Objective To explore the treatment perscription with the method of integrated traditional and western medicine in type 2 diabetes.Methods With the methods of differential diagnosis of diseases in western medicine and differential symptoms and signs in traditional Chinese medicine(TCM),the diseases were separated into different patterns of syndrome and treated with propotional prescription of TCM.The curative effect was evaluated with the scores in the integration of symptoms and the changes on the levels of blood glucose and glycated-hemoglobin.Results Clinical curative effects were achieved using the prescription of TCM and the simple western medicines.The curative effects were much better on lowering integration of symptoms and the level of pre-meal blood glucose with the prescription of TCM than those of the simple western medicine.Conclusion The clinical curative effects are significant on relieving the clinical symptoms of patients with the prescription of TCM than those of the simple western medicine.

Objective To study the chemical components from Dryopteris fragrans and their biological activities.Methods By means of HPLC and other column chromatography,the chemical components were isolated from D.fragrans and their chemical structures were identified by spectral and chemical tests in accordance with their physicochemical characteristics.Furthermore,the cytotoxicity of the chemical components for Bel-7402,HCT-8,and A-549 cells was measured by MTT method.Results Four compounds,geniposide(Ⅰ),3S,5R,6R,7E,9S-megastigman-7-ene-3,5,6,9-tetrol-3-O-?-D-glucopyranoside(Ⅱ),(6S,9R)-3-oxo-?-ionol-9-O-?-D-glucopyranoside(Ⅲ),and fragranoside a(Ⅳ) were iso-lated and identified.Conclusion Compound Ⅳ is a new compound.And all the other three compounds Ⅰ-Ⅲ are found in plants of Dryopteris Adanson for the first time.The results of pharmacological experiments indicate that compounds Ⅰ and Ⅲ show strong cytotoxicity.

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting P85 and protein kinase B1 (PKB1/Akt1) and study its effects on the growth of SGC-7901 human gastric adenocareinoma cells. Methods P85 and Aktl shRNA expression frames were subcloned to pGSadeno adenovirus vector with homologous recombination technology to construct pGSadeno-P85 + Akt1 (rAd5-P + A) vector. After screening and amplification, the recombinant adenovirus vector was digested with PacI and transfected into SGC-7901 cells and then its titer and transfection efficiency were detected with fluorescent microscope. P85 and Akt1 mRNA protein expression was identified with real-time PCR and Western blot. The proliferative activity of tumor cells was evaluated with MTr assay and flow cytometry in vitro, rAd5-HK and rAd5-P + A mediated by adenovirus were injected into the established subcutancous SGC-7901 gastric adenocarcinoma in nude mice. During the observation period of 21 days, tumor volume was measured every 3 days to further testify the anti-tumor effect of rAd5-P + A on the SGC-7901 gastric adenocarcinoma cells and cell in situ apoptosis was detected with TUNEL assay. Results The adenovirus vector rAd5-P + A was successfully constructed and it dramatically downregulated P85 and Akt1 mRNA expression in SGC-7901 gastric adenocarcinoma cells. Compared with a control group of SGC-7901 cells and cells transfected with general adenovirus rAd5-HK as control, P85 and Akt1 protein expression 48 h and 72 h after rAd5-P + A transfection was decreased by 57.5% and 63. 7%, 67. 8% and 75.6% with statistical significance(P = 0. 005, P = 0. 003). Cell proliferative activity in rAd5-P + A transfected cells was suppressed from the second day (P <0. 001) and the decreased P85 and Akt1 expression was accompanied by 5.9% -7. 1% decrease of S phase fraction and 12. 1% - 13.7% increase of G0/G1 phase. The tumor volume of rAd5-P + A treated group was smaller than that of the control and rAd.5-HK group with statistical significance (F = 9. 871, P = 0. 025) . Moreover, rAd5-P + A could induce cell in situ apoptosis. Conclusions Adenovirus-mediated targeting P85 and Akt1 shRNA can inhibit the growth of SGC-7901 human gastric adenocarcinoma cells and this may provide a new strategy of combination gene therapy in gastric adenocarcinoma.

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting Aktl (protein kinase B1, PKBI/Aktl) and cyclooxygenase-2 (COX-2) and study its effects on the invasion and metastasis of SGC-7901 human gastric adenocarcinoma cells. Methods Aktl and COX-2 shRNA expression frames were subcloned to pGSadeno adenovirus vector by homologous recombination technology to construct pGSadeno-Aktl+COX-2 (rAdS-A+C) vector. After screening and amplification, the recombinant adenovirus vector was digested with PacI and transfected into SGC-7901 cells, the titer and transfection efficiency were detected by fluorescent microscopy. Aktl and COX-2 mRNA and protein expression was identified by real-time PCR and Western blot. MMP-2 and MMP-9 contents in control group SGC-7901、rAd5-HK and treatment group rAdS-A+C were detected by ELISA assay and transwell assay analyzed cell invasion and metastasis ability. Results Adenovirus vector rAdS-A+C was successfully constructed and it dramatically down-regulated Aktl and COX-2 mRNA and protein expression in SGC-7901 gastric cancer cells. MMP-2 and MMP-9 contents in treatment group rAd5-A+C were respectively (39.7± 1.7) ng/ml, (31.3±3.6) ng/ml, and they were lower than those in control group SGC-7901 (278.4± 15.5) ng/ml, (225.4±15.1) ng/ml and rAd5-HK (275.5±2.1) ng/ml, (226.0±23.3) ng/ml (P= 0.01, P=0.021). Transwell assay showed treatment group rAd5-A+C significantly inhibited the invasion and metastasis of SGC-7901 gastric adenocacinoma cells. Conclusions Adenovirus-mediated targeting Aktl and COX-2 shRNA can inhibit the invasion and metastasis of SGC-7901 human gastric adenocarcinoma cells.

ObjectiveTo investigate methods of early postoperative rehabilitation and its effects on patients with bicondylar tibial plateau fracture treated by modified dual plating.Methods66 patients with bicondylar tibial plateau fracture from Tianjin Hospital were divided into 2 groups according to the starting time for postoperative rehabilitation: early rehabilitation group (n=30), convalescents rehabilitation group (n=36). The two groups had the same treatment since the fourth week postoperative. Tibial plateau angle (TPA) and posterior slope angle (PA) of tibial plateau were measured to evaluate the stability of proximal tibial and knee alignment. The Hospital for Special Surgery (HSS) score system and knee joint range of motion (ROM) were used as the parameters for knee function.ResultsThe mean value of TPA and PA had no significant changes, compared to the final follow-up and postoperative X-ray films(P>0.05); the differences between the two groups were statistically significant in the mean HSS score and mean value of knee flexion and extention ROM(P<0.01 or 0.05). There was significantly positive correlation between starting time and the total number of treatment was significant(P<0.01), while negative correlation with flexion ROM of knee joint and the HSS score(P<0.01).ConclusionThe correlation between rehabilitation intervention timing and functional recovery for patients with bicondylar tibial plateau fracture treated by modified dual plating is significant, early individual and systematic rehabilitation therapy can effectively improve the prognosis features of patients.

Objective To summarize the key points of nursing care in reservation of catheters in 11 cases of nasopharyngeal carcinoma patients who received concurrent chemo-radiotherapy with symptomatic thrombosis after ultrasound-guided implantation of double-lumen PICCs(PowerPICC).Methods From January,2014 to December,2015,totally 11 cases with symptomatic venous thromboembolism were identified among 109 cases of nasopharyngeal carcinoma patients receiving concurrent radiotherapy and chemotherapy,and observation and nursing care were provided at the early stage of thrombosis and during thrombosis.Results All double-lumen PICCs were reserved,and no recurrence or aggravation of thrombosis was recorded to the end of the treatment.The duration of carrying PICCs was 67～89(77.45±6.65) days.Conclusion With careful treatment and nursing,PICC catheter-related complications can be reduced and the duration of carrying catheters can be prolonged,which leads to accomplishment of the treatment plan for patients.

OBJECTIVETo identify the clinical predictors of atrial fibrillation (AF) after coronary artery bypass grafting (CABG).

METHODS322 consecutive patients who had undergone isolated CABG were reviewed. Preoperative, intraoperative and postoperative data were collected. Patients were grouped according to whether AF appeared postoperatively.

RESULTSAF occurred in 75 patients (23.3%). Most cases of AF (85.6%) appeared on or before the third postoperative day. The mean age for patients with AF was 62.5 years compared with 56.7 years for patients without AF (P < 0.05). The mean aortic crossclamp time for patients with AF was 67 min compared with 60.3 min for patients without AF (P < 0.05). The mean duration of cardiopulmonary bypass for patients with AF was 109.6 min compared with 97.3 min for patients without AF (P < 0.05). The mean duration of mechanical ventilation for patients with AF was 19.1 h compared with 15.7 h for patients without AF (P < 0.05). Multivariate logistic regression analysis was used to identify the following independent predictors of postoperative AF (P < 0.05): age > or = 65 years (OR 2.7; 95% CI 1.5 to 5.1), lesions in the right coronary artery (OR 2.5; 95% CI 1.4 to 4.5), and early postoperative withdrawal of beta blocker (OR 3.9; 95% CI 2.1 to 7.7).

CONCLUSIONSAF remains the most common complication after CABG. Age and lesions in the right coronary artery can influence the incidence of AF, and beta blocker and magnesium may be the most economical and effective prevention for AF early after CABG.

Adult ; Age Factors ; Aged ; Atrial Fibrillation ; diagnosis ; etiology ; Coronary Artery Bypass ; adverse effects ; Coronary Vessels ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Prognosis

Objective:To explore whether the specific synaptic vesicle glycoprotein 2A (SV2A) targeted imaging agent ( R)-4-(3-fluoro-5-(fluoro- 18F)phenyl)-1-((3-methylpyridin-4-yl)methyl)pyrrolidin-2-one ( 18F-SDM-8) can be used to detect epileptic foci. Methods:Twenty male Sprague-Dawley (SD) rats (8-9 weeks) were injected with 1.2 μl of kainic acid (16 rats in the epilepsy group) or saline (4 rats in the control group) into the right hippocampus. 18F-SDM-8 and 18F-FDG mircoPET/CT imaging were respectively performed at 1-2 d (acute phase), 6-7 d (incubation period) and 45-60 d (chronic phase) after the seizure. Asymmetric index (AI) was used to evaluate the epileptic foci identify ability of 18F-SDM-8. Paired t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze data. Results:In the three periods of 18F-SDM-8 imaging, the differences of AI of hippocampus between the epilepsy group and control group were statistically significant ( z values: from -2.64 to 2.67, all P<0.05). Both imaging agents had asymmetric uptake in the epilepsy group (right was lower than left), and the decrease in the medial right temporal lobe was the most significant. The pathological staining results were consistent with the imaging results. In the chronic phase of the epilepsy group, the differences of 18F-SDM-8 SUV mean (right versus left) in each brain area of interest were statistically significant ( t value: from -33.40 to -5.60, all P<0.05). The asymmetric uptake of the two imaging agents in the hippocampus had a better correlation ( r=0.97, P=0.001), and the AI of 18F-SDM-8 ((34.2±8.4)%) in this area was 1.4 times higher than that of 18F-FDG ((24.6±4.7)%). Conclusions:18F-SDM-8 PET is a promising method to test the level of SV2A. It can reflect the changes of SV2A in the rat epilepsy model induced by intrahippocampal injection of kainic acid, and improve the sensitivity of molecular imaging for epileptic foci.