Objective: To observe the clinical efficacy and safety of the combination therapy of sitagliptin and irbesartan in the treatment of early diabetic nephropathy.Methods: Totally 49 cases of initial diagnosed diabetic nephropathy were randomly divided into the observation group (25 cases) and the control group (24 cases).On the basis of diabetic diet, health education and regular hypoglycemic drugs, the control group was treated with irbesartan tablets, 150 mg, po , qd, and on the basis of the control group, the observation group was treated with sitagliptin tablets 100mg, po , qd.All the patients were treated for 3 months.The fasting blood glucose (FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), urinary microalbumin (mAlb) and body massindex(BMI) were compared between the groups before and after the treatment.Results: After the treatment, FBG, PBG, HbA1c, SBP, DBP and mAlb in the observation group were significantly lower than those before the treatment (P＜0.05).Hypoglycemia occntrredin in one patient in the observation group.There were no significant changes in FBG, PBG and HbA1c in the control group (P＞0.05), and SBP, DBP and mAlb decreased significantly (P＜0.05).After the treatment, the decrease of FBG, PBG, HbA1c and mAlb in the observation group was more significant than that in the control group, and the difference was statistically significant (P＜0.05).The decrease of blood pressure between the groups was not statistically significant (P＞0.05).Hypoglycemia occnrredin in one patient in the observation group.There was no significant difference in BMI between the groups and before and after the treatment (P＞0.05).There was no significant difference in the incidence of hypoglycemia between the groups after the treatment (P＞0.05).Conclusion: The combination of sitagliptin and irbesartan in the treatment of early diabetic nephropathy can effectively decrease blood glucose, reduce mAlb excretion and delay the progression of nephropathy.

OBJECTIVE:To reduce the error rate of inventory in the automated pharmacy of our hospital. METHODS:Activi-ties were designed and implemented by the management method of quality control circles(QCC)-PDCA(Plan,Do,Check and Ac-tion)cycle. The reasons for the errors of inventory in the automated pharmacy were analyzed to investigate and implement counter-measures. Visible and invisible achievements were evaluated,and then standardized processes were made. RESULTS:The errors of inventory in the automated pharmacy mainly included those of drug dispensing,drug shelving,drug return sheet,automatic medi-cine dispensing machine and system. In view of the above reasons,relevant standards were formulated and performed,including the process of warehouse-out check and shelving of drugs,drug dispensing process for the automated pharmacy,the process of sec-ondary check,etc. After the implementation of the activities,the error rate of inventory in the automated pharmacy reduced from 9.17% to 3.77%,which was visible achievement;and the above-mentioned standardized processes could ensure continuous run-ning of PDCA cycle. The practice,sense of responsibility,communication and coordination of management members in PDCA cy-cle namely invisible achievements were improved to some extent. CONCLUSIONS:The management method of QCC-PDCA cycle is feasible in reduction of the error rate of inventory in the automated pharmacy,which can provide a reference for automated phar-macy management.

Objective To study the effect of paeonol (PAE) and panax notoginseny saponins (PNS) on the expressions of collagenⅠandⅢprotein and mRNA in rats with acute myocardial infarction (AMI), and to explore the molecular mecha?nism of improving myocardial fibrosis. Methods The rat model of AMI was made using the left anterior descending coro?nary branch ligation.According to the intervention rats were divided into model group, PAE (8 mg/kg) group, PNS (40 mg/kg) group, PAE (4 mg/kg)+PNS (20 mg/kg) group, PAE (8 mg/kg)+PNS (40 mg/kg) group and captopril positive control group (10 mg/kg). Sham operation group, only wear line without ligation. The left ventricular mass index (LVMI) was detected after treatment for 28 d. Masson staining was used to observe changes of myocardial fibrosis. Western blot assay and RT-PCR technique were used to detect protein and mRNA expression levels of collagenⅠandⅢ. Results The values of LVMI were increased in model group compared with those of sham operation group and treatment groups. Compared with PAE group and PNS group, values of LVMI were significantly decreased in PAE (4 mg/kg)+PNS (20 mg/kg) group and PAE (8 mg/kg)+PNS (40 mg/kg) group. There was a more significant decrease in formula high dose group (P < 0.01). The model group showed pathological change. There were different degrees of improvement in pathological structure in all treatment groups, more sig?nificant improvement was found in formula low dose group, formula high dose group and captopril positive control group. There were different degrees of increase in expressions of collagenⅠandⅢprotein and mRNA in model group compared with those of sham operation group and treatment groups. Compared with PAE group and PNS group, the protein and mRNA expression levels of collagenⅠandⅢwere significantly decreased in formula low dose group and formula high dose group,more significant decreased was found in formula high dose group (P<0.05). Conclusion Compound of paeonol and PNS can improve myocardial fibrosis in myocardial infarction rats, which may be related with reduced expressions of collagenⅠandⅢprotein and mRNA.

Objective To study the effect of paeonol (PAE) and PNS on the expression of transforming growth factor (TGF)- beta 1/ Smad2/3 pathway in rats with acute myocardial infarction (AMI), and the possible molecular mechanism thereof. Methods Model of AMI was made using left anterior descending coronary branch ligation. According to the inter?vention methods rats were divided into model group, PAE group (8 mg·kg-1), PNS group (40 mg·kg-1), PAE (4 mg·kg-1)+PNS (20 mg·kg-1) low dose group, PAE (8 mg·kg-1)+PNS (40 mg·kg-1) high dose group and captopril positive control group (10 mg · kg-1). Rats without ligation were used as Sham operation group. Left ventricular systolic blood pressure (LVSP), left ventricular diastolic pressure (LVEDP) and the maximum rise and fall rate (/dtmax DP) were detected after 28-day treat?ment. HE staining was used to observe changes of myocardial tissue. The protein expression levels of TGF-β1 and Smad2/3 were detected by Western blot assay. Results There were significant differences in parameters used for detecting treatment group and model group, formula group and single drug group, formula high dose group and formula low dose group (P <0.01). The model group showed pathological changes. All treatment groups showed different degrees of pathological improve?ment. There was the most significant improvement in formulae group and captopril group. Compared with the model group, TGF-β1 and Smad2/3 protein expressions were decreased in treatment group. The expression levels of TGF-β1 and Smad2/3 were significantly decreased in formula group than those of PAE group and PNS group, and lower levels in formula high dose group than those of formula low dose group (P<0.05). Conclusion Paeonol and PNS can inhibit the expressions of TGF-β/Smad 2/3 protein in rats with AMI, by blocking TGF-β/Smad pathway.

Objective:To analyze the clinical value of ultrasound monitoring of endometrial thickness in assessing pregnancy rate improvement after estrogen administration following a missed abortion.Methods:A retrospective study was conducted on 86 patients who underwent surgical abortion at Cixi Maternal and Child Health Hospital from January 2022 to June 2023. Based on the treatment received, the patients were divided into two groups: a control group and an observation group, with 43 patients in each group. The control group received only routine postoperative care without any medication, while the observation group received estrogen treatment after surgery. The clinical efficacy, endometrial thickness, intrauterine adhesion and re-pregnancy rate were compared between the two groups.Results:In the observation group, there was significant difference in endometrial thickness in terms of intergroup, group-by-time interaction, and time effect ( Fintergroup =129.49, Finteraction =14.25, Ftime =146.64, all P < 0.001). Intrauterine adhesions were less severe in the observation group compared with the control group ( χ2 = 4.34, P < 0.05). The clinical effective rate was significantly higher in the observation group than in the control group [88.37% (38/43) vs. 69.76% (30/43), Z = 2.35, P = 0.019]. Additionally, the rate of re-pregnancy was significantly higher in the observation group than in the control group [46.54% (20/43) vs. 13.95% (6/43), χ2 = 10.81, P < 0.05]. Conclusion:Patients who have retained abortion can benefit from ultrasound examination to assess endometrial thickness after estrogen administration. This approach significantly enhances endometrial thickness, promotes menstrual recovery, and reduces intrauterine adhesions. It also improves the rate of re-pregnancy and is highly valuable in clinical settings.

Objective: To investigate the effect of three-dimensional ultrasound in the diagnosis of uterine abnormalities. Methods: From January 2017 to December 2017, 50 patients with uterine abnormalities admitted to the Maternal and Child Health Care Hospital of Cixi were selected.GE Voluson E8 high-resolution color Doppler ultrasound system were used for all patients to conduct two-dimensional ultrasound and three-dimensional ultrasound examinations.The results of the two methods, including the time taken for the inspection and the correctness of the inspection were compared. Results: The time used for three-dimensional ultrasonic testing[(2.39±0.25)min] and the accuracy of inspection (100%) were better than two-dimensional ultrasonic testing[(5.77±0.66)min, 80%], the differences were statistically significant (t=33.864, χ²=11.111, all P<0.05). Conclusion Three-dimensional ultrasonography can accurately present the external contour of the uterus and the shape of the intima.The abnormal uterus can be timely discovered.At the same time, it has advantages of non-invasive and safe.

OBJECTIVETo study the radiobiological characteristics of a HepG2 cell line with mitochondrial DNA (mtDNA) deletion.

METHODSHepG2 cells were cultured in a medium containing ethidium bromide, acetylformic acid and uracil. The HepG2 cell line with mtDNA deletion (ρ(0)HepG2 cells) were acquired after 30 subcultures by limited dilution cloning. The cell survival was then observed in the absence of acetylformic acid and uracil, and the total mtDNA deletion in the cells was confirmed by PCR. The radiosensitivity of HepG2 and ρ(0)HepG2 cells was evaluated by exposure to gradient doses of 6 MV X ray irradiation. The cell apoptosis was assessed following a 2 Gy X-ray exposure with Hochest33342 staining, and the invasiveness of ρ(0)HepG2 cells was measured by Transwell assay.

RESULTSHepG2 cells could survive 30 subcultures in the presence of ethidium bromide, and massive cell death occurred after removal of acetylformic acid and uracil from the medium. PCR confirmed total mtDNA deletion from ρ(0)HepG2 cells, whose α/β value was significantly lower than that of HepG2 cells. ρ(0)Hep-G2 cells showed an obviously lowered cell apoptosis rate following X-ray exposure with enhanced cell invasiveness.

CONCLUSIONHepG2 cells can be induced by ethidium bromide into ρ(0)HepG2 cells with an increased radiation resistance, anti-apoptosis ability and cell invasiveness.

Apoptosis ; Culture Media ; chemistry ; DNA, Mitochondrial ; genetics ; Ethidium ; chemistry ; Hep G2 Cells ; radiation effects ; Humans ; Radiation Tolerance ; genetics ; Sequence Deletion ; X-Rays

Objective: To explore the utility of pharyngeal pH monitoring which positive standard is Ryan index in diagnosis of laryngopharyngeal reflux disease. Methods: In a retrospective study, clinical data of 590 patients who had symptoms laryngopharyngeal reflux disease from February 2016 to March 2017 were analyzed. All patients were received electronic laryngoscopy, assessment of reflux symptom index(RSI) and reflux finding score(RFS), and pharyngeal pH monitoring. SPSS 19.0 software was used to analyze the date. Results: There were 94 patients whose Ryan index were positive(15.93%). Among the 94 patients, 70 were positive during upright, 12 during supine and 12 during both upright and supine. There were 40 patients(6.78%)with pH decline events related to symptoms, while those Ryan index were normal. There were 536(90.85%), 417(70.68%), 233(39.49%) and 117(19.83%) patients with pH<6.5, pH<6.0, pH<5.5 and pH<5.0 events respectively. The positive rate of RSI, RFS, RSI and RFS, RSI or RFS were 44.24%, 16.78%, 7.12%, 53.90% respectively. The RFS score in Ryan index positive group was higher than that in Ryan index negative group[(8.2±2.4) vs (4.0±2.9), u=5.424, P<0.05], while the RSI score in Ryan index positive group was not statistically different from that in Ryan index negative group[(11.3±6.2) vs (12.7±5.8), t=1.247, P=0.167]. Conclusions Pharyngeal pH monitoring is an objective and non-invasive method which can reflect laryngopharyngeal reflux directly. However, with the Ryan index as a criterion for the diagnosis of laryngopharyngeal reflux disease, partial patients may be missed. Further studies are needed to obtain more accurate and objective laryngopharyngeal pH statistical index for diagnosis of laryngopharyngeal reflux disease.