Objective To investigate the type 2 diabetic patients with glomerular filtration rate and urinary albumin value as renal finction evaluation.Methods A total of 1217 patients with type 2 diabetic nephropathy from August 1,2010 to June 31,2012 were selected.Evaluated glomerular filtration rate (eGFR) was calculated according to the currently recommended simplified modification of diet in renal disease study (MDRD) formula.According to the K/DOQI guidelines for chronic kidney disease,patients were divided into three groups:group A [eGFR ≥90 ml/ (min ·1.73 m2)] of 891 cases,group B [60 ml/(min· 1.73 m2) ≤eGFR ＜ 90 ml/(min· 1.73 m2)] of 256 cases,group C[eGFR ＜ 60 ml/(min· 1.73 m2)]of 70 cases,respectively.Eight-hour urinary albumin excretion rate (UAER) was compared between and among the groups; according to 8-hour UAER,patients were divided into three groups:group a (8-hour UAER ＜20 μg/min) of 946 cases,group b (20 μg/min≤8-hour UAER ＜200 μg/min) of 193 cases,group c(8-hour UAER ≥ 200 μ g/min) of 78 cases.eGFR was calculated and compared between and among the groups.Results Eight-hour UAER was (32.71 + 79.62),(57.56 + 130.59),(107.50 + 222.64) μ g/min in group A,B,C,and the difference among three groups was statistically significant (P＜0.05).eGFR was (110.78 ±32.75),(108.26 ±45.78),(94.96 ±32.30) ml/ (min ·1.73 m2) in group a,b,c,and the difference between group a and group c,or between group b and group c was statistically significant (P ＜0.05),but the difference between group a and group b was not statistically significant (P ＞0.05).Conclusion When evaluating the function of type 2 diabetic nephropathy,two indicators should be considered:glomerular filtration rate and urinary albumin.

Objective To investigate the relationship between the severity of diabetic retinopathy and serum bilirubin level. Methods From August 1 2008 to December 31 2009, hospitalized patients of 1062 cases with type 2 diabetes were divided into three groups according to fundus examination: no diabetic retinopathy (NDR) group (457 cases), non-proliferative diabetic retinopathy (NPDR) group (484 cases)and proliferative diabetic retinopathy (PDR) group ( 121 cases). The difference in serum bilirubin level was compared. Results Total bilirubin in PDR, NPDR and NDR group were (9.96 ± 3.84), ( 11.41 ± 3.82),( 13.38 ± 3.98) μ mol/L respectively. There was significant difference among three groups (P ＜ 0.01 ). Logistic multivariate regression analysis showed that a drop in serum total bilirubin level was an independent risk factor of diabetic retinopathy. Conclusions Bilirubin level and the severity of diabetic retinopathy have some relationship. The antioxidant bilirubin and anti-inflammatory effect should be paid attention to.

BACKGROUND:3D printing technology for preoperative planning has been a trend at present. Moreover, this technology has been extensively used in bone tumor resection and maxilofacial surgery, but seldom used in fracture repair. OBJECTIVE: To explore the value of 3D printing technology application in preoperative evaluation of pelvic fracture, planning and during surgery. METHODS:Pelvic fracture patients underwent preoperative CT scan. Pelvic models of the patients were printed using 3D printing technology at 1:1. Preoperative processing was conducted, including choice of approach, design of incision exposure range, design of fracture reduction, pre-implantation position of the steel plate, optimal plastic design of steel plate, measurement of screw length and design of screw direction. Matta score of pelvic fracture reduction and Majeed score of pelvic function after repair were measured during folow-up. RESULTS AND CONCLUSION:The operation time was 55-130 minutes, averagely (84.75±20.15) minutes. Intraoperative blood loss was 200-800 mL, averagely (417.00±173.58) mL. After operation, no incision infection, fracture nonunion, fixator loosening or breakage appeared. Al patients were folowed up for 8-24 months. The fracture healing time was 10-16 weeks, averagely 12.5 weeks. Fracture reduction was assessed according to Matta scoring: excelent in 15 cases, good in 3 cases, average in 2 cases, and poor in 0 case, with an excelent and good rate of 90%. Postoperative function was assessed according to Majeed scoring: excelent in 13 cases, good in 5 cases, average in 2 cases, and poor in 0 case, with an excelent and good rate of 90%. These findings showed that the application of 3D printing technology in pelvic fracture can determine the fracture’s displacement, is helpful for accurate reduction and plate modeling, reduces surgery duration and intraoperative blood loss and complication, finaly achieves better surgical result. 3D printing technology can better evaluate and plan the pelvic fracture before repair, and can be used as a routine project preparation of pelvic fracture repair.

It has gradually become a consensus in the industry that the traditional Chinese medicine gypsum should be decocted first, but the understanding of decocting method is not completely unified in the works of doctors since ancient times, and there are occasional disputes about whether it is necessary to decocting first. In this study, the phase determination, physical and chemical characterization, qualitative and quantitative analysis of inorganic and organic components of the decoctions of herbal pairs and the whole prescription Maxingshigan decoction with gypsum as the center, and the pre-decoctions and co-decoctions of them were carried out to explore the scientific connotation of the pre-decoctions of gypsum. Results show that decoction phases were different between the co-decoctions and pre-decoctions of licorice-gypsum (Gancao-Shigao, GC-SG), ephedra-gypsum (Mahuang-Shigao, MH-SG) and almond-gypsum (Xingren-Shigao, XR-SG). The results of the micromorphology, particle size and zeta potential of herbal pairs and prescription (Quanfang, QF) showed that the supramolecular particles in pre-decoctions were smaller, more uniform and more stable than the co-decoctions. The results of organic components analysis showed that different cooking methods did not change the organic composition and content. ICP-OES results showed that the content of inorganic components in pre-decoctions was higher than in co-decoctions for the same boiling time of gypsum. The IR results showed that the pre-decoctions had stronger chemical functional group effect than the co-decoctions. To sum up, compared with the co-decoction, the pre-decoction of gypsum has different phase state and chemical composition interaction, and the difference of inorganic composition is an important material basis affecting the change of phase state compared with the co-decoction. It indicates that the material basis of traditional Chinese medicine decoction is indeed different whether gypsum is decocted first or not, which can provide a basis for the clinical application of decocted gypsum.

OBJECTIVETo explore the perioperative cardiovascular dysfunction and its relevance to age in patients with silent coronary heart disease (or silent myocardial ischemia), and explore the clinical treatment and recovery of perioperative arrhythmias.

METHODSOne hundred and eighty cases were selected from selective surgery patients with silent myocardial ischemia (SMI). Among the cases, 130 patients older than 51 years old were divided into 51 - 60 year-old group, 61- 70 year-old group and 71 - 80 year-old group. Control group was set up by other 50 patients younger than 51 years old. Electrocardiogram data of 24 h before the operation, 24 h after the operation and 48 h after the operation were continuously monitored by dynamic electrocardiogram (DCG). The electrocardiogram data of ST shifting, arrhythmia incidences of different type and at different time were analyzed by professional doctors. At the same time, the treatment and recovery of perioperative arrhythmia were recorded.

RESULTSAs the age increase, the magnitude and duration of ST shifting appeared upward trend compared to the control group (P < 0.05, P < 0.01). The incidence of ST elevation in 71 - 80 year-old group was higher than the control group (P < 0.05). The ST depression duration in 61 - 70 and 71 - 80 year-old group and ST elevation magnitude in 71 - 80 year-old group were higher than 51 - 60 year-old group (P < 0.05). Compared to the control group, the incidence of accelerated idioventricular rhythm (AIR) in 61 - 70 year-old group and the incidence of sinus bradycardia (SB), ventricular premature beat (VPB), ventricular tachycardia (VT) in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). Compared to the 51 - 60 year-old group, the incidence of atrial fibrillation (AF) in 61 - 70 year-old group and the incidence of VP, VT, AF in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). The arrhythmia incidences in 24 h after operation were higher than 48 h after operation and 24 h before operation (P < 0.01). As the age increase, the recovery incidence by removing inducement was decreased, but the recovery incidences by drug and electric-shock treatment were increased (P < 0.05).

CONCLUSIONOld SMI patients have high levels of perioperative myocardial ischemia and arrhythmia, and 24 h after operation is the period of high incidence.

Aged ; Aged, 80 and over ; Cardiovascular System ; physiopathology ; Coronary Disease ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period

Hepatitis, Viral, Human ; drug therapy ; Humans ; Prostaglandins E ; therapeutic use ; Randomized Controlled Trials as Topic ; Research Design

Objective To study the antigenicity of human thyrotropin receptor(hTSHR)amino terminus (amino acid 29～280)and its association with Graves' disease.Methods Total thyroid RNA was prepared from human normal thyroid tissue.RNA was then reversely transcripted and cDNA was subjected to PCR amplification.PCR product was cloned into pcDNA3.1 and the recombinant plasmid was named pcDNA3.1/hTSHR188～940bp. Balb/c mice were immunized with peDNA3.1/hTSHR188～940bp. The levels of serum thyroxin,anti-TSHR antibody(TRAb)and thyroid stimulating antibody(TSAb)were measured,and the pathological changes of thyroid tissue were also observed.Results A 753 bp fragment encoding hTSHR ectodomain amino end was obtained after PCR amplification.Confirmed by Hind Ⅲ restriction enzyme digestion and DNA sequencing,pcDNA3.1/hTSHR188～940bphad been constructed successfully,with the correct sequence and direction of hTSHR188～940bp.In the Balb/c mice treated with pcDNA3.1/hTSHR188～940bp,elevated TRAb in week 6(0.148±0.018)were observed compared with those at week o(0.106±0.006,P＜0.01),and kept a higher level till week 10(0.134±0.011,P＜0.01).T4 and TSAb index values were significantly increased in week 10.Serum T4 concentration increased from(41.02±7.97)μg/L in week 0 to(62.20±12.77)μg/L in week 10(P＜0.01);TSAb index values rose from 0.864±0.076 at week 0 to 1.392±0.615(P＜0.01).Thyroid pathological examination showed that proliferated thyroid follicular epithelial cells and foll icular eapacity increased.Inflammatory cells were occasionally found.Conclusions There are antigen epitopes in hTSHR ectodomain amino acid 29～280,which can stimulate the production of TSAb.And the latter induces hyperthyroidism and Graves' disease like manifestations.It suggests that hTSHR ectodomain amino acid 29～280 is closely associated with Graves' disease,and maybe one of important etiological factors leading to the disease.

Objective To investigate the relationship between raf kinase inhibitor protein (SKIP), a novel metastasis suppressor gene, and metastasis of ovarian carcinoma. Methods Immunohistochemistry, RT-PCR, and western blot analysis were performed to examine the expression of SKIP in clinical samples of ovarian tumors and five human ovarian carcinoma cell lines. Stable cell lines over-expressed or deleted of SKIP were cloned to investigate the function of SKIP in ovarian cancer cells. The recombinant plasmids expressing sense (ss) or antisense (as) SKIP cDNA or empty vector was transfected into ovarian cancer cell line SKOV3 by lipofectamine. The expression level of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK) and extracellular signal-regulated kinase (ERK) in ovarian cancer cells were detected by western blot analysis. Assays of cell proliferation, soft-agar colony formation, cell adhesion, and cell invasion in vitro were used to examine the malignant phenotypes of the transfected cells. Flow cytometric analysis was performed to observe the effect of SKIP on cell cycle distribution before and after transfection. Results (1 ) The expression levels of SKIP protein in ovarian carcinoma tissues from patients were found to be reduced than those in ovarian benign tumor and borderline tumor. SKOV3 clones stably expressing full-length recombinant ssRKIP, asRKIP, and their respective empty vector were obtained. (2)RKIP was able to block basal levels of MEK and ERK in ovarian cancer cells. The expression level of phosphorylation MEK in ssRKIP#1 and ssRKIP#4 cells were 0. 35, 0. 34; while the expression level of phosphorylation ERK in ssRKIP#1 and ssRKIP#4 cells were 0.48 and 0.46. (3) Abilities of cell proliferation in the ssRKIP vector-transfected cells were decreased compared with that in the non-transfected cells (P ＜0. 01 ). (4)Anchorage-independent growth in the ssRKIP#1 and ssRKIP#4 cells (83.7 ± 5.7, 106. 0±9. 2) were decreased compared with that in the empty vector-transfected cells (158.3 ± 14. 6, P＜ 0. 01). (5)Cell adhesion in the ssRKIP#1 and ssRKIP#4 cells [(68.3±0. 8)%, (64. 1±0. 9)%] were decreased compared with that in the non-transfected cells [(100. 0 ± 1.1 )%, P ＜ 0. 01]. (6) Cell invasion in the ssRKIP#1 and ssRKIP#4 cells (24 ± 5, 25±4) were decreased compared with that in the non-transfected cells (68 ± 5, P ＜ 0. 01 ). (7) ssRKIP cells had a significant increase in the G1 phase and decrease in the G2 + S phase. Conclusion RKIP could inhibits the metastasis, but also the growth of ovarian cancer cells.

To investigate the expression changes of Toll-like receptors (TLR) in the lungs of human metapneumovirus infected BALB/c mice, and to explore the effects of PolyI:C on viral replication, HMPV-infected group, PolyI:C+hMPV group, PolyI:C+DMED group and DMEM control group were set up for this study. All mice were sacrificed on day 1, 3, 5, 7, 9 and 16 post inoculation. Lungs were used for viral titration, pulmonary histopathology and detection of TLRs mRNA expression by RT-PCR and real-time PCR. Results showed that the levels of viral replication in the lungs of PolyI:C+hMPV infected mice were significantly decreased and lung inflammation were also lessened compared with those of hMPV infected mice. RT-PCR detection showed that mRNA levels of most TLRs were up-regulated (P < 0.05) in the lungs of hMPV infected group compared with DMEM group. Real time PCR assay showed that TLR7-8 mRNA significantly increased in hMPV infected group in a time-dependent manner. The level of TLR3 mRNA was significantly up-regulated in PolyI:C+hMPV group at the 24 hour after intranasal inoculation. The results showed that hMPV infection up-regulated the expression of TLRs in lungs of BALB/c mice and TLR7/8 pathway might play an important role in the start of natural immune response. PolyI:C was capable of inhibiting viral replication in the lung of mice and reducing lung inflammation probably through the early activation of TLR3.
Animals ; Disease Models, Animal ; Female ; Gene Expression ; Humans ; Lung ; drug effects ; metabolism ; virology ; Metapneumovirus ; drug effects ; genetics ; physiology ; Mice ; Mice, Inbred BALB C ; Paramyxoviridae Infections ; drug therapy ; genetics ; metabolism ; virology ; Poly I-C ; therapeutic use ; Toll-Like Receptors ; genetics ; metabolism ; Virus Replication

Objective To synthesize and analyze sodium 18F-fluoroacetate (FAC) and its precursor ethyl O-mesylglycolate (EOMG). Methods EOMG was synthesized using modified method. Its chemical purity was checked by HPLC and its structure was elucidated on the basis of spectral analyses. Final product of 18F-FAC was synthesized based on general nucleophilic reactions module Explora GN using EOMG as a precursor. Liquid chromatography Explora LC was applied to get rid of its chemical impurities.Then HPLC and radio-thin layer chromatography were used to assay its radiochemical purity, chemical purity and specific activity. Results EOMG was synthesized and identified. Its yield was 70% and its chemical purity was 97.0% (calculated by chromatographic peak area). The radiochemical purity of 18F-FAC was more than 98%, and its specific activity was 236. 5 MBq/μmol. Conclusion This synthetic method for 18F-FAC and its precursor can be defined as effective and highly quality-controlled.