Objective To discuss the effect of alprostadil combined with irbesartan in patients with early diabetic nephropathy.Methods Ninety-six patients with early diabetic nephropathy were divided randomly and voluntarily into the control group (n =48) and observation group (n =48).All patients were given regular treatment,the patients of the control group were given irbesartan (150 mg,oral) based on regular treatment while the observation group were given alprostadil(intravenous drip alprostadil 10 g with saline 250 ml,1 times a day)based on treatment of the control group,the course was four weeks.The blood rheology,serum albumin,24 hours urinary albumin excretion rate (UAER) and urea nitrogen (BUN),serum creatinine (Scr) and clinical effect between the two groups were compared.Results After treatment,the whole blood midst shear viscosity values,whole blood low shear viscosity values and whole blood high shear viscosity values of observation group were respectively (5.32±1.16) mPa · s,(8.73±2.15) mPa · s and (3.52±0.52) mPa · s,significantly lower thanof control group((6.74± 1.92) mPa · s,(9.96±2.43) mPa · s,(4.53±0.64) mPa · s),the differences were statistically significant (t =4.627,4.728,4.226;P＜0.05).The Alb of observation group was (36.36±7.24) g/L,obviously higher than that of control group (29.73 ± 5.36) g/L,the difference was statistically significant (t=5.336,P＜0.05),while the UAER,BUN and Scr of observation group were respectively (375.84±24.24)mg/L,(9.61 ± 1.42) mmol/L and (136.36 ± 26.73) μmol/L,obviously lower than that of control group ((636.42± 43.56) mg/L,(13.45 ± 3.14) mmol/L,(176.32 ± 41.62) μmol/L),the differences were statistically significant (t =6.738,4.628,6.662;P＜ 0.05).The total effective rate of observation group was obviously higher than that of control group,the differences were statistically significant (93.75％ (45/48) vs.66.67％ (32/48);x2 =6.637,P＜ 0.05).Conclusion Alprostadil combine with irbesartan can effectively improve the blood rheology and renal function in patients with early diabetic nephropathy and improve the living quality,the effect is better than irbesartan only,it is worth popularization and application.

Objective To discuss the influence of different dose α-lipoic acid on blood glucose and C-reaction protein(CRP) in type 2 diabetic patients with macroangiopathy.Methods Seventy-two cases type 2 diabetic patients with macroangiopathy were divided randomly and voluntarily into the conventional dose group(n=36) and high dose group(n=36).The patients of conventional dose group were given conventional dose α-lipoic acid(300 mg/d) based on glucose treatment while high dose group were given high dose α-lipoic acid (600 mg/d) based on glucose treatment,the courses were all 15 d.The fasting blood glucose(FBG),2 h postprandial blood glucose(2 hBG),serum CRP of before and after treatment of between the two groups and safety during the treatment were compared.Results The FBG,2 hBG and CRP of before and after treatment were respcetively (9.24±2.18) mmol/L and (8.18±1.38) mmol/L,(13.26±3.17) mmol/L and (11.26±1.63) mmol/L,(21.52±4.17) mg/L and (14.72±3.73) mg/L;(9.26±2.04) mmol/L and (5.82±1.27)mmol/L,(13.52±2.45) mmoL/L and (8.92±1.04) mmol/L,(22.65±4.67) mg/L and (8.61±1.52) mg/L,all groups decreased obviously,the differences were statistically significant compared to that of before treatment(t=4.265,4.654,4.956 and 5.562,6.254,7.654,P＜0.05),and the high dose group showed more lower (t=5.353,5.783,6.257,P＜0.05).After treatment,ALT ((37.26±9.64) U/L),AST ((38.22±7.04) U/L),BUN((7.25±1.52) mmol/L) and Scr((55.25±11.25) mmol/L) of all groups increased obviously than pretreatment((33.53±6.37) U/L,(33.15±7.16) U/L,(5.43±4.67) mmol/L,(53.15±13.65) mmol/L),but the differences were no statistically significant compared to that of before treatment (t=-2.061,-2.165,-1.455,-0.689,P＜0.05),and there were also no statistical significance between the two groups(t =2.125,3.026,1.235,1.035,P＜0.05).Conclusion α-lipoic acid can obviously decrease the blood glucose and CRP in type 2 diabetic patients with macroangiopathy,which has a significant dose effect relationship,and is safe and worthy of clinical application.

Ten healthy mongrel dogs of either sex were divided into two groups: Dex-treated group (n=6) and NS-treated group (n=4). The dogs were attacked with hemorrhagic shock by bleeding via left femoral artery. Dex-treated group was given Dexamethasone (5mg/kg) at mean arterial pressure (MAP) of 13.3 kPa. NS-treated was given placebo of 0.9% Nad solution. The atrial natriuretic peptide (ANP) was determined by radioimmunoassay. Plasma level of ANP decreased progressively 5 h after shock. There was a significant positive correlation between the extent of reduction of MAP and that of plasma ANP (r=0.871203, n=16, P

Objective To investigate the significance of changes of serum high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-alpha (TNF-α),interleukin 6 (IL-6) and urinary microalbumine levels in patients with diabetic kidney disease.Methods Serum hs-CRP,TNF-α,IL-6 and urinary microalbumine levels were measured with RIA in 60 type 2 diabetic patients and 20 controls.The 60 diabetic patients were divided into three groups based on urine albumin excretion rate.Group A:without alblminuria ( UAER ＜ 20 μg/ min,n =20 ) ; Group B:micro-albuminuria ( UAER ＜ 200 μg/min,n =20 ) ; Group C:macro-albuminuria ( UAER ＞ 200 μg/min,n =20 ).The serum levels of hs-CRP,TNF-α,IL-6 of patients in the four groups were measured.Results The serum levels of hs-CRP,TNF-α,IL-6 of patients in the healthy group were ( 1.21 ± 0.87 ) mg/L,( 1.27 ± 0.93 ) ng/L and ( 4.31 ± 1.72 ) ng/L,in the nonalbuminuria group were ( 2.31 ± 1.07 ) mg/L,( 1.95 ± 1.34 ) ng/L and ( 5.79 ± 1.68 ) ng/L,in the microalbuminuria group were ( 3.47 ± 1.25 ) mg/L,(2.86 ± 1.26) ng/L,(7.13 ± 1.57 ) ng/L,in the macroalbuminuria group were (4.83 ± 1.47 ) mg/L,(4.03 ±1.43)ng/L,(9.14 ±2.43)ng/L Serum levels of hs-CRP,TNF-α and IL-6 were significantly higher in all the patients with type 2 diabetes than those in the control group (P ＜ 0.01 ).Serum levels of hs-CRP,TNF-α and IL-6 were significantly higher in type 2 diabetic patients with microalbuminuria than those in patients without albuminuria (P ＜0.05).Serum levels of hs-CRP,TNF-α and IL-6 were significantly higher in diabetic patients with macroalbuminuria than those in patients with micrealbuminuria (P ＜ 0.01 ).The levels of hs-CRP,TNF-αand IL-6 were positively related to the urinary microalbumine levels ( rs =0.67,0.64,0.75,P ＜ 0.01 ).Conclusion Determination of serum hs-CRP,TNF-α and IL-6 levels might be helpful for early detection of diabetic kidney disease and monitoring the progress of the disease process.

Objective To observe the clinical effect of mifepristone combined with intramuscular injection of methotrexate in the treatment of cesarean scar pregnancy.Methods Fifty-six patients with uterine scar pregnancy after cesarean section were divided into observation group and control group by random number method.The control group was intramuscularly injected methotrexate,the observation group was given methotrexate combined with mifepristone therapy.The therapeutic effect,blood β human chorionic gonadotropin(β-HCG) decreased to normal time,vaginal bleeding time,mass size were observed.Results After treatment,the serum β-HCG decreased to normal time[(15.96±3.71)d] and vaginal bleeding time[(5.12±2.08)d] of the observation group were significantly shorter than those of the control group [(25.42±4.02)d,(7.39±3.37)d],the mass size of the observation group [(1.88±0.15)cm] was also significantly smaller than (2.14±0.33) cm of the control group,and there were significant differences between the two groups(t=4.3142,3.0331,3.7954,all P＜0.05).Conclusion Mifepristone combined with intramuscular injection of methotrexate has significant effect on uterine scar pregnancy after cesarean section.

Long non-coding RNAs are important regulators of gene expression.ANRIL which was coded on the Chr9p21.3 loci participates in the pathogenesis of tumor, coronary artery disease, type 2 diabetes mellitus and oth-er diseases.Multiple ANRIL isoforms are tissue-specific.ANRIL mainly functions through Polycomb proteins, while there are also other downstream targets.The mechanism of each isoform and the downstream pathways are hotspots incurrent researches.

After the advantages and disadvantages of appointment registration systems in different large hospitals of Beijing were compared, the problems in their appointment registration systems were analyzed and suggestions were put forward for establishing the public appointment registration systems with powerful systematization and compati-bility which are integrated into the EMR system of Beijing.

BACKGROUND: The imaging methods of evaluating the volume of necrotic femoral head are based on Kerboul angle and necrosis index revealed on X-ray, as well as CT and MRI three-dimensional reconstruction, but the accuracy of each method is different, and none is widely accepted. Additionally, the association of the volum and degree of necrotic femoral head with the status of blood supply to the femoral head remain unclear. OBJECTIVE: To evaluate the accuracy of each imaing method for assessing different stages of femoral head necrosis, and to confirm a convenient method used for measuring the volum of necrotic femoral head. METHODS: This diagnostic in vivo animal trial was finished in the Affiliated Zhongshan Hospital of Dalian University, Liaoning Province, China. The canine models of steroid-induced necrosis of femoral head were prepared, and received CT and MRI examinations, followed by three-dimensional reconstruction combined with Micro-CT to make accuratediagnosis; the degree of necrotic femoral head and its association with the status of blood supply were evaluated throughangiography and histopathological examination. All above outcome measures were compared with the Association Research Circulation Osseous to testify the consistency of this precise method with traditional methods. The experiment follows the national guidelines for the Care and Use of Laboratory Animals, and Consensus author guidelines on animal ethics and welfare by the international Association for Veterinary Editors (IAVE). The article was prepared in accordance with the Animal Research: Reporting of In Vivo Experiments Guidelines (ARRIVE Guidelines). RESULTS AND CONCLUSION: The aim of the study is to obtain a accurate measurement method by detecting different stages of osteonecrosis using different imaging techniques, which enables surgeons make exact diagnosis and clinical stage of osteonecrosis, thus desiging standardized treatment program.

Objective:To discuss the effect of optimum program on hypertensive cerebral hemorrhage in acute phase.Methods:380 patients with hypertensive cerebral hemorrhage were selected.They were randomly divided into test group by given two agents(Xuezhongxiao/Zhongfengfangzhiling)+comprehensive rehabilitation(rehabilitation of modern acupuncture)+ medicine-based treatment +microinvasive surgical therapy,and control group by given Chinese medicines(Xuekang /Naoan capsule) + modern rehabilitation+ medicine-based treatment + craniotomy treatment.The curative effects was observed and compared between the two groups.Results:The test group was evidently superior to the constrol one in haematoma clearance rate,nerve functions recovery,extremity rehabilitation and symptoms improvement(P

Management of hyperthyroidism in pregnancy and lactation has been the topic for many years. This article has discussed the use of antithyroid drugs(ATDs) in pregnancy and lactation, including the choice, the safety, as well as the influences of ATDs to infants.