Objective To evaluate the efficacy and safety of acarbose tablets combined with protamine zinc recombinant lai pulp mixing insulin injection in the treatment of elderly patients with type 2 diabetes.Methods 170 elderly patients with type 2 diabetes were randomly divided into the observation group and the control group.85 cases in the observation group were given acarbose tablets combined with protamine zinc recombinant lai pulp mixing insulin injection,85 cases in the control group received aspart 30.The patients were followed up for 12 weeks,the blood glu cose levels,blood glucose fluctuation,glycosylated hemoglobin (HbAlc),the incidence of hypoglycemia and insulin dosage were observed.Results' The level of fasting plasma glucose (FPG) (t =9.92,P ＜ 0.05),2h postprandial blood glucose(2hPG) (t =18.18,P ＜0.05),the mean blood glucose within 4h(t =13.62,P ＜0.05),days of average blood glucose fluctuations (t =14.56,P ＜ 0.05) of observation group dropped significantly compared with that before treatment;HbAlc achieved rate(6.5％)of the observation group and control group were 35.29％,28.23％,re spectively,HbAlc achieved rate (7.0％) of observation group and control group were 57.64％,52.94％,the differences were not statistically significant(all P ＞ 0.05).The dose of insulin was significantly lower in the observation group(20.11 ±3.36) u/d than(35.78 ±4.68) u/d in the control group(t =25.08,P ＜0.01).There were 2 cases of hypoglycemic events and 3 cases in the control group.Conclusion Protamine zinc recombinant insulin lispro injection combined with acarbose has reliable clinical efficacy and safety.

Objective To understand the variation of the DNA double-strand break rejoining capacity among different cultured cancer cell lines and the primary cancer cells from brain cancer patients,and to explore the predictor of radiotherapy responses of cancers. Methods DNA double-strand breaks (DSBs) were induced by 60Co γ-irradiation. Pulsed-field gel electrophoresis was used to analyze the initial production and rejoining of DNA DSBs. Radiosensitivity was determined by in vitro assay of clonogenic-forming capacity. Results A wide variation of radiosensitivity, e.g. The survival parameter of D0 varied from 0.65 to 2.15 Gy, was displayed among the eight cell lines derived from different type of cancers. Although differential level of initial DNA DSBs induced by 20 Gy γ-rays was observed among various cell lines, it was not correlated with the radiosensitivity. The deficiency of DNA DSB rejoining in radiosensitive cell lines was shown either in the early rapid-rejoining phase (SX-10 cells) or in the late slow-rejoining phase (A2780 cells). A significant relationship was observed between the residual level of DNA DSBs measured at 2 h post-20 Gy irradiation and the cellular radioseusitivity (D0 or SF2). The kinetic curves of rejoining DNA DSBs in the primary human brain tumor cells indicated a variation on DSB rejoining capacity among different individual tumor. The residual level of DNA DSBs after 2 h of rejoining post 20 Gy irradiation in primary human brain tumor cells is compatible to the results obtained in vitro culture cancer cell lines. Conclusions The residual level of DNA DSBs is correlated with radioresistance of cancer cells, and the residual DNA damage is a useful parameter in predicting the response of tumor tissue to radiotherapy.

At present,the AIDS epidemic situation in college students is becoming more and more serious.In view of the particularity of colleges students and the lack of professional team for AIDS prevention and control in colleges and universities,there exists ethical issues when carry out the prevention and control for AIDS in colleges and universities such as the ethical issue in publicity and education,the ethical issue in AIDS behavioral intervention,the ethical issue in the consultation and detection for AIDS.This paper suggests that it should confront the current situation of AIDS prevention and control,improve the professional level of carrying out AIDS prevention and control,adhere to the necessary principles of AIDS prevention and control,and explore a new mode to construct AIDS prevention and control in colleges and universities.

Objective To evaluate efficacy and safety of intravenous chemotherapy combined with TACE in the treatment of gastric cancer with hepatic metastasis.Methods In this study 60 gastric cancer patients with hepatic metastasis were divided into two groups randomly,the trial group (30 cases) took intravenous chemotherapy consisted of docetaxel 60 mg/m2 intravenous drip d1,oxaliplatin 80 mg/m2 intravenous drip d1 followed by 5-fiuorouracil 500 mg/m2 intravenous drip d1-5 after TACE.The control group (30 cases) took the same chemotherapy protocol and one treatment cycle covering 4 weeks.Results The overall response rate in trial group was 53％ and the increase rate of Karnofsky was 70％ while that was 37％ and 40％ respectively in the control group (P ＜ 0.05).The median overall survival of trial group was 13 months and which was 8 months in the control group (P ＜ 0.05),meanwhile the toxicities and side reactions of trial group didn't increase notably.Conclusions Intravenous chemotherapy combined with TACE is safe and more effective in the treatment of gastric cancer with hepatic metastasis.

Objective To investigate the effects of bone marrow stromal cell (BMSC) transplantation on axonal and glial scarring after spinal cord injury (SCI).Methods Thirty New Zealand white rabbits were randomly assigned to a sham operation group (group A),a saline treatment group (group B) or a BMSC treatment group (group C).Group A served as controls,in which the canal was opened without damage to the spinal cord.In groups C and B SCI models were established with aneurysm clips and the rabbits of groups C and B were then given injections of BMSCs and saline solution respectively via the intra-intercostal artery at 1 week post injury.At 1 day,1 week,2 weeks and 4 weeks post injury,Basso Beattie-Bresnahan (BBB) scores were assessed to evaluate the recovery of locomotor function in the hind limbs.Spinal cord samples were harvested for HE and Nissl staining,and immunohistochemistry and image analysis were used to detect any changes in neurofilament (NF200) and glial fibrillary acidic protein (GFAP) in the injured spinal cords.Results The average BBB scores of group A were significantly higher those that of groups B and C at each time point,and those of group C were significantly better than those of group B at the 2nd and 4th week post injury.At the 4th week post injury,HE staining showed there was no glial scarring or cavities in group A,but that there was glial cellular proliferation,glial scarring and cavity formation at the injury site in groups B and C.In group C all were obviously less than in group B.Nissl staining indicated there were more typical neurons in group A,while there were a larger number of ruptured neurons,more degradation,and irregular remaining neurons in groups B and C.These abnormalities were again significantly more prevalent in group C.Immunohistochemical examination showed significant increases in NF200 positive neurons and GFAP in groups B and C compared with group A.The number of NF200 positive neurons was significantly higher in group C than in group B,but the GFAP positive area was significantly smaller in group C than in group B.Conclusion BMSC transplantation via the intercostal arteries can effectively improve axonal regeneration,attenuate glial cellular proliferation and reduce glial scar formation,promoting functional recovery after SCI,at least in rabbits.

Objective To compare the efficacy and safety of modified FOLFOX4 program with docetaxel-oxaliplatin-5-fluorouracil (DOF) program as neoadjuvant chemotherapy in stage Ⅲ gastric cancer patients.Methods In 86 cases of stage Ⅲ gastric cancer patients,42 received modified FOLFOX4 chemotherapy,44 cases were treated by DOF program.After two cycles of chemotherapy,the treatment effect and adverse reactions were evaluated.Results The total effectiveness in modified FOLFOX4 group and DOF group was 60％ (25/42) and 68％ (30/44) respectively (P ＞ 0.05).Tumor control rate was 83％ (35/42) and 89％ (39/44) respectively (P ＞ 0.05).The incidence of nausea,vomiting and leukopenia was higher in DOF group than modified FOLFOX4 group (P ＜ 0.05).The D2 lymph node dissection rate between modified FOLFOX4 group and DOF group was 80％ (20/25) and 87％ (26/30) respectively (P ＞ 0.05),the R0 resection rate was 72％ (18/25) and 83％ (25/30) respectively (P ＞ 0.05).In 43 R0 resection patients using FOLFOX4 the median survival time was 38.7 months,1-,3-year survival rate was 90％,and 60％ ; while that in DOF group the median survival time was 39.6 months,1-,3-year survival rate was 95％,and 75％.Multivariate analysis showed that postoperative TNM stage only was an independent risk factor for prognosis.Conclusions TNM stage was the independent risk factor for prognosis of gastric carcinoma patients after radical gastrectomy.

Objective To evaluate systematically whether administration of hypertonic saline transfusion affects clinical outcomes with compared to standard fluid in the early stage of resuscitation for traumatic shock patients.Methods Seven English and Chinese routine biology and medicine databases were searched for randomized controlled trials (RCTs) published from January 2002 to August 2012,and established inclusion and exclusion criteria to evaluate these RCTs.The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad' s score scale.RevMan 5.0 statistical software was used for meta-analysis.Results After evaluated 211 related literatures,five RCTs met all the inclusion criteria and were enrolled for meta-analysis.The meta-a nalysis demonstrated that early hypertonic transfusion did not decrease short-term (first 48 hours after admission) mortality (RR =1.04,P =0.74); nor did it decrease later-term (7day to 3month after injury) mortality (RR =0.97,P =0.72).It also did not decrease the total volume of fluid and blood transfusion required during the first day (P =0.38).Similarly,it did not affect the incidents of infections (RR =1.04,P =0.70),the length of stay in ICU (P =0.2) and total length of stay in the hospital.Conclusions Compared to standard fluid,there was no advantage on mortality and hospital infection by using hypertonic supplement transfusion in the early stage of resuscitation for traumatic shock patients.Hypertonic transfusion did not have any significant effect on the volume of total fluid and blood transfusion required the first day,and no trend of reduction for the length of ICU and hospital stay.Further well-designed randomized controlled trials are needed to demonstrate the cost effectiveness of hypertonic transfusion to traumatic shock patients while in ICU.

Objective To observe the changes of the brain function during reading recovery by using functional MRI (fMRI),and to provide the experimental data in elucidating the mechanism on the recovery of reading and language function.Methods fMRI was performed in a native Chinese patient with pure alexia on the 45 th and 130 th day after the onset,respectively.Three kinds of Chinese characters were presented during the scan and the patient was asked to make the judgement weather he could recognize the characters or not.The brain activation maps were acquired after postprocessing,and the activated location and volume were compared between the first and second experiments.Results In both experiments,Broca area,Wernicke area,and the right extrastriate were significantly activated,while the left extrastriate around the lesion was markedly activated only in the second experiment,and the volume of activation in the right extrastriate in the second experiment was about 3 times as large as that in the first experiment.Conclusion The left extrastriate cortex is one of the key areas responsible for reading function in the brain.The recovery of reading function can be compensated in contralateral corresponding cortical area,or it can be the result of reorganization in ipsilateral peri-lesion cortex.Both mechanisms may simultaneously play important roles in reading recovery.

Purpose To study the reversal effect on multidrug resistance (MDR) by TNF-α gene combined with verapamil (VRP) or tamoxifen (TAM). Methods By using recombinant retrovirus vector, TNF-α gene was transfected into multidrug-resistant human breast cancer cell line MCF7/ADR. The TNF-α secreting cell clone MCF7/ADR-TNF was obtained by G418 screening. The integrating and secreting of TNF-α were analyzed by PCR and ELISA. MTT assay and formula"I = d/D1 + d/D2" were used to evaluate the reversal effect of multidmg resistance with TNF-α gene combined with verapamil or tamoxifen. ResultsThe level of TNF-α secreted by MCF7/ADR-TNF was 1 737 pg/ml (106cells/48 h). Compared with control,the resistance to ADR of MCF7/ADR-TNF was reversed by 1.6 times. The reversal effect produced by combination of TNF-α gene and VRP was antagonistic. The combination of TNF-α gene and TAM produced synergic effect (interaction index I = 0.64). ConclusionsTNF-α gene combined with TAM has synergic effect on reversing MDR.

BACKGROUND:Whether plumbum(Pb) exposure induced learning and memory disorder in animals is correlated with the changes of the activity of protein kinase C(PKC) in the brain tissue? OBJECTIVE:To investigate the alterative rules of PKC activity in the brain tissue of rat in development stage under chronic exposure of Pb and its effects on the memory development of the mice. DESIGN:A randomized controlled study employing experimental animals as subjects. SETTING: Cellbiology Key Laboratory of the Ministry of Health,China Medical University. MATERIALS:The study was conducted in the Laboratory of Biochemistry and Molecular Biology of China Medical University. Totally 72,5- 6 weeks old Kunming mice were selected. METHODS:Lead acetate of different concentration was used to feed female mice after copulation.Fetal mice contacted Pb through breast feeding and drinking water.Fetal mice were executed separately on 1st day(P1),8th day(P8),15th day(P15),22nd day(P22), and 30th day(P30) after birth for brain tissue harvesting.PCK activity in the brain tissue of the mice exposed to Pb was detected in vitro by[γ 32P] ATP.Budding mice were exposed to lead acetate of different concentration for the observation of the effects of Pb in difference concentration on the memory of the mice through memory behavioral training and test by passive avoidance response experiments. RESULTS:PKC activity detection indicated that PKC activity in brain of Pb exposed budding mice during initial growth stage was higher than normal,while it was lower than normal during advanced stage of growth.High concentration Pb had relative stronger inhibition on PKC activity.Memory behavioral training indicated that low concentration Pb would induce elevation of memory curve in the initial stage of the development in mice but reduction of memory curve in middle and long term.The increase of Pb concentration would reduce memory curve. CONCLUSION:Pb has inhibitive effects on the development of PKC activity in brain tissue of mice:the higher the Pb concentration is, the more significant the inhibition is.Low concentration Pb seems to have stimulatory effects on memory in short period while long term exposure to Pb would induce memory inhibition.The inhibitive effect of high concentration Pb is more significant.Pb has certain correlation with PKC activity in brain tissues of budding mice and memory function.