Objective To evaluate two regimes of transient intensive insulin therapy in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Methods Sixty-eight newly diagnosed type 2 diabetic patients with fasting plasma glucose(FPG)≥10.0 mmol/L and glycated hemoglobin A1c (HbA1c)≥8.0％were randomized to either cantinuous subcutaneous insulin infusion(CSII)group or multiple daily injection(MDI)group.Glycemic control,daily dose of insulin,body mass index(BMI),the mean area under the insulin curve(AUC),β-cell function(HOMA-β)and insulin resistence(HOMA-IR) were compared before and after treatment.Results There were no significant differences between two groups in days reaching glycemic control and BMI.The maximal insulin dose for glycemic control in CSII group was(0.53±0.06)U·kg-1·d-1 and that in MDI group was(0.71±0.04)U·kg-1·d-1(t= 11.100,P＜0.01).After CSII and MDI treatment,HOMA-β and the mean AUC of insulin were significantly increased(P＜0.01),but there was no significant difference between two groups(P＞0.05).No significant changes in HOMA-IR were observed before and after treatment or between two groups.There were no severe hypoglycemic episodes in two groups and mild hypoglycemic episodes were 0.34％(13/3806)in CSII group and 1.09％(44/4045)in MDI group.Conclusions The excellent glycemic control can be reached by short.terra CSII and MDI treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Lower insulin dose and less mild hypoglycemic episodes seem to be the advantage of CSII regime than MDI regime.β-cell function can be dramatically improved in both therapy regimes.

Objective To analyze the expression and clinical significance of tumor suppressor phosphatase -tension protein gene(PTEN)in differentiated thyroid carcinoma and the relationship with the V600E gene site muta-tion of murine sarcoma viral oncogene homolog B1(BRAF).Methods The expression of PTEN was assayed by im-munohistochemical staining in differentiated thyroid carcinoma and adjacent tissues.The differences were compared between clinical pathological features.The BRAF V600E gene mutation was detected by fluorescence quantitative pol-ymerase chain reaction(PCR)and to investigate the correlation between the expression of PTEN and BRAF V600E mutation.Results The negative rate of PTEN was 78.75%(63 /80)in differentiated thyroid carcinoma,13.75%(11 /80)in adjacent tissues(χ2 =27.236,P =0.000).There were significant differences in the expression of PTEN between I -II and III -IV in TNMstage,grade I and II,and lymph node metastasis(χ2 =10.395,6.948,9.263,P =0.000,0.006,0.000).The differences were not significant in the expression of PTEN between different gender,≤45 years and >45 years different pathological types and tumor diameter <2cm and ≥2cm(χ2 =1.113,0.941, 2.301,1.567,P =0.185,0.213,0.087,0.181).There was correlation between the expression of PTEN and BRAF V600E mutations(r =0.301,P =0.004).Conclusion The expression of PTEN is involved in the occurrence and development of differentiated thyroid cancer and is associated with BRAF V600E.The PTEN has the predictive value of prognosis in tumors.

Objective To understand the serotype distribution ,prevalence and antimicrobial susceptibility of Salmonella strains isolatd from diarrhea patients in Dongguan ,Guangdong Province .These data may be useful for disease control and prevention and clinical treatment .Methods From April to December in 2013 ,we collected 1 150 stool specimens from diarrhea patients . Salmonella strains were cultured by using Salmonella selenite brilliant green sulfa enrichment broth and selective chromogenic plates .Antimicrobial susceptibility was tested by ATB microbial identification and drug susceptibility system .Results A total of 72 strains of Salmonella were identified including 21 serotypes .The detection rate was 6 .3% (72/1 150) .Most of the strains were Salmonellatyphimurium (22/72 ,30 .5% )and Salmonellaenteritis (16/72 ,22 .2% ).Forty‐two (58 .3% )of the strains were isolated from the patients under one year of age ,12 (16 .7% ) strains from the patients of 3‐10 years of age ,and 18 (25 .0% ) strains from the patients of at least 20 years old .The results of antimicrobial susceptibility testing showed that 50 .0% of the strains were resistant to piperacillin and 48 .6% resistant to ticarcillin .Conclusions The prevalence of Salmonella typhimurium is the highest in local Salmonella‐associated diarrhea patients ,followed by Salmonella enteritis .Most of the Salmonella diarrhea occurred in the patients under one year of age .Clinicians should strengthen the monitoring of Salmonella in patients with diarrhea , especially in infants and young children , for early detection and treatment so as to reduce complications .

Objective To understand the drug resistance situation of pathogenic bacteria clinically isolated in Dongguan Munici-pal People′s Hospital during 2013.Methods The drug sensitivity test were performed by adopting the associated reagent strip of the VITEK2-compact microbial analyzer from French bioMerieux company,including AST-GN test,AST-GP33 test,AST-GP68 test and K-B method (only for Haemophilus influenzae).The data were analyzed by the Whonet5.5 software.Results In 2013,to-tally 7 543 strains of pathogens were detected out,including 6 031 strains(79.9%)of Gram negative bacteria,1512 strains(20.1%) of Gram positive bacteria.The detection rates of ESBL in Escherichia coli and Klebsiella pneumoniae were 46.9% and 28.1%,re-spectively.The detection rates of MRSA and MRCNS in Staphylococcus were 16.8% and 77% respectively.The detection rate of multidrug resistant strains was 21.5%.The resistant rate of Escherichia coli and Klebsiella pneumoniae to ampicillin and cefazolin were greater than 60%;which of Pseudomonas aeruginosa to ampicillin,furosemide,trimethoprim-sulfamethoxazole,ceftriaxone,ce-fotetan and cefazolin was more than 80%;which of Baumanii to imipenem was still 61.2%,which to aztreonam,ceftriaxone,cefotet-an,cefazolin was more than 98%.The resistance rate of Enterococcus faecium to vancomycin was 6.2%.No vancomycin-resistant Staphylococcus aureus strain was detected out.Conclusion The detected pathogenic bacteria in 2013 were dominated by Gram-neg-ative bacilli,the multidrug resistant bacterial strains had the higher detection rate,the drug resistance of Baumanii was serious.The resistance of Enterococcus faecium to vancomycin showed the increasing trend.Monitoring the bacterial drug resistance every year and understanding the change of pathogenic drug resistance can provide the basis for the rational selection of antimicrobial drugs in clinic.

Objective To evaluate the protection of combined clostridium butyricum and bifidobac-terium living powders for antibiotic-associated diarrhea ( AAD ) with all kinds of infections in hospitalized children,and to compare the therapeutic effect with saccharomyces boulardii. Methods This study was a prospective,randomized case-control clinical trial which collected the data of the hospitalized children with all kinds of infections in Pediactric Department of Shengjing Hospital of China Medical University between May 2011 to May 2012. A total of 552 cases were enrolled and 480 cases completed the study. A total of 240 chil-dren were in experimental group,80 cases received combined clostridium butyricum and bifidobacterium liv-ing powders 840 mg per time,twice a day and the other 160 cases received saccharomyces boulardii 250 mg per time,twice a day,for one week; the control group took none of probiltics. Two groups received routine antibiotic therapy. Everyday′s defecate frequency was recorded, the traits of excrement according to bristol stool assessment scale were evaluated,the incidence of diarrhea and drug related adverse reactions were coun-ted. Results During the studied 7 days,the AAD incidence was 4. 2%(10/240) in experimental group and 20. 4%(49/240) in control group,there was significant difference between two groups. The risk of AAD in experimental group decreased 58. 5%. Compared to saccharomyces boulardii,combined clostridium butyricum and bifidobacterium living powders decreased 38. 2% (RR=0. 728, 95%CI 0. 257~0. 784, P=0. 009). Compared to control group,the average defecate frequency decreased in experimental group,diarrhea duration contracted,there was statistic difference between two groups ( P<0. 01 ) . No drug related adverse reactions happened during the trial. Conclusion Both combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii could effectively reduce the risk of AAD in hospitalized children with bacterial infection,relieve diarrhea symptoms,short the duration of diarrhea,and did not find the adverse reac-tions. Combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii had the same protective effect for AAD of northern China children.

Objective To investigate the relationship of the initiative-aggressive behavior and D2S1338,D19S433 loci.Methods PCR and electrophoresis method were used to conduct genotype analysis on D2S1338 and D19S433 in the peripheral blood of 187 male initiative-aggressive violent offenders and 459 healthy men living in Jiangsu area.Results D2S1338 and D19S433 loci in initiative-aggressive behavior group and healthy group were found to coincide with Hardy-Weinberg equilibrium (P ＞ 0.05).There were significant difference in locus D19S433 (P ＜ 0.05)between initiative-aggressive behavior group and healthy group,but not on locus D2S1338 (P＞0.05).Univariate analysis showed significant differences at allele 14.2 and genotype 14-14 on locus D19S433 between the two groups (P =0.0011,P =0.0008) with the OR values being 0.50 (95 ％ CI:0.33-0.76) and 3.49(95％ CI:1.62-7.52),respectively.Conclusion Locus D19S433 may be related to with initiative-aggressive behavior with allele 14.2 being the resistant factor and genotype 14-14 being the susceptible factor.

Objective To evaluate the protective effects of oxymatrine injection on rats with endotoxic shock. Methods Wistar rat model of endotoxic shock was produced in this study. Twenty-four Wistar rats were randomly divided into normal control group (n=8), endotoxic shock group (n=8) and oxymatrine injection treatment group (n=8). Fifteen min?utes after the infusion of LPS (15 mg/kg) from femoral vein, oxymatrine was injected from femoral vein in treatment group, then we observed the mean arterial pressure (MAP) for six hours. At the end of experiment blood samples were harvested for measurement of urea and creatinine (Cr), which reflect renal function. Also contents of IL-6, IL-10, TNF-αin the renal ho?mogenate were detected. Results Oxymatrine can prevent progressive decrease of MAP in endotoxin shock treatment group. The contents of plasma urea and Cr were significantly higher in endotoxin shock group than those of control group. The contents of IL-6, IL-10 and TNF-αin renal homogenate increased obviously, but after the injection of oxymatrine, the contents of urea and Cr significantly decreased in treatment group, also IL-6 and TNF-α were significantly declined. Conclusion Oxymatrine provides protection at renal function after endotoxin shock, and its mechanism may be related to inhibit the releasing of inflammatory cytokines in kidney.

In this study, we evaluated the effects of ascorbic acid (VC), epidermal growth factor (EGF) and follicle stimulating hormone (FSH) on in vitro culture of sheep ovarian cortical tissue. Using 2 x 2 x 2 factor experimental design, we cultured sheep ovarian cortex fragments in 8 media with MEM (control), MEM+VC (50 microg/mL), MEM +EGF (100 ng/mL), MEM+FSH (50 ng/mL), MEM+VC+EGF, MEM+VC+FSH, MEM+EGF+FSH, MEM+VC+EGF+FSH. After 0 (non-cultured control), 2, 6, 12 days of culture, the pieces of ovarian cortex were proceed to histological and proliferating cell nuclear antigen (PCNA) examination, or observed by transmission electron microscopy (TEM). The percentages of developing follicles were increased (P < 0.05) and the percentages of healthy follicles were reduced (P < 0.05). When compared to the MEM group, the addition of FSH with VC or EGF promoted a significant increase of follicles diameter and follicles survival rate (P < 0.05), and stimulated the proliferation of granulosa cells. After 12 days of culture, medium supplemented with MEM+VC+EGF resulted the lowest proportion of developing follicles (49.3% +/- 3.2%), follicles diameter((32.3 +/- 2.3) microm), follicles survival rate (41.6% +/- 3.1%) and the proportion of PCNA stained follicles (26.4% +/- 1.2%, P < 0.05). In contrast, MEM+VC+EGF+FSH resulted the highest follicles diameter ((42.5 +/- 5.1) microm), follicles survival rate (59.7% +/- 6.1%) and proportion of PCNA stained follicles (43.5% +/- 4.1%, P < 0.05). Ultrastructural analysis confirmed the integrity of follicles cultured in VC+EGF+FSH group, while follicles cultured in MEM+VC+EGF groups showed more degeneration characters. In conclusion, the addition of VC and EGF to culture medium inhibited follicular development, VC+EGF+FSH was the most effective treatment to maintain follicular integrity and promote sheep primordial follicular activation and growth during in vitro culture.
Animals ; Ascorbic Acid ; pharmacology ; Culture Techniques ; Epidermal Growth Factor ; pharmacology ; Female ; Follicle Stimulating Hormone ; pharmacology ; Ovarian Follicle ; growth & development ; Ovary ; growth & development ; Proliferating Cell Nuclear Antigen ; analysis ; Sheep

This article takes the modern distance education of Beijing University of Chinese Medicine for example, and analyzes the current situation and future development paths of modern distance education in traditional Chinese medicine (TCM) colleges and universities, which has provided references for other TCM colleges and universities to set up modern distance education, and laid the foundation for further improving the quality of distance education and social influence, optimizing the modern TCM talent cultivation system, and enhancing the quality of TCM talent cultivation.

Objective:To explore the multidisciplinary management that centred on gastroenterology department, and follow-up study of children with Alagille syndrome(ALGS).Methods:The clinical data of 19 children diagnosed with ALGS in Pediatric Gastroenterology Department, Shengjing Hospital of China Medical University since June 2013 to December 2022 was retrospectively analyzed, and the clinical manifestations of various systems of the body were followed up and evaluated, and then developed the personalised management strategies.Results:Among the 19 confirmed patients, 18 cases were confirmed by genetic testing.Eighteen cases(94.7%) had characteristic facial features.To follow-up node, 8 cases(42.1%) had cholestasis, with alanine aminotransferase(210.20±110.50)U/L, aspartate aminotransferase(187.86±96.70)U/L, and direct bilirubin(110.93±108.15)μmol/L.Eighteen cases(94.7%) had pruritus.Eighteen cases(94.7%) of the patients had a high risk of malnutrition, and the level of total bilirubin[(76.17±107.34)μmol/L] and total bile acid[(100.18±83.78)μmol/L] were significantly increased in the children with obvious growth retardation.Thirteen cases(68.42%) had diffuse liver injury.The clinical opinions on genetic counseling, application of new drugs, liver transplantation, cardiac medicine and surgery follow-up, spine and oral surgery orthodontics were given by multiple disciplines.Conclusion:ALGS children have a high risk of long-term malnutrition and are associated with the severity of liver injury, and pruritus and jaundice are the main clinical manifestations.The management of ALGS patients should be centered around liver disease doctors, combined with multiple disciplines, paying attention to changes in various related organs of ALGS patients, and improving their quality of life.