BACKGROUND: Diabetic glycometabolism disorder and lipoid metabolism disorder are often reciprocal causation, which cause the reduction of hepatic glycogen and the changes of many plasma factors. Hence, the occurrence of vascular complications in heart, kidney and brain is common. It becomes a hot topic in latest researches to find an effective medicine for the secondary prevention of diabetes.OBJECTIVE: To study the interventional effects of leizhusun' s juice on hepatic glycogen, plasma glucose and blood fat.DESIGN: A randomized and controlled observatory study by employing experimental animals as subjects.SETTING: Laboratory of Pharmacy College of Xianning College.MATERIALS: Totally 40 male Wistar rats with a bodymass of (230 ± 20) g were obtained from the Experimental Animal Center of Wuhan General Hospital of Guangzhou Military Area.METHODS: The diabetic rat model was established by the injection of Alloxan(200 mg/kg) into abdominal cavity in the laboratory of Pharmacy College of Xianning University between September 2002 and June 2003. Leizhusun' s juice(LZS) of different doses(205.70 mg/kg and 436. 40 mg/kg) was respectively perfused into the stomach for 28 days, and healthy rats were used as normal control. Levels of hepatic glycogen(HG) in liver and the factors in plasma were detected.MAIN OUTCOME MEASURES: HG, glucose(Glu), triacylglycerol (TG), non-esterified fatty acid(NEFA), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-c), high-density lipoprotein cholesterol (HDL-c), and malondialdehyde(MDA) contents, and superoxide dismutase (SOD) activitiesRESULTS: The level of Glu in LZS-Ⅱ group(436.40 mg/kg) was (9.65± 1.14) mmol/L, TG was(1. 31 ±0. 18) mmol/L, NEFA was(0. 51 ±0. 04)mmol/L, LDL-c was(0.79 ±0. 19) mmol/L, and MDA was(6.31 ±0. 83)nmol/L, which were significantly lower than Glu of (16. 14 ± 1.59) mmol/L,TG of(1.94 ±0. 31) mmol/L, NEFA of(0.59 ±0. 05) mmol/L, LDL-c of (1.34 ±0.28) mmol/L and MDA of(10.95 ±2.90) nmol/L in experimental control(Model) group( t= 3. 478 - 9. 379, P ＜ 0.01), while the HDL-c was (1.09±0.13) mmol/L, SOD was(39.76±6.23) NU/mL and HG was (6.70 ±0.62) mg/g in LZS-Ⅱ group, which were significantly higher than HDL-c of(0.55 ± 0. 11) mmol/L, SOD of (23.24 ± 3.35) NU/mL and HG of (4.06±1.24) mg/gin Model group( t = 5. 388 - 9. 000, P ＜0.01). Furthermore, the decreasing effect on LDL-c and increasing effect on SOD in both LZS groups had dose-dependence relationship( P ＜ 0.05 -0.01 ).CONCLUSION: LZS significantly decreases plasma Glu, TG, NEFA, LDL-c and MDA levels, but increases HDL-c, SOD and HG levels, which displays obvious antidibetic effects.

Objective To compare the effects of Baimai ointment and baclofen in stroke patients with spas-ticity.Methods 84 cases accompanied by limb spasticity in stroke patients by digital table were randomly divided into Baimai ointment group and baclofen group,42 cases in each group.The Baimai ointment group were treated with Baimai ointment on the spastic limbs,the baclofen group received oral baclofen tablets 30 -75mg/days for 2 weeks, 4 weeks,8 weeks.The curative effects of the two groups were compared before and after treatment.Results Before and after treatment in the two groups,the levels of spasticity,pain and activities of daily living (ADL)differences were statistically significant and Baimai ointment in the treatment of spasm.After 4 weeks and 8 weeks,the Ashworth score of the Baimai ointment group were (1.59 ±0.46)points,(0.89 ±0.56)points,and those of baclofen group were (1.75 ±0.64)points,(1.45 ±0.48)points,the differences were statistically significant(t values were 2.916, 3.367,all P <0.05).After 2 weeks,4 weeks and 8 weeks,the VAS score of the Baimai ointment group were (2.72 ± 0.54)points,(2.02 ±0.24)points,(1.24 ±0.12)points,and baclofen group were (3.56 ±0.44)points,(3.15 ± 0.48)points,(2.58 ±0.26)points,the differences were statistically significant(t values were 2.975,3.359,5.416, all P <0.05),activities of daily living (ADL)was higher than that of the baclofen group.After 8 weeks,the MBI score of the Baimai ointment group was (64.46 ±10.78)points,and baclofen group was (50.74 ±9.18)points,the difference was statistically significant between the two groups (t values was 3.562,P <0.05).Conclusion Baimai ointment has the better antispasmodic effect than baclofen in patients with stroke.

Objective To investigate the feasibility and safety of surgical device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary.Methods A total of 45 patients diagnosed as doubly committed sub-arterial ventricular septal defect (dcVSD) with transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE) were enrolled from June 2014 to August 2016 in Henan Children Heart Center,Henan Provincial People's Hospital.There were 39 males and 6 females,with the mean age of (2.2 ±2.1) years old(0.5-8.0 years),the body weight (13.8 ± 7.1) kg(7.0-34.1 kg),the defect size (4.5 ± 1.0) mm (3.0-8.0 mm).After general anesthesia,the patients were in supine and evaluated by TEE which indicated whether they were fit to closure.Then,they were turned to the right lateral position while this technique was determined.A vertical incision of 2-3 cm was made between the third and the fifth intercostal space and invasion in thoracic space via fourth intercostal space.Puncture was done at the anterior surface of right ventricular outlet tract to build a delivery tract.The occluder was released and the VSD was occluded under transesophageal echocardiography guidance.Results Forty-one patients had a successful surgical dcVSD closure with asymmetric occluders sized (6.0 ± 1.5) mm(4-10 mm).Among 4 failure cases,2 cases (4.4％) were switched to open-heart surgical repair,1 case (2.2％) due to device related aortic regurgitation,the rest 1 case (2.2％) experienced a dislocation of occluder into pulmonary artery and was converted to surgical repair after retrieve of occluder.Trivial residual shunt was detected in 2 cases (4.4％) postoperatively,a spontaneous closure was observed by 1 month follow-up and 3 months follow-ups,respectively.All the patients were discharged 5 to 8 days after the operation.With a follow-up of (10.4 ±5.0) months [3-24 months],there were no complications such as pericardial effusion,displacement of device,atrioventricular block or new valvular dysfunction.Conclusions Minimally invasive device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary is a feasible and safe treatment for closure of dcVSD.This technique has advantages of minor wound,less exudation,covert incision,however,long term follow-up is necessary.

Objective To analyze the changes of the cost and structure of coronary intervention patients before and after the centralized procurement of coronary stents in Zhejiang Province.Methods It was conducted on the medical expenses of patients in the FM1 group(percutaneous coronary stent implantation)of a Class A tertiary hospital in Zhejiang Province from February to December in each 2020 and 2021.The number of cases was 1 403 and 1 698,re-spectively.A nonparametric test was conducted on the patient expenses before and after the reform.Results There are significant differences in total medical expenses,material expenses,treatment expenses,operation expenses and drug expenses before and after centralized purchase(P＜0.01);After the implementation of centralized procure-ment,material cost of patients decreased significantly,while the treatment cost increased;At the same time,the more coronary stents were placed,the greater the decrease in the total medical expenses and material expenses.Conclusion The centralized procurement of coronary stents can reduce the medical burden of patients,improve the structure of medical expenses,enhance the value of technical labor services of medical personnel,and promote DRG cost control.

Objective: To analyze the correlation between circumcision and incidence and clearance of male genital HPV infection. Methods: From May to July 2014, 18-55 year old men who had sexual behavior history were recruited from the general population in Liuzhou, Guangxi to set up a cohort. Totally, 113 circumcised and 560 uncircumcised men were enrolled and interviewed using a questionnaire (including information on demographic characteristics and sexual behaviors), then they were followed-up with 6-month interval for 2 times. On each visit, specimens of male external genitalia were collected and genotyped for HPV DNA. The differences of incidence and clearance of genital HPV infections between circumcised and uncircumcised men were analyzed by Log-rank test. Cox regression was used to analyze the relationship between circumcision and incidence and clearance of HPV infection. Results: The median age (P₂₅, P₇₅) of circumcised and uncircumcised men were 28 (24, 35) and 32 (24, 31), respectively. The incidences of any HPV infections were 9.1 (95%CI: 2.4-15.7) and 8.4 (95% CI: 5.6-11.2) per 1 000 person-months (χ²=0.10, P=0.758), respectively. The clearance of circumcised men [136.3 (95%CI: 70.0-202.7) per 1 000 person-months] was higher than that in uncircumcised men [89.6 (95%CI: 65.9-113.3) per 1 000 person-months] (χ²=8.19, P=0.004). In multivariate COX regression analysis, compared with uncircumcised men, circumcised men had higher possibility to clear any HPV infections (HR: 2.41, 95%CI: 1.30-4.46). Compared with men having one sexual partner, people having more than 4 sexual partners had lower possibility to clear any HPV infections (HR: 0.49, 95%CI: 0.25-0.96). Compared with 18-25 years old men, men aged 26-35 years old had higher possibility to clear high-risk HPV infections (HR: 2.14, 95%CI: 1.08-4.23). Conclusion Circumcised and uncircumcised men had similar incidence of genital HPV infection, whereas, men conducted circumcision and having fewer sexual partners could increase the clearance of genital HPV infections.