Many studies have shown that diabetes mellitus is associated with vascular cognitive impairment (including vascular dementia),mild cognitive impairment,and Alzheimer's disease.Its pathophysiological mechanism is very complex,involving in vascular mechanisms and including non-vascular mechanisms of hyperglycemia,hypoglycemia,and insulin resistance.

To study the mechanism of preventing proteinuria by traditional Chinese medicine YSGJD in early diabetic nephropathy (DN) in rats.

Objective To investigate the value of dual source CT iodine concentration in the assessment of pathological grade of esophageal carcinoma. Methods Retrospective review was performed on 60 cases with pathologically?confirmed esophageal carcinoma. Among them, 17 tumors were well differentiated, 24 were moderately differentiated and 19 were poorly differentiated. The dual?energy plain scan and double phase enhanced scan of dual?source CT were performed on all 60 cases. Normalized iodine concentration (NIC) and the enhancement degree of the esophageal carcinoma in the arterial and venous phase were measured. The difference of NIC and enhancement degree among different grades of esophageal carcinoma were analyzed by analysis of variance. To evaluate the efficiency of NIC and enhancement degree in differentiating the well?moderately differentiated esophageal carcinoma from poorly differentiated esophageal carcinoma, ROC curve was plotted. Results The NIC values of the well differentiated, the moderately differentiated and the poorly differentiated esophageal carcinoma in the arterial phase were (1.54±0.34),(1.72±0.50)and(2.10±0.40)mg/ml, respectively;the NIC values in venous phase were(1.55± 0.52),(1.80±0.62)and(2.18±0.35)mg/ml,respectively, and the degrees of CT enhancement in venous phase were(25.65 ± 4.43),(27.55 ± 6.82)and(30.77 ± 6.38)HU, respectively. The differences between groups were statistically significant(P<0.05). The degrees of CT enhancement of well differentiated, moderately differentiated and poorly differentiated esophageal carcinoma in arterial phase were(14.40 ± 3.91),(14.26 ± 7.35)and(16.17 ± 6.89)HU, respectively, and there were no statistically significant differences(P=0.582). Areas under the ROC curves to differentiate well?moderately differentiated from poorly differentiated esophageal carcinoma for NIC in arterial phase, NIC in venous phase and the degree of CT enhancement in venous phase were 0.801, 0.817 and 0.730. Conclusion The iodine concentration measured on dual source CT has a certain value in evaluating the pathological grades of esophageal carcinoma.

OBJECTIVE:To evaluate the application of mixture design in the design of formulation.METHODS:Isosorbide mononitrate (ISMN) was used as model drug,and the formulation of ISMN sustained-release tablet was optimized by the mixture design.The optimized ISMN sustained-release tablets were compared with the ISMN sustained-release tablets in market in respect of the release rate in vitro.RESULTS:The comparison between the validating value and the target value of the optimized sample showed a similarity factor(f2) of 86.56,and there were no differences between the optimized sample and that in market in respect of the drug release in vitro.CONCLUSION:The mixture design is applicable for the optimization of formulation and it can be used to predict the drug release in vitro.

Background and purpose:VATS lobectomy has gained popularity for lung cancer around the world.Complete anatomic resections and node dissections are routinely being performed at many centers under VATS,but some thoracic surgeons are concerned regarding the safety,benefit and radical resection of this operative method.Our study is to evaluate the reliability and feasibility of pulmonary resection by video-assisted mini-thoractomy(VAMT) for patients with lung cancer.Methods:72 patients with lung cancer received either lobectomy and systemic lymph node dissection by video-assisted mini-thoracotomy(VAMT group;n=32) or conventional thoracotomy(conventional group;n=40),lobectomy was performed by conventional or thoracoscopic instruments,specific lymph node clamps were applied for lymph node dissection.Results:VAMT was successfully performed without significant postoperative complication and blood transfusion.No significant differences were observed in the two groups with respect to the length of operation and the total groups of dissected lymph nodes.This study showed that VAMT is a minimally invasive surgery without impairing of the outcome and needed less operative blood loss and shorter postoperative hospitalization compared to conventional thoracotomy.Conclusions:Major pulmonary resection by video-assisted minithoractomy for patients with lung cancer is safe,reliable and less invasive,it is consistant with the surgical standard of lung cancer.Its long-term benefit needs to be clarified after further follow-up.

Purpose: To evaluate the causes and management of bronchial pleural fistula after pneumonectomy. Methods: Retrqspective analysis for Bronchus-pleural fistula( BPF) of 16 cases after pneumonectomy of 820 cases of lung cancer in our hospital. BPF occurred in right peumonectomy( 13/320) is more than in left pneumonectomy(3/500) . BPF occurred in the positive stump of bronchus ( 10/41) more than in negative stump of bronchus (6/779) ; BPF occurred in preoperative chemotherapy cases( 5/110) more than in non-preoperative chemotherapy cases( 11/710), No BPF occurred in the 70 cases in which the bronchial stump was covered by autogenous tissue. The management principle in early stage is thoracocentesis and wash with antibiotics; after identification of the infection in thoracic cavity or BPF, closed drainage for thorax was done. If the results of drainage are not very good, open drainage is necessary. Results: 2 cases were discharged with completely healing, (the cavity of 1 case was washed again and again with 5% NaHC03and urokinase , another case was operated again to cover the BPF using muscle flaps 3 days after the first operation), 8 cases were discharged with closed drainage, 4 cases were discharged with open drainage changing the wound covering every day, the BPF did not heal for a long time after open drainage in 1 case, 1 case died of function failure of body organs. Conclusions: BPF is related to management of the bronchial stump and radical resection for tumor, It is a useful method to cover the bronchial stump with autogenous tissues to decrease BPF's, especially for right pneumonectomy and preoperative chemotherapy or radiotherapy cases. The management principle of BPF is thoracocentesis for early cases, especially washing with antibiotics and 5% NaHC03and urokinase repeatedly, closed drainage when necessary is also a good method for curing empyema and BPF.

Purpose:To evaluate the clinical effects and indications of surgical treatment of non small lung cancer invading the left atrium and great vessels and trachea carina. Methods:From August 1998 to Auguest 2003, we performed operations on patients with non-small lung cancer invading the left atrium in 3 cases, invading the descending aorta in 1 case, invading trachea carina in 3 cases; all the patients have been examined to exclude distant metastasis, including nuclear bone scan to exclude bone metastasis; there were 2 cases of left pneumonectomy and one of right pneumonectomy invading the left atrium, there were 3 cases of right sleeve pneumonectomy invading the trachea carina. For the cases invading the descending aorta, we performed the operation with atrium-aorta bypass, Pathology examination: all of the cases were squamous lung cancer, staging of T 4N 0M 0 for 6 cases,T 4N 2M o for 1 case. Results:No complication, follow up: 6 cases survived more than 1 year,1 case survived more than 9 months;4 cases were alive for more than 3 years, 1 case invading the atrium died in 30 months because of brain metastasis,1 case invading the carina died in 15 months because of pulmonary infection. Conclusions:For localized advanced non-small lung cancer invading the aorta and invading the carina and the atrium, if we selected the patient correctly and with a good surgical technique with complete radical resection of the tumor ,we can acquire good results.

OBJECTIVE:To establish a method for content determination of bavachin and bakuchiol in Psoralea corylifolia.METHODS:HPLC method was adopted.The determination was performed on Shim-Pack VP-ODS column with mobile phase consisted of acetonitrile-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 246 nm,the column temperature was 30 ℃,and the sample size was 10 μL.RESULTS:The linear ranges of bavachin and bakuchiol were 48.9-489 ng(r=0.999 8),784-7 840 ng(r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 2.0％.Average recoveries ranged 95.30％-99.63％ (RSD=1.45％,n=9),96.89％-100.82％ (RSD=1.36％,n=9).CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for the simultaneous determination of bavachin and bakuchiol in P corylifolia.

Objective To evaluate the reliability of video-assisted mini-thoracectomy(VAMT) for the diagnosis and treatment of patients with pulmonary peripheral nodules.Methods A total of 55 patients with pulmonary peripheral nodules(1 case of multiple nodules and 54 cases of solitary nodule) underwent VAMT.The surgery included wedge resection in 23 patients and lobectomy with lymph node dissection in 32 patients(The lobectomy was performed by using conventional combined with thoracoscopic instruments.A self-made lymph node clamp was applied for lymph node dissection).Results The operation was successfully accomplished under thoracoscopy in all the 55 patients.The operation time was 35~180 min(mean,109 min) and the intraoperative blood loss was 50~400 ml(mean,122 ml).No blood transfusion was required.Postoperative complications included air leakage in 1 patient(discharge on the 32 postoperative day) and delayed wound healing in 1 patient(discharge on the 19 postoperative day).The length of postoperative hospital stay of the other 53 patients was 4~11 days(mean,8.3 days).Final pathological diagnosis showed 15 cases of benign lesions,38 cases of primary lung carcinoma,1 case of atypical adenomatous hyperplasia,and 1 case of metastatic lung cancer.The benign lesions were cured by wedge resection.Anatomic lobectomy with lymph node dissection was performed in 32 patients with primary lung cancer.Of other 6 patients with terminal lung cancer,4 patients were conservatively treated because of an extensive dissemination and 2 patients received a palliative wedge resection because of poor pulmonary functions.Conclusions Video-assisted mini-thoracectomy is helpful for the diagnosis and treatment of pulmonary peripheral nodules.Its long-term effects for clinical early-stage lung cancer need further follow-up investigations.

Objective To study the effect of endothelial progenitor cells mobilization on vascular endothelial repair after carotid artery injury in rats.Methods The rat balloon-injured carotid model was established.In the control group:saline was administrated intragastrically;the simvastatin group:simvastatin 10 mg/(kg?d)was administrated intragastrically and in the simvastatin+ granulocyte colony stimulating factor(G-CSF)group:G-CSF 100 ?g/(kg?d)was intraperitoneally injected togother with intragastrical simvastatin from 1 week before operation to 2 weeks after operation.The repair rate of injuried endothelium,neointima/media area ratio(IA/MA),the positive cell index of proliferating cell nuclear antigen(PCNA)and nitric oxide(NO)release in peripheral blood were detected.In addition,the ratio of CD34+VEGFR2+ double positive expression cell was detected by fluorescence activated cell sorter(FACS),which indicated the level of EPCs.Results The repair rate of injured endothelium was increased(12.3%)in the simvastatin group compared with the control group;IA/MA was reduced 18.4%;NO release was increased 33.9% and the positive cell index of PCNA was reduced 5.7%.These data were 38.2%,50.3%,33.9% and 37.2% respectively in simvastatin+G-CSF group.Compared with the control group,the ratio of CD34+VEGFR2+ double positive expression cell was increased 87.6% in peripheral blood,and it increasd 343.4% in simvastatin+G-CSF group.Conclusion The results suggest the possibility that simvastatin may promote the EPCs from bone marrow to peripheral blood,so it can improve the effect of repair rate of injured endothelium and inhibit neointimal hyperplasia.In addition,G-CSF can enhance the effect of simvastatin on the injured endothelium and neointima hyperplasia.