Sixty three new type 2 diabetes(T2DM)mellitus were treated with insulin pump for 2 weeks.Free insulins,fasting plasma slucose,tumor necrosis factor-α(TNF-α)and interleukin(IL)-6 level and other parameters were measured before and after insulin treatment.HOMA-insulin resistance (HOMA-IR)and β-cell function(HOMA-β)were compared.After 2 weeks insulin intensive treatment, TNF-α and IL-6 level were significant lower(P<0.01).HOMA-IR and HOMA.B were signifiant improved (P<0.01).TNF-α and IL-6 levels were positively associated with tlle body mess index and HOMA.IR (P<0.01).TNF-α,IL-6 and HOMA-IR could be significanly improved by short-term insulin pump intensive treatment in new T2DM patients with severe hyperglycemia.

Objective: To investigate the effect and mechanism of brain-derived neurotrophic factor (BDNF) pretreatment for reducing myocardial ischemia/reperfusion (I/R) injury in experiment rats.
Methods: Rat’s myocardial I/R model was established by left anterior descending artery ligation for 30min followed-by reperfusion for 180 min. The rats were divided into 5 groups:Sham operation group, I/R group and IR with BDNF pretreatment (1, 10, 100) nmol/(kg·ml) groups respectively. The LVSP, LVEDP, ±dp/dtmax were recorded after I/R;serum levels of LDH, CK and the cardiac tissue levels of MDA, SOD were examined;the ratios of left ventricular myocardial infarction area in different groups were observed by by Evans blue staining;cell apoptosis rates were evaluated by Tunel staining;the total-TrkB and p-TrkB in myocardium were detected by Western-blot analysis.
Result: Compared with I/R group, in 3 IR with BDNF pretreatment groups, LVSP, ±dp/dtmax were gradually increasing and LVEDP were gradually decreasing, all P<0.05;the leaking levels of LDH, CK and the content of MDA were gradually decreasing and the SOD activity was gradually increasing, all P<0.05;the average ratios of MI area/ischemic area were decreased from (47.54 ± 6.35)%to (28.68 ± 4.56)%, the apoptosis rates decreased from (37.89 ± 5.46)%to (10.24 ± 3.05)%, the level of p-trkB/Total-TrkB increased from (0.16 ± 0.03) to (0.42 ± 0.03), P<0.05.
Conclusion: BDNF pretreatment could maintain the cardiac function in experiment rats after I/R injury, it may reduce MI area, decrease oxidative damage and apoptosis, therefore, protect myocardial cells for reducing IR injury.

Objective To explore skills and values of needle-knife in difficult papillosphincterotomy.Methods 222 cases underwent needle-like fenestration(NKF),and other 194 cases directly underwent needle-knife papillotomy(NKP) using needle-knife.Results The success rate of operation in the NKF Group and NKP Group was 75.2%(167/222) and 97.9%(190/194) respectively,with total success rate 85.8%(357/416).Infections of biliary tract occurred in 5 cases(1.2%) after operation,in which 3 cases were treated by surgical biliary tract drainage,2 cases were placed drainage tubes under endoscope once again and administrated antibiotics for controlling infection.Pancreatitis occurred in 24 cases(5.8%) postoperatively,in which 1 case of acute severe pancreatitis was cured with abdominal paracentesis drainage in 3 sites,other 23 cases were given medical conservative treatment.1 cases had massive bleeding of incision and was cured by injecting sclerosing agent under endoscope.Conclusions Using niddle-knife can make papillotomy successful in most of standard EST or pre-cut failure.The success rate of NKP is significantly higher than that of NKF,and re-NKP can improve the success rate without increasing severe complications and death mortality,but NKP should be restricted to duodenal hypo-papilla and stenotic terminal of common bile duct.

Objective To investigate the clinical significance of P27~ KIP1 and S-phase kinase-associated protein 2 (SKP2) expression in human gastric carcinoma. Methods The expression of P27~ KIP1 and SKP2 was determined by SP immunohistochemical method in 69 specimens of gastric carcinoma. Results The positive rates of P27~ KIP1 and SKP2 expression were 46.38% and 33.33%, respectively. The positive rate of P27~ KIP1 expression in gastric carcinoma decreased with the poor differentiation,deep invasion and progression of pathological grade (P0.05). There was a negative correlation between the P27~ KIP1 and SKP2 expression(P

Objective To observe the effect of Fuyuan Capsule (FC) on vascular endothelial cell function of rats with qi deficiency and blood stasis.Method Forty-eight 16-month-old SD rats were equally randomized to 5 groups:FC group,positive control group (Qishen Capsule),model group and blank control group.Rat models of qi deficiency and blood stasis were induced by exertion,starvation and cold.The mice were given the drugs by gastric perfusion for 4 weeks.After treatment,endothelin (ET),6-keto-prostaglandin F_(1a) and nitric oxide (NO) levels were mea- sured.Results NO and 6-keto-PGF_(1a) levels were lower in the model group than those in the blank control group (P

Background and purpose:Myasthenia gravis(MG)is an auto-immune disease affecting neuromuscular joints.1/4 of these patients may have thymoma.Surgical treatment remains the most important method for either MG or thymoma.In this retrospective analysis,we evaluated the clinical effects of surgical treatment for myasthenia gravis patients with thymoma.Methods:32 myasthenia gravis patients with thymoma underwent surgical treatment between Jan 2001 and Dec 2006 in our hospital.The data including age,gender,pathological founding,duration and gravity of myasthenia gravis were analyzed.Tumor recurrence and outcome of myasthenia gravis were documented during follow-up for all patients.Results:All patients received median sternotomy for thymectomy.Resection of pericardium,pleural or part of lungs was taken as needed for complete removal of tumor tissue.One patient died during peri-operative time.The median follow-up period for the the rest of the 31 patients was 37(14-61)months.8 patients received post-operative radiotherapy.Only one patient had recurrent thymoma and was re-operated,achieving tumor-free status.Complete remission of myasthenia was achieved in 7 patients with 13 partial remission,9 stable and 2 progressed.The overall effective rate for myasthenia gravis was 64.5%,and patients with different data has no signifi cance(P

Objectives A new method for the detection of PCR ampli fied DNA in capillary electrophoresis and laser induced fluorescence (CE LIF) system based on molecular beacons hybridization is described.Methods The method is based on the hybridization of molecular beacons into the amplification product, then separating the hybridized product with CE LIF system. This method was applied to the detection of p73exon3, p53exon5 and p16exon2 for gastric carcinoma. Results Detected with CE LIF molecular beacons method, the wild type percent of p73exon3 is 100%, same as SSCP; p53exon5 is 60 0%, while SSCP is 63 3%, P=0 99; p16exon2 is 20 0%, same as SSCP(20 0%).Conclusion The results demonstrate that the specific peaks appeared in wild type samples while no peaks or unspecific peaks in mutation ones. The results showed correlation with the results of PCR SSCP. The method is able to develope as a clinical screening method for tumor suppressor genes to diagnose carcinoma.

Objective To investigate the effects of short term insulin pump intensive therapy on flow-mediated dilation (FMD) in type 2 diabetes mellitus (T2DM) patients with and without vascular complications. Methods Seventy-six patients with T2DM (T2DM group) were divided into 2 subgroups: T2DM1 subgroup (28 patients with vascular complications) and T2DM2 subgroup (48 patients without vascular complications). Meanwhile, 30 healthy cases were selected as NC group. All research subjects accepted high-frequency ultrasound detection on brachial artery for FMD. After insulin pump intensive therapy,FMD in T2DM group was reexamined, fasting insulin was detected and HOMA-IR was calculated. Results Compared with that in NC group, FMD in T2DM group was significantly lower(P＜ 0.01). However, glycosylated hemoglobin (HbA1c ), fasting plasma glucose (FPG ),H0MA-IR and blood fat were significantly higher (P＜0.01 or ＜0.05). Correlation analysis showed that FMD had negative correlation with HbA1c, FPG, HOMA-IR, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C)(P＜0.01),and had positive correlation with high-density lipoprotein cholesterol (HDL-C). After 2 weeks of insulin pump therapy, the improvement of FMD between the two groups was different. FMD in T2DM1 subgroup increased from (4.25 ± 1.96)% to (4.96 ± 1.36)%(P＞0.05), and FMD in T2DM2 subgroup increased from (4.02 ± 2.35)% to (7.56 ± 2.34)%(P＜ 0.01). Conclusion Insulin pump intensive therapy can evidently improve FMD in T2DM patients without vascular complications.

Teaching urinary system diseases by problem-based learning method for eight-year program medical students was applied in nephrology department in affiliated Tongji hospital of Huazhong university of science and technology since 2008.They had accumulated experiences in compiling teaching plan,fostering teachers,practicing teaching and evaluating teaching.These steps may future intensify education reform on long schooling system and improve teaching quality of eight-year program.

In order to analyze the cai]ses of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM), the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared. MM patients in our hospital were studied retrospectively. Those who referred renal impairment were divided into two groups: group I presented to nephrologists prior to MM diagnosis (n=29) and group II presented to hematologists directly (n=62). The age, sex, initial symptoms, haematological and biochemical parameters, the phenotype of paraprotein, bone marrow biopsy and cytology were undertaken and analyzed. The results showed that the median time between the initial symptoms and diagnosis in the patients of group I was longer than that in group II (P<0.001); patients in group I had significantly lower incidence of bone pain (P<0.01) and worse renal function (P<0.05) on presentation. There were lower level of myeloma cells (P<0.05), lower incidence of hypergammaglobulinemia (P<0.05), lower positive rate of monoclonal immunoglobulin (M protein) (P<0.05) and M protein level (P<0.05) in the patients of group I than those in group II. The ratio of monoclonal to lambda monoclonal proteins in a population was 1:3.67 in patients of group I, whereas 1:0.90 in patients of group II (P<0.01). Moreover, patients with λ type had a higher degree of renal insufficiency than those with κ type (P<0.05). It was suggested that the median time between the initial symptoms and diagnosis in the patients presented to nephrologists was longer than that in those presented to hematologists; the patients presented to nephrologists had the lower incidence of bone pain, lower level of myeloma cells and M protein, which made early diagnosis more difficult; more patients presented to nephrologists had the majority of λ light chain type, moreover, patients with λ light chain type had a higher incidence of renal insufficiency.