Volume 91  ·   Issue 16  ·  2011

Objective To ascertain the diagnosis of such a rare disease as Ehlers-Danlos syndrome type Ⅳ by the technique of DNA(deoxyribonucleic acid)analysis.Methods The primer sequences of Col3A1 gene were designed. Genomic DNA was isolated from the peripheral blood samples. The amplification of polymerase chain reaction(PCR)was performed and direct sequencing used to screen the mutations.A definite diagnosis was made in conjunctions with clinical features.Results Two nucleotide mutations for Col3A1 were found. One was in intron 15 while another in exon 30. The latter was an important mutation of a G to A transition(c.2209G＞A)resulting in alanine to threonine substitution at position(p.Ala698Thr).The mutations were inherited from proband of pedigree.Conclusion Genetic testing of Col3A1 mutation can facilitate an accurate diagnosis of Ehlers-Danlos syndrome.

Objective To explore the clinical features and surgical treatment of tumors associated with Castleman's disease(CD).Methods The clinical profiles of 19 patients with neck giant lymph node hyperplasia were analyzed retrospectively.There were 8 males and 11 females with a median age of 40 years old(range:7-74).The tumor locations were neck(n=12),neck & mediastinal cavity(n =2),axillary fossa(n=2),retroperitoneal area(n=2)and abdominal cavity(n=1).Results Eighteen of them underwent surgical resection of tumor or lymph nodes. All were diagnosed as CD by pathological examinations.There were 16 localized CD(LCD)including hyaline vascular type(HV type,n=11),mixed type(mix type,n =4)and plasma cell type-Hodgkin's disease(n=1).Among 3 multicentric CD (MCD),there were 2 case of plasma cell type(PC type)and Ⅰ case of mixed type(mix type).Long-term survival was achieved in 19 cases among which 1 case of plasma cell type MCD survived for 5 years and underwent a second operation and postoperative chemotherapy of CVP(cyclophosphamide,vincristine & prednisone)regimen for 3 cycles due to recurrence in 2 years and 1 case of plasma cell type LCD-Hodgkin's disease survived for 15 months and underwent a second operation and postoperative chemotherapy of ABVD (adriamycin,bleomycin,vinblastine & dacarbazine)regimen for 6 cycles due to recurrence in 6 months.One case of plasma cell type MCD in abdominal cavity on chemotherapy of CHOP(cyclophosphamide,hydroxydaunorubicin,vincristine & prednisone)regimen for 6 cycles was discharged after a successful management of intestinal obstruction. ConclusionsThe major clinical symptom of CD is a gradually enlarging painless mass.Surgical resection of tumor remains the first-line treatment for localized CD and the prognosis is excellent.Multicentric and plasma cell type CDs are prone to recurrence and transformation to lymphoma.And their first-line therapeutic should encompass multi-modality regimens of surgery and adjuvant chemotherapy.However,the clinical prognosis is still poor.

Objective To improve the treatment of pyonephrosis with upper urinary tract calculi (UTC).Methods A total of 49 UTC patients with pyonephrosis were selected at our hospital during May 2004 to February 2010. Among them,22 cases were treated with transurethral ureteroscope lithotripsy followed by tube internal drainage while another 27 cases underwent percutaneous nephrolithotomy.Results No such complications as septicemia and septic shock occurred during the first stage of external and internal drainage.The bacteremic symptoms of chill or fever occurred in 3 cases during the second stage of percutaneous nephrolithotomy and pyelolithotomy/ureterolithotomy(11.1%). There were 3 cases of nephrectomy.A follow-up period of 3 months to 5.5 years showed that all 33 cases had a varying degree of recovered renal functions.And there was no ephrectomy.Conclusion The keys to a successful surgical treatment of pyonephrosis with upper urinary tract calculi are early diagnosis,timely drainage and relief of obstruction. Ureteroscopic lithotripsy,double-J placement and percutaneous nephrostomy drainage are excellent for relieving obstruction.As a safe procedure with minor complications,it creates proper conditions for a second stage operation.

Objective To investigate the risk factors of morbidity and prognosis in patients with acute kidney injury(AKI)due to sepsis.Methods A case-control retrospective study was carried out in AKI patients with/without sepsis from February 2000.to March 2010.APACHE Ⅲ and ATN-ISI were calculated.Multivariate logistic regression analysis was used to explore the clinical data and the risk factors of morbidity and prognosis in patients with septic AKI.Results (1)The overall mortality rate was 23.3%and the mortality rate of septic AKI patients 44.6%.(2)With no correlation with the level of D-dimer(r=0.356,P=0.019),the number of failed organs was positively correlated with the mortality rate in septic AKI patients(r=0.545,P＜0.01).(3)As demonstrated by multivariate analysis,D-dimer(＞ 2.2mg/L),supports of vasoactive agents,APTT(activated partial thromboplastin time)(＞ 50 s)were the pathogenetic risk factors for septic AKI patients;APACHE Ⅲ score(＞60),the number of fai1ed organs,supports of mechanical ventilation were the prognostic risk factors for septic AKI patients.Conclusion sThe pathogenetic risk factors of septic AKI patients are D-dimer(＞ 2.2 mg/L),supports of vasoactive agents and APTT(＞ 50 s);APACHE Ⅲ score(＞ 60),the number of failed organs and supports of mechanical ventilation are the prognostic risk factors for septic AKI patents.D-dimer may predict the morbidity of septic AKI patients,but it can not predict their prognoses.

Objective To compare the prognostic effects of different time windows on initiating PCI (percutaneous coronary intervention)in AMI(acute myocardial infarction)patients.Methods Ninety-five AMI patients undergoing PCI were enrolled continuously from January 2007 to September 2008.According to the timing of direct PCI,the patients were divided into 3 groups:after AMI,＜ 6 h(Group A,n=45),6-12 h(Group B,n=45)and 12-24 h(Group C,n=35).Comparisons were made among these 3 groups in terms of the post-PCI incidence of heart failure and mortality.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic inside diameter(LVEDV)were measured by echocardiogram at Month 6.Results During the hospitalization and follow-up,Group A had a lower incidence of heart failure and mortality than Groups B and C.And Group B had a lower rate than Group C.The difference was significant (P＜0.05).Compared with LVEF(%)(52.25 ± 4.27)in Group B and LVEF(%)(47.75 ± 6.86)in Group C,LVEF(%)(57.51 ±6.9)in Group A were significantly improved on ECG at Month 6 months.LVEDV(mm)(45.89 ±4.23)in Group A were significantly lower than LVEDV(mm)(49.0 ±3.1)in Group B and LVEDV(mm)(52.46 ±4.9)in Group C.The differences were both statistically significant (P＜0.05).Conclusion An early time windows of initiating PCI in AMI patients can significantly improve the left ventricular functions and reduce the incidence of heart failure,left ventricular remodeling and the mortality rate.All these measures could improve left ventricular functions and prognosis.

Objective To gain insights into the construction and content of literature on infectious keratitis in China during the past two decades.Methods Through VIP-VMIS,SinoMed and PubMed databases for the period of 1989 to 2008,the literature regarding infectious keratitis published in domestic and foreign journals by China authors was retrieved. Numbers,types,time,journal distribution of documents published and provincial distribution of authors were recorded.Meanwhile the subject content was roughly analyzed. ResultsThere were 1982 Chinese articles on infectious keatitis during the past two decades,of which 629 were pertaining to traditional Chinese medicine. In the remaining 1353 of Western medicine articles,704 were published in kernel journals,78 in serial journals of Chinese Medical Association and 443 as original research articles(including 160 basic research papers). Moreover,30articles regarding epidemiology and etiology of infectious keratitis were retrieved from VIP-VMIS. And 31papers published in foreign journals were retrieved from PubMed database.Conclusion sDuring the past two decades,the China oculists have made great progress in research works on infectious keratitis.However more attention should be devoted to the basic researches,epidemiologic survey and etiologic analysis.

Objective To investigate the efficacy and possible action mechanism of Qianlie Beixi Capsules in the treatment of unliquefiable semen.Methods A total of 190 patients with unliquefiable semen were treated with Qianlie Beixi Capsules for 1 or 2 courses(3 weeks per a course).The seminal changes were observed and recorded.Results Of the 190 patients in the l-course treatment arm,99 were cured and 91 failed to respond after the first course.And the effectiveness rate was 52.1%.Of the 122patients in the 2-course treatment arm,81 were cured and 41 failed to respond after the second course.And the effectiveness rate was 66.4%.The efficacy of 2-course regimen was obviously better than that of 1-course regiment.In the meantime,sperm density improved in the 2-course treatment arm.Sperm motility improved slightly in the effective subjects of 1-course treatment arm Allthe above results had statistically significant differences(P＜0.05).Conclusion Qianlie Beixi Capsules is both safe and effective for unliquefiable semen and may shorten the time of seminal liquefaction.

Objective To analyze the characteristics of the electrocardiogram(ECG)of left anterior descending coronary artery(LAD)occlusion in patients with acute STelevation myocardial infarction (STEMI).Methods Patients included were those diagnosed with STEMI in Peking Union Medical College Hospital from January 1996 to March 2009,and underwent coronary angiography(CAG).The infarction related artery(IRA)was LAD,and there were no significant stenosis in left circumflex artery and right coronary artery.A total of 170 cases were consecutively enrolled.They were divided into 2 groups according to occlusive sites of the LAD:LAD proximal(n =77),LAD medius distal group(n =93).Standard 18leads ECG within 12 hours from the onset of STEMI were recorded and ST segment deviation was analyzed quantitatively.Results Proximal LAD occlusion as IRA was diagnosed with aVL ≥ 0.1 mV,ST aVL ＞aVR,sum of Ⅱ,Ⅲ and aVF STsegment depression ≥ 0.1 mV,in which sensitivity was 39.0%,37.7% and 50.6%,specificity was 78.5%,77.4% and 74.2% respectively.Statisticully significarct(P＜0.05).Medius-distal LAD occlusion as IRA was diagnosed with no Ⅱ ST depression,aVF ST depression and sum of Ⅱ,Ⅲ and aVF ST segment depression ＞0.1 mV,In which sensitivity were 86.0%,81.7% and 74.2% and the were 31.2%,48.1% and 50.6% respectively.Statisticully significarct(P ＜0.05).Conclusion In STEMI patients with isolated LAD occlusion,ECG can be useful to predict the occlusion site.

Objective To evaluate the role of serum vascular endothelial growth factor(VEGF)and urine basic fibroblast growth factor(bFGF)in the differential diagnosis of vascular anomalies by receiver operating characteristic curve.Methods Using the method of enzyme linked immunosorbent assay (ELISA),364 cases of various vascular anomalies(proliferating hemangiomas,n=146;hemangiomas,n=106;vascular malformations,n=112)and 440 cases of various vascular anomalies(proliferating hemangiomas,n=154;involuting hemangiomas,n=148;vascular malformations,n=138)subjects were examined for the serum levels of VEGF and the urine bFGF respectively.Nonparametric statistical tests were used for data analysis.The VEGF levels of proliferating hemangioma,involuting hemangioma,vascular malformation and control groups were analyzed by the Kruskal-Wallis test.When there was significance (P＜0.05),a subgroup analysis was performed by the Mann-Whitney U test. A receiver operator characteristic(ROC)curve was constructed for both the serum levels of VEGF and urine bFGF to determine the optimal diagnostic cut-off to differentiate proliferating hemangioma from involuting hemangioma,vascular malformation and controls.Results The serum level of VEGF and the urine bFGF in proliferating hemangiomas were significantly higher than those in involuting hemangiomns,vascular malformations and negative controls(P＜0.01). And the differences among the latter three groups were not statistically significant(P＞0.05).The optimal diagnostic cut-off point of serum VEGF and urine bFGF to differentiate proliferating hemangioma from involuting hemangioma,vascular malformation and controls was 99.6 pg/mg and 0.16 ng/mmol respectively. The area under ROC curve,the sensitivity and specificity were 99.7%,99.3%,99.7% and 91.9%,98.7%,71.1% respectively. The differences of the area under ROC curve of serum VEGF and urine bFGF showed no statistical significance(P＞0.05).Conclusion Serum VEGF and urine bFGF are helpful for differentiating proliferating hemangioma from involuting hemangioma,vascular malformation and controls.Both parameters have higher values of clinical application.

Objective To investigate the relationship of glucose metabolic rate (GMR) and plasma levels of adiponectin and leptin in patients with metabolic syndrome (MS). Methods A total of 30 MS subjects aged 36 -60 years old were selected as MS group. And 20 normal adults were selected as control group. The GMR was evaluated by the technique of hyperinsulinemic euglycemia clamp. The plasma concentrations of adiponectin and leptin were detected by enzyme-linked immunosorbent assay (ELISA). Blood pressure, waist circumference (WC), body weight and body height were measured.Results ( 1 ) During the steady state ( last 30 min), the GMR was significantly lower in MS group than that in control Group [ (4. 13 ± 1.34) mg· kg- 1 · min -1 vs ( 8.33 ± 1.59 ) mg · kg- 1 · min -1, P ＜ 0. 01 ].(2) The plasma level of adiponectin was significantly lower in MS group than that in control group [ (5. 15 ±2. 54) μg/ml vs ( 10. 28 ±5.50 ) μg/ml, P ＜0. 01 ]. The plasma level of leptin were significantly higher in MS group than that in control group [(189.37 ±90.48) nng/ml vs(126.55 ±72.70) ng/ml, P ＜0.01].(3) In MS group, glucose metabolic rate was associated with WC, BMI, TG, HDL-C FINS, leptin, and adiponectin, ( all P ＜ 0. 05 ). Conclusion The technique of hyperinsulinemic euglycemic clamp shows that the BMR of MS patients significantly decreases. It may be associated with their lowered plasma levels of adiponectin and leptin.

Objective To evaluate the performance of a newly installed fully automatic coagulation analyzer and compare the consistency of its testing results with the confirmed clinical automatic coagulation analyzer at our department MethodsPrecision,linearity,carryover and accuracy of the newly installed coagulation analyzer were evaluated according to the national required standards.Then the testing results were analyzed between the newly installed and confirmed coagulation analyzers according to the EP-5 and EP-9 documents of national committee for clinical laboratory standards(NCCLS).Results For the newly installed coagulation analyzer,the low,median and high values of relative intra-precision were:0.93%,1.32% and 1.27% for prothrombin time(PT);1.42%,0.84% and 1.17% for activated partial thromboplastin time(APTT);1.82%,3.13% and 3.19% for fibrinogen(FIB);1.78%,1.76% and 1.38% for thrombin time(TT)respectively.The linear regression equation of FIB actual and theoretical values was y=1.012x + 0.0219(P＞0.05).There was no significant statistical difference between the intercept and 0(t=0.2287,P＞0.05)and between linear slope and 1(t=0.3221,P＞0.05).The carryover was-2.33%.The testing results of defined acceptable bias of PT and FIB in CLIA'88 for two analyzers were within the acceptable 95%confidence interval of bias. ConclusionThe precision,linearity,carryover and accuracy of the newly installed coagulation analyzer meet the requirements of instrument user manual.The performance and the testing results of the same sample from two coagulation analyzers are consistent.

Objective To explore the influences of milk or coenzyme Q10 pretreatment to acrylonitrile on vascular endothelial functions in rats.Methods A total of 80 rats were randomly divided into 4 groups:control group(Con),acrylonitrile exposure group(ACN),milk pretreatment group (M + ACN)and coenzyme Q10 pretreatment group(Q10 + ACN).The experiment was conducted by the method of gavage exposure in rats.Control group was exposed to corn oil;acrylonitrile was administered to other three groups at the doses of 25 mg/kg.The M + ACN and Q10 + ACN groups were pretreated by milk or coenzyme Q10 at 30 minutes before acrylonitrile exposureAfter a 12-week exposure,the activities of inducible nitric oxide synthase(iNOS)and endothelial nitric oxide synthase(eNOS)were measured in serum and aortal tissues.Results As compared with Con group[(21.9 ± 1.6)U/ml],the activity of blood serum iNOS was higher in ACN,M + ACN and Q10 + ACN groups[(42.9 ± 2.5)U/ml,(26.5 ± 4.4)U/ml,(26.7 ±3.3)U/ml,P＜0.05].As compared with Con group[(0.540 ± 0.028)U/mgprot],the activity of aortal iNOS was higher in ACN,M + ACN and Q10 + ACN groups[(0.812 ± 0.008),(0.773 ± 0.019),(0.622 ±0.013)U/mgprot,(P ＜0.05)].Furthermore the activity of aortal eNOS in Q10 + ACN group[(0.471 ±0.011)U/mgprot]was higher than Con,ACN or M +ACN group[(0.371 ±0.029),(0.380 ±0.016),(0.425 ±0.020)U/mgprot,P ＜0.05].Conclusion Chronic administration of ACN by gavages results in vascular endothelial dysfunctions.Milk and coenzyme Q1o pretreatment reduce this effect in rats.

Objective To investigate the protective effects of ischemic postconditioningand and penehyclldine hydrochloride on gastric injury induced by ischemia-reperfusion of lower limb in rats.Methods The model of limb ischemia reperfusion injury was used to perform this experiment.One hundred and forty four male Wistar rats weighing 220-250 g were randomly divided into 4 groups:group Ⅰ Control (C),group Ⅱ Ischemic Reperfusion(IR),group Ⅲ Ischemic postconditioning(IPO)and group Ⅳpenehyclidine hydrochloride(IPHC);C,IR,IPO and IPHC groups has been followed for 0(T0),1(T1),3(T3),6(T6),12(T12),or 24(T24)perfusion,all the groups were secondary separated into six subgroups as time point and each subgroup contained six rats,respectively.Blood samples from the inferior vena cava were taken for determineation of LDH,CK activities and TNF-α,IL-10 content at every time point of reperfusion;the animals were killed at every time point respectively and the gastric were removed for determineation of SOD,MPO,XOD and LDH activities,MDA content,and histologyical examination and the expression of HIF-1α was analyzed.Results Compared with group C,IR,IPO and IPHC,in serum LDH and CK activeities were increased,TNF-α and IL-10 content were increased(P ＜0.05 or P ＜0.01);and in gastric tissue MPO,XOD and LDH activeities were increased and MDA content increased,while SOD activity decreased in group IR,IPO and IPHC(P＜0.05 or P＜0.01);and gastric tissue resulted in significant injury as evidenced by infiltrated of few neutrophils or eosinophils and rare neutrophils between the gastric mucosa or muscularis mucosa and the glands,interstitial vascular dilation hyperemia and small quantity hemorrhage from deep layers of mucosa or interstitial vascular dilation hyperemia,and the expression of HIF-1α was significantly increased(P ＜0.01).Compared with group IR,IPO and IPHC in serum LDH and CK activeities,TNF-α content decreased while IL-10 content were increased(P ＜0.01);and in gastric tissue MDA content,MPO,XOD and LDH activeities were decreased,and SOD activity increased in group IPO and IPHC(P ＜0.05 or P ＜0.01);and the histologyical injury were milder and the expression of HIF-1α was significantly decreased(P ＜0.01).Compared with group IPO,IPHC,in serum LDH activeities were markably decreased,CK activeities were first increased and then declined,TNF-α content markaly declined while IL-10 content were increased(P ＜0.05 or P ＜0.01),and the histologyical injury were milder and the expression of HIF-1α was markably decreased(P＜0.01)and in gastric tissue SOD activity were markably increased,MPO activeities significantly decreased,MDA content increased at T3,XOD activeities increased after T12,LDH activeities increased at T3 and declined after T12 in group IPHC(P＜0.05 or P＜0.01).Conclusion The combination of ischemia postconditioning and postconditioning with penehyclidine hydrochloride can protect the gstric from ischemia-reperfusion injury induced by ischemia reperfusion of the lower limbs in rats,the main mechanism may be reducing post-ischemic oxidative damage,inflammatory reaction,amelio-rating microcirculatory and cellular energy metabolism et al.Additionally,this study found that the protective effects of penehyclldine hydrochloride on gastric injuryinducedbyischemiareperfusionof thelowerlimbs,werebetterthanischemic postconditioning,and the mechanism might be related to its anti-inflammatory effect,antioxidant action and prevention of cell injury et al.

Objective To explore the production of connective tissue growth factor(CTGF)by Angiotensin Ⅱ(Ang Ⅱ)in human embryonic lung fibroblast via the RhoA-ROCK pathway. Methods Human embryonic lung fibroblast(HFL-1)was divided into 4 groups:(1)control group:no stimulation;(2)AngⅡgroup:stimulation of AngⅡ(10-7 mol/L);(3)Irbesartan plus Ang Ⅱ group:stimulation by Ang Ⅱ(10-7 mol/L)with AT-1 receptor antagonist irbesartan(10-6 mol/L)pre-treatment;(4)Irbesartan plus Ang Ⅱ group:stimulation by Ang Ⅱ(10-7 mol/L)with ROCK inhibitor Y27632(10-6 mol/L)pretreatment.Then the products of protein and RNA were collected.Western blot and QuantiGene were used to detect the activation of RhoA-Rock pathway and CTGF.Results Exploring the affect of irbesartan on Ang Ⅱ through the Western blot analysis of CTGF and RhoA protein expression:the CTGF level was up-regulated by AngⅡ(0.89±0.05 vs control 0.48 ±0.10,P ＜0.01).Such an effect was markedly blocked by a pretreatment of irbesartan(0.72 ± 0.05,P＜0.05).After the use of Ang Ⅱ,the expression of RhoA protein was significantly enhanced(3.40 ± 0.46 vs control 1.77 ± 0.37,P＜0.01)and blunted by a pretreatment of irbesartan(2.27 ± 0.45,P＜0.05).The Western blot analysis of CTGF protein expression showed that Ang Ⅱ caused a robust increase in CTGF(0.62 ± 0.15 vs control 0.16 ± 0.05,P＜0.01).Such an effect was markedly blocked by a pretreatment of Y27632(0.17 ± 0.04,P＜0.01).The result was similar at the gene level.Ang Ⅱ significantly increased the expression of CTGF mRNA(1.16 ± 0.06 vs control 1.00 ± 0.01,P＜0.01).And it was markedly blocked by a pretreatment of irbesartan(0.99 ±0.07,P＜0.01)or Y27632(1.04 ±0.08,P＜0.05).AngⅡ significantly increased the expression of RhoA mRNA(1.21 ± 0.07 vs control 1.00 ± 0.06,P＜0.01).And it was markedly blocked by a pretreatment of irbesartan(1.00 ± 0.12,P＜0.05)but not Y27632(1.10 ± 0.05,P＞0.05).Conclusion Ang Ⅱ activates HFL-1 to produce CTGF through the AT-1 receptor.And the RhoA-Rock pathway is involved.

Medical Record Abstract A 59-year-old male was admitted to the respiratory department of Peking Union Medical College Hospital on November 24, 2010 due to "shortness of breath after activity and lower limb mass found for more than 5 years". In 2005, the patient had shortness of breath after strenuous activity (such as walking rapidly and going up 5 floors) without obvious inducement, without cough, hemoptysis, chest pain and other accompanying symptoms, and was able to do daily life. In April 2005, the chest CT of the local hospital showed "multiple patches on both lungs (Figure 1)", which was not treated. In October 2005, a mass on the lateral side of the right thigh was found, about 2 cm ×2 cm, with redness, swelling, ulceration and pus flowing out on the surface, and went to the local hospital for "right thigh mass resection"; Pathological report: T cell anaplastic large cell lymphoma; Immunohistochemistry: CD3 (+), CD30 (+), CD15 (-), CD20 (-), ALK (-).

Medical Record Abstract The patient was a 45-year-old male. He went to the liver transplantation department of the Third Affiliated Hospital of Sun Yat-sen University on February 11, 2009 because the liver occupied space for 1 week in physical examination. The patient had no obvious trigger 1 week ago. The patient had no obvious discomfort, no pain in the right upper abdomen, occasionally accompanied by acid reflux and belching. He had no fear of cold, fever, nausea, vomiting, abdominal distension, diarrhea, yellowing of skin and sclera, hematemesis, melena, gingival bleeding, epistaxis, and edema of both lower limbs. The patient had been seen in a local hospital, and the alanine aminotransferase (ALT) was slightly elevated. He was temporarily given anti-inflammatory and hepatoprotective conservative treatment, but no special treatment was given at that time. Now he is admitted to our department for further diagnosis and treatment. Since the onset of the disease, the patient's spirit and sleep are still acceptable, his urine is normal, his stool is yellow and shaped, once a day, and his weight has suddenly lost about 5 kg in the past month. He has a history of "hepatitis B small triple yang" for more than 9 years, and denies a history of "hypertension, diabetes, heart disease". Deny the history of infectious diseases such as tuberculosis and typhoid fever, deny the history of major surgery, trauma and blood transfusion, deny the history of drug and food allergies. 1 pack of cigarettes/d for more than 20 years. Deny the history of family genetic diseases and similar diseases.

Reducing sugars such as carbonyl groups of glucose and biological macromolecules such as proteins, nucleic acids or amine-containing lipids form reversible products Schiff base and Amadori products through non-enzymatic glycosylation, which then undergo a series of molecular rearrangements to form irreversible polymers. This reaction process is called Mailland reaction, and the series of polymers produced are called advanced glycation end products (AGEs). These polymers are brown-yellow, refractory to degradation, easy to cross-link reactions, and some of them also have fluorescence characteristics. Previous studies have found that AGEs play an important role in the pathological mechanism of diabetes and its complications, kidney diseases, cardiovascular diseases and other chronic diseases [1]. Therefore, detecting the content of AGEs in vivo is of great significance for the prediction, diagnosis and treatment of many diseases. However, due to the complex and diverse structure of AGEs, there is still a lack of standard detection methods. In recent years, various new methods of detecting AGEs have been continuously applied in clinical research of many diseases. The progress of clinical detection and application of AGEs is summarized as follows.

According to the report published on 28 February 2011 in<Scientists at Queen's University Belfast have discovered an innovative micro-gene transport system that can directly introduce genes into breast cancer cells to make them self-destructive, according to a study published in the International Journal of Pharmaceutics. Funded by the Breast Cancer Campaign, Dr Helen McCarthy of Queen's University School of Pharmacy used a transport system called Designed Biomimetic Vector (DBV) to package a gene into nanoparticles 400 times smaller than the diameter of human hair, which can be directly introduced into human breast cancer cells in the laboratory.

An 11-year-old woman was admitted to hospital on February 18, 2008 due to an epileptic seizure for 2 months. The child had an epileptic seizure without obvious trigger 2 months ago, which was manifested as involuntary twitching of the right limb, unconscious loss at the time of the seizure, no foaming at the mouth and incontinence. It was relieved after about 2 minutes. After that, she had frequent seizures, 4~5 times/month. After relief, she had fatigue discomfort, memory loss, poor speech, no headache, dizziness and nausea. Physical examination: There were no positive signs in the nervous system. MRI showed that there were rounded slightly longer T1 and slightly longer T2 signal nodules at the top of the left frontal lobe near the brain, about 1.5 cm in diameter, with uneven signals, and long T1 and long T2 signal shadows. The lesion intersected with the left frontal meninge at an acute angle, with large edema around it, slightly compressed left ventricle, and slightly shifted midline structure to the right (Figure 1,2).