BACKGROUND: Diabetic cardiomyopathy is closely related to the high incident rate of diabetic heart failure. It is extremely significant to set up the successful dietetic cardiomyopathy model for the study on improving cardiac function.OBJECTIVE: To understand the influence of high blood sugar on myocardium by setting up the model of type 2 diabetes and diabetic cardiomyopathy.DESIGN: Completely randomized design, randomized and controlled study,in which, the experimental animals were taken as the objects.SETTING: Department of endocrinology of a university.METHODS: In the experiment, 99 newly born Wistar male rats were employed, randomized into experiment group (75 rats) and the control group(24 rats). In the control group, abdominal injection was done with sodium citrate buffer and the single abdominal injection was done with strptozocin(STZ)90 mg/kg in the experiment group. Ten weeks later, the glucose tolerance was assayed to determine the set-up of diabetes model. The ultrastructure of myocardium of rats was tested under electronic microscope after being sacrificed.MAIN OUTCOME MEASURES: To observer whether the myofibrillae and mitochondria of myocardiocytes alter or not in diabetic rats.RESULTS: In the experiment group, the fasting blood sugar[(8.87± 0.76)mmol/L] was slightly higher than that[ (5.88 ± 0. 45)mmol/L] in the control group, the blood sugar 2 hours after meal was remarkably higher than that in the control group and the glucose tolerance was abnormal. Under the electronic microscope, the myofibrillae presented focal degeneration and disarranged order of myofilament; mitochondria of myocardiocytes presented swelling and focal proliferation.CONCLUSION: This model is the satisfactory carrier for the study on diabetes Ⅱ and its myocardiopathy, which lays an experimental foundation for the study on cardiac function of type 2 diabetes.

Objective To improve the recognition of dermatomyositis (DM) complicated with intracranial neoplasma and to explore its pathogenesis aimed to collect the experience of diagnosis and treatment. Methods Twelve DM patients complicated with intracranial neoplasma were analysed and the literature of recent 23 years were reviewed. Results DM complicated with intracranial neoplasma was associated with the p53 genic mutation and it was rare because of blood-brain barrier and scanty of lymphocytes in brain tissue. Correct diagnosis depended on clinical manifestations and the computerized tomography or the magnetic resonance imaging of brain. Glucocorticoid was the first choice treatment.However, removal the neoplasma was necessary. Conclusion DM complicated with intracranial neoplasma is rare. Clinicians should make the diagnosis promptly and chosen the appropriate treatment.

Objective To analyze the clinical risk factors of the occurrence of severe proliferative vitreoretinopathy (PVR) after scleral reattachment surgery. Methods A total of 4 031 eyes of 4 031 consecutive patients with reghmatogenous retinal detachment (RRD) and PVR (grade C1 or less), on whom the scleral buckling was performed, were retrospectively studied. Twenty-two clinical characteristics of the patients (including the ocular tension, condition of lens and vitreous, characteristics of retinal detachment, whether or not with choroidal detachment, et al) were recorded. In 4 031 patients, 2 660 were followed up for more than 3 months, and 72 (in PVR group) of the 2 660 patients underwent the second surgery (vitreoretinal surgery) because of the occurrence of postoperative severe PVR; in the other 2 588patients, 72 (72 eyes) with retinal reattachment for more than 3 months were selected randomly as the control. The data were analyzed in SPSS (10.0) software. Results Logistic regression analysis revealed that the significant risk factors for PVR were incomplete posterior vitreous detachment (P2 DD,P

Objective To explore the protective effect of ozone oxidative preconditioning on hepatic ischemia reperfusion injury in rats.Methods Eighteen 8-week-old SPF Sprague-Dawley male rats weighting 250 ～300 g were randomly divided into three groups (n =6 each):sham operation group (group S),ischemia/reperfusion group (group I/R) and ozone oxidative preconditioning group (group O3 + I/R).In Group O3 + I/R,rats received five-day preconditioning treatments by intraperitoneal injection of ozone and oxygen mixed gases (ozone concentration 50 mg/L,1 mg · kg-1 · d-1),and then experienced the procedure of hepatic ischemia/reperfusion injury.Model of hepatic ischemia/reperfusion injury was established by clamping the branches of hepatic artery and portal vein in the median and left lateral hepatic lobes for 45 min,followed by 3-h reperfusion.After reperfusion,blood samples were taken from the aorta abdominalis for detecting serum aminotransferases (ALT & AST).These rats were executed and the hepatic tissue samples were collected for measuring hepatic malondialdehyde (MDA) and superoxide dismutase (SOD) level.Results Compared with group S,concentrations of serum ALT,AST and hepatic MDA were increased in group I/R and O3 + I/R;concentrations of hepatic SOD were decreased (P ＜ 0.05) in group I/R,but concentration of hepatic SOD was increased in group O3 + I/R.Compared with group IR,concentrations of serum ALT,AST and hepatic MDA were decreased,while concentration of hepatic SOD was increased in group O3 + I/R (P ＜ 0.05).Conclusion Ozone oxidative preconditioning could inhibit the lipid peroxidation to protect the rats against hepatic ischemia/reperfusion injury.

To compare the performances of community family physicians in different patterns of chronic disease management.From June 2011 to April 2012,3 different models (A,B,C) of chronic disease management were employed for a total of 4972 patients.Statistics analyses were performed.The number of participants,session and average effective working time were different.In terms of standard management of hypertension,diabetic management rate and non on-site management rate,model C was superior to models A and B (P ＜ 0.01).And model A had the lowest rate of non on-site management (P ＜0.05).Though with each own advantage,three models are complementary.But model C reflects the residents' self-management concept of chronic disease.

Objective To observe the changes and significance of blood fat and myocardial enzymes in patients with hypothyroid myopathy before and after substitutional treatment.Methods The levels of TC, TG, LDL-C,AST, LDH, HBDH and CKMB were detected in 72 cases with hypothyroid myopathy patients before and after substitutional treatment and 60 healthy controls. Results The levels of TC,TG and LDL-C in hypothyroid myopathy patients before substitutional treatment were significantly higher than those in control group ( all P ＜ 0. 05 ), and then significantly low after treatment,which had no significant difference with control group( all P ＞0. 05). The levels of AST,LDH,HBDH and CKMB in hypothyroid myopathy patients before substitutional treatment were significantly higher than those in control group( all P ＜ 0. 05 ) ,and then significantly low after treatment,which had no significant difference with control group( all P ＞0. 05). Conclusion The levels of blood fat and myocardial enzymes were significantly increased in hypothyroid myopathy patients, and recovery to normal after substitutional treatment.

Objective To explore the effect of remifentanil postconditioning on rats subjected to ischemia reperfusion injury and the relative mechanisms.Methods Seventy-eight Sprague-Dawley rats, weighing 200-250 g, were randomly divided into six groups (n=13): sham group (group S), ischemia/reperfusion group (group IR), naloxone group (group NAL), 5 μg·kg-1·min-1 remifentanil postconditioning group (group R1), 10 μg·kg-1·min-1remifentanil postconditioning group (group R2) and 20 μg·kg-1·min-1remifentanil postconditioning group (group R3).Group IR was given 45 min ischemia in the left descending anterior (LAD), followed by a 24-h period of reperfusion.Groups R1, R2, R3 received 10 min of remifentanil infusion of 5, 10 and 20 μg·kg-1·min-1 after 35 min ischemia followed by a 24 h period of reperfusion.Group NAL was given injection of naloxone 0.1 mg/kg at the point of 25 min myocardial ischemia, after 10 min, then remifentanil 10 μg·kg-1·min-1 for 10 min.The myocardial infarct size and pathological changes of myocardial tissue were observed, serum cTnI, LDH and CK-MB level were measured.Results Compared with group S, serum cTnI, LDH and CK-MB and myocardial infarct size were markedly increased in groups IR, NAL, R1, R2 and R3 (P<0.05), and pathologic injury of myocardial cells were augmented.In comparison with group IR, the indexes were decreased in groups R1, R2 and R3 (P<0.05).Conclusion Remifentanil postconditioning could protect against myocardial ischemia reperfusion injury in rats.The protection may be related to remifentanil activating the opioid receptors.There were ceiling effects of remifentanil postconditioning induced myocardial protection.

Objective To explore the effect of standardized rehabilitation training and acupuncture therapy on knee osteoarthritis(KOA).Methods One hundred KOA patients were evenly divided into the treatment group and the control group by random digits table.The control group were treated by acupuncture plus general functional exercise guidance and the treatment group by standardized rehabilitation training and treatment for 3 courses(10 d as 1 treatment course).After 3 courses,the two groups were observed in terms of knee joint pain,joint function improvement and clinical curative effect.Result After treatment,the treatment group was significantly better than the control group in terms of knee joint pain,joint function improvement and clinical curative effect(all P<0.05 ).Conclusion The standardized rehabilitation training combined with acupuncture therapy may be effective in the reduction of the knee pain and improvement of knee function for patients with osteoarthritis.

Objective To evaluate the effect of dexmedetomidine on the intraocular pressure during laparoscopic gastrectomy.Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 34-64 yr,weighing 45-81 kg,scheduled for elective laparoscopic gastrectomy,were randomly divided into 2 groups with 20 patients in each group using a random number table:control group (group C) and dexmedetomidine group (group D).In group D,a loading dose of dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min,followed by continuous infusion of dexmedetomidine at 0.4 μg·kg-1 · h-1 until the end of surgery.In group C,normal saline 0.25 ml/kg was infused intravenously over 15 min,followed by continuous infusion of normal saline at 0.1 ml·kg-1 · h-1 until the end of surgery.Anesthesia was induced with propofol,sufentanil and rocuronium.After tracheal intubation,intermittent positive pressure ventilation was carried out.PET CO2 was maintained at 33-36 mmHg.Anesthesia was maintained with sevoflurane,propofol,cisatracurium and sufentanil.The pressure of carbon dioxide insufflation was maintained at 9-14 mmHg and airway pressure was maintained at 11-23 cmH2O.Intraocular pressure was measured at 5 min after intubation (T1),at 5,30 and 60 min of pneumoperitoneum (T2-4),and at 5,30 and 60 min after pneumoperitoneum (T5-6).Results Compared with the value at T1,intraocular pressure was significantly increased at T2-6 in group C,and intraocular pressure was increased at T3-5 in group D.Intraocular pressure was significantly lower at T3-5 in group D than in group C.Conclusion Dexmedetomidine can decrease the intraocular pressure during laparoscopic gastrectomy.

Objective To investigate the level and clinical significance of laminin (LN) and hyalu-ronic acid (HA) in cerebrospinal fluid (CSF) of patients with neuropsychiatric lupus (NPLE). Methods The level of LN and HA in CSF in 31 cases of NPLE, 36 cases of no-NPLE SLE, 23 cases of no-SLE cerebrovascular disease and 39 normal controls were messured by radioimmunoassay method. Results The level of LN and HA in CSF of NPLE patients was higher than that of the no-NPLE, no-SLE cerebrovascular disease and normal controls (P