Objective To observe the relationship between homocysteine (Hcy),C-reactive protein (CRP) and type 2 diabetes peripheral vascular disease (PVD).Methods Fifty-eight patients with type 2 diabetes according to the condition of PVD were divided into simple type 2 diabetes mellitus group (DM group,30 cases) and PVD group (28 cases).Twenty-five healthy people were chosen at the same period as control group.The fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C),Hcy and CRP levels were detected among 3 groups,and the body mass index (BMI),ankle brachial index(ABI) was calculated.Results The BMI,TG,TC and HDL-C levels among 3 groups had no statistical significance (P ＞0.05).The FBG,HbA1c and LDL-C in DM group and PVD group were significantly higher than those in control group [(7.54 ± 1.25),(8.12 ± 1.57) mmol/L vs.(4.68 ±0.54)mmol/L; (6.92 ± 0.89)％,(7.54 ± 0.97)％ vs.(4.80 ± 0.54)％ ; (3.79 ± 0.73),(4.41 ± 0.93) mmol/L vs.(2.68 ± 0.54) mmol/L],and the difference was statistically significant (P ＜ 0.05).But the difference between PVD group and DM group had no statistical significance (P ＞ 0.05).Hcy and CRP in DM group and PVD group were higher than those in control group [(10.26 ± 3.62),(19.83 ± 5.54) μ mol/L vs.(8.92 ± 2.41)μ mol/L; (4.12 ±0.57),(5.47 ±0.85) mg/L vs.(2.73 ±0.54) mg/L],ABI was lower than that in control group(0.92 ± 0.18,0.81 ± 0.16 vs.1.02 ± 0.23),and the difference was statistically significant (P ＜ 0.05);Hcy,CRP in PVD group were obviously higher than those in DM group,ABI was lower than that in DM group,and the differences were statistically significant (P＜ 0.05).Spearman analysis showed that Hcy was negatively correlated with ABI (r =-0.635,P ＜ 0.05),CRP was negatively correlated with ABI (r =-0.529,P ＜ 0.05),and Hcy was positively correlated with CRP (r =0.528,P ＜ 0.05).The partial correlation analysis results showed that Hcy and ABI still showed a negative correlation (r =-0.315,P ＜ 0.05),CRP and ABI still showed a negative correlation (r =-0.243,P ＜ 0.05).Conclusion Hcy and CRP participating in the occurrence and development of type 2 diabetes PVD,can be used as a predictor of type 2 diabetes PVD.

Objective: To evaluate effects of atrioventricular nodal ablation, pacemaker and pharmaco logic agents on ventricular rate control. Methods:Three patients with chronic sustained atrial fibrillation ( AF) were treated by atrioventricular nodal ablation. Fast-slow junctional cardiac rhythm in this course meant the ablation was successful. Unless the ablation was able to get Ⅱ? Ⅱ type or Ⅲ? AVB, R-R intervals ≥3 s, ventricular rate≤40 bpm, it would be canceled. Otherwise implantation of a permanent pacemaker was performed. Results:One patients having complete atrioventricular block and a ventricular rate of 38 -40 bpm had implantation of a permanent pacemaker. Two patients having no atrioventricular block, prolongation of R-R intervals and ventricular rate of 90 - 120 bpm were given antiarrhythmic drugs. Conclusion: Patients with chronic sustained AF can be treaded with atrioventricular nodal ablation, pacemaker and pharmacologic agents effectively.

High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.

AIM: To explore the effects of hyperbaric oxygen (HBO) therapy on language function of aphasics and it's mechanisms. METHODS: Forty patients with aphasics after mild and moderate cerebral trauma and stroke were chosen and divided into therapy group (20 patients) and control group (20 patients). All the patients in both groups received routine therapy.Besides routine therapy, patients in therapy group also received HBO therapy. The HBO treatment contained three courses, each lasts for 15 days at an interval of 3 days. The language functions ( including 11 sub - items) were tested with the Apparatus ZM2.1for Diagnosis and Treatmern of Language Disorders (Language Disorders ZM2.1) before and after each course of HBO and be compared between the two groups. RESULTS: The therapeutic effects between the therapy group and the control group: the scores of 10 sub- items are significantly higher than those of the control group after the 2nd course (P＜0. 05); After the 3rd course, all 11 sub - items were improved significantly ( P ＜ 0.05). The therapeutic effects before and after each course of the therapy group:the scores of the advanced dictation, voice expression and semantic expression increased significantly after the 1st and the 2nd course ( P ＜ 0.05). CONCLUSIONS: The HBO therapy might facilitate the recovery of the language function of the aphasics by promoting the recovery and the self- reparation of the neurocytes and alleviating the focal ischemia - reperfusion. The result of this effect would facilitate the original recovery velocity and not be focused on some language functions and much more obvious in the 1st and the 2nd course.

AIM:To investigate the effects of estrogen on the expression of matrix metalloproteinases-2(MMP-2), tissue inhibitor of metalloproteinases-2(TIMP-2) and transforming growth factor-β1(TGF-β1) in cultured human corneal stromal cells.METHODS: Inflammatory environments of human corneal stromal cells were simulated by using 1.5ng/mL IL-1β.The cells were then treated with or without different concentrations of estrogen(0, 1×10-4, 1×10-6, 1×10-8, 1×10-10mol/L estradiol)in vitro.Cell viability was evaluated by MTT.Expression levels of MMP-2, TIMP-2 and TGF-β1 proteins were measured by enzyme-linked immunosorbent assay(ELISA).RESULTS:Estrogen did not affect the viability of human corneal stromal cells.Compared with the control group, expression levels of MMP-2 and TGF-β1 proteins in E2 treatment group significantly decreased after being treated with estrogen, while the expression level of TIMP-2 significantly increased.CONCLUSION: Estrogen could, to some extent, down-regulate the expression of MMP-2 and TGF-β1 and up-regulate the expression of TIMP-2, which might contribute to protecting human cornea.

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

Objective Allograft vasculopathy (AV), feature of chronic rejection, is a major serious long-term post-operation complication in organ transplantation. The accurate mechanisms for AV have not been definitively established, but extensive basic and clinical studies demonstrate AV is triggered by immune reaction and nonimmunologic factors, and also possibly attributed to the metabolism of branched-chain amino acids (BCAA). Methods The transplanted hearts from Lewis to Sprague-Dawely rats served as allografts and those from Lewis to Lewis rats as isografts based on Ono 's model. The differential proteins in transplanted hearts were separated by comparative proteomic technique, and some enzymes which regulated the metabolism of BCAA were identified and validated.Results All transplanted hearts at second week postoperation were characterized by lumen loss (total area-luminal area/total area) in coronary artery, but more predominant at 8th week. All samples from the left ventricles were analyzed by proteomic techniques and the subunits E1 a, E1β and E3 of branched-chain α-ketoacid dehydrogenase (BCKDH) complex were decreased in the heart allografts.Immunohistological detection also showed the expression of BCKDH was reduced not only in the cardiac muscle but also more significantly in blool vessels with cardiac allograft vasculopathy (CAV).BCAA concentrations were increased in the cardiac allografts, but there was no difference in the serum. Conclusion These findings suggest that the catabolic pathways of the BCAA may be inhibited owing to the reduced expression of BCKDH complex, and elevated intracellular concentrations of leucine. The vascular smooth muscle cell and cardiac muscle cell proliferation is stimulated via mTOR-dependent and mTOR-independent pathways, which is associated with the formation of myocardial hypertrophy and AV in the heart allografts.

Objective To assess the safety and feasibility of CT-guided percutaneous argon-helium cryoablation in the treatment of adrenal tumors.Methods 1 7 patients with adrenal tumors were treated with CT-guided percutaneous argon-helium cryoablation. Three of these patients were retreated second cryoablation three months later due to the lager tumor diameters.Percutaneous tran-scatheter arterial embolization was performed in four patients because of rich blood supply before cryoablation.Continuous arterial blood pressure monitoring was performed in eight pheochromocytoma patients.Results Technical success was achieved in all pa-tients.There were no serious complications.Eight pheochromocytoma patients experienced a significant increase in systolic blood pressure and diastolic pressure when compared with the basic values (P <0.05).There were no enhancement on enhanced CT and/or up-take on FDG PET-CT in the ablated zones during the follow-up period (3-24months).Conclusion It is safety and efficacy of CT-guided percutaneous argon-helium cryoablation for adrenal tumor.It might be initial treatment of choice for the patients who were not suitable for resection.

To study the potential molecular mechanism of tumor angiogenesis in its microenvironment, we investigated the effects of HepG2 conditioned medium on the proliferation of vascular endothelial cell and vascular angiogenesis in our laboratory. Human umbilical vein endothelial EA. hy926 cells were co-cultured with HepG2 conditioned medium in vitro. The proliferation and the tubulogenesis of EA. hy926 cells were detected by teramethylazo salt azole (MTT) and tube formation assay, respectively. The results showed that the survival rate of the EA. hy926 cells was significantly increased under the co-culture condition. HepG2 conditioned medium also enhanced the angiogenesis ability of EA. hy926 cells. In addition, the expressions of intracellular VEGF and extracellular VEGFR (Flk-1) were regulated upward in a time-dependent manner. In conclusion, the proliferation of vascular endothelial cells and Vascula angiogenesis were improved under the condition of indirect co-culture.
Carcinoma, Hepatocellular ; pathology ; Cell Proliferation ; Coculture Techniques ; Culture Media, Conditioned ; Endothelial Cells ; cytology ; Hep G2 Cells ; Human Umbilical Vein Endothelial Cells ; Humans ; Liver Neoplasms ; pathology ; Neovascularization, Pathologic ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism