Objective To explore the effects of high insulin and high glucose concentrations on glucose transport activity,the expression of insulin signaling peptides and glucose transporter 4(GLUT4) translocation in primary cultured rat adipocytes.Methods Isolated rat adipocytes were cultured for 24h at insulin(10 4?U/ml) and different concentration glucose(5,10,15 and 25mmol).Then the glucose uptake,cellular contents of insulin receptor substrate(IRS) 1/2,phosphatidylinositol 3-kinase 85 subunit(p85),protein kinase B(PKB) and GLUT4 were measured by Western blotting method.Results These adipocytes treated with insulin and different high concentration glucose had shown to impair glucose uptake in a dose-dependent manner,inhibited cellular IRS1 expression,impaired IRS2 protein expression independent on glucose concentration in the medium,it did not influence the contents of p85,PKB and GLUT4,but decreased GLUT4 translocation.Conclusions Chronic high insulin induced insulin resistance may be caused by the increasing glucose concentration surrounding the cells.The mechanism may be involved in affecting IRSs protein expression and GLUT4 translocation.

OBJECTIVE:To probe into the occurrence characteristics of the adverse drug reactions(ADR) in Lanzhou area and to intensify the reporting,monitoring and management of ADR.METHODS:A retrospective analysis was performed on 345 valid ADR cases.RESULTS:The ADR reports were mainly submitted by medical institutions,account for 88.70%.The clinicians and hospital pharmacists were the chief reporting personnel.16 drug categories totaled 143 varieties were involved in the ADR,leading the list were traditional Chinese medicine preparation that account for 48.70%and antibacterial drugs that account for 29.86%.CONCLUSION:The reporting and monitoring of ADR should be intensified so as to decrease the rate of missing report and incidence of ADR to a large extent.

Objective To explore the clinical efficacy of captopril combined with nifedipine in the treatment of type 2 diabetes mellitus complicated with hypertension.Methods 100 patients with type 2 diabetes mellitus complicated with hypertension were divided into two groups by randomized single blind method.The two groups were given conventional hypoglycemic therapy,50 cases in the control group were treated with captopril,while 50 cases in observation group received captopril combined with nifedipine sustained -release tablets.The clinical therapeutic effect was compared between the two groups.Results The effective rate of the observation group was 94%,which of the control group was 80%,the difference was statistically significant (χ2 =9.65,P<0.05).After treatment,the diastolic blood pressure[(80.45 ±3.65)mmHg],systolic blood pressure[(128.67 ±5.66)mmHg],fasting blood glucose[(6.65 ±0.37)μmol/L],2h postprandial blood glucose[(9.76 ±1.22)μmol/L]of the observation group were significantly reduced than before treatment (t =8.06,8.18,8.00,7.94,all P <0.05),and diastolic blood pressure and systolic blood pressure were significantly different with the control group(t=8.66,7.90,all P<0.05). After treatment,the serum creatinine (97.44 ±6.32)μmol/L,urea nitrogen (4.20 ±0.30) mmol/L and 24h urinary albumin (17.99 ±4.10) mg/L of the observation group were significantly reduced compared with before treatment (t=7.67,8.27,8.32,all P<0.05),and the indicators had significant differences with the control group(t=7.23, 7.65,7.67,all P<0.05).Conclusion Captopril and nifedipine sustained-release tablets in the treatment of type 2 diabetic patients with hypertension can effectively reduce the blood pressure,improve renal function,and it has good clinical application and promotion value.

Objective To analyze the clinical presentation and maternal neonatal outcome of 30 cases with HELLP syndrome and to discuss the diagnosis, treatment and prognosis of the disease. Methods 30 cases of HELLP syndrome were collected retrospectively including 19 cases of complete HELLP syndrome and 11 partial HELLP syndrome. The blood test, clinical presentations, complications and pregnant outcomes were analyzed. Results LDH value in complete HELLP group(CHG) [(622?481)U/L] was significantly higher than that in partial HELLP group(PHG) [( 369?101) U/L, P

Objective To investigate the expression of glucose transporters(GLUTs)in placentas of pregnant women with abnormal glyeometabolism,and to explore its effect on glucose transport between mother and fetus and its relation with the birth weight.Methods Placentas of 41 pregnant women with abnormal glycometabolism(7 cases of DM,10 GDM A1,10 GIGT and 14 GDMA2)and 15 normal pregnant women as control were selected.The expression of GLUT1 and GLUT3was detected by immunohistochemistry.The birth weight was measured at delivery.Results GLUT1 was expressed in the syncytiotrophoblasts and cytotrophoblasts,whereas GLUT3 in some endothelial cells.The expressions of GLUT1 and GLUT3 were significantly different among the five groups(P＜0.01).Positive correlation was shown between the GLUT1 expression and the birth weight(rs=0.532,P＜0.01),but not in GLUT3 expression.Conclusions The expression of GLUT1 and GLUT3 in placentas of pregnancy with abnormal glycometabolism is enhanced,and GLUT1 may play a predominant role in the fetal glucose uptake.

Objective To study three single nucleotide polymorphisms (SNP), SNP-43, -19 and - 63 of calpain-10 (CAPN10) gene in pregnant women with glucose metabolism disorders and their relationship with the risk of these disorders. Methods Totally, 270 pregnant women including 156 with an abnormal oral glucose tolerance test (study group) and 114 healthy controls were selected among those delivered at the Department of Obstetrics and Gynecology, Peking University First Hospital from Jan. 2005 to Dec. 2006. The SNP of CAPN10 gene at posifons 43, 19, and 63 were analyzed by primer-introduced restriction analysis-polymerase chain reaction (PIRA-PCR). Results (1) The frequencies CAPN10 SNP-19 2R/2R genotype (26.9% ,42/156) and 2R allele (48.9%, 152/312 ) were higher than those in controls (12.3% ,14/114 and 36.8% ,84/228, respectively; P=0.012, 0.006). (2) Stratified analysis according to family history of diabetes mellitus showed the proportion of the CAPN10 SNP-19 2R/2R+2R/3R genotypes (83% ,47/57) in the study group were significantly higher than that of control group (52%,11/21 ; P=0.009), and the proportion of SNP-63 T/T + T/C genotypes(47% ,27/57) in study group were significantly higher than that of control group (14%, 3/21 ; P=0.026) among those with positive family history. (3) The combined effect of CAPN10 SNP-43, -19 and -63 on glucose metabolism disorders was analyzed by comparing with the other haplotypes and showed that the haplotype 121 distribution in study group was significantly higher than those in controls(P=0.036), and 221 haplotype was significantly lower than controls (P=0.042). Conclusions (1) CAPN10 SNP-19 is associated with glucose metabolism disorders in pregnant women. And 2R allele might be the risk factor. CAPN10 SNP-19 2R/2R +2R/3R and SNP-63 T/T + T/C genotypes might increase the risk of glucose metabolism disorders in women with positive family history. Haplotype 121 might increase the risk of glucose metabolism disorders in pregnant women and 221 be a protective factor.

To strengthen nursing ethics education and nursing construction are the solid foundation for successful emergency nursing.This paper analyzes the demand for building a reasonable nursing echelon,explores problems in current condition,and comes up with feasible countermeasures,thus providing reference for strengthening nursing echelon construction.

Objective To explore the diagnostic value of cystatin C(CysC) on early kidney damage in primary hypertension. Method To detect the CysC, BUN, Scr, UA in Ⅰ (31), Ⅱ (31), Ⅲ (31) stage of primary hypertension patients and 40 control cases ,then compared these results with normal control. Results The level of CysC in serum of Ⅰ , Ⅱ, Ⅲ stage of primary hypertension was(0. 81 ± 0. 16), (0. 94 ± 0. 23), (1.19 ± 0. 46) mmg/L, all of them were higher than normal control (0. 75 ± 0. 10) mg/L. The difference of CysC between Ⅱ、Ⅲ stage of primary hypertension and normal control was significant (t = 4. 195, t = 4. 446, P ＜ 0.01). The level of CysC in Ⅲ stage of primary hypertension was higher than in Ⅰ , Ⅱ stage(t = 4. 382 ,t = 4. 250,P ＜ 0.01). Significant positive correlation was observed between CysC and Scr(r = 0. 713,P＜0.01) ,CysC and UA(r=0. 45,P ＜0.01). Conclusion Serum CysC was a sensitive and reliable indicator on early kidney function damage in primary hypertension.

Objective to investigate the clinical application value of endometriosis fertility index (EFI) in the evaluation of ab‐dominal surgery endometriosis(EMT) combined infertility patient .Methods the date of 105 cases of infertility EMT merge were retrospectively analyzed from January 2009 to January 2013 in the Yuanzhou MCH and the obstetrics and gynecology department of Yuanzhou people′s hospital .All patients were followed up for two years and the rates of cumulative pregnancy were compared .Re‐sults the rates of two year cumulative pregnancy rate were 64 .80% (68 cases) .The two year cumulative pregnancy rates of EFI score ≤ 4 points ,5 to 7 points ,8 to 10 points were 34 .48% ,57 .14% ,92 .68% (P<0 .05) .There were no difference in cumulative pregnancy rate of different types of EMT in patients(P>0 .05) .Conclusion EFI and EMT with infertility pregnancy after conser‐vative treatment has a close relationship ,and EFI score would provide important guidance for follow up treatment .