objective To investigate the effects of health management on the progress of early diabetic nephropathy (DN).Methods A total of 98 patients with early stage DN were randomly assigned to the study group (n =49 ) and the control group (n =49 ).Questionnaire survey was performed,and urinary albumin to creatinine rate (ACR),body weight,fasting glucose,postprandial 2 h glucose,blood pressure,and lipid profiles were measured.The patients of the study group received health and disease management for 3 years; however,those of the control group received no additional intervention other than essential treatment. At 3 years, all the participants completed the questionnaires and above-mentioned measurements.Results In comparison with the control group,ACR of the study group was significantly decreased at 3 years ( P ＜ 0.05 ).In the control group,urinary protein was found in 15 patients and 3participants developed end-stage renal disease.However,neither urinary protein nor end-stage renal disease was found in the study group.Risk factors of DN,including high blood glucose,high blood pressure,and high cholesterol,were significantly decreased in the study group (all P ＜ 0.05 ).Conclusion Early effective health management of DN may contribute to decreased risk factors of renal disease and delayed disease progression.

AIM: To establish a quality control for Longshen Buyi Granule(Radix et Rhizoma Ginseng,Radix Panacis Quinquefolii,Radix Astragali,etc.. METHODS: Ingredients of Radix Ginseng,Radix Panacis quinquefolii,Fructus Corni,Fructus Ligustri lucidi,Radix Ophiopogonis,Pericarpium Cirri reticulatae,Radix Glycyrrhizae were identified by TLC,and astragaloside IV in the granule was determined by HPLC-ELSD. RESULTS: The spots in the TLC were clear and distinguished well.The linear range was within(0.333 8)-10.680 0 ?g(R=0.999 1).The average recovery was 99.42%,and the RSD was 2.00%. CONCLUSION: This method can be used for quality control of Longshen Buyi Granule.

A comparison of the number of clinicians per 1000 residents in the province,and analysis of their distribution and characteristics identified an imbalance of such resources between regionsand between urban and rural areas.A further analysis of the payment flow of medical insurance fund of the counties and districts probed into the deployment efficiency of clinical in the province,holding that the hck of a human resources deployment and guidance mechanism for clinical resources is key to toor healthcare equity and difficulties in accessibility of healthcare service.

Objiective To evaluate the histocompatibility of gelatin-bletilla/Salvia-miltiorrhiza i material and to discuss the appropriate concentration of salvia-miltiorrhiza in the material. Method Salvia-miltiorrhiza together with gelatin and bletilla was used to make a kind of porous membranes. A total of 175 rats were divided randomly (random number) into 5 groups ( n = 35 in each). The porous membranes containing salvia-miltiorrhiza material in different concentrations of 1, 2, 4, and 5 mL/100 g were implanted subcutaneously into the rats of the four experimental groups, respectively. The gelatin-bletilla material without salvia-miltiorrhiza was implanted into the rats of control group. In 1, 3, 7, 14, 21, 28 and 56 days after implant, the materials were taken out of the bodies of the rats, separately. The material implanted for 1, 3, 7 and 14 days were observed with immunohistoche-mistry. Results In the area of implant, no noticeable inflammation or other was found. The implanted materials were degraded and entirely absorbed in vivo in 8 weeks. The salvia-miltiorrhiza in concentration of 2 mL/100 g in vivo promoted the angiogenesis most significantly. Conclusions The gelatin-bletilla/salvia-miltiorrhiza material has excellent histocompatibility and the appropriate concentration of salvia-miltiorrhiza in material is 2 mL/100 g.

Objective To observe the effect of angiotensin-converting enzyme inhibitor(ACEI) on insulin sensiti-(vity) in dogs with acute myocardial infarction(AMI) after thrombolytic treatment. Methods Twenty dogs were made as AMI models and then underwent thrombolytic treatment.The dogs were divided into the control group(n=10) and the captopril group(n=10) randomly.Insulin,plasma glucose,erythrocyte insulin receptor(EIR),nitrogen(NO) and angiotensin Ⅱ(AT Ⅱ) were(detected) and insulin sensitivity index(ISI) was calculated.The changes of these values in the two groups were contrasted. Results After reperfusion for 120 min,in the control group,ISI and AT Ⅱgot much more rise while EIR and NO fell much more(P

Objective To establish a method of reverse hybridization to detect five subfamilies of low risk Human Papillomaviruses(HPV6,11,42,43 and 44)and eighteen subfamilies of high risk HPV (HPV16,18,31,33,35,39,45,51,52,53,56,58,59,66,68,73,83 and MM4)in one reaction.Methods Special probes for twenty-three HPV subfamilies were fixed on nylon membrane bars,biotin labeled general primers mediated polymerase chain reaction(GP-PCR)were applied in HPV DNA amplification.PCR amplified DNA fragments were reversely hybridized with special probes that were fixed on the membranes. All samples(136)detected by reverse hybridization method were paralleled with the methods of Hybridization Capture Ⅱ(HC-Ⅱ)and sequencing.Results Positive rate of the 136 samples detected by reverse hybridization was 41.9%,while HC-Ⅱ 42.6% and sequencing 40.4%.Reverse hybridization detection indicated coherence with the other two methods(Kappa 0.8644 and 0.9089,respectively).While sequencing was lab standard for DNA test,the sensitivity was 96.36%,specificity was 95.06%,accuracy was 95.59%.Conclusions Method of reverse hybridization is adaptable to 23 kinds of HPV subfamilies, which can confirm the exactly subfamilies of HPV infection.This method is adaptable in clinical detection of HPV,with high sensitivity,high specificity,simply and convenient operation and the results are easily to be read.

Objective To explore the clinical effect of posterior pedicle screw internal fixation in the treatment of multiple level noncontiguous thoracolumbar fractures.Methods Thirteen patients with multiple level noncontiguous thoracolumbar fractures were treated by posterior pedicle screw internal fixation.The Frankel score,percentage of vertebral compression and Cobb angle of the injured vertebral segment were analyzed to evaluate the surgery efficacy.Results All patients were followed up from 12 to 24 months ( averaged 15 months ).All cases achieved bone fusion with no implant failure.The Cobb angle of the injured vertebral segment was corrected from preoperative(22.2 ±5.3) degree to postoperative(5.3 ±3.5) degree and(6.2 ±3.6) degree at the last follow up.The percentage of vertebral compression was corrected from preoperative (45.7 ± 14.1 )％ to postoperative ( 6.1 ± 3.8 ) ％ and ( 7.2 ± 3.9 ) ％ at the last follow up.All improvements showed significant differences when compared statistically( t =15.03,t =12.05,Ps ＜0.05 ).The spinal cord function was improved 1 to 2 degree in all patients except 2 patients of grade A.Conclusion The posterior fixation with pedicle screw is a secure,safe and effective method in treating multiple level noncontiguous thoracolumbar fracture.

Objective To evaluate the clinical outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures. Methods From January 2008 to March 2009, 9 patients (4 males and 5 females) with a vertically unstable pelvic fracture were treated with modular external fixator with lumbopelvic distraction spondylodesis. According to the classification of Tile, 9fractures were classified as type C. This fixation construct comprises a vertical lumbopelvic distraction component which fixed L4.5 and the posterior superior iliac spine and a transverse fixation which fixed anterior iliac spine with external fixator. Results All patients were followed up 12-18 months after surgery, with an average of 14.3 months. Postoperative X-ray showed satisfactory reduction of pelvic fracture. Pelvic fractures healed in all patients without loss of reduction 3-6 months after operation. According to Matta reduction evaluation criteria, 6 patients were excellent and 3 good. For the two patients with sacral neurological injuries,appropriate surgical decompression was performed to improve the symptom and minimize the deformity. No iatrogenic complications of neurovascular injury occurred. Patients now walk unassistedly without pain in the waist or legs, and with no shortening of lower limbs or claudication. By considering symptom and satisfactory scores, the Majeed functional assessment revealed that seven patients had excellent results and two good at one year. Conclusion External fixator with lumbopelvic distraction spondylodesis that allowed early mobilization and ambulation, with general applicability and definite safety, is an effective surgical technique for the treatment of vertically unstable pelvic fracture.

Objective To investigate the radiologic and angiographic findings of dilated superior ophthalmic vein(SOV)associat- ed with orbital arteriovenous malformations(AVM).Design Retrospective case series.Participants Six cases of orbital AVM patients, with clinical symptoms and signs mimicking a carotid cavernous fistula(CCF).Methods Examinations of the six cases,such as CT, MRI,and selective cerebral angiography,were summarized and analyzed.Main Outcome Measures Images findings and hemodynam- ics.Results All patients were found with dilated SOV on CT and MRI.Additional radiographic findings included proptosis and AVM. All six AVM were located at the orbit,and one of them was also found with AVM in brain.The main draining vein was SOV in all cas- es.The branches contributing to the fistula's blood supply were the middle meningeal artery,the internal maxillary artery,and the oph- thalmic artery.Conclusions Orbital AVM can cause similar clinical signs and radiologic features to those associated with a CCF.How- ever,the bulging cavernous sinus cannot be found in most AVM.Angiography is necessary for definitive management,non-invasive techniques have an important role in pre-angiographic diagnostic decisions.(Ophthalmol CHN,2007,16:395-398)

Objective To evaluate the efficacy of methylprednisolone pulse therapy in the treatment of thyroid-associated oph- thalmology. Design Meta analysis. Participants Published literatures about methylprednisolone pulse therapy for thyroid-associated ophthalmopathy. Methods A meta-analysis of published randomized clinical trials was used. Published literatures were selected for study based on a computerized search of the literature and a manual search of the bibliographies of relevant papers. Studies meeting se- lected criteria were reviewed systematically by meta-analysis. Data was extracted on the basis of the intention-to-treat principle. Treat- ment effect was measnred as relative risk(RR) of response rates. Main Outcome Measures The effective rate and the relative risk(RR). Results A total of 6 articles were included in this meta-analysis. The RR (95%CI) were 7.50 (1.14, 49.26) when comparing methylpred- nisolone pulse therapy with placebo, 3.33 (0.51, 21.89) when comparing methylprednisolone pulse therapy with surgical decompression, and 1.50 (1.12, 2.00) when comparing methylprednisolone pulse therapy with oral steroids. The combination of methylprednisolone pulse therapy and orbital radiotherapy was significantly effective than oral steroids combined with orbital radiotherapy which pooled RR (95% CI) was 1.42 (1.11, 1.81). Conclusions Methylprednisolone pulse therapy appears to be an effective treatment for thyroid-associated ophthalmology, and seems to have increased effect when given with orbital radiotherapy.