Objective To investigate the association of insulin dose with clinical factors of type 2 diabetes. Methods We reviewed the data of 214 type 2 diabetic patients who received insulin regimens.We compared the insulin dose and period at the targeted blood glucose levels among 6 groups according to different type of oral hypoglycemic agents. Results There existed statistically significant correlations of the glucose-targeted insulin dose with course,FPG,BMI,combination therapy with oral hypoglycemic agent(P<0.1,test level P=0.1).Merely metformin failure group took less insulin than the group admitted due to combination therapy failure (P=0.016, 0.53(0.35～0.62)U/kg and 0.63(0.51～0.75)U/kg respectively).The longest targeted period existed in the later. Relationship between the targeted bedtime insulin NPH dose and FPG level can be demonstrated by equation Y=0.255X+7.8. Conclusions The targeted insulin dose is influenced by synthetic factors. Patients admitted due to combination oral hypoglycemic drug failure have the maximal targeted insulin dose and the longest titration period. The final bedtime insulinNPH dose can be predicted by FPG level.

ObjectiveTo observe the changes of expression of aquaporin-1(AQP-1)and AQP-4 in drowned and postmortem immersed rats’lungs.MethodsThirty healthy male Wistar rats were randomly divided into drowning group, postmortem immersion group and cervical dislocation group. The morpho-logical changes of rats’lungs were observed using HE staining. The mRNA and protein expressions of AQP-1 and AQP-4 in rats’lungs were detected by real-time PCR, immunohistochemistry and Western blotting, respectively.ResultsThe results of immunohistochemistry and the Western blotting showed that the protein expression of AQP-1 of the drowning group was higher than the postmortem immersion group and the cervical dislocation group(P<0.05). The result of immunohistochemistry showed that the protein expression of AQP-4 of the drowning group was higher than the postmortem immersion group and the cervical dislocation group(P<0.05)while no difference were detected among the three of them by Western blotting(P>0.05). The mRNA expressions of AQP-1 and AQP-4 in rats’lungs of the drown-ing group was significantly higher than the postmortem immersion group(P<0.05).ConclusionThe in-crease of mRNA and protein expressions of AQP-1 and AQP-4 in lungs of rats with cute lung injury of the drowning group would be useful for differentiating vital drowning from postmortem immersion.

OBJECTIVE:To provide reference for prevention of nosocomial drug-induced liver injury(DILI),early diagnosis of DILI and appropriate disposal of DILI.METHODS:4 975 medical records were randomly collected from a grade three class A hospital during 2008～2009.The incidence of DILI,hospitalization costs,extended time of hospital stay and prevention of DILI were analyzed retrospectively and economic evaluation was carried out.RESULTS:DILI occurred in 63 cases with the incidence rate of 1.27%.Among these cases,10 cases(15.87%) were preventable.For each DILI,average increased medical cost was 3 220.26 yuan and average extended time of hospital stay was 4.38 d.For the preventable DILI,the average increased medical cost was 6 239.85 yuan,and average extended time of stay was 8.30 d.The top 3 drugs which caused liver injury were anti-infective drugs(including antitubercular agent,41.27%),antineoplastic agents(28.57%) and cardiovascular drugs(7.94%).Types of DILI were as follows:live cell injury accounted for 65.08%,cholestasis accounted for 25.40%,and mixed type accounted for 9.52%.CONCLUSION:DILI is characterized with high incidence rate among patients and high medical cost.Some of DILI cases are preventable.Therefore,There is advantage both in clinical and economic aspects to reduce the incidence rate of preventable DILI by emphasizing rational use of drugs.

Mother-to-child transmission (MTCT)is an important way of hepatitis B virus (HBV)transmission.Blocking the HBV MTCT has a great significance for the prevention and treatment of hepatitis B.This article reviews the current blocking strategies implemented in the antepar-tum,peripartum,and postpartum stages,and summarizes the controversies existing in the blocking strategies in different stages.The significance of HBV occult infection and germ cell transmission in the HBV MTCT is analyzed.The results indicate that the current strategies for the prevention of hepatitis B MTCT need further improvement.Attentions should be focused on HBV occult infection and germ cell transmission.

Objective To investigate the changes in Toll-like re ceptor 4 (TLR4) and myeloid differential protein-2 (MD-2) gene expression in t he liver of septic rats, and to elucidate the relationship between the expressio n of TLR4/MD-2 mRNA and TNF? mRNA. Methods Sepsis model was reproduced in rats by intraperitoneal injection of LPS (5mg/kg). 80 Wistar rats were randomly divided into 4 groups: normal control and 1h, 2h, 6h after LPS in jection (20 rats for each group). Rats were sacrificed at different time points, and the expression of TLR4/MD-2 mRNA and TNF-? mRNA in the liver was measure d by RT-PCR. Results The expressions of TLR4/MD-2 mRNA and TN F-? mRNA were up-regulated, peaking 1h after LPS injection, and then declined gradually 2~6h after LPS challenge. The expressions at every time point were hi gher than that in control group (P

Objective To investigate the effects of endotoxin on the activation of nuclear factor-kappaB in myocardium, and to explore the molecular mechanism of acute myocardial injury. Methods Forty male Wistar rats were randomly divided into normal control group (n=10), lipopolysaccharide (LPS) 1h, 2h, 6h groups (n=10 for each group). In the latter two groups, LPS was injected into the peritoneal cavity. Tissue samples from the myocardium were collected to determine NF-?B activation by electrophoretic mobility shift assay (EMSA), and the mRNA expression of TNF-? was measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) with GAPDH as internal standard. Results The activation of NF-?B (2.173?0.063) and TNF-? mRNA expression (0.292?0.031) could be detected in myocardium in very low values in normal control group rats, while both the activation and expression were up-regulated markedly after LPS challenge, and peaked 2 hours afterwards (37.793?4.785 and 1.182?0.146, respectively). They were down-regulated (17.910?3.791 and 0.901?0.128, respectively) 6 hours after LPS challenge. Compared to normal controls, both NF-?B activity and TNF-? mRNA expression were significantly elevated at various time points following LPS stimulation (all P

With the improvement of living conditions,people pay more attention to food sanitation,following which the incidence rate of food allergy is higher and higher.Food allergy threatens public health seriously.It is caused mainly by dominance of T helper type 2-based immune responses,which breaks the dynamic balance of Th1/Th2 immune responses and resultes in over secreting of IL-4,IL-5 and IL-13,production of specific antibody IgE,degranulation of mast cells,alteration of intestinal microflora and so on.At present,a lot of investigations have been reported,of which the probiotics therapy attracted more attention.As the indigenous flora,probiotics could not only prevent and treat food allergy but could also modulate immune responses and recover the dynamic balance of it via secreation of cytokines such as IFN-?,IL-10,TGF-?.

ObjectiveTo investigate the anti-tuberculosis treatment response and outcomes in treatment naive patients infected with multidrug-resistant tuberculosis (MDR-TB).MethodsA total of 408 patients who were diagnosed with MDR-TB in Shanghai Pulmonary Hospital from January 2006 to January 2009 were recruited in this study.These patients were divided into two groups based on their previous treatment history:treatment naive group and re treatment group. The treatment response,outcomes andadverse eventswere observed. The outcomes of thesetwo groupswere compared by cohort analysis and x2 test.ResultsThe sputum conversion rates,the lesions absorption rate and the cavity closing or shrinking rate of the treatment naive MDR TB group were significantly higher than those of the re treatment group,while the adverse events rate was not significantly different between two groups (x2 =0.434,P＞0.05).Among 89 treatment naive cases,66 cases (74.16％) were cured,8(8.99％) completed the full treatment course,7(7.87％) were treatment failure,3(3.37％) died,and 5(5.62％) were lost to follow-up.Among the 319 cases of re-treatment MDR TB group,134 (42.01％) were cured,31(9.72％) completed the full treatment course,116 (36.36％) were treatment failure,12(3.76％) died,26(8.15％) were lost to follow-up.The cure rate of the treatment naive MDR-TB group was significantly higher than that of re-treatment group (x2=28.783,P＜0.01).The factors influencing the treatment outcomes included the stage of the disease,the range of lesions and cavity, the patients'generalnutritional status, underlying complications,and the drug-resistant strains. Conclusions The anti-tuberculosis treatment outcomes are better in treatment naive patients with MDR-TB infection compared to the treatment experienced and retreated patients.Therefore,the status of the drug resistance should be closely monitored in order to detect MDR-TB as early as possible.With the early diagnosis,the treatmcnt regimen may be modified timely and as a result the treatment outcomes can be improved.

Objective To explore the prevalence and influencing factors of obstructive sleep apnoea syndrome(OSAS)among hypertensive patients. Methods Two hundred and ninety-eight hypertensive patients who used a portable OSAS monitoring device were selected as our subjects. Of which,197 patients who completed their OSAS monitoring were divided into OSAS group( 165 cases) and non-OSAS group. Stepwise linear regression and Logistic regression analysis were used to analyze the relevant factors correlated to AHI and OSAS with hypertension. Results The average age of the 197 patients(122 were males)were 59. 93 ± 10. 18 years old. The prevalence of OSAS was 83. 8% in hypertension patients. Body mass index( BMI),systolic pressure (SBP),diastolic pressure(DBP),low density lipoprotein cholesterol(LDL-C)and waist circumference in OSAS groups were(26. 37 ± 2. 77)kg/ m2 ,(159. 59 ± 14. 42)mmHg,(98. 71 ± 9. 40)mmHg,(2. 85 ± 0. 82)mmol/L,(90. 56 ± 8. 62)cm,higher than those in non-OSAS group((22. 43 ± 2. 04)kg/ m2 ,(146. 83 ± 4. 60) mmHg,(85. 51 ± 7. 52)mmHg,(2. 22 ± 0. 60)mmol/ l. ,(81. 84 ± 8. 00)cm). There were statistical differences between the two groups(t = - 7. 654,- 4. 945,- 7. 490,- 4. 110 and - 5. 289;P < 0. 001). BMI,SBP and DBP were positively associated with AHI,and they were in depended risk factors of OSAS(OR(95% CI)=2. 554(1. 408 - 4. 632),1. 432(1. 154 - 1. 777),1. 286(1. 058 - 1. 562);P < 0. 05). Conclusion The prevalence of OSAS is high in hypertension patients. Higher BMI,SBP,DBP are associated with OSAS in hypertension pateints.

Objective To assess the subgenotypes of pathogenic Cryptococcus gattii isolates from China and to elucidate the epidemiological links between these domestic isolates and those from other parts of the world. Methods DNA was extracted from 9 clinical isolates of Ctyptococcus gattii from China. The partially variable regions of the three unlinked loci, namely IGS1, PLB1 and GEF1, were amplified and sequenced, and the bioinformation at these loci was obtained from GenBank for multi-locus sequences alignment and phylogenetic analysis. Results Of these 9 clinical isolates, 8 were genotype VG Ⅰ and mating type α with the same sequences at the tested regions as the reference strain WM276, which was a representative isolate of an independent subgenotype; 1 was of genotype VG Ⅱ and mating type α, which was the first report in China, with the tested sequences consistent with those of the referrence strain R272. Sequencing and phylogenetic analysis of GEF1 gene, which was located at mating type locus, successfully identified the genotypes and mating types of all the Cryptococcus gattii isolates involved here. Conclusions Multi-locus sequence analysis shows that causative Cryptococcus gattii isolates of genotype VG Ⅰ in China carry similar sequences at the tested loci in IGS1, PLB1 and GEF1 genes, to a widely distributed subgenotype in the world, and the sequences of the first VG Ⅱ genotype isolate from China resemble the less virulent subgenotype VG Ⅱ b found in Vancouver islands.