Objective To investigate the levels of serum tHcy and Lp(a)and their association with insulin resistance in patients with type 2 diabetes and CHD. Methods T2DM patients were divided into two groups with CHD and without CHD in addition to normal control.The fasting serum levels of tHcy,Lp(a),FPG and FIns were detected, ISI were calculated，and the correlations among them were analyzed. Results The serum levels of tHcy,Lp(a),FIns,FPG of T2DM plus CHD were significantly higher than those of T2DM without CHD and controls(P<0.01~0.05).ISI was significantly lower in T2DM cases with CHD than those of T2DM cases without CHD and controls(P<0.01). ISI was negatively correlated with tHcy and Lp(a)in T2DM plus CHD group(P<0.05)but not correlated with those in T2DM case without CHD group(P>0.05). Conclusions Detections of the serum levels of tHcy and Lp(a)of T2DM play significant roles in knowing patient condition,guiding clinical treatment and earlier preventing and treating vascular complication of diabetes.

AIM To inVestigate the positiVe transcription elongation factor b(P-TEFb)expressjon and the effect of berberine on diabetic retina of the rat.METHODS Type 2 diabetes mellitus rat models were diabetic control rats(group A)that neither received STZ nor the high-carbohydrate/high-fat diet;16-wk diabetic rats without any drug treatment(group B);diabetic rats treated with berberine at a dose of 75,150 or staining and P-TEFb(cyclin-dependent kinases 9(CDK9)and cyclin T1)protein expression was detected by immunohistochemjstry.RESULTS The retinas of control group were thicker than those of other 6 groups.After thickness but no difference in retinal structure among all groups.Middle-.high-dose berberine and rosiglitazone fenofibrate showed no effect on CDK9 and cyclin T1 expression.CONCLUSION Berberine modulating P-TEFb level in diabetic retina may probably be one of the mechanisms to ameliorate retinopatby induced by STZ and the high-carbohydrate/high-fat diet.

AIM To investigate cyclin dependent kinase 9(Cdk9) and cyclin T1 protein expressions in diabetic rat kidney and the effect of berberine on them. METHODS Type 2 diabetes mellitus (T2DM) rats were induced by injection (ip) with diet for 16 weeks. From week 17 to 32, diabetic rats were given berberine 75, respectively. The kidney tissue structure was observed with hematoxylin/eosin (HE) staining, kidney to body weight ratio was calculated, and Cdk9 and cyclin T1 expressions were examined by immunohistochemistry. RESULTS Compared with control rats, the volume of diabetic model rat glomerulus accreted, some intercapillary cells proliferated and mesangial region expanded, both glomerular basement membrane and renal tubular basement membrane thickened. Treatment with diabetic nephropathy symptom. The diabetic kidney to body weight ratio protein expressions in diabetic kidney to near control level. CONCLUSION Berberine regulates Cdk9 and cyclin T1 protein expressions in diabetic kidney which may partly contribute to ameliorate nephropathy complication induced by STZ and the high-carbohydrate/high-fat diet.

Retinopathy is a major cause of morbidity in diabetes and remains the primary cause of new blindness. Therefore, it is necessary to find new drug to treat diabetic retinopathy. Type 2 diabetes mellitus (T2DM) rats were induced by injection (ip) with streptozotocin (STZ) 35 mg·kg-1 and fed with a high-carbohydrate/high-fat diet 2 weeks later. From week 17 to 32, diabetic rats were given different doses of berberine 75, 150, and 300 mg·kg-1, fenofibrate 100 mg·kg-1 and rosiglitazone 4 mg·kg-1, separately. Retinal structure was observed with hematoxylin-eosin staining and peroxisome proliferator-activated receptors (PPARs) α/δ/γ protein expressions were detected by immunohistochemistry. The retina of control rats was thicker than that of other groups, 16 weeks treatment with berberine (150 and 300 mg·kg-1) and rosiglitazone 4 mg·kg-1 thickened the diabetic retina, but no difference existed in retinal structure among groups. Both berberine (150 and 300 mg·kg-1) and rosiglitazone 4 mg·kg-1 significantly decreased PPARγ expression in diabetic retina;while berberine (150 and 300 mg·kg-1) and fenofibrate 100 mg·kg-1 obviously increased both PPARα and PPARδ expressions in diabetic retina. Berberine modulates PPARα/δ/γ protein levels in diabetic retina which may contribute to ameliorate retinopathy complication induced by STZ and a high-carbohydrate/high-fat diet. It is expected that berberine might be a more beneficial drug to treat diabetic retinal complication comparing with fenofibrate and rosiglitazone.

Objective To explore the etiology of abdominia incision hernia and treatments of giant incisional hernia of abdominal wall. Methods 14 cases with AGIH treated in our hospital from Oct 2003 to May 2008 were analyzed retrospectively. Results The etiology of abdominia incision hernia were very important,and abdominal longitudinal incision was performed, 10 cases ＞ 67y among 14 cases with incision hernia were 71.42%. Infection of incision and essential conditions( diabetes, chronic cough ,hypoalbum inemia)were also easily induced of incisional hernia. All of them chose the marlex patch. The cases were all cured and no serious postoperative complications. None of cases recurred during a follow up of 3 to 56 months. Conclusion The etiology of AGIH related with longitudinal incision,old ( ＞ 60y)and essential conditions. AGIH were repained with polypropylene mesh. Essential conditions should be treated before operation and abdominal wall should be trained comfortablely. Repairing abdominal incision hernial with artifical patch was a safe and simple operation with minimal postoperation pain.

Advanced and recurrent cervical cancer has a poor prognosis and few effective therapeutic option.With the development of molecular biology,the targeted drugs for patients with locally advanced cervical cancer continuously appear,such as inhibiting human papillomavirus,targeting angiogenesis,epidermal growth factor receptor,mammalian target of rapamycin,cyclooxygenase-2,sarcoma gene,proteasome inhibitor,DNA methylation,etc.With the development of new molecular targeted therapy,more effective or even treatment measures of cervical cancer might be found,which can provid a new approach for the individualized treatment of cervical cancer.

OBJECTIVE:To study the composition of pathogenic bacteria and drug resistance in biliary tract infection for clinicians' reference about rational application of antibiotics. METHODS:Bacteria culture and drug susceptibility analysis were performed for the bile samples of 235 cases. RESULTS:The detection rate of pathogenic bacteria in bile was 61.7%,with gram-negative bacilli representing 59.3%,gram-positive bacilli 38.9% and Candida mycoderma 1.8%. With regard to constituent ratios of the bacteria,leading the first 4 places were enterococci(37.7%),Escherichia coli(29.3%),Klebsiella(18.6%) and Pseudomonas aeruginosa(5.4%). The main gram-negative bacilli were sensitive to imipenem and amikacin; whereas Enterococci were sensitive to vancomycin,amphemycin,ampicillin,penicillin and high concentration of gentamicin. ESBLs-producing Escherichia coli and Klebsiella totaled 30 strains,and the ESBLs-producing rate was 37.5%. CONCLUSION:Bile bacteria culture and drug resistance analysis serve as reference for clinical rational use of antibiotics.

OBJECTIVE:To explore the best way of drug application&taking in pharmacy through computer.METH-ODS:Ratio ordering method was applied to the high and low limit setups of drug stocks.RESULTS:The timely and dynamic high and low limit data setups through computer has successfully overcome the drawbacks of those from manual labor,thus more scientific and rapid drug application&taking was available.CONCLUSION:Ratio ordering method deserves to be generalization and application in drug application&taking by computer.

This article was aimed to study on clinical application of Shanyao (Dioscorea opposita Thunb.) in each historical period, which can offer some suggestions for clinical doctors to use Shanyao correctly. A total of 668 pieces of formulae containing Shanyao were recorded from the classic format Dictionary of Traditional Chinese Medicine Formula. And then, statistic analysis was made on the emerging frequency according to its effect. The results showed that different effects of Shanyao started to be widely applied from the Song dynasty. It was most widely applied in the Ming and Qing dynasty. Nowadays, the difference between using Shanyao has been gradually decreased. During the whole historical period, clinical functions of Shanyao are mainly reinforcing the spleen and the stomach, tonifying the kidney and strengthening yin. However, clinical functions of reinforcing the kidney and restraining yin, tonifying the lung and promoting fluid are used secondly. It was concluded that the research analyzed clinical application of Shanyao in each historical period, which can offer scientific basis for clinical practice and health maintenance with the using of Shanyao.

Objective:To explore whether metoprolol administration before emergency percutaneous coronary inter‐vention (PCI) can reduce incidence rate of reperfusion arrhythmia (RA) or not .Methods :According to random number table ,a total of 80 patients with acute anterior wall myocardial infarction (age< 75 years ,baseline heart rate >70 beats/min ,no PR interval prolongation ) were randomly and equally divided into routine treatment group (didn't receive metoprolol tartrate tablet before emergency PCI ) and metoprolol group (received metoprolol tartrate tablet 25 mg before emergency PCI ) .Incidence rate of RA after PCI was compared between two groups .Results:In metoprolol group ,a total of 32 cases received PCI and eight cases received percutaneous transluminal coronary angioplasty (PTCA);in routine treatment group ,a total of 35 case received PCI and five cases received PTCA ,suc‐cess rates of both groups were 100% .In metoprolol group , RA occurred in 4 cases ,including one case with ventric‐ular fibrillation (VF);in routine treatment group , RA occurred in 15 cases ,including four cases with VF .Inci‐dence rate of RA after emergency PCI in metoprolol group was significantly lower than that of routine treatment group (10.0% vs .37.5% ,P=0.032) .Conclusion:Metoprolol administration before emergency PCI can reduce in‐cidence rate of reperfusion arrhythmia in patients with acute myocardial infarction .