Objective To evaluate the impacts of comprehensive diabetes intervention to provide evidence for effective diabetic control in rural communities.Methods Diabetic patients from four communities at Wujin District of Changzhou City were selected.One hundred and seventy-three patients from two communities received comprehensive intervention,including medication therapy,diabetes education,and diet.exercise,and behavior instruction(intervention group);142 patients from the other two communities got medication therapy only (control group).All the participants were interviewed with structured questionnaire and phyrsical examination.The second epidemic investigation was conducted at 4 years to evaluate the effects of the intervention.Results At the end of the intervention,the awareness rates of normal fasting plasma glucose,major diabetes risk factors,healthy diet,and therapeutic strategies in the intervention group were 90.8%.74.6%,89.6%,and 59.5%,respectively,which were significantly higher than those in the control group (all P<0.05).For the intervention group,the rates of diet behavior or physical exercise change were 68.8% and 58.4%.respectively.which were much higher than those of the control group(all P<0.05).The average levels of systolic pressure,diastolic pressure,fasting plasma glucose,and total cholesterol were (130.6±10.4)mm Hg(1 mm Hg=0.133 kPa),(78.4±7.5)mm Hg,(6.2±3.1)mmol/L,and (4.5±0.9)mmol/L,respectively,in the intervention group,which were lower than those in the control group(all P<0.05).Conclusion Comprehensive intervention shows significant effects on rural community patients with diabetes.

Objective To investigate the prevalence and influencing factor of metabolic syndrome(MS)in rural elderly population. Methods With randomized cluster sampling,investigations including questionnaires,physical examination,fasting plasma glucose,blood lipids were performed in rural population aged over 60 years in Changzhou city in 2004-2005. Results A total of 4976 elderly people were enrolled in the study.The prevalence of MS was 24.1%,and 10.3%in men,34.3%in women by international diabetes federation(IDF)2005 definition.86.2%individuals had one or more of the metabolic disorders.Logistic regression analysis showed that sex,smoking,sweetmeat,family history of essential hypertension(EH)and tea drinking were influencing factors of MS. Conclusions The prevalence of MS is high in rural elderly population,especially in females.

Objective To study the CT features of small hepatocellular cancer.Methods 37 patients with small hepatocellular cancer proved histopathologically underwent spiral CT examinations including plain scans and contrast-enhanced scans.The arterial phase scan,the portal phase scan and delayed phase scan started at 25th second,70th second and 5th minute respectively after injecting the contrast medium with the high pressure syringe,the velocity was 2.5 ~3 ml/s,and the dose was 1.5 ml/kg.Results 73% (27/37) of tumors showed hyperdensity in arterial phase,65%(24/37) of tumors was hypodensity and 35% (13/37) had hyperdensity during portal phase,of which eight showed hypodensity in equilibrium phase.Conclusion Spiral CT can display the features of blood supply of small hepatocellular carcinoma that is of benefit in early diagnosis.

AIM:ToobservetheeffectofcepharanthineonhumanlungadenocarcinomaLTEP-a-2cellgrowth, and to explore the changes of related microRNA ( miRNA) expression in the cells .METHODS:LTEP-a-2 cells were trea-ted with cepharanthine at concentrations of 0μmol/L, 10μmol/L, 20μmol/L and 40μmol/L.The growth inhibition rate was detected by MTT assay , and the cell morphological changes were observed under light microscope .The cell apoptosis was analyzed by flow cytometry .The expression of let-7c, miR-34a and miR-34b was measured by real-time PCR.RE-SULTS:Cepharanthine inhibited the cell activity of LTEP-a-2 cells in a dose-dependent manner .With the increase in cepharanthine concentration , the pyknosis of the cells was visible under the inverted microscope .Flow cytometry analysis found that different concentrations of cepharanthine induced the increase in the apoptotic rates of LTEP -a-2 cells.The re-sults of real-time PCR showed that the cepharanthine also increased the expression of let -7c, miR-34a and miR-34b.CON-CLUSION:Cepharanthine inhibits the growth of LTEP-a-2 cells, and induces apoptosis .Cepharanthine increases the ex-pression of let-7c, miR-34a and miR-34b, indicating that these miRNAs in LTEP-a-2 cells has the function as tumor sup-pressor genes .

Objective To investigate the prognostic value of CDKN2A mRNA in glioblastoma (GBM).Methods CDKN2A gene mRNA data were obtained from three different GBM database online (TCGA,REMBARNDT and GSE16011).The correlations between overall survival (OS) and CDKN2A expression were analyzed by Kaplan-Meier method and multivariate Cox regression analysis.Results In the TCGA database (n =358),patients with high CDKN2A mRNA level got longer OS than those with low expression level [median OS:18.0 months (95 ％ CI 15.0-21.0 months) vs 13.9 months (95 ％ CI 12.4-15.4 months),P =0.001].In another two validation datasets,patients with high CDKN2A mRNA level had longer OS than those with low expression level [median OS in REMBRANT:16.6 months (95 ％ CI 13.3-19.8 months) vs 11.8 months (95 ％ CI 7.3-16.4 months),P =0.019; in GSE16011:11.9 months (95 ％ CI 8.3-15.6 months) vs 8.4 months (95 ％ CI 6.2-10.5 months),P =0.005].CDKN2A mRNA level was an independent prognostic factor for GBM.The combination of CDKN2A mRNA expression with MGMT promoter methylation status or G-CIMP status/IDH1 mutations provided an optimized prognostic factor in GBM patients.Conclusion The CDKN2A mRNA has prognostic value in GBM patients,which provided an optimized stratification strategy based on multiple biomarkers.

Objective The application of intraoperative evoked EMG monitoring during lumbar pedicle screw fixation and to find new stimulus threshold criterion.Methods The validity of the evoked EMG monitoring in detecting the malposition of the pedicle screws was tested again by animal experiment.Nineteen patients was inserted pedicle screws with persistent evoked EMG monitoring via tap stimulator,and the electric current was set at 30% of bone threshold of the same pedicle,all patients were ohecked by CT scan to prove the outcome.Results Thirty-two pedicles of six dogs were inserted Kirchner wires.The stimulate thresholds of mal-position wires had significant difference with those of normal-position wires.During clinical trial,122 screws were inserted in to nineteen patients.Four screws were positive during intraoperative evoked EMG monitoring.Of which one screw was confirmed as mal-position during operation and was then adjusted;another screw was found to be mal-positioned by CT scan post-operation;the other two screws were found normal by CT scan.The sensitivity of this technique was 100% and the specificity was 98%.Conclusion Intraoperative evoked EMG monitoring during lumbar pedicle screw fixation can detect the mal-positioned screws and to protect the nerve roots.The stimulate current may set at 30% of the bone threshold of the relevant pedicle.

Objective:To explore the efficacy and security of endoscopic papillary balloon dilatation(EPBD)in lithotomy of common bile duct stones.Methods:The clinical data of 76 patients with common bile duct stones who underwent EPBD were retrospectively analyzed.Results:The common bile duct stones were successfully removed in 73 of the 76 patients.The success rate was 96.1% while the mean operative time was (30±12)min.There was no intestinal perforation.Five cases suffered intra-operative active bleeding which was successfully stopped by topical spraying norepinephrine or submucosal injection of 1∶10000 epinephrine.One case was complicated by postoperative acute pancreatitis while eight cases had hyperamylasemia.All the cases above were cured by conservative treatment.The average length of hospital stay was (3±4.5)d.Conclusions:The application of EPBD is safe in lithotomy of common bile duct stones,which has the advantage of short operative time and small trauma, quick recovery and few complications.

Objective To observe the effect of brain-derived microvesicles (BDMVs) on cytoskeleton in human umbilical vein endothelial cells (HUVECs).Methods BDMVs were prepared in vitro and identified by transmission electron microscopy and particle size identification.HUVECs were co-cultured with PKH26-1abeled BDMVs for 0.5,1,and 2 h;flow cytometry was used to detect the phagocytosis of HUVECs for BDMVs at different time points.HUVECs cultured in vitro were divided into control group,BDMVs treatment group and nimodipine treatment group;cells in the BDMVs treatment group were given 1.5× 107/mL BDMVs;cells in the nimodipine treatment group were pretreated with 2 μg nimodipine (0.2 mg/mL) for 10 min,and then,given 1.5×107/mL BDMVs.After being stained with rhodamine-labeled phalloidin,the fluorescence intensity and number of stress fibers of fibroactin in HUVECs were observed by laser confocal microscopy.Results BDMVs had complete membrane structure with a diameter of 100-1000 nm under transmission electron microscopy.The proportion of cells phagocytizing BDMVs increased significantly with prolonged incubation time,enjoying significant differences (0.5h:22.7％±1.2％;1 h:52.3％±1.3％;2h:71.6％±1.9％,P＜0.05).Laser confocal microscopy showed that,as compared with the control group,the fluorescence intensity ofcytoskeletal protein was obviously increased and the number of stress fibers increased was obviously larger in the BDMVs treatment group.As compared with those in the BDMVs treatment group,the fluorescence intensity of cytoskeletal protein was decreased and the number of stress fibers was obviously smaller in the nimodipine group.Conclusion The role of BDMVs in phagocytosis of HUVECs becomes stronger as time being prolonged,and BDMVs phagocytosis leads to cytoskeletal remodeling,which can be partially blocked by nimodipine.

Objective: Signaling lymphocytic activation molecule family members (SLAMFs) play a critical role in immune regulation of malignancies. This study aims to investigate the prognostic value and function of SLAMFs in ovarian cancer (OC). Methods: The expression analysis of SLAMFs was conducted based on The Cancer Genome Atlas Ovarian Cancer Collection (TCGA-OV) and Gene Expression Omnibus (GEO) databases. Immunohistochemistry (IHC) was further performed on tissue arrays (n=98) to determine the expression of SLAMF7. Kaplan-Meier plotter and multivariate Cox regression model were used to evaluate the correlation of SLAMF7 expression with survival outcomes of patients. The molecular function of SLAMF7 in OC was further investigated using Gene Set Enrichment Analysis (GSEA). Results: SLAMF7 mRNA expression were significantly upregulated in OC tumor tissue compared to normal tissue. IHC revealed that SLAMF7 expression was located in the interstitial parts of tumor tissue, and higher SLAMF7 expression was associated with favorable survival outcomes. GSEA demonstrated that SLAMF7 is involved immune-related pathways. Further analysis showed that SLAMF7 had a strong correlation with the T cellspecific biomarker (CD3) but not with the B cell (CD19, CD22, and CD23) and natural killer cell-specific biomarkers (CD85C, CD336, and CD337). Furthermore, IHC analysis confirmed that SLAMF7 was expressed in tumor-infiltrating T cells, and the IHC score of SLAMF7 was positively correlated with CD3 (r=0.85, p<0.001). Conclusion SLAMF7 is expressed in the interstitial components of clinical OC tissue, and higher SLAMF7 expression indicated a favorable prognosis for patients with OC.Additionally, SLAMF7 is involved in T-cell immune infiltration in OC.

Objective: Signaling lymphocytic activation molecule family members (SLAMFs) play a critical role in immune regulation of malignancies. This study aims to investigate the prognostic value and function of SLAMFs in ovarian cancer (OC). Methods: The expression analysis of SLAMFs was conducted based on The Cancer Genome Atlas Ovarian Cancer Collection (TCGA-OV) and Gene Expression Omnibus (GEO) databases. Immunohistochemistry (IHC) was further performed on tissue arrays (n=98) to determine the expression of SLAMF7. Kaplan-Meier plotter and multivariate Cox regression model were used to evaluate the correlation of SLAMF7 expression with survival outcomes of patients. The molecular function of SLAMF7 in OC was further investigated using Gene Set Enrichment Analysis (GSEA). Results: SLAMF7 mRNA expression were significantly upregulated in OC tumor tissue compared to normal tissue. IHC revealed that SLAMF7 expression was located in the interstitial parts of tumor tissue, and higher SLAMF7 expression was associated with favorable survival outcomes. GSEA demonstrated that SLAMF7 is involved immune-related pathways. Further analysis showed that SLAMF7 had a strong correlation with the T cellspecific biomarker (CD3) but not with the B cell (CD19, CD22, and CD23) and natural killer cell-specific biomarkers (CD85C, CD336, and CD337). Furthermore, IHC analysis confirmed that SLAMF7 was expressed in tumor-infiltrating T cells, and the IHC score of SLAMF7 was positively correlated with CD3 (r=0.85, p<0.001). Conclusion SLAMF7 is expressed in the interstitial components of clinical OC tissue, and higher SLAMF7 expression indicated a favorable prognosis for patients with OC.Additionally, SLAMF7 is involved in T-cell immune infiltration in OC.