O bjective Different degrees of oxidative stress may exist in patients with diabetes mellitus (DM).The aim of this study was to explore the roles of oxidative stress and the level of vascular endothelial growth factor ( VEGF) in the development and progression of DM in the rat model of type 1 DM (T1DM). Methods We established the T1DM model in 23 male SD rats and in-cluded another 17 in the control group .We determined the total anti-oxidation capacity ( T-AOC) and the levels of super-oxide dis-mutase (SOD), glutathione (GSH), and malondialdehyde (MDA) by chromatometry, and measured that of VEGF by ELISA. Results At 7 weeks after modeling, the level of fasting blood glucose(FBG) was significantly increased in the T1DM rats as com-pared with the controls ([23.01 ±3.62] vs [5.08 ±0.46] mmol/L, P<0.05); the levels of GSH and SOD were markedly lower (18.8 [0.36] vs [3.82 ±1.05] g/L and [192.06 ±34.57] vs [242.37 ±32.79] U/mL, both P<0.05) while those of serum MDA and VEGF remarkably higher in the T1DM than in the control rats ([4.94 ±0.63] vs [4.42 ±0.37] nmolm/L and [23.97 ±1.84] vs [22.32 ±1.71] pg/mL, both P<0.05);no statistically significant differences were found in T -AOC between the two groups (P>0.05).FBG was correlated positively with MDA (r=0.51) and VEGF (r=0.47) but negatively with GSH (r=-0.71) and SOD (r=-0.40), while serum VEGF positively with MDA (r=0.32) and negatively with GSH ( r=-0.34 ) in the experimental rats . Conclusion Peroxidation is increased and the anti-oxidation mecha-nism weakened during the development and progression of T 1DM, which is closely related to hyperglycemia .High VEGF is associated with hyperglycemia and enhanced peroxidation .

Objective To observe the clinical effects of prostaglandin E1 on liver cirrhosis patients and evaluate its security. Methods 68 cases with liver cirrhosis admitted in Luqiao hospital were randomly divided into experimental group(34 cases)and control group(34 cases)equally. Patients in control group were received normal therapy,while in experimental group were added prostaglandin E1 on basis of normal therapy. The efficacy and adverse reactions were observed and compared. Results Compared with before treatment,the average value of albumin in two groups were increased obviously,which in experimental group from (27.9 ±4.1)g/L to (36.5 ±4.3)g/L,control group from (27.8 ±4.0)g/L to (31.7 ±4.2)g/L,the differences were significant(P<0.05 ),and the difference between two groups was significant(P<0.05 ),too. The content of alanine aminotransferase and aspartase aminotransferase in two groups were decreased significantly(P<0.05 ),and experimental group was more lower than control group(P<0.05 ). The number of effcacy in experimental group was 28 and account for 82.35%,while in control group was 1 1 and account for 32.35%,the difference was significant(P<0.05). Conclusion Prostaglandin E1 can improve liver function,and has good clinical effects and high security in treatment with liver cirrhosis patients.

Objective To explore the diagnostic value of gram-stained sputum smears in elderly patients with ventilator-associated lower respiratory infection (VALRI).Methods 368 elderly patients undergoing mechanical ventilation over 48 hours in ICU were retrospectiely analyzed from Jun 2009 to Jun 2011.42 patients fulfilled the inclusion criteria (with good-quality sputa and presence of the same microorganism in sputum and blood cultures).58 gram-stained smears and sputum cultures were obtained and analyzed.Results The diagnostic sensitivity and specificity of Gram-positive bacteria and Gram-negative bacteria by gram-stained smears were 82.35％ and 78.05％,80.49％ and 82.35％,respectively.The positive and negative predictive value of Gram-positive bacteria and Gramnegative bacteria were 63.64％ and 91.43％,91.67％ and 60.87％,respectively.The coincidence rates in diagnosing Gram-positive bacteria and Gram-negative bacteria were 81.03％ and 79.31％,respectively.Conclusions Gram-stained sputum smear is reliable in diagnosing ventilator-associated lower respiratory infection in elderly patients,and has a certain clinical significance in guiding to the selection of antibiotics.

OBJECTIVE:To provide reference for the construction and development of hospital modernization pharmacy in Chi-na,and to promote the application of pharmacy automation system in hospital. METHODS:By introducing the change of pharma-cy management due to the debugging and application of outpatient pharmacy automation system(rapid dispensing machine,intelli-gent access machine)in our hospital,the problems of automation system and countermeasures were put forward,and the effects of automation system in our hospital were evaluated. RESULTS:With the application of automation system,the pharmacy layout was adjusted,the drugs in the machine was debugged and optimized,the procedure on adding drugs and stocktaking drugs were im-proved,the reasonable scheduling work in outpatient pharmacy was worked,the complete management plan on validity of drugs was established;referring to the problems of automation system,the procedures of adding drugs by rapid dispensing machine and intelligent access machine were formulated as well as related working guide. The adding and delivering drug failure emergency han-dling procedure of rapid dispensing machine,intelligent access machine failure emergency handling procedure were formulated ac-cording to the possible fault of automation system. Related index evaluation showed that automation system was applied and continu-ously improved,which reduced labor intensity(step count of pharmacists adding drug decreased from 5 634.6 steps/day to 4 087.8 steps/day);the work efficiency was improved greatly(the number of prescriptions increased from 226.55 sheets/h to 311.55 sheets/h during rush hours);the work error was reduced(the number of dispensing internal error decreased from 54.75 items/week to 21.50 items/week). CONCLUSIONS:After appling the automation system in outpatient pharmacy,the drug dispensing and staff manage-ment has been standardized,and it become the hospital pharmacy development inevitable trend. But it is suggested to adjust and op-timize the automation system continuously so as to exert its maximal efficacy.

Objective To analyze the characteristics and the related risk factors of the contractility of pelvic floor muscles in old women with pelvic floor dysfunction(PFD).Methods A cohort of 125 elderly patients with symptoms of pelvic floor dysfunction,including 60 of postpartum urinary incontinence(SUI)and 65 of pelvic organ prolapse(POP),were recruited.60 women volunteers with normal pelvic floor function were recruited as a control group.A questionnaire survey was conducted to record the general situation of the subjects.The pelvic floor muscle strength was determined by the methods of electromyography and pressure feedback recording.Results The body mass index,the average number of delivery,newborn baby's body weight were significantly higher in the SUI and POP group than in control group,with statistically significant difference(F=5.29,6.27,5.26,P=0.007,0.003,0.008),but without statistically significant difference between SUI and POP groups (P =0.674,0.554,0.578).The rapid contractility value was significant lower in SUI group than in POP and control groups(all P＜0.01),and the sustained contractility value was significant lower in POP group than in SUI and control groups(all P＜0.01).Conclusions The postpartum pelvic floor dysfunction may be correlated with BMI,vaginal delivery rate,the average number of delivery,newborn baby's body weight and a history of increased abdominal pressure.The postpartum pelvic floor dysfunction may be associated with the declined contractility of pelvic floor muscle,among which the POP may be associated with class Ⅰ muscle and the SUI with class Ⅱ muscle.

Objective To investigate the pancreas size and echo characteristics of patients with glucose metabolism disorders including type 2 diabetes,and to study its related factors.Methods One hundred and fifty-seven patients from Nanjing Drum Tower Hospital with normal glucose metabolism,impaired glucose regulation,newly diagnosed type 2 diabetes and established type 2 diabetes were collected.The average gray scale intensity of the liver,kidney,pancreas region of interest was measured by using the histogram method.Then the liver and kidney echo ratio,liver attenuation coefficient was calculated,and the fat content of liver was determined by using formula.The size of pancreas head,body and tail was detected by ultrasound,and the sum of three values was used as the pancreas size indicator.Univariate and multivariate logistic regression analysis was performed on the size of pancreas and intensity of echo.Results The size of pancreas ranged from 2.39 ～ 6.09 cm with a mean size of (4.43 ± 0.59) cm,and the size was ≤ 5 cm in 130patients,＞5 cmin 27 patients.The intensity of echo ranged from 41.0 ～ 190.6 with a mean number of 120.0 ±31.1,and the intensity of echo was ≤120 in 83 patients,＞ 120 in 74 patients.The content of liver fat ranged from-1.11％ ～ 62.50％ with a mean number of (15.67± 11.97)％.Univariate logistic regression analysis suggested the size of pancreas was related to age and obesity,and pancreas echo was related to obesity degree,types of participants,the level of blood glucose,and grade of fatty liver (all P ＜ 0.05).Multivariate logistic regression analysis indicated obesity degree is the most important factor for prediction of pancreas size and echo (P ＜ 0.05).Conclusions Quantitative ultrasound measurement of pancreas size and echo can reflect the degree of fat infiltration of pancreas,and it has some clinical value.

We developed a three-dimensional finite element model of the shoulder glenohumeral joint after shoulder arthroplasty including humerus shaft, scapular, scapular cartilage and eight muscles, while each of the muscles was simulated with 50 spring elements. To reduce the element number and improve the analytical precision, we used mixed tetrahedral and hexahedral elements in the model. We then used the model to calculate the biomechanics of the shoulder glenohumeral joint after hemiarthroplasty during humeral external rotation. Results showed that the maximum joint reaction force was 374.72 N and the maximum contact stress was 6. 573 MPa together with the contact areas at 40 degrees external rotation. These might be one of the reasons for prosthetic disarticulation, and would provide theoretical bases to prosthetic design.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Humeral Head ; anatomy & histology ; Models, Anatomic ; Prosthesis Design ; Range of Motion, Articular ; Rotation ; Shoulder Joint ; anatomy & histology

Objective To explore the clinical value of expression of CEA and CK-20 detected by flow cytometry (FCM) in peritoneal washes on predicting peritoneal metastasis and prognosis of gastric carcinama.Methods Clinicopathological characteristics and follow up data of 105 patients with gastric carcinoma who were underwent D2 radical resection (R0) were collected.Peritoneal washes was collected.Peritoneal lavage cytology examination (PLC) was used to find intraperitoneal free cancer cells (IFCC).FCM was used to determine the CEA and CK-20 expressions.Meanwhile,13 patients with benign lesion on the stomach and the gastric carcinama cell line SGC-7901 were served as the negative and positive control,respectively.Results Positive expression of CEA was in 48 (45.7 ％) patients,of CK-20 was found in 67 (63.8 ％) patients,and of CEA and CK-20 was in 85 (81.0 ％) patients by FCM.However,positive expression of IFCCs was found in 31 patients(29.5 ％) by PLC.The expression of CEA and CK-20 were related to serosa invasion,lymphnode metastasis and pTNM stage (P ＜ 0.05).The median survival of patients with negative expression of both CEA and CK-20 (n =20) was significantly longer those with positive expression (n =30)(52 vs 18 months,P ＜ 0.05).Conclusions Combined Detection of CEA and CK-20 in peritoneal washes by FCM can be used to predict peritoneal micrometastasis and may predict the prognosis of gastric carcinoma.

Objective To study the effects of benzyl propionate nandrolone (BPN ) on the nicotinamide phosphoribosyl transferase (Nampt), insulin receptor substeate-2 (IRS-2 )and pancreatic duodenal homeobox-1 (PDX-1)expressions, cell cycle changes as well as insulin secretion in pancreatic islet cell NIT-1 lines, and to explore the influence of BPN in the Nampte xpression in NIT-1 cells and insulin signaling molecules in high glucose oxidation stress.Methods The NIT-1 cells were cultured with different concentrations (5.6,11.1,16.7,and 27.6 mmol·L-1)of glucose,then they were treated with 10 mg·L-1 BPN for 48 h with no BPN treatment as corresponding control groups.The expression levels of Nampt,IRS-2,and PDX-1 were tested by Western blotting assay.The changes of cell cycle were determined by FCM and the cell insulin secretion levels were measured with radioimmunoassay.Results Compared with corresponding control groups,the expression levels of Nampt,IRS-2, and PDX-1 proteins in the NIT-1 cells in various BPM groups were increased (P<0.05 or P<0.01).The G0/G1 phase arrest was relieved (P<0.01)when the cells was cultured in low glucose (5.6 mmol·L-1 )condition,and the G2/M block was remitted significantly in high glucose (27.6 mmol·L-1 )condition (P<0.01),furthermore, the cell insulin secretion was promoted compared with control groups except 1 1.1 mmol· L-1 glucose group (P<0.01).Conclusion BPN can promote the expression levels of Nampt,ISR-2 and PDX-1 proteins in NIT-1 cells. There is close relationship between the Nampt expression in NIT-1 cells and insulin signaling pathway and BPN prevents the cells from insulin resistance.

Objective To evaluate the effect of acupressure on chemotherapy-induced digestive tract reaction of malignant tumor patients.Methods We searched Pubmed,Medline,Embase,AMED,Cochrane Library,Cancerlit and Cinabl,China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),VIP database (VIP)and Wanfang database,the databases were searched from the establishment of the database to March 2014.We identified randomized controlled trials (RCTs) and of acupressure on chemotherapy-induced digestive tract reaction for malignant tumor patients.Results In total,8 RCT,959 patients were included.Meta-analysis showed that compared with the no implementation of acupressure,acupressure could effectively reduce the frequency,duration and severity of chemotherapy-induced nausea,vomiting and retching.Meanwhile,acupressure could decrease anti-emetic medication dosage,but could not increase quality of life.Conclusions Acupressure can improve the digestive tract reaction of malignant tumor patients,alleviate the suffering of patients.Meanwhile acupressure couldn't increase the medical burden and mental burden of patients.More attention should be paid to the effect of acupressure on baseline level of state anxiety,functional state and more items.