Objective To investigate the effect of hyperuricemia on early renal damage in patients with type 2 diabetic,and to explore the improvement of albumin-to-creatinine ratio (ACR) after lifestyle intervention to control the level of serum uric acid.Methods One hundred and sixty patients with type 2 diabetic mellitus from our hospital from January 2012 to December 2012 were recruited and divided into the high uric acid group (HUA,60 cases),and the normal uric acid group (NUA,100 cases).Fasting blood glucose (FBG),insulin (FINS),glycosylated hemoglobin (HbA1c),serum lipid levels,morning urine albumin-to-creatinine ratio (ACR) were detected in each group,and body mass index (BMI),insulin resistance index (HOMA-IR) were calculated.The HUA group was intervened by lifestyle for at least 6 months,and related indexes were measured again.Results The FINS,HOMA-IR,ACR and triglyceride(TG) of the patients in the HUA group were higher than that in the NUA group((110.33 ±38.73) pmol/L vs.(72.64 ±21.94) pmol/L,t =2.876; (7.0 ±2.3)vs.(4.6±1.3),t =2.364;13.6(5.1,53.2) mg/mmol vs.6.4(2.9,16.8) mg/mmol,H=3.390;(2.53± 1.45) mmol/L vs.(1.71 ± 1.32) mmol/L,t =2.626 ; P ＜ 0.05).By the Spearman correlation analysis,the level of serum uric acid was positively correlated with FINS,HOMA-IR,ACR,and BMI (r =0.304,0.225,0.248,0.271 respectively; P ＜ 0.05).After adjusting the factor of age,duration,obesity,blood glucose and insulin resistance,the level of serum uric acid was still positively correlated with ACR (r =0.312,P ＜ 0.01).The FINS,UA,HOMA-IR and ACR in group HUA were lower than those before lifestyle intervention ((463.7± 18.6) μmol/L vs.(380.3 ± 9.5) μmol/L,t =3.065 ; (110.33 ± 38.73) pmol/L vs.(83.30 ± 28.21)pmol/L,t =2.532; (7.0 ±2.3) vs.(5.0 ±0.9),t =2.165;13.6(5.1,53.2) mg/mmol vs.8.1(4.9,20.4)mg/mmol,H =2.912 ; P ＜ 0.05).Conclusion The patients with type 2 diabetes complicating hyperuricemia were likely to having abnormal ACR.Controlling the level of serum uric acid by lifestyle intervention may be benefit for delaying the development of early diabetic nephropathy in patients with type 2 diabetes.

Objective To observe the clinical efficacy of small needle therapy in the treatment of retrograde lumbar spine stenosis. Methods About 30 patients with retrograde lumbar spinal stenosis from June 2015 to March 2016 were set as control group;30 patients with the same disease from ApriI 2016 to December 2016 were set as observation group. The control method of traction and massage therapy, the observation group on the basis of increased by small needle knife therapy. Result The effect of the observation group was better than the control group, the difference was statistically significant (P<0.01). Conclusions Treatment of retrograde lumbar spinal stenosis with small needle knife therapy is effective in treating patients' pain and improving clinical effect. Well condition observation and nursing during the treatment can ensure the smooth progress of treatment, the correct guidance and urged patients to exercise to reduce the recurrence of the disease, has the vital significance.

Objective To investigate the clinical effect and safety of alpha lipoic acid injection combined mecobalamin and prostaglandin E on type 2 diabetic patients complicated with diabetic peripheral neuropathy(DPN).Methods One hundred and sixty type 2 diabetic patients complicated with DPN in the General Hospital of Benxi Iron and Steel Group Corporation from Jan.2011 to Dec.2012 were randomly divided into the treatment group(n =80) and the control group (n =80).Three cases of the treatment group and 5 cases of the control group discharged early from the study because of their own reasons.There were 77 cases in the treatment group and 75 cases in the control group.On the basis of controlling blood glucose,patients in the two groups were given 500 μg mecobalamin combined with intramuscular injection once two days,as well as prostaglandinE 10 μg injection once a day.Patients in treatment group were added with 600 mg alpha lipoic acid for intravenous injection once a day for 10-14 days.Total symptom score (TSS),nerve conduction velocity,satisfaction and adverse reactions were evaluated before and after treatment.Results TSS score,tingling score,burning sensation score and hypoesthesia score,numb score in treatment group were (3.5 ± 2.5),(1.1 ± 0.4),(0.9 ± 0.7),(1.3 ± 0.4),(1.3 ± 0.9),significantly lower than those in control group (4.3 ± 2.1,t =2.11,P ＜0.05;1.5 ±0.5,t =1.86,P＜0.05;1.3 ±0.5,t =1.83,P ＜0.05;1.7 ±0.5,t =1.87,P ＜0.05; 1.9 ± 0.4,t =1.91,P ＜ 0.05).The median nerve conduction velocity,peroneal nerve motor conduction velocity,median nerve sensory conduction velocity,common peroneal nerve sensory conduction velocity of patients in treatment group were (53.6 ± 1.4) m/s,(49.6 ± 1.1) m/s,(47.3 ± 1.1) m/s,(48.2 ± 1.9) m/s,lower than those in control group((48.5 ±2.7) m/s,t =-4.94,P ＜0.05;(43.9 ±2.1) m/s,t =-5.36,P ＜0.05; (41.6 ± 1.8) m/s,t =-5.09,P ＜0.05;(43.2 ±2.5) m/s,t =-4.27,P ＜ 0.05,P ＜0.05).In the treatment group,97.4％ (75/77) physicians and 92.2％ (71/77) patients were satisfied with treatment effect,while in the control group,84.0％ (63/75) physicians and 78.7％ (59/75) patients were satisfied with treatment effect.During the study periods,there were 3 cases with facial flushing and 1 cases of dizziness in the treatment group,and 2 cases of facial flushing and 1 cases of dizziness in the control group.All adverse reactions were spontaneous remission without any special treatment.Conclusion Alpha lipoic acid intravenous drip is effective in term of treating type 2 diabetic peripheral neuropathy,and with high safety.

Objective To study the effect of simvastatin(SV) on NF-kappa B p65 expression in liver of insulin resistant rats. Methods Male Wistar rats were divided into two groups:basic chow(NC,n=15)or high-fat diet(HF,n=20)for 10 weeks feeding, then assessed by euglycemic-hyperinsulinemia clamp technique. Rats in HF group were treated with(HFS,n=5)and without (HFN,n=5) SV 10mgkg-1d-1 in gavage for 5 weeks.NF-kappa B p65 expressions were tested with Western blot. Results The glucose infusion rate (GIR) in HF group decreased significantly compared with NC group (P

Objective To investigate the difference of serum high sensitivity C-reactive protein(hs-CRP)concentrations in subjects with various glucose tolerances,and to analyze the correlation with insulin resistance.Methods A total of 90 subjects,who came from the Medical Examination Center of the First Hospital Affiliated to China Medical University from Oct.2004 to Apr.2005,were divided into five groups according to oral glucose tolerance test(OGTT):normal glucose tolerance(NGT)group;impaired fasting glucose(IFG)group;impaired glucose tolerance(IGT)group;IFG and IGT(IGT/IFG)group;newly diagnosed,complication-free type 2 diabetes(T2DM)group.By using the ELISA methods,the concentration of serum high sensitivity C-reactive protein(hs-CRP)was measured in these subjects,and its correlation with homeostasis model assessment insulin resistance index(HOMA-IR)was andlysed.Results The concentration of hs-CRP was significantly higher in IFG,IFG/IGT,T2DM than in NGT.The concentration of hs-CRP was positively correlated with glucose metabolism index and insulin resistance index.Conclusion Our study demonstrates that inflammation already exists not only in T2DM patients but also in subjects with IFG.Inflammation might participate in the occurance and development of T2DM.

Objective To observe the effect of tetraethylplyrazine(TMP) on outward K~+ channel of outer hair cells in guinea pig cochlea.Methods 60 guinea pigs were divided into 6 groups randomly in the experiment.Auditory brainstem response was used to monitor the change of ABR thresholds and patch clamp techniques to observe the effect of TMP on outward K~+ channel.Results TMP decreased the elevated ABR threshold caused by streptomycin. The TMP increased the amplitudes of calcium sensitive potassium channels (I_ K(Ca) ) and delayed outward potassium channels (IK) of outer hair cells of guinea pig cochlea.Conclusion The study indicates that TMP may act as a protective agent against ototoxicity of streptomycin. The amplitudes of I_ K(Ca) and IK of outer hair cells are increased by the TMP,suggesting the possible mechanisms of reducing ototoxicity.

Objective To study the association of the serum soluble intercellular adhesion molecule-1(SICAM-1) and soluble vascular cell adhesion molecule-1(SVCAM-1) with metabolic syndrome(MS) and its components. Methods The MS was defined by criteria of the international diabetes federation. The levels of SICAM-1 ,SVCAM-1,plasma glucose,insulin,lipids,uric acid, glycosylated haemoglobin A(1C), and blood viscosity were measured. Results The concentrations of SICAM-1 and SVCAM-1 were significantly higher in subjects with MS and its components than in those without them. The concentrations of SICAM-1 and SVCAM-1 were correlated positively with disorder number of BMI, WHR, SBP, DBP,FPG, 2 hour plasma glucose, triglyceride, uric acid, HbA1c, blood viscosity and HOMA-IR,and negatively with high density lipoprotein cholesterol. Conclusions The concentrations of SICAM-1 and SVCAM-1 rise with the increase of the number of MS components. Endothelial dysfunction might participate in the occurrence and development of MS.

Objective To investigate the clinical efficacy of postoperative three-dimensional conformal radiotherapy concurrent with paclitaxel +TS-1 chemotherapy in the treatment of advanced gastric carcinoma.Methods A total of 60 patients with advanced gastric carcinoma were randomly divided into treatment group and control group.In treatment group,30 patients received simultaneous three-dimensional conformal radiations therapy combined with paclitaxel +TS-1 chemotherapy.In control group,30 patients received paclitaxel +TS-1 chemotherapy.The long term survival rate,local recurrence rate and side reactions were observed in two groups.Results The 1,2-year survival rate in treatment group [93.1％ (27/29),75.9 ％ (22/29)] and control group [72.4 ％ (21/29),48.3 ％ (14/29)] had significant difference (P ＜ 0.05).The 1,2-year local recurrence rate in treatment group [6.9％ (2/29),13.8％ (4/29)] and control group [31.0％ (9/29),44.8 ％ (13/29)] had significant difference (P ＜ 0.05 or ＜ 0.01).The side reactions in two groups were mainly manifested as leukopenia,thrombocytopenia,anemia,nausea,vomiting,liver function damage and oral mucositis.The incidence rate of nausea,vomiting in treatment group was significantly higher than that in control group [83.3％ (25/30) vs.53.3％ (16/30)] (P =0.012).Conclusions Postoperative threedimensional conformal radiotherapy concurrent with paclitaxel +TS-1 chemotherapy in the treatment of advanced gastric carcinoma may improve the long-term survival rate,lower local recurrence rate.But the adverse reactions are increased.

OBJECTIVE To study the current infection control issues and discuss protocols of nosocomial infection management. METHODS Based on the characteristics and progresses of domestic and international nosocomial infection management,we analyzed the existing problems and countermeasures of some key issues. RESULTS Enhancing nosocomial infection objective-surveillance,the personnel construction,information technology,etc are the chief methods to improve the quality of nosocomial infection control. CONCLUSIONS Adopting some new measures to strengthen the nosocomial infection management is essential and important to the security of medical treatment.

BACKGROUND: Twin-block appliance has been confirmed to efficiently change hard tissue and the profile of soft tissue.Whether a linear relationship exists between soft tissue and hard tissue changes remains unclear.OBJECTIVE: To evaluate the face convexity changes of soft and hard tissues after Twin-block appliance therapy and compare with controls.METHODS: Thirty-one class Ⅱ division 1 malocclusion subjects with hand-wrist radiographs in FG-G stage were selected.Among the 31 patients,17 received Twin-block appliance therapy,serving as experimental group,and the remaining 14 subjects abandoned treatment,serving as control group.Cephalometric radiographs of each included subject were taken prior to and after treatment or observation.Face convexity of soft and hard tissues,as well as the face convexity changes,was compared between the experimental and control groups.Linear regression equation was employed to analyze the linear association between soft-and hard-tissue changes.Regression equations of experimental and control groups were compared.RESULTS AND CONCLUSION: Prior to and after Twin-block appliance therapy,a significant correlation existed between the position changes of superior and inferior alveolar sockets relative to the nose and mandible,and the position changes of upper and lower lip pits relative to the nose and mandible,i.e.,there was a linear correlation between A-E change and Ss-E change,and between B-E change and Si-E change.The largest Pearson's correlation coefficient(0.839)appeared between Si-E change and B-E change,indicating the best correlativity between these two changes.Statistical analysis revealed that the linear equations of face convexity changes of soft and hard tissues after Twin-block appliance therapy were Si-E=0.745 B-E,Ss-E=0.276 A-E.These linear equations would be helpful to explain mandible growth and face convexity change after Twin-block appliance therapy and predict the prognosis of face convexity change.