Objective To investigate the effect of Danzhijiangtang Capsule on serum resistin level in insulin resistance (IR) rats induced by low dose of streptozotocin (STZ) and high calorie food. Methods Male Wistar rats were randomly divided into normal group, model group, low dose and high dose of Danzhijiangtang capsule treating group. The rats of normal group were fed with common food while the others with high calorie food and injected with low dose of STZ. The weight, fasting blood glucose (FBG), fasting insulin (FIns), blood fat, resistin level of all rats were measured, and insulin sensitivity index (ISI) was calculated accordingly. Results Danzhijiangtang capsule could reduce body weight of IR rats. According to the results of biochemical indicator detection, Danzhijiangtang capsule could reduce FBG and FIns level, improve blood fat condition, enhance ISI effectively and decrease resistin level (P

Objective To observe the effects of sports with different strength combined with traditional Chinese medicine on expression of PGC-1α and function of vascular endothelium of IGT rats; To discuss the synergistic action and its mechanism.Methods Seventy healthy male SD rats were randomly divided into blank group (10 rats), which were given regular diet, and the other 60 rats were given high-glucose and high-lipoid diet to establish the IGT model rats, which were then randomly divided into 5 groups, including IGT model group (model group), simple Chinese medicine group (Chinese medicine group), low strength sports+Chinese medicine (low strength group), middle strength+Chinese medicine (middle strength group), and high strength sports+Chinese medicine groups (high strength group), 10 rats in each group. Rats in blank group, model group and Chinese medicine group exercised freely. While rats in different sport strength groups conducted treadmill exercise with different strength, and were givenDanzhi Jiangtang Capsules for gavage. Changes of NO, eNOS, vWF and EMP before and after the treatment were compared, the PGC-1α level was detected.Results Compared with the blank group, levels of NO, eNOS and PGC-1α decreased, while the levels of vWF and EMP increased in model group (P<0.05). Compared with the model group, levels of NO, eNOS and PGC-1α increased in all treatment groups, while the levels of vWF and EMP decreased (P<0.05,P<0.01). Conclusion Middle strength sports combined withDanzhi Jiangtang Capsules may effectively improve function of vascular endothelium.

Objective To study the characteristics of peripheral nerve conduction (PNC) in advanced-stage amyotrophic lateral sclerosis (ALS) patients undergoing mechanical ventilation.Methods The sensory conduction velocity (SCV),motor conduction velocity(MCV),distal motor latency(DML) and amplitude of compound muscle action potential(CMAP) were determined in three ALS patients undergoing mechanical ventilation.The clinical data and PNC characteristics of the patients were analyzed.Results The 12 motor nerves were abnormal in all the three patients,including absence of responsive wave (66.7%,8/12),decreased amplitude of CMAP(33.3%,4 /12),prolongation of DML(16.7%,2 /12) and reduction of MCV(16.7%,2 /12).The CMAP amplitude of patients gradually decreased with the progression of disease,and finally led to adverse reactions.The SCV and amplitude of sensory nerve action potential were normal in all the three patients.Conclusion ALS patients undergoing mechanical ventilation may have severely damaged motor nerve conduction,and their sensory nerve is generally not affected,with the specific reason remains to be further studied.

This study was aimed to observe the effect of Danzhi Jiangtang Capsule ( DJC ) on expression of solu-ble thrombomodulin ( sTM ) and soluble endothelial cell protein C receptor ( sEPCR ) in experimental rats of type 2 diabetes mellitus (T2DM). This study also explored possible mechanisms of Yiqi Yangyin Huoxue method on vascular endothelial tissue and discussed mechanisms of prevention and management of T2DM vascular lesions . A total of 60 male Sprague-Dawley ( SD ) rats were fed for one week and then randomly divided into the nor-mal control group ( group N , n = 12 , rats were fed with routine food ) and diabetes mellitus group ( n = 48 , rats were fed with high-fat diet). After 4 weeks, rats in the diabetes mellitus group were injected with strepto-zotocin ( STZ ) to induce T2DM . According to the blood glucose level , rats were divided into three groups , wh ich were the model group (group M), pioglitazone (group P), and pioglitazone combined with DJC (group D). Group P was treated with pioglitazone (10 mg?kg-1?d-1), group D was given pioglitazone (10 mg?kg-1?d-1) and DJC ( 0 . 47 g?kg-1?d-1 ) . The group N and group M were treated with sodium chloride ( 5 mL?kg -1?d-1 ) . After four-week drug administration , the levels of sTM , sEPCR , PT , APTT and FIB in each group were tested . The results showed that compared with the control group , the levels of sTM , sEPCR and FIB in group M , group P and group D were significantly increased ( P < 0 . 05 ) , and the levels of PT and APTT were obviously reduced ( P < 0 . 05 ) . Compared with group P , the levels of sTM , sEPCR , FIB of group D were significantly reduced ( P< 0 . 01 ) , and the level of APTT was significantly increased ( P < 0 . 05 ) . However , there was no significant dif-ference in the increasing of PT. It was concluded that the Yiqi Yangyin Huoxue method can reduce the levels of sTM and sEPCR , and effectively improve coagulation . The possible mechanisms of protective effect on the vascular endothelium can be from reducing levels of sTM and sEPCR in order to enhance the activity of anti-coagulation and fibrinolysis , regulate the function of blood coagulation to improve hypercoagulable state .

This study was aimed to observe the effect of Danzhi Jiangtang Capsule ( DJC ) on NF-κB in the peripheral blood mononuclear cell , and inflammation indices such as serum MCP-1 , TGF-β1 and urinary albu-min excretion rate ( UAER ) in early diabetic nephropathy ( EDN ) , in order to discuss the possible mechanism of DJC on anti-inflammatory and renal protection effect of EDN. A total of 72 EDN patients which met the in-clusion criteria after the start-up stage were taken as research objects . They were randomly divided into the control group and the treatment group. The western comprehensive treatment plan was given to both groups. In the treatment group, DJC was added. And the treatment course was 8 weeks. Changes of MCP-1, NF-κB, TGF-β1 and UAER were observed before and after the treatment . The results showed that MCP-1 , NF-κB and TGF-β1 had significant positive correlation with UAER ( P < 0 . 05 , or P < 0 . 01 ) . Compared to pre-treat-
ment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER in the control group and treatment group after treat-ment were significantly declined ( P < 0 . 05 ) . Compared with the control group , after treatment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER of the treatment group were obviously reduced ( P < 0 . 05 , or P <0 . 01 ) . It was concluded that DJC can reduce the UAER , delay the renal injury , and downregulate levels of MCP-1, NF-κB and TGF-β1, block the expression of inflammatory mediators, inhibit inflammatory reaction and improve microinflammatory state of EDN. This may be one of the important mechanisms in the protection of renal function .

Objective To assess the effect of levothyroxine , lipoic acid and their combination therapy on improving the cognitive deficit and on the level of oxidative stress in the serum and hippocampus tissue of adult hypothyroid rast .Methods Fifty male SD rats were randomly divided into five groups:normal group , hypothyroidism group [ propylthioaracil ( PTU ) group], the levothyroxine sodium (L-T4) treatment group (PTU +L-T4 group), the lipoid acid(LA) treatment group (PTU+LA group), and the two-drug combination group (PTU+LT-4+LA group).After 8 weeks of treatment, the learn-ing and memory abilities of the rats were evaluated by Morris Water Maze ( MWM ) .The content of malondialdehyde ( MDA) and the activities of superoxide dismutase ( SOD) in the serum and hippocampus were respectively measured using thiobarbituric acid ,and xanthine-xanthine oxidase methods .Results Compared with the normal group , the escape latency was longer(P<0.01), the MDA level was increased and the SOD activity was decreased in the serum and hippocampus in the PTU group (P<0.001).Compared with PTU group, the SOD activity was increased and the MDA level was decreased in the PTU +L-T4 group, PTU +LA group and PTU +L-T4 +LA group(P<0.05).There was significant difference in MWM test score .Conclusion The L-T4 and LA combination therapy can significantly improve the cognitive function of hypothyroid rats.

Objective To analyze the clinical competency test results of general practitioners (GPs) in Shanghai Pudong New Area.Methods Total 1 160 GPs from Pudong New Area attended the clinical ability tests,all participated in theory test and 327 GPs attended practice skill tests.The results were reviewed by computer and the scores were automatically generated.Results The average score and pass rate of theory test were (64.24 ± 12.23) points and 64.2％ (745/1 155),respectively.The average scores of GPs with master or above degree were the highest (67.09 ± 13.38 points),however,the pass rate of GPs with undergradnate degree was the highest (69.7％,349/501).GPs with senior professional title got the highest average score and pass rate [68.26 ± 9.92 points and 82.7％ (43/52),respectively].Introduction to General Practice (69.7％),Internal Medicine (68.6％) and Cancer (66.9％) were the top 3 subjects with the highest correct rate.The pass rate of clinical skills was 39.1％ (128/327),GPs with master degree or above (192.87) and those with junior professional titles (171.08) had the highest scores.GPs with master degree or above (50.0％,8/16) and those with intermediate professional title (40.1％,97/242)had the highest pass rate.Conclusions The analysis shows that the average score and pass rate of both theory test and clinic practice skills test are not satisfactory among GPs in Shanghai Pudong New Area.The clinical ability of GPs need to be further improved,and the study of some specific disciplines need to be further strengthened.

Purpose:To analyze the clinical manifestations, so the diagnosis of hepatoid adenocarcinoma of the stomach (HAS) may be made and treatment instituted as early as possible. Methods:A total of 65 cases of HAS reported in the literature in recent ten years reviewed.Results:①Clinical symptoms and signs: The incidence of HAS in male was higher than that in female (6.2:1).Upper abdominal discomfort and physical signs of mass bclow the sternum were most commonly seen.②Diagnosis: The serum content of AFP were discombfort high level with a positive rate of 66.7%(22/33). The positive rate of AFP expression with immunohistochemical method was 94.5%(52/55).The percentage of liver metastasis detected by US B or CT was 20.5%(9/44) preoperation, and mostly seen at the gastric sinus was ahout 63.3%(19/30). The final diagnosis of HAS depends on gastrocopy and pathology. ③Treatment and Prognosis: The possibility of radical operation(D 2 ) is only 17.9%(5/28). The death ratio within one year was 56.3%(18/32).Conclusions: HAS is primarily a gastric carcinoma. The serum AFP levels are help fulin the diagnosis and differential diagnosis of HAS. The diagnostic evidence of HAS is dependant on its specific forms. The prognosis is often poor because of frequent liver metastasis.

Objective To summarize the clinical, electrophysiological, pathological characteristics of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Methods From Jan 1990 to Dec 2003, 32 patients of CIDP were admitted by our hospital, 14 male and 18 female. The age range of onset of illness was 13 to 74 years old (averaging 42.56) with the prime period of 40 to 50. Before hospitalization, the course was from 2 months to 5 years. Among all patients, there were 8 cases of a relapsing course and 24 cases of a chronic progressive course. Twenty-four patients were treated with corticosteroids, while 7 received immuglobin (IG) and corticosteroids. The clinical data before and after the treatment was studied retrospectively. Results Most of the patients had subacute or chronic onsets. The common initial symptoms are numbness, paresthesia, and extremity weakness. Diplopia, decreased visual acuity, dysarthria, and dysphagia could also be found initially. It was usually a symmetric sensorimotor neuropathy with either a relapsing course or a chronic progressive course. It could be accompanied with autonomic dysfunction and cranial nerve involvement. Electromyogram demonstrated that the motive and sensory nerve conduction velocities were slow. The sural nerve biopsy showed demyelination and remyelination. `IG and corticosteroids were both effective. Conclusion CIDP might result in widespread peripheral nerve damages, in which autonomic dysfunction and cranial nerve involvement were common. The dominant electrophysiological changes showed peripheral nerve demyelination accompanied by axon degeneration. The sural nerve biopsy played an important role of diagnosis. The treatment with IG and corticosteroids was a most effective way for CIDP nowadays.