methods We retrospectively analyzed the clinical data of 432 patients who underwent PICC cannulations maintenance between July 2005 and June 2008.The reasons of 26 cases of NPD were analyzed.Results The main reasons of NPD included cannulation occlusion,cannulation ectopia or translocation,cannulation exfoliation,cannulation-related infections,mechanical phlebitis,and thrombus formation.The complications usually were caused by the poor cannulation material,incorrect fixation,top of canuulation not reaching superior vena cava,lack of management measures for outpatients,accidents,and others.Effective measures for preventing NPD included:use silica gel cannulation;ensure the top of canuulation reach the superior vena cava;and improve the communications between outpatients and nurses.Conclusion NPD of PICC may be caused by various reasons and effective prevention measures should be taken.