Objective To observe the clinical efficacy using curette and stripping wire method in treating diabetic foot. Methods 36 hospitalized patients diagnosed as diabetic foot were enrolled, and 18 of them were chosen as the experimental group according to random digital table method who was treated with medical therapy plus curette and stripping wire method in treating diabetic foot. The other 18 patients were named as the control group who were treated by medical treatment and routine treatment. The granulation tissue maturity, wound healing, and the differences on curative effect were compared. Results 10 cases′wound granulation tissue maturity in the experimental group got++and+++on the 10th day while 4 cases in control group. Wound healing rate of the experimental group at the 10th and 14th day were (78.6±10.5)%and (82.7±8.4)%while the control group were (43.2±8.7)%and (66.2±10.1)%. Cure rate of the experimental group was 14/18 four weeks after treatment, the inefficiency was 0, while the control group was 6/18 and 3/18. Conclusions Curette and stripping wire method is a good method to promote the dressing diabetic foot wound healing. It is superior to traditional methods, worthy of clinical application.

Objective To summarize the clinical presentation, pathology features, and treat-ment principle for primary testicular non-Hodgkin's lymphoma. Methods Twelve patients were di-agnosed with primary testicular lymphoma. The mean age was 62 years (36-78). Of the patients, unilateral primary testicular tumors were found in 11 cases and bilateral tumors were found in 1 case. All cases had swollen testes, 3 cases had mild pain and 1 had low-grade fever. Ultrasonic examination detected solid mass in all 12 cases. CT scan revealed retroperitoneal enlarged lymph nodes in 3 cases. Nine patients were diagnosed with disease of stage Ⅰ E, 2 of stage Ⅱ E, and 1 of stage Ⅲ E. All of the patients underwent radical orchiectomies. Postoperative treatment included: CHOP chemotherapy for 10 cases, radiotherapy after chemotherapy for 5 cases, and surgery alone for 2 cases. Results Post-operative pathology results were non-Hodgkin's lymphoma in all cases. One patient lost in follow up, one died within 2 years because of other disease. The 1, 3 and 5 year actual survival rates were 82% (9/11) ,40%(4/10),20% (2/10), respectively. The relapsed organs included contralateral testis(3/ 11), central nervous system(3/11), liver(1/11)and retroperitoneal lymph node(1/11). Conclusions The prognosis of the primary testicular non-Hodgkin's lymphoma is very poor. Chemotherapy must be used after surgery for any stage. Stage Ⅰ E and Ⅱ E patient should be treated by surgery combined with radiotherapy and chemotherapy. Contralateral testis should be irradiated prophylactically. Pa-tients beyond stage Ⅱ E should accept chemotherapy after surgery and radiotherapy according to the patient's status.

Objective To evaluate the clinical efficacy and safety of Holmium laser in the treat ment of calyceal stricture and atresia through antegrade percutaneous nephrostomy. Methods Ante grade percutaneous nephrostomy was performed in 68 patients with calyceal stricture and atresiathrough a rigid 8/9.8 F ureteroscope. The stricture and atresia was incised in a linear fashion by theHolmium laser with a 550 mm fiber. After completion of the incision,a double J ureteral stent wasplaced for 6-8 weeks and nephrostomy tube was kept for 7 days thereafter. Patients were then fol lowed up with IVU and/or ultrasound at 3-6 month intervals. Results The mean operative timewas 90 min,ranged from 80 to 120 min. The mean postoperative hospital stay was 8 d(7-9d). Hy dronephrosis was significantly improved in 38 cases in an average follow up of 9 months (4-26 months). Repeated laser incision was performed to 4 treatment failures and all turned out to be suc cessful. Conclusions The Holmium laser treatment through antegrade percutaneous nephrostomyfor calyceal stricture and atresia has characteristics of minimal invasion,short hospital stay,good effi cacy in short term and repeated cases. This procedure to be used as the first choice for patients withgood renal function and mild hydronephrosis,especially accompanied with renal calculus.

Objective To study early changes in biochemical markers of bone turnover for prodicting the bone mineral density(BMD) response to alendronate therapy in Chinese men with osteoporosis. Methods Seventy-eight men aged 60 to 82 years with osteoporosis [mean age (69.8 ±11.8) years]were treated with alendronate sodium 70 mg/week for 12 months. Serum bone gla-protein (BGP) and serum pyridinoline-eross-linked earboxyterminal telopeptide of type I collagen (ICTP) level were measured by chemiluminescence (equipment is Roche E170). Serum BGP, ICTP and BSALP levels were measured before and 3 months and 12 months after treatment. BMD in lumbar spine and femoral neck were measured with dual energy X-ray absorptiometry (GE PRODIGY Inc. ) at L1-4 and at the left hip(total hip,trochanter,Ward's area and femoral neck)before and 12 months after treatment. Results After 3-months and 12-months treatment, the percent reductions of serum ICTP levels were 45.8% and 51.6%, serum BGP level 32.0% and 37.5%, serum BSALP level 35. 3% and 39.9% ,respectively. After 12-months treatment, the percent increase of lumbar BMD was 11.8%, femoral neck BMD 11.4 %. The percent reductions of serum ICTP level at months 3 and 12 after treatment were positively correlated to the percent increase of lumbar BMD (r=0.28, 0.295,P <0.05 and P<0.01)and of fermoral neck BMD at 12 months after treatment(r=0.262, 0.333, P＜0.05 and P<0.01)respectively. The percent reductions of serum BGP level at months 3 and 12 after treatment were positively correlated to the percent increase of lumbar BMD (r=0. 322, 0.401,all P<0.01) and of fermoral neck BMD at 12 months after treatment (r=0.277,0.284, all P＜0.05)respectively. The percent reductions of serum BSALP level at months 3 and 12 after treatment were positively correlated to the percent increase of lumbar BMD (r=0.133,0.231,all P＜0.05) and of fermoral neck BMD at 12 months after treatment(r=0.248, 0.317, all P＜0.01)respectively.Conclusions Early changes in biochemical markers of bone turnover rates can predict BMD response to alendronate in Chinese men with osteoporosis.

Objective To explore the effects of polymorphisms of Crohn's disease related NOD2 gene and human beta-defensin 2 (hBD-2) on transcription of hBD-2 gene and its mechanism. Methods HEK293T cells were transfected with hBD-2 gene and NOD2 eukaryotic expression plasmid, and were then stimulated with LPS, TNF-α, or BAY 11-7082 (antagonist of NF-κB), respectively. Transcriptional activity of hBD-2 was detected afterwards. Results LPS could suppress transcription of hBD-2 (P=0. 020), which was increased by TNF-α in a dose-dependent manner (P =0. 004). In the presence of LPS, there was sig-nificant difference in transcriptional activity of hBD-2 between wild-NOD2 transfected group and mutated NOD2 (P268S) transfected group (P=0. 008), but there was no significant difference between wild hBD-2 transfected group and mutated hBD-2 transfected group (P=0. 053). With the stimulation of TNF-α (5 ng/ml), there was a significant difference between mutated hBD-2 transfected group and wild hBD-2 transfected group (P=0. 006), but no significant difference between wild-NOD2 transfected and mutated NOD2 transfected group was defected (P = 0. 064). Pretreatment with BAY 11-7082 before TNF-α (5 ng/ml) significantly inhibited the transcriptional activity of hBD-2 (P < 0. 001). Conclusion The poly-morphism of NOD2 affects the innate expression of hBD-2, the polymorphism of site in hBD-2 promoter (-233) may lead to significant decline of the inducible expression of hBD-2, and NF-κB might be a key pathway that NOD2 protein mediates the expression of defensin.

Objective To investigate the association of two single nuclear peptides(SNPs)polymorphisms(rs11209026 and rs11805303)which lies in interleukin-23 receptor(IL23R)gene with susceptibility to inflammatory bowel disease(IBD).Methods The target SNPs were directly sequenced by polymerase chain reaction(PCR)and gene polymorphisms of 50 healthy and 81 patients with IBD (Crohn's disease in 41 patients and ulcerative colitis in 40 patients)were analyzed using chromassoftware.Results The geno-type frequency and allelic frequency of rs11209026 were 7.3%and 3.7%in patients with Crohn's disease respectively,15.0%and 7.5%in patients with ulcerative colitis respectively as well as 14.0%and 7.0%in normal population respectively(all P value＞0.05).The geno-type frequency and allelic frequency of rs11805303 were 22.0%and 52.4%in patients with Crohn's disease respectively,15.0% and 41.2% in patients with ulcerative colitis respectively as well as 34.0%and 59.0%in normal population respectively(all P value＞0.05).But in allelic frequency there was significant difference between ulcerative colitis patients and normal population(P=0.018).The polymorphisms of rs11805303 loci did not correlate with age,gender,disease duration.activity and site in patients with ulcerative colitis.Conclusions IL23R gene polymorphism is not associated with the susceptibility to Crohn's disease.rs11805303 allele may be related with susceptibility to ulcerative colitis.But no correlation was found between the SNP polymorphisms and the clinical characteristic of ulcerative colitis.

Aim To investigate the protective effect of astragaloside IV (AS-Ⅳ) on human retinal pigment epithelium injury induced by methylglyoxal (MGO), and explore its molecular mechanism.Methods The injury of ARPE-19 cells was induced by MGO and the cell viability was measured by CCK-8 method.The morphology of cell nucleus was analyzed by Hoechst 33342 staining and the cell apoptosis was analyzed by flow cytometry to detect labbled Annexin V-FITC/PI.JC-1 staining and fluorescence probe DCFH-DA were employed to evaluate the change of mitochondrial membrane potential and reactive oxygen species (ROS).The levels of SOD, MDA, caspase-9 and caspase-3 were determined by respective kits.Western blot was used to analyse the expression of Bcl-2, Bax and PARP.Results AS-Ⅳ could significantly inhibit the decrease of cell viability induced by MGO, improve the morphology of cell nucleus, reduce the ARPE-19 cell apoptosis rate and the level of ROS and MDA, and increase the activity of SOD.Furthermore, AS-Ⅳ could enhance mitochondrial membrane potential, the ratio of Bcl-2/Bax and the expression of PARP, and inhibit the activation of caspase-9 and caspase-3.Conclusion AS-Ⅳ may protect ARPE-19 cells from the injury induced by MGO by increasing the antioxidant ability of ARPE-19 cells and inhibiting cell apoptosis.

Aim To investigate the optimum trypsin digestion time and the optimum trypsin concentration of the long-term formalin-fixed retina in rats.Methods Male SD rats were sacrificed by cervical dislocation. The removed eyes were fixed in 4% formaldehyde fixa-tive for 2 days,2 weeks,4 weeks,3 months,5 months and 7 months respectively.Fixed retinas at dif-ferent time were separated and put in 3%,6% and 9% trypsin at 37℃ in incubator.The time required was recorded for complete digestion of retinas,which fixed for different time and digested in different con-centrations of trypsin.The retinal blood vessels were recorded under a microscope after PAS staining of stretched retinal blood vessel.Results After conven-tionally fixed for 48 hours,retinas were digested com-pletely in 3% trypsin at 37℃ for 3.5 hours.The di-gestion time extended to 9 hours and 1 4 hours for the 2 weeks and 1 month fixed eyes,using 3% trypsin, which achieved the same result as conventional fixed eyes.For the 3 months fixed eyes,a complete retinal blood vessel could also be attained by using conven-tional concentrations of trypsin,and only by extending digestion time to 22 hours.It is also indicated that the increased concentration of trypsin did not shorten the time of digestion.In addition,for the fixed eye from 5 months to 7 months,6% and 9% trypsin could short-en,to some extent,the time to 22 hours and 28 hours respectively,which was conductive to obtaining rela-tively complete retinal blood vessels.Conclusions Retinal tissues which fixed time shorter than 3 months can completely be digested using 3% trypsin.Howev-er,for retinal tissue,which fixed from 5 months to 7 months,both the extending time of digestion and the increasing concentration of trypsin to 6% are necessary to get optimum retinal vascular digestion.

Two hundreds postmenopausal women with osteopenia, aged 45-80, were randomly divided into 4 groups, and received different drug interventions. After treatment for 12 months, the lumbar spine bone mineral density(BMD)and total hip BMD in alendronate group increased significantly(3.5% and 2.6%, both P＜0.05), the lumbar spine BMD raised 2.0% in selective estrogen receptor regulator group(P＜0.05). Bone turnover indices improved in both groups(all P＜0.05). No change in BMD or bone turnover indices was found in patients treated with active vitamin D3and calcium.

Objective To investigate the risk factors for postmenopausal osteoporosis in Shanghai.Methods Five hundred postmenopausal community-dwelling women aged 45-80 years were recruited. The case-control study was performed from June 2008 to September 2008.A total number of 250 women with postmenopausal osteoporosis identified with their bone mineral density (BMD) were selected as case group, and 250 non-osteoporosis women were selected as control group. BMD was measured by dual energy X-ray absorption (DEXA). Results Univariate logistic regression analysis showed that age, eduction level, occupation, years since menopause, BMI, use of calcium,historyofnon-violencefracture,fall,diabetesmellitus,chronicgastricdiseases, gastrointestinal resection and diarrhea were related to osteoporosis.Multiple logistic regression showed that age, years since menopause and nutritional status were the risk factors for osteoporosis. ConclusionsThe occurrence of osteoporosis is related with many factors in postmenopausal women in Shanghai, and women with early menopause, low BMI and older age should pay more attention to the prevention and treatment of osteoporosis.