OBJECTIVE:To evaluate the status quo and tendency of utilization of hypoglycemic drugs in medical insurance inpatients.METHODS:DDD was used to analyze the data of utilization of hypoglycemic drugs in medical insurance inpatients in class A grade three hospital during 2007～2009.RESULTS:The consumption sum of hypoglycemic drug used for medical patients increased year by year.The rates of increase were up to 14.04% for 2008 and 21.65% for 2009.The consumption sum of insulin increased rapidly.The rate of drug combination was 81.57% among which the rate of using two-drug was 68.66%.CONCLUSION:The new type of hypoglycemic drugs have become the main drugs in the hypoglycemics market.Domestic drug manufacturers should develop effective,safe,economical and be benefit for the treatment of complication so as to decrease medical costs and save the resources of medical insurance.

Not only does autophagy play a vital role in maintaining kidney cell survival and homeostasis,but al-so it is involved in the pathophysiology of several kidney diseases. Recent studies have indicated that autophagy was ac-tivated in kidney cells during acute kidney injury and its regulatory mechanism was unclear. Autophagy activation in kidney may be associated with oxidative stress, endoplasmic reticulum stress, hypoxia inducible factor-1α, p53 and Bcl-2 family. The role of autophagy in acute kidney injury is still controversial. Most believe that it plays a protective role during acute kidney injury. Therefore autophagy will become a novel and potential target for the prevention and treatment of acute kidney injury.

Objective To evaluate the feasibility of measuring phrenic nerve conduction time(PNCT)and elicited compound muscle action potential(CMAP)of diaphragm with surface electrodes.Methods PNCT and amplitude of diaphragm CMAP elicited by unilateral magnetic stimulation(UMS)of the phrenic nerve were measured with surface electrodes and the results were compared with those measured with oesophageal electrodes.Results (1)PNCT measured with oesophageal electrode was similar to those measured with surface electrode;the amplitude of CMAP measured with oesophageal electrode was higher than those with surface electrode.(2)There was a significant relationship between the amplitudes of right CMAP measured with oesophageal electrode and those with surface electrodes,whereas there was no such relationship for the left side.(3)The PNCT and the amplitude of CMAP were not related to age,height,weight and perimeter of abdomen no matter measured with oesophageal or surface electrodes.Conclusion Surface electrodes is a useful and noninvasive method to evaluate the function of phrenic nerve and diaphragm.

Remote organ ischemic preconditioning is to conduct a transient and sublethal ischemic adaptation in non-vital organs before occurring cerebral ischemia/reperfusion injury in remote vital organs. Remote organ iscbemic preconditioning has been studied for as long as 15 years in the field of myocardial iscbemia. However, only recently it has become a therapeutic strategy for the treatment of cerebrovascular diseases, This article briefly reviews the methods and mechanisms involved in the protective effects of cerebral ischemia of remote organ ischemic preconditioning.

Objective:To study the adhesive strength between fiber posts and four different composite resin core materials.Methods:Four resin core materials (Multicore Heavy Body、LuxaCore、 LIGHT-CORE and Z100) were placed around the fiber posts. The adhesive strengths of the samples were tested by the universal electrical testing machine. The interface between fiber post and resin core was observed by SEM. Results:Different resin core materials exhibited significant different influences on adhesive strengths(P<0.05). The LuxaCore reached the maximum of (314.31±15.36) N and the Z100 was the minimum of (267.39±10.54) N.Conclusion:Resin core material exhibits a significant influence on adhesive strength. The dual-curing composite core material with low viscosity has the highest bond strength in all groups.

As an endogenous organism protective measure in vivo, preconditioning/ postconditioning in the process of ischemia/reperfusion may play common protective mechanisms, such as reducing the generation of oxygen free radicals, activating adenosine receptor, increasing endogenous nitric oxide and heat shock protein, inhibiting immune inflammatory response and neuronal apoptosis, activating intracellular signal transduction pathways, opening mitochondrial ATP-sensitive potassium channels, as veil as closing mitochondrial permeability transition pores. Investigating the common target of these mechanisms may provide a new theoretical basis for developing new drugs and reducing ischemia/reperfusion injury.

AIM: To investigate the effects of early application of thymosin peptide alpha 1 on lymphocyte subsets after operation in patients with hepatocellular carcinoma. METHODS: Forty-six patients with hepatocellular carcinoma were randomly divided into control and treatment groups for this study. Thymosin α1 at dose of 1.6 mg was injected subcutaneously on day 1, 3, and 5 after operation in treatment group. The percentages of CD3+, CD4+ and CD8+ cells, and CD4+/CD8+ ratio in both groups were counted before operation and on day 1, 4, and 7 after hepatectomy. RESULTS: CD4+ cell population and CD4+/CD8+ ratio decreased, but CD8+ increased after operation in control group (P<0 05). In thymosin peptide alpha 1 treatment group, there was no statistical difference in the percentages of CD3+, CD4+, CD8+, and CD4+/CD8+ before and after operation. In addition, thymosin α1 significantly increased CD4+ cell population and CD4+/CD8+ ratio (P<0 05). CONCLUSION: Operation suppresses the immune function in patients with hepatocellular carcinoma. Thymosin α1 increases CD4+ T lymphocyte subsets in patients after operation.

AIM: To study the apoptosis induction of cyclooxygenase - 2 ( COX - 2) inhibitor, celecoxib and adriamycin (ADM) on tumor apoptosis of gastric carcinoma MGC - 803 cells, and to explore their possible molecular mechanism(s) and interactions. METHODS: The number of MGC - 803 cells was observed by MTT assay. Tumor apoptosis was studied by fluorescence microscopy, flow cytometry (FCM), and DNA ladder. RESULTS: MGC -803 cell number was significantly decreased with increasing dose of ADM. Cells were accumulated in G0/G1 phase and the number of cells in S phase was decreased. ADM (5 mg/L) combined with celecoxib (25 μmol/L) markably inhibited the growth of MGC - 803 cells. Significant morphological changes of typical apoptosis were observed after treatment with combined use of celecoxib and ADM. Compared with ADM or celecoxib alone, ADM plus celecoxib obviously enhanced the DNA ladder fragment revealed by agarose gel electrophoresis of DNA. After exposure to combined celecoxib and ADM treatment for 48 h, MGC - 803 cells were accumulated in G0/G1 phase. There was a decrease in the number of cells in S phase as compared to celecoxib or ADM alone. CONCLUSION: Celecoxib and ADM appear to have synergistic effects for the apoptosis induction. This may be an important prospect for applying COX - 2 inhibitors to assist chemical therapy of ADM in clinical use.

Objective To summarize the experience of nursing patients undergoing NovaSure endometrial ablation. Methods Two hundred and eleven patients with abnormal uterine bleeding claiming no need of giving birth,who were hospitalized in our hospital during August 2011 to April 2013,were managed with NovaSure endometrial ablation and nursing care was performed.Follow-ups were conducted for investigating the curative effects.Results All the patients lived through the operations,their life signs were stable.As for the adverse effects,124 of them had mild abdominal pains,7 medium-level or severe hypogastralgia,1 dizziness and nausea,10 uterial hematocele,and 1 cystitis.All of them got recovered after treatment.One-month follow-up after hospitalization showed a success rate of 98.0%.Conclusions NovaSure is a new approach to abnormal uterine bleeding.It is advantageous for its simplicity,shortness in operation duration,less trauma to patients and good effects.Meanwhile,preoperative mental care and cooperative care during operation may facilitate their recoveries.

Objective:To investigate the recent and long-term efficacy and safety of pancreaticoduodenectomy for pancreatic head carcinoma and periampullary carcinoma.Methods:82 cases of pancreatic cancer combined with periampullary carcinoma patients admit ted in our hospital from August 2009 to June 2013 were selected and randomly divided into the control group and the observation group With 41 patients in each group.The control group received palliative surgical treatment,while the observation group underwent pancreatoduodenectomy.The operation time,hospitalization time,intraoperative bleeding volume and the incidence of complications,1,2,3-year survival rate and the recurrence rate at 1 year after operation and tumor eradication rate were compared between twp groups.Results:The amount of bleeding,operation time of observation group were significantly higher than those of the control group(P＜0.01),no signif icant difference was found in the hospitalization time between the two groups(P＞0.05);the incidence of complications in the observation group (41.46％) was significantly higher than the control group (22.96％)(P=0.03);the 2-year and 3-year survival rate of observation group were significantly higher than those of the control group (P＜0.05),the recurrence rate at 1 year after operation of observation group was significantly lower than that of the control group (P=0.04),the tumor eradication rate was significantly higher in the observation group than that of the control group (P=0.04).Conclusion:Though pancreaticoduodenectomy could prolong the operation time,increase the risk of bleeding and complications for pancreatic head carcinoma and periampullary carcinoma,but it could effectively reduce the possibility of recurrence after operation,significantly improve the long-term survival rate.