Oxidative stress play a key role in the pathogenesis of diabetic peripheral neuropathy.Reactive oxidative species(ROS), derived from hyperglycemia through abnormal mitochondrial electron chain and NADPH oxidase et al, may damage lipids, DNA, and proteins by oxidation.ROS can also promote other classical mechanisms of diabetic peripheral neuropathy, and further cause apoptosis of neurons and Schwann cells, or inflammation of nerve tissue, and finally lead to nerve injury.The relationship between oxidative stress and mechanisms of diabetic peripheral neuropathy was reviewed in this article, in order to get a clue for more effective treatment strategies.

Though lack of definite evidences,closed suction drainage after arthroplasty is routinely employed by the majority of orthopaedic surgeons with the aim of preventing the formation of wound haematoma,reducing delayed wound healing and the risk of deep infection.But the optimal time to remove drains is controversial.The usual time to remove drains is 48~72 h after operation when the volume of drains is less than 50ml within 24 h.But some scholars find that the time of draining more than 24 h increases the risk of wound infection.This paper reviews the literature of draining time,and concludes that the optimal time to remove drains is 24 h after the primary arthroplasty.

Objective To understand the effect of astragalus on insulin resistance and plasma amylin levels in newly diagnosed type 2 diabetic patients.Methods 88 patients of newly diagnosed type 2 diabetes were randomly divided into three groups:Group A (lifestyle intervention group) contained 30 patients,Group B (metformin treatment group) also contained 30 Patients,and Group C (astragalus and metformin treatment group) contained 28 Patients.Patients in group A were intervened with the control of diet,blood pressure and lipids level; patients in group B were additionally treated with metformin on the basis of group A; patients in group C were additionally treated with metformin and astragalus on the basis of group A.The course for both treatments were 8 weeks.Various clinical and biochemical parameters were detected before and after the treatment in all three groups and enzyme-linked immunosorbent assay was adopted for the detection of plasma amylin.Results Fasting blood glucose levels were significantly decreased after treataent in the three groups (t=-2.696、-4.029、-3.995,P＜0.05) ; insulin resistance index reduced in group B and group C (t=-2.599、-3.813,P＜0.05),the difference between group C and group B was statistically significant (t=-2.334,P＜0.05) ;treatments of group B and group C could improve the beta cell function index (t=2.303、2.384,P＜0.05),and they also could increase the plasma amylin level (t=2.341、3.045,P＜0.05).Conclusion Astragalus and metformin can improve insulin resistance index and increase plasma amylin levels in newly diagnosed type 2 diabetic patients.

Objective To analyze the epidemiological characteristics of reported emergency public health events at schools from 2006 to 2013, and provide a scientific basis for better disposal of school-related events. Methods The reported emergency public health events at schools in Tianjin from 2006 to 2013 were collected, and descriptive epidemiological analysis was conducted on data. Results A total of 267 reported emergency public health events at school in Tianjin during 2006-2013, of which 257 infectious disease events, accounting for 96.25%. The incident occurred in primary schools and nurseries. The peak was from March to June and October to December for the incident. The top three species of disease onset were influenza (2 360 cases), chicken pox (2 032 cases) and mumps (1 813 cases). There was a correlation between the duration and interval from onset of the first case to report of emergency public health events(rs=0.522,P＜0.05). Conclusion In recent years, school public health emergency events are high momentum, mainly in rural areas, primary schools and nurseries. Timely detection and disposal of emergency public health events can reduce the harm generated by them.

Objective To discuss the features of MRI and differential diagnosis of cerebral fat embolism syndrome(CFE).Methods The features of MRI of 4 final diagnosis cases of CEF were retrospectively analysed.Results MRI showed that there were spotty and patchy high T_2-weighted signals and some of them were low or equal signals on T_1-weighted.These signals were distributed in bilateral centrum semiovale,corona radiata,thalamus,deep part white matter of brain along the lateral ventricle,the cortex of brain of watershed,collose,brain stem and the hemisphere of cerebellum.The position of these abnormal signals was symmetric in the rough.The figure of the MRI signals in the midbrain liked the reverse Chinese number "eight".Brain swelling was showed in 2 of 4 cases.Conclusion There are some features of the CEF on T_2-weighted of MRI,but the history,the physical signal and the results of laboratory must be considered,and must be differential diagnosed with the diseases liking diffuse axonal injury,etc.

Objective To study the clinial application value of MR dispersion arthrography in meniscus tear of knee.Methods The conventional MR scans of 24 knee joints in 24 patients who were considered to have meniscus tear were performed and followed by MR dispersion arthrography.All cases were approved by arthroscope or operation.The results of both convention MR scan and MR arthrography were compared with arthroscope and operation.The sensitivity and the specificity of plain MR scan and MR dispersion scan were evaluated respectively.Results The signal intensity in the area of meniscus tear was obiously highen on MR dispersion scan than that of MR plain scan.The sensitivity was improved from 74.2% to 94.3% ,and the specificity improved from 88% to 94.3%.Conclusion MR dispersion scan is superior to convention MR scan in image quality and sensitivity in detecting meniscus tear.

Objective To understand the serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were chosen from 2010 September to 2011 December in Department of Endocrinology Changshou Chinese medicine hospital in Jiangsu Province,and 30 healthy people were screened as control group.Various clinical and biochemical parameters were detected,using enzyme-linked immunosorbent assay for the detection of serum AGEs and sRAGE levels.Results The levels of serum AGEs in newly diagnosed type 2 diabetic patients and control group were (1379.2 ± 431.8) and (1154.5 ±326.4) pg/ml,and there were significant differences between two groups (P＜0.05).The levels of serum sRAGE in newly diagnosed type 2 diabetic patients and control group were (14.6± 9.3)and (19.5 ± 8.9)ng/ml,and there were also significant differences between two groups (P＜0.05).The level of serum AGEs in newly diagnosed type 2 diabetic patients was positive correlation with glycosylated hemoglobin (HbA1c),and the level of serum sRAGE was associated with low density lipoprotein cholesterol (LDL-C) negative correlation.Conclusion The level of serum AGEs increase in newly diagnosed type 2 diabetic patients,and the level of serum sRAGE decrease in newly diagnosed type 2 diabetic patients.

Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) with polyvinyl alcohol (PVA) particles as embolic material in patients with primary hepatic cancer (PHC). Methods Twenty patients with PHC underwent TACE. The mixed emulsion of chemotherapy agents and lipiodol was given to embolize the tumor vssTranscatheter arterial chemoembolization using polyvinyl alcohol feeding artery of tumors. The tumors size, response rate and Alpha-Fetoprotein (AFP) value were monitored respectively at the end of the first month, the third month, the sixth month and the first year after TACE. The changes of liver function, including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (TBILI), were recorded within 1 week and 1 month after TACE. The time to progression and the overall survival were recorded. Results Compared with pre-TACE, the tumor size decreased obviously at the end of the first month, the third month, the sixth month and the first year after TACE (P<0.05), the response rate reached 80.00%, 90.00%, 95.00% and 95.00%, respectively. The AFP value decreased obviously. Serum AST, ALT and TBILI significantly increased in the first week after TACE (P<0.05), but returned to preoperative level within 1 month. The average follow-up time was (19.8±7.0) months (range 12-32 months), the time to progression was (17.0±6.8) months, and the overall survival was (19.3±7.0) months. Conclusion PVA particles are optimal embolic material for TACE of PHC. Superselective embolization is necessary in TACE to achieve effective tumor devascularization and reduce liver damage.

Objective To investigate the etiological and antibiotic resistance profile in the old patients with bloodstream infection (BSI).Methods Microbiological and clinical data were collected and reviewed retrospectively for the patients with confirmed bloodstream infection and at least 65 years of age who were treated as inpatients in Tongling People′s Hospital from January to December 2015.Results A total of 107 strains of pathogen were isolated from the blood samples of 107 patients with bloodstream infections, of which community-acquired BSI accounted for 57.9 % (62/107), and hospital-acquired BSI 42.1 % (45/107). Gram negative bacilli accounted for 67.7 % in the pathogens of community-acquired BSI and gram positive cocci accounted for 55.5 % in the pathogens of hospital-acquired BSI. More male BSI patients were secondary to respiratory tract infection than female patients (P<0.001), while more female BSI patients were secondary to urinary tract infection than male patients (P<0.001). Of the 107 isolates, gram negative bacilli, gram positive cocci and fungi accounted for 55.1 % (59/107), 42.1 % (45/107) and 2.8 % (3/107), respectively. The top six pathogens were E. coli (30.9 %), coagulase negativeStaphylococcus (CNS) (20.6 %), S. aureus (10.3 %),K. pneumoniae (6.5 %),Enterococcusspp. (6.5 %) and Acinetobacter spp. (4.7 %). About 51.5 % of the E. coli isolates and 28.6 % of the K. pneumoniae isolates produced extended-spectrum β-lactamases (ESBLs).E. coli isolates showed low resistance rate (< 10 %) to amikacin,cefoxitin and piperacillin-tazobactam. No E. coli isolate was found resistant to carbapenem. About 14.3 % to 28.6 % of K. pneumoniae isolates were resistant to carbapenems. No tigecycline-resistant K. pneumoniae was found. The prevalence of MRSA and MRCNS was 36.4 % and 72.7 %, respectively. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. One strain of E. faecium was identified as resistant to vancomycin (VRE).Conclusions This surveillance data indicate that gram negative bacilli play an important role in the BSI of old patients. E. coli and CNS are the most common pathogens. We should pay more attention to the effect of gender and site of infection on the BSI in old patients.

BACKGROUND: One unit of umbilical cord blood does not have a sufficient number of peripheral blood stem cells to meet the requirements of transplantation in adults. One solution of this problem is their ex vivo expansion, which requires not only a longer time and higher culture conditions, but also easily leads to the differentiation of stern cells, thus affecting the effects of transplantation. OBJECTIVE: To transduce human interleukin-3(IL-3) gene into umbilical cord blood CD34" cells and to observe IL-3 expression. DESIGN, TIME AND SETTING: A cell-genomics in vitro experiment was performed in the Chengde Medical College in 2008. MATERIALS: Human peripheral blood mononuclear cells (PBMC) of healthy adult were provided by Chengde Blood Center, and umbilical cord blood was provided by Chengde Maternal and Child Care Hospital. Written informed consent was obtained from each donor. METHODS: Peripheral blood mononuclear cells were isolated by Ficoll gradient centrifugation and umbilical blood CD34+ cells were isolated using immunomagnetic beads method. IL-3 mRNA was extracted. IL-3 cDNA was synthesized by RT-PCR, and IL-3 cDNA was subcloned into eukaryotic expressing vector pcDNA3. In the experimental group, pcDNA3/IL-3 vectors were transduced into umbilical cord blood CD34+ cells, while in the control group, transfection was not performed. MAIN OUTCOME MEASURES: Detection of IL-3 level in umbilical cord blood CD34" cells suspension using ELISA kits. RESULTS: Theoretically, the amplified IL-3 cDNA was 616 bp, and actually, after agarose gel electrophoresis, the PCR products exhibited a strip with expected size under ultraviolet ray. Extraction of IL-3mRNA was successful and reversely transcripted cDNA was complete. A 616-bp inserted fragment was observed by agarose gel electrophoresis after double digestion with BamH Ⅰ and Xba Ⅰ, and it was the same as IL-3 sequence. Within 1-7 days after transfection, IL-3 level in the umbilical cord CD34+ cells suspension was significantly higher in the experimental group than in the control group (t = 3.46, P < 0.05). CONCLUSION: IL-3 cDNA was successfully cloned, and eukaryotic expressing plasmid pcDNA3/IL-3 that could be effectively expressed within short term in umbilical cord CD34+ cells was successfully constructed.