Objective To investigate clinical characteristics and risk factors in elderly patients with type 2 diabetes mellitus (T2DM) complicated with chronic kidney disease (CKD).Methods Two hundred and two T2DM patients aged ≥60 y admitted in Tongren Hospital from August 2009 to February 2012 were enrolled in the study,including 64 cases complicated with CKD (CKD group)and 138 cases without CKD (non-CKD group).Hemoglobin (Hgb),albumin (ALB),glycated hemoglobin A1C (HbA1 c),fasting plasma glucose(FBG),postprandial glucose (PBG),serum creatinine (Scr),blood urea nitrogen (BUN),uric acid (UA),total cholesterol (TC),triglyceride (TG),high densitylipoprotein (HDL-C),low density lipoprotein (LDL-C) were measured and ratio of urinary albumin to creatinine (UAER/CR) were calculated,ankle brachial index (ABI) and ambulatory blood pressure was examined.Results The duration of diabetes in CKD group was longer than that in non-CKD group [(13 ± 11) vs.(10 ± 7) y,t =2.35,P ＜ 0.05].Hgb and ALB in CKD group were lower than those in non-CKD group [(12.1 ± 1.7) vs.(13.3 ±1.3) g/L,(34.4±2.6) vs.(36.8 ±3.4) g/L,t=-5.73,-4.75,allP＜0.01]; UA,TG,24 h systolic blood pressure (SBP),24 h pulse pressure (PP)in CKD group were higher than those in non-CKD group [(367 ± 81) vs.(323 ± 74) μmol/L,(1.6 ± 0.9) vs.(1.3 ± 0.7) mmol/L,(133 ± 14) vs.(127±16)mmHg,(65 ±12) vs.(58 ±12)mmHg,t =3.82,2.50,2.47,3.68,all P＜0.1].The UAER/CR in CKD group and non-CKD group was 86.2 mg/g (24.6-374.8 mg/g) and 6.0 mg/g (3.6-17.8 mg/g),respectively (P ＜ 0.01) and ABI in CKD group and non-CKD group was 0.94 ± 0.18 and 1.03 ±0.18 (-2.78,P ＜0.05).There were no significant differences in FBG,PBG,HbA1c,TC,HDL-C andLDL-C between two groups(t =-2.02,1.47,1.48,-0.53,-1.20,-0.76,all P＞0.05).Logistic regression analysis showed that ALB,TG and UAER/CR were the independent risk factors of CKD in T2DM patients(OR:0.79,3.63 and 1.04,95％ CI:0.62-1.01,1.45-9.01 and 1.00-1.08).Spearman correlation analysis demonstrated that eGFR was positively associated with Hgb,ALB,ABI (r =0.38,0.33 and 0.28,all P ＜ 0.01),negatively associated with age,BUN,Cr,UA,TG,UAER/CR,24 hSBP and PP in all diabetes patients(r =-0.32,-0.63,-0.89,-0.34,-0.18,-0.65,-0.16 and -0.248,all P ＜0.01).Conclusions ALB,TG,UAER/CR are the independent risk factors of chronic kidney disease in elderly patients with type 2 diabetes mellitus.

It has been demonstrated that astrocyte elevated gene 1 ( AEG-1 ) can promote tumor initia-tion and progression .Over expression of AEG -1 is correlated with tumor angiogenesis ,metastasis and chemother-apy resistance of tumor cells of different origins .The present article is a review on the mechanism of AEG -1 me-diated drug resistance .Studies have shown that AEG -1 participates in carcinogenesis through Ha -ras,myc,NF-κB and PI3K/Akt signalling pathways .AEG-1 can also promote autophagy through activating AMP Kinase . Other researchers demonstrate that AEG -1 promotes MDR1 protein translation by up-regulating MDR1 mRNA expression ,and thus increases polyribosome .It is testified that AEG-1 can influence drug susceptibility and ex-pression of MDR gene as a RNA binding protein .Multiple functions of AEG -1 in drug resistance in multiple cancers demonstrate that AEG -1 can be used as a novel target for antitumor drugs .

Objective To investigate effects of Kanglaite injection on proliferation, cycle and apoptosis of human breast cancer MCF-7 cells;To discuss its relevant mechanism. Methods Logarithmic growth phase cells were divided into control group and Kanglaite-treatment group (10, 20, 40μL/mL). Cells were cultured in RPMI-1640 for 24 h before drug treatment. The inhibition rate of Kanglaite injection on proliferation of human breast cancer MCF-7 cells was detected by MTT assay. Apoptosis and cell cycle of MCF-7 cells were detected by flow cytometry. Changes in cell nucleus were determined by Hochest staining assay. Protein expressions of Bcl-2 and Bax were detected by ELISA and Western blot. Results Kanglaite injection for 12 h, 24 h or 48 h resulted in a significant inhibition of MCF-7 cells proliferation (P<0.05, P<0.01);Compared with the control group, Kanglaite injection-treated cells showed increased percentage in G2/M and G0/G1 phases (P<0.001, P<0.01), but showed decreased percentage in S phase (P<0.01), and apoptosis rate increased (P<0.05, P<0.001). Kanglaite injection significantly decreased protein expression of Bcl-2, and enhanced protein expression of Bax of MCF-7 cells (P<0.01, P<0.001). Conclusion Kanglaite injection can inhibit the proliferation of human breast cancer MCF-7 cells, decrease cell cycle and induce apoptosis, the mechanism is related with decreasing protein expression of Bcl-2 and enhance the protein expression of Bax.

A method to assess library-holding journals according to their weighted citations was proposed in light of the actual needs of users for core journals, the use of library-holding journals and references by authors in different orders of precedence.The Western journal of rheumatology, highly cited by authors of Second Military Medical U-niversity, were assessed using this method, showing that this method is better than the citation analysis-based tra-ditional method in assessment of journals.

Background Glial cell line derived neurotrophic factor (GDNF) is determined to have a neurotrophy effect and promoting effect to the growth of axon.GDNF has been applied in ophthalmology.Research showed that artemin,a new member of GDNF family,has a better function in protection of neuron,but seldom relevant document of distruibution of artemin in retina is found so far.Objective The aim of the present study is to investigate the distribution and expression of artemin in normal rat retinal neuron cells and retinal ganglion cells,and imitate diabetic environment to observe the expression of artemin at the condition of high glucose.Methods Retinal tissue was isolated from clean neonatal SD rats and cultured by expand culture method in DMEM/F12 containing 10% fetal bovine serum.40 mmol/L of glucose was added in medium in the seventh day after culture for 12 hours as experimental group.The expression and location of artemin in retina were tested by real-time PCR and cell immunofluorescence assay.Use of experimental animals followed the Management Regulation of experimental animals of Jiangsu Province.Results Cultured cells showed the typical cell body and processes in the seventh day.Cultured retinal ganglion cells (RGCs) presented the red fluorescence for Thy1.1 antibody,and multiple fluorescence label revealed that RGCs exhibited the green fluorescence for artemin antibody and red fluorescence for Thy1.1 antibody,indicating artemin protein was positively expressed in cultured RGCs.The numbers of positive cells for Thy1.1 antibody was (442±9)/high field in normal culture group and (263±7) /high field in 40mmol/L glucose culture group,showing a significant difference between them (P＜0.05).The expression of artemin mRNA in normal culture group and in 40 mmol/L glucose culture group,was showing a considerably difference between them(P＜0.05).Conclusion Artemin can be expressed in cultured retinal neuron cells and RGCs in rats.High glucose environment down-regulate the expression of artemin.This study proved a new idea for protecting RGCs against damage.

Objective To investigate the application value of virtual touch tissue image technology (VTI) and virtual touch tissue quantification technique (VTQ) in the differential diagnosis of benign and malignant superficial lymph nodes. Methods Fifty superficial lymph nodes were obtained, including 23 for nonspecific inflammatory, 2 for tuberculosis, 5 for lymphoma and 20 for metastasis. All lymph nodes were confirmed by biopsy pathology or follow-up after anti-inflammatory treatments and scanned by traditional ultrasound, VTI and VTQ before resections or treatments. Receiver operating characteristic curve of traditional ultrasound, VTI and VTQ was made to determine the optional cut-off point in the differential diagnosis of benign and malignant superficial lymph nodes and calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Final diagnosis was defined as the golden standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated by the combined application of traditional ultrasound with VTI and VTQ technology. Results Nine (evaluation value) was taken as the critical value which was scanned by both two-dimensional ultrasound and color Doppler. The ROC curve indicated that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of conventional two-dimensional ultrasound of benign and malignant lymph nodes were 76.0%, 84.0%, 80.0%, 82.6%, and 77.8%. Taking three (critical value) as the cut-off point, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VTI in the diagnosis of benign and malignant lymph nodes were 88.0%, 64.0%, 76.0%, 71.0%and 84.2%. Taking 2.755 m/s (shear wave velocity) as the cut-off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VTQ in the differentiation of benign and malignant superficial lymph nodes were 80%, 92.0%, 86.0%, 90.9%and 82.1%. Defined“traditional ultrasound +VTI+VTQ series method” as using conventional ultrasound, VTI, VTQ simultaneously, superficial lymph nodes could be diagnosed with malignant or benign if each method confirmed the same diagnosis. Defined“traditional ultrasound+VTI+VTQ parallel method”as using conventional ultrasound, VTI, VTQ simultaneously, superficial lymph nodes could be diagnosed with malignant if any one method indicated malignancy, otherwise benign. Specificity of‘traditional ultrasound+VTI+VTQ series method’ was consistent with VTQ, which was 92.0%, while the sensitivity and accuracy decreased significantly, which was 64.0%and 78.0%, respectively;the sensitivity and negative predictive value increased significantly by using “traditional ultrasound +VTI+VTQ parallel method” when compared with traditional ultrasound, VTI or VTQ, almost near 100%, but declined significantly in specificity and accuracy, which was 64.0%and 82.0%, respectively. Conclusions Traditional ultrasound, VTI and VTQ have certain clinical value for differential diagnosis of benign and malignant superficial lymph nodes. Combined application of traditional ultrasound, VTI and VTQ can improve the accuracy in the diagnosis of benign and malignant lymph nodes effectively.

Through ethical analysis of the conflicts appearing in four special cases in the four steps of assisted reproductive technology implementations, this paper pointed out the measures to solve them in the perspective of le-gal protection, standardized management, ethical supervision, and self-regulation for making the research and ap-plication of assisted reproductive technology serve patients better and promoting the healthy development of assisted reproductive technology.

By expounding the definition and application status quo of egg freezing with non-medical factors, this paper ethically analyzed the conflict between egg freezing with non-medical factors and assisted reproductive technology standard management. After systematic evaluation on effectiveness, safety, economy and ethics, it sug-gested that the egg freezing with non-medical factors required careful consideration.

Objective To establish an in vitro skin sensitization test,human cell line activation test (h-CLAT),based on THP-1 cell line (a human acute monocytic leukemia cell line),and to assess the sensitizing potency of plant raw materials of chemical and cosmetic products by this in vitro skin sensitization test.Method THP-1 cells were cultured in vitro and exposed to 11 reference skin sensitization chemicals and 9 samples,by monitoring the cell viability,cell surface marker CD54 /CD86 and relative fluorescence intensity of cells surface after the cells was exposures to the substances,and to discover whether there is a positive reaction.At the same time,Buehler test was used to validate the results of samples tested by h-CLAT.Results 11 reference chemicals were distinguished correctly by h-CLAT.Among the 9 samples tested,7 samples were recognized as negative sensitizer and 2 plant extracted substances were identified as suspicious skin sensitizer.The qualitative classification of the 9 samples by h-CLAT test was consistent with the results obtained by animal test.Conclusions The h-CLAT-in vitro test can be used to replace some animal tests for the prediction of soluble skin sensitizing substances.

Objective To explore the use of integrated two methods in vitro in prediction of eye irritation caused by cosmetics.Method Chorioallantoic membrane vascular assay ( CAMVA), bovine corneal opacity and permeability (BCOP) and Draize rabbit eye irritation test were used to determine the predictive potential of eye irritation of 60 kinds of cosmetics.Results CAMVA method was able to distinguish 41 non-irritant samples and 18 irritant samples.BCOP method was able to predict 35 non-irritant samples , 21 mild-moderate irritant samples and 4 severe irritant samples . Combination of CAMVA and BCOP methods could obviously improve the identification ability of irritation , and the classification consistency with Draize rabbit eye irritation testing reached 98.3%.Conclusions The integrated test strategy combined BCOP with CAMVA can be used to appropriately predict ocular irritation of cosmetics , with a prediction range covering non-irritant to severe irritant samples .