Objective To explore the relationship between P-selection,nitric oxide(NO),high-sensitive-C-reactive protein(hs-CRP)and type 2 diabetes mellitus(T2DM)with macroangiopathy.Methods In sernm of 125 T2DM subjects(60 subjects with macroangiopathy and 65 subjects without macroangiopathy)and 55 normal controls,the activity of P-selection,NO and hs-CRP was detected by ELISA,Nitrate Reductase Assay and scattering immunoturbidimetric method,respectivley.Results The activity of serum P-selection and hs-CRP was significantly higher in diabetic macroangiopathie group than in non macroangiopathic group and control normal.Serum NO was significantly lower in diabetic rnacroanglopathic group than in non macroangiopathic group and control normal.Serum P-selection was positively correlated with hs-CRP-systolic blood pressure(SBP),LDL-C,and was negatively correla- ted with NO:P-selection,hs-CRP,LDL-C and SBP were independently risk factors for T2DM with macroangiopathy. Conclusion Determination of P-selection and NO is very important for prevention and diagnosis of diabetic mac- roangiopathy in early stage.

ABSTRACT:Many studies show that helminth‐derived molecules can induce immunoregulatory cells to form immune net‐work‐mediated immune ,thereby inhibiting allergic and autoimmune diseases .Helminth parasites can induce immune cell activa‐tion and produce cytokine .And parasites play an inhibitory effect to affect other immune related diseases .However ,the associ‐ation between helminths infections and immune related diseases does not always have an unequivocal outcome .While some hel‐minths infections protect against allergic diseases ,other helminth can exacerbate this immunopathology .

ObjectiveTo observe the efficacy of maintenance hormonal treatment after response to chemotherapy in advanced breast cancer. Methods8 patients with advanced breast cancer were treated with chemotherapy,maintenance hormonal therapy were given after response to chemotherapy.The efficacy was evaluated every 2 cycles of chemotherapy and 2 months of endocrine therapy according to RECIST standard.Results8 patients received chemotherapy for 2-8 cycles (median 4 cycles). All patients got PR, the duration of chemotherapy was 1-6 months (median 2 months), the time to failure of chemotherapy was 4 months. Until the last follow-up day (31th December 2010), the time to progression was 6-86 months (median 13.5 months).Survival was 6-86 months(median 21.5 months).Seven patients quit the chemotherapy due to severe side effects of hematologic toxicity,fatigue or nausea vomiting.One patient died because of allergy to paclitaxol.Conclusion Maintenance hormonal treatment after patients with metastatic breast cancer response to chemotherapy may prolong the duration of effective therapy and improve the QOL.

ObjectiveTo investigate the role played by acute glucagon response in the short-term intensive insulin therapy induced long-term remission of newly-diagnosed type 2 diabetes.MethodsTen newly-diagnosed type 2 diabetic patients( 7 males,3 females) received intensive continuous subcutaneous insulin infusion( CSII )therapy for 2 weeks.Intravenous glucose tolerance test (IVGTT) and hyperinsulinemia euglycemia clamp test were performed before and after CSII.Glucose infusion rate ( GIR ),acute insulin response ( AIR ) and acute glucagon response (AGR) were assessed.Long-term remission was defined as good glycaemic control without any hypoglycaemic agent (fasting plasma glucose ＜ 7.0 mmol/L 及 2 h postprandial glucose ＜ 10 mmol/L) one year after CSII.Relationship between AGR and long-term remission were analyzed by one way ANOVA and Spearman correlation analysis.Results ( 1 ) Five of the ten patients achieved long-term remission in this study.GIR and AIR in the remission group were increased significantly after CSII compared with those before CSII [ GIR ( 5.39 ± 1.76 vs 2.02 ± 0.83 )mg · kg-1 ·min-1,AIR ( mean 54.1 vs mean 3.39 ) mU · L-1 · min,P＜0.01 respectively ],however both of them were not associated with the remission.(2) AGR in the remission group was significantly higher than that in the non-remission group before CSII ( 5.10±0.60 vs 2.85 ± 1.86,P＜0.05 ) and was decreased significantly after CSII.The mean of AGR after CSII was apparently lower in the remission group than that in non-remission group (0 vs 3.04±2.00,P＜0.01 ).(3)Spearman analysis showed that AGR before CSII and its range of reduction after CSII were correlated with remission ( r for both were 0.731,P=0.016).ConclusionHigher level of AGR before CSII and greater reduction after CSII in the subjects with newly-diagnosed type 2 diabetes were significantly associated with long-term remission,suggesting that pancreatic α cells may play a unique role in the induction of remission of type 2 diabetes.

Objective To observe the expression of bone matrix proteins and the change of intima-tunica media thickness ratio in diabetic rat small renal artery and to explore their correlation and effects on diabetic nephropathy. Methods Seventy healthy SD rats were randomly divided into diabetic group(DN,n=40)and normal control group(N,n=30).DN rat model was induced by streptozotocin(STZ)intraperitoneal injection and the N group rats were given the same dose of citrate buffer.Thirty-five rats were successfully induced in DN group.The rats were sacrificed at week 4,12 and 24,respectively.The protein and mRNA expression of core-bind factor alpha 1(Cbfcd).bone morphogenetic protein 2(BMP-2)and matrix Gla protein(MGP)in smallrenal artery were detected by immunohistochemistry,in-situ hybridization and real-time PCR at each time point. Results Cbfctl and BMP-2 were expressed obviously in small renal artery of DN group by immunohistochemistry stain and in-situ hybridization from 4 to 24 weeks compared with N group at each time point,reaching the peak at week 24.Real-time PCR showed that the MGP mRNA was evidently increased at week 4,slightly decreased at week 12,lowest at week 24in DN group.The BMP-2 mRNA began to increase from week 4 onward,being peak at week 24in DN group.The ratio of intima to tunica media thickness had no significant difference in DN group compared with N group at week 4,but at week 12 and 24 there were significant difference between them.There was a positive correlation between Cbfα1 and BMP-2 expression,but they were negatively correlated with the expression of MGP.The ratio of intima to tunica media thickness was significantly-correlated with the expression of Cbfα1 and BMP-2. Conclusions The ratio of intima to tunica media thickness is positively correlated with Cbfα1 and BMP-2 in small renal artery of early DN.Cbfα1,BMP-2 and MGP may be involved in the progression of vascular lesions in DN.

Objective To compare and evaluate the clinical efficacy and side effect of vinorelbine plus gemcitabine and vinorelbine plus cisplatin combinations in advanced non-small-cell lung cancer(NSCLC). Methods 56 cases with non-treated advanced NSCLC were unrandomly divided into two groups: the GN group (27patients) treated with vinorelbine plus gemcitabine, the NP group (29 patients) treated with vinorelbine plus cisplatin,1/3 weeks×2～6 cycles. Results For the GN group, the overall response rate was 37.7 %, MTTP was 5.1months,one year survival rate (1-ySR) was 40.7 %. There were no significant difference in the response rates and the survival rates for the GN group compared with the NP group (P ＞0.05); But on the side effect of toxicities, WHO grade anemia and nausea/vomiting and tiredness of the GN group was significantly milder than the NP group (P ＜ 0.05). Conclusion Vinorelbine combined Gemcitabine regimen (GN) is active and well-tolerated. It is worth to investigate GN recommended as the first line chemotherapeutic regimen for the treatment of patients with advanced NSCLC.

Objective To observe the change of intima/media thickness ratio and expression of inflammatory factors in renal small artery of diabetic rats, and to explore the correlations of intim/media ratio with inflammatory factors and vascular lesions of diabetic nephropathy (DN) rats. Methods Seventy healthy SD rats were randomly divided into diabetic nephropathy group (DN, n=40) and normal control group (N, n=30). DN rat model was induced by intraperitoneal injection of streptozotocin (STZ). Thirty-five DN rats were successfully established. N group received same dose of citrate buffer. Rats were sacrificed after 4, 12, 24 weeks respectively.The intima/media thickness ratio in renal small artery was detected by immunofluorescence. The monocyte chemoattractant protein-1 (MCP-1) protein and mRNA expression of renal small artery were detected by immunohistochemistry and in-situ hybridization at each time point. Results Blood glucose and urine protein excretion (24 h) at different time points in DN group were significantly higher than those of N group (P＜0.05). From the 12th week, Scr, BUN, serum phosphorus were significantly higher than those of N group (P＜0.05). At the 4th week, renal small artery had the expression of MCP-1 protein and mRNA. The expression increased gradually with time, reached the highest at the 24th week, and was significantly higher than that of N group at each time point (P＜0.05). Immunofluorescence results showed that as compared to N group, in the first 4 weeks, intima/media thickness ratio in DN group was not different, at the 12th week the ratio was higher but without significant difference, at the 24th week the ratio was significantly higher (P＜0.05). Small artery intima/media thickness ratio of DN group was positively correlated with MCP-1, cholesterol, triglyceride, serum phosphate (r=0.742, P＜0.01; r=0.740, P＜0.01; r=0.829, P＜0.01; r=0.580, P＜0.01). Conclusions The arterioles intima/media thickness ratio of early DN is significantly correlated with MCP-1, lipids and phosphorus. MCP-1 may be involved in the DN vascular disease.

Objective To investigate the clinical effect and feasibility of interventional treatment of cervical artery stenosis in the elderly patients aged 75 years and over. Methods The data of 60cases aged 75 years or over who underwent interventional treatment of the cervical arteriostenosis involving carotid artery (CA), vertebral artery (VA) or proximal segment of the subclavian artery (SCA) were analyzed retrospectively. The clinical manifestations, imaging characteristics,interventional managements and follow-up results were recorded. Results In this cohort, the mean age was (78. 9±3.7) years (range from 75 to 89). The 50 patients (93.3%) complained of cerebral ischemic symptoms, and all the patients had concurrent diseases or risk factors, including hypertension, diabetes mellitus, coronary heart disease (CHD), stroke history, and so on. Digital subtraction angiography (DSA) data showed 55 cases (91.7%) had 2 or more cerebral arteries with a stenosis exceeding 30%. Among all cases, 84 lesions were treated with 84 stents, with a technical success rate of 98.8%. After stenting, the percent diameter stenosis of lesions decreased from a mean of (80.8 ± 12.9) % to (7.1 ± 9.5 ) %. The periprocedural and 30-day postoperative neurological complication rate was 8. 3 %, resulting in a permanent complication rate of 5 %. Clinical improvement rate was 87.5%. During a follow-up period of (36.7±26. 3) months (range from 5 to 99), there were 4 deaths: 2 died from myocardial infarction, 1 died from brain metastases of lung cancer and 1 died from cerebral hemorrhage. Cerebral infarction recurred in 3 cases. Imaging follow-up in 78. 3% of patients for 66 stents, including ultrasound, CTA, MRA or DSA, showed that the general in-stent restenosis rate was 9. 1%, and the restenosis rate of VA, CA and SCA was 21.7% (5/23), 2.6%and 0, respectively. Conclusions The results of this series suggest that interventional treatment ofcervical artery stenosis in the elderly patients aged 75 years and over is effective and feasible. In our experience, clinical comprehensive management and skillful technique of the operator are equally important for the elderly patients aged 75 years and over with high incidence of concurrent diseases or risk factors.

Objective:To observe the effects of hyperthermia on the sensitivity of gastric cancer cell lines to paclitaxel (TAX) . Methods :To establish TAX-resistant gastric cancer cell line through a method of increasing concertration gradient and named it MKN-45/TAX .Immunocytohistochemistry staining method was used to detect the expression of multi-drug resistance gene (MDR1) in MKN-45/TAX and MKN-45 .CCK-8 test was used to detect the proliferation inhibition rates in two kinds of cell lines under different temperatures and different TAX concentration .Real-time polymerase chain reaction (RT-PCR) and West-ern blotting were used to detect the expression of MDR1 mRNA and P-glycoprotein (P-gp) before and after target siRNA treat-ment .Results:Establishment of MKN-45/TAX cell line was successful .The expression level of MDR1 was high in MKN-45/TAX whereas it was low in MKN-45 .As TAX concentration increased ,the proliferation inhibition rates of both cell lines in-creased .At 42 ℃ the proliferation inhibition rate of MKN-45/TAX to TAX chemotherapy decreased ,while that of MKN-45 was the opposite .Both the expression of MDR1 mRNA and P-gp decreased after the siRNA transfection .Conclusions :Hyper-thermia combined with chemotherapy may enhance the resistance of TAX-resistant gastric cancer cell line to TAX ,while it may enhance the sensitivity of TAX-sensitive gastric cancer cell line to TAX .The mechanism may be related to the expression of MDR1 .

Objective:To compare the clinical efficacy of laparoscopy-assisted choledochoelectroscopy and endoscopic retrograde cholangiopancreatography on treatment of acute cholangitis with bile duct stones .Methods :The clinical datum of 103 cases of a-cute cholangitis with bile duct stones treated by laparoscopy-assisted choledochoelectroscopy (Group L ,n=64) or endoscopic retrograde cholangiopancreatography (Group E ,n=39) from October 2008 to September 2013 were analyzed retrospectively . In hospital days ,costs ,the rates of residual stones ,the rates of complications and the stone recurrence rates were compared between the two groups .Results:The operation success rates were 96 .25% and 89 .74% ,and hospital days were (9 .6 ± 0 .9) and (8 .3 ± 0 .7) days in Group L and Group E ,respectively ,but had no stastically significant differences (P> 0 .05) .The cost ,the rate of residual stones ,the rates of complications and the stone recurrence rate in Group L were significantly lower than those in Group E (P<0 .05) .Conclusions :Acute cholangitis with bile duct stones can be treated by laparoscopy-assisted choledochoelectroscopy or endoscopic retrograde cholangiopancreatography .However ,the former presents more clinical advan-tages .