Objective: To study the relationship between the activation of hepatic stellate cell(HSC) and the early stage of liver fibrosis in experimental diabetic tree shrews.Methods: Tree shrews were divided randomly into normal control group and streptozocin(STZ)-treated group.STZ-treated animals were then divided into diabetic group and STZ control group.ALT,AST,Type Ⅳ collagen(Ⅳ-C),Laminin(LN) and Hyaluronic acid(HA) were detected respectively before and after modelling.Liver biopsy was performed at the end of the experiment(8th week).All of the liver specimens were observed in light microscope and transmission electron microscope.?-smooth muscle actin(?-SMA) was detected by immunohistochemistry and computer image analysis system.Results: Early fibrosis of the liver in diabetic tree shrews can be found by both light and electron microscope.There were some ?-SMA positive HSCs,namely,activated HSCs could be observed in the liver of diabetic group but not in other two groups.The expression of ?-SMA increased significantly in the liver of diabetic group as compared with that of other two groups.In addition,the level of expression of ?-SMA was positively correlated with the collagen area density in diabetic group.Conclusion HSC may play an important role in the development and aggravation of liver fibrosis in diabetic tree shrews.

Objective To investigate the efficacy of intermittent epidural bolus ( IEB) for patient?controlled epidural analgesia ( PCEA) during delivery. Methods Eighty?five parturients requesting epi?dural analgesia, who were at full term ( 37-42 weeks of gestation) with a singleton fetus in vertex presenta?tion, of American Society of Anesthesiologists physical statusⅠorⅡ, with body mass index< 35 kg∕m2 , were divided into either IEB group ( n=42) or continuous epidural infusion ( CEI) group ( n=43) using a random number table. The analgesia solution contained 0.08% ropivacaine and 0.4μg∕ml sufentanil in both groups . IEB settings were a 6 ml bolus every hour at the rate of 400 ml∕h with a bolus dose 6 ml and lockout interval 30 min. CEI settings were background infusion 6 ml∕h with a bolus dose 6 ml and lockout interval 30 min. Numeric rating scale score was maintained≤5, and if the efficacy was not satisfactory, a bolus of pump solution 5-10 ml was added. The consumption of analgesics per hour, initial PCA time, and occur?rence of lower extremity numbness, motor block, nausea and vomiting, and pruritus were recorded. Pa?tients′satisfaction with analgesia was scored, and the duration of labor and mode of delivery were recorded. Results Compared with group CEI, the initial PCA time was significantly prolonged, the satisfaction score was significantly increased, the incidence of lower extremity numbness was significantly decreased ( P<0.05) , and no significant change was found in the consumption of analgesics per hour, incidence of motor block, nausea and vomiting, and pruritus, constituent ratio of mode of delivery, and duration of la?bor in group IEB ( P>0.05) . Conclusion IEB can be safely and effectively used for PCEA during deliver?y, and the efficacy is better than that of CEI in the parturients.

Objectives To investigate the relationship between the insertion and deletion (I/D) polymorphism of human angiotensin converting enzyme (ACE) gene and the vascular complications in type 2 diabetes. Methods The I/D polymorphism of ACE gene was detected by polymerase chain reaction in 120 type 2 diabetic patients and 100 healthy controls. Results The frequency of DD genotype was significantly higher, while frequency of II genotype was lower in diabetic nephropathy patients (DN) than those in control group. The frequency of ID genotype was significantly higher, while frequency of II genotype was lower in type 2 diabetic patients with coronary heart disease (CHD), when compared to those without CHD. The frequencies of ACE genotypes in patients with diabetic retinopathy (DR) or hypertension (HP) were not different from those in control group and non-DR or non- HP patients. Conclusions ① There were relationships between the I/D polymorphism of ACE gene and DN and CHD in type 2 diabetes. ② The DD genotype and D allele of ACE gene might be as markers in predisposing DN, while II genotype and I allele as protective factors for DN in diabetes. The ID genotype might be as a marker in predisposing CHD, while II genotype as a protective factor for CHD in diabetes.③ There was no relationship between I/D polymorphism of ACE gene and HP or DR in diabetes in Guangxi region.

Objective To establish an RP-HPLC method for determining serum level of valproate.Methods A symmetryshield RP18 column (5?m,3.9mm?150mm) was used.The mobile phase,methanol-water(80:20) was used at a flow rate of 1.0ml/min.The detector was Waters 2487 dual?absorbance detector,which was set at the wavelength of 248nm.Serum sample was extracted with 2ml acetic n-hexane,then valproic acid in organic layer was derived by adding into?-bromoacetophenone,and cyclohcxanecarboxyiic acid was selected as an internal stan- dard.Results The calibration curve was linear in the range of 5.0 to 250.0vtg/ml.The average recovery rate was 98.23%,and the RSD within-day and between-day were both less than 3 %.Conclusion This method is suitable for therapeutic drug monitoring of phenytoin.

OBJECTIVE: To observe the effect and safety of exenatide therapy in type 2 diabetes patients with failure to metformin. METHODS: Sixty patients with type 2 diabetes who did not achieve satisfactory blood glucose control were randomly assigned either to add exenatide or glargine. postprandial blood glucose, HbA1C, blood lipid, and body mass index of the patients before and after treatment were recorded, and the side effects were also recorded for 52 weeks. RESULTS: The FPG and HbA1C of patients decreased more significantly after exenatide therapy than glargine treatment (P<0.05). The exenatide group had a significantly higher level of ΔHOMA-13 than the glargine group. CONCLUSION: Exenatide can be used for long-term control of blood glucose with improving lipid metabolism and low occurrence of hypoglycemia, without increasing body weight.

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Objective To determine the contents of scutellarin and chlorogenic acid in Qingkailing extract by HPLC.Methods Kromasil C18 column was adopted and the mobile phase consisted of methnol-water-phosphoric acid (20 ∶80 ∶0.2) with the flow rate being 1.0 mL?min-1 and column temperature being 25 ℃.The detection wavelength was 327 nm.Results The linearity of scutellarin was good in the range of 0.090～0.540 ?g,r=0.999 9,and its average recovery rate was 100.3 %(RSD=0.99 %);the linearity of chlorogenic acid was good in the range of 0.196～1.176 ?g,r=0.999 9,and its average recovery rate was 99.9 %(RSD=1.06 %).Conclusion This method is sensitive,simple,accurate,and can be used for the quality control of Qingkailing extract.

Objective To investigate the effect of the evaluation on teaching hospitals affiliat-ed to medical colleges in Guangdong province. Methods Questionnaire and on on-the-spot investi-gation was conducted among 18 teaching hospitals which owned the accreditation for 2-3 years based on Guangdong provincial teaching hospital accreditation indicator system 2008 modified version. Contents of investigation included general situation,teaching condition,management and implementa-tion of teaching activities as well as medical staffs' comments and suggestions for the teaching work. SPSS 13.0 software was used for frequency analysis. Results The general situation,teaching condi-tion,management and implementation of teaching activities were improved to varying degrees after the evaluation according to results of the questionnaire. 90.0%(54/90)people thought that the overall scale of the hospital was expanded and 5.0%(3/60)people thought that the overall scale of the hos-pital was obviously reduced or marinated the original level. 11.6%(7/60)and 88.3%(53/60)people thought that medical quality of the hospital was improved or obviously improved. 60.0%(36/60)people thought that educational occupancy of the hospital was improved while 5.0%(3/60)people thought that it was unsatisfactory. 83.3%(50/60)people thought that teaching mold and infrastructures were improved while 10.0%(6/60)people thought that it was unsatisfactory. 95.0%(57/60)people thought that teaching management was improved. Due to the lack of incentives and support in teaching work, management of teaching was loose. Conclusions The teaching work of t hospitals affiliated to medical colleges in Guangdong province do persevere basically and achieve desired purposes.

Objective To investigate the clinical skill and experience of laparoscopic herniorrhaphy in the treatment of abdominal hernia. Methods Clinical data of 30 cases of abdominal hernia undergoing laparoscopic her-niorrhaphy in Shengjing Hospital from May 2004 to December 2008 were analyzed retrospectively. There were 23 in-guinal hernia,4 incision hernia and 3 hiatal hernia. TEP in 20 cases,TAPP in 3 cases,lPOM in 4 cases and Nissen hiatal hernia repair in 3 cases were performed. Results The mean operating duration was 72 min for TEP, 127 for TAPP,150 min for IPOM,and ]60 min for hiatal hernia repair and the mean time for hospitalization was 4.6,5.8, 7.5, and 5.3 days. No conversion to open surgery happened among these cases. No recurrence was found. Conclu-sions Laparoscopic herniorrhaphy appears to be an effective and convenient technique for the treatment of abdomi-nal hernia and has many advantages of minimally invasive surgery.

Objective To study the effect of bird's nest nursing on the vital signs,gastroenteric function,body weight and growth of premature infants.Methods 456 cases of premature infants were divided into the warm box group and the bird's nest group randomly according to odd and even number of birth,namely 228 cases in each group.The warm box group adopted routine nursing care.The bird's nest group adopted routine nursing care and bird's nest nursing in the mean time,namely the bird's nest wag put into the warm box,the premature infants slept in the pre-heated bird's nest.The condition of the two groups Was compared.Results On the first day of birth,there were no statistical difference(P＞0.05)between the two groups in respiration,heart rate,milk amount and body weight.On the seventh and fourteenth day,respiration and heart rate were stable and milk amount and body weight increased rapidly in bird's nest group.There Was statistical difference(P＜0.05)between the two groups.In bird's nest group,the premature had long sleeping time and body temperature-fluctuation was reduced.There was statistical differencere(P＜0.01)between the two groups.Conclusions After the bird's nest was used in premature care,diseases were recovered rapidly,hospitalization days were shortened and it was beneficial to the development of intelligence and body and mind of the premature infants.