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.

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 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.

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.

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 Insulin-like growth factor-1 (IGF-1) participates in the regulation of the biological activity of cells.Researches showed that the serum IGF-1 level is significantly raised in the patients with Graves diseases.Thyroid associated ophthalmopathy (TAO) is one of Graves diseases,and orbital adipose cells are the target cells of thyroid autoantigens.However,whether IGF-1 is associated with TAO is still unclear.Objective This study was to investigate the expressions of IGF-1 in both circulating blood and orbital adipose tissue in TAO patients.Methods A retrospective cohort study was performed.Eighty-six TAO patients were enrolled in West China Hospital of Sichuan University from August 2009 to February 2014.According to the clinical activity score criteria(CAS) ,the patients were divided into active stage (CAS ≥ 4,35 patients) and inactive stage (CAS ＜4,51 patients).Eighty-six health adult persons were enrolled as the controls.The periphery blood of 3 ml was collected from each subject to detect the serum IGF-1 level by ELISA.Orbital adipose tissues were obtained during the surgery from 35 TAO patients and 35 patients with benign orbital tumor or orbital adipose prolapse from August 2009 to February 2014.The histopathological examination of orbital adipose tissue was carried out to evaluate the pathological characteristics, and the expression of IGF-1 in orbital adipose tissue was assessed by immunochemistry.This study protocol was approved by Ethic Committee of West China Hospital of Sichuan University, and informed consent was obtained from each subject before entering the cohort.Results The mean serum IGF-1 level was (0.862±0.026)ng/ml in the TAO patients,and that in the normal controls was (0.767 ± 0.480) ng/ml, without significant difference between them (P=0.281).The mean serum IGF-1 level was (0.877±0.355) ng/ml and (0.803±0.031) ng/ml in active stage and inactive stage of patients, respectively, and no significant difference was found between them (P =0.834).IGF-1 expression located in cellular membrane and cytoplasm.The expressing intensity of IGF-1 in orbital adipocytes was significantly enhanced in the TAO patients with the positive rate of 74.29% , and that in the controls was 45.46％ ,showing a statistical difference between the two groups (x2=5.289,P=0.021).Conclusions Serum IGF-1 level dose not rise in TAO patients, but the expression of IGF-1 in orbital adipocytes up-regulates, indicating that mature orbital adipocytes of TAO are regulated mainly by IGF-1.

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.

The use of electronic medical records in Beijing hospitals was investigated and some feasible suggestions were put forward for the sharing of electronic medical records according to the problems in their use in order to pro-mote medical information sharing in Beijing hospitals.

Objective To understand the pathogenic bacteria distribution and drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The retrospective analysis was per-formed in the sputum culturs and drug resistance results of 740 patients with AECOPD. Results The positive rate of bacterial infection was 39. 1%. Among them, gram-negative bacteria were 196 strains (62. 4%), gram-positive bacteria 21 strains (6. 7%), and fungi 97 strains(30. 9%). The main kinds of gram-negative bacteria were Pseud-omonas aeruginasa, Acinetobacter baumannii,Klebsiella pneumoniae,Stenotrophomonas maltophilia and Escherichia-coli. Staphylococcus haemolyticus, Streptococcus pneumoniae and Staphylococcus aureus were the most frequent gram-positive bacteria. The major fungi was Candida albicans. Gram-negative bacteria showed high resistance to the third-generation cephalosporins,penicillins, moderate resistance to aminoglycosides,low resistance to imipenem. Gram-positive bacteria were resistant to many kinds of antibiotics, but they were responsive to linezolid and vancomycin. Fungi showed high sensitivity to antifungal agents. Conclusion The pathogens of AECOPD mainly are gram-nega-tive bacteria with a high drug resistance rate. To monitor pathogenic bacteria is conducive to master the pathogens distribution, drug resistance and provide the basis of rational use of antibiotics,which can slow down the emergence and spread of resistant bacteria.