Diabetes Mellitus ; drug therapy ; Diabetic Angiopathies ; drug therapy ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypoglycemic Agents ; therapeutic use ; Medicine, Chinese Traditional ; Phytotherapy

Abstract Objective:To investigate whether mRNA of prolactin(PRL) ,an important immunomodulatory hormone,is expressed in thyroidglands of patients with Graves'disease(GD) .Methods:The expression of PRL mRNA was examined by nonisotopic in situ hybridization in GDthyroid glands and the control ones( including multinodular goiters and samples of normal thyroid tissue adjacent to adenomas) as well as intra-thyroidal mononuclear cells isolated from GD thyroid glands and primary thyroid follicular cell(TFC) cultures derived from them.Results:PRL mRNA was expressed in GD thyroid glands, but not in the control ones. It was localized in infiltrating mononuclear cells and vascular endothelial cells adjacent to mononuclear cell infiltrates, but not in TFC .(9.8?.3)% (x ?s) of intrathyroidal mononuclear cells isolated from GD thy-roid were found containing PRL mRNA.It was absent in the primary TFC cultures. Conclusion:PRL mRNA is expressed in GD thyroid tissue. This indicates that PRL-like substance can be locally produced in GD thyroid tissue, which may play an important role in GD pathogenesis by autocrine and paracrine mechanisms.

Diabetic peripheral neuropathy (DPN) is a common complication of diabetic mellitus. The treatment is so difficult that doctors have not found reliable methods to cure this disease. The research progress both in TCM and western medicine of this disease were reviewed in terms of aspects of etiology, pathogenesis and differential treatments.

Objective To survey the knowledge of chronic stable coronary artery disease management among general practitioners (GPs) in Shanghai Pudong New Area.Methods The survey was conducted among 363 GPs with at least 2-year work experiences from community health service centers in Shanghai Pudong New Area from July to September in 2014.A self-designed questionnaire based on the guidelines/consensus of chronic stable coronary artery disease management were used in the survey.The questionnaire consisted of 4 parts:diagnosis,drug therapy,revascularization and treatment of special types.Results Among 363 participants 362 questionnaires were completed.History taking,physical examination and electrocardiogram were applied for diagnosis in all participants,49.2％ (178/362) also used coronary computed tomography angiography,26.5％ (96/362)used exercise testing for assistant examination.More than 95.0％ of participants recognized that smoking,obesity,hyperlipidemia,hypertension,diabetes were risk factors.75.7％ (274/362) of participants used aspirin,91.4％ (331/362) knew the dose of aspirin as 75-150 mg;for aspirin intolerance 14.6％ (53/362)would use clopidogrel alternatively.50.6％ (183/ 362) of participants sometimes used statins;and 39.2％ (142/362) did not use stain because of not knowing the contraindication.Facing increases of alanine aminotransferase or aspartate aminotransferase levels 95.3％ (345/362) of participants would immediately discontinue stain;80.4％ (291/362) discontinued statins as creatine kinase increased.32.0％ (116/362) of participants gave enough drug-free period avoiding nitrates resistance.79.6％ (288/362) seldom used β-blockers and 42.5％ (154/362) failed to use β-blockers because not knowing the contraindication.78.7％ (285/362) knew percutaneous coronary intervention but did not know its indications;83.1％ (301/362)knew coronary artery bypass but did not know its indications.27.6％ (100/362) knew calcium antagonists were first-line drugs for variant angina and 93.6％ (339/362) never heard of microvascular angina.Conclusion The survey shows that GPs from community health service centers in Shanghai Pudong are not well familiar with examination of coronary heart disease and lack of sufficient knowledge of drugs recommended by the guideline,not well understand the indications for revascularization and the diagnosis and treatment of special types of coronary heart disease.

Objective To investigate the treatment of chronic heart failure in two communities in Pudong and find the deficiency of standardized treatment in community hospital.Methods A retrospective study of all the inpatient,family bed and outpatient with heart failure who visit Hudong and Lujiazui community health Service center was conducted from March 2012 to March 2015 retrospectively.General situation(gender,age,smoking history,drinking history,daily salt intake,concomitant disease),etiology and if have the acute heart failure onset in half a year and what are the incentives,drug treatment and treatment of concomitant hypertension and diabetes mellitus were analyzed by face to face follow up.Results The study included 300 patients,average age was (58 ± 10) years.Daily salt intake of 55.0％ (165/300)patients was more than 9 g.Coronary heart disease (45.7 ％,137/300),hypertension (30.7％,92/300)and cardiomyopathy (9.0％,27/300)were the chief heart failure etiology.59.3％ (178/300) patients had acute heart failure in half a year.Acute blood pressure(20.8％,37/178),transfusion too fast or too much and infection(14.6％,26/178) were the chief incentives leading to acute heart failure.83.3％ (250/300)patients used ACEI/ARB,but only 32.0％ (80/250) of them applied the target dose.53.7％ (161/300)patients used beta blockers and 98.1％ (158/161) of them could not reach the target dose.Tartaric acid metoprolol (51.6％,83/161),peso parlour (18.6％,30/161) and carvedilol (14.9％,24/161) were commonly used drug in clinic.76.6％ (230/300)patients had hypertension and blood pressure was controlled in 82.2％ (189/230) of them successfully.44.0％ (132/300) patients had diabetes mellitus and glycosylated hemoglobin (HbA1c) was controlled from 7 ％ to 8 ％ in 23.5 ％ (31/132) of them.Conclusion In the community treatment of heart failure,the drugs recommended by guidelines were low usage and achieved the target dose rarely.Treatment of concomitant diseases was not good.The knowledge of new progress was not enough.

To optimize bacteriocin production,researching was done on the respect of incubation condition and the media components. And the optimum incubation time was 24h, the optimum temperature was 30℃, the optimum broth initial pH was 6.5. The optimum media component was: lactose 30g, trypone 15g, soybean peptone 20g, meat extract 30g, peptonethe 20g, Tween 80 1mL, K_(2)HPO_(4 )2g, NaAc 5g, Tri-Ammonium citrate 2g, (MgSO_(4)) 0.58g, MnSO_(4) 0.25g, H_(2)O 1000mL. Production of bactericoin under the optimum broth was 640AU/mL, 8 times than MRS media.

Objective To testify the limitation of Sanxiao differentiation and to prove the objectivity and practicability of three-typed syndrome differentiation by mining data of common diabetic symptoms and symptomatic flocks from the gathered cases of type 2 diabetes mellitus. Methods The diagnotherapeutic data of 533 cases of type 2 diabetes were collected applying structurally clinical informational gathering system. Then the symptoms, symptomatic flocks and correlated symptoms of typical Sanxiao symptoms were analyzed. Result Among those symptoms, weakness was the tiptop of 473 cases, accounting for 88.74%. 303 cases with thirst and pleased drink, among which 32.23% had both polyuria together with polyphagia and hungary. 106 cases had polyuria (19.89%), 26.46% of which were thirst and pleased drink accompanied with polyphagia and hungary. 77 cases were polyphagia and hungary (14.45%), among which 35.37% had both polyuria together with thirst and pleased drink. 2.25% cases had Sanxiao symptoms at the same time. The frequency of deep and thready pulse was the most aommonly one, which accounted for 133 cases (24.95%). Tongue quality mainly appeared dull and red (218 cases, 40.9%). Among the symptomatic flocks, tongue quality weak and white often accompanied by thirst, please drink and weakness. Conclusions The theory of treatment based on syndrome differentiation of Sanxiao exists localization in the regarding the complexity of type 2 diabetes symptoms and symptomatic flocks. The three-typed syndrome differentiation possesses the objectivity and practicability.

ObjectiveTo comprehensively evaluate the curative effect ofTCM reating type 2 diabetes with three type dialectical therapy by Fuzzy Mathematics.Methods261 cases of 2 type diabetes were divided into three groups by syndrome differentiation,as follows:type of heat with yin deficiency,type of deficiency of both qi and yin,and type of deficiency of both yin and yang,and received corresponding therapies.The course of treatment was 24 weeks,in the first 12 weeks (period 1),on the basis of western medicine treatment,patients of the three groups were respectively treated by qingrungranules,ziyigranule and shuangtiaogranules.In the next 12 weeks (period 2),all patients were only treated by western medicine.The value of FBG,P2BG,HbAlc,TC,TG,BMI of the two periods were comprehensively evaluated by the methods of fuzzy mathematics.ResultsAt the end of period 1,the total effective rate of the type of heat with yin deficiency was 91.38％,the type of deficiency of both qi and yin was 87.16％,and the type of deficiency of both yin and yang was 83.34％; while at the end of period 2,the total effective rate of the three types was 59.18％,48.65％a nd32.65％ respectively.ConclusionThe effective rate was obviously improved in period 1; while in period 2,the effective rate was decreased.

Objective: To analyze the correlated risk factors of endodontic interappointment emergencies(EIAE) and the intervention effect of microwave endodontic sterilization. Methods: 163 patients with chronic periodontitis, pulpitis or dental pulp necrosis (without acute inflammation) were involved in the study. All the patients were distributed into microwave group (n=80) and control group (n=83) randomly. Unitarily finished endodontic therapy was conduced in microwave group after the microwave endodontic sterilization. Same endodontic therapy was applied in control group but without microwave endodontic sterilization. Risk factors of EIAE were investigated by releasing questionnaire. Logistic regression analysis was used to analyze the data. Results: Incidences of EIAE were related to age, gender, the position of the tooth, with or without fistula, filling condition and with or without microwave endodontic sterilization. The risk factors of EIAE of ultra-filling, posterior inferior tooth,the age older than 45 years and the female was 3.32,3.49, 5.87 and 3.71 respectively (P