OBJECTIVE: To explore the clinical efficacy of irbesartan, enteric-coated aspirin combined with tetramethylpyrazine in the treatment of diabetic nephropathy. METHODS: 75 patients with diabetic nephropathy were randomly divided into treatment group(n=40) and control group(n=35). Both groups were administered with 150 mg irbesartan(p.o.) and 100 mg enteric-coated aspirin (p.o.) once a day. Treatment group were additionally treated with 0.9% normal saline containing 200 mg tetramethylpyrazine once a day (i.v.gtt). During 28 days of treatment, treatment group was compared with control group in respect of 24-h urine protein, blood lipids, blood rheology. RESULTS: After treatment, hemorheological indexes (?b, EAI), renal function indexes(Scr、BUN、24-h urine protein) , Serum lipids(TG, TC) were decreased significantly(P

Objective To discuss 64-slice CT three-dimensional reconstruction (3D) and MPR (MPR) in the application of the nasal bone fracture. Methods 102 patients with recent nasal fracture in our hospital underwent 64-slice CT scan axial thin spiral. Nasal fracture imaging was observed using workstations in the three-dimensional reconstruction (3D) and MPR (MPR). Results 102 cases of nasal bone fracture,dislocation fractures in 47 cases,non-fracture dislocation of the 55 cases,46 cases of bilateral nasal bone fracture,unilateral 22 cases(13 cases the left side of the right of nine cases),15 cases of fracture of the nasal septum,nasal bone fracture associated with maxillary The amount of bone fracture in 13 cases,only six cases of separation suture. All the nasal bone fractures 3D imaging and after the MPR can display three-dimensional fractures of the location,shape,type,degree of collapse and three-dimensional information. Conclusion 64-slice CT3D and MPR technology can improve the accuracy of diagnosis of the nasal bone fracture,and provide valuable information for clinicians in the choice of treatment program.

Objective To explore the mechanism of long chain noncoding RNA RORin regulating prolifer-ation and apoptosis of pancreatic cancer cell. Methods Pancreatic cancer cell line BxPC-3 was selected. The RNA level of lncRNA ROR and notch1 was detected by RT-PCR.Notch1 protein level was detected by Western blot. The regulating relationship between lncRNA ROR and notch1 was analyzedby RNAhybird and luciferase re-porter assay. At last ,CCK-8 and TUNEL were applied to detectthe proliferation and apoptosis of cell line. Re-sults lncRNA ROR and notch1 were highly expressed in pancreatic cancer tissue ,compared with normal tis-sues. There was positive correlation between them. lncRNA ROR was over-expressed in BxPC-3,cell proliferation activity was increased and the percentagesof DNA damaged positive cells was decreased ,accompanied by in-creased levels of notch1 mRNA and protein. Luciferase assay confirmed that ROR could bind to notch1and inhibit its activity by miR-137. Compared with control group ,the proliferation of pcDNA-ROR + si-notch1 cells reduced and the proportion of TUNEL positive cells increased. The differences were statistically significant. Conclusionl ncRNA ROR regulated the proliferation and apoptosis of pancreatic cancer cells by promoting the expression of notch1.

Objective To investigate the influencing factors for spontaneous bacterial peritonitis (SBP) in patients with acute-on-chronic liver failure (ACLF),and to provide a reference for clinical diagnosis and prognosis evaluation.Methods A retrospective analysis was performed for the clinical data of 667 patients with ACLF who were hospitalized and treated in our hospital from January 2009 to December 2014,and according to the presence or absence of SBP,they were divided into ACLF group(n =232) and ACLF-SBP group(n =435).The general information,laboratory markers,and incidence of complications were compared between the two groups.The t-test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups,and a logistic regression analysis was used to identify independent risk factors for ACLF complicated by SBP.Results The comparison of laboratory markers and comorbidities showed that there were significant differences between the two groups in albumin (Alb) (t =-4.110,P ＜ 0.001),alanine aminotransferase (U =-6.653,P ＜ 0.001),aspartate aminotransferase (t =-8.045,P ＜ 0.001),blood sodium (t =-2.879,P =0.006),prothrombin time activity (t =-2.140,P =0.037),international normalized ratio (t =1.453,P =0.042),hemoglobin (t =-3.446,P =0.001),upper gastrointestinal bleeding (x2 =48.252,P =0.002),hepatorenal syndrome (x2 =16.244,P =0.031),and pulmonary infection (x2 =13.564,P ＜ 0.001).The multivariate logistic regression analysis showed that there were significant differences in Alb (OR =1.119,95 ％ CI:1.052 ～ 1.189),platelet count (PLT) (OR =1.035,95 ％ CI:0.755 ～ 1.084),upper gastrointestinal bleeding (OR =1.117,95 ％ C1:0.072 ～ 1.135),and pulmonary infection (OR =2.275,95 ％ CI:0.978 ～ 5.292) (P =0.002,0.038,0.022,and 0.036).Conclusion In the treatment of ACLF patients,risk factors including low Alb,low PLT,upper gastrointestinal bleeding,and pulmonary infection should be prevented,and early diagnosis and intervention of these risk factors helps to reduce the incidence of SBP.

Objective To investigate the incidence of hepatocellular carcinoma (HCC) among patients with esophageal varices bleeding previously treated with endoscopic sclerotherapy, and to evaluate the factors influencing prognosis of HCC patients.Methods The clinical data of patients (from April 1987 to May 2003) who had received sclerotherapy for esophageal varices bleeding, and also that of HCC patients who had had sclerotherapy for esophageal varices bleeding were retrospectively reviewed. The survival rates of HCC patients were evaluated with Wilcoxon-Gehan method. Sixteen risk factors for HCC were assessed by multivariate analysis (Cox model). Results A total of 934 cases were treated with sclerotherapy, among which 109 patients suffered from HCC while 825 patients did not. In 22 HCC patients with esophageal varices bleeding sclerotherapy was not given. 31 out of 825 patients (3.76%) developed HCC during the follow-up period. 17 out of 31 patients received regular follow-up while 14 cases did not. The median surviving time of 31 patients was 13 months. The survival rate of patients with HCC under regular follow-up was significantly higher than that of patients under irregular follow-up(P=0.0002); risk factors, i.e. Child-Pugh classification, age and regular or irregular follow-up, were significantly related to the prognosis of patients with HCC(P=0.039、0.029 and 0.021, respectively). Conclusion Surveillance of patients with decompensated liver cirrhosis may increase the diagnostic rate of small HCC and prolong life expectancy; sclerotherapy can lower the incidence of HCC and it may play an active role in decreasing the incidence of HCC.

Objective To understand the abnormal status of alanine aminotransferase (ALT),fasting blood glucose (GLU),to-tal cholesterol (TC)and triglyceride (TG)in urban and rural residents,to provide the basis for making the effective prevention measures,health education and health promotion to community work more targeted and effective.Methods The data of physical ex-amination results of 4 042 residents were analyzed retrospectively,the levels and abnormal rates of ALT,TG,TC,GLU were com-pared between different gender and age.Results Among 4 042 residents,the abnormal rate of male was significant higher than that of female,but the abnormal rates of TG,TC of female were significant higher than those of male(P <0.05).The highest rates of ALT,TG,TC,GLU in male were in 20-<40 years old,40-<60 years old,60-<80 years old,≥80 years old.The highest rates of ALT,TG,TC,GLU in female were in 0-<20 years old,60 -<80 years old,≥ 80 years old,≥80years old.Conclusion The health status of urban and rural residents is not optimistic,the community intervention,health guidance should be strengthened to prevent and control the occurrence and development of diseases and improve the health level of urban and rural residents.

Objective: To investigate the role of T cell in the antitumor immune responses induced by MIF gene-modified tumor vaccine. Methods: MIF gene was transferred into FBL3 erythroleukemia cel l by adenovirus carrier and a new type of tumor vaccine was prepared. The chang es of the number and the function of T cell in spleen and lymph node was observe d. Results: After the mice were immunized with MIF gene-m odified FBL3 vaccine, the number of lymphocyte in spleens and lymph nodes increa sed markedly and the specific CTL activities of splenocytes also increased great ly. FACS analysis showed that the CD3+,　CD4+,　CD8+ T cells and CD28 posi tive cells in draining lymph nodes of MIF-FBL3 group mice increased more marked ly than that of control groups. When the wild type FBL3 cells were injected into the mice immunized with MIF gene-modified FBL3 vaccine, the growth of tumors w ere obviously inhibited and the survival rate of the mice was increased. Conclusion: It is suggested that MIF gene-modified tumor vaccine can induce specific antitumor immune responses mediated by T cells and may be a candidate for gene therapy of tumor.

Objective To determine if stimulation of cholinergic anti-inflammatory pathway mediated by vagus can protect liver against sepsis.Methods Male SD rats weighing 250-300 g were anesthetized with intraperitoneal methane 1g?kg~(-1).Left common carotid artery,was cannulated for MAP monitoring and blood sampling.Sepsis was produced by ligation of cecum which was punctured twice at an interspace of 3 mm with a 9G needle(CLP).Bilateral vagus nerves were isolated,ligated with 4-0 silk and cut(VGX).The distal end of the vagus nerve was stimulated with direct current(5V,2 ms,1 Hz)continuously for 20 min(STM).Forty animals were randomly divided into 4 groups(n=10 each):group Ⅰ sham operation;group Ⅱ CLP;group Ⅲ CLP + VGX and group Ⅳ CLP+VGX+STM.Arterial blood samples were obtained at 0,1,2 and 4 h after operation for determination of plasma TNF-? concentration and serum ALT and AST activities.The animals were then killed and the livers removed for ultrastructure examination with electron microscope.Results Electrical stimulation of the distal end of vagus nerve significantly attenuated the significant decrease in MAP and increase in plasma TNF-? concentration and serum AST and ALT activities and the damage to the organelle in the liver cell induced by sepsis.Conclusion Our results show that electrical stimulation of vagus nerve can protect liver from sepsis to some extent through cholinergic anti-inflammatory pathway.

Objective Toevaluatetheclinicalvalueofmagneticresonanceenterography (MRE)indiagnosingCrohn’sdisease (CD).Methods ThearticlesconcerningthediagnosisofCD byusing MRE weresystematicallysearchedindatabasesincluding PubMed,EMbase,CochraneLibrary,WebofScience,CNKI,CBM,WanFangandVIPdata.Tworeviewersindependentlyscreenedliterature, extracteddata,andassessedbiasriskofincludedstudiesbyusingtheQUADAS-2.Then,thisMeta-analysiswasperformedbyusing Stata12.0software.Thepooledweightedsensitivity,specificity,positivelikelihoodratio(PLR),negativelikelihoodratio (NLR)and diagnosticoddsratio(DOR)werecalculated,thesummaryreceiveroperatingcharacteristiccurve(sROC)wasdrawnandtheAUC wascalculated.Results Atotalof16studieswereincluded,involving1276patientsand919bowelsegments.TheresultsofMeta-analysisshowed that,thepooledsensitivity,specificity,PLR,NLR,DORandAUCofMREdiagnosingCDwere0.87(95%CI:0.79,0.92),0.92(95%CI:0.89, 0.94),10.6(95%CI:7.4,15.2),0.15(95%CI:0.09,0.24),72.69(95%CI:32.7,161.51),0.95(95%CI:0.93,0.97),respectively.Theresultsof subgroupanalysissuggestedthat,thestudytype,MRT-field,pathogenicsiteanddiagnosticcriteriaplayedlittleeffectonthevalueof MREdiagnosingCD (P>0.05).Conclusion MREhadhigheraccuracyfordiagnosingCDand mayservedasanefficientimaging methodfordiagnosingCD.

Objective To study the effect of cyclophosphamide(CP) and its metabolites acrolein(ACR) on PTEN gene deleted on chromosome 10 after acting on ovarian cancer cellsSKOV3.Methods Different concentrations of CP and ACR were selected to act on recombinant PTEN protein.The phosphorylation activity of PTEN was detected by PNPP.The expression of PTEN protein was detected by Western blot.The binding mode of drug with protein was detected by the biotin combined with protein;meanwhile the expression change of P53/TP53 in PTEN gene pathway was analyzed.The target protein was obtained by immunoprecipitation(IP) after different drug concentrations acting on the cells.The phosphorylation activity of the target protein was detected by high performance liquid chromatography(HPLC).Results After the drug metabolites acting on recombinant PTEN protein,the phosphorylation activity was decreased with the increase of drug concentration,while the expression of ACR antibody action was increased with the drug concentration elevation.The expression of protein and biotin in different experimental groups was increased with the increase of drug concentration.The PTEN phosphorylation activity was decreased with the drug concentration increased in cells,and so did the expression of TP53 protein.Conclusion CP metabolite ACR induces the cytotoxicity by inhibiting PTEN protein phosphorylation activity.