Objective:To evaluate the application status and change trends of insulin and its analogs in Nanjing area during 2011 to 2013. Methods:The varieties, sales amount and DDDs of insulin and its analogs in 43 hospitals of Nanjing during 2011 to 2013 were analyzed. Results:The use of insulin and its analogs was increased year by year from 2011 to 2013 with the average annual growth rate of 16%. Glargine, pre-mixed insulin 30R, aspart 30, human insulin and aspart ranked the top five in the sum of money with the proportion above 80%. Pre-mixed insulin 30R, aspart 30, glargine, human insulin and common insulin ranked the top 5 in DDDs. Conclusion:The application of insulin and its analogs is wide in clinics, and the usage and sum of money both show rapid growth trend.

P2 X7 receptor is a member of ATP-gated non-selective cation channels;and is one subtype family of the P2X purinergic receptor.Signaling pathways of P2X7 receptor couple with several key inflammatory molecules including IL-1β;IL-6 and COX-2;which suggests that P2 X7 receptor plays a key role in the development of dis-eases via increased inflammation;indicating its potential as a novel therapeutic target.Recent studies show that P2 X7 receptor has a relationship with renal diseases.This article reviews the effect of P2 X7 receptor on renal diseases and its mechanism.P2 X7 receptor may be a new drug target;and its selectivity antagonist may be a new therapeutic agent for the treatment of renal diseases.

Because of their physiological and anatomical immaturity, premature infants are prone to disorders of glucose metabolism. In the ifrst week after birth, infants have the greater risk of abnormal glucose metabolism. Compared with term infants, the glucose/insulin homeostasis of preterm infants is very different. This article reviewed the characteristics of glycometabolism in premature infant and the methods of glucose test.

Multidrug resistance (MDR) is the phenomenon observed in tumor cells that describes the simultaneous emergence of cellular resistance to the cytotoxic attack by structurally and mechanism unrelated chemotherapeutic drugs. The mdr 1 gene was sufficient to confer the MDR phenotype, including the expression of the P Glycoprotein (P Gp). P Gp appears to play an important role in tumor cells by acting as an energy dependent efflux pump to remove various drugs from the cell before they have a chance to exert their cytotoxic effects. It is generally accepted that reversal or inhibition of P Gp function in tumor cells is an important way for modulating MDR. It has been demonstrated in the laboratory that MDR mediated by the P Gp may be modulated by a wide variety of compounds. These compounds , which include verapamil and cyclosporin, generally have little or no effect by themselves on the tumor cells, but when used in conjunction with antineoplastic agents, they decrease, and in some instances eliminate, MDR. This paper will introduce some new reversal agents and discuss their physical and chemical characteration and others.

0.05). ③All of the OSAHS patients suffered seri-ous lipid metabolic disorders. CONCLUSION ① Fatty infiltration in the pharyngeal tissue may lead to collapse of the pharyngeal airway during sleep. ②The epithelial cells of mucosa,endothelial cells of small vessels and glandular cells of minor salivary glands can potentially produce leptin. Leptin existing with Ob-Rb shows the peripheral action of leptin. The positive ex-pression of leptin and Ob-Rb had no significant differ-ence between the two groups, which may explain theectopic accumulation of lipid. ③ Disordered lipid me-tabolism may not be the determinant factor in the patho-genesis of OSAHS. ④ Endogenous hyperleptinemia may be the protective response to respiratory distur-bance and disordered lipid metabolism, and is also as-sociated with the continuous hypersympathetic activity. The level of leptin in plasma has a positive correlation with the severity of OSAHS.

Objective To explore the clinical value of enhanced recovery after surgery (ERAS) in the perioperative period of biliary surgery.Methods The prospective study was adopted.The clinical data of 800 patients diagnosed as benign biliary tract diseases who were admitted to the Cangzhou's Central Hospital from March 2011 to January 2015 were collected.Patients were randomly divided into the case and control groups by random sequence method.The patients of case group received the ERAS management and patients of the control group received traditional perioperative management.(1) Stress state evaluation:the insulin resistance (IR) index and level of serum C-reactive protein (CRP) were calculated.(2) Levels of inflammatory cytokines:levels of IL-6 and TNF-α in the 2 groups were detected by enzyme-linked immunosorbent assay (ELISA).(3)Nutritional status:level of serum prealbumin (PA) was detected.(4) Postoperative status:time to anal exsufflation,time of defecation,duration of hospital stay and treatment expenses were recorded.(5) Postoperative complications were observed.Measurement data with normal distribution were represented as x ± s and comparison between groups was analyzed using t test.Repeated measurement data were analyzed by the repeated measures ANOVA.Count data were represented as ratio and analyzed using the chi-square test.Results The 800 patients were screened for eligibility,including 400 in each group.(1) Stress state evaluation:the levels of IR and CRP from pre-operation to 7 days after operation were from 3.8 ± 0.8 to 3.7 ± 0.7 and from (18 ± 5) μg/L to (27 ±8) μg/L in the case group,from 3.9 ±0.9 to 3.8 ±1.0 and from (18 ±5) μg/L to (38 ±9) μg/L in the control group,respectively,with statistically significant differences in the changing trends (F =12.38,17.85,P ＜0.05).(2) Comparisons of levels of inflammatory cytokines:levels of IL-6 and TNF-α from pre-operation to 7 days after operation were from (9.3 ± 3.1) ng/L to (12.5 ± 2.8) ng/L and from (10.2 ± 3.5) ng/L to (12.8 ±3.3)ng/L in the case group,from (8.9 ±3.3)ng/L to (17.3 ±6.5)ng/L and from (9.9 ±2.8) ng/L to (14.3 ±4.2)ng/L in the control group,with statistically significant differences in the changing trends (F =19.93,15.74,P ＜ 0.05).(3) Comparison of nutritional status:level of PA from pre-operation to 7 days after operation was from (335 ± 53)mg/L to (332 ±50)mg/L in the case group and from (330 ± 49)mg/L to (331 ± 45)mg/L in the control group,with a statistically significant difference in the changing trends (F =4.46,P ＜ 0.05).(4)Comparisons of postoperative status:time to anal exsufflation,time of defecation,duration of hospital stay and treatment expenses were (30 ± 10)hours,(51 ± 13) hours,(7.7 ± 2.5) days,(10.2 ±2.3) × 103 yuan in the case group and (54 ± 8) hours,(70 ± 16) hours,(15.4 ± 3.1) days,(15.6 ± 4.7) × 103 yuan in the control group,with statistically significant differences (t =37.73,18.62,38.67,20.64,P ＜0.05).(5) Comparisons of postoperative complications:incidence of complications was 15.00％ (60/400)in the case group and 22.50％(90/400) in the control group,and the numbers of patients with incision infection,nausea and vomiting,abdominal infection,intra-abdominal infection,urinary tract infection,intro-abdominal hemorrhage and bile leakage were 23,15,8,5,4,3,2 in the case group and 30,20,13,10,7,5,5 in the control group,respectively,showing statistically significant differences in the incidence of complications (x2=7.39,P ＜ 0.05).Conclusion ERAS management in the perioperative period of biliary surgery is beneficial to postoperative recovery of patients,and it can also relieve postoperative stress state and inflammatory response,reduce the duration of hospital stay,treatment expenses and incidence of postoperative complications.

The role of myeloid-derived suppressor cells (MDSCs)in promoting inflammatory response and immune escape of tumor cells and the mechanism by which MDSCs promote the development and progression of tumors are reviewed.This could provide a new way for the investigation of immunological mechanism of liver fibrosis and liver cancer.Besides,MDSCs may be an effective therapeutic target for liver cirrhosis and liver cancer.

Hypopharyngeal cancer is considered to be one of the head and neck tumor with poor progno -sis.The clinical curative effect of different treatments for hypopharyngeal cancer is also different .Surgery and ra-diotherapy of comprehensive treatment are the main treatments of hypopharyngeal cancer .Chemotherapy and bio-logical therapy also plays an important role on hypopharyngeal cancer .In this paper,we summarize the clinical curative effect of different treatments for hypopharyngeal cancer .

Objective To optimize the temporal bone scanning parameters, upgrade the picture quality, shorten the scanner time, and decrease the radiographic exposure during the scanning. Methods The scanning was performed on 20 volunteers using 16 spiral CT in the same position and range with optimizer parameters and general parameters respectively, and then the volume data were collected. Results Through comparision and analysis of the images of the 20 volunteers, 17 of them using the optimizer parameters were better than those using general ones, 2 of them showed no obvious difference, and 1 was not as good as the general one. Conclusions Through the experiment and the statistics of 1000 cases using optimizer parameters, the picture quality using optimizer parameters is better, the scanner time is 1/7 of the general scanning, and the radiographic exposure is decreased. Optimizer parameters are better than the general ones and worth popularizing.