BACKGROUND: Diabetic retinopathy is a commonly chronic-vascular complication in a course of diabetes mellitus (DM), and its relation with apoptosis and changes of ion level needs to be proved.OBJECTIVE: To observe apoptosis and changes of Na+ and K+ contents in retinal tissue of DM rats.DESIGN: Randomized controlled study.SETTING: Department of Ophthalmology, Liuzhou Municipal People's Hospital.MATERIALS: The experiment was completed at the Department of Ophthalmology, Liuzhou Municipal People's Hospital. A total of forty adult male Wistar rats, aged 20 months, weighing 320-350 g, were provided by Animal Center of Medical College Affiliated to Sun Yat-sen University.METHODS: Forth Wistar rats were randomly divided into control group and experimental group with 20 in each group. Streptozotocin was used to induce DM in the experimental group. Apoptosis and changes of Na+ and K+ contents in retinal tissue were measured on the 4th, 6th, 12th and 16th weeks after DM onset. Rats in the control group were injected only with the same volume of citrate buffer solution. Then, correlations on the aspect of fasting blood glucose (FBG), hemoglobin glycosylation (HbAlc), Na+ and K+ contents and DM course were analyzed between the two groups.MAIN OUTCOME MEASURES: ① Na+ and K+ contents; ② FBG concentra tion and HbAlc level; ③ changes of apoptosis; ④ correlations among markers.RESULTS: Apoptosis could be detected in retinal tissue in the experimental group at 4 weeks after DM onset, and with course elongating, level of apoptosis was aggravated gradually. Na+ concentration was increased in retinal tissue, but K+ concentration was decreased (P ＜ 0.01 or 0.05). Levels of apoptosis in retinal tissue in the experimental group were positive correlation with FBG concentration, HbAlc level, Na+ content and DM course (r=7.584, 7.844, 7.369, 6.246; P ＜ 0.01); however, they were negative correlation with K+ content in retinal tissue (r=7.658, P ＜ 0.01).CONCLUSION: There are apoptosis and abnormal Na+ and K+ contents in retinal tissue of DM rats. Moreover, these changes may be one of pathological bases of diabetic retinopathy.

Objective To investigate the influence provided by irbesartan on aldosterone escape during an-giotensin-converting enzyme inhibitor(ACEI) therapy in patients with essential hypertension (EH). Methods 166 EH patients were treated with ACEI. Plasma angiotensin Ⅱ ( Ang Ⅱ ) and aldosterone(Ald) concentrations were meas-ured by radioimmunoassay following the therapy of 3 months treatment. Aldosterone escape was estimated by the plas-ma Ald level after 3 months treatment. Patients with aldosterone escape were given irbesartan for 6 months. The aldo-sterone escape were observed following the therapy with irebesartan at 1,3,6 months. Results Following the treat-ment of irbesartan for 1 month, plasma Ang Ⅱ and Ald concentrations significantly decreased (P < 0.01 ). However, it began to increase after 3 and 6 months treatment, still lower than that of the therapy not given irbesartan ( P < 0.01 ).The levels of plasma Ang Ⅱ and Aid were higher in 6 months than in 1,3 months ( P < 0.01 ), but there are no differ-ences between 1 and 3 months(P>0.05). Conclusion Irbesartan can reduce aldosterone escape during 6 months.But aldosterone escape may be occur again after 6 months treatment of irebesartan.

0.05) Conclusion Subtotal colectomy and intraoperative colonic irrigation are effective methods for management of obstructing carcinoma in the left colon To select an effective technique depends on the analysis of the practical situations and evaluation of the idiographic complexions.

Objective To investigate the changes of platelet aggregation rate and platelet surface CD 41+CD62P+ expression af-ter clopidogrel discontinuation in the patients with percutaneous coronary interventions (PCI)) .Methods The platelet aggregation rates and platelet surface CD41+CD62P+ in 52 PCI patients with oral clopidogrel for near 12 months and discontinuation soon were measured before clopidogrel therapy(T0 ) ,in 1 week after clopidogrel therapy(T1 ) ,1 week before clopidogrel discontinuation(T2 ) , 1 week(T3 ) and 1 month after clopidogrel discontinuation (T4 ) .Results Compared with T0 ,the platelet aggregation rate and the expression of platelet CD41+CD62P+ at T1 were significantly decreased ,the difference showing statistical significance (P<0 .05) , which at T2 maintained the lower levels ;which at T3 were increased ,which at T4 were recovered to those at T0 .The platelet aggre-gation rates at various time points were (44 .20 ± 18 .36)% ,(25 .38 ± 12 .10)% ,(23 .74 ± 8 .15)% ,(51 .79 ± 10 .55)% and(45 .97 ± 16 .42)% respectively ,and the positive rates of CD41+ CD62P+ were(12 .96 ± 11 .48)% ,(3 .93 ± 3 .33)% ,(4 .72 ± 3 .14)% , (13 .90 ± 10 .38)% and(10 .84 ± 8 .13)% ,respectively .Conclusion In the patients treated with 12-month clopidogrel after PCI ,the platelet aggregation rate and the CD41+CD62P+ positive rate are mildly increased at 1 week after clopidogrel discontinuation and gradually returned to the level before discontinuation at 1 month after clopidogrel discontinuation .

Objective To explore the value of miniprobe sonography (MPS) in differentiating Crohn??s disease (CD) and ulcerative colitis (UC). Methods 46 patients with active inflammatory bowel disease (IBD) were included into the patient group (16 patients with CD and 30 cases with UC). 20 healthy cases ( underwent physical examination in outpatient department) were recruited as the control group. All cases underwent MPS and high sensitive C-reactive protein (Hs-CRP) test.The MPS measurement index include thetotalwallthickness(TWT), mucosal thickness (MT), submucosal thickness (SMT), muscularispropria thickness (MPT), and the number of enlarged colic and paracolic lymph nodes. Results TheTWT, M, SM, MP(mm)and Hs-CRP(mg/L)in CD, UC and control group are 5.84 ± 1.42, 1.48 ± 0.23, 1.88 ± 0.28, 2.31 ± 0.85, 40.58 ± 19.33, 4.74 ± 1.01, 1.79 ± 0.35, 1.41 ± 0.25, 1.32 ± 0.34, 22.41 ± 15.25,2.86 ± 0.23, 0.97 ± 0.13, 1.06 ± 0.11, 0.64 ± 0.0 and 1.70 ± 0.65. TWT, MT, SMT, MPT and Hs-CRP in UC group has significant different with those in controp group(P<0.05). The mean value of TWT, MT, SMT, MPT and Hs-CRP in CD group are higher than those in UC group. M in UC group is higher than that in CE group. The difference is significant(P<0.05). 5 cases in CD and 2 cases with UC had enlarged colic or paracolic lymph nodes. Conclusions The MPS can distinctly observe the changesof different colonic tissue layers and the surrounding tissue structures in IBD patients,which helps for distinguishing active CD from UC.

Objectives To investigate the efficacy and safety of quadruple regimen containing doxycy-cline,amoxicillin and clavulanate potassium in the treatment of Helicobacter pylori(Hp)after the failed initial eradication. Methods A total of 136 patients who had a failed course of initial eradication therapy were randomly divided into four groups. The 46 patients in group A were given rabeprazole,colloidal bismuth tartrate,doxycy-cline,amoxicillin and clavulanate potassium for 14 days). The 45 cases in group B were treated with rabeprazole, colloidal bismuth tartrate,doxycycline,amoxicillin and clavulanate potassium for 10 days. The 45 cases in control group received rabeprazole,colloidal bismuth tartrate,levofloxacin,amoxicillin for 14 days. After 4 weeks of treat-ment,the 13C-urea breath test was performed. The Hp eradication rates,adverse reactions,treatment compliance and cost-effectiveness ratio of the three groups were evaluated. Results A total of 130 patients completed the study. The intention to treat(ITT)and Per-protocol(PP)analyses revealed that the eradication rates of the three groups were 71.74% and 76.74%(group A),71.11% and 72.72%(group B),51.11% and 53.49%(control group),respectively. The ITT and PP of group were significantly higher than those of control group(P < 0.05). But there was no significant difference between group B and control group(P > 0.05). The rates of adverse reac-tions in each group were not statistically significant(P > 0.05),and the patient compliance of three groups was more than 80%. The cost and cost-effectiveness ratio showed that group B < control group < group A. Conclu-sions The quadruple therapy containing doxycycline,amoxicillin and clavulanate potassium as a rescue regimen given for 14 days is safe,effective and with high patient compliance,which is of high clinical significance.