Objective To investigate the efficacy of monotherapy or combination of ACEI and ARB in treating diabetic nephropathy(DN). Methods 183 patients with DN were randomly allocated into three treatment groups: benazepril,losartan or the combination of these two drugs for 12 weeks.The changes of blood pressure, proteinuria, serum potassium and creatinine, creatinine clearance(Ccr)were observed before and after treatment. Results Both of benazepril and losartan reduced blood pressure and proteinuria efficiently.And their effects were similar.In contrast, the reduction in proteinuria was greater in the combination therapy than in treatments of either drug alone(P<0.05), but their reductions in blood pressure were achieved to the same level(P>0.05).There were not significant differences in serum levels of potassium, creatinine and Ccr before and after treatment(P>0.05). Conclusion A combination of ACEI and ARB in patients with DN produces a better anti-proteinuric effect than either of the monotherapies.This protection is not dependent on changes in blood pressure.

Objective To explore the difference of the clinical effect and changes of neck’s curvature after different pulling treatments on cervical spondylopathy between two groups. Methods Seventy eight patients were randomly divided into 2 groups. Therapy group(39 cases) were treated with traction and counter-traction manipulation of Chinese massage in supine position, and control group(39 cases) were treated with conventional traction in sitting position . Results After first period of treatment, the rates of cure were 79.5% in therapy group and 43.6% in control group . There was significant difference between the two methods(P

Objective:To investigate the role of TCF7L2 gene polymorphism and related mechanisms in postmenopausal women with type 2 diabetes mellitus (T2DM) who are at high risk for osteoporosis (OP) .Methods:148 postmenopausal women with T2DM from Jan. 2019 to Jun. 2020 were selected as study subjects. Among them, 86 patients combined with OP (T2DM+OP group) and 62 patients without OP (T2DM group) were included, and 100 healthy postmenopausal women who underwent physical examination in our hospital during the same period were included as the control group. Fasting venous blood was extracted to detect clinical and bone metabolism indicators. Two SNP sites of TCF7L2, rs7901695 (T>C) and rs290487 (C>T) , were genotyped by capillary electrophoresis and section analysis (SNaPshot) . The relative mRNA expression of TCF7L2 gene was determined by quantitative real-time fluorescence quantitative PCR assay. To investigate the effects of overexpression and silencing of TCF7L2 on proliferation of rat osteoblasts, lentiviral vectors were constructed.Results:For rs7901695, TT, TC and CC genotypes in T2DM+OP group, T2DM group and control group were significantly different ( χ2=12.545, P=0.014) , and the frequency distribution of T and C alleles was significantly different among the three groups ( χ2=17.089, P<0.001) . For RS290487, CC, CT and TT genotypes of T2DM+OP group, T2DM group and control group were significantly different ( χ2=10.500, P=0.033) , and the frequency distribution of C and T alleles was significantly different among the three groups ( χ2=14.665, P=0.001) . For rs7901695, FPG and TG levels in T2DM+OP patients with CC+TC genotype were significantly higher than those with wild-type TT genotype (FPG: t=2.559, P=0.014; TG: t=2.034, P=0.036) , while serum calcium and 25OHD3 levels were significantly lower than those with Wild-type TT genotype (calcium: t=3.889, P<0.001; 25OHD: t=4.112, P<0.001) . For rs290487 site, serum calcium, BGP and 25OHD3 levels in T2DM+OP patients with TT+CT genotype were significantly lower than those with wild-type CC genotype, and the difference was statistically significant (calcium: t=3.751, P<0.001; BGP: 2.731, P=0.007; 25OHD3: t=3.225, P=0.002) . The relative mRNA expression level of TCF7L2 gene in T2DM+OP patients was significantly lower than that in T2DM group and the control group ( F=5.735, P<0.05) . With the increase of Allele C at rs7901695, the relative mRNA expression level of TCF7L2 gene decreased gradually ( F=5.723, P<0.05) . In addition, the proliferation rate of rat osteoblasts overexpressed by TCF7L2 was significantly increased, while the proliferation level of TCF7L2 silenced osteoblasts was significantly decreased ( F=7.846, P<0.05) . Conclusion:In postmenopausal WOMEN with T2DM, the variation of TCF7L2 gene will lead to the decrease of gene expression level, and the suppression of osteoblasts proliferation, thus participate in the pathogenesis of OP.

Objective To explore the treatment of laterognathism of the mandible.Methods Nineteen cases of laterognathism of the mandible were treated by Lefort Ⅰ osteotomy,sagittal split ramus osteotomy,genioplasty,anterior mandibular subapical osteotomy and prosthesis implantation,respectively,and their efficacy was evaluated and clinical experience summarized.Results The nineteen cases were followed up for average 12 months after the treatments and all the patients were satisfied with the surgical effects.All osteotomy lines healed well and there were no complications,such as root damage or neurotrosis.Conclusions The orthognathic procedure for laterognathism of the mandible should be selected according to the types and locations of asymmetry deformities.Anterior mandibular subapical osteotomy combined with mandibular cosmetic surgery for slight laterognathism of the mandible could achieve satisfactory results.

According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.

Objective To investigate the relationship between TNF-α, IFN-γand intestinal muco-sal permeability in a mouse colitis model and its inhibiting effect by balsalazide. Methods Forty-five C57BL/6J mice were divided randomly into five groups. Normal group was only fed with distilled water, DSS group and balsalazide groups at doses of 42, 141,423 mg/kg were both fed with 5% DSS. Balsalazide was given by intragastric administration. At the end of the experiment, colon tissue was collected for assessment of histological index(HI) and the MPO activity. Small intestinal mucosa was collected for assessment of the content of TNF-α and IFN-γ,transmission electron microscope(TEM), and detection of permeability by Ev-arts blue method. Results Compared with normal group, DSS group mice all manifested severe weight loss associated with hematocbezia and diarrhea, HI score, and the colon MPO activity and the content of TNF-α and IFN-γ were increased significantly. Intestinal mucosa showed a thinning of microvillous carpet, with de-curtated and broaden junctional complex and enlarged intercollutar space under TEM observations. The amount of Evans blue permeated into intestinal wall was obvious. Compared with DSS group, the HI score, the MPO activity and the content of TNF-α and IFN-γ were decreased by balsalazide. The amount of Evans blue permeated into intestinal wall was less. Ileal microvillous carpet was ameliorated dose dependently by balsalazide. Conclusion In DSS-induced colitis model, the change of the content of the TNF-α and IFN-γ, was accordance with the increase of intestinal mucosal permeability while balsalazide can significantly amelio-rate intestinal mucosal permeability by its anti-colitis effect.

Objective To investigate the effects of nitric-oxide synthase inhibitor on matrix metalloproteinases (MMPs) expression in osteoarthritis (OA) cartilage by Luminex analysis,and to explore the mechanism of nitric-oxide synthase inhibitor on modification of the metabolism of OA cartilage.Methods Fifteen specimens of articular cartilage taken from the patients with OA were cultured and divided in two groups.The control group was those with no intervention.L-NIL group was co-cultured with NOS inhibitor L-NIL.After 72 h cultivation,the release of NO and the activity of NOS on OA cartilage were measured by Griess reaction and spectrophotometric methods.MMPs (MMP-1,MMP-2,MMP-3,MMP-9,MMP-13) expression was measured by Luminex analysis.Comparisons between groups were performed with paired sampies t test.Results After cultured for 72 h,spectrophotometric analysis showed high concentration of NO release[(216±47) μmol/L ] and high level of active NOS [(5.7±1.3)U/ml]in supernatants of the control,1 mmol/L concentration L-NIL could evidently reduce NO release [(55±20)μmol/L,P<0.01] and NOS activity [(1.7±0.7)U/ml,P<0.01 ].Luminex analysis demonstrated high MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression in cartilages of the control group [respectively for (10.8±5.4)ng/ml,(9.2±3.3) ng/ml,[11.6±4.2 )ng/ml,(1.27±1.07)ng/ml,(3.6±1.3)ng/ml] and 1 mmol/L concentration L-NIL could evidently inhibit MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression [respectively for (3.6±1.8)ng/ml,(2.3±1.2)ng/ml,(3.6±1.4)ng/ml,(0.65±0.21)ng/ml,(1.8+0.5)ng/ml,P<0.05 ].Conclusion Luminex analvsis has shown that NOS inhibitor can reduce NO release and NOS activity and modify metabolism of articular cartilage by inhibiting the over-expression of MMPs.

Objective To evaluate the modification of C_(60) on the radiation effects of ~(60)Co-γ irradiation on zebrafish.Methods The adult and embryonic zebrafish were used as model organisms to examine the potential of C_(60) to elicit oxidative stress responses on the surviving rate,hatching rate and malformation occurrence,both upon exposure to light or in the dark.Reactive oxygen species (ROS) production and DNA damage were examined as the possible underlying mechanism.Results 500 × 10~(-9) nano-C_(60) waterborne exposure could enhance the γ-irradiation effects by decreasing adult fish survival upon light exposure,which resulted in ROS and DNA damage increasing.The hatching rates were also inhibited with higher malformation,though dark exposure did not make any enhancement,except that the 5000× 10~(-9) C_(60) would inhibit larvae hatching and induced more malformation.Conclusions Waterborne nano-C_(60) exposure may enhance the radiation effects on zebrafish,ROS production and DNA damage increasing may be the underlying mechanism.

OBJECTIVE:To standardize periooperative prophylactic application of antibiotics. METHODS:According to the characteristics of orthopaedic and parenchyma surgery,classifying evaluation table of typeⅠincision infection risk was designed sci-entifically and rationally. The individual application of antibiotics in surgery patients had been achieved through infection risk evalua-tion. High risk typeⅠincision patients used antibiotics rationally and low risk patients seldom used or didn’t use at all. RESULTS:Through using infection risks classifying table,the rate of antibiotics prophylactic application in typeⅠincision drops from 74.10%to 28.68%,and and the per capita duration of antibiotics prophylactic application shortened from 4.23 d to 2.21 d. The postopera-tive infection rate remained the same. CONCLUSIONS:Through infection risk classifying evaluation,individual application of anti-biotics can be achieved in surgery patients,so as to promote rational use of antibiotics for prophylactic use,reduce antibiotics dos-age and antibiotics abuse under the condition of controllable surgery infection.

OBJECTIVE To investigate the phylogenetic analysis of Acinetobacter baumannii strains in elderly.METHODS The 33 kinds resistant genes were detected by PCR and cluster analysis.RESULTS The positive rates of AmpC(chromosome type),TEM and PER were 85%,55% and 25%,respectively.The positive rates of aac(3)-Ⅰ,ant(3″)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰb and armA were 95%,95%,40%,15% and 35%,respectively.The positive rate of qacE△1-sul1 was 75%.There were very high positive percentages of AmpC(chromosome type),TEM,PER,aac(3)-Ⅰ,ant(3″)-Ⅰ,armA and qacE△1-sul1 genes in A.baumannii isolates among elderly.There were clones transmitted phenomenon.CONCLUSIONS The resistance phenotype of A.baumannii isolates among elderly is in accordance with genetic testing.A.baumannii can induce clones transmitted hospital infection.