Objective To detect the changes of renal hemodynamics, radionuclide renal dynamic imagings were performed in patients with type 2 diabetes millitus (DM) in different stage. Methods Fifty seven patients with type 2 DM were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1)GroupDM1:UAER200 ?g/min, 20 cases. 99m Tc DTPA and 99m Tc EC renal dynamic imagings were performed in the type 2 DM patients of 3 groups and 20 normal controls (NC). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renogramweregainedsimultaneously.Results GFR and ERPF were significantly increased in group DM1 than those in NC (P

BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.

Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.

Objective:To improve the therapeutic gain ratio from 125I seed implants by investigating the QA/QC strategies used in brachytherapy treatment of lung cancer. Methods:A total of 287 lung cancer and pulmonary metastases cases were studied. Among which, 184 are male and 103 are female with a mean age of 61.9 years. The NOA-NSCLC subgroup and pulmonary metastases were targeted on conventional CT positioning. Considering that COA-NSCL subgroup on the tumor target area is difficult to determine with CT, the coincidence circuit SPECT was used to assist in positioning. A dose-volume histogram was constructed to evaluate the quality of the TPS and optimization. Corrections on real-time positioning are necessary when using an image-guided implantation. The C-LC should be aligned with the FFB for CT-guided percutaneous puncture implantation. After implantation, dosimetry verification was con-ducted. Results:The NOA-NSCLC subgroup, comprising the risk organs such as heart, lung, and spinal column, received an average dose of 137, which was significantly lower than that of normal tissue dose tolerance. The NOA-NSCLC subgroup and lung metastases have matched peripheral dosages of 92.1 and 106.2 Gy with local-control efficiency rates of 91.97% (126/137) and 96.0% (48/50), 1-year survival rates of 91.24%and 83.4%(42/50), and 2-year survival rates of 50.36%(69/137) and 52.3%(26/50), respectively. The 35 COA-NSCL subgroup and 65 lung cancer group have local control efficiency rates of 91.43%(32/35) and 92.3%(60/65) and 1-year survival rates of 88.57%(31/35) and 80.30%(53/66), respectively. Conclusion:Proper radiation dosimetry as a QA/QC strategy was found to improve particle-implantation therapy gain and greatly reduce the risks of radiation pneumonia and pulmonary fibrosis.

BACKGROUND: Animal experimental studies have confirmed that cell transplantation, neurotrophic factor infusion or transplantation as well as other methods can alter the local environment of injured spinal cord and promote its partial function recovery.OBJECTIVE: This study aimed to assess the clinical efficacy of olfactory ensheathing cell transplantation for the treatment of the sequel of myelitis, and to explore whether it would promote the recovery of the spinal cord function.DESIGN: A non-randomized self-control study.SETTING: Ward of Second Department of Surgery of Taian Disabled Soldiers Hospital of Shandong Province.PARTICIPANTS: Thirty-two patients with obsolete myelitis, who come from all over China and suffered from disease for 0.5 to 7 years, admitted to our hospital between June 2004 and July 2007 were recruited in this study. The involved patients, including 21 males and 11 females, were aged 5-48 years. Their neurological functions were not obviously improved after various conventional treatments and limb function exercise. Meanwhile, various sensorimotors and autonomic nerve functional impairments were left. Among the patients, 18 suffered from acute viral myelitis, 8 from acute purulent myelitis and 6 from tuberculous myelitis. After onset, they were all given large doses of radiosonde,dexamethasone, anti-inflammatory and immunomodulatory drugs and various neurotrophic drugs. Twenty-six patients presented complete injury and six patients incomplete injury. Informed consent of treatment was obtained from each patient. The therapeutic protocol was approved by the Ethics Committee of the hospital. Embryonic olfactory bulbs were harvested from aborted embryo, which was donated voluntarily by the patients or their relatives.METHODS: Cells were isolated from embryonic olfactory bulbs, cultured and purified for 7 to 14 days, and finally they were digested into single-cell suspension. Under the surgical miscroscope, the cells were transplanted onto the regions which were above or below the spinal cord injury site. Two weeks to 2 months postoperatively, neurological function of spinal cord was assessed by using the American Spinal Injury Association (ASIA) Scoring Standard formulated in 2000, and was compared to pre-operation function.MAIN OUTCOME MEASURES: ①Sensory function change. ②Motor function change.RESULTS: Half a year to 2 years after olfactory ensheathing cell transplantation, the sensory and motor functions of 32 patients were all obviously improved (motor function: 55.72±10.50 vs. 51.53±13.41; light touch:69.53±11.68 vs.63.06±15.98; pain sense: 69.50±12.20 vs. 64.03±15.0, all P ＜ 0.01 ).CONCLUSION: Olfactory ensheathing cell transplantation can help to promote the neurological function recovery of patients with the sequel of myelitis. However, its long-term curative effect needs to be further investigated.

Objective To evaluate the early detection of diabetic cystopathy(DCP)with the technology of noninvasive urodynamics.Methods 70 patients with type 2 diabetes mellitus(DM)and 30 normal control subjects were checked with the technology of noninvasive urodynamics.Based on their disease course of less or mole than 5 years.the DM patients were divided into two groups.Maximal flow rate,average flow rate,the volume leading to first bladder sensation and residual urine volume were measured by using noninvasive urodynamic technology.Results Among the 70 DM patients,34 were detected to have bladder residual urine,so the DCP detection rate was 48.6%.In the patients with DCP,the average residual urine volume Was 7-139 ml(30.1±27.1)ml,while there was no residual urine in the normal control group.As compared with the normal control group,maximal flow rate and average flow rate were decreased in all the patients with DM and those with DCP(P＜0.01).After follow up of the disease,the patients with a course of more than five years of disease control had even lower maximal flow rate and average flow rate.Conclusion Maximal flow rate decrease and bladder residual urine detected with the technology of noninvasive urodynamics may be widely used in early detection and early diagnosis of DCP.

ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.

After treatment for 3 months in the patients with impaired glucose tolerance (IGT), plasma glucose, insulin and homeostasis model assessment for insulin resistance (HOMA-IR) were decreased both in rosiglitazone therapy group and in the group treated with rosiglitazone combined with body weight control.Those parameters in the latter group were decreased more significantly than those in the former.Rosiglitazone ameliorates the insulin resistance in patients with IGT, which is further improved when combined with body weight control.

BACKGROUND: Many factors affect the outcome of olfactory ensheathing cell transplantation for obsolete spinal cord injury, such as the time of injury, segment and sex. The best time to do olfactory ensheathing cell transplantation is unknown up to now. OBJECTIVE: To investigate the influence of time windows of olfactory ensheathing cell transplantation on the recovery of motion and sensation function in spinal cord injury patients. DESIGN: Self-control observation. SETTING: Department of Neurosurgery, Taian Disabled Soldier's Hospital. PARTICIPANTS: 135 patients with spinal cord injury were enrolled at the Department of Spinal Cord Surgery, Taian Disabled Soldier's Hospital of Shandong Province from June 2004 to June 2007, including 121 males and 14 females, aged 7-59 years, averagely 36 years. Duration of spinal cord injury included 0-6 months in 21 cases, 7 months-2 years in 71 cases and over 2 years in 43 cases. These patients or their guardians signed an informed consent of the cell transplantation. The experimental procedures were accorded with the rules of Ministry of Health of China (No. 91-006) and approved by the Taian Disabled Soldier's Hospital of Shandong Province. METHODS: ①Olfactory bulbs of aborted fetus were digested into single olfactory ensheathing cells, and then cultured for 7-15 days. Parturients signed the informed consent. This study was approved by the Hospital Ethical Committee. ②After general anesthesia, olfactory ensheathing cell suspension was implanted into the corresponding region by the multi-targeted injection with a microscope. According to the injury condition, targets generally located in upper or lower injured region and left or right normal spinal cord. The amount of targets depends on the size of the injured region. About 1 000 000 units of cells were injected into each target, about 50 μL of suspension, at 2×1010 L-1, 2-5 targets. ③American Spinal Injury Association impairment scale was used to assess the motion and sensation function in spinal cord injury patients before transplantation and 2-8 weeks after transplantation. MAIN OUTCOME MEASURES: Scores on American Spinal Injury Association impairment scale. RESULTS: 135 spinal cord injury patients were involved in the result analysis. Motion and sensation function was improved in spinal cord injury patients at different time windows compared with that before transplantation (P < 0.01). There was no significant difference in scores on motion and sensation function and the increased degree of the score at different time windows after transplantation (P > 0.05).CONCLUSION: Olfactory ensheathing cell transplantation can promote the recovery of nerve function in spinal cord injury patients, without the difference in time windows.

BACKGROUND: A series of basic researches have confirmed that,the olfactory ensheathing cell transplantation can promote spinal cord regeneration and recover some neurological functions of spinal cord in animal models of spinal cord injury.Some clinical trials also prove that transplantation of olfactory ensheathing cells can indeed improve neurological function in patients with spinal cord injury,and then improve their quality of life.OBJECTIVE: To verify the effectiveness and safety of olfactory ensheathing cell transplantation in repair of neurological function of spinal cord injury patients.METHODS: The aborted embryonic olfactory bulb was collected and digested into single olfactory ensheathing cells.After they were cultured and purified 2 weeks,olfactory ensheathing cell suspension was prepared.A total of 213 cases of spinal cord injury were selected.Under general anesthesia,the prepared olfactory ensheathing cell suspension was injected through several target sites surrounding the injured spinal cord.ASIA scale was used to assay the patients before transplantation,3 weeks to 2 months after transplantation,so as to evaluate spinal cord recovery.RESULTS AND CONCLUSION: The spinal cord nerve function in all patients altered to different degrees at 3 weeks postoperation.Spinal cord function score,the sensory and motor functions were significantly increased compared with preoperation(P < 0.001),and showed a trend of continuous improvement with time; the patients were visited as follow-up for no more than 5 years,and no impairment of the restored nervous function or transplant adverse reactions were observed.It is confirmed that olfactory ensheathing cell transplantation can promote the recovery of nerve function in patients with spinal cord injury,it can restore and improve some spinal cord functions,and the treatment is safe.