BACKGROUND: Many basic researches and clinical observations prove that compound preparation of gingko extract and dipyridamole has an obvious effect on microcirculation. Methycobal is commonly used to repair nerve on clinic. Combination of compound preparation and methycobal has a great effect on treating diabetic peripheral neuropathy (DPN).OBJECTIVE: To observe the improved effect of combination of compound preparation and methycobal on conduction velocity of common peroneal nerve and hemorheology of DPN patients.DESIGN: Randomized controlled design and validated experiment on the basis of patients.SETTING: Department of Comprehensive Medicine, Tongji Hospital of Tongji Medic.al College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 120 patients with type 2 diabetes mellitus (DM) combined with DPN were selected from the Department of Comprehensive Medicine in Tongji Hospital of Tongji Medical College affiliated to Huazhong University of Science and Technology between January 2002 and January 2005. Subjects were randomly divided into treatment group and control group with 60 in each group. All cases were consent.METHODS: Cases in the treatment group were venously dripped with 25 mL compound preparation and 250 mL saline (Guizhou Yibai Pharmacology Company Limited) once a day; meanwhile, 500 μg methycobal (Eisai Community, Japan) was intramuscularly injected into cases once a day for 4 successive weeks. Cases in the control group were intramuscularly injected with 500 μg methycobal once a day for 4 weeks.MAIN OUTCOME MEASURES: Conduction velocity of peroneal nerve and hemorheological indexes (blood viscosity, hematocrit and aggregative rate of platelet) of patients in the two groups at 1 day before treatment and at 4 weeks after treatment.RESULTS: A total of 120 patients were involved in the final analysis. ① Conduction velocity of motor nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.6±4.3), (38.5±3.8), (41.4±6.2) m/s, t=9.585, 4.312, P ＜ 0.01]; conduction velocity of sensory nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.8±4.2), (36.7±4.8), (38.2±4.9) m/s, t=11.047, 9.120, P ＜ 0.01]. ② Values of high-shearing blood viscosity, low-shearing blood viscosity and plasma viscosity were lower in treatment group after treatment than those before treatment and those in control group after treatment (P ＜ 0.01). ③Value of hematocrit was lower in treatment group after treatment than those before treatment and those in control group after treatment [(41.32 ±3.56)%,(46.32±3.43)%, (44.32±4.49)%, t=7.834,4.05, P ＜ 0.01]. ④ Aggregative rate of platelet was lower in treatment group after treatment than those before treatment and those in control group after treatment [(31.35±2.11)%,(48.44±2.68)%, (45.91±3.54)%, t=38.810, 27.367, P ＜ 0.01].CONCLUSION: Combination ofcompound preparation and methycobal can increase nerve conduction velocity and decrease blood viscosity and aggregative rate of platelet, and it is also an effective method for treating DPN.

Secretion of the salivary glands of leeches contains more than 100 bioactive substances,in recent years it has become the focus of many researchers'attention, which was the most extensive and in-depth study of the salivary glands of leeches anticoagulant and inhibit the biological activity of platelet aggregation substance, and some species have been successfully applied to the treatment of cardiovascular diseases.in addition, a growing number of studies have found that leech salivary gland secretion also has antibacterial, antitumor, analgesic, vasodilator, anti-inflammatory, wound healing and other biological functions.Thus, leech salivary gland secretion with functions of biological diversity.Moreover, the leech is not just for the treatment of human diseases, but also applied to the treatment of several diseases of animals.This review expatiating the functional diversity of leech salivary secretions by consulting a large number of iterature , that the use of leech salivary gland secretion and other blood-sucking animal salivary gland secretions functions provide a useful reference.

Objective To study the expression of hepatocyte growth factor (HGF) in placenta from normal pregnancy and pregnancy induced hypertension (PIH) and the effect of HGF on angiogenesis in placenta. Methods Immunohistochemistry was used to determine the location and intensity of HGF staining in placenta from 20 cases of normal pregnancy and 58 cases of mild,moderate and severe PIH groups. HE staining was used in order to count the number of the vessles. Results HGF mostly were expressed in villous core mesenchymal cells,less in decidual cells . Intensity of HGF immnostaining in villous mesenchymal cells was significantly reduced in the severe PIH group compared with the normal group(H=7.395,P=0.003),while there were no statistical differences between the mild,moderate PIH group and the normal group (H=0.869,P=0.351,H=0.017,P=0.896) .The count of vessels reduced in severe PIH (F=10.676,P=0.008). There was positive correlation between the expression of HGF and the count of vessels in villous(r=0.246,P=0 030). Conclusion These results suggested that HGF is secreted mainly by villous core mesenchymal cells in human placenta and the reduction of HGF in PIH may be responsible for the impaired vascularization in PIH.

Objective To investigate the efficacy and safety of statins in primary and secondary stroke prevention.Methods We search in PubMed(1966—2006),Cochrane library(issue 1,2006),CNKI(1979—2006)and VIP(1989—2006)to get systematic reviews(SRs),meta-analyses and randomized controlled trials(RCTs)about statins for stroke prevention.Results We found 4 meta-analyses,8 RCTs about the primary stroke prevention and 1 Cochrane systematic review and an ongoing RCT about secondary stroke prevention.Conclusion Statins therapy can reduce the incidence of stroke,especially in high-risk patients with coronary heart disease,hypertension and diabetes.Statins have positive effect for primary stroke prevention and do not increase the incidence of hemorrhagic stroke and tumor.The clinical evidence about the effect of statins in secondary stroke prevention is insufficient.An ongoing stroke trial will provide important evidence for secondary stroke prevention.

Objective To investigate the expression of serum Golgi protein 73 in hepatocellular carcinoma(HCC) and analyze the clinical significance.Methods The expression of GP73 was measured by ELISA in 75 HCC ,30 chronic hepatitis and normal con -trols.Results The serum concentrations of GP73 were (128.3 ±33.6)μg/L,(80.3 ±19.2)μg/L and (78.3 ±18.5)μg/L in the HCC, chronic hepatitis patients and normal controls .The serum level of GP73 was significantly higher in HCC than those with chronic hepatitis and healthy controls .GP73 expression was positively correlated with clinical stage , humor size and metastasis.The positive rate of GP73 in stage was 60%,higher than the AFP positive rate(33%).Conclusions The serum level of GP73 is high in HCC and was helpful for distinguishing benign and malignant liver diseases .GP73 can be used as a diagnostic marker for HCC .

Objective To investigate the efficacy of Saxagliptin on the glucose and lipids metabolism and adipokines levels in diet-induced insulin resistance rat,and to explore the regulatory mechanism of saxagliptin in insulin resistance.Methods 36 4-week-old male Wistar rats were randomly divided into two groups:control group (n=12) and high-glucose and fat diet group(HF,n =24).The HF rats were randomly divided into two subgroups:HF group and saxagliptin group,and continued the treatment for 8 weeks.Levels of blood glucose,insulin,triglyceride (TG),total cholesterol (TC),TNF-α and adiponectin were determined.Results After four months,serum levels of fasting glucose,insulin,TG,TC were significantly increased in HF group as compared with control group [(7.07±1.61) mmol/L vs.(5.10±0.44) mmol/L,(23.70±7.37) mU/L vs.(19.35 ± 6.38) mU/L],[(3.21± 1.44) mmol/L vs.(0.83 ± 0.39) mmol/L,(3.04 ± 1.62) mmol/L vs.(1.14±0.24) mmol/L,all P＜0.05],and were all decreased after the treatment of saxagliptin.The glucose infusion rate was lower in HF group than in control group and was higher in saxagliptin group than in HF group [(18.80±1.57) mg · kg-1 · min-1 vs.(24.31±2.65) mg · kg 1 · min 1,(21.45 ±1.80) mg· kg-1 · min-1 vs.(18.80±1.57) mg· kg 1 · min-1,P＜0.01 or 0.05].Compared with the control group,serum THF-α was higher and adiponectin level was lower in HF group [(1.38 ±0.18) μg/L vs.(2.33±0.21)μg/L,(2.65±0.29) mg/L vs.(1.38±0.20)mg/L,both P＜0.01].Saxagliptin can significantly increase the serum level of adiponectin and decrease the level of TNF-α in HF group (P＜0.01 or 0.05).Conclusions Saxagliptin treatment can improve high-fat dietinduced insulin resistance,decrease blood lipids levels and regulate the levels of adipokines in HF rats.

Objective To have a research on the improvement of visual field of advanced primary glaucoma with tubular visual field after the surgery.Methods Twenty-six patients in the hospital during Nov.2010-Dec.2011 were treated with the compound trabeculectomy.Have a comparison between the preoperative period and postoperative period about the visual field index,visual acuity,intra-ocular tension,bleb After 6-18 mouths following-up,have a summary on the complication rate.Results The visual field index,visual acuity,intra-ocular tension,bleb in the postoperative period were much better than that in the preoperative period.There were no serious complications after the surgery.Conclusion To use the compound trabeculectomy to treat the advanced primary glaucoma with tubular visual field patients is worthy to be promoted and applicated in clinical practice.This method is full of safety and availability.

Objective To investigate the influence of chronic renal disease (CKD) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and hospitalization.Methods Fifty patients clinically diagnosed as COPD complicating CKD in our hospital from January 2011 to June 2013 were selected as the observation group and 50 patients with CKD-free COPD were taken as a control group.The comparative analysis was performed by retrospecting the data of lung function,exercise tolerance and hospitalization situation in 1 year follow up.Results The mortality rate,total occurrence rate of AECOPD,occurrence rate of severe AECOPD,hospitalization rate,hospitalization time,self-rating test (CAT) score,mMRC dyspnea index,CRP and blood creatinine level in the observation group were higher than those in the control group,the difference was statistically significant (P<0.05);FEV1%pred,6MWD and creatinine clearance rate in the observation group were lower than those in the control group,the difference was statistically significant (P<0.05);FEV1/FVC had no statistical difference between the two groups (P>0.05).Conclusion The condition in COPD patients complicating CKD at 1 year after clinical diagnosis is significantly aggravated compared with COPD patients without complicating CKD,and the prognosis for patients complicated with CKD is poorer.

This paper introduces pediatrician training model in Britain, from medical students to consults, including its step-by-step training methods, multi angle multi-level evaluation methods, and em-phasis on the professionism and clinical competence. Through the comparison of the current pediatrician training model in China, this paper provides a reference for Chinese pediatrician training model in future.

Objective To evaluate the advantages of plasma cell enrichment combined with fluorescence in situ hybridization (FISH) based on a panel of probes by the conventional cytogenetic (CC) analysis.Methods Fresh heparinized bone marrow samples were collected by bone marrow biopsy.Plasma cells were enriched in BM samples using a magnetic cell-sorting procedure to select CD138+ cells.The common chromosome abnormalities of MM were detected by FISH based on a panel of probes and CC analysis after short-term culture of the BM cells,in order to compare the differences between these two methods for the frequency of common cytogenetic abnormalities.Results 72 of 95 (75.8％) MM patients were found to carry clonal chromosome abnormalities by FISH.And RB 1 deletion was the highest at 44.2％ (42/95) followed by CKS1B (1q21) amplification (42.1％).The frequencies of CDKN2C (1p32) deletion,TP53 deletion,IGH/CCND1 and IGH/FGFR3 were 8.4％ (8/95),12.6％ (12/95),14.7％ (14/ 95) and 14.7％ (14/95),respectively.IGH/MAF was negative.Thirty-two of 95 (33.7％) patients were found to carry clonal aberrations by CC analysis.The frequency of chromosome abnormalities detected by FISH was significantly higher than CC analysis (75.8％ vs 33.7％,P =0.000).Conclusion Plasma cell enrichment combined with FISH based on a panel of probes can greatly increase the frequency of chromosome abnormalities,which provides cytogenetic basis for risk stratification and prognosis of MM patients.