Objective To observe autonomic nerve function damage in diabetic patients with gastrointestinal symptoms. Methods Twenty-four patients of diabetes mellitus (DM) with gastrointestinal symptoms, as well as 20 cases of DM without gastrointestinal symptoms and 17 health volunteers were recruited from the clinic of gastroenterology, Jishuitan Hospital, Beijing during December 2008 to May 2009, and standard cardiovascular reflex test was performed for all of them to determine their functions of the autonomic nerve. Results Respiratory rate (an indicator of parasympathetic nerve function) was ( 14 ± 5 ) times per minute in patients of DM without dyspepsia, obviously lower than that in healthy controls [(20±10) times per minute], and that in patients of DM with dyspepsia was (9 ±6) times per minute, obviously lower than that in healthy controls and asymptomatic ones ( P ＜ 0. 05 ). Scores of five indicators of the autonomic nerve functions, and the sympathetic, parasympathetic nerve and overall autonomic nerve functions were significantly higher in patients of DM with gastrointestinal symptoms than those in the patients without dyspepsia and healthy controls. Abnormality rate of autonomic nerve functions was 96 percent (23/24) in the patients with dyspepsia, 58 percent (14/24) in those definitely and seriously involved, and five percent (1/20) in those without dyspepsia. Conclusions Autonomic neuropathy exists in most diabetic patients with dyspepsia, both sympathetic and parasympathetic nerve involved. Impairment of parasympathetic nerve function occurs earlier than that of sympathetic nerve in patients of DM.

Fifty four diabetic patients, including 26 cases with dyspepsia and 28 cases without gastrointestinal symptoms, and 21 healthy volunteers were enrolled in this prospective study.To determine the function of proximal stomach, water load test was performed and the area and circumference of gastric corpus were measured by ultrasonography, and the differences between threshold and maximum were calculated.Results showed that the threshold and maximum drinking volumes in diabetic patients with dyspepsia were lower than those without dyspepsia [(638 ±311) ml vs.(870 ±225) ml and(1 000 ±424) ml vs.(1 360 ±322) ml,t=2.779 and 3.111,P<0.05].The threshold drinking volume in patients without dyspepsia was significantly higher than that of control group [ ( 870 ±225 ) ml vs.( 688 ±225 ) ml, t =-2.450, P<0.05].The differences of drinking volume and corpus area in patients with dyspepsia were lower than those of patients without dyspepsia and controls [(362 ±146) ml vs.(490 ±150) ml, (550 ± 157) ml, t=2.838,3.920,(11.76 ±6.85) cm2 vs.(19.78 ±12.07) cm2, (20.80 ±10.65) cm2,t=2.769, 3.311, P<0.05].The difference of circumference in diabetic patients with dyspepsia was lower than in controls [(3.67 ±2.17) cm vs.(6.22 ±3.06) cm, t=3.139,P<0.05].The study indicates that the proximal stomach function is impaired in diabetic patients, presenting a declined sensory threshold and reduced relax function.

Teacher is called as the engineer of human souls,and the guide for college students' growth,medical teachers' level of professional ethics has a direct impact on the quality of medical talents.To cope with the moral imbalance in the new economic interests,ideological and moral construction should be strengthened and a Chinese characterized system of teachers' professional ethics constructed.Teachers should be promote their function of role modeling,and cultivate their morality of "self discipline".Autonomic moral self-discipline should be strengthened,while the heteronomous role of morality further developed.

Objective: To determine the relationship between serum omentin-1 concentration and bone mineral desity in postmenopausal women, and the adipose influence of tissue on bone mineral density (BMD). Methods: BMD values of 336 participants were measured by dual-energy-x-ray absorptiometry (DEXA) at various skeletal sites: the anteroposterior spine, femeral neck, total hip (T-hip) and total body BMD (TBMD). Body compositions including lean tissue mass (LTM) and body fat mass (FBM) were measured by DEXA. hTe plasma concentrations of adipocytokines (omentin-1, adiponectin,leptin,resistin,visfatin, andapelin) were measured by ELISA. Results: hTe overweight and obese groups had higher T-hip,femerol neck, intertrochanter BMDthan the nomal weight group. Plasma omentin-1 was negatively correlated with anteroposterior spine, femeral neck, trochanter, intertrochanter, T-hip and Ward’s BMD, after adjustment for age, BMI and fat body mass, and the correlation was not significant. Multiple stepwise regression anlysis revealed that lean body mass, menopause duration and estrogen level were the most important variables affecting the BMD and each explained 12.2%–13.7%, 6.9%–13.1%, 0.9%–1.7% of the variance. Serum adiponectin was independently associated with T-hip, lumbar spine and total BMD. Conclusion: Plasma omentin-1 is not significantly correlated with BMD in postmenopausal women. Lean body mass, menopause duration and estrogen level are the most important variables affecting the BMD. Serum adiponectin is an independent predictor of T-hip, lumbar spine and total BMD.

Objective To analyze and compare the therapeutic drug monitoring (TDM) and regularity of tacrolimus in deceased donor liver transplantation (DDLT) and living-donor partial liver transplantation (LDLT) the therapeutic drug monitoring (TDM) and regularity of tacrolimus.Method The clinical data of 68 patients undergoing liver transplantation from January 2010 to October 2011 were analyzed retrospectively.Thirty cases underwent LDLT as group A,and the remaining 37 underwent DDLT as group B.Result The time to reach therapeutic window was shorter in group A(3.9 ± 0.7 days) than in group B (6.5 ± 1.0 days,P＜0.01).The tacrolimus dosage in group A was significantly less than that in group B during the first 28 days post-transplantation.However,the tacrolimus dosage approached gradually and tended to be consistent after 28 days.On the postoperative day 7,14,21 and 28,the Tacrolimus dosage in group A was 72.37％,79.31％,90.11％ and 95.45％ of that in group B respectively.Concentration-dose ratio in group B was in a steady state (80-90 g/L).Concentration-dose ratio in group A was decreased with time,culminating at 28th day and close to that in group B.Correlation analysis revealed that graft recipient weight ratio(GRWR) had a significantly positive correlation with the tacrolimus dosage on the first 7 days (r =0.557) and a significantly negative correlation with the tacrolimus concentration/dose ratio (r =-0.578).Conclusion The early tacrolimus dosages in patients subject to LDLT were correlated significantly with the GRWR.The early tacrolimus dosages in patients undergoing LDLT were about 70％ of those in patients undergoing LDLT.However,with the regeneration of the liver,they tended to be consistent after 28 days.

Objective To observe continuous venous-venous hemofiltration (CVVH) for treatments and cares of severe acute pancreatitis(SAP). Methods From August 2004 to August 2006, 15 cases with SAP were in conventional treatment (the control group), from September 2006 to August 2010, 20 cases with SAP were nursed with CVVH(the observation group). We surveyed patients' vital signs (including body temperature, heart rate, breathing and blood pressure),mental symptoms, abdominal signs and monitored liver and kidney functions. Additionally we executed APACHE Ⅱ scores. We analyzed them retrospectively. Results The afore - mentioned indexes of two groups were significant in statistics, the observation group had lower incidence of MODS、MOF than the control group after 10 days caring. Conclusions The CVVH could correct systemic inflammatory reaction of SAP and prevent complications. Standard technical operation and intensive nursing can ensure smooth process of CVVH and decrease complications caused by CVVH.

Objective To investigate the current status of medication compliance of patients with anky-losing spondylifis and analyze its related factors. Methods Seventy-four patients with ankylosing spondylitis were investigated about their general conditions,medication compliance and its related factors.The results were analyzed. Results Thirty-nine patients(52.7%) had good medication compliance while the rest 35 cases has poor medication compliance among which 24 patients with drug withdrawal exceeded 1 month.The medication compliance for patients with disease process of lower than 0.5 year,0.5 to 1.0 year,1 to 2 years and above 2 years was 82.0%,60.0%,25.0%and 31.0%.The logistic regression analysis showed that the disease process,dis-ease knowledge and media advertisement were the main influencing factor for medication compliance,while the age,sex,marital status,education background,adverse reaction,satisfaction degree with medication effect, economic conditions and depression were not major influencing factors. Conclusions About half of patients with anky-losing spondylitis had poor medication compliance,especialy with disease process of above 1 year.The main in-fluencing factors include disease process,disease knowledge and media advertisement.

Objective To establish a rapid diagnostic method for the detection of marine vibrios,and then construct a new technology platform for the clinical diagnosis of marine vibrio infection.Methods A pair of PCR primers and a sequencing primer based on the whA gene of V.vulnificus and the toxR genes of V.parahemolyticus and V.alginolyticus were designed respectively,and then the specific DNA fragments were amplified.Next,the single-stranded DNA templates were prepared for pyrosequencing.The obtained base sequence was validated by NCBI alignment.In addition,the 16S rRNA genotyping of V.vulnificus was also performed.Results The PCR primers and sequencing primer of V.vulnificus showed good specificity,and a 167 bp DNA fragment was amplified from 4 strains of V.vulnificus.The pyrosequencing results completely matched with the whA gene sequence of V.vulnificus.Meanwhile,the control strains were negative.A 105 bp DNA fragment and a 134 bp DNA fragment were amplified from 11 strains of V.parahemolyticus and V.alginolyticus,respectively,and the pyrosequencing results were consistent with the expected sequence.In addition,one of 4 strains of V.vulnificus was identified as 16S rRNA-A type,and the other 3 as 16S rRNA-B type.Conclusion The PCR-pyrosequencing method established in this study is a new method for the real-time detection of short nucleotide sequences.It has some advantages such as high throughput,high precision and simple operation,and may be applied to the fast and accurate identification of marine and terrestrial pathogenic bacteria.

OBJECTIVE: To study the effect of allopurinol on the function of blood vessel endothelium in patients with essential hypertension complicating hyperuricemia. METHODS: 65 cases with essential hypertension complicating hyper uricemia were randomized into treatment and control group. The control group was given the classic non- pharmacotherapy: reduced intake of sodium, more exercise, weight loss etc. The treatment group was treated wilh 100mg allopurinol b.i .d for 4 weeks besides the classical non - pharmacotherapy as stated for the control group. Serum uric acid level, brachial artery flow -mediated diastolic (FMD) function, the base internal diameter of brachial artery, nitrogen oxide (NO), von Willebrand' s factor(vWF) were compared between two groups before and after treatment. RESULTS: As compared with prior treatment, the treatment group had decreased level of uric acid and decreased vWF level, increased level of NO and a significantly increased level of FMD, all had statistical significances(P0.05) . CONCLUSION: Allopurinol can ameliorate the function of blood vessel endothelium in patients with essential hypertension complicating hyperuricemia.

Objective To investigate the relationship between CYP3A5 gene polymorphism and tacrolimus concentration/dose ratio in children living donor liver transplantation and the correlation with clinical efficacy,for the relatives living donor liver transplantation in children tacrolimus individualized medication providing reference indicators.Methods Peripheral blood samples were collected from children with relatives living donor liver transplantation in the center of liver transplantation,the genotype of CYP3A5 was determined by polymerase chain reaction (PCR)/pyrophosphate sequencing,The dosage of tacrolimus and blood concentration,liver and kidney function and other related indicators were measured within 3 months after operation According to genotypes,the children can be divided into gene expression group (CYP3A5 *1/*1 and CYP3A5 *1/*3) and non-expression group (CYP3A5*3/*3).The drug concentration (C0),tacrolimus dose / body weight (D/W) ratio,drug concentration/dose (C0/D) ratio of each genotype at 1 day,3 d,5 d,7 d,14 d,28 d,2 months and 3 months after administration and the genotype at the time point on liver and kidney function was carried out statistics.Results Among the 80 cases,36 cases (45.0％) were CYP3A5*3/*3,37 cases (46.2％) were CYP3A5*1/*3,7 cases (8.8％) were CYP3A5*1/*1.CYP3A5 gene expression group reached a therapeutic concentration range (C0 ＞ 8 μg/L) than the gene non-expression group takes longer time.There was no significant difference in CYP3A5 gene expression group between the non-expression group on the initial dose (P＞ 0.05);CYP3A5 gene expression group than the non-expression group,tacrolimus C0 within 1 month after operation were statistically significant.CYP3A5 gene expression group than the non-expression group,tacrolimus D/ W in addition to the first day after surgery,other time points were statistically significant (P＜0.05).CYP3A5 gene expression group than the non-expression group,C0/D at the above time points were statistically significant (P＜0.05);There were no significant differences in liver and kidney function between the two genotypes (P ＞ 0.05),but there was significant difference in the alkaline phosphatase.Conclusion CYP3A5 gene expression in children than non-expression group of children need higher doses to reach the therapeutic drug concentration;CYP3A5 gene polymorphism had significant effects on early tacrolimus C0,D/W and C0/D values;CYP3A5 gene polymorphism is instructive for the administration of tacrolimus in children with living donor liver transplantation,CYP3A5 gene type tests should be regular,improve efficacy and reduce the incidence of adverse reactions.