Effect of VvLaeA on the growth and development of Beauveria bassiana / 生物工程学报

It is unclear how VvLaeA functions in regulating the growth and development of Volvariella volvacea (Bull. ex. Fr.) Sing.. Firstly, bioinformatics analysis of VvLaeA was carried out in this study. Subsequently, the Vvgpd promoter and the open reading frame (ORF) fragment of VvlaeA were amplified and fused by polymerase chain reaction (PCR). The fusion fragment was cloned into the pK2 (bar) plasmid. The recombinant construct pK2(bar)-OEVvlaeA was transfected into Beauveria bassiana by Agrobacterium tumefaciens-mediated transformation. Finally, the growth and development of the transformants were examined. The results showed that VvLaeA shared a low homology with similar proteins in other fungi. Compared with the wild type, the colony diameter of the transformant was significantly increased. However, the pigment deposition, conidial yields and germination rates were significantly decreased. The overexpression strains were more sensitive to stresses than that of the wild type. Further studies showed the conidial cell wall properties of the transformants were altered, and the expressions of genes related to the conidial development were significantly down-regulated. Collectively, VvLaeA increased the growth rate of B. bassiana strains and negatively regulated the pigmentation and conidial development, which shed a light for the functional identification of straw mushroom genes.

Simultaneous Determination of 9 Components in Huoxiang Zhengqi Oral Liquid by HPLC / 中国药房

OBJECTIVE： To establish a method for simultaneous determination of nine components in Huoxiang zhengqi oral liquid， and to improve and perfect the quality standard of Huoxiang zhengqi oral liquid. METHODS： The contents of nine components in 10 batches of Huoxiang zhengqi oral liquid were determined by HPLC， such as licorice coumarin， isorlicin， liquiritinapioside， narirutin， liquiritin， saponins， hesperidin， magnolol and honokiol. The determination was performed on Kromasil Eternity XT-5-C18 column with mobile phase consisted of acetonitrile-0.05％ phosphoric acid solution （gradient elution） at the flow rate of 1 mL/min. The detection wavelength was set at 220 nm， and column temperature was 25 ℃. The sample size was 10 μL. RESULTS： The linear range of licorice coumarin， isorlicin， liquiritinapioside， narirutin， liquiritin， saponins， hesperidin， magnolol and honokiolin were 0.000 5-0.007 5， 0.000 8-0.025 0， 0.006 1-0.976 0， 0.001 6-0.250 0， 0.007 8-0.025 0， 0.000 4- 0.062 7， 0.008 6-0.276 0， 0.010 0-0.500 0， 0.010 0-0.500 0 mg/mL （r＝0.999 2-1.000 0）. The detection limits were 0.001 3， 0.000 1， 0.004 7， 0.005 0， 0.012 0， 0.001 3， 0.007 8， 0.007 7 0， 0.005 8 μg/mL， and the quantitative limits were 0.013 0， 0.000 8， 0.047 0， 0.050 0， 0.120 0， 0.013 0， 0.078 0， 0.070 0， 0.058 0 μg/mL， respectively； RSD of precision， stability and repeatability tests were less than 3.0％ （n＝6）. Average recovery rates were 98.67％， 101.85％， 98.97％， 103.05％， 100.00％， 97.78％， 97.91％， 100.13％， 101.95％； RSDs were 1.14％， 2.18％， 0.40％， 0.17％， 1.38％， 0.85％， 1.38％， 0.10％， 1.35％ （n＝6）. CONCLUSIONS： The established method is accurate and reliable， which can provide reference for the establishment of the overall quality control evaluation system and the improvement of quality standard for Huoxiang zhengqi oral liquid.

Correlation analysis between lean body mass and bone mineral content in patients with type 2 diabetes mellitus / 中国综合临床

Objective To investigate the relationship between lean mass and bone mineral content (BMC)and bone mineral density(BMD)in normal and increased BMI overweight and obese patients with type 2 diabetes mellitus.Methods Seventy-two patients with type 2 diabetes mellitus treated in the First Affiliated Hospital of Nantong from June 2014 to August 2016 were selected in this study.According to body mass index (BMI),the patients were divided into the normal group(BMI<24 kg/m2)and the obese diabetic group(BMI=24 kg/m2).The systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),waist circumference(WC),fasting blood glucose(FBG),glycosylated haemoglobin(HbA1c),blood lipids(TC,TG, HDL-C,LDL-C),alanine aminotransferase(ALT),creatinine(Cre),calcium(Ca),phosphorus(P)and serum 25 hydroxyvitamin D(25OHD)were measured.The bone mineral density(BMD),bone mineral content (BMC),body fat percentage(BF%),lean body mass(LBM),fat mass(FM),and the ratio of male fat to female fat(A/G)were measured by dual energy X-ray(DXA).The above indicators were statistically analyzed.Results 25OHD in the obese diabetic group was(17.1+ 12.6)μg/L,lower than that in the normal diabetic group((23.8±8.2)μg/L)(P<0.05),but BMI,WC,BMD,BMC,%BF,FM in the obese diabetic group(BMI:(27.8±2.1)kg/m2,WC:(96.8±7.9)cm,BMD:(1.12±0.14)g/cm2,BMC:(2.47±0.38) kg,fat and fat percentage:(1.18±0.23))were higher than those in the normal group(BMI:(22.3±1.7)kg/m2,WC:(84.5 + 7.9)cm,BMD:(0.93 ± 0.13)g/cm2,BMC:(2.02 ± 0.28)kg,fat and fat percentage:(2.02±0.28))(P<0.05).There was a significant positive correlation between LBM and BMC in different parts of the body(R=0.37,0.37,0.35,0.43,P<0.05,P<0.001).The ratio of BMI and A/G was also positively correlated with BMC and BMD(r=0.38,0.31,0.28,0.33,0.27,0.25,0.23,0.37,P<0.05,P<0.001).There was a negative correlation between body fat percentage and BMC,BMD(r=-0.30,-0.27,-0.25,-0.33,P<0.05,P<0.001).After correction of age,sex,BMI and 25OHD,multiple linear regression analysis was used to indicate that LBM was a strong predictor of BMC(regression coefficient=0.210,P=0.001).Conclusion In patients with type 2 diabetes mellitus,BMC and BMD increased significantly in patients with elevated BMC,and lean body weight was a strong influencing factor for BMI.

Plasma gelsolin levels in prediction of prognosis of ST-segment elevation myocardial infarction / 中国介入心脏病学杂志

Objective To investigate the predictive value of plasma gelsolin in the prognosis of patients with ST-sgement elevation myocardial infarction ( STEMI ) and undergone primary percutaneous coronary intervention ( PCI ) .Methods The study included 206 patients with STEMI and undergone primary PCI, 148 patients with stable angina pectoris and received elective PCI and 80 healthy volunteer as the health population (NP) control.Blood samples were taken at admission on day 1, 3, 5, 7 and 9 to determine the plasma gelsolin level .Patients′baseline clinical characteristics , blood biochemistry tests results , details of operation and their cardiovascular risk factors were recorded .Major adverse cardiovascular events (MACE) within one year were recorded.Results (1) Compared to the stable angina group and the NP group, the level of plasma gelsolin of STEMI patients were obviously decreased at various time points ( all P<0.05 ) .There were no statistical differences between the stable angina group and the NP group .( 2 ) Patients with STEMI were catagorized into MACE group (n=78) and non-MACE group (n=128) according their follow up record in 1 year.The level of plasma gelsolin in patients with MACE were lower than the non-MACE group ( P <0.05 ) with the minimum value detected on day 7.Among patients complicated with MACE (n=78), they were further devided into the deceased group (n=18) and the survival group (n=60).Plasma gelsolin levels were lower in the deceased group with satistical differences found on day 5, 7 and 9.(3) Single factor Logistic regression analysis showed that the level of plasma gelsolin on day 7 was independent risk factor of MACE within one year ( P =0.014 ) .( 4 ) Setting the cutoff value of plasma gelsolin on day 7 as 21.7 mg/L,the sensitivity and speciticity for the MACE in STEMI patients treated with primary PCI within one year were 82.1%and 81.4%respectively , with the area under the receiver operator characteristic curve ( ROC ) was 0.854 ( 95% confidence interval 0.732 -0.961 , P <0.01 ) . Conclusions Plasma gelsolin levels are correlated with the severity of STEMI lesions and plasma gelsolin can be used as predicting factor of prognosis .

Influence of lumbar disc degeneration on the efficacy of lumbar fixed-point rotation manipulation in sitting position：a finite element study / 针灸推拿医学（英文版）

Objective:To investigate the influence of lumbar disc degeneration on the efficacy of lumbar fixed-point rotation manipulation in sitting position in treating lumbar intervertebral disc herniation (LIDH). Methods:We simulated lumbar fixed-point rotation manipulation of sitting position using three finite element models including a normal model, a mild degeneration model and a moderate degeneration model of L3-5, in which the herniated disc was assumed at the left rear of L4 disc and the rotation manipulation was carried out on the right side. The displacement and stress at the left rear of L4 disc of the three models were analyzed. Results:When lumbar fixed-point rotation manipulation in sitting position was carried out, a displacement and stress were generated at the left rear of L4 intervertebral disc of the three models directing forward. The displacement and stress in degeneration models were less than those in the normal model, and the smallest values were found in the moderate degeneration model. From normal model to mild and then to the moderate degeneration model, the displacement decreased by 36% and 59%, and the stress decreased by 22.3% and 45.2%, respectively. Conclusion:The lumbar disc degeneration affects adversely the effectiveness of lumbar fixed-point rotation manipulation in sitting position in the treatment of LIDH. The severer the lumbar degeneration, the greater the influence.

Subemergency reconstruction of grade Ⅲ and Ⅳ thumb defect by great toe wrap-around flap combined with the tissue flap of second toe / 中华显微外科杂志

Objective To explore the surgical technique and clinical effect of combined great toe wraparound flap and second toe tissue flap transfer for subemergency reconstruction of grade Ⅲ and Ⅳ thumb defect.Methods From July,2011 to March,2014,12 patients of grade Ⅲ and Ⅳ thumb defect were treated by transfering combined great toe wrap-around flap and second toe tissue flap transfer.The second toe tissue flap was carried out to cover donor site defect of the big toe.Results All the 12 transplants survied and were followed up for 6 to 24 months.The reconstructed thumbs had near nomal appearace and good fuction,2-point discrimination ranged from 0.6 cm to 0.8 cm.According to the trial standard of upper limb part of functional assessment of the Hand Surgery Branch of Chinese Medical Association,among the 12 eases,there were excellent in 9,good in 3.Impact on the donor foot was minor with limited complications.The patients were able to weight-bearing walking after one months of operation.For long-term follow-up,no case had successive ulces,obvious pain and claudication.Conclusion The reconstructed thumbs by great toe wrap-around flap combined with the tissue flap of second toe had near nomal appearace and good fuction.

Association between the polymorphism of C-reactive protein gene and plasma hs-CRP level in ischemic stroke patients / 中华老年医学杂志

Objective To investigate the association between the polymorphism of C-reactive protein (CRP) gene and plasma level of hs-CRP in patients with ischemic stroke.Methods 548 patients with acute ischemic stroke were considered to be the case group and 993 age-matched healthy controls were randomly selected from community-based population.Three tagging SNPs of the CRP gene (rs876537,rs3093059,and rs3091244) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The plasma hs CRP levels were measured by routine method and multiple logistic regression was applied to evaluate genetic effect on plasma hs-CRP level.Results (1) The hs-CRP concentration and elevation (≥3.0 mg/L) proportion were significantly higher in case group than in control group [(3.534 ± 3.484) mg/L vs.(1.957 ± 2.344) mg/L,43.1％ vs.16.6％,t=10.74 and 23.45,both P＜0.05].(2) Compared with controls,the case group had higher conventional vascular risks,including higher blood pressure [SBP:(145.33 ± 22.11) vs.(134.92±19.48) mmHg,t=14.30,P＜0.05; DBP:(88.14±12.72) vs.(81.42± 12.44) mmHg,t=12.44,P＜0.05],higher low-density lipoprotein cholesterol [(2.714±0.904)vs.(2.286 ± 0.704) mmol/L,t =9.72,P＜ 0.05],and lower concentration of high-density lipoproteincholesterol [(1.213±0.317) vs.(1.438±0.262) /L,t=-12.89,P＜0.05].(3) Both rs876537 and rs3093059 polymorphism of CRP gene showed statistical associations with elevation of plasma hs-CRP level in case group.After adjusted for covariates including age,sex,hypertension,type 2 diabetes and other factors,additive model and dominant model of rs3093059 showed that the adjusted ORs (95 ％ CI) were 1.548 (1.103-2.171),1.562 (1.070-2.281) respectively (both P＜ 0.05).And ORs (95％ CI) of additive model and dominant model of rs876537 were 1.368 (1.067-1.753),1.719 (I.190-2.482) respectively after adjusted for covariates (both P ＜ 0.05).Conclusions Plasma hs-CRP concentration is significantly higher in ischemic stroke patients than in healthy population.The polymorphism of rs876537 and rs3093059 of CRP gene has association with elevation of plasma hs-CRP level in ischemic stroke patients.

PDCA circle in training of endoscopic nurse / 中华消化内镜杂志

Objective To evaluate PDCA circle in training of cooperation quality in endoscopic nurse.Methods PDCA circle was applied to train endoscopic nurses.Knowledge of endoscopic nursing and techniques as well as operators' satisfaction with endoscopic examination were compared before and after PDCA circle training.Results Nursing scores increased from 92.40 to 96.00 with statistical significance (P ＜ 0.05).Performance scores increased from 93.03 to 98.13 (P ＜ 0.05).Operators' satisfaction increased from 81.3％ to 96.9％.Conclusion PDCA circle could improve not only endoscopic nursing but also the quality of endoscopic training.

Application of vacuum sealing drainage technique in the treatment of snake bites / 中国基层医药

Objective To explore the influence of vacuum sealing drainage(VSD) technology in snake bite treatment.Methods 108 patients of snake bites need to incision decompression were randomly divided into two groups,VSD group (VSD) 58 cases,conventional group (wound change dressings ordinarily) 50 cases.The secondary suture of time,the number of change dressings,material consumption fees,antibiotics use cost,wound infection rate,in hospital,average length of hospital stay were compared between two groups.Results Compared the VSD group with the conventional group,the secondary suture of time (t =11.743,P ＜ 0.05),the number of change dressings (t =50.661,P ＜ 0.05),material consumption fees (t =9.054,P ＜ 0.05),antibiotics use cost (t =21.515,P ＜ 0.05),wound infection rate (x2 =9.155,P ＜ 0.05),in hospital,average length of hospital stay (t =10.350,P ＜ 0.05) had significant differences.Conclusion VSD technique can be a ideal way to treat snake bites patients and worth popularizing at this stage.

Influence of systematic nursing model on treatment compliance and clinical efficacy of elderly patients with diabetes / 中国实用护理杂志

Objective To probe into the effect of systematic nursing model on treatment compliance and clinical efficacy of elderly patients with diabetes. Methods 100 elderly patients with diabetes in our hospital were selected from January 2008 to December 2010.The patients were divided into the study group and the control group randomly,50 cases in each group.The patients in the control group were treated with conventional care model,while the patients in the study group were treated with systematic nursing model.The compliance,clinical treatment effect,and improvement of clinical indicators were compared and ana lyzed in two groups respectively. Results Compared with the control group,treatment compliance indexes such as self-monitoring,diet control,medication compliance,exercise therapy in the study group were significantly improved,the difference was statistically significant.Compared with the control group,the clinical efficacy of patients in the study group was significantly improved.Compared with the control group,the FBG,PBG and HbAlc were improved significantly,the difference was statistically significant. Conclusions Systematic nursing model plays a positive role in promoting treatment compliance and clinical effects of elderly patients with diabetes mellitus.The interventions need to be further enriched and perfected.

Association of the C-reactive protein gene polymorphisms and plasma hs-CRP level in ischemic stroke / 中华检验医学杂志

Objective To investigate the association of C-reactive protein (CRP) gene polymorphisms and plasma hs-CRP level,and effect on the genetic susceptibility of ischemic stroke (IS).Methods A case-control study was conducted and 548 patients with acute ischemic stroke and 993 agematched controls from community-based population were included in this study.Epidemiological questionnaires were managed to collect for demographic information.Blood pressure was measured and blood glucose,triacylglycerol,cholesterol,and high sensitivity C-reaction protein (hs-CRP) were detected.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for genotyping of CRP gene in all participants.Results The levels of plasma hs-CRP and the proportion of elevated plasma hs-CRP (≥3.0 mg/L) in the ischemic stroke patients (3.534 ± 3.484) mg/L (43.1％) were significantly higher than those of controls (1.957 ±2.344) mg/L (16.6％),t =9.475,P ＜ 0.01,x2 =128.326,P ＜ 0.01.The results of association analysis indicated that rs3093059 and rs3091244 of CPR gene presented statistical associations with ischemic stroke.After correction for confounding factors,ORs (95％ CI) of additive model and dominant model of rs3093059 were 0.697 (0.528-0.921),0.671 (0.487-0.923) respectively.ORs 95％ CI) of dominant model of rs3091244 was 0.728 (0.536-0.988).Further analysis indicated the polymorphism of rs876537,rs3093059,rs3091244 of CPR genotyping were significantly associated with plasma hs-CRP elevation (≥ 3.0 mg/L) both in ischemic stroke patients and in controls (P ＜0.05).Conclusion The CRP genetic polymorphisms were negatively associated with ischemic stroke,and positively corrleted with plasma hs-CRP elevation.However,plasma hs-CPP was positively correlated with ischemic stroke.These results suggested that the plasma hs-CRP levels might be accompanied by ischemic stroke.

The therapeutic effects of highly active anti-retroviral therapy in 74 treatment-naive patients with AIDS in China / 中华内科杂志

Objective To evaluate the therapeutic effect of highly active anti-retroviral therapy (HAART) in treatment-na(i)ve Chinese patients with AIDS, to provide evidences for standardizing HAART.Methods Seventy-four treatment-naive AIDS patients were initiated with HAART and followed up regularly for 3 years. The clinical and laboratory data, side effects and drug resistance were observed and analyzed during the follow-up period. Results Of the 74 patients, 46 were males and 28 were females, with the average age being 42 years. The mean HIV viral load was ( 2. 2 ± 2.0 ) × 105 copies/ml and the baseline mean CD4+ T lymphocyte count was (62 ± 71 )cells/μl before treatment. After treatment for 3, 6, 12, 18,24, 30 and 36 months, the percentage of undetectable HIV viral road (less than 50 copies/ml ) was 71.6%, 83.8%, 75.7%, 77.0%, 82.4%, 81.1% and 79.7% respectively, and CD4+T lymphocyte count ascended to ( 167 ± 105), ( 177 ± 129), (238 ± 137), (290 ± 158), (304 ± 191 ), (331 ± 175) and ( 352 ± 202 ) cells/μl. The increase in amplitude of CD4+ T lymphocyte count in different periods examined was different, with the period of 0-3 months post-treatment demonstrating the most obvious augmentation ( P ＜ 0. 01 ) . The most common adverse reactions were liver function injury ( 52/74,70. 3% ), hyperlipemia (52/74, 70. 3%), hematopoietic inhibition of the bone marrow (33/74, 44. 6% ),peripheral neuritis (32/74, 43.2% ) and lipoatrophy (26/74, 35. 1%). Clinical drug resistance were found in nine patients and HIV gene mutations were detected in these patients. Conclusions Chinese treatment-naive AIDS patients have achieved good virological and immunological response to generic-drugpredominant HAART regimes with low drug resistance, but relatively more side effects.

Case-control study on ginkgo-dipyridimolum and mecobalamin for treatment diabetic peripheral neuropathy / 中国基层医药

ObjectiveTo observe the effect of the combined therapy of ginkgo-dipyridimolum and mecobalamin for diabetic peripheral neuropathy (DPN).MethodsA total of 102 DPN cases were randomly divided into treatment group(n =50) and control group(n =52).The treatment group was given ginkgo-dipyridimolum and mecobalamin, and the control group was given only mecobalamin for 4 weeks.We observed the change of symptom and sign of both groups before and after treatment,and the MNCV and SNCV of median nerve,ulnar nerve and peroneal nerve were detected.ResultsIn the treatment group, the improvement of DPN symptoms (x2 = 10.090, P ＜ 0.01) and nervous conducting speed were much more obvious than that in the control group(MNCV of median nerve, ulnar nerve and peroneal nerve was(49.12 ± 3.32) m/s, (52.11 ± 3.12) m/s and(47.32 ± 3.21) m/s respectively; SNCV of median nerve,ulnar nerve and peroneal nerve was(47.13 ± 2.56) m/s, (55.12 ± 2.31) m/s, (46.78 ± 2.66) m/s respectively,all P ＜0.05).ConclusionThe combined therapy of ginkgo-dipyridimolum and mecobalamin could effectively improve the therapeutic outcome of DPN, and the treatment was safe and worthy of widespread use.

Modified ( narrowed ) gastric tube and establishment of enteral feeding pathway in surgery of esophageal carcinoma (esophagectomy) / 中华临床营养杂志

ObjectiveTo describe the modified (narrowed) gastric tube and two methods on the establishmentof enteral feeding pathway in esophagectomy.MethodsFrom July 2003 to April 2006,we made traditional gastric tube for patients underwent esophagectomy to substitute the dissected esophagus while from May 2006 to November 2009,we made modified gastric tube for the same purpose.From July 2003 to November 2009,enteral nutrition tubes for all these patients are placed intraoperatively by two different ways,which made early post-operative nutrition support possible for these patients.ResultsNo perioperative death occurred among the patients.The length of the modified gastric tube ensured the anastomosis by circular stapler at the apex thorax or in the bases of cervical region.No statistical differences were found between the two group in terms of survival rate.The intraoperative establishment of enteral nutrition pathway ensured the early enteral nutrition support after the operation.ConclusionThe utility of the modified gastric tube extends the length of gastric tube to make mechanical anastomose easier and safer; meanwhile,the intraoperative establishment of enteral nutrition pathway ensures the early enteral nutrition support after the operation.

Effect of nateglinide or sequential treatment with metformin on glycemic stability in newly diagnosed type 2 diabetic patients / 中华内分泌代谢杂志

The effect of nateglinide or sequential treatment with metformin on glycemic stability in newly diagnosed type 2 diabetes was investigated. Thirty-four cases of newly diagnosed type 2 diabetes received nateglinide therapy, or sequential treatment with metformin according to fasting and postprandial blood glucose, and were classified into isolated nateglinide therapy group(n=14) and sequentially treated with metformin group(n=20). Glycemic stability, reflected by mean amplitude of glycemic excursions(MAGE) and HbA1C, was determined in all patients before and after therapy for three months. HbA1C and MAGE in two groups were all improved after treatment(P＜0.05). The therapy of nateglinide alone or combined with metformin can significantly improve glycemic stability in newly diagnosed type 2 diabetes.

Effect of neoadjuvant chemotherapy on R0 resection rate of esophageal carcinoma / 肿瘤研究与临床

Objective To investigate the possibility of increasing R0 resection rate in esophageal carcinoma after neoadjuvant chemotherapy. Methods 30 patients underwent operation after neoadjuvant chemotherapy mainly by paclitaxel combined with cis-platinum, including 18 squamous carcinoma cases. 10 adenocarcinoma cases and 2 small cell carcinoma cases.Results In these 30 patients,the overall effective rate of neoadjuvant chemotherapy is 56.7%(17/30)(CR+PR),R0 resection rate is 100%,and the incidence rate of anastomotic leakage is 3.3%(1/30),without perioperative death.Conclusion The neoadjuvant chemotherapv is significant in improving the R0 resection rate in esophageal carcinoma,and the impact of long-term survival after surgery needs further follow-up.

Low-density lipoprotein immune complexes in patients with type 2 diabetes / 中华全科医师杂志

This study was designed to observe the clinical value of low-density lipoprotein immune complexes (LDL-ICs) in patients with type 2 diabetes mellitus (T2DM). Fifty-four patients with type 2 diabetes + macroangiopathy (DM-MA group), 48 patients with type 2 diabetes (DM group), 45 patients with macroangiopathy ( MA group), and 30 normal controls ( NC group) were enrolled. LDL-ICs levels in the DM-MA group were significantly higher than those in the other three groups. The levels of LDL-ICs in the MA group were higher than those in the NC and DM groups. There was a significant difference in LDL-ICs between the DM and NC groups. LDL-ICs levels were positively related with body mass index (BMI), glycesylated hemoglobin Alc(HbAlc), blood pressure, total cholesterol, and triglyceride. There was no significant relationship between low-density lipsprotcin cholesterol and LDL-ICs. A significantly negative correlation was recorded between high-density lipoprotein cholesterol and LDL-ICs. Our study suggests that LDL-ICs, blood pressure, and HbAlc may be risk factors of macroangiopathy in type 2 diabetic patients.

A comparison of different surgical approaches for the treatment of thoracic middle/lower segment esophageal cancer / 中华胸心血管外科杂志

Objective Surgical approech differs between China and western countries in the treatment of middle/lower aegment thoracic esophageal cancer. This study was designed to compare the effects of different surgical modalities on traumatic reaction, heal-ing process and lymph node dissection.Methods Fifty-nine petients,diagnosed with middle/lower segment of thoracic esophageal cancer, were enlisted and had undergone curative RO esophagectomy.The patients were categorized based on different approaches as the following three groups:group of Ivor-Lewis operation,group of McKeown operation and group of esophagectomy through left tran-sthoracic approach.Clinical data was summarized and malyzed.Results (1)No surgical death was reported in this study.(2)There were no statistical difference among the three groups in tenms of postoperative hospital stay,diration of systemic inflammatory re-sponse syndrome and total body fluid loes (P=0.287,0.641,0.355).(3) The number of total lymph nodes harvested from the above three groups was 22.5(11-39),26(14-56).and 17(7-44)(P=0.005),respectively.The number of abdominal lymph nodes harvested from the above three groups was 10(5-26),12(4-32),and 8(3-19)(P=0.021),respectively.No statistical difference was found to the number of thoracic lymph nodes among three groups.(4)Lymph node metastasis occurred most frequently in the station of pericardial lymph nodes,followed by middle thoracic paraesophageal nodes along the left gastric ar-tery.The range of metastasized lymph nodes dissected through left transthoracic approach was much limited compated with right tran-sthoracic approach.Conchuslon The was no difference between left and right transthoracic approach in terms of surgical trauma and overall rehabilitation.The number of lymph nodes harvested from right transthoracic approach surpassed that from the left approach, which might be due to the extent of abdoominal lymphadenectomy.Considering wide range of lymph node metastasis,We recommedn a more extended lymph node dissection for middle/lower segment of thoracic esophageal cancer for the purpose of better local control control and survival benefit.

Clinicial analysis of the first imported ease of Chikungunya fever in China / 中华传染病杂志

Objective To investigate the epidemiological, clinical and pathogenic characteristics and prognosis of the first imported case of Chikungunya fever in China in 2008. Methods Epidemiological and clinical data of this mate adult patient were analyzed retrospectively. Chikungunya virus (CHIKV)-IgM was detected using enzyme linked immunosorbent assay (ELISA) and colloidal gold immunoassay. CHIKV-RNA was detected using real-time fluorescent polymerase chain reaction (RT-PCR). Results This patient had onset of fever on March 2 in 2008 and lasted for 5 days. In addition, he felt joint and muscle pains, headache and found generalized engorged maculopapule. The laboratory tests showed leukopenia and thrombocytopenia. CHIKV-IgM was detected positive at day 9 after the onset and CHIKV-RNA was all positive at day 3, 5, 7, 9 after the onset. A 575 bp fragment of RT-PCR product was sequenced and detected the nucleotide homology was 99% compared with CHIKV sequences in GenBank. The patient recovered with symptomatic supportive treatment.Conclusion This imported case of Chikungunya virus infection is reported for the first time in China.It shows similar clinical manifestations with dengue fever.

The effects of metformin on the serum levels of adiponectin,interleukin-18 and C-reactive protein in patients with type 2 diabetes mellitus / 中国糖尿病杂志

Objective To observe the effects of metformin on the serum levels of adiponectin,interleukin-18(IL-18) and C-reactive protein(C-RP) in overweight/obese type 2 diabetes. Methods The changes of serum levels of HOMA2-IR,adiponectin,IL-18,C-RP and lipid profiles were observed before and after the treatment of metformin. Results After the eight weeks of treatment,the levels of adiponectin and IL-18 were not significantly changed,while C-RP(0.49±0.23 vs 0.89±0.22ng/dl),total cholesterol(TC)(4.58±0.83 vs 6.15±2.23mmol/L),LDL-C(2.65±0.78 vs 3.66±0.84mmol/L) and HOMA2-IR(1.1±0.7 vs 2.3±1.7) were decreased (all P<0.05),HDL-C(1.23±0.30 vs 1.02±0.24mmol/L) was increased (P<0.05). Conclusions Metformin may reduce the serum C-RP level and modulate the disorder of blood lipids,but may have no effect on adiponectin and IL-18