OBJECTIVE:To compare the effects and costs between metformin and acarbose when combined with insulin in treating type2diabetes mellitus.METHODS:Cost-minimization analysis in medical economy was applied to analyze the therapeutic effects,costs and cost related factors with the respect for the patients.RESULTS:There was no statistically sig?nificant difference in effects of the2therapeutic regimens.Total cost and drug cost per head in metformin group were1941.46yuan and138.86yuan respectively as compared with2308.37yuan and229.82yuan respectively in acarbose group.The analysis on cost related factors showed no statistical significance.CONCLUSION:Metformin combined with insulin is a preferable therapeutic regimen.

Nucleus raphe dorsalis (RD) plays an important role in acupuncture analgesia. We carried on further studies on the projections of RD from the forebrain and brain stem of the cat by using a horseradish peroxidase (HRP) retrograde axonal transport method.We have observed the labeled neurons in layer Ⅴ of the proreate gyrus, area prepyriformis, nucleus lateral habenular, and hypothalamic areas (preoptic, lateral, medial and posterior areas) when HRP was injected into the rostral part of the RD. The labeled neurons were giant pyriform in shape in prereate gyrus and area prepyriformis and various shapes in the lateral habenular and hypothalamic areas.We have also found the labeled neurons in the periaqueductal gray matter, locus coeruleus, lateral and medial parabrachial nuclei, other raphe nuclei (n. centralis superior, n. raphe magnus and n. linearis intermediate) and reticular formation of the brain stem when we injected HRP into the caudal part of the RD.This present results confirm that the fibers project to the RD directly from the forebrain cortex (proreate gyrus and area prepyriformis), latral habenular nucleus hypothalamic areas, periaqueductal gray matter, locus coeruleus and other raphe nuclei. We also have found that the afferent projections to the rostral part of the RD and the caudal part of the RD had different origins, that is, the rostral part receives fibers from the forebrain and the caudal part receives fibers not only from the forebrain, but also from the brain stem. The study provided a foundation for explaining acupuncture analgesia and physiological functions of RD.

L6.A longitudinal column of HRP-labeled motoneurons was found in the dorsolateral and mediolateral portions of the spinal cord,distributing in the lamina Ⅸ from the caudal L4 to the rostral L6.Additionally,the transganglionic HRP-labeled central projection axonal terminals were found to be dense in the central part of laminae Ⅰ-Ⅱ from L4 to the rostral L6,and to scatter in the central part of gracile nucleus.Conclusion HRP-labeled primary afferent and efferent innervating acupoint "Taixi"(KI 3) are DRGs of L4-L6,the dorsolateral and mediolateral motoneuron columns of L4-L6,and the centrally projecting axonal terminals of laminae Ⅰ-Ⅱ of the spinal cord and the gracile nucleus.

Objective To access the ability of MRI for detecting the radial meniscal tears.Methods Arthroscopy of the knee was performed by a single orthopedic surgeon on 1085 patients. On the basis of the results of arthroscopy, 107(9.9%) knees had radial tears of menisci. Through interval sampling of the patients with meniscal tears but not radial tears, 100 patients were selected as a controlled group. All MR images were analyzed by two radiologists independently. Four radiological signs were used to detect radial tears: cleft and marching cleft sign, detached sign, ghost sign, and small meniscal sign. All the features of MRI were compared with the results of the arthroscopy. Results (1) The most frequent location of radial tears was the midbody of lateral meniscus (71/107, 66. 4%)followed by the boundary of anterior horn and midbody of the lateral meniscus (25/107, 23.4%). (2) One hundred and two of 107 patients were identified as radial tears on MRI. However, 11 of 100 patients with non-radial tears were misdiagnosed as radial tears by MRI. The sensitivity, specificity, positive predictive value, and negative predictive value of MRI were 95.3% (102/107),89.0% (89/100),90.3% (102/113), and 94.7% (89/94),respectively. (3) The cleft sign (59/102, 57.8%) and detached sign (43/102, 42.2%) were the most frequent and important MRI signs. Conclusion The accuracy of MRI to identify the radial meniseal tears'is very high and MRI is the best imaging modality for patients suspected of radial meniscal tears.

OBJECTIVE:To compare the curative effect of domestic cefoperazone/sulbactam and imported one for lower respiratory infection. METHODS:The curative effects of domestice vs. imported cefoperazone/sulbactam in 201 vs. 198 patients with lower respiratory infection in recent two years in our hospital were analyzed retrospectively. RESULTS:The effective rate was 61.6% for imported product and 51.7% for domestic product. Significant difference was noted between 2 groups statistically(P

Objective The purpose of this article was to investigate the internal tunnel position during anterior cruciate ligament (ACL) reconstruction with single-bundle ACL. Methods MRI were performed in 10 knees form 10 volunteers at full extension and at 30°, 60°, 90°, and 120° flexion position. All the images obtained were exported into Mimics 10.01. Three-dimensional models were established with Mimics in a computer. All the mark points were confirmed on femur and tibia. The distance between the femoral mark point and tibial mark point was measured. The isometric point was determined as the change in the distance was shorter than 3mm during knee flexion-extension. Results Ten three-dimensional models were established successfully and the isometric points of A0-X, A15-X, A30-X, A45-X, B0-Y, B15-Y, B30-Y, B45-Y, C0-Z, C15-Z, C30-Z, C45-Z, and C60-Z were identified. Conclusion There was no absolute anatomical isometric point, whereas the physiological isometric point did exist. Therefore, determination of tibial point should be considered synthetically. B45-Y was recommended for tunnel position.

Objective To explore the difference in pain threshold between related acupoints and the specificity of acupoints in cholecystitis patients.Method Actual measurement was made in 80cases, a normal group of 30 cases (volunteers without psychological and physiological diseases) and a patient group of 50 cases (volunteers with cholecystitis). The probe of an algometer was perpendicularly placed on the selected acupoint, the pressure point was pushed and pressing was stopped immediately after the subject felt pain. The pain thresholds displayed by the measured acupoints were recorded. The pain thresholds of the selected acupoints were compared between the normal and patient groups and thedifferences were analyzed to explore the specificity of acupoints.Result A comparison of the pain thresholds of the Back-Shu points of the Bladder Meridian of Foot-Taiyang between the patient and normal groups showed that there were no significant differences in the thresholds of the left Back-Shu points Geshu (BL17), Ganshu (BL18), Danshu (BL19), Pishu (BL20), Weishu (BL21) and Dachangshu (BL25) of the bladder meridian between the two groups (P>0.05) and there were significant differences in the thresholds of the right Back-Shu points Geshu, Ganshu, Danshu, Pishu, Weishu and Dachangshu of the bladder meridian between the two groups (P<0.01). The pain threshold was significantly lower in thepatient group than in the normal group. A comparison of the pain thresholds of the main points of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between thepatient and normal groups showed that there were significant differences in the thresholds of the right points Liangmen (ST21), Riyue (GB24) and Qimen (LR14) of the liver, gallbladder and stomach meridians (P<0.01) and no significant difference in the threshold of the right point Taichong (LR3) between the two groups (P>0.05). The pain thresholdwas significantly lower in thepatient group than in the normal group. There were no significant differences in thethresholds of the left points Liangmen, Riyue, Qimen and Taichong of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between the patient and normal groups (P>0.05).Conclusion The pain sensitivity of ipsilaterali related acupoints increase and the relative specificity of acupoints exist in cholecystitis patients.

The purpose of the present work is to observe whether Tau protein Ser202/Thr205 is hyperphosphorylated in braintissues of diabetic mice and to study the effect of App17 peptide. Mouse diabetic model was produced with streptozotocin, andApp1 7 peptide as a treatment was injected subcutaneously into diabetic mice. Four weeks later, fixative was injected intravascu-larly into the mice, the brain was removed and crystat sections prepared. Immunohistochemical staining was done with AT-8. Inthe brains of diabetic mice positive AT-8 reacting neurons were numerous, darkly stained, and widely distributed in retrosplenialgranular cortex, hippocampus, thalamus et al. , while in normal mice and App17 peptide-treated diabetic mice positive cells werescarce and poorly stained. Tau protein is hyperphosphorylated at Scr202/Thr205 site and widely distributed in the brains of dia-betic mice, while App17 peptide can normalize the expression of AT-8 positive cells.

Objective Through the observation on the distribution of hyperphosphorylated Tau,to investigate the connection between hyperphosphorylated Tau and learning, memory tasks. Furthermore, the treatment of App17 on brain tissues of diabetic mice. Methods Diabetic model mouse was produced in the use of streptozotion and App17 peptide as a curative was injected subcutaneously. Four weeks later, removed the brains. Immunohistochemical stainning was done with AT\|8, Tau\|1, again with Tau\|1 antibody after dephosphorylation. Results In the brains of diabetic mice positive AT\|8 reacting neurons were widely distribution in retrosplenial granular cortex, hippocampas, thalamus et al, the cytoplasm was darkly stained, while in normal mice and App17 peptide\|treated diabetic mice positive cells were localized in retrosplenial granular cortex, however, in hippocampas and RSG area, the cytoplasm were poorly stained. Conclusion Hyperphosphorylated Tau is widely expressed in brains of diabetic mice. App17 peptide can improve the hyperphosphorylated Tau in brains of diabetic mice, therefore, it may improve learning ability and memory.\;

Objective To investigate the effect of a peptide,APP17,on regulating the expression of insulin receptor substrate\|1(IRS\|1) and insulin\|like growth factor (IGF\|1R) in neurons of the hippocampus from diabetic mouse. Methods Diabetic mouse models were established by injection of streptozotion.In experimental group,these models were injected with APP17 peptide subcutaneously and their brain sections were taken after 4 weeks of survival. The immunohistochemical stainning of these sections were then performed with IRS\|1 and IGF\|1R antibody.With regard to control groups,the mouse models were only injected saline and gone through the same procedure of immunohistochemistry together with normal mice. Results IRS\|1 and IGF\|1R positive neurons were widely distributed in the hippocampus of the diabetic mice,and the cytoplasm was darkly stained.In the contrast,positive cells in the hippocampus were lightly stained in those normal mice and the APP17 peptide\|treated diabetic mice. Conclusion The expression of IRS\|1 and IGF\|1R could increase in the hippocampus of dabetic mice.The APP17 can regulate the distribution of IRS\|1 and IGF\|1R in the brain of diabetic mice and return them to normal situation.