Objective To investigate the pathogenic features and antibiotic resistance profile of nosocomial and community-acquired spontaneous bacterial peritonitis (SBP) in liver cirrhosis patients.Methods Two hundred and twenty-six cirrhotic patients with SBP who were admitted to Beijin Ditan Hospital from January 2001 to December 2008 were recruited into this study. The bacterial identification and drug susceptibility were performed. The data were analyzed by Chi square test and t test. Results Eighty-six(38.0% ) patients were diagnosed with nosocomial SBP and 140 (62.0%)were diagnosed with community-acquired SBP. The proportion of Child-Pugh Class C cases in patients with nosocomial SBP was higher than patients with community acquired SBP (97.7% vs. 82.8%; x2= 11. 489, P=0.001). Mortality rate in patients with nosocomiat SBP was also higher than patients with community acquired SBP (50. 0% vs. 30. 0%; x2 =9. 081,P=0. 003). Total 28 species (232strains) of bacteria were isolated from these patients. 77.5 % (69/89) of the nosomial SBP cases and 76.9% (110/143) of community-acquired SBP cases were caused by Gram-negative bacteria (mainly were Escherichia coli and Klebsiella pneumoniae). 19.1% nosocomial SBP cases and 21. 8%community-acquired SBP cases were caused by Gram-positive bacteria. Fungus infections accounted for 3.4% and 1.4% of these two population, respectively(P＞0.05). In patients with nosocomial SBP,19 out of 32 Escherichia coli stains and 5 out of 14 Klebsiella pneunmoniae strains were extended spectrum β-lactamase (ESBL) positive, while among 60 Escherichia coli stains and 32 Klebsiella pneunmoniae strains, only 11 Escherichia coli stains were ESBL positive (P＜0.05). The resistance rates of Gram-negative strains to cephalosporin and quinolone in nosocomial SBP patients were both higher than those in community-acquired SBP patients(P＜0. 05), but all Gram-negative isolates were sensitive to imipenem (P＞ 0. 05). No Gram-positive isolates resistant to vancomycin were found.Conclusions The liver cirrhosis patients with Child-Pugh Class C are vulnerable to nosocomial SBP and the prognosis is poor. Although the pathogenic spectrum are similar in cirrhotic patients with nosocomial and community-acquired SBP, which mainly are Escherichia coli and Klebsiella pneumoniae, the percentage of ESBL producing strains is higher in nosocomial SBP patients compared to that in community-acquired SBP patients.

Objective To observe the distribution of the neuropeptides in mouse sublingual gland. Method Using immunohistochemical ABC method. Results The striated duct cells in the sublingual gland showed somatostatin and calcitonin gene related peptide immunoreactivity positive which were in the cytoplasma, but the nucleus negative.Conclusion The striated duct cells in mouse sublingual gland also contained neuropetides; which may play an important role in regulating acinar secretion and blood supply.

OBJECTIVE:To establish fingerprint of Zhizi jinhua pills(ZZJHW)and analyze the relationship of it with in vitro antioxidant activity,in order to provide the basis for the quality control of them. METHODS:HPLC method was adopted. The sep-aration was performed on a Sinochrom ODS-BP C18(200 mm×4.6 mm,5 μm)column with mobile phase consisted of 0.2% acetic acid(containing 3 mmol/L sodium heptanesulfonate solution)-acetonitrile(gradient elution)at the detection wavelength of 254 nm and flow rate of 0.8 ml/min. The column temperature was controlled at 38 ℃,and injection volume was 10 μl. The“Chromato-graphic Fingerprint Similarity Evaluation System for TCM”(2012.130723 edition) issued by Chinese Pharmacopoeia Commission was used to evaluate the similarity of the 12 batches of ZZJHW using baicalin as reference peak so as to attribute the common peak of fingerprint. DPPH free radical scavenging assay was used to investigate the in vitro antioxidant activity of 12 batches of ZZJHW,and the relationship between its fingerprint and antioxidant activity was studied. RESULTS:The fingerprint of 12 batches of ZZJHW was established and the similarity between the fingerprint of ZZJHW with their reference fingerprint were all above 0.9 (except S1,S2,S3,S12). 30 common peaks were marked,all of which were assigned to the herbs. Antioxidant experiment result showed the differences in the antioxidant capacity among different batches of ZZJHW;spectrum effect relationship showed that 13 common peaks were positively related with oxidation activity and 17 common peaks negatively related with it;among known com-ponents,oxidation activity components were mainly from Lonicera japonica,Scutellaria baicalensis and Rheum palmatum. CON-CLUSIONS:The spectrum effect relationship of established fingerprint with its antioxidant activity can provide reference for the quality control of ZZJHW.

The total fatty acid in adipose tissue and total and free fatty acid in plasma, using tridecanoic (Cl3:0) and heptadecanoic acid (Cl7:0) as the internal standard (IS) respectively, were analysed by GC. In analysing total fatty acid, the esterification rate was 103.53% (IS Cl3:0) and 102.86% (IS C17:0); the recovery of lauric, myristic, stearic and arachidic acid was 101.0-103,3%, 102,1-494.1%, 103,1-104.5% and 100,0-105.0%; the CV of individual fatty acid were within the range of 2.24-8.46%. In analysing free fatty acid, the esterification rate in use of C17: 0 as the IS was 102.99%; the recovery of lauric, myristic, stearic and arachidic acid was 83.5-87.3%, 96.4-99.6%, 94.3-101.9%, and 82.0-105.0% respectively, the CV of individual fatty acid were within the range of 1.41-6.21%. The procedure analysing total fatty acid is especially simple, speedy, and reliable.

Objective To study the location and significance of leptin and leptin receptor in rat submanibular gland. Methods Submandibular gland from SD rats were observed by hematoxylin-eosin, leptin and leptin receptor immunohistochemical staining. Result The granular convoluted tube and striated duct were leptin and leptin receptor positive. The density of positive cells in granular convoluted tube were much high than those of in striated duct. The acini were negative.Conclusion leptin and leptin receptor were widly expressed in granular convoluted tube and striated duct. These results might indicate that submandibular gland participated in adjusting the balance of energy.;

The association of coagulation function with progressive proteinuria in type 2 diabetic patients was retrospectively analyzed.With increasing microalbuminuria,fibrinogen level was increased significantly.Fibrinogen was an independent risk factor of microalbuminuria. In patients as the early-stage diabetic nephropathy (DN)progressed to clinical-stage DN,the baseline level of fibrinogen was also increased [ ( 3.5 ± 0.9 vs 3.0 ± 0.6 ) g/L,P＜0.05 ].Fibrinogen may serve as a useful predictor of progressive proteinuria in type 2 diabetes.

According to the analysis of 9 237 hospitalized type 2 diabetic patients, the prevalence of diabetic retinopathy ( DR )was 32.9％ , with the prevalence of mild, moderate, and serious non-proliferative DR and proliferative DR being 10. 1％, 18. 3％, 3.2％, and 1.3％ respectively. The prevalence of diabetic macular edema ( DME ) was 3.56％ in type 2 diabetics and i 0. 8％ in patients with DR. Diabetes duration and proteinuria were the common risk factors of DR and DME.

Blood lipid level and its associations with insulin resistance were studied in patients with impaired glucose tolerance (IGT).Two hundred and twenty first degree relatives of type 2 diabetes mellitus were grouped into normal glucose tolerance (NGT) and IGT groups according to results of oral glucose tolerance test.Compared with the NGT group,the IGT patients had higher serum levels of total triglyceride (TG),total cholesterol (TC),low density lipoprotein-C (LDL-C) but a lower serum level of high density lipoprotein-C (HDL-C).Homeostasis model of assessment for insulin resistance index (HOMA-IR) and area under curve of insulin (AUCI) also increased.A positive relationship was found between TG and HOMA-IR (or AUCI),but a negative relationship existed between HDL-C and HOMA-IR.In conclusion,abnormal blood lipid metabolism is present in IGT patients and it has a close correlation with insulin resistance.

Objective To evaluate the inhibitory effect of statins on glucose-stimulated insulin secretion (GSIS) of pancreatic islet in rat and to explore its mechanisms. Methods According to the average volume, freshly isolated or 24-hour cultured pancreatic islets were randomly divided into control group( incubated with Kreb-Ringer bicarbonate buffer), the atorvastatin group( incubated with 100 μ mol/L atorvastatin), the fluvastatin group (incubated with 100 μ mol/L fluvastatin)and the pravastatin group (incubated with 100 μ mol/L pravastatin). Stimulated by 2. 8,5. 5,11.1,16. 7 mmol/L and 25.0 mmol/L glucose respectively, the effect of 100 μ mol/L statins on ATP content and GSIS was compared in the four groups. GSIS was performed by the 37℃ bath incubation method and ATP content was measured by chemiluminescence method. Results Incubated with 100 μ mol/L atorvastatin for 30 minutes, in the presence of 16. 7 mmol/L glucose, the ATP content [(9. 54 ± 1. 64) pmol/islet vs ( 12. 33 ± 1.89) pmol/islet] and GSIS (1.60 ± 0. 21 vs 2. 39 ± 0. 30) were significantly reduced in comparison with the control group (P＜0. 05). Cultured with 100 μmol/L fluvastatin for 24 hours, the ATP content [( 10. 24 ±2.01 )pmol/islet vs (12. 31 ±2. 16) pmol/islet] and GSIS (3. 12 ± 0. 32 vs 4. 17 ±0. 37 ) were all significantly decreased at the higher glucose concentration of 16. 7 mmol/L ( P ＜ 0. 05). Conclusion Atorvastatin and fluvastatin may inhibit GSIS by decreasing ATP content in pancreatic islet and the inhibitory effect is related to the strength of its lipophilicity.

[Summary] To investigate the association between sleep disorder and ambulatory blood pressure rhythm in patients with type 2 diabetes. 418 patients with type 2 diabetes were divided into two groups according to Pittsburgh sleep quality index ( PSQI):patients without sleep disorder and patients with sleep disorder. Oral glucose tolerance test, insulin releasing test, and C-peptide releasing test were performed to investigate the differences in the β-cell function, the circadian rhythm of blood pressure, and blood pressure variation between the two groups after fasting and glucose-load. The correlation and regression analysis were performed between PSQI and other indicators. (1)The level of HbA1C , fasting plasma insulin, area under curve of insulin, fasting plasma C-peptide, area under curve of C-peptide, and homeostasis model assessment for insulin resistance ( HOMA-IR) were significantly higher in patients withsleepdisordercomparedtothoseinpatientswithoutsleepdisorder[(8.2±2.1)% vs(7.4±1.8)%,(13.42± 4.55vs11.86±4.52)mU/L,(8.51±0.54vs8.38±0.51)mU·L-1·min,(2.42±1.25vs1.79±0.73)ng/ml, (6.59±0.39vs6.49±0.43)μg·L-1·min,4.63±1.12vs3.86±0.97,allP<0.05]. Insulinsensitivityindex (ISI) was lower in patients with sleep disorder than that in patients without sleep disorder(-4. 26 ± 0. 78 vs-4. 05 ± 0.62,P<0.05). (2)Thelevelof24hmeansystolicanddiastolicbloodpressure,nocturalsystolicanddiastolicblood pressure, and systolic blood pressure during daytime and nighttime were significantly higher in patients with type 2 diabetes who were suffering from sleep disorder. The blood pressure variation was more marked in patients with sleep disorder. (3)Multiple stepwise regression analysis showed that PSQI score was positively related to area under curve of C-peptide, HOMA-IR, 24 h mean systolic blood pressure, and noctural systolic blood pressure (β=0. 242, 0. 293, 0. 352, 0. 413, all P<0. 05), and negatively related to ISI and decreasing ratio of noctural systolic blood pressure (β=-0. 124 and -0. 226, both P<0. 05). Sleep disorder may cause abnormal circadian rhythm of blood pressure through various mechanisms. Improving sleep disorder may help to ameliorate insulin resistance and restore normal circadian rhythm of blood pressure.