Objective To observe the clinical efficacy of captopril combined with simvastatin for treating patients with early diabetic nephropathy.Methods 180 patients with diabetic nephropathy were randomly divided into three groups,and each group had 60 cases,group A was given captopril for treatment,group B was given simvastatin and group C was received captopril and simvastatin for treatment.The clinical efficacy,renal function before and after treatment and incidence of adverse reactions were compared in three groups.Results The clinical efficacy of group C was significantly better than group A and group B ( P ＜ 0.05 ) ; after treatment,the value of Ma/Cr,SCR and Bun of three groups were lower than pre-treatment ( t =3.12,3.08,3.17,3.41,3.19,3.20,3.04,3.44,3.48,all P ＜ 0.05 ) ;and the value of Ma/Cr,SCR and Bun after treatment in group C were significantly lower than group A and group B ( t =4.58,4.69,5.02,4.89,5.11,4.87,all P ＜0.05 ) ;the incidence of adverse reactions in group C was significantly lower than the other two groups.Conclusion Captopril combined with simvastatin could significantly improve the clinical efficacy of the early diabetic nephropathy and had small side effects.

OBJECTIVE:To develop a RP-HPLC method for determination of the content of berberine hydrochloride in the Fukezhidai tablets METHODS:HPLC was performed on Dimonsil C18 column with CH3CN-KH2PO4(30∶70)as mobile phase The detection wavelength was 347nm RESULTS:The linear range of berberine on calibration curve was 0 4 052～2 026?g/ml The average recovery of berberine was 98 18%,RSD=0 92%(n=5) CONCLUSION:The method was simple and accurate,and can be used for the quality control of Fukezhidai tablets

Objective:To study the possibility that responses of fever and c- Fos expression in rat PVN and NTS to intraperitoneal administration of LPS are rnediated by vagal afferents. Methods: Rectal temperature was detected by digital temperature detecting instrument. c-Fos expressis was detected by immunohistochemistry staining.Results:The rectal temperature change value in vagotomy LPS gnoup was significantlydecreased compared with that in sham IPS group,and there was striking difference betwen them, p ＜0.05.It was increased significantlycompared with that in vagotomy NS group, P ＜ 0.05.The percentage of c-Fos positive neurons in rat PVN and NTS in vagotomy LPS group wassignificantly decreased compared with that in sham LPS group,and there were difference between them, p ＜0.01.Itwas stnkingly increased compared with that in vagotomy conrol group,respectively, P ＜0.01.Conclusion:The results indicate that vagus nerve is one of thepathways of peripheal LPS signal communicating to CNS.

OBJECTIVE To investigate the antibiotic resistance pattern of MRSA,homology and carriage of Panton-valentine leukocidin(PVL) in 50 meticillin-resistant Staphylococcus aureus isolates to guide the clinical treatment.Results of homology provide the proof for molecular epidemiology.METHODS According to CLSI′s guideline,antimicrobial susceptibility tests were performed with disk diffusion method.PVL gene and mecA gene were detected by PCR.The homology was analyzed by repetitive estra-genic palindromic elements(Rep)-PCR method.RESULTS MecA gene was detected in all 50 MRSA isolates.All isolates MRSA were resistant to oxacillin and cefoxitin.But they were all sensitive to vancomycin and teicoplanin.The rates of sensitivity to clindamycin,ciprofloxacin,piperacillin and sulbactam,SMZ-TMP,gentamicin,cefazolin and erythromycin were 7.5%,1.9%,24.5%,92.5%,20.8%,1.9% and 3.8%,respectively.The resistance rates of MRSA were higher than that of MSSA.Twenty PVL genes were detected from 50 MRSA isolates.CONCLUSIONS The resistance rates of MRSA are higher than MSSA.There is no isolate resistant to vancomycin and teicoplanin.40.0% MRSA carry PVL gene and part isolates have high homology.

Objective : To explore expression of related genes in breast cell line T47D induced by heregulin β1. Methods: Suppression subtractive hybridization was performed using cDNA sub traction kit to detect expression of heregulin-responsive genes in T47D cells. Results: ATP syn thase 6 was up-regulated by heregulin β1 in T47D cells at 1 and 6 hours. Conclusion: Heregulin β1 participates in the regulation of expression of both ATP synthase 6 and oxidative phosphoryla tion of T47D cells.

ObjectiveTo explore the correlation of gastrointestinal symptom of severe cases and abdominal compartment syndrome (ACS),improve monitor technique. MethodsUsing descriptive study to do classified description according to the distribution of 384 severe cases' gastrointestinal symptom and using regressive analysis to analyze the dangerous factors of 46 cases who suffered ACS. Results①The rate of gastrointestinal symptom of 46 cases with ACS:one case with nausea and vomiting occupied 2.2％ ,45 cases with abdominal distension and pain occupied 97.8％ ,45 cases with bowel sound occupied 97.8％,2 cases with diarrhea occupied 4.3％,45 cases with constipation occupied 97.8％. ②Aceording to the single factor logistic regressive analysis shows statistical significant symptoms relating to ACS as follows:abdominal distension and pain,bowel sound decline and constipation,etc. With multi-factors unconditional progressively logistic regressive analysis shows:the first dangerous factor of ACS is abdominal distension and pain(OR=259.106),then is bowel sound decline. CondusionThe correlation exists between the gastrointestinal symptoms and ACS. The clinical nurses should pay attention to the monitor of gastrointestinal function so that the incidence of ACS can be reduced through promoting monitor skills.

Community medical staff construction centered on general practitioner is a basic engineering to improve the quality and enhance the level of basic medical and health service system.The developed western countries have up-to-date experiences in general and further education of community general practitioners.By combining these experiences with China's national conditions,this thesis explored the 'targeted recruitment-employment mode' for general practitioners and discussed the reform in curriculum,teaching content and teaching organization in order to promote the practice base construction and further education after graduation as well as to cultivate all-around talents of high quality who can meet the requirements of the basic-level medical work.

As the largest protective barrier of the body,gastrointestinal tract helps the organism resist the invasion and attacks of harmful substances from the outside world.There are three kinds of protective barriers:mechanical barrier,biotical barrier,and immune barrier.In recent years,increasing researches indicate the importance of gastrointestinal immune barrier and the important immunologic mechanism of enteral nutrition in improving the clinical outcome.This article reviews the effect of gut immunity in the improvement of clinical outcome by enteral nutrition.

Objective To investigate the significance of levels of IL-8,TNF-α in serum of patients with aplastic anemia(AA).Methods Serum levels of IL-8 and TNF-α in 45 patients and 30 normal controls were measured by enzyme linked immunosorbent assay.Results The serum levels of IL-8,TNF-α increased significantly in AA and acute AA(AAA)group than in the control group(P＜0.05),there was no statistical significance between chronic AA(CAA)group and the control group(P＜0.05),and the levels in AAA group were much higher than in CAA group(P＜0.05).The serum level of IL-8 was positively related to TNF-αin AA group(r=0.682,P＜0.05).Conclusion There are immunological disorders in patients with AA and the overproduction of IL-8,TNF-α might be involved in the immunopathogenesis of AA,AAA.

Toll-like receptors is a super-family of pathogen recognition-receptors discovered in recent years.During the process of ischemia-reperfusion, the Toll-like receptor 4 (TLR4) combines with lipopolysaccharide and many endogenous ligands such as high mobility group protein B1, heparan sulfate, and fibrinogen. Through the myeloid differentiation protein 88 -dependent and -independent signaling pathways, the products induce the release of inflammatory cytokine-mediated inflammatory response, leading to injuries. ω-3 polyunsaturated fatty acids, by inhibiting the signal pathway activation and target gene expression of TLR4, can influence the function of many immune cells and regulate the body's inflammatory response and immune function. This article reviews the function of TLR4 during ischemia-reperfusion injury and the possible interventional role of ω-3 polyunsaturated fatty acids.