One hundred and thirty-six adult patients with type 2 diabetes ( ≥40 years, body mass index > 24) were assigned to the low-dose Mefformin, high-dose Mefformin, and control groups. Plasma lactic acid level was detected with ultraviolet enzyme kinetics assay. Our data showed that plasma lactic acid of the low-dose or high-dose mefformin group was significantly higher than the control group (2.314 vs. 2.511, P<0.05 ), although there was no significant difference between the low-dose and the high-dose Mefformin group. In all the 3 groups, increased lactic acid ( > 2. 2 mmol/L) was found in some patients ( Mefformin group vs. Control group: X2 = 7.43, P < 0.05 ), and no lactic acid > 5.0 mmol/L was found. Insulin resistance index and hemoglobin Alc were similar between the 3 groups. Thus, mefformin may not increase the risk of lactic acidosis in diabetic patients with normal cardiorespiratory and renal function.

Objective To estimate the relationship of fibroblast growth factor-1 (FGF-1),mitogen activated protein kinase-1 (MAPK-1) and CD34 expressions with clinicopathological findings in lesions of psoriasis vulgaris.Methods Skin specimens were collected from 30 patients with psoriasis vulgaris,whose general information and clinical findings were recorded.The protein expressions of FGF-1,MAPK-1 and CD34 in these specimens were detected by tissue chip technology and immunohistochemistry,and the mRNA expression of FGF-1 by reverse transcription-PCR.The correlations of FGF-1 protein expression with patients' gender,age,clinical stage,psoriasis area and severity index (PASI) score,angiogenesis and abnormal epidermal proliferation were statistically analyzed.Results The protein and mRNA expressions of FGF-1 were significantly higher in the lesions than in the control skin (both P ＜ 0.05).The protein expressions of CD34 and MAPK-1 were significantly increased,and positively associated with the protein expression of FGF-1 in psoriatic lesions.The up-regulation of FGF-1 protein was unrelated to the age or gender of patients,but associated with clinical stage and PASI score.The proportion of patients with increased FGF-1 expression was significantly larger in patients at active stage and with high PSAI score than in those at quiescent stage and with low PSAI score (P ＜ 0.05).Conclusions In psoriasis vulgaris,FGF-1 may participate in the abnormal epidermal proliferation and vascular dysplasia in dermal papilla,and the upregulation of FGF-1 appears to be associated with the progression of disease and aggravation of lesions.

Objective To investigate the intra-and postoperative course of patients undergoing laparoscopic liver resections under intermittent total pedicle occlusion (IPO),hemihepatic vascular occlusion (HVO),and selective vascular occlusion(SVO).Methods Retrospective analysis the data of 41 cases of laparoscopic liver resection were conducted in three groups of patients under different occlusion methods,including 15 cases of intermittent total pedicle occlusion (IPO),12 cases of hemihepatic vascular occlusion (HVO) and 14 cases of selective vascular occlusion (SVO).Intraoperation blood loss,operation time,conversion to open operation,changes in postoperative liver function,hospital stays and complications were compared among the three methods.Results There was no operative death in any of the 41 patients.There was no conversion to open surgery.Generally,there was no significant difference among the three groups in blood loss,clamping time or operative time.Ten patients had postoperative complication and all were cured.The effect on liver function for Gro-HVO and Gro-SVO was significantly less severe than that for Gro-IPO (P ＜ 0.05) after operation.Conclusions Both HVO and SVO are feasible and safe in laparoscopic hepatectomy(LH),and have advantage in reducing liver remnant ischemia injury and modality rate over IPO.HVO is easy to do for left lateral lobe or resection of the left half of the liver.SVO is suitable for right lobe resection.

This study is to investigate the influence and mechanism of action of asymmetrical dimethylarginine (ADMA) and the induced oxidative stress level on Alzheimer's disease (AD) incidence. ADMA concentration, nitric oxide, Abeta(40)/Abeta(42) ratio, inducible NO synthase (iNOS) activity and the concentrations of the induced free radicals including malondialdehyde (MDA), 3-nitrotyrosine (3-NT) and peroxynitrite (ONOO-) in the cerebrospinal fluid (CSF) from 34 neurologically normal controls and 37 AD patients were quantitatively determined and statistically compared. The results showed that the ADMA concentration significantly decreased in AD patients, and it showed negative correlation with the NO, iNOS activity, and showed positive correlation with MMSE score. ADMA concentration was negatively correlated with Abeta(40)/Abeta(42) ratio (P<0.01) with the observation that Abeta(40)/Abeta(42) ratio increased while ADMA level decreased in CSF in AD patients. The concentration levels of MDA, 3-NT and ROS significantly increased compared with the control with all the P values less than 0.05. These findings suggested that the ADMA disorder and the oxidative damage effect of the induced free radicals in CSF of AD patients are an important mechanism of AD incidence, and their joint regulation may provide new idea for the prevention and clinical treatment of AD.

Objective To study the effect of radiotherapy and prognostic factors for patients with post-operative loco-regional recurrence of esophageal carcinoma. Methods From 2000 to 2005,91 patients with esophageal carcinoma who developed post-operative loco-regional recurrence were analyzed retrospectively. The interval between surgery and recurrence was 1 -35 months, with a median interval of 11.1 months. There were 4 patients with anastomosis relapse, 6 with anastomosis and mediastinal lymph nodes relapse,4 with abdominal lymph node relapse, 20 with supra-clavicular lymph node relapse, 34 with mediastinal lymph node relapse, and 23 with mediastinal and supra-clavicular lynph node relapse. There were 56 and 35 patients who received conventional and three-dimensional conformal radiation therapy respectively, with a total radiation dose of 50 -70 Gy. Sixty-eight patients received adjuvant chemotherapy.Results The follow-up rate was 95%. The 1-,2-and 3-year overall survival rates were 52%, 20% and 14%, respectively. In univariate analysis, the recurrence time (P = 0. 001), postoperative stage (P =0. 000), radiation dose (P =0. 001) ,overall response rate (P =0. 000) ,T stage (P =0. 028), and N stage (P = 0. 003) were related with prognosis. Multivariate analysis showed that the recurrence time (P =0. 014), postoperative stage (P = 0. 006), radiation dose (P = 0. 009), overall response rate (P = 0. 000)were independent prognostic factors for survival. Conclusions Radiotherapy may improve the survival of esophageal carcinoma patients with postoperative recurrence. Patients with long recurrence-free time, early stage, high response rates, and radiation dose of higher than 60 Gy have better prognosis.

OBJECTIVE: To study the preparation technology of baicalin glycosides liposomes. METHODS: Baicalin liposomes modified by vitamin E and Tween 80 were prepared by reverse phase evaporation method. The free drug was separated by ultracentrifugation and the encapsulation rate was determined by UV spectrophotometry. Based on the results from single factor tests, orthogonal experimental design was used to investigate the factors influencing the envelopment rate of liposomes. The baicalin liposomes prepared by the optimized process were characterized for particle size, Zeta potential, and morphology. RESULTS: The optimum conditions for the preparation of liposomes were as follows: the ratio of water phase to organic phase 1∶3, the concentration of baicalin 3 mg•mL-1, the ratio of cholesterol to soy lecithin 1∶6, dosage of vitamin E 2 mg,dosage of Tween 80 120 μL. The mean diameter was 52.2 nm, Zeta potential was -51.9 mV, the encapsulation rate was 70.22% and drug loading capacity was 3.18%. Transmission Electr Microscope(TEM) results showed that the shape of the liposomes was good, the particle size was relatively uniform and consistent with the results of laser granulometry. CONCLUSION: The stability of baicalin liposomes can be improved by the addition of vitamin E and Tween 80.

TongJi University School of Medicine has performed teaching reforms in the early stage of medical students through curriculum integration of life science,the introduction of PBL,and designing of comprehensive experiments to achieve comprehensive professional competence of medical students.The results showed that the training system is beneficial to the cultivation of students' clinical thinking and early medical professional competence.It has been recognized by both students and faculty.Preliminary practice has proved to be successful.

Objective To investigate the effects of macrophage inflammatory protein-1α (MIP-1α) combined with molecule 4-1BB L on the tumorigenicity of hepatocellular carcinoma cells in vivo. Methods Mouse MIP-1α (mMIP-1α) expressed Hepa 1-6 cells were transfected with m4-1BBL recombinant retrovirus, the anti-histidinol cells clones were selected and amplified. The expression of m4-1BB L was confirmed by flow cytometry. The growth curve of Hepa 1-6 cells transfected with mMIP-1α and m4-1BBL alone or together was drawn and compared. C57B/L Mice were randomly divided into 7 groups, 9 mice in each group, injected with mMIP-1α+m4-1BB L Hepa 1-6 cells, m4-1BB L Hepa 1-6 cells, mMIP-1α Hepa 1-6 cells, Hepa 1-6 cells, pLXSHD Hepa 1-6 cells or PBS respectively. The tumorigenicity of hepatocellular carcinoma cells and the mice survival rate were compared between each groups. Results Hepa 1-6 mMIP-1α+m4-1BB L cells which expressed both mMIP-1α and m4-1BB L were successfully established. The expression of mMIP-1α and m4-1BB L alone or together did not affect the growth curve of Hepa 1-6 cells. Observed for 5 weeks, no tumor developed in Hepa 1-6 mMIP-1α+m4-1BB L injected mice. The tumorigenicity of Hepa 1-6 mMIP-1α+m4-1BB L was lower than that of Hepa 1-6 mMIP-1α or Hepa 1-6 m4-1BB L in vivo. The survival rate of Hepa 1-6 mMIP-1α+m4-1BBL injected mice(9/9) was higher than that of Hepa 1-6 m4-1BB L injected mice (6/9)or Hepa 1-6 mMIP-1α injected mice (1/9). Conclusion Chemokine MIP-1α combined with costimulatory 4-1BB L lowered the tumorigenicity of hepatocellular carcinoma cells in vivo, and prolonged the mice survival period.

Objective To approach the diagnostic value of contrast-enhanced ultrasonography(CEUS)for the detection of traumatic laceration of pancreas. Methods Sixty cases of pancreatic traumatic model were made in twelve healthy swines after the animals were anesthetized and laparotomized. Then the conventional ultrasonography(US) and CEUS were performed in each case to diagnose the traumatic region,immediately. The results were compared with surgical findings. Results Among sixty injuries,the detection rate of conventional ultrasonography was 66. 7%,the detection rate of CEUS was 88.3%. Conclusions CEUS shows higher detection rate than conventional US in diagnosing pancreatic laceration,and it also can improve the diagnostic value of ultrasound for the detection of pancreatic laceration.

Objective To investigate hypolipemic treatment of hyperlipidemic panereatiti(HLP)with integrated traditional Chinese and western medicine.Methods Cinical data of 20 patients of HLP were analyzed retrospectively.Eight patients in the control group were treated with conventional therapies,while 12 patients in the treatment group were treated as follows:①Enema with 180ml solution(50% magnesium sulfate 30 ml.Glycerin 60ml,water 90ml).②Rhubarb gastrogavage with 9 g tid.③Intravenous drip with 24 g salvia miltiorrhiza qd.Results The treatment group had significant difference comparing with the control group in terms of the serum TG in 48 hours(P<0.01),time of autonomous bowel movement recover(P<0.01),days of abdominal pain disappear(P<0.05),days of hospitalization(P<0.01).Conclusion The treatment of Enema with 180 ml solution.Rhubarb gastrogavage with 9g tid,and Intravenous drip with 24 g salvia miltiorrhiza qd can relieve the symptoms of HLP and decrease blood-fat greatly.