Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) were analyzed in 25 cases of pituitary dwarfism with 30 age-matched healthy children as control. The effect of human growth hormone (hGH) therapy for 3 months on these indices were also observed.As a result, the mean values of TC, TG, LDL-C and Apo B in the patients were significantly higher than those in the control, while the mean Apo A1 value was below that of the control. After a 3-month hGH therapy, the TC, LDL-C and Apo B levels decreased significantly while TG and Apo At levels increased significantly. We concluded that lipid metabolic disorder existed to certain extent in patients with pituitary dwarfism and that growth hormone deficiency ,was the main cause of the disorder.

OBJECTIVE:To investigate the clinical efficacy of integrated treatment of traditional Chinese medicine and west-ern medicine for subacute thyroiditis. METHODS:98 patients with subacute thyroiditis were randomly divided into control group and observation group by random number table with 49 patients in each group. Control group was given conventional oral treat-ment of prednisone tablets,and observation group was additionally treated with Chinese patent medicine(Shuanghuanglian oral so-lution+Antiviral oral solution+Tripterygium glycosides tablet)on the basis of control group. A treatment course lasted for 4 weeks, and both groups received 2 courses of treatment. Therapeutic efficacy,symptom and sign improvement time,total treatment course,recurrence rate and ADR were observed and compared between 2 groups. RESULTS:the total effective rate of observation group was 100%,significantly better than the control group 79.59%,and there were significant differences(P<0.01). The defer-vescence time,thyroid pain recovery time,thyroid swelling fadeaway and total treatment course of observation group was shorter than those of control group,with statistical significance(P<0.01). Following up 2 months after drug withdrawal,the recurrence rate of observation group was 6.12%,which was significantly lower than that of control group(22.45%),with statistical signifi-cance (P<0.05). Small number of ADR occurred in 2 groups. CONCLUSIONS:The integrated treatment of traditional Chinese medicine and western medicine for subacute thyroiditis can control the symptom rapidly,reduce the possibility of palindromia and reduce ADR.

OBJECTIVE:To evaluate the clinical efficacy and safety of triple therapy in the treatment of type 2 diabetes melli-tus(T2DM),and to open up more effective way to treat T2DM. METHODS:76 patients with T2DM were randomly divided into control group and observation group with 38 cases in each group. The control group received conventional therapy,i.e. oral hypo-glycemic agents Glipizide controlled-release tablet 5 mg,qd+Metformin tablets 5 mg,tid. The observation group was treated with triple therapy,i.e. berberine hydrochloride 0.5 g,tid,for 3 months,on the basis of control group. The biochemical index were compared between 2 groups Before and after treatment,including fasting blood glucose (FBG),postprandial 2 h blood glucose (2 h FPG),glycosylated hemoglobin(HbA1c),insulin(FINS),total cholesterol(TC)and triglyceride(TG),high/low density li-poprotein cholesterol (HDL-C/LDL-C),etc.,to evaluate its safety. RESULTS:After treatment,FBG,2 h FPG,HbA1c,FINS, TC and LDL-C of 2 groups and TG of observation group were all decreased significantly,while the level of HDL-C was increased significantly,with statistical significance(P<0.05);FBG,2h FPG,HbA1c,FINS,TC and LDL-C of observation group were im-proved more significantly than control group,the difference was statistically significant(P<0.05). ADR was found in 4 patients of observation group,and the symptoms were relieved after symptomatic treatment. CONCLUSIONS:In the treatment of T2DM,tri-ple therapy can down-regulate blood lipid and blood sugar stably,have definite therapeutic efficacy and little side effect.

Objective To detect the changes of visceral sensitivity in rats presenting intestinal dysbacteriosis and the expressions of tight junction protein (ZO-1)and Toll-like receptor 4 (TLR4)so as to explore the effect of intestinal dysbacteriosis on visceral sensitivity and the possible mechanisms.Methods We randomly divided 30 male SD rats of SPF grade into normal control group (n = 12 )and dysbacteriosis group (n = 18 ).Rats in dysbacteriosis group were administered with lincomycin hydrochloride (300 mg/mL),1 mL each time per rat once a day for 7 consecutive days;those in normal control group were fed with the same amount of saline.On the eighth day,six rats were randomly selected from normal control group and dysbacteriosis group respectively to detect whether the model was successful.After the model was successfully constructed,the remaining 12 dysbacteriosis rats were randomly divided into the negative control group and the probiotics intervention group with 6 in each.Rats in the intervention group were given probiotic bifidobacterium triple viable capsules (Bifico)orally,one capsule with 1/3 mL of saline,1 mL each time per rat once a day for 7 consecutive days;those in the negative control group received the same amount of saline.On the eighth day,fresh feces was cultured for flora to detect visceral sensitivity by abdominal withdrawal reflex (AWR),the mRNA and protein expressions of ZO-1 and TLR4 in the colon,and the expression of serum inflammatory cytokines IL-10 and TNFα.Results The expression of ZO-1 in the colon was significantly lower in the rats of dysbacteriosis group than those in the control group,and the expression of TLR4 was also significantly increased.Correspondingly,the expression of pro-inflammatory factor TNFα in the serum of the rats in dysbacteriosis group was significantly increased,while that of anti-inflammatory factor IL-10 was significantly lower than in the control group (P <0.05).Furthermore,compared with dysbacteriosis group,the expression of ZO-1 was increased significantly and TLR4 was decreased in probiotics group in varying degrees. Similarly,the expression of TNFα was obviously lower while that of IL-10 in the serum was higher (P < 0.05 ). Conclusion Inhibiting the expression of ZO-1 and increasing the expression of TLR4,thus leading to chronic low-grade inflammation, may be one mechanism of visceral hypersensitivity caused by intestinal dysbacteriosis. Probiotics may restore the dysbacteriosis and thus improve visceral hypersensitivity.

Objective To investigate the feasibility of high fat-introduced hyperlipeidemia model in male SD rat and study the time rule of molding .Methods 30 Male adult rats of SD Strain bred in the animal house of the institute were divided into 3 groups after 1 week adaptation , group 1:control group, normal diet;group 2:model 1 group, high fat high cholesterol diet;group 3:model 2 group, high fat high cholesterol diet .The period of experiment was 8 weeks.Food and water intake were measured everyday and body weight were measured every four days .Blood were collected by orbital venous at the end of fourth ,sixth,eighth week to test their serum lipid level .At the end of experiment ,animals were killed to collect liver and aorta tissue for HE stain .Results Compared with control group ,the food intake of model 1 was higher and model 2 was significant lower , water intake of model 2 was significant lower , the ratio of liver/weight of two model groups were significant heavier ,and weight of model groups were higher .High fat diet significantly increased TC levels of model groups at the end of fourth ,sixth week.The level of LDL-c in model 1 group were higher and the HDL-c were lower compared with control group .HE stain showed the livers of control group were regular ,arrangements of the liver cells were trim, dyeing present uniformity .The two model groups showed a large range of hepatocyte fatty change ,a few liver blood sinus were in congestion and infiltrated with inflammatory cells .Aorta HE stain showed no significant change among 3 groups.Conclusions The method of high fat-introduced hyperlipeidemia model in male SD rat is feasible and the model turned out to present hypercholesterolemia with severe fatty liver .On the other hand,levers of serum lipid increased within an increase—inter-adjustment—increase state .In the process of modeling ,how to overcome the symptom of anorexia and the state of cholesterol inter-adjustment in animals is the key to successfully establish hyperlipeidemia model .

Objective To investigate the relationship between human leptin receptor(LEPR)gene G3057A polymorphism and type 2 diabetes complicated with non-alcoholic fatty liver disease(NAFLD).Methods 216 cases of newly diagnosed type 2 diabetes(104 cases complicated with NAFLD)and 108 cases of normal glucose tolerances(NGT)were recruited.Hemi-nested PCR-RFLP and PCR direct sequence analysis were conducted to detect the polymorphisms of LEPR G3057A polymorphism.The plasma leptin and insulin levels were measured by ELISA kit.Plasma lipid and glucose metabolic parameters were measured routinely.Liver ultrasound scanning Was carried out among all subjects.Results Type 2 diabetic patients complicated with NAFLD had higher plasma alanine aminotransferase(ALT),triglycerides(TG),low density lipaprotein cholesterol(LDL-C),leptin levels and lower plasma insulin levels than those cages without NAFLD and NGT.The variant frequency at nucleotide 3057 G to A transversion Was 76.0% in type 2 diabetic patients complicated with NAFLD,which Was also significant higher than those cases without NAFLD(62.1%)or NGT cases(53.2%)(x2=14.63,P＜0.01).Conclusions The polymorphism of LEPR gene 3057 probably contributes to the onset of NAFLD in type 2 diabetes by regulating lipid metabolism and affecting insulin sensitivity.

The rats were assigned to blank control group, classical induction group, and drynaria total flavonoid group. Whole bone marrow culture method was applied to isolate and purify rats bone mesenchymal stem cells (BMSCs). Akaline phosphatase activity, calcium nodes, TGF-β1 and BMP-2 secretion in the process of bone mesenchymal stem cells osteogenic differentiation were detected. The results showed that compared to the blank group and classical group, drynaria total flavonoid promoted osteogenic differentiation accompanied with increased TGF-β1 and BMP-2 secretion (all P＜0. 05). Drynaria total flavonoid may promote osteogenic differentiation of BMSCs via upregulating TGF-β1 and BMP-2 expressions, and play an active role in the treatment of osteoporosis.

Objective To study the different oral compound polyethylene glycol electrolyte powder on the effect of bowel preparation before colonoscopy.Methods A total of 602 inpatients or outpatients were selected from department of gastroenterology,and they were randomly divided into tranditional group(n =288)and improvement group(n =314).All patients took a dose of two box of compound polyethylene glycol electrolyte powder 4 hours before colonoscopy.Endoscopic doctor investigated the antibiotic tolerance,adverse reactions,heart rate,blood pressure,blood electrolytes and blood glucose during treatment in form of questionnaire with single blind Bosdon bowel preparation scale (BBPS)score.Results The BBPS scores of the tranditional group and improvement group were (7.03 ± 1.24)points,(7.82 ±1.12)points,the score of the improvement group was significantly higher than the traditional group(t =2.259,P <0.05).The taste scores were (1.89 ±0.07)points,(1.25 ±0.09)points (t =2.624,P <0.05),the fully taking rates were 90.28%,95.86%(χ2 =7.375,P <0.05 ),and the second taking rates were 88.54%,93.95%(χ2 =5.566,P <0.05).In contract,the score of adverse reactions of the improvement group was significantly lower than that of the traditional group [(2.58 ±0.07)points vs(2.22 ±0.09)points,t =2.068,P <0.05].There was no significant difference of colonoscopy time between the two groups[(10.78 ±4.34)min vs (9.89 ± 1.77)min,t =1.766,P >0.05 ],althought the improvement group was shorter than the tranditional group. Conclusion The modified way of oral compound polyethylene glycol electrolyte powder not only can improve the qulity of intestinal cleaning,but also acts as a more effective method in preparation of colonoscopy due to its high tolerance, good comfort,less pain and high acceptance of patients.Therefore,it is worthy of clinical promotion and application.

Objective To investigate distribution and antimicrobial resistance among nosocomial pathogens from 13 teaching hospitals in China in 2009. Methods Non-repetitive pathogens from nosocomial BSI, HAP and IAI were collected and sent to the central lab for MIC determination by agar dilution method.WHONET5.6 software was used to analyze the data. Results A total of 2 502 clinical isolates were collected. The top three pathogens of BSI were Escherichia coli [27. 1% (285/1 052 )] , coagulase-negutive staphylococcus [12. 6% ( 133/1 052)] and Klebsiella pneumoniae [10. 8% ( 114/1 052)]. The top three pathogens of HAP were Acinetobacter baumannii [28. 8% (226/785)], Pseudomonas aeruginosa [16. 1% (126/785)] and Klebsiella pneumoniae [14.6% (115/785 )] . The top three pathogens of IAI were Escherichia coli[31.0% ( 206/665 )], Klebsiella pneumonia [11.3% ( 75/665 )] and Enterococcus faecium [10. 8% (72/665)]. Against Escherichia coil and Klebsiella spp. , the antimicrobial agents with higher than 80% susceptibility rate included imipenem and meropenem (98. 1%-100% ), tigecycline (95.3%-100% ), piperacillin-tazobactam ( 88.6% -97. 1% ) and amikacin ( 88. 3% -92. 5% ). Against Enterobacter spp. , Citrobacter spp. and Serratia spp. , the susceptibility rates of tigecycline were 93.5% -100% whereas the value of imipenem and meropenem were 92.9% -100%. Other antimicrobial agents with high activity included amikacin ( 85.2% -96. 7% ), pipcracillin-tazobactam ( 82.4% -96.4% ), cefepime ( 79. 6% -96. 7% ) and cefoperazonc-sulbactam (78. 7%-90. 0% ). Polymyxin B showed the highest susceptibility rateagainst Pseudomonas aeruginosa ( 100% ), followed by amikacin ( 81.9% ) and piperacillin-tazobactam (80.1% ). Polymyxin B also showed the highest susceptibility rate against Acinetobacter baumannii (98. 8% ), followed by tigecycline (90. 1% ) and minocycline (72. 0% ). The incidence of carbapenemresistant Acinetobacter baumannii was 60. 1%. The MRSA rate was 60. 2% and the MRSCoN rate was 84. 2%. All Staphylococcus strains were susceptible to tigecycline, vancomycin, teicoplanin and linezolid except for one isolate of Staphylococcus haemolysis with intermediate to teicoplanin. Two Enterococcus faecalis isolates which were intermediate to linezolid and one Enterococcus faecium isolate which was resistant to vancomycin and teicoplanin was found in this surveillance, while the MICs of tigecycline against these three isolates were 0. 032-0. 064 μg/ml. Conclusions Tigecycline, carbapenems, piperacillin-tazobactam,amikacin and cefepime remain relatively high activity against nosocomial Enterobacteriaceae. Pseudomonas aeruginosa exhibite high susceptibility to polymyxin B, while Acinetobacter baumanni shows high susceptibility to polymyxin B and tigecycline. Tigecycline, vancomycin, teicoplanin and linezolid remain high activity against nosocomial gram-positive cocci.

Objective To evaluate the performance of modified Hodge test on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Methods Fortynine Enterobacteriaceae isolates with decreased susceptibility to carbapenems ( MIC of imipenem, meropenem or ertapenem was ≥ 2 μg/ml ) were collected from 16 teaching hospitals from 2004 to 2008. MICs of imipenem, meropenem and etapenem were determined by agar dilution method. Carbapenemases were detected by modified Hodge test. Carbepenemase-causing positive results and AmpCs-causing positive results were differentiated by phenyl boronic acid and oxacillin. Beta-lactamases encoding genes including blaNDM-1were detected by PCR and sequencing. Results Thirty-six of 49 isolates were non-susceptible to imipenem (MIC >4 μg/ml), 31 were non-susceptible to meropenem (MIC > 4 μg/ml) and 47 were non-susceptible to ertapenem (MIC > 2 μg/ml). Twenty-three isolates showed positive modified Hodge test result, including 9 weak-positive results and 14 strong-positive results. Through PCR detection and sequencing, 2 out of 9 isolates showing weak-positive results carried blaKPC-2 and other 7 did not carry any carbapenemase genes but AmpCs/ESBLs genes. Among the 14 isolates showing strong-positive results, 4 carried blaKPC-2, 8 carried blaIMP-4 and 2 caried blaIMP-8. All 26 isolates with negative modified Hodge test result didn't carry any carbapenemase genes. No isolate carried blaNDM-1. Carbapenemases genes PCR detection was regarded as a gold standard, and the sensitivity, specificity, positive predictive value and negative predictive value of modified hodge test was 100%, 79%, 70% and 100% on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Conclusions Modified Hodge test revealed great sensitivity but showed a few false positive results. True and false positive results can be effectively differentiated by phynel boronic acid and oxacillin.