OBJECTIVE:To investigate the influence of hypoglycemic combined with lipid-lowering statin therapy on lipid profile of mixed dyslipidemia patients with T2DM and TG in 2.3-4.5 mmol/L. METHODS:In total of 80 patients with T2DM and mixed dyslip-idemia of TG in 2.3-4.5 mmol/L in our hospital was determined according to the patient’s age,chronic complications of diabetes and life expectancy. Hypoglycemic(insulin joint oral hypoglycemic drugs,or oral antidiabetic drug alone)treatment was given according to corresponding target,meanwhile statin lipid-lowering therapy was also given. HbA1c,TG,TC,HDL-C and LDL-C were determined and BMI was calculated before treatment. Alipid was reviewed after two weeks,then the difference was compared. RESULTS:Com-pared with before treatment,TG,TC and LDL-C were decreased by 50.28%,42.91% and 44.37% after hypoglycemic combined with lipid-lowering statin therapy,with significant difference(P<0.01). Insulin was the better choice to reduce the level of TG,there was significant difference between insulin treatment and oral hypoglycemic drugs alone (P<0.05). CONCLUSIONS:For T2DM patients with mixed dyslipidemia of TG between 2.3-4.5 mmol/L,hypoglycemic combined with lipid-lowering statin therapy can not only signifi-cantly reduce the levels of TG,TC,LDL-C and TG to 2.3 mmol/L or less,and even normal. Compared with oral hypoglycemic drugs alone,the compliance rate of TG was higher in the combination of insulin and oral hypoglycemic drugs.

Objective To discuss the method and treatment outcome of vascular variation in repairing skin defect of the hand by free transplantation of posterior interosseous perforator flap.Methods Eight cases with vascular variation were adjusted flap position,two cases were repaired by single perforator flap,three cases were repaired by cutting perforator and anastomosing perforator after changing the path,three cases were repaired by designing composition leaves flap.Results Seven flaps survived,one flap partly necrosis and healed by skin-grafting,and all of the patients were followed-up 3 to 18 months.The color,texture and thickness of the flaps were satisfactory.The movements of the fingers were satisfactory.According to the hand function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,outcomes were rated excellent in 1 case,good in 5 cases,fair in 2 cases.The excellent and good rate was 75％.Conclusion When finding vascular variation in repairing skin defect of the hand by free transplantation of posterior interosseous perforator flap,adjust flap position,repair by single perforator flap,cutting perforator and anastomosing perforator after changing the path,or designing composition leaves flap is a good treatment option.

Objective To understand the moving patterns of Oncomelania snails, intermediate host of S.japonicum, in the water bodies. . Methods. Based on the biological features of the snails, methods and techniques in relation to hydraulics and silt engineering were adopted to investigate the active scrawl ability and passive movement of the snails. . Results and Conclusion . The scrawl speed of the snails themselves was very low, 2.^45 mm per minute only. The active movement in the water current was therefore almost negligible. The major moving patterns of the snails in rivers and canals were that: 1. Snails adsorbed on different kinds of carriers drifted on the water. 2. Snails suspended on the water and drifted with the current, these were the young snails under 7 weeks of age. Adult snail showed a strong ability of adhesion, 12 times higher than its body weight.

Objective To compare the torque resistance effect with different types of reconstruction of the distal radioulnar joint (DRUJ) dislocation,in order to explore biomechanical basis for clinical practice.Methods Six adult cadaver forearm were used,including 4 males and 2 females.The average death age was 64.9 years (range,36-78 years).Three were right side,3 were left side.The DRUJ dislocation model was made after the standardized resection of the palmar and dorsal DRUJ ligament.Clinic reconstruction methods of the DRUJ include trans-bone tunnel renconstruction (intra-articular reconstruction) and Looptie up reconstruction (extra-articular reconstruction).The mechanical properties as follows:torque velocity:5°/min,maximum torque angulation:90°,maximum torsion force:1 N· mm.Each limb was detected for the torque mechanic under four conditions:normal,DRUJ dislocation,intra-articular reconstruction and extra-articular reconstruction.Results Each limb was inspected for intact mechanic baseline and without the visual damage to the bone.The average pronation torque resistance on normal condition was (0.44±0.10) N·mm,(0.37±0.09) N·mm on DRUJ dislocation group,(0.45±0.09) N-mm on intra-articular reconstruction group,and (0.42±0.09) N·nun on extra-articular reconstruction group.Pronation torque resistance of DRUJ dislocation group was apparently lower than the normal group (t=2.043,P=-0.047).The pronation torque resistance reconstruction group had no significant difference with normal group.The average supination torque resistance on normal condition was (0.56±0.16) N·mm,while on DRUJ dislocation group was (0.42±0.11) N-mm,on intra-articular reconstruction group was (0.54±0.16) N·mm,on extra-articular reconstruction group was (0.51±0.13) N·mm.There were no apparent differences among four groups.Conclusion Both internal and external reconstruction could recover the rotation stability and normalize the torque resistance,without statistical difference.

Aim To investigate the effect of insulin glargine and human insulin on proliferation of a human breast cancer cell line MDA-MB-231 and the role of ERK in the process.Methods MDA-MB-231 cells were incubated with insulin glargine and human insulin at different concentrations and for different time courses.A specific ERK1/2 inhibitor,PD98059,was used either alone or in combination with insulin glargine or human insulin to test the involvement of ERK pathway in cell growth.Cell proliferation was evaluated using cell counting kit-8 reagents.Cell cycle distribution was analyzed by flow cytometry.Results Both insulin glargine and human insulin dose-dependently enhanced MDA-MB-231 cell proliferation at the concentrations from 1 to 100 IU?L-1 after treatment for 96 h.At the concentration of 10 IU?L-1,both drugs promoted cell growth at 48,72,and 96 h.The percentage of S+G2/M cells was significantly increased in both insulin glargine and human insulin treated groups as compared to untreated controls.No significant difference was observed between insulin glargine and human insulin in their effects on cell proliferation and cell cycle distribution.Cell proliferation was significantly inhibited by PD98059.However,in the presence of PD98059,both drugs still promoted cell proliferation significantly as compared to untreated controls.Conclusions Insulin galrgine and human insulin similarly promote proliferation of MDA-MB-231 cells independent of ERK activation.

[ Objective] To compare the protective mechanism of Zuojin Pill (Rhizoma Coptidis: Fructus Evodiae = 6:1) and Fan Zuojin Pill (Rhizoma Coptidis: Fructus Evodiae = 1: 6) on gastric secretion and gastric mucosal barrier. [Methods] Pylorus - ligated rat model was applied. Rats were divided into normal saline group, Zuojin Pill groups (1.4 g/kg and 2.8 g/kg) and Fan Zuojin Pill groups (1.4g/kg and 2.8g/kg) and then the drugs were given by duodenal feeding. Gastric secretion and gastric mucus synthesis were examined. [Results] Zuojin Pill and Fan Zuojin Pill (1.4 g/kg and 2.8 g/kg) both inhibited gastric secretion and decreased total acid output and pepsin activity in a dose- effect manner. Zuojin Pill and Fan Zuojin Pill also increased the content of gastric adherent mucus (GAM) and tended to elevate the mucus level in gastric juice. [Conclusion] The preventive mechanism of Zuojin Pill and Fan Zuojin Pill on gastric mucosa may be related to the regulation of gastric secretion and gastric mucus synthesis.

ObjectiveTo evaluate the curative effect of reconstruction of the hand and foot defects with bones and tendons exposure using free medial sural artery perforator flap(MSAP). MethodsRadiographs of 2 cadavers injected with a modified lead oxide-gelatin mixture were digitally analyzed. Between April 2007 and December 2010, thirty-four patients with soft tissue defects in the distal limb were treated with the free MSAP flap transplantation. The sizes of the defect ranged 6 cm × 4 cm-13 cm × 8 cm, and the flaps ranged 7 cm× 5 cm-14 cm × 9 cm. These clinical cases included 25 hands and 9 feet, all of them with bones and tendons exposure.In these defects,twenty-two were clean,twelve got infections.In our cases, twenty-three flaps were nourished with single perforator vessel and else 11 with two;perforator vessel fifteen flaps were dissected one superficial vein to anastomose with that of the recipient sites in addition to accompanying vein anastomosis;The sensation of 9 flaps recovered the hands were reconstructed with cutaneous nerve anastomosis. ResultsA partition of the calf skin blood vessels,and three-dimensional reconstruction image of the sural artery were obtained.All flaps survived,five of them appeared partially violet and bubbles. Followed up 6-21 months, the cosmetic results were satisfactory and without apparent bulkiness.The flap colors were similar to recipient sites. The flap senses reconstructed with neural anastomosis recover to S2-S3. ConclusionThe new flap is very suitable to repair the soft tissue defect in the distal limbs,because the fairly constant perforator vessel,the reliable blood supply and the cosmetic shape of the MSAP flap are all advantages of it in addition to no damage to low leg chief artery and gastrocnemius.

Objective To provide anatomical landmarks with which to facilitate flap dissection,we studied the perforator artery of the dorsal forearm including its source,quantity,origination,caliber,variation and pedicle length. Methods Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture,and three-dimensional graphics of the perforator vessels of the dorsal forearm were reconstructed with a computed tomography. In addition, twenty upper extremity specimens were injected with red latex via the axillary artery.The integument of the forearm was dissected,and perforators were identified,including type,course,size and location were documented.Surface areas were measured with Scion Image. Results The average number of the posterior interosseous artery cutaneous perforators in the dorsal forearm was (5±2),the average outer diameter of the perforator artories was (0.5 ± 0.1) mm,and the pedicle length was (2.5 ±0.2) cm.The average cutaneous vascular territory was (22.0 ± 15.0) cm2.The dorsal branch of the anterior interosseous artery dispersed on the wrist dorsum or the distal third of the dorsal forearm. It's average diameter was 0.8 mum. Conclusion The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by the dorsal branch of the anterior interosseous artery for defect reconstruction are feasible.

Objective To construct the recombinant yeast expressing PreS2 120-146-hepatitis B surface antigen (HBsAg),and to evaluate the immune effects of whole yeast cells.Methods PreS2 120-146 and HBsAg gene sequence were optimized according to the yeast cell codon preference,and were recombined and cloned into pPIC3.5K yeast expression vector to construct pPIC3.5K/PreS2 120-146 plasmid.After digested and linearized by Bgk Ⅱ restriction enzyme,pPIC3.5K/PreS2 120-146-HBsAg recombinant plasmid was electrotransformed into GS115 strain to screen PreS2 120-146-HBsAg-recombinant Pichiapastoris .The expression of PreS2 120-146-HBsAg was identified by sodium doclecyl sulfate polyacrylamide gel electrophogesis (SDS-PAGE),Western blot and enzyme linked immunosorbent assay (ELISA)analysis. BALB/c mice were vaccinated by inactivated whole recombinant yeast cells expressing target protein. Specific antibodies to HBsAg were detected by ELISA.Cytotoxic T lymphocyte (CTL)response induced by interferon (IFN)-γ was detected by reverse transcription-polymerase chain reaction (RT-PCR)when immune spleen cells of mice were stimulated by CTL epitope on HBsAg.Independent sample t test was used. Results Data of PCR detection,restriction enzyme digestion and sequencing analysis showed that recombinant pPIC3.5K/PreS2 120-146-HBsAg plasmid was successfully constructed.SDS-PAGE,Western blot and ELISA verified the expression of PreS2 120-146-HBsAg in the lysate of the recombinant Pichiapastoris induced by methanol.Levels of specific anti-HBsAg IgG antibodies produced by inactivated yeast cells vaccinated mice were comparable to purified HBsAg immunization (t =0.946,P =0.381 ). Analysis of HBsAg-specific CTL responses revealed that the level of IFN-γwas significantly higher when the immune spleen cells of mice were stimulated by CTL epitope peptides on HBsAg (t =2.305 ,P =0.044).Conclusions PreS2 120-146-HBsAg target protein is successfully expressed by construction of recombinant Pichiapastoris . The specific humoral and cellular immune responses are induced by recombinant whole yeast cells vaccinated mice.

Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.