The many difficult problems in the course of actual operation are introduced in more than 5 years with governmental centralized procurement of medical equipment. By aiming at specificity of medical equipment that is a relative specialized material and applying existing laws and regulations system, the more scientific and operational solutions are found.

Objective To evaluate the utility of the Chinese version of the Edinburgh postnatal depression scale(EPDS)when being used in puerperas in Chengdu.Methods Following translation and back translation,the EPDS was commented by six experts,then a prospective cohort of 732 women completed the EPDS and the Beck depression inventory(BDI)three to fourteen days after siring birth.Rusuits The concordance rates of translation and back translation were all 100%;the content validity ratio of the EPDS was 0.9333;the Cronbaeh's alpha coefficient of the EPDS was 0.76,the cumulative variance contribution of the two factors was 44.979%,and the spearman correlation coefficient between the EPDS and BDI was 0.584,＜0.01.Conclusions The EPDS possesses good cknical pefformanee,is very concise,easy to read and understand and well accepted by mainland Chinese puerperas and researchers.It is a good instrument for screening for postnatal depression in puerperas of Chengdu.

Objective To compare the distribution and expression differences of glycogen synthase kinase-3?(GSK3?) among normal adult,aged and amyloid beta(A?)-induced neurodegenerative rat brains,so as to explore its functional role in neurodegeneration. Methods Aggregated A? was microinjected into normal adult rat hippocampus under a stereotaxic system. The rats over 12 months were defined as aged rats. The distribution and localization of GSK3? were examined using immunohistochemistry. Western blotting was performed to assess expression change in cortex and hippocampus quantitatively. Results The GSK3? positive cells were distributed extensively around the whole brain and almost with neuron-like morphology. In normal adult rats,the strong anti-GSK3? immunoreactivity located in the neocortex pyramidal layer,hippocampus pyramidal layer,dentate gyrus,thalamus,substantia nigra,etc. The amount of GSK3? positive cells was much more in the aged and A?-injected group than in normal ones. The immunoreactive signals usually extend to the distal area of neurite in the A?-injected ones. Western blot showed that the expression intensity of GSK3? was stronger in the aged and neurodegenerative rat brain than in the normal adult rat brain. Conclusion The expression of GSK3? increases apparently in the neurons of aged and A?-injected brain. It may play a role in the neurodegenerative process.

Seventy patients with type 2 diabetes (T2DM),23 subjects with impaired glucose tolerance (IGT) and 35 individuals with normal glucose tolerance (NGT) were recruited in the study.Fasting free fatty acids (fFFA) and postprandial free fatty acids (2 hFFA) after oral glucose tolerance test (OGTT) were measured; homeostasis model assessment of insulin resistance (HOMA-IR),area under the curve of free fatty acids (AUCFFA) were calculated.The carotid artery intima-media thickness (IMT) was assessed by color ultrasonography.HOMA-IR,fFFA,2 hFFA,AUCFFA and IMT in T2DM group were 3.3 ±3.2,(0.55 ± 0.20) mmol/L,(0.28 ±0.18)mmol/L,(0.83 ±0.34)mmol · L-1 · h-1 and (0.12±0.05) cm,which were significantly higher than those in NGT group,respectively [1.9 ± 1.3,(0.41 ±0.15) mmol/L,(0.12 ± 0.10) mmol/L,(0.53 ± 0.20) mmol · L-1 · h 1 and (0.09 ± 0.03) cm,all P ＜0.05].Both HOMA-IR and IMT were positively correlated with fFFA,2 hFFA and AUCFFA (all P ＜ 0.05).The results indicate that the levels of fasting and postprantial free fatty acid were related with insulin resistance and atherosclerosis of carotid artery.

Objective It is to observe the clinical effect of Wenxinkeli combined with metoprolol on frequent ventricular premature beat (FVEB).Methods234 patients with FVEB were randomly divided into the study group and control group.117 patients in the control group were treated with metoprolol combined with placebo, and 117 patients in the stduy group were treated with Wenxinkeli combined with metoprolol.4 weeks were a course of treatment.After four weeks, the heart rate variability, QT interval dispersion and 24h average heart rate of two groups were observed, and the clinical effect were evaluated.ResultsAfter 4 weeks of treatment, 5 cases in the study group and 7 cases in the control group were excluded.The efficiency of control group and study group were 89.29% and 79.09% (P<0.05), respectively.After treatment, the SDNN、SDANN、RMSSD and PNN50 of two groups were significantly higher than those before treatment(P<0.05), and the increase value of the study group was higher than that of the control group(P<0.05).After treatment, the QTd and QTcd of two groups were decreased than those before treatment(P<0.05), and the decreased value of the study group was higher than that of the control group(P<0.05).There was no significant change in the heart rate of the two groups before and after treatment.ConclusionWenxinkeli combined with metoprolol in the treatment of FVEB can prolong HRV, reduce QTd, improve the treatment effect, has no significant effect on the heart rate.

Objective To investigate the effect of lithium chloride(LiCl),an inhibitor of glycogen synthase kinase-3beta(GSK-3beta),on proliferation and differentiation of neural stem cells(NSCs).Methods The NSCs were isolated from cortex of rat fetus and expanded in culturing system.Their morphological changes and attachment process were observed under microscope.The cell cycle dynamics of NSCs was examined with flow cytometry.And the expression of GSK-3β and β-catenin was examined quantitatively with Western blot.Results The culturing NSCs treated with LiCl were usually floated and much dispersed in the media.Many of the neurospheres became small and the time of attachment after serum induction became longer.Using flow cytometry,it was detected that the proportion of G1 phase NSCs declined gradually accompanying the increased concentration of LiCl,while the percentage of S and G2/M phase cells showed an increasing trend.Western blotting results revealed β-catenin expression increased whereas Gsk-3βdecreased gradually under the treatment of LiCl and also showed a dose dependent manner.Conclusion These results suggest that LiCl may promote the proliferation of NSCs and prevent them from differentiating,which may partly involve the activation of wnt/β-catenin signaling pathway.

OBJECTIVE:To observe the efficacy and safety of metformin in the treatment of type 2 diabetes(T2DM) with non-alcoholic fatty liver disease(NAFLD). METHODS:106 patients with T2DM with NAFLD were randomly divided into control group and observation group. Control group was received health education about T2DM with NAFLD and living intervention(diabe-tes diet and physical therapy);observation group was additionally given Metformin tablet 0.5 g,orally,3 times a day. The treat-ment course for both groups was 12 weeks. Clinical efficacy,and liver fat content,BMI,FPG,IR,TG,TC,LDL-C,HDL-C,HbA1c before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,liver fat con-tent and related index in 2 groups were significantly better than before(except HOMA-IR in control group),and observaton group was better than control group,the differences were statistically significant(P<0.05). The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,metformin has good efficacy and safety in the treatment of T2DM with NAFLD.

Objective To investigate abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index (BMI).Methods Seven male patients with type 2 diabetes and normal BMI were divided into two groups according to the abdominal visceral fat area (VFA) measured by CT:visceral obesity group (VFA ≥ 100 cm2) and non-visceral obesity group.Indicators of glucose and lipids metabolism were measured in two groups.Results Among 70 patients 50 (71％) had visceral obesity.In 59 patients who had normal BMI and normal waist circumference (≤90 cm),41 presented visceral obesity (69％).Compared with non-visceral obesity group,the waist circumference,homeostasis model assessment of insulin resistance (HOMA-IR),triglyceride,and VFA were significantly higher in visceral obesity group [(86.4 ± 5.6) vs.(81.2 ± 4.8) cm,t =-2.980,P ＜ 0.01;2.83±2.31 vs.2.01±1.30,t=-2.025,P＜0.05;1.93(1.26-2.79) vs.1.11(0.75-1.46) mmol/L,Z=-3.777,P＜0.01;(143.6 ±31.8)vs.(73.7 ±17.3)cm2,t =-11.456,P＜0.01].Fasting insulin,fasting plasma glucose and glycosylated hemoglobin tended higher in visceral obesity group but not significantly (P ＞ 0.05).Multiple linear regression analysis showed that after adjustment for age and body mass index,abdominal VFA was positively correlated with HOMA-IR (r =0.240,P ＜ 0.05).Conclusion Male type 2 diabetic patients have a high rate of visceral obesity even when their body mass index and waist circumference are normal.Abdominal visceral fat area is closely associated with insulin resistance.

Objective To investigate the association of serum visfatin and free fatty acid (FFA) with insulin resistance in type 2 diabetes mellitus (T2DM).Methods One hundred and nineteen patients with T2DM and 65 health subjects with normal glucose tolerance (NGT) were enrolled in the study.TheT2DM patients were further classified as insulin resistant (HOMA-IR ＞ 2.8 mU/L,T2DM-IR group,n =61) and non-insulin resistant (HOMA-IR≤2.8 mU/L,T2DM-NIR group,n =58).Serum visfatin,free fatty acid and related clinical variables were measured,and HOMA-IR was calculated.Results The serum levels of visfatin and FFA in T2DM patients were significantly higher than those in healthy controls [(4.7 ±2.5) vs.(1.7±0.9) ng/L,t=-11.831,P＜0.01; (1.65±0.69) vs.(0.61 ±0.21) mmol/L,t=-9.239,P ＜0.01].The serum levels of visfatin and FFA in T2DM-IR group were significantly higher than those in T2DM-NIR group [(6.3±2.3) vs.(3.0±1.4) ng/L,P＜0.01; (2.16±0.45) vs.(1.12± 0.46) mmol/L,P ＜0.01].Multiple regression analysis showed that FFA,fasting insulin level and waist/ hip ratio (WHR) were independent risk factors of serum visfatin level (r =0.564,0.267 and 0.188 respectively,all P ＜ 0.05).Conclusion Serum levels of visfatin and FFA are increased in T2DM,and they are closely associated with insulin resistance.

Objective To investigate the association of serum levels of soluble intercellular cell adhesion molecule-1 (sICAM-1),soluble vascular cell adhesion molecule-1 (sVCAM-1) and high sensitivity C-reactive protein (hs-CRP) with peripheral vascular disease of lower limbs in patients with type 2 diabetes mellitus (T2DM).Methods One hundred and thirty T2DM patients admitted from October 2011 to October 2012,and 30 age/sex-matched healthy subjects were enrolled in the study.The serum levels of sICAM-1,sVCAM-1,hs-CRP and other clinical parameters were measured; the peripheral blood vessels of lower limbs were examined with color Doppler ultrasonography.Based on the extent of angiopathy of lower limbs T2DM patients were classified as normal vascular group (n =26),mild angiopathy group (n =45),moderate/severe angiopathy group (n =59).Results The serum levels of sICAM-1 and sVCAM-1 in moderate/ severe angiopathy group of T2DM patients were higher than those in mild angiopathy group,normal vascular group and healthy controls (t:4.15-8.93,all P ＜0.05) ; the serum levels of hs-CRP in moderate/severe angiopathy group were higher than those in mild angiopathy group,normal vascular group and healthy controls (t:2.18-4.27,all P ＜ 0.05).The serum sICAM-1 level was positively correlated with total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and sVCAM-1.The serum sVCAM-1 level was positively correlated with course of disease,systolic blood pressure and CRP.Conclusions Serum levels of sICAM-1,sVCAM-1 and hs-CRP are correlated with the extent of angiopathy of lower limbs in T2DM patients,and the elevated sICAM-1 ; sVCAM-1 and hs-CRP levels are also associated with hyper blood pressure,dislipidemia and chronic inflammation.