Hyperglycaemia attenuates?-cell insulin secretion in response to plasma glucose elevation and reduces insulin-mediated glucose transport. The long-standing severe hyperglycaemia may irreversibly damage?-cells. However, in this regard, there are increasing evidences showing that short-term intensive insulin therapy may significantly improve the response to endogenous insulin by normalizing blood glucose, so as to induce a "honeymoon period" for several years in a considerable number of subjects with newly diagnosed type 2 diabetes. Thus, a question has been raised: whether or not insulin therapy should be taken as a part of the strategy of the primary treatment for type 2 diabetes? A number of experts believe that it is an important therapeutic strategy, however, others hold that insulin therapy may yield more cost than benefit and suggest that to halt this cycle of progressive metabolic deterioration by any means may transiently restore metabolic re-compensation in type 2 diabetes. This issue was discussed in the fourth meeting of China Group on Insulin Secretion and in 66th ADA scientific session this year. Here we offer our consideration on this question for your reference.

Purpose:The aim of this study was to evaluate the clinical efficacy and toxicity of treatment with gemcitabine and cisplatin for hormone independent prostate cancer.Methods:18 cases of advanced hormone independent prostate cancers who received castration and antiandrogen medicines were confirmed to have multiple bone metastatic carcinomas by emission computed tomography(ECT), and hepatic , adrenal and intracranial metastasis were found respectively each in 1 patient, and the value of PSA(prostatic special antigen) had on ascending trend in all patients. Gemcitabine 1000 mg/m~(2) +NS 100 ml was administered by intravenous drip on days 1,8 and cisplatin 100 mg/m~(2) +NS 500 ml was administered by intravenous drip on day 1 or cisplatin 30 mg/m~(2) +NS 250 ml was administered by intravenous drip on days 1 to 5 in each 28-day cycle.Results:Levels of PSA descent to normal titer(

Objective To observe the effect of saline gauze tamponade of calculus bovis sativus on the level of IL-6 and IL-8 in the tissue of patients with perianal abscess after operation,and to explore its possible mechanism of action in promoting wound healing.Methods Patients with 84 cases of anal abscess surgery,were randomly divided into treatment group(n=42)and control group(n=42).Treatment group calculus bovis sativus research pressed into powder,take 0.10~0.15g evenly scattered in the saline gauze on the wound packing,the control group was treated with physiological saline gauze wound.After treatment,3,7 and 10d were treated with local granulation tissue about 0.2cm×0.2cm×0.1cm size,the IL-6 and IL-8 cytokines in local tissues were detected by enzyme-linked immunosorbent assay.Results There was no significant difference in the expression of IL-6 and IL-8 between the two groups 3 days after treatment(P>0.05),IL-6 and IL-8 in the treatment group(7,10d)were significantly lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion Calculus bovis sativus in the treatment group,IL-6 and IL-8 levels were significantly lower than those of the control group,indicating that calculus bovis sativus can reduce local inflammation response,promote healing of wound after perianal abscess operation.

Objective To examine the expression of tight junction protein claudin-5 in blood-spinal cord barrier (BSCB) after spinal cord injury about rat. Methods One hundred-twenty adult male SD rats were randomly divided into blank group (60) and injured group (60). The animal model of spinal cord injury was established using modified Allen method. The expression of claudin-5 in BSCB was examined at 6 h, 12 h, 1 d, 3 d, 5 d and 7 d (five rats per time point). Western blot and RT_PCR were used to detect protein and mRNA expression levels of claudin-5, respectively. Results The success rate of spinal cord injury molding was 81.7%. In injured group, EB content increased gradually over time, reached the peak at the third day(0.9435 ± 0.0813)μg/g and then reduced gradually (P<0.05), EB content was signifi-cantly higher in injured group than in blank group. Claudin-5 mRNA expression in injured group reduced gradually over time and reached the lowest point at the third day(2.871 ± 0.527)and then increased gradually(P<0.05). Claudin-5 mRNA expression was significantly lower in injured group than in blank group(P<0.05). Claudin-5 protein expression in injured group reduced gradually over time, reached the lowest at the third day(0.072 ±0.008)and then increased gradually (P<0.05). Claudin- 5 protein expression was significantly lower in injured group than in blank group(P<0.05). Con-clusions The alteration of claudin-5 expression after SCI may lead to the permeability of BSCB, which may in turn con-tribute to the secondary spinal cord injury.

Objective To analyze changes in lactic acid level in patients with late-onset intracranial hematoma after craniocerebral injury and investigate their relativity.Methods Forty-eight patients with late-onset intracranial hematoma after craniocerebral injury treated in our hospital between May 2009 and December 2012 were enrolled as observation group.There were 32 males and 16 females.Moreover,50 cases checked up in our hospital during the same period were studied as health population controls,including 35 males and 15 females.Level of lactic acid was measured on admission,at the time of definite diagnosis as well as at days 7 and 14 after treatment and compared between groups.Results Level of lactic acid was (1.77 ±0.21) mmol/L in control group and (1.82 ± 0.25) mmol/L in observation group respectively on admission (t =1.070,P ＞ 0.05) ; Level of lactic acid was (3.32 ± 0.89) mmol/L in observation group at the time of definite diagnosis,which increased to (3.74 ± 1.16) mmol/L at days 7 after treatment and decreased to (1.89 ±0.75) mmol/L at days 14 after treatment.When diagnosed and treated for 7 days,level of lactic acid differed significantly between the two groups (P ＜ 0.05).Level of lactic acid related to craniocerebral injury at each time point,but higher correlation coefficient was observed at the time of definite diagnosis and 7 days after treatment with 0.986 and 0.989 respectively.Conclusion Level of lactic acid relates to late-onset intracranial hematoma after craniocerebral injury,which can be used as reference for progression of the disease.

Objective To study the effects of methylprednisolone on the permeability of blood-spinal cord barrier (BSCB) and claudin-5 expression after spinal cord injury in rats. Methods The rat model of spinal cord injury was estab?lished using modified Allen method. SD rats were randomly divided into sham-operated group, spinal cord injury group and methylprednisolone pretreatment group. The permeability of BSCB and expression of claudin–5 were assessed at 12 h, 1, 3, 5, and 7 d after the onset of spinal cord injury (five animals per each time point). RT-PCR and Western blot were used to detect the expression of claudin-5. Results The success rate of the model was 84.0%. EB content was sig?nificantly higher in spinal cord injury group than in sham-operated group at each time point (F value 27.732,P<0.05). EB content was lower in methylprednisolone pretreatment group than in spinal cord injury group (F value 48.149,P<0.05). The mRNA expression of claudin-5 was lower in spinal cord injury group than sham-operated group at each time point (F value 12.248,P<0.05). The mRNA expression of claudin–5 was higher in methylprednisolone pretreatment group than in spinal cord injury group at each time point (Fvalue 15.316,P<0.05). The protein expression of claudin-5 was lower in spinal cord injury group than in sham operated group at each time point (Fvalue 18.108,P<0.05). The pro?tein expression of Claudin-5 was higher in methylprednisolone pretreatment group than spinal cord injury group at each time point (F value 20.247,P<0.05). Conclusions Methylprednisolone improves permeability of BSCB after spinal cord injury probably through enhancing claudin-5 expression in rats.
was lower in spinal cord injury group than in sham operated group at each time point (Fvalue 18.108,P<0.05). The pro?tein expression of Claudin-5 was higher in methylprednisolone pretreatment group than spinal cord injury group at each time point (F value 20.247,P<0.05). Conclusions Methylprednisolone improves permeability of BSCB after spinal cord injury probably through enhancing claudin-5 expression in rats.

Objective To investigate the correlation of angiotensin Ⅱ type 1 receptor (AT1R) gene polymorphism with AT1R expression levels and brain edema after hypertensive intracerebral hemorrhage .Methods 45 operative patients with hypertensive intracerebral hemorrhage in the Affiliated Yongchuan Hospital of Chongqing Medical Univercity from December 2011 to August 2012 were collected as the experimental group and 45 operative patients with refractory epilepsy weres selected as the control group .The venous blood in the two groups were collected for detecting the AT 1R gene polymorphism ;The brain tissue was taken from lesions in operation ,then AT1R mRNA concentration was determined by RT-PCR and the AT1R protein level was determined by Western blot ;Head CT was performed on postoperative 1 ,3 ,5 d;the degree of cerebral edema was reflected by CT value . Results The levels of two kinds of genotype AT1R mRNA in the experimental group had no statistically significant difference(P>0 .05);the operative area CT value of AC genotype was significantly lower than that of AA genotype with statistical difference (P<0 .05);the ATIRmRNA of various genotypes ,protein level and cerebral edema in the control group had no statistical differences . Conclusion The AT 1R gene polymorphism has no obvious correlation with the concentration expression of AT 1R mRNA in the brain tis-sue;there is correlation between AT 1R protein level and AT 1R protein level and the cerebral edema degree in the brain tissue .

Objective To probe into effective surgical methods to reduce post-operational recurrence rate of nodular goiter.Methods One hundred and fifty-seven patients with nodular goiter who were admitted and had operations in our hospitals between Jan,2007 and June,2011 were assigned to one of the following 4 groups:total thyroidectomy(TT),nearly total thyroidectomy (NTT),subtotal thyroidectomy (STT),removal of lesion only or partial thyroidectomy (also termed as local removal,LR).Postsurgical recurrences and complications were compared among these groups.Results The recurrences were statistically analysed.There was a highly significant difference between TF and STT、TT and LR、NTT and LR; no difference was observed between TT and NTT,STT and STT + E,STT and LR.A statistical analysis was also carried out on the postsurgical compications in these patients.highly significant differnce was found between TT and STT,TT and NTT,TT and LR.There was a significant diffrence between STT and NTT.There was no difference between STT and LR,NTT and LR.Conclusion TT,STT,NTT are all effective operations for nodular goiter and should be advocated.Satisfactory efficacy may be obtained with oral thyroxine or euthyrox for postsurgical lifetime.However,LR or partial thyroidectomy should be adopted cautiously.

Objective To investigate the expression and relationship between Phosphatase and tension homolog deleted on chromosome ten (PTEN) and Alpha fetoprotein(AFP) in hepatocellular carcinoma. Methods PTEN and AFP expression was examined by immunohistochemical method. Results PTEN expression was significantly weaker in patients with tumor less than 5.0 cm and patients with CLIP score≥1 (P<0.05). The expression of PTEN and AFP was negatively correlated ( Rs=-0.422, P=0.043), serum AFP and tissue expression of AFP was positively correlated (Rs=0.380, P=0.042), but for individual expression was not consistent. Conclusions PTEN and AFP is respectively negative and positive adjustment factor of PI3K/AKT pathway. Tissue expression of AFP may be more significant, and may become the new targets for the treatment of hepatocellular carcinoma.

Objective To provide a practical device and protocol to hold conscious rats for subsequent operations which can overcome the disadvantages of existing methods .Users can complete the experiment more efficiently , with or without prior experience .Methods Using transparent plastic film , plastic sealing machine and sponge to make a simple device for holding rats , by taking advantage of their escaping nature .To compare the performance of the new method and existing methods for holding and injecting rats .Results Compared with existing methods , the new device and method can reduce the time-consuming to hold rats by 44.7%, from 18.13 seconds to 10.03 seconds.For holding and injecting , the new method can reduce the time-consuming by 55.3%, from 139.33 seconds to 52.26 seconds .Conclusions The new device and method is good for holding and injecting rats or drawing blood from the caudal veins .It can shorten the time of operation and reduce the stress reaction in the animals .It’ s especially helpful for inexperienced experimenters such as students in teaching and research tasks .