Humans ; Occupational Diseases ; prevention & control ; Risk Assessment ; Safety

Serum adiponectin concentration in diabetic nephropathy (DN) group was significantly higher than that of simple diabetes mellitus (SDM) group.In clinical diabetic nephropathy group with massive albuminuria it was remarkably higher than those of normal control,SDM,and early DN.Furthermore,serum adiponectin concentration was positively correlated with urinary albumin excretion rate and negatively correlated with waist hip ratio.Why it is markedly increased in patients with overt DN merits further investigation.

Ischemic stroke causes varying degrees of cognitive impairment, and its incidence is very high. Early diagnosis of cognitive impairment may provide the best intervention treatment opportunity, and slow disease progression. Therefore, it has attracted more and more attention. This article reviews the advances in etiology, pathogenesis, risk factors, diagnosis, prevention and treatment of cognitive impairment after ischemic stroke.

Carcinoma, Papillary ; genetics ; Humans ; Mutation ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroid Neoplasms ; genetics

Objective To determine the predictive factors for lateral lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC). Methods From January 2002 to December 2009,77 patients with PTMC were treated by modified radical neck dissection. We analyzed the association between lateral LNM and clinical factors, US features, hematological parameters and pathologic features of PTMC. Results The rate of lateral LNM was 39% in 77 PTMCs (30/77). We found a statistically significant association between lateral LNM and age, pathologic features ( extrathyroid invasion and central LNM), higher platelet counts and US features of PTMC (upper pole location,contacting area of the tumor with the capsule of throid gland > 25% of the perimeter of the tumor) in univariate analysis (statistic values were 2.425,6. 392,12. 584,2. 143,8.755 and 6.89,respectively,Ps< 0.05). Age,pathologic features (central LNM) and US features of PTMC (upper pole location) were found to be independent predictive factors for lateral LNM in multivariate analysis ( OR and 95%C/ was 0.942(0.889 -0.998) ,4. 396( 1. 241 - 15. 573) and 4.436( 1. 194 - 16. 482) ,P was 0. 042, 0.022 and 0.026,respectively). Conclusion In patients with PTMC,independent factors in predicting lateral LNM were age, US features of PTMC ( upper pole location) and pathologic features (central LNM ). These patients should receive relatively aggressive initial treatments and vigilant follow-up.

Objectives To evaluate the clinical efficacy of treatment uterine leiomyoma using radiofrequency ablation. Methods From September 2004 to March 2005, 30 patients of uterine leiomyoma were treated using radiofrequency ablation under B ultrasonic scouting; the diameter of uterine leiomyoma was 1.5～4.8cm. Results The 30 patients were callback after the operation 3～6 months; the curative effect rate was 100%, including cure rate 50%, obvious effect rate 33.3%, and efficient effect rate 16.7%. Conclusion The radiofrequency ablation is a simple, safe, effective and economic technique with tiny hurt and remains the functions of uterine on the therapy of uterine leiomyoma.

Objective To investigate the clinicopathological significance of transforming growth factor-β1 (TGF-β1), transforming growth factor-β1 receptor Ⅱ (TGF-βRⅡ ), Smad4 and Smad7 protein expressions in gastric carcinomas. Methods 109 cases of gastric carcinomas,28 of high grade dysplasia,20 of low grade dysplasia,30 of chronic atrophic gastritis,29 of intestinal metaplasia, and 21 of normal gastric mucosa were selected for the detection of the expression level of TGF-β1,TGF-βRⅡ , Smad4 and Smad7 proteins by immunohistochemistry. Results The expression of TGF-β1,TGF-βRⅡ and Smad7 proteins in gastric carcinomas and dysplasia (high and low grade) were significantly higher than those in chronic atrophic gastritis, intestinal metaplasia and normal gastric mucosa (all P <0. 001 ) ,whereas the expression of Smad4 was significantly increased in high and low grade dysplasia (cytoplas-mic IS :4.89±2.38,5.80±1.54, respectively; nuclear IS: 3.89± 1.52,3.80±1.33, respectively), and decreased in gastric carcinomas (cytoplasmic IS:2.41±2.27,nuclear IS:2.02±2. 14) (P <0.001 ,P <0.001 ,respective-ly). Meanwhile,the expressions of TGF-β1,TGF-βRⅡ and Smad7 were higher in advanced gastric cancer (4.36± 2.66,3.05±1.93,4.84±3.06, respectively) than those in early gastric cancer ( 2.93±1.85,2. 17±1.87, 4. 14±2.46, respectively) ( P < 0.01, P < 0.05, P < 0. 05, respectively ) ; however the expression of Smad4 protein was much higher in early gastric cancer (P < 0. 001 ). The expression of Smad4 protein was significantly correlated with tumor size( P < 0.05 ), lymph node metastasis ( P < 0. 001 ), T stage ( P < 0. 001 ) and chnical stage ( P < 0.001) ,and the expressions of TGF-βRⅡ and Smad4 proteins were correlated with patients' 5-year survival rate (P<0.05 ,P < 0.01 ). TGF-β1 showed the positive correlation with TGF-βRⅡ and Smad7 (r1= 0.45 ,P <0. 05; r2 = 0.49, P <0. 05), but negative correlation with Smad4 ( r = - 0.21,P < 0.05 ). Conclusion TGF-β1, TGF-βR Ⅱ, Smad4 and Smad7 protein may play an important role in the carcinogenesis of gastric carcinoma,and smad4 is the key in TGF-β pathway. Also, the detection of these proteins expression can be a useful marker for predicting the gas-tile cancer invasion,metastasis and patients' prognosis.

Objective To investigate the results of dynamic hip screw (DHS) intemal fixation for the treatment of femoral intertrochanteric fractures. Methods Thirty patients with femoral intertroehanteric fractures treated with DHS internal fixation were enrolled in the study. The classification of fracture, operative methods, postoperative treatment and therapeutic results were assessed. The mean follow-up period was one year. Results All the patients completed the follow-up. Fractures healed up without coxa vara, external rotation or shortening deformity of the lower extremity in all patients. Good hip joint function was obtained in 86.7% of the patients. Conclusion DHS internal fixation is an ideal method for the treatment of femoral intertrochanteric fractures.

Objective To study the clinical effect of Shenkang injection combined with valsartan in the treat-ment of patients with early stage diabetic nephropathy,and its influence on the expression changes of homocysteine ( Hcy) ,transforming growth factor β1 ( TGF -β1 ) , the inflammatory cytokines high sensitive C -reactive protein (hs-CRP),and interleukin-6 (IL-6).Methods 138 cases of early stage diabetic nephropathy were randomly divided into control group ( conventional treatment, valsartan act as antihypertensive drug ) and treatment group ( treated with Shenkang injection combined with valsartan) by digital table.The total effective rate,glycemic index, renal function,levels of Hcy and TGF-β1,expression levels of inflammatory cytokines of two groups were compared. Results The total effective rate of the treatment group (91.30%) was significantly higher than the control group (76.81%) (χ2 =5.004,P<0.05).The values of FPG,2h PG,HbAlc,UAER,CysC and Scr were lower in the treat-ment group compared with the control group (t=4.514,3.743,4.754,6.214,3.925,3.777,all P<0.05).Com-pared with the control group,the concentrations of Hcy,TGF-β1,hs-CRP and IL-6 decreased significantly[ (11. 78 ±1.95)μmol/L vs (9.21 ±1.64)μmol/L,(71.32 ±14.88) mg/L vs (60.04 ±11.75) mg/L,(7.07 ±1.25) mg/L vs (5.81 ±1.14)mg/L,(50.24 ±21.86)pg/mL vs (32.55 ±17.01)pg/mL],the differences were statistical-ly significant (t=8.378,4.942,6.187,5.305,all P<0.05).Conclusion Shenkang injection combined with val-sartan for the treatment of early stage diabetic nephropathy has significant clinical efficacy.It can improve patients're-nal function and reduce blood sugar levels.The effects may be related with inflammatory response inhibition and Hcy, TGF-β1 levels reduction.