Objective To investigate the application value of virtual touch tissues quantization(VTQ)in the stages of type 2 diabetic nephropathy.Methods 120 cases of type 2 diabetes were divided into 3 groups according to urinary albumin excretion rate (UAER):diabetes without urinary albumin,diabetes with trace albuminuria and diabetes with mass albuminuria.The control group consisted 30 normal cases.VTQ was used to measure the renal shear wave velocity (SWV),then compare were made between the 4 groups.Besides,correlation analysis was made between SWV and UAER in diabetic nephropathy group.Results When compared SWV,there was no significant difference between diabetes without urinary albumin and control group (P =0.144),but there was significant difference between each 2 group of diabetes with trace albuminuria,diabetics with mass albuminuria group and control group (P ＜ 0.05).There was also significant difference between each 2 group of diabetes (P ＜ 0.05).The correlation coefficients for SWV and UAER in diabetes were 0.697(P ＜0.05).ROC analyses showed the area under curves for SWV diagnosis for diabetic nephropathy was 0.93.The best cutoff point,sensitivity and specificity were 2.43 m/s,85.7％ and 84.5 ％,respectively.Conclusions The renal SWV increases as the renal injury progresses,which also plays an important role in diabetic nephropathy stages.

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T_4 was coupled to human serum albumin(HSA)to make the conjugate T_4-HSA,a polyvalent T_4 analogue rather than monovalent T_4 per se alone.A new strategy for sandwich enzyme immunoassay model system of small molecular hapten hormones FT_4 was developed,such as intra-assay CV,inter-assay CV,average recovery, normal and abnormal values were fit for clinical application.The sensitivity was as much as 10 times higher than conventional competitive enzyme immunoassay.

Objective To analyze the death causes of of dermatomyositis(DM)and polymyositis(PM)patients with interstitial pneumonia.Methods A retrospectively analysis of the clinical and laboratory characteristics of 15 dead DM and PM patients with interstitial pneumonia was carried out,and 23 survivors served as controls.Results The age of the dead group was(50.1?12.0)years old,and 12(80%)patients died within the six months after onset.The mortality was higher in the acute or subacute interstitial pneumonia patients than that in the chronic patients.With longer course of the disease,lung infections became the major cause of death.Significantly higher serum lactate dehydrogenase,glutamate- pyruvate transaminase,glutamic-oxalacetic transaminase levels were found in the dead group.The dead group had higher incidence of dyspnea and“Velcro”-like crackles and louer arterial oxygen pressure.The elevation of lactate dehydrogenase indicated worse prognosis.The elevation of creatine kinase and anti Jo-1 antibody werent the death causes. Conclusion The early onset of interstitial lung disease and lung infection were the major death causes in dermatomyositis and polymyositis patients.The earlier treatment of pneumonia-may improve the prognosis and reduce mortality.

Objective To explore the effects of low frequency electric stimulation on the clinical manifes- tation and its influence on the level of plasma Endothelin (ET),atrial natriuretic peptide (ANP),thromboxane B_2 (TXB_2),angiotensinⅡ(AngⅡ),Calcitonin Gene Related Peptide(CGRP) and Neuron-specific Enolase(NSE) and its clinical significance in the patients with vertebrobasilar insufficiency(VBI). Methods One hundred and tewenty cases of VBI patients were randomly divided into two groups:a treatment group and a control group.Both groups received routine drug treatment.The treatment group (n=60) was also treated with low frequency electric stimulation at bilateral mastoid processfes in addition.The improved rate of the clinical symptom,the plasma level of ET,ANP,TXB_2,AngⅡ,GRP and NSE were observed after treatment. Results The patients treated in the treatment group had significantly better outcome than the control group in terms of symptom relief.The effective rate was 87.93% and 67.80% in the treatment group and control group,respectively(P

Objective To investigate the clinical features of primary retroperitoneal fibrosis (RPF), and to find out better method for diagnosis and therapy. Methods Nine patients with primary RPF in Peking Union Medical College Hospital since 1990 to 2003 were analyzed retrospectively. Results All patients had abnormal findings in CT or MRI, and 8 of them had chronic non-specific inflammation of the retroperitoneum in pathology. Six patients had renal involvement and 2 of them had severe renal failure. Eight of the patients had received therapy with corticosteroid or tamoxifene. Conclusions RPF is an uncommon collagen vascular disease characterized by a chronic non-specific inflammation of the retroperitoneum.Because of the atypical manifestations of RPF, awareness of the disease is important.CT and (or) open biopsy remains the gold standard for diagnosis.Management typically includes surgery and drug treatment.Corticosteroid therapy or more recently,tamoxifen has been used successfully. The clinical and radiographic improvement with drug treatment has been seen in several patients and confirmed the diagnosis,thereby early diagnosis and treatment can bring the patient more excellent renal and general outcome.

Objectives To assess the presence of autoantibodies directed against the epitopes of SmB and SmD in systemic lupus erythemotosus(SLE) as well as other different connective tissue diseases(CTDs) and analyze the clinical significance of them.Methods Polypeptides of SmB and SmD were designed with the animo acids sequence by the biologic technical software.The sera from different patients including 102 SLE,153 other CTDs and 54 controls were detected by ELISA with thesynthetic polypeptides.Results The positive percentage of anti-SmB and antiSm-D epitopes were higher in SLE than in other groups (P

Objective To study the solute clearance effect of the new concentrated anticoagulation hemodiaiysate of citrate for hemodialysis in patients with high risk of bleeding. Methods Forty-two kidney failure patients with high risk of bleeding were divided into two groups (Group A and Group B) according to their hemodialysis manners. Patients in Group A were hemodialyzed with bicarbonate hemodialysate with low-molecular-weight heparin (dalteparin) anticoognlation and those in Group B with the new citrate antieoagnlation hemodialysate prepared in our hospital without any other anticoagulant. Blood urea nitrogen (BUN) and creatinine (Cr) concentrations were measured before and after dialysis, and Kt/V and urea reduction rate (URR) were calculated. In addition, activated clotting time (ACT) and ionized calcium (iCa2+) concentration were also measured at the arterial and venous ends. Results ACT was extended and iCa2+ concentration decreased significantly at the venous end compared with those at the arterial end in Group B (P<0.01). BUN and Cr concentrations were markedly decreased after dialysis compared with those before dialysis in both groups (P<0.01), and no significant difference in solute clearance effect, as indicated by Kt/V and URR, was observed between Group A and Group B (P>0.05). Conclusion The solute clearance effect of the new concentrated anticoagnlation hemodialysate of citrate is excellent during hemodiaiysis in kidney failure patients with high risk of bleeding.

Endostatin is a potent, endogenous inhibitor of angiogenesis, which corresponds to the C-terminal fragment of collagen ⅩⅧ. The human endostatin gene was amplified from a human fetal liver cDNA library by means of PCR and was cloned into pPIC9K vector. Soluble endostatin was superexpressed in Pichia pastoris (50.5mg/L) . The recombinant protein was purified by cation exchange chromatography with the final yield of more than 95%. Western blotting analysis showed positive immunoreactivity to the expressed product. Recombinant endostatin was able to suppress the angiogenesis on the CAMs. Also, the endostatin inhibited specifically of the migration of HMECs stimulated by bFGF, with EC50 being about 0.4 ?g/ml.

Objective To evaluate the diagnostic value of dermoscopy and reflectance confocal microscopy (RCM) alone or in combination for melanocytic nevus.Methods A total of 37 patients with clinically diagnosed melanocytic nevus were collected.Skin lesions were firstly examined by dermoscopy and RCM,then were resected to be subjected to histopathological examination for final diagnosis.The imaging features of melanocytic nevus were summarized.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of different skin imaging techniques were calculated,and the consistency was analyzed between skin imaging techniques and histopathological examination.Results Based on the dermoscopic and RCM findings,2 kinds of nevus cells with different morphological features were observed in the dermis of intradermal nevus.One kind of nevus cells was characterized by a nonfusional,highly-refractive round structure in the papillary dermis under RCM,and by a brown or light brown homogenous pattern under dermoscopy,which was observed in 5 skin lesions.The other kind of nevus cells appeared as irregular,highly-refractive cell clumps in the papillary dermis under RCM,and by a cobblestone or globular pattern under dermoscopy,which was observed in 31 skin lesions.For the diagnosis of melanocytic nevus,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of RCM combined with dermoscopy were 91.7％,87.5％,90.9％,97.1％ and 70％ respectively,those of RCM were 86.1％,75％,84％,93.9％ and 54.5％ respectively,and those of dermoscopy were 77.8％,87.5％,75％,96.3％ and 41.2％ respectively.All the diagnostic indices of RCM combined with dermoscopy were higher than those of RCM or dermoscopy alone,except that the specificity was equal to that of dermoscopy alone.RCM showed higher sensitivity,accuracy and negative predictive value,but lower specificity and positive predictive value compared with dermoscopy.There were no significant differences in the diagnostic yield in melanocytic nevus between RCM combined with dermoscopy or RCM alone and histopathological examination (x2 =0.25,0.57,P =0.63,0.45,Kappa value =0.72,0.53,respectively).However,a significant difference in the diagnostic yield in melanocytic nevus was observed between dermoscopy and histopathological examination (x2 =5.81,P =0.012).Conclusion RCM combined with dermoscopy shows higher diagnostic accuracy for melanocytic nevus compared with RCM or dermoscopy alone.