Objective To investigate the predictive values of hypoxia-induced factor(HIF)- 1α and vascular endothelial growth factor (VEGF) in patients with type 2 diabetic kidney disease, and its relationship between HIF-1α, VEGF and glomerular filtration rate (eGFR). Methods Seventy-six patients with type 2 diabetic kidney disease were divided into two groups:DKD1 group [eGFR>90 mL/(min·1.73 m2),n=48] and DKD2 group [60 mL/(min·1.73 m2)0.05). Serum levels of HIF-1α and VEGF were significantly higher in DKD2 group than those of DKD1 group (P<0.05). There were negative correlation between VEGF and HIF-1αlevels with eGFR level (r=-0.59, P<0.01;r=-0.55, P<0.01). ROC curve showed that serum VEGF and HIF-1αlevels were above the opportunity diagonal. The diagnostic sensitivities of HIF-1 to DKD1 and DKD2 were 92.1%and 87.4%. The diagnostic specificities of HIF-1 to DKD1 and DKD2 were 91.7%and 85.4%. The diagnostic sensitivities of VEGF to DKD1 and DKD2 were 96.1%and 86.2%, and specificities were 93.3%and 89.1%. Conclusion Serum levels of VEGF and HIF-1αchange with the severity of diabetic nephropathy are likely to be an early predictor for the progression of diabetic kidney disease.

Objective_ To investigate the effect of resting heart rate on the progression to diabetes in impaired glucose regulation patients. Methods A total of 638 patients with impaired glucose regulation, from January 2011 to December 2012 in our endocrinology clinic, were selected for the study. According to the resting heart rate, patients were divided into four groups:<66 beat/min group, 66 to 69 beat/min group, 70 to 75 beat/min group, and>75 beat/min groups. All patients'baseline data were collected. The incidences of diabetes in different resting heart rate groups were compared, and the relationship between resting heart rate and the progression to diabetes was estimated using multiple regression analysis. Results In 704 patients with impaired glucose regulation, 636 patients have been completed 2 years follow-up, or reached the end of follow-up ( diagnosed as diabetes ) , the follow-up rate was 90. 34%. During two years follow-up, the incidence of diabetes of<66 beat/min group, 66 to 69 beat/min group, 70 to 75 beat/min group, and>75 beat/min group were 16. 2%, 19. 4%, 25. 0%, and 33. 0%, respectivlely. And the Cochran Armitage trend test showed that χ2 =11. 109, P=0. 001, the difference was statistically significant ( P<0. 05). According to blood glucose monitoring, the 636 patients with impaired glucose regulation were divided into impaired fasting glucose group, impaired glucose tolerance group and impaired fasting glucose combined with impaired glucose tolerance group:the Cochran Armitage trend test showed that, with the resting heart rate accelerating, the incidence of diabetes increased. The incidence of diabetes in impaired fasting glucose combined with impaired glucose tolerance group was higher than that of impaired fasting glucose group and impaired glucose tolerance group ( P=0. 062, 0. 113). The average resting heart rate in 68 impaired glucose regulation patients progressed to diabetes was (79.8±8.3)beat/min,andin568non-diabetescases,itwas(74.5±7.2)beat/min(t=-5.043,P<0.01). With the use of patients progressing to diabetes as the dependent variable, different resting heart rate group as independent variables, and resting heart rate<66 beat/min group as a reference, the logistic regression analysis showed that the risk of the progression to diabetes increased with the resting heart rate levels. Conclusion Higher resting heart rate is linked to higher risk of diabetes in patients with impaired glucose regulation.

Objective To study transmission characteristics of Acinetobacter baumannii (A.baumannii )clone and clinical features of infected patients in a respiratory intensive care unit (RICU),so as to guide the effective pre-vention and control of A.baumannii transmission.Methods 40 A.baumannii strains isolated from RICU patients were performed homology analysis by pulsed-field gel electrophoresis (PFGE)and cluster analysis,relationship of strains was determined,antimicrobial resistance and clinical data were analyzed.Results 40 A.baumannii strains were divided into 11 genotypes(A-K),the main epidemic strains were type A,B and E.The resistant rate to imipen-em was the lowest(70.00%),the next was levofloxacin (77.50%).The average age of 40 infected patients was 67 years old,the average length of hospital stay was 41 days,12 patients died because of invalid treatment.There was overlapping hospitalization among patients infected with type A and E strains;among patients infected with type B strain,there was no overlapping hospitalization among the last 6 and first 6 infected patients.Conclusion The main epidemic strains of A.baumannii were type A,B and E,antimicrobial resistant rate is high;the infected patients are with high average age and long length of hospital stay.It is important to reduce the transmission of A.baumannii through rational use of antimicrobial agents,strict aseptic operation,and intensified disinfection and sterilization of hospital environment and medical devices.

AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI) in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes) with diabetic retinopathy(Ⅲ~Ⅳstage) from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department.The health control (HC) group of 55 normal people was established simultaneously.Ocular blood flow velocity of the 55 normal people (110 eyes) and the 60 patients (120 eyes) was examined by CDFI of central retinal artery (CRA) and posterior ciliary artery (PCAs) using the PHILIPS HD6.Peak systolic velocity(PSV) was recorded.The examinations of CDFI, electroretinogram(ERG) and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of CRA of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the PSV of PCAs of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of PCAs of the DR group after photocoagulation with the data before, there was a significant difference at 1d postoperatively(P<0.05), there was no significant difference at 7d, 1, 3 and 6mo(P>0.05).Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05).Compared the aA and bA of ERG of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the aT and bT of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the aT and bT of ERG of the group DR after photocoagulation with the data before, there was no significant difference(P>0.05).The vision of 49 cases(98 eyes) was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes) remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect.Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic` eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.

AIM: To observe the morphologic characters and the expression of vimentin on human lens epithelial cells (hLECs)cultured on laminin and fibronectin.METHODS: The primarily and secondarily hLECs were cultured on plates treated with laminin or fibronectin. The feature of hLECS was observed and recorded using an inverse microscope with digital camera and statistical analysis was applied. MTT assay was used to show the growth curve of subcultured cells (the 3rd passage). Immunofluorescent staining was used to demonstrate the morphologic change in vimentin expression in the 3rd passaged hLECs.RESULTS: The hLECs in laminin or fibronectin group grew out significant earlier than the untreated group. The cells could be subcultured fluendly in those two treated groups,while only a few survival cells were found in the untreated group. But the hLECs could undergo apoptosis in laminin group at the terminal phase of their life cycle, while lentoid bodies emerged in fibronectin treated group. There were more viable cells in the fibronectin group from the 4th to the 7th day by MTT reaction. Immunofluorescent staining showed a clear morphological difference between the two groups.CONCLUSION: Laminin provide a suitable growth microenvironment for the hLECs while fibronectin promotes the cells proliferation and differentiation.

Objective To learn the levels of serum 25-(OH)D in 0 12 years old chindren in Kunming.Methods Serum 25-(OH)D levels of children (4 498) were measured by using Roche cobas 8 000 / E602 automatic electrochemical luminescence immunoassay.Results As the increase of age,the levels of serum 25-(OH)D were gradually decreased,different age groups had significant difference (P＜0.05).The levels of 25-(OH)D between boys and girls had no significant difference (P＞0.05);The average level of sernm 25-(OH)D was 83.48 nmol/L,the level of serum 25-(OH)D was distributed in 0 ～ 1 years old group,and most concentrated in the 6 ～ 9 years old group.Conclusion The levels of 25-(OH)D in 0 ～ 12 years old chindren are in a good status,but with the increase of age,the level of 25-(OH)D is decreasing gradually,especially the levels of 25-(OH)D decreased significantly after the age of three,in shortage or lack of status,this should cause everybody's attention.

Amygdala ; drug effects ; metabolism ; Animals ; Conditioning (Psychology) ; Morphine ; adverse effects ; Rats ; Receptors, Opioid, kappa ; metabolism

Objective: To learn HIV related stigma and its associated factors among the patients on antiretroviral therapy ( ART ) in Wenshan Prefecture, Yunnan Province, so as to provide evidence for eliminating HIV discrimination. Methods: A total of 419 subjects were recruited by convenience sampling from three ART clinics in Wenshan City and Maguan County between October 2017 and January 2018. HIV/AIDS Related Stigma and Discrimination Scale developed by Li Xianhong et al was employed. The multivariate linear regression model were used to explore the influencing factors for HIV stigma. Results: The median scores of disclosure concern, public rejection, family stigma, internalized stigma, health service providers＇ stigma were 24.00, 6.00, 10.00, 20.00, 2.00, respectively, and the overall was 68.00. The multivariate linear regression analysis showed that female patients ( standardized β=0.135 ) , patients with opportunistic infection ( standardized β=0.120 ), patients had no HIV infected family member ( standardized β=-0.128 ) , patients without family support ( standardized β=-0.175 ) , patients received gift from ART clinics ( standardized β=0.124 ) , patients scored lower in ART knowledge ( standardized β=-0.117 ) were likely to scored higher in HIV stigma. Conclusions The stigma on disclosure concern and internalized stigma dimensions are grievous among ART patients in Wenshan Prefecture. Gender, opportunistic infection, HIV infection in family, family support, receiving incentive gifts from clinics and awareness of ART are associated with HIV stigma.

Objective To observe the effect of clindamycin for preventive infection in arthroplasty prophylac-tic.Methods 108 knee replacement patients were injected by 600mg intravenous clindamycin preoperation and con-tinue to use 1 -2 days after operation.The average postoperative hospitalization,postoperative outcome,body tempera-ture and blood after WBC changes of CRP and ESR in the fall of superficial infection trend,the average postoperative day,take out stitches after operation and the number of cases,postoperative deep infection early after infection (2 weeks)and delayed infection cases (within one year)were observed in order to evaluate the efficacy of preopera-tive antibiotics.Results 2 cases had superficial infection due to wound dehiscence (two times after suture recover-y),there was no complications of surgical wound in the other cases.In all cases,after operation,body temperature and blood WBC became to the normal level in seventh days,postoperative patients'CRP,ESR monitoring were significantly higher than those before operation (CRP:F =105.32,P =0.045;ESR:F =118.47,P =0.039),but on the 5 day after operation they were started to decline,CRP in the 21 postoperative day gradually returned to normal,and ESR gradually returned to normal after 6 months of operation.Preoperative HSS score was significantly lower than the post-operative score[(46.8 ±9.7)points vs.(91.7 ±3.4)points,t =6.38,P <0.05].Conclusion Clindamycin plays a definite role in prevention of infection,especially in the beta lactam antibiotic allergy cases,it can be preoperative antibiotic prophylaxis instead of cephalosporins.

Objective: To observe the effects of moxibustion therapy at Shenshu (BL 23) and Zusanli (ST 36) of rats with induced rheumatoid arthritis (RA) on the serumal intercellular cell adhesion molecule-1 (ICMA-1) and the pathological tissue, to discuss the mechanism of the warming and activating effect of moxibustion. Methods: After establishing the RA rats model, the induced rats were treated with moxibustion therapy on the acupoint Shenshu (BL 23) and Zusanli (ST 36), followed by analyzing the pathological section of the ankle of the hind limb and testing the ICAM-1 content with ELISA. Results: The plantar circumferences of the induced rat increased significantly compared with the rats in the control group (P<0.01), accompanying with the increase of the synovial layer, the erosion of phlogocytes to chondrocytes and the specific increase of ICAM-1 content. After the moxibustion therapy, the plantar circumferences decreased significantly (P<0.01) while the synovial layer tended to reduce. In addition, there was no pathological damage of the articular cartilage and the ICAM content decreased with significant deviation (P<0.01), compared to the model group. Conclusion: It was concluded that moxibustion therapy could inhibit the arthrosynovitis and hyperplasia, ameliorate the erosion of phlogocyte to cartilage, prevent articular periosteal lesions and delay the pathological course. The warming and activating effect of moxibustion therapy may involve the inhibition of the formation of ICAM-1 and pannus.