High fat diet is one of the important factors leading to type 2 diabetes mellitus and insulin resistant symptom.Developing a steady and applied model using high-fat diet-fed animals becomes an important part of type 2 diabetes mellitus and insulin resistant symptom researches.Whether high fat diet leads to insulin resistant symptom in experimental animals depends on the following factors: the artifactitious pattern and the fat proportion of the feed,the total amount of calories absorbed by the experimental animal,the duration of the animal model development,the breed and gender of experimental animals and the assistant medicament etc.

The paper introduced the hospital's attempt to build a scientific and practical set of performance evaluation system based on KPI.The system determines the quantitative indicators for the efficiency and performance of each department,and effectively helps accomplish common objectives of the hospital and its departments,playing a key role in the sustaimble development of the hospital.

Objective To analyze the effect of clinical pathways on single disease management.Methods Clinical controlled trials on tumors of uterine,benign biliary tract diseases and benign thyroid neoplasm were collected and related literatures were screened according to the criteria of inclusion.The literature so collected underwent a Meta analysis.Results A total of 21 literatures were included.Meta analysis indicated that statistical difference existed in the total cost of hospitalization(WMD=1046.06,95％CI:- 1281.15 ～ - 810.96,P＜0.00001) and length of hospital stay (WMD=- 2.18,95％CI:-2.59～- 1.76,P＜0.00001)between non-clinical pathways group and clinical pathways group.Conclusion Implementation of clinical pathways can further reduce hospital costs and shorten hospital days of the single disease management.

AIM:To investigate the effects of pioglitazone on the quantity and function-related factors of regu-latory and effector T cells ( Treg and Teff ) of uremic apolipoprotein E knockout mice in vitro with or without the stimulation of atherosclerotic plaque-specific antigen oxidized low-density lipoprotein ( oxLDL) .METHODS:Uremic apolipoprotein E knockout mouse model was established by 2-step surgical procedure.After intervention with different concentrations ( 2μmol/L and 20μmol/L) of pioglitazone and PPARγantagonist GW9662 (5μmol/L) on splenocytes of uremic mice for 12 h in the presence or absence of oxLDL (2 mg/L), the levels of CD4 +CD25 +Foxp3 +Treg and IFNγ+CD4 +Teff were de-termined by flow cytometry.The mRNA expressions of Foxp3 and IFNγwas detected by real-time fluorescent quantitative PCR.RESULTS:In vitro, oxLDL induced a Treg/Teff imbalance in splenocytes from the uremic mice.Pioglitazone up-regulated the level of Treg and mRNA expression of Foxp3 in the presence of oxLDL, which was not antagonized by GW9662.Meanwhile, pioglitazone downregulated the level of Teff and mRNA expression of IFNγin the presence or ab-sence of oxLDL, which was reversed by GW9662.CONCLUSION:oxLDL induces a Treg/Teff imbalance in uremic apo-lipoprotein E knockout mice.Pioglitazone modulates the Treg/Teff imbalance probably through PPARγ-independent and-dependent mechanisms.

Objective To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women.Methods From Jan.2009 to Jun.2010,a multi-center clinical observational study was performed.Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study.Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery.Results Before and after IUD insertion surgery,10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2,total scores were 107 ± 27 and 105 ± 25,respectively.Before and after surgery,total average score both were 1.2,the average score of positive items both were 2.1.The difference of the above results were not statistically significance (all P ＞0.05).Preoperative and postoperative,the rate of positive items was 9.2％-19.6％ and 7.7％-17.6％,respectively.In addition to anxiety and fear,the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P ＜ 0.05).The incidence of the observed objects postoperative of each factor score,deteriorated was in the range of 4.9％ to 23.0％,improved was in the range of 26.3％-50.1％.The incidence of total scores,deterioration was 28.8％ (166/575),improved was 45.6％ (262/575).The incidence of the average score of positive items,deterioration was 3.7％ (21/575),improved was 52.3％ (301/575).Logistic analysis showed that,in addition to unit level,there were no other significant influencing factors for women' mental state of postoperative (all P ＞ 0.05).Conclusion IUD insertion surgery has no adverse effect on women's mental state.

Objective To evaluate the anticonvulsant effect of midazolam and diazepam when administered nasally on maximal electroshock seizure and metrazol seizure threshold test models .Methods Rats were randomly divided into 7 groups:model group, low-dose, middle-dose and high-dose of midazolam nasal spray groups , diazepam nasal spray in low-dose, middle-dose and high-dose of midazolam nasal spray groups .After the establishment of the maximal electroshock seizure( MES) and metrazol seizure threshold test models ( MST) in rats, the anticonvulsant effects of different doses of midazolam and the clinically used antiepileptic drug diazepam were evaluated and compared .HE staining was used to observe the histopathological changes in the hippocampus , cortex and amygdala in rats .Results Significant anticonvulsant effects were observed on MES and MST in rats pretreated with different dosages of midazolam .In addition , the anticonvul-sant effects of midazolam were stronger than those of diazepam at the same dosage on MES and MST (P<0.05,P<0.01). Histopathological results showed that both midazolam and diazepam could effectively prevent the seizure -induced brain inju-ries, inhibit the increase of microglial cells and the inflammatory cell infiltration in the hippocampus, cortex and amygdala, and reduce the nucleus pycnosis and neuronophagia .Conclusion Midazolam has significantly anticonvulsant and neuropro-tective effects on different seizure models when administered nasally in rats .

Objective To analyze the epidemiological characteristics, clinical manifestations, diagnosis and treatment effect of brucella in=nfection, and to provide practical foundation and valuable experience for clinical treatment and prevention of brucellosis.Methods One hundred and nineteen patients with brucella infection hospitalized at the First Hospital of Lanzhou University from January 1st 2011 to July 30th 2011 were enrolled.Clinical data including gender, age, contact history with bovine and clinical manifestations such as fever, sweating and joint and muscle pain were extracted.Diagnosis and treatment effect of these patients were all recorded.The epidemiological characteristics and clinical manifestations were analyzed.Results The majority of patients were middle-aged male, and the number of male cases were 2.5 times of female cases.The brucella infections were observed all seasons in Lanzhou, while most cases were observed between May and July.A total of 78 cases had clear animal contact history.Among them, 53 cases (44.54%) had contact history with bovine.Main clinical manifestations included fever (n=84, 70.59%), muscle and joint pain (n=93, 78.15%), sweating (n=52, 43.70%), fatigue (n=29, 24.37%), and the most common clinical symptoms was joint and muscle pain.Blood routine test showed neutropenia (n=25, 21.01%), increase in blood sedimentation (n=34, 28.57%) and blood coagulation dysfunction (n=30, 25.21%).Liver function examination showed increase in ALT (n=37, 31.09%) and AST (n=43, 36.13%).Other examination showed that splenomegaly (n=28, 23.52%) was the most common finding, and liver diffuse lesions (n=22, 18.49%) ranked second.The most common drugs were doxycycline (n=79, 66.39%), rifampin (n=60, 50.42%) and cephalosporins (n=50, 42.02%).Among them, 45 cases (37.82%) were treated with combination therapy of rifampin and doxycycline, and 31 cases were treated with combination therapy of doxycycline and rifapentine or cephalosporins.Totally 112 cases (94.12%) recovered.Conclusions The majority of patients with brucellosis are male.The clinical manifestations of brucellosis are varied.Clinicians should pay attention to identify and prevent misdiagnosis.The timely and effective treatment should be provided according to patients' conditions.The relevant departments should also strengthen supervision and education of brucellosis.

Objective To explore whether the Chinese medicine Guben Yiliu III can improve the effect of gemcit -abine on human pancreatic cancer xenograft in nude mice . Methods Nude mice with transplanted human pancreatic cancer were divided randomly into 4 groups: control group, gemcitabine treatment group , combined ( Guben Yiliu III +gemcitabine) group, and Guben Yiliu III group, 10 mice in each group.The gemcitabine group and combined group were treated with gemcitabine from the 8th day after transplantation in a dose of 100 mg/kg by i.p.injection, twice a week. Guben Yiliu III and combined groups were given the aqueous solution of Guben Yiliu III granules p .o.since the 8th day af-ter transplantation .Result The inhibition rate of transplanted tumor in the three treatment groups were 48.9% in the gemcitabine group , 68.9%in the combined group , and 28.0%in the Guben Yiliu III group .The combined group showed a significantly higher inhibition rate than the gemcitabine group (P<0.05).The gemcitabine group, combined group and Guben Yiliu III group showed a significantly slower growth rate than the control group .However, the combined treatment group showed a pronounced side effect and body weight loss than the other 3 groups .Conclusions The Chinese medicine Guben Yiliu III can improve the inhibitory effect of gemcitabine on nude mice with human pancreatic cancer xenograft in the auxilla of nude mice .

Objective: To identify Tongren Wujibaifeng Pills and Xiaoshuanzaizao Pills respectively by analysis of IR fingerprint. Methods: Both drugs were extracted with hexane, ether and butanone and then the extracts obtained were measured with FT IR spectrometer. Results: By analizing IR fingerprint of 25 batches Tongren Wujibaifeng Pills and 31 batches Xiaoshuanzaizao Pills, we found that different batches of the same drug have stable and repeatable fingerprint. Conclusion: By using IR fingerprint, either Tongren Wujibaifeng Pills and Xiaoshuanzaizao Pills can be identified. It provides a rapid method for drug identification and quality control.

Liver biopsy plays an important role in the diagnosis and treatment of liver diseases and can give a comprehensive and detailed description of the morphology of lesions and objective grading and staging scores. There are several pathological grading and staging systems for chronic viral hepatitis and chronic hepatitis due to other causes. This article describes the application and advantages/disadvantages of each scoring system and summarizes related precautions.