OBJECTIVE:To find out the situation of antidiabetic drugs used in 47 hospitals of Shanghai and to make objective evaluation as reference for production,sale and consumption departments.METHODS:To investigate the hypoglycemic drugs used in 47 hospitals of Shanghai during the period 1998～2001 in respect to the sum of money of consumption,kinds of drugs,DDDs and DDC.RESULTS:In recent 4 years,the annual rate of growth of antidiabetic drugs were 11.98% in DDDs?6.32% in DDC and 19.05% in sum.Among the increasing ranges of antidiabetic drugs in DDDs,joint venture drugs occupied the first place,imported drugs came second,and domestic drugs got the least.CONCLUSION:Antidiabetic drug is a kind of common drug which has developmental future.

Owing to climate influence, mean daily temperature in north China differs greatly from that of the southern regions during the same season. The introduction of Fritillaria thunbergii to Beijing for cultivation was hampered by delayed emergence of seedling and a shortened period for their growth, resulting in degeneration with the underground bulb becoming smaller year after year. With forcing culture as described in this paper, the emergence of seedling came earlier and growth period prolonged. The blossom and fruit became normal.By combining the method with formalin treated seed, diseases and pest index of the bulb were reduced distinctly and the yield increased with increased proportion of larger bulb year after year.

Objective To assess whether mTOR was activated in peripheral T lymphocytes of acute coronary syndrome (ACS)patients and to investigate the relationship among mTOR,regulatory T cells and cytokins. Methods Patients with acute coronary syndrome (n=32) were selected in ACS group. Meanwhile, patients who complainted of chest pain but were proven to be normal in ECG and in coronary arteriography, were excluded as ACS patients but were diagnosed as Chest Pain Syndrome (CPS) and selected in CPS group (n=28). The expression levels of mTOR, phospho-p70S6KT389 (indicative of mTORC1 activity) and phospho-AKTS473(indicative of mTORC2 activity) were investigated in T cells, which were isolated from peripheral blood of patients in ACS group or CPS group, using Western blot. The proportion of CD4+CD25+Foxp3+Tregs over CD4+cells were evaluated by FACS. And T cell subset related cytokines such as IFN-γ, IL-4, IL-17 and TGF-β1 were exam?ined by ELISA. Then we investigated the relationship among mTOR,regulatory T cells and cytokins by Spearman analysis. Results mTOR and p-p70S6KT389 expression were significantly enhanced in ACS group as compared with those in patients from CPS group (P<0.01). Higher levels of IFN-γ, IL-17 but lower level of TGF-β1 cytokines as well as decreased propor?tion of Tregs were observed in ACS group than those in CPS group (P<0.05). There was no significant difference in the level of IL-4 and p-AKTS473 between the two groups (P>0.05). By correlation analysis, p-p70S6KT389 expression level positively correlated with IFN-γ, IL-17(rs=0.91,092,P<0.01)and negatively correlated with Tregs and TGF-β1(rs=-0.85,-0.80, re?spectively, P<0.01). Conclusion mTORC1 pathway was activated in peripheral T lymphocytes of ACS patients, and Tregs insufficiency and cytokins imbalance both contribute to the activation of mTORC1 pathway and pathological process of ACS.

Receptor activity modifying proteins (RAMPs) is a kind protein with transmembrane functionality.RAMPs can interact with TypeⅡ G protein coupled receptors (GPCRs) such as calcitonin gene-related peptide receptor (CGRPR),calcitonin receptor (CTR) and calcitonin receptor-like receptor (CRLR),to form a stable heterodimer expression on the cell membrane.Different RAMPs can combine with CRLR or CTR to produce different receptor phenotypes with ligand-specific affinity and thus can decide biological effect of the receptors.In addition,RAMPs can also interact with other GPCRs,which promise broader application in function regulation of G-proteincoupled receptor of RAMPs'.RAMPs' regulation of GPCRs depends on its molecular basis.Our studies of RAMPs provides a new perspective to further researches on GPCRs functionality and CGRP signal transduction.

Objective To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods 124 cases with primary liver carcinoma were randomly divided into two groups:60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results The total effective rates (CR+PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5,1,1.5 years survival rate were 81.3%,62.5%,43.8% respectively in the control group;93.3%,83.3%,63.3% respectively for the combined group. There was an obvious difference between the two groups of 1,1.5 years of survival rates. Conclusions Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time.

Objective To investigate whether the spleen diameter,serum albumin and periphefial blood cells might be as non-invasive predictive indicators for the presence of esophageal varices(EV)in patients with liver cirrhosis.The predictive values of these parameters to the large esophageal varices were evaluated.Methods OBe hundred and sixty-seven patients with liver cirrhosis underwent endoscopic examination.Among them,127 patients(mild in 41,medium in 38,severe in 48)were found with EV and 40 patients without(NEV).The diameters of portal vein and spleen vein,the sizes of spleen and the ratio of platelet count/spleen size were examined by Doppler ultrasound.The platelet count and the level of albumin were calculated.Results The average of age,diameter of portal vein and spleen vein,and sizes of spleen were higher in EV group than those in NEV group,while the platelet count,the level of albumin and the ratio of platelet count/spleen size in EV groups were lower than those in NEV group.Multifactor analysis revealed that the index related to serious EV were the blood platelet count(＜70×109/L),the ratio of platelet count/spleen size(＜1.0)and albumin level (＜35 g/L).Conclusions The degree of EV in patients with liver cirrhosis were paralleled with the degree of portal hypertension.The patients who present with platelet count＜70×109/L,or platelet count/spleen size＜1.0 or albumin＜35 g/L should be considered as EV,and endoscopic examination is needed.

Objective To study the distribution of hemodynamics in carotid artery under the fluid-solid interaction at the typical point of time during a single cardiac cycle, and to explore the mechanism of the formation and development of carotid atherosclerotic plaque. Methods Numerical analysis the blood flow characteristics within a cardiac cycle in carotid artery was analyzed by using computational method of fluid dynamics. Based on the hemodynamic parameters, the influences of the cardiac systole and diastole on the blood flow distribution were analyzed. Results The distribution of blood flow in the carotid artery within a typical cardiac cycle was obtained. Compared with the findings in cardiac diastole, a larger area of blood stasis at the entrance of external carotid artery was observed. In this area, the flow velocity, the wall pressure and the wall shear stress were all lower, while the arterial wall deformation and von Mises equivalent stress were larger. Conclusion Under fluid-solid interaction, the low blood flow in carotid artery causes blood reflux, resulting in the deposition of lipid, fiber and other large molecular materials. The low wall pressure produced“negative pressure” effect, thus the normal blood flow is changed, the flow velocity becomes slow, and the blood supply of the brain becomes insufficient. The low wall shear stress destroys the blood flow near the wall, causing the increase of platelet activity and intimal hyperplasia. The larger arterial wall deformation variable and von Mises equivalent stress can cause stress concentration and increase vascular rupture risk.

Objective To discuss the treatment and clinical efficacy of repair of soft tissue and nerve defect of thumb with island flap of first dorsal metacarpal artery based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.Methods The skin and nerve defect in 14 thumbs were repaired by dorsal island flap of index fingers based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.The size of skin defect ranged from 52 mm × 32 mm to 10 mm × 8 mm.The length of the nerve defect ranged from 9 mm to 22 mm.Results The average followup was 6-35 months.All 14 flaps survived with satisfactory appearance and function.The injured side of thumb pulp sensation recovered S3 + and the injured two-point discrimination ranged from 4 mm to 7 mm.No scar contracture or sensory dysfunction complication were observed in the donor sites.Conclusions The repair of soft tissue and nerve defect of thumb with dorsal island flap of index finger based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve is recommendable,since it can obtain satisfactory clinical efficacy and be easily and conveniently oerformed.

Objective To assess the curative effect of different therapeutic regimen in perimenopausal and postmenopausal pa-tients with depressive disorder ,in order to guide clinical work .Methods Relevant literatures were collect by retrieving a number of online database ,,screen documents independent ,the randomized controlled trial(RCT) and cohort study were included ,and carried on the quality evaluation and data extractione ,then completed the Meta analysis .Results 19 papers were inclouded (2 312 cases) , including 10 RCT papers and 9 cohort papers .There was no statistically significant difference for cure rate (RR=1 .15 ,P=0 .07) , the difference of effective rate had statistically significant (RR=1 .17 ,P=0 .005) .Hormone in combination with antidepressants compared with hormone replacement therapy :the difference of cure ratio (RR=1 .73 ,P=0 .003) and effective rate (RR=1 .52 , P<0 .01) all had statistically significant .The difference of effective rate between antidepressants and hormone replacement therapy had statistically significant (RR=1 .37 ,P=0 .003) .Hormone replacement therapy compared with placebo :the difference of cure rate had statistically significant(RR=2 .17 ,P=0 .03) ,the difference of effective rate had no statistically significant (RR= 0 .78 ,P=0 .15) .Conclusion Although the hormone replacement therapy has a positive effect on the mood ,it′s promoting effect on the anti-depressant of perimenopausal and postmenopausal women is uncertain .

Objective To study the two-phase flow dynamics distribution and red blood cell distribution under the fluid-solid coupling interaction in left coronary artery at the typical time point within one cardiac cycle,and to investigate the formation and development mechanisms of left coronary artery atherosclerotic plaque Methods The blood was regarded as a two-phase fluid.Based on fluid-solid interaction between blood and vascular wall,the computational fluid dynamics method was used to make the transient numerical simulation of two-phase flow in the left coronary artery under fluid-solid interaction;the distribution of blood flow in the left coronary artery at the typical time point within one cardiac cycle was studied,the relationship between hemodynamic parameters and the formation of atherosclerotic plaque was analyzed.Results A lowspeed eddy zone existed in an area between the distal segment of circumferential branch and the proximal outside of blunt-edge branch of the left coronary artery,where both internal wall shear stress and red blood cell volume fraction were very small and the blood flow pattern was very complicated.Conclusion At the lowspeed eddy zone that carries small wall shear stress,the lipid concentration polarization and macromolecular material deposition are easy to be produced.The area that has less red blood cells is liable to develop hypoxia,resulting in increased vascular wall permeability and intimal injury,which will activate the immune system,causing lipid accumulation in vascular wall and intimal hyperplasia and,thus,to induce the formation of atherosclerotic plaque.(J Intervent Radiol,2017,26:253-257)