Objective To investigate the relationship between early diabetic nephropathy and arterial stiff-ness in patients with type 2 diabetes mellitus.Methods The clinical data of one hundred twenty patients with T2DM were collected for retrospective study.The patients with T2DMwere divided into an early diabetic nephropathy group (Group A)and a non -early diabetic nephropathy(Group B)according to the albuminuria to creatinine ratio(ACR)of first morning urine.Then compared the difference of the arterial stiffness between the two groups.Results An inde-pendent -sample T test was used for analysis.The brachial -ankle pulse wave velocity(baPWV)in group A and group B was(1 827.3 ±450.2)cm/s and(1 634.5 ±285.8)cm/s,respectively,which was statistically significance (t =2.164,P <0.05).Logistic regression analysis,in which baPWV was regarded as dependent variable,while age, blood pressure,ACR,and blood urea nitrogen(BUN)were independent variables,showed that age,systolic pressure, ACR,and BUN had an influence on the result of baPWV.Conclusion The patients with T2DMwith arterial stiffness are prone to early diabetic nephropathy.Therefore,dectection of arterial stiffness maybe an effective measure to evalu-ate the renal function of patients with T2DM,and make an intervention as soon as possible.

Remodeling and spacing factor-1 (Rsf-1), firstly discovered in 1998 and located in the nucleus, is one of the most commonly amplified gene and its protein molecular weight is about 240 ×103. The interaction between Rsf-1 and human sucrose non-fermenting protein 2 homologue (hSNF2H) changes the cell growth signals and environment, which is inclined to cause the cells loss of the normal regulation, leading to the abnormal proliferation and occurrence of tumors. Recent study has shown that Rsf-1 is closely related to the prognosis of a lot of human malignancies, such as genitourinary system tumors, gastrointestinal tumors, head and neck cancer, non-small cell lung cancer and glioma.

In recent years, with the application and exploration of fluorescence imaging technology in pancreatic surgery, it has brought new changes and new hope for the intraoperative treatment of pancreatic diseases. Intraoperative fluorescence imaging with indocyanine green (ICG) as probe is increasingly applied in identify neoplasms, real-time margin assessment, tissue perfusion, lymph node detection, anastomotic leakage and so on, which provides a new means for intraoperative decision-making. This article reviewed the progress in the application of ICG fluorescence imaging in pancreatic surgery.

OBJECTIVE: To study the therapeutic effect of treating knee arthropathy with total knee arthroplasty using rotating-platform knee prosthesis. METHODS: A total of 62 patients (74 knees) in Provincial Hospital Affiliated To Shandong University from January 2005 to January 2009 were selected, including 36 males (41 knees) and 26 females (33 knees), aged 52-79 years, mean aged 61.5 years; 28 cases with left knee, 22 cases with right knee and 12 cases of both knees. The cases were composed of 34 cases with osteoarthritis, 21 cases with rheumatoid arthritis and 7 cases with traumatic arthritis. All the patients received the total knee arthroplasty for the first time using rotating-platform knee prosthesis, no replacement of the patella. The clinical results of pre-operetion and after-operation were evaluated by the HSS knee rating score system. RESULTS: All the patients were followed-up for averaged 22 months (3-48 months) after operation. Incisions of all the cases were healed, and there was no infection and hematoma. Lower extremity deep venous thrombosis occurred in 2 cases at 3 days after operation. Swelling disappeared through drug treatment 10 days later. Pain and function of all the patients were obviously ameliorated after operation. The average HSS knee rating score was 44.99 (from 34 to 58) before total knee arthroplasty, which was improved to 88.78 (from 69 to 98), and the good-to-excellent rate was 98% (excellent 45 cases, good 16 cases, average 1 case). There were no signs of prosthetic dislocation or loosening in the X-ray films. CONCLUSION: Total knee arthroplasty using rotating-platform knee prosthesis owns advantages of easy surgical operation, tess complications, good recovery and satisfactory results in a short-term.

Objective To investigate effects of low shear stress on atherosclerosis,the development of atherosclerosis and expression of ?actin and cMyc proteins were studied in VSMC of common carotid artery under low shear stress. Methods We established the atherosclerotic model of left common carotid artery that presented low shear stress by the operation of ligating the left external carotid artery in rabbits.The histomorphology of the carotid arteries was examined by light microscopy.The expression of ?actin and cMyc was studied by immunohistochemistry. Results The typical atherosclerosis was observed and the atherosclerotic lesion was obviously accelerated under low shear stress.The expression of ?actin was downregulated and the phenotype of VSMC converted from contractile phenotype into synthetic phenotype,and expression of cMyc increased in VSMC of the artery under low shear stress.Conclusion This new model of atherosclerosis under low shear stress was successfully established,which provides a new tool for studying the effects of low shear stress on atherosclerosis.The results show that the atherosclerotic lesion is obviously accelerated and VSMC tends to proliferate in response to low shear stress.

Objective To evaluate the feasibility,validity and safety of pulmonary endarterectomy for patients with chronic thromboembolic pulmonary hypertension.Methods 50 patients undertook pulmonary endarterectomy operations were enrolled in this study.Of them,38 were males (76％),the average age was (43.35 ± 12.51) years,23 patients had deep venous thrombosis.Obvious pulmonary hypertension and hypoxemia were observed in all patients.Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest.Preoperative systolic pulmonary artery pressure was(104.16 ± 16.95) mmHg,pulmonary vascular resistance was(129.68 ± 50.88) kPa · s · L-1,central venous pressure was (14.91 ± 4.88) mmHg,and cardiac output was (3.28 ± 1.04) L/min.Results The average time of cardiopulmonary bypass was(294.37 ± 94.01) min,aortic cross clamp time was(127.93 ± 35.57) min,circulatory arrest time was(34.30 ±21.74) min.Post-operative mechanical ventilation time was (97.24 ±70.53) hours,and the ICU stay was (9.52 ± 12.96) days.There were 4 patients that died after PEA surgery for postoperative residual pulmonary hypertension of reperfusion pulmonary edema.Post-operation,all patients had significant decrease in systolic pulmonary artery pressure (54.11 ± 16.86) mmHg and pulmonary vascular resistance(20.55 ± 15.17) kPa · s · L-1,and central venous pressure (9.00 ± 3.09) mmHg,and great improvement in cardiac output (5.75 ± 1.48) L/min.6-months follow-up showed that the cardiac function of 44 (95.7 ％) cases returned to NYHA class Ⅰ or Ⅱ,with great improvement in computed tomography pulmonary angiography.All patients go back to normal work and physical exercise at 1-year follow-up.Conclusion Conclusions According the successful experience of surgery for CTEPH patients,pulmonary endarterectomy for patients with CTEPH results in significant pulmonary hemodynamic improvement,with favorable outcomes of heart and lung function in short and middle time follow-up.

Objective To compare the consistency of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in detecting c-erbB-2 status in breast cancer tissues. Methods A total of 50 breast cancer paraffin embedded samples were selected, of which there were 10 cases of c-erbB-2 protein expression (+), 20 cases of (++) and 20 cases of (+++). FISH was used to assess the amplification of c-erbB-2 gene, and SPSS 13.0 software was employed to analyze the difference and consistency between the two methods. Results IHC and FISH methods had a good consistency when detecting c-erbB-2 (+) and (+++) expressions in breast cancer tissues, with the coincidence rate of 89.2%. However, when IHC was used to test c-erbB-2 (++), the result of FISH was quite different, with the coincidence rate of only 35.3%. Conclusion IHC is a preliminary method to detect c-erbB-2 status in breast cancer. IHC and FISH methods have a good consistency in detecting c-erbB-2 (+) and (+++) status in breast cancer tissues. As detection of c-erbB-2 (++) with IHC has a different result from FISH, such patients should receive FISH confirmation for herceptin therapy.

OBJECTIVE:To observe the clinical effect of Zweymüller bicon-threaded cup in total hip arthroplasty for treating hip rheumatoid arthritis.METHODS:A retrospective analysis was performed on 24 cases (39 hips) of rheumatoid arthritis selected at the Department of Joint surgery of the Affiliated Provincial Hospital of Shandong University,including 8 males (14 hips) and 16 females (25 hips),aged from 32 to 64 years (average 49.2 years old),course of disease being from 4 to 15 years (average 8.5 years).All the cases the state of wound healing and perioperativ complications were examined,and the position of acetabulum prosthesis was observed by X-ray film.RESULTS:All patients were followed up,and the follow-up time ranged from 14 to 62 months (average 37.5 months).They were all obtained first-stage wound healing,and two cases of gastrocnemius vein thrombus were found among them,occurred by non-operation.All patients were free from pain with stable fixation and mobility increasing.The process of osseo integration being well,the radiolucent line and radiographic loosening of acetabulum prosthesis and sedimentation of stem were not found on antero-posterior pelvis-radiograph and lateral radiograph of ipsilateral hip.The Harris hip score increased from preoperative 33.5 points (17-46 points) to postoperative 86.5 points (79-96 points) at 3 months.There were no complication appeared such as dislocation,fracture and nerve injury.rheumatoid arthritis.

Objective To discuss the security and reliability of preoperative thoracoscopic pericardial exploratory and to evaluate of the surgical indications.Methods Video full-assisted thoracoscopic pericardioscopy has been implemented in 41 central type lung cancer cases before radical resection.Results Video assisted pericardioscopy group underwent thoracotomy lung resection with procession of intrapericardial pulmonary artery in 8 cases (partial pericardial resection in 2 cases),with pulmonary vein in 10 cases,and out-pericardial lung resection in 9 cases.Spiral CT projections were consistent with surgery was only 65.8 ％.The average time of explorationa was (23±10) min.Conclusion Except for widely used in pulmonary wedge resection and lobectomy,video-assisted thoracoscopic pericardial exploration can improve resection rate and survival rate in central type lung cancer patients which can reduce the need for exploratory thoracotomy.

Objective To study the expression of nicotinamide phosphoribosyl transferase (Nampt) in breast cancer and to investigate the effects of Nampt inhibitor on the growth and chemotherapy sensitivity of breast cancer cells.Methods Nampt mRNA expression in breast cancer tissues and adjacent normal tissues was detected by qRT-PCR method.The effect of Nampt inhibitor on the growth of breast cancer cells and chemotherapy sensitization was detected by MTT and soft agar clonogenic assays.Results Nampt in breast cancer was significantly higher than that in normal breast tissue (P=0.000).Nampt inhibitor FK866 repressed breast cancer cell proliferation (24 h,P=0.003;48 h,P=0.001) and suppressed cell anchorage-independent growth (0.3 nM vs 0 nM,P=0.02;3 nM vs 0.3 nM,P=0.0143;0 nM vs 3 nM,P=0.02).FK866 also increased the chemo-sensitivity of breast cancer cells to fluorouracil by greater inhibition of cell proliferation.Conclusion Our findings indicate that Nampt may be a new therapeutic target for breast cancer.