Objective:To evaluate the utilization of oral hypoglycemic drugs in 34 hospitals of Nanjing to provide clinical reference for the drug rational use. Methods: According to the sales data of oral hypoglycemic drugs in 34 hospitals of Nanjing from 2011 to 2013,the utilization of oral hypoglycemic drugs was analyzed retrospectively in respect of consumption sum,DDDs and defined daily cost ( DDC) by daily dose limit analysis method. Results: The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose,glimepiride and metformin. In terms of DDDs,glimepiride, metformin and gliclazide ranked the top 3. The consumption sum and DDDs of oral hypoglycemic drugs were increased year by year in Nanjing. The ratio of serial number of consumption sum and DDDs was from 0. 3 to 2. 0. Conclusion: The demanded quantity of oral hypoglycemic drugs is increased year by year from 2011 to 2013. The application conforms to the safe, effective and economic principle. The drugs should be chosen according to the drug characteristics in order to improve the abnormal glucose metabolism and prevent and treat the complications.

Objective To observe the effect of exercise on the expression of TNF-α in the adipose tissue of insulin resistant rats fed a high fat diet. Methods Thirty healthy male rats were randomly divided into a high fat di- et group and a normal chow group. Eighteen weeks later, the high fat group was randomly divided into a resting group fed with the high fat diet only, and an exercise group fed the high fat diet, but receiving swimming training for 6 weeks. Changes in their metabolism of glucose and lipids were observed, and the insulin sensitivity index was calcu-lated. Meanwhile, the level of TNF-α mRNA in their adipose tissue was detected with a real-time fluorescence quan-titative polymerase chain reaction (PCR), and protein in the adipose tissue was measured using Western blotting. Results After 18 weeks of high fat diet feeding, the insulin sensitivity index of the high fat diet group decreased sig-nificantly as compared to the normal chow group, suggesting that insulin resistance had been acquired in the high fat diet group. 24 weeks later, the insulin sensitivity index of the resting group had decreased further, again significantly when compared to the normal chow group. Compared to the resting group, the insulin sensitivity index of exercise group was significantly higher, and the expression of TNF-α mRNA and protein in their adipose tissue was significant- ly increased. Conclusion Insulin resistance can be induced by high fat diet feeding. Exercise can improve insulin resistance by increasing the expression of TNF-α in adipose tissue.

Objective:To evaluate the utilization of antifungal drugs in Nanjing area, and provide clinical reference for the rational use of antifungal drugs. Methods:According to the sales data of antifungal drugs in 34 hospitals in Nanjing area from 2013 to 2015, the utilization of antifungal drugs was analyzed in respects of consumption sum, DDDs and DDC. Results:The consumption sum and use of antifungal drugs increased year by year. The maximum amount of consumption sum growth rate was 41. 13%. Triazole drugs oc-cupied the top of consumption sum during the past three years, and the sales amount accounted for more than 60% of all. In term of consumption sum, voriconazole, fluconazole, itraconazole and caspofungin ranked top 4 of antifungal drugs. Clotrimazole topical prepa-rations and oral itraconazole ranked top 2 of DDDs, and caspofungin, micafungin and voriconazole ranked top 3 of DDC. Conclusion:The clinical application of antifungal drugs continues to increase during 2013 and 2015. Invasive fungal infection is a lethal factor at high risk. Choosing reasonable, effective, safe and economic of antifungal drugs is the first principle in clinical treatment.

Objective:To establish the drug release determination conditions and method for phencynonate hydrochloride extended release tablets. Methods:The drug release of the tablets was determined by HPLC using a Diamonsil C18 (250 mm × 4. 6 mm, 5 μm) column with the mobile phase of acetonitrile-water-phosphoric acid-triethylamine (270∶400∶1. 3∶2), the detection wavelength was 220 nm, the flow rate was 1. 0 ml·min-1 , the column temperature was 30 ℃ and the injection volume was 20 μl. The effects of different release apparatus, release media and rotation speeds on the release of phencynonate hydrochloride extended-release tablets were studied as well. Results:The established drug release determination method had a good linear relationship within the range of 0. 3-5. 0 μg· ml-1(r=0. 999 8), and the average recovery was 100. 6%(RSD=1. 16%, n=15). Under the conditions of 900ml pH 3. 0 phos-phate buffer solution as the release medium, rotation speed of 50 r·min-1 and the settlement basket as the apparatus, the release be-havior of the product was complied with a zero-level model in vitro, and the release equation was as follows:Q=6. 141 2t-9. 328 7(r=0. 996). Conclusion:The method is simple, accurate and reliable, and suitable for the quality control of phencynonate hydrochlo-ride extended-release tablets.

BACKGROUND:Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE:To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS:Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION:The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.

Objective To observe the effects of exercise on serum adiponectin and adiponectin receptor (AdipoR) level in skeletal muscle of insulin-resistant rats. Methods A total of 30 healthy male rats were randomly divided into a control group ( NC, n = 8) and a high-fat group ( HF, n = 22), fed with normal chow and high fat diet, respectively. Eighteen weeks later, the high-fat group was randomly divided into a high-fat diet control group (HC, n = 10) and an exercise group (HE, n = 12). The HC and HE group were continually fed with high fat diet, while the HE group was administered with swimming training for 6 weeks in addition at the same time. After 24 weeks, the insulin sensitivity index was calculated, and serum adiponectin level was detected by using ELISA. The expressions of AdipoR mRNA in skeletal muscle were detected with real-time fluorescence quantitative polymerase chain reaction (PCR). Results After 18 weeks, compared to NC group, the insulin sensitivity index of HF group decreased significantly. It suggested that insulin resistance appeared in HF group. Twenty-four weeks later, compared to NC group, the ISI of HC group was significantly decreased, meanwhile the level of serum adiponectin, expression of AdipoR1 and AdipoR2 mRNA in skeletal muscle of HC group were 71.9% , 59.9% and 69.2% of those of the NC group, respectively; compared to HC group, the ISI was increased significantly by exercise, meanwhile the expression of AdipoR1 mRNA in skeletal muscle was significantly increased by 1.33 times, however the level of serum adiponectin and the expression of AdipoR2 mRNA in skeletal muscle were not altered in HE group. Conclusion Six weeks of exercise improves insulin sensitivity through increasing the expression of AdipoRI mRNA in skeletal muscle.

Objective To establish a CLCN3/MMTV-PyMT double transgenic mouse model of spontaneous breast tumor with simultaneously overexpressing ClC-3.Method CLCN3 transgenic mice were crossed with MMTV-PyMT spon-taneous mammary tumor model mice.The genotype was determined by PCR.The expression of ClC-3 in tissues was detec-ted by immunofluorescence and Western blot.Results CLCN3 and MMTV-PyMT transgenic mice were bred and CLCN3/MMTV-PyMT hybrid mouse model was successfully established.The ClC-3 expression in CLCN3/MMTV-PyMT hybrid mice was higher than that in the MMTV-PyMT mice, assessed by immunofluorescence and Western blot analysis.Conclu-sions Transgenic mouse models of spontaneous breast cancer with simultaneously overexpressing ClC-3 are successfully es-tablished.The double transgenic mice provide a good animal model for further research of ClC-3 in tumor growth and metas-tasis.

AIM: To investigate the frequency of P459H(CCC→CAC) in exon 10 of CYP21 gene among normal population.METHODS: The exons 3-10 of CYP21 gene were amplified with polymerase chain reaction(PCR).The PCR round products were digested by restriction enzyme Pst I to confirm that CYP21 gene was specifically amplified.PCR-based amplification-created restriction site(PCR-ACRS) was performed using the first round PCR products as template.After the second PCR products were digested by restriction enzyme Fsp I,10% polyacrylamide gel electrophoresis was used to screen the frequency of P459H in exon 10.RESULTS: The codon 459 in exon 10 of CYP21 gene was all CCC among 100 normal cases tested.CONCLUSION: P459H(CCC →CAC) of CYP21 gene might be a novel point mutation causing CAH.Furthermore,PCR-ACRS was a fast and safe method for gene mutation screening.

OBJECTIVE:To determine the plasma concentration of Phencynonate hydrochloride(PCH)in dogs,and to calcu-late pharmacokinetic parameters. METHODS:6 Beagle dogs were given PCH tablets(2 mg and 4 mg)intragastrically. The blood samples were collected 5 min before medication and 0.17,0.25,0.5,0.75,1.0,1.25,1.5,2,3,4,6,8,10,12,14,16,18, 24 and 36 h after medication,2 ml each time. Using penehyclidine hydrochloride as internal standard,HPLC-MS/MS method was adopted to determine the plasma concentration of PCH. The medication plans were interchanged 2 weeks later. The pharmacokinetic parameters were calculated using DAS 2.0 software. RESULTS:The linear range of PCH was 0.1-15 ng/ml(r=0.999 6);the low-est limit of quantification was 0.1 ng/ml;the methodology recovery were 97.30%-103.20%;the extraction recovery were 52.30%-60.11%(RSD<11%,n=5). The main pharmacokinetic parameters of low and high doses were as follows as t1/2α of (0.678±0.525)and(0.405±0.465)h,tmax of(1.042±0.401)and(0.900±0.418)h,cmax of(14.063±6.29)and(31.580±9.673) mg/L,AUC0-36 h of(48.186±14.776)and(79.269±34.649)mg·h/L. CONCLUSIONS:The method is simple,sensitive and speci-fic,and can be used for pharmacokinetic study of PCH in dogs.

Objective To analyze the application of clinicopathological features and LEF-1 in the diagnosis of solid pseudopapillary neoplasm of the pancreas (SPN).Methods Clinical and pathological data of 227 cases who were pathologically diagnosed as pancreatic SPN at Changhai Hospital from Jan 2000 to Dec 2015 were collected and analyzed.Immunochemical assay was used to detect the expression of LEF-1 in 132 cases of SPN, and the results were compared with β-catenin, which is most commonly used for diagnosing SPN.Results 81.9% of patients with SPN were female (186/227).Mean age at the onset was 34 years.Mean tumor size was 5.4 cm.48.5% tumors were localized in the pancreatic tail, and 33% in the head.46.3% tumors were cystic and solid, 42.3% were solid, and 11.4% were cystic.There were 2 cases of lymph node metastasis (0.9%), 15 cases of vascular tumor thrombus (6.6%), 14 cases of nerve invasion (6.2%), and 13 cases of adjacent organs invasion (5.7%) based on microscopic observations.Immunochemical analysis showed that 130 of 132 cases with SPN expressed LEF-1 with strong nuclear positivity, and the positivity rate was 98.5%.But no obvious expression of LEF-1 can be seen in normal pancreatic tissue and other pancreatic tumors.The specificity was 100%.The positivity of β-catenin expression in SPN was 96.6%(144/149), and β-catenin was positively expressed in only one case of acinar cell carcinoma.Tumors were completely removed by surgery in 165 cases, and the median follow-up was 51 months.By Oct 31, 2016, 162 patients (98.2%) survived, 5 had liver metastasis, and 1 had recurrence.Conclusions SPN is predominantly encountered in young female patients, and the clinical manifestations are not specific.LEF-1 can be used as a specific marker for the diagnosis and differentiation of SPN, which is more accurate than β-catenin.