The effects and the mechanism of insulin treatment on intracellular lipid metabolism in liver of diabetic rats were evaluated. Type 2 diabetic rats were induced by injecting the streptozotocin (25 mg/kg) and fat rich food. According to the results of oral glucose tolerance test (OGTT) and glucose-induced insulin secretion test (IRT), the rats were divided into two groups: untreated group (UT) and insulin-treated group (IT). Normal rats (NC) served as controls. The treatment with either Humulin N (4--6 U/kg every day), or saline lasted for 4 weeks. Body weight, OGTT, IRT, blood lipids, intracellular lipids in liver, hepatic fatty acid oxidation and the activity of fatty acid synthase (FAS) were detected. The change of liver histology was observed. The insulin sensitivity index (ISI) was applied to assess the status of insulin resistance. The results showed that as compared with NC group, the plasma and hepatic intracellular Triglyceride (TG), total cholesterol (TC) and free fatty acids (FFAs) were increased significantly in UT group (P < 0.05), and lipid droplets could be seen dispersedly in the liver specimens, the hepatic fatty acid oxidation was increased markedly (P < 0.05), while the fatty acid synthase activity decreased (P < 0.05). Insulin treatment resulted in a further accumulation of lipids in liver by 55.7%, 19.87% and 22.2% increase in TG, TC, FFAs respectively. The size of hepatocytes was enlarged and the cells were filled with fat drops. Plasma lipids showed little decrease and still significantly higher than those in NC group after the insulin treatment. Meanwhile, insulin treatment was companied by 20% decrease in the rate of fatty acid oxidation and 31% increase in hepatic FAS activity compared to UT group. It was concluded that treatment with insulin on type 2 diabetic rat increases hepatic intracellular lipid accumulation by inhibiting hepatic fatty acid oxidation and activating FAS.

Objective To investigate differences between Han and Uyghur children in dyslexia prevalence and potential environmental risk factors as well as to provide diagnosis and treatment evidence for dyslexia children . Methods We used cluster sampling to recruit 2 854 students in grades 3~6 from five Uyghur -Chinese bilingual primary schools in Xinjiang province .The children with dyslexia were selected step by step according to the defini‐tion of ICD-10 and DSM -IV .The children with DD and children without DD were selected and compared by 1∶1 of the same class ,ages and genders .Then single factor analysis and logistic regression analysis were used to as‐sess children'environmental risk factors .Results In total ,2 438 effective quostionnaires have been got .The difference between Han (3 .89% ) and Uyghur (7 .05% ) dyslexia prevalence was statistically significant .The factor analysis revealed that educational grades ,family income ,father's and mother's occupations ,and their education levels as well as some home literacy environmental factors were significantly different for the two groups of children with dyslexia (P<0 .05) .Conclusion The prevalence of dyslexia was high in both groups ,and especially for Uyghur children . Some environmental factors may be responsible for the differences noted ,especially for the occupation of mother .

AIM: To campare the therapeutic effects and security between actarit (MS 932) and methotrexate(MTX) in the treatment of rheumatoid arthritis(RA). 　METHODS: One hundred and twenty patients with RA were randomly divided into two groups. Eighty patients of actarit group receved actarit, 100 mg, po, tid for 12 wk. The other forty patients received methotrexate 10 mg, po, qw for 12 wk as control.　RESULTS: The total effective rates were 73 % for actarit and 78 % for MTX (P>0.05). The adverse reactions were 9 % and 18 %(P<0.05).　CONCLUSION: Actarit is as same as methotrexate in the therapeutic effect, but actarit is better than MTX in security.

The standardized training of resident physicians of Chinese medicine specialized graduate students (standardized training) is a great reform of clinical postgraduate education and a major initiative to improve professional degree graduates education. It contributes to higher professional qualities of clinicians in China. At this stage, the standardized training in our school just started and some problems existed such as department arrangement, training and checking system, curriculum and tutors instruction. Here, taking the standardized training in our school as an example, this paper discussed some issues on the training and put forward suggestion. This will help standardize our training, improve the training quality of our graduate students and develope medical professional talents.

Objective:To screen the factors that were conducive to prolonging the effective half-life of 131I, and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive 131I. Methods:Between July 2017 and March 2019, a total of 61 patients (23 males, 38 females, age: 13-73 (37.7±1.9) years) who received lithium carbonate adjuvant therapy before 131I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study. Clinical parameters (serum free triiodothyronine (FT 3), serum free thyroxine (FT 4), iodine uptake rate (2 h, 12 h, 24 h) and ratio of iodine uptake rate (2 h/24 h, 4 h/24 h) before and after taking lithium carbonate were compared by using paired t test. The factors which were conducive to prolonging the effective half-life of 131I were analyzed by linear and multiple regression analyses. Results:Compared with the pretreatment results, lithium carbonate treatment significantly improved the 24 h iodine uptake rate ((74.82±2.69)% vs (82.38±2.33)%; t=2.674, P=0.010), decreased the ratio of 4 h/24 h iodine uptake rate ((88.96±2.85)% vs (82.12±2.27)%; t=2.644, P=0.010), prolonged the effective half-life of 131I ((123.03±3.09) vs (130.38±2.49) h; t=2.656, P=0.010), and decreased serum FT 3 ((26.46±1.65) vs (21.31±1.42) pmol/L; t=3.421, P=0.001) and serum FT 4 ((56.59±2.12) vs (49.24±2.19) pmol/L; t=3.289, P=0.002). Linear regression analysis showed that 2 h and 4 h iodine uptake rate, the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate, and effective half-life of 131I before lithium carbonate treatment were related to the effective half-life of 131I after lithium carbonate treatment ( b values: from -0.576 to 0.642, all P<0.05). Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life of 131I after taking lithium carbonate ( b=0.642, 95% CI: 0.453-0.832, P<0.001). Multiple linear regression equation was y=-49.785+ 0.642 x. Lithium carbonate treatment could prolong the effective half-life of 131I if the ratio of 4 h/24 h iodine uptake exceeded 77.55%. Conclusion:The ratio of 4 h/24 h iodine uptake rate is the main factor affecting the change of the effective half-life of 131I after lithium carbonate treatment, and patients with hyperthyroidism whose ratio of 4 h/24 h iodine uptake rate exceeds 77.55% can effectively prolong the effective half-life of 131I after taking lithium carbonate.

目的探讨应用湿性愈合疗法治疗压疮的疗效。方法将54例压疮患者分为湿性愈合治疗组和传统治疗组,并对两组患者的创面愈合时间、护理工作量、治疗费用进行比较。结果与传统疗法相比,湿性愈合疗法可使压疮的平均愈合时间缩短,换药次数与时间明显减少,而治疗费用接近。结论在有效处理伤口的基础上,湿性愈合疗法更有助于伤口愈合,无需每日换药,不增加患者负担,可替代传统换药方法。

The effects and the mechanism of insulin treatment on intracellular lipid metabolism in liver of diabetic rats were evaluated. Type 2 diabetic rats were induced by injecting the streptozotocin (25 mg/kg) and fat rich food. According to the results of oral glucose tolerance test (OGTT)and glucose-induced insulin secretion test (IRT), the rats were divided into two groups: untreated group (UT) and insulin-treated group (IT). Normal rats (NC) served as controls. The treatment with either Humulin N (4-6 U/kg every day), or saline lasted for 4 weeks. Body weight, OGTT,IRT, blood lipids, intracellular lipids in liver, hepatic fatty acid oxidation and the activity of fatty acid synthase (FAS) were detected. The change of liver histology was observed. The insulin sensitivity index (ISI) was applied to assess the status of insulin resistance. The results showed that as compared with NC group, the plasma and hepatic intracellular Triglyceride (TG), total cholesterol (TC) and free fatty acids (FFAs) were increased significantly in UT group (P＜0.05), and lipid droplets could be seen dispersedly in the liver specimens, the hepatic fatty acid oxidation was increased markedly (P＜0.05), while the fatty acid synthase activity decreased (P＜0.05). Insulin treatment resulted in a further accumulation of lipids in liver by 55.7 %, 19.87 % and 22.2 % increase in TG, TC, FFAs respectively. The size of hepatocytes was enlarged and the cells were filled with fat drops. Plasma lipids showed little decrease and still significantly higher than those in NC group after the insulin treatment. Meanwhile, insulin treatment was companied by 20 % decrease in the rate of fatty acid oxidation and 31% increase in hepatic FAS activity compared to UT group. It was concluded that treatment with insulin on type 2 diabetic rat increases hepatic intracellular lipid accumulation by inhibiting hepatic fatty acid oxidation and activating FAS.

Anaphylaxis is increasingly in children, which is currently undernotified, underdiagnosed, and undertreated in China.In order to further improved the understanding and management of anaphylaxis, this issue reviews the pathogenesis, triggers and risk factors, clinical diagnosis and management of anaphylaxis, thus offers the recommedations of anaphylaxis in Chinese children based on previous published evidence-based guidelines and practice parameters.Recommendation aims to develop guiding principles for the diagnosis and management of anaphylaxis in children, and provide a framework for the development of new guidelines.

OBJECTIVETo analyze the clinical characteristics and diagnosis of 2 cases with chylothorax due to primary lymphatic dysplasia and to elevate pediatrician's recognition level for this disease.

METHODClinical manifestations of the children were retrospectively analyzed. Primary lymphatic dysplasia was diagnosed by lymphoscintigraphy.

RESULTThe first patient was a male aged 2-year-7-month who presented with a history of tachypnea for 43 days, fever and sore throat for 5 days at the early stage of the illness. He had a history of external injury before his illness. Physical examination showed his left chest bulging and left side diminished breath sound. His pleural effusion showed dark red (It was divided into two layers after standing, the upper layer turned into milky white, and the lower turned into hemorrhagic liquid) . White blood cell (WBC) count was 9 000×10(6)/L, mononuclear cell was 0.9, polykaryocytes was 0.1, triglyceride was 12.37 mmol/L in the pleural effusion. Contrast-enhanced lung CT (revascularization) showed pericardial effusion and a massive left sided pleural effusion. The second patient was a male aged 9 years and 6 months, who presented with a history of cough for 24 days, intermittent fever, vomiting, abdominal pain for 19 days, and edema of lower limbs for 4 days. Physical examination showed edema in both eyelids, lower extremities and scrotum. The level of albumin was 14 g/L and the titer of Mycoplasma pneumoniae IgM was 1: 320 in the serum. His hydrothorax pleural effusion showed milk white. White blood cell (WBC) count was 74×10(6)/L, mononuclear cell was 0.78, polykaryocytes was 0.22, triglyceride was 1.01 mmol/L in the pleural effusion. Chyle test showed positive in his pleural effusion and seroperitoneum. High-resolution CT of the lung revealed bilateral interstitial and parenchymal infiltration and both sided pleural effusion. Abdominal ultrasound showed giant hypertrophy of the gastric mucosa and massive ascites. Gastroscopy showed giant hypertrophy of the gastric mucosa. Lymphoscintigraphy revealed primary lymphatic dysplasia in both children.

CONCLUSIONPrimary lymphatic dysplasia might occur in children and result in dropsy of serous cavity (chylothorax, chylopericardium, chylous ascites). Dropsy of serous cavity showed bloody or milk white. WBC count might elevate with lymphocyte increasing mostly, triglyceride was often higher than 1.0 mmol/L in dropsy of serous cavity. Primary lymphatic dysplasia can be diagnosed by lymphoscintigraphy.

Child ; Child, Preschool ; Chylothorax ; diagnosis ; etiology ; pathology ; Humans ; Leukocyte Count ; Lymphatic Abnormalities ; complications ; diagnosis ; pathology ; Lymphoscintigraphy ; Male ; Pericardial Effusion ; diagnosis ; etiology ; Pleural Effusion ; diagnosis ; etiology ; pathology ; Tomography, X-Ray Computed

To study alkaloid constituents in Corydalis decumbens,thirteen compounds were isolated from 95％ ethanol extracts of Corydalis decumbens (Thunb) Pers.by silica gel,RP-C1s,Sephadex LH-20 column chromatographer,recry stallization,thin-layer chromatography and HPLC.Their structures were elucidated on the basis of spectral data combined with physiochemical properties as tetrahydropalmatine (1),oxyhydrastinine (2),doryanine (3),palmatine (4),bicuculline (5),canadine (6),tetrahydrocoptisine(7),corydaldine (8),epicorynoxidine (9),N-methylcorydaldine (10),(+)-corlumine (11),N-methyl-6,7-dimethoxyisoquinolone (12) and oxysanguinarine (13).Compounds 2,3,6,7,and 9-13 were isolated from this plant for the first time.In addition,compounds 2,3,and 9-13 were obtained firstly from this genus.Pharmacological experiments showed that tetrahydropalmatine (1) might have analgesic or sedative effects,and the bicuculline (5) could probably induce epilepsy.