10.3969/j.issn.1000-3606.2013.06.001

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 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.

This study was aimed to carry out the research by statistics to analyze the influence of specific clinical function of Dioscorea opposita Thunb. from the viewpoint of prescription in order to summarize its rules. Formula containing D. opposita Thunb. in the classic book of the Formula Dictionary of Traditional Chinese Medicine were recorded. The prescription type of D. opposita Thunb. was taken as the mainline. Excellwas used in the chart analy-sis. The results showed that for the function of reinforcing spleen-stomach, the effect of powder was increased, but the effect of pill was reduced. For the function of reinforcing lung and generating essence, the effect of decoction was significantly increased, but the effect of pill was significantly reduced. For the function of reinforcing kidney-yin, the effect of pill was significantly increased, but the effect of decoction was reduced. For the function of strengthening the kidney and restraining yin, the effect of powder was reduced. It was concluded that preparation had a strong in-fluence on the clinical function of D. opposita Thunb., which provided references for both clinical practice and health cultivation.

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.

Objective To investigate influence and significance of preoperative transcatheter arterial chemoembolization (TACE) on disease-free survival rates and overall suvival rates in patients with respectable large hepatocellular carcinoma(HCC). Methods One hundred and eight patients with respectable large primary liver cancers were prospectively randomized into two groups: preoperative TACE group(n=52) and one-stage operation group(n=56). We compared between two groups according to daughter nodules and tumor thrombus. Results There were no significant differences in the incidence of disease-free survival rates and overall suvival rates in the two groups. Conclusion Preoperative TACE for resectable large HCC should be used on bases of strict selection because it does not decrease the recrudescence rates and results in delayed surgery in some cases.

With the increase number of children with obesity or diabetes,the incidence of nonalcoholic fatty liver diseases (NAFLD)in children becomes higher and higher,which has a strong impact on the growth of the children.As the pathologic change of NAFLD in children is mainly about the intrahepatic fatty infiltration, the determination of liver fat content plays an important role in the diagnosis and treatment of fatty liver.At pres-ent,the magnetic resonance technique for quantitative evaluation in hepatic fat fraction includes Dixon method, chemical shift imaging and magnetic resonance spectroscopy and so on.This article reviews the advances of MRI technique for quantification in children with NAFLD.