Objective To analyze the influencing factors of hemoglobin A1c in type 2 diabetic patients,including blood glucose,anti-diabetic therapeutic regiments,disease course,age,diabetic education,degree-educated,self-monitoring blood glucose.Methods Seventy-eight type 2 diabetic patients were divided into two groups by different degree of blood glucose,anti-diabetic therapeutic regiments,disease course,age,diabetic education,degree-educated,self-monitoring blood glucose.The levels of hemoglobin A1c in two groups were compared.Results There were significant changes in the levels of hemoglobin A1c between fasting blood glucose (FBG) ≤ 6.1 mmol/L group (30 cases) and FBG ＞ 6.1 mmol/L group (48cases),2 h postprandial blood glucose (2hBG) ≤8.0 mmol/L group (32 cases) and 2hBG ＞ 8.0 mmol/L group (46 cases ),insulin treatment group (27 cases) and no-insulin treatment group ( 51 cases ),combined drugs treatment group ( 36 cases ) and single drug treatment group ( 15 cases),age ≤ 65 years old group (41cases) and age ＞65 years old group (37 cases),disease course≤ 10 years group (39 cases) and disease course ＞ 10 years group( 39 cases),degree-educated above high grade group( 34 cases) and degree-educated below high grade group (44 cases),diabetic education ≥2 times/month group (20 cases) and diabetic education ＜ 2 times/month group (58 cases),self-monitoring blood glucose≥2 times/week group ( 19 cases)and self-monitoring blood glucose ＜ 2 times/week group (59 cases)[ (6.7 ± 1.5 )％ vs.(7.9 ± 1.3 )％,(6.8 ±1.1)％ vs.(7.8 ± 1.2)％,(6.7 ± 1.5)％ vs.(8.1 ± 1.4)％,(6.8 ± l.0)％vs.(8.0 ± 1.6)％,(6.9 ± 1.7)％ vs.(7.4 ± 1.6)％,(6.5 ± 1.2)％ vs.(8.2 ± 1.3)％,(6.9 ± 1.0)％ vs.(7.6 ± 1.4)％,(6.1 ± 1.7)％ vs.(8.0 ±1.1 ) ％,(6.7 ± 1.1 )％ vs.(7.6 ± 1.2)％ ] (P ＜ 0.01 or ＜ 0.05 ).Conclusion Blood glucose,anti-diabetic therapeutic regiments,disease course,diabetic,degree-educated,self-monitoring blood glucose are the important factors influencing hemoglobin A1c.

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

Hemodynamic effects of Laigechongji (LGCJ)were studied in anesthetized open-chest dogs. LGCJ(in doseof 8. 5 and 17.0g/kg,id. )decreased significantly SBP, DBP, MAP, HR, LVSP, +dp/dt max and TPVR, 30~45 mins after medication,and continued for about 90~ 150mins. However,they had no significant effects ondp/dt max,LVEDP,CO,CI,SV and SI. These results suggest that LGCJ may cause hypotension,and its hypotensive effects may be related to its bradycardiac,negative inotropic and vascular resistance reducing activities.

OBJECTIVE: To determine the protective effects of nourishing spleen yin recipe (Zibu Piyin Recipe, ZBPYR), a compound traditional Chinese herbal medicine, on endoplasmic reticulum (ER) in neuronal cells responding to the stress by using sero-pharmacological method. METHODS: The mouse neuroblastoma cell line Neuro2a cells were treated with tunicamycin (Tm, an inhibitor of N-glycosylation). The ZBPYR-treated cell group was established by incubating cells with ZBPYR serum for one hour and treated with Tm. Reverse transcriptase PCR (RT-PCR) was utilized to detect the mRNA expressions from two genes after treatments, ER molecular chaperone glucose regulated protein 78 (GRP78) and transcriptional factor CCAAT/ enhancer-binding protein-homologous protein (CHOP). Lactate dehydrogenase (LDH) assay was also carried out to determine the LDH leakage from Neuro2a cells after treated with Tm and staurosporine (STS). RESULTS: The ZBPYR-treated cell group at all tested ZBPYR dosages showed significantly reduced expressions of both genes compared with Tm (5 microg/ml) treated control group (P<0.05). Therefore, ZBPYR serum inhibited the expressions of GRP78 and CHOP in mRNA level under ER stress induced by Tm. Different concentrations of ZBPYR serum pretreatment reduced the LDH leakage compared with the Tm and STS groups (P<0.05). Therefore, ZBPYR serum may inhibit the LDH leakage induced by Tm and STS. CONCLUSION: ZBPYR has neuroprotective effects. The mechanisms may be associated with inhibition of ER stress and mitochondrial dysfunction.

OBJECTIVE　To study the effects of Panax quinquef olium 20S-protopanaxdiol saponins extracted from the leaves of panax qu inque-folium (PQDS) on the hemodynamics and cardial oxygen metabolism in dogs with acute myocardial infarction (AMI).METHODS　The paramete rs of hemodynamics and cardial oxygen metabolism were determined by using the mo del of ligation of LAD in the anaesthetized open-chest dogs.RESULTS 　In dogs treated with PQDS (in a dosage of 10 and 20 mg*kg-1 iv infusion),the myocardial blood flow (MBF) was increased and coronary vascular re sistance (CVR) was decreased significantly.The heart rate (HR) was slowed.The ar terial blood pressure (ABP),left ventricular pressure (LVP),the maximum rise rat e of left ventricular pressure(+dp/dtmax),left ventricular work index (LVW I) and total periphery resistance(TPR) were reduced,whereas the stroke index(SI) and cardiac index (CI) were increased.In addition,the decreasing range of the m aximum decline rate of left ventricular pressure(-dp/dtmax) and the rising range of left ventricular end diastolic pressure (LVEDP) were reduced.Meanwhile the cardiac oxygen consumption,myocardial oxygen utilization rate and cardiac o xygen consumption index were also decreased.CONCLUSION　PQDS had protective effects on acute myocardial ischemia including improving heart fu nction,decreasing cardiac oxygen consumption and increasing myocardial blood flo w,etc.

Objective To compare the effects of paired associative stimulation (PAS) and repetitive transcranial magnetic stimulation (rTMS) on motor cortex excitability.Methods The baseline corticospinal excitability of the left hemispheres of 10 healthy subjects was measured in terms of resting motor threshold (RMT) and other indicators of motor evoked potentials (MEP).On the following day they received PAS composed of trascranial magnetic stimulation (TMS) to the motor cortex of the left hemisphere and electric stimulation (ES) of the median nerve contralateral to the motor cortex,with an interval of 10ms between the TMS and ES (termed PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ of the RMT,for a total of 90 pulses.The MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.After the PAS intervention,an interval of one week was allowed to eliminate any effect of PAS on motor cortex excitability.Then rTMS was delivered to the subjects' left motor cortex at the same time of day at a frequency of 1 Hz and an intensity of 120％ of the RMT,for a total of 1000 pulses.MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.The two interventions were compared in terms of MEP amplitude,MEP latency and RMT.Results The average MEP amplitude,MEP latency and RMT at baseline were (2.93 ± 0.99) mV,(20.97 ± 1.67) ms,and (46.06 ±5.32) ％,respectively.One minute after PAS10,the MEP amplitude,MEP latency and RMT were (1.14 ± 0.76) mV,(21.87 ± 1.09) ms and (52.06 ±4.20) ％,respectively.One minute after rTMS,the MEP amplitude and latency and the RMT were (2.24 ± 0.79) mV,(20.88 ± 1.94) ms,and (49.00 ± 4.54) ％,respectively.The differences in MEP amplitude,MEP latency and RMT pre-and post-intervention were (0.69 ± 0.10) mV,(0.09 ±0.05) ms and (3.94 ± 0.93) ％,respectively for rTMS.For PAS10 they were (1.83 ± 0.14) mV,(0.90 ± 0.26)ms and (6.00 ± 1.13)％,respectively.The differences in MEP amplitude decrease and MEP latency lengthening between the two stimulation protocols were significant,but the difference in RMT elevation was not.Conclusion Both PAS10 and low frequency rTMS suppressed motor cortex excitability,but the suppressive effect of PAS10 is more significant.

Objective To investigate the effects of paired associative stimulation (PAS) on the recovery of upper limb motor function in stroke patients,and to analyze the relationship between the change of motor cortex excitability in the contralesional hemisphere and the recovery of motor function in the affected upper limb.Methods Thirty hemiplegic stroke patients were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation therapy,but the treatment group also received PAS consisting of transcranial magnetic stimulation (TMS) of the intact motor cortex and electrical stimulation (ES) of the median nerve at the wrist of the intact arm with an interval of 10 ms between the TMS and ES (PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ the resting motor threshold (RMT),once daily for 30 minutes,five times a week for 4 weeks.Corticospinal excitability was measured using motor evoked potentials (MEP) and the RMT.The FuglMeyer upper limb assessment (FMA),Brunnstrom staging and the modified Barthel index (MBI) were also applied before and at the end of the 4 weeks of treatment.Correlation was sought between any changes in MEP amplitude,the RMT of the contralesional hemisphere and changes in the FMA results.Results Before the intervention there were no significant differences between the two groups in terms of any of the assessments.After 4 weeks of treatment,all the assessments had changed significantly compared to those before the treatment,but there were still no significant differences between the two groups in terms of any the assessments.After 4 weeks of treatment,the differences in MEP amplitude from the contra-lesional hemisphere and the differences in FMA scores were positively and significantly correlated with a correlation coefficient of r =0.431.The lesioned hemisphere was also positively correlated with the differences in FMA scores with a significant correlation coefficient of r =0.608.Conclusion PAS10 can facilitate the recovery of upper limb motor function.The change in motor cortex excitability of the contra-lesional hemisphere significantly correlates with functional recovery in the upper limb.

Objective To explore the inhibitory effects of Zibu Piyin Recipe(ZBPYR)serum on neuron apoptosis induced by tunieamyein(Tm,5 μg/ml)and its mechamsm in vitro by using sero-pharmacological method.Method Totally 12 healthy adult male SD rats(220～250 g)(SPF)were divided randomly into control group and ZBPYR group,6 in each group,then the blank and ZBPYR serum were prepared.The mouse.neuroblastoma cell line Neum2a cells were treated with Tunicamycin(Tin,an inhibitor of N-glycoslytion)to establish the endoplasmic reticulum(ER)stress model.The cells treated by ZBPYR aerum of different concentrations were interventional groups,and the cells treated by blank serum were control group.The viability of Neuro2a cells was meusurcdd by MTT assay.Flow cytometry wus applied to observe the apoptosis of Neuro2a cells.Western blotting was utilized to detect the protein expressions of two molecules,ER molecular chaperone-ucose regulated protein 78(CRP78)and transcriptional factor CCAAT/enhancer-binding protein-homologous protein(CHOP).The results were analyzed by sNK-q test.Results Compared to Tm group(cell viability 0.1673±0.0213,apoptotic rate 62.7050±1.4056),The cell viability of interventional groups(5%0.5295±0.0373,10%0.5843±0.0428,15%0.6274±0.0324)increased significantly(P<0.05);and the apoptotic rate(5%47.8733±2.8166,10%46.3366±1.2748,15%39.8833±1.0524)reduced significantly(P<0.05).The protein expressions of GRP 78(5%2.1228±0.2251,10%1.3293±0.9443,15%;15%0.0931±0.1168)and CHOP(5%1.1776±0.2927,10%0.7290±0.1708,15%0.6577±0.1883)of interventional groups reduced significantly compared with Tm group(GRP78 2.9149±0.5355;CHOP 1.6611±0.2913)P<0.05.Condusions ZBPYR serurn could increase the cell viability of Neuro2a cells treated with Tm and inhibit cell apoptosis.Thereby it may have neuroprotective effects,and the mechanism may be associated with the inhibition of ER stress and apoptosis pathway.

The heel vessel belongs to the eight extra meridians in human meridian system, which is closely related to the human motion function. Balance function plays an essential role in successful completion of activities in daily life, so the physiological function and pathology of heel vessel as well as human balance function are analyzed, and from the aspect of running course of heel vessel and syndrome, the correlation between heel vessel and human balance function is explored, and the application status of acupoints related to heel vessel for balance dysfunction is introduced. It is believed that heel vessel is closely related to human balance function, especially the motion regulation mechanisms of balance function, and it is hoped that new ideas and methods can be provided for acupuncture treatment for the balance function disorders.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Meridians ; Postural Balance

Objective To study the application effectiveness of healthcare failure modes and effects analysis before the secure transportation of post anesthesia care unit(PACU) patients. Methods A total of 689 general anesthesia post-operative patients who had been recovered in PACU and transported between January to December in 2015 by convenience sampling were divided into 2 groups to receive nursed by traditional method before transportation (contrast group, 346 cases) or nursed both with traditional way and healthcare failure modes and effects analysis method to analyze (observation group, 343 cases). The Medical Risk Priority Number (RPN), Status of Failure modes and satisfaction value of physicians and nurses were compared. Results The RPN value of observation group had been cut down from (229.00 ± 52.91) points to (57.14 ± 16.04) points, there was significant difference (t=7.58, P=0.01). The occurrence rate of failure mode of observation group was 2.62%(9/343), which was obviously lower than 19.36%(67/346) of contrast group, there was significant difference (χ2=49.19, P<0.01). The satisfaction rate of observation has improved significantly from 74.36%(58/78) to 93.59%(73/78), there was significant difference (χ2=10.72, P<0.01).Conclusions Healthcare failure modes and effects analysis management method could find out the failure mode of PACU patient before the secure transportation in time, could decrease the effect of failure mode and would continuously improve the quality of PACU nursing service .