Abstract?AIM: To observe the effects of different antidiabetic therapies on macular thickness in diabetes patients without fundus complication.?METHODS: The macular thickness was measured by optical coherence tomography ( OCT) .The retina volume on the center of macula was scanned, and it generated automatically the average thickness data of three rings and nine areas of 1mm, 3mm and 6mm.The data were statistically analyzed.?RESULTS: Healthy control group, oral hypoglycemic drug group and insulin treatment group were enrolled. Each group included 22 cases 22 eyes.The macular retinal thickness of healthy control group is 268.09±17.97μm (the 1st ring), 340.41 ±22.25μm ( the 2nd ring) and 298.14 ± 12.90μm ( the 3 rd ring ) , respectively. The macular thickness of oral hypoglycemic drug group is 260.00 ± 18.17μm (the 1st ring), 335.44±21.12μm (the 2nd ring) and 295.63 ±15.92μm ( the 3rd ring), respectively.The macular thickness of insulin therapy group is 271.01 ± 26.09μm (the 1st ring), 340.86±17.10μm (the 2nd ring) and 298.57 ±12.14μm ( the 3rd ring ), respectively. Comparison of the macular thickness of the 1st ring among 3 groups was insignificant (F=1.21, P=0.31), neither the comparison of the 2nd ring (F=0.35, P=0.71), neither the comparison of the 3rd ring (F=0.22, P=0.81).? CONCLUSION: Compared with healthy individuals, both oral antidiabetic medicines and insulin therapy don't alter the macular thickness of patients with diabetes while without fundus complication.

Objective To study the clinical effect of Shenkang injection combined with valsartan in the treat-ment of patients with early stage diabetic nephropathy,and its influence on the expression changes of homocysteine ( Hcy) ,transforming growth factor β1 ( TGF -β1 ) , the inflammatory cytokines high sensitive C -reactive protein (hs-CRP),and interleukin-6 (IL-6).Methods 138 cases of early stage diabetic nephropathy were randomly divided into control group ( conventional treatment, valsartan act as antihypertensive drug ) and treatment group ( treated with Shenkang injection combined with valsartan) by digital table.The total effective rate,glycemic index, renal function,levels of Hcy and TGF-β1,expression levels of inflammatory cytokines of two groups were compared. Results The total effective rate of the treatment group (91.30%) was significantly higher than the control group (76.81%) (χ2 =5.004,P<0.05).The values of FPG,2h PG,HbAlc,UAER,CysC and Scr were lower in the treat-ment group compared with the control group (t=4.514,3.743,4.754,6.214,3.925,3.777,all P<0.05).Com-pared with the control group,the concentrations of Hcy,TGF-β1,hs-CRP and IL-6 decreased significantly[ (11. 78 ±1.95)μmol/L vs (9.21 ±1.64)μmol/L,(71.32 ±14.88) mg/L vs (60.04 ±11.75) mg/L,(7.07 ±1.25) mg/L vs (5.81 ±1.14)mg/L,(50.24 ±21.86)pg/mL vs (32.55 ±17.01)pg/mL],the differences were statistical-ly significant (t=8.378,4.942,6.187,5.305,all P<0.05).Conclusion Shenkang injection combined with val-sartan for the treatment of early stage diabetic nephropathy has significant clinical efficacy.It can improve patients're-nal function and reduce blood sugar levels.The effects may be related with inflammatory response inhibition and Hcy, TGF-β1 levels reduction.

[Objective] To study the effects of different growth periods on the contents of volatile oil and the curcumol in Curcuma aromatica Salisb. samples,which provided theoretical bases to control the quality of the crude drug of Curcuma aromatica Salisb.[Method]The contents of volatile oil in Curcuma aromatica Salisb. samples were determined by the method of Pharmacopeia,and HPLC method for determination of curcumol in different samples was established. [Result]The contents of volatile oil in different samples lied in the range of 0.820%～0.471%(g/g),and the contents of curcumol in different volatile oil samples were between 0.862%(g/g) and 1.380%(g/g). [Conclusion]Compared with the Curcuma aromatica Salisb. of a shorter growing period,the contents of longer growth period were higher.Different growing time had effects on the accumulating of volatile oil and the curcumol in Curcuma aromatica Salisb.

Objective To develop a HPLC method for the simultaneous content determination of three terpenoids inMelastoma dodecandrum Lour. (asiatic acid, betulinic acid, oleanolic acid).Methods The chromatographic column was set with waters SunFire C18 column (4.6 mm×150 mm, 5μm); the moving phase was acetonitrile -0.1%H3PO4; the column temperature was 30℃; the detection wavelength was 200 nm; the flow rate was 0.6 ml/min; and the sample volume was 25μl.Results A good linear relationship was observed in the range of 0.310-6.200μg (r=0.9999), 0.405-8.100μg (r=0.9999), 0.169-3.375μg (r=0.9998) for asiatic acid, betulinic acid, oleanolic acid respectively, with the average recovery rates of 102.08%, 101.81%, 102.22%. Conclusions The established method is convenient and sensitive, repeatability and stability, quality evaluation for Melastoma dodecandrum Lour.

Objective To investigate the complications of different enteral nutrition in patients after surgery for massive cerebellar infarction,so as to guide rational application of enteral nutrition in patients.Methods Forty-nine patients with massive cerebellar infarction were divided into three groups randomly:conventional nasogastric tube feeding group (group A,n =12),nasogastric tube feeding plus gastric motor drug group (group B,n =18),and nasojejunal tube feeding group (group C,n =19).The incidences of diarrhea,reflux,aspiration,upper gastrointestinal bleeding and aspiration pneumonia within 3 weeks after initiation of enteral nutrition were observed and compared among the groups.Results The incidence of diarrhea showed no statistically significant difference among the 3 groups (x2 =0.092,P =0.955).Compared with group A,the incidences of reflux,aspiration and aspirafion pneumonia were significantly lower in group B and group C (P ＜ 0.05),and lower in group C compared with group B (P ＜ 0.05).Compared with group C,the incidence of upper gastrointestinal bleeding was significantly lower in group C than in group A and group B (x22 =4.748,P2 =0.029;x23 =4.284,P3 =0.038),but the difference between group A and group B was not significant (x21 =0.000,P1 =1.000).Conclusions Because of the unique pathophysiological features in patients after surgery for massive cerebellar infarction,early enteral nutrition by conventional nasogastric tube feeding may be inappropriate.Nasogastric tube feeding plus gastric motor drug may be applied in mild case with short course of disease.Nasojejunal tube feeding may be the approach of choice for enteral nutrition in critical patients with massive cerebellar infarction for its association with lower incidence of complications.

Objective To analyze the true‐positive results ( ≥ 95% ) S/CO value of Treponema pallidum specific antibody (anti‐TP) positive samples caused by 2 different chemiluminescence detection assay in comparison with Treponema Pallidum Particle As‐say (TPPA) .Methods We collected the Treponema pallidum specific antibody positive samples of outpatient and hospitalization from October 2014 to January 2016 in Peking union medical college hospital as the research objects .There were 145 positive cases of Abbott laboratories (S/CO value of 1 .02 to 39 .29) ,24 positive cases of Roche (S/CO value of 1 .4 to 33 .07) .The 169 cases of Treponema pallidum specific antibody positive samples were detected with two methods of chemiluminescence detection at the same time ,TPPA was performed as repetition and confirmed test .Gathering and sorting the statistics of the positive predictive value seg‐mented ordered by specimen S/CO value ,to determine 95% or higher S/CO value of true positive results .Results After retested and confirmed by TPPA of the 169 positive cases ,the Abbott positive coincidence rate was 78 .7% ,the Roche positive coincidence rate was 81 .3% .When the S/CO value of Abbott ≥ 8 and the S/CO value of Roche ≥ 14 ,the positive predictive value was 100% . Conclusion When the S/CO value of Abbott ≥ 8 and the S/CO value of Roche ≥ 14 ,the S/CO value can be used as the true posi‐tive results( ≥ 95% ) .Abbott laboratories results S/CO value ≥ 8 ,Roche test results S/CO value ≥ 13 ,it is a 95% or higher S/CO limit of true positive results .

Objective To observe the expression of aggrecanase 2 and a tissue inhibitor of metalloproteinase 3 (TIMP-3) in degenerate human lumbar intervertebral discs and their role in degeneration of the nucleus pulposus.Methods Pfirrmann classification was used to class degenerate intervertebral discs observed through MRI.They were divided into three groups:a control group (Pfirrmann grade Ⅰ-Ⅱ),a degeneration group (Pfirrmann grade Ⅲ-Ⅳ),and a severe degeneration group (Pfirrmann grade Ⅴ).A total of 45 cases accepted lumbar spine surgery for removing nucleus pulposus specimens.Each group contained 15 cases.After formalin-fixation and paraffin embedding,immunohistochemistry was used to detect aggrecanase 2 and TIMP-3 expression in the nucleus pulposus cells.Results The percentages of cells positive for aggrecanase 2 were (13.58 ± 7.76) ％,(33.48 ± 13.95) ％ and (56.00 ± 18.39) ％ in the control,degeneration and severe degeneration groups respectively.These differences had statistical significance.The percentages of cells positive for TIMP-3 were (34.78 ± 13.80) ％,(46.77 ± 10.98) ％ and (50.65 ± 16.45) ％,and these differences were again statistically significant.The aggrecanase 2/TIMP-3 ratios were also significantly different.Conclusion As the degree of degeneration of the nucleus pulposus increased,the expression of aggrecanase 2 and TIMP-3 rose,which indicates that both changes were closely connected with the degeneration.Their ratio was correlated with the degree of degeneration of the nucleus pulposus.

Background Posterior capsular opacification (PCO) following the extracapsular extract of cataract is associated with the proliferation and migration of residual lens epithelial cells (LECs).Study showed that the incidence of PCO is higher in diabetic patients than those of non-diabetes.So if insulin-like growth factor-1 (IGF-1) participates in the pathogenesis of PCO deserve research.Objective This study was to explore the active mechanism of IGF-1/IGF-1 receptor (IGF-1 R) system in the migration of LECs and offer theoretical basis for clinical prevention and treatment of PCO.Methods Human lens epithelial cell lines (HLEC-B3) were cultured and passaged in DMEM.The cells were identified using fluorescence immunocytometry.IGF-1 with the concentrations of 0,30,90 μg/L were added into the medium separately for 48 hours.The numbers of migrated cells were calculated by Transwell test.The cells were cultured in DMEM containing 0,1.5,30,60,90 μg/L IGF-1,and the expressions of IGF-1 Rα and IGF-1Rβ in the cells were assayed and compared by Western bolt.Results The cultured showed the positive response for α-crystallin anibody with red fluorescence in the cellular membrane.Twelve hours after Transwell incubation,the number of migrated cells (Median) was 0(0,1),10(10,11) and 29(27,31) in the 0 μg/L IGF-1 group,30 μg/L IGF-1 group and 90 μg/L IGF-1 group,respectively,showing a significant difference among the 3 groups (Z=12.610,P=0.002).The number of migrated cells in the 30 μg/L IGF-1 group and 90 μg/L IGF-1 group was significantly more than that of the 0 μg/L IGF-1 group (both at P =0.008),and the number of migrated cells in the 90 μg/L IGF-1 group was significantly more than that of the 30 μg/L IGF-1group (P =0.009).Western blot assay showed that the expressions of IGF-1Rα and IGF-1Rβ in the cells were significantly different among the 0,1.5,30,60,90 μg/L IGF-1 groups (F=63.700,130.530,both P =0.000).The expressions of IGF-1 Rα and IGF-1Rβ were gradually elevated as increase of IGF-1 doses when then concentration of IGF-1 was ＞ 30 μg/L,with significant differences among the different concentrations groups (all at P＜0.05).Conclusions IGF-1 can upregulate the expressions of IGF-1R in HLEC-B3 cells in vitro in a dose-dependent manner.Also,IGF-1 enhances the migration ability of HLEC-B3 cells.These results suggest that activation of IGF-1/IGF-1R system may be associated with the pathogenesis of PCO.

BACKGROUND: Vertigo caused by vertebral artery stenosis accounts for a corresponding large percent in vertigo patients. There is not a unified criterion in diagnostic method, which affects accuracy of diagnosis. Application of simply check such as neck rolling-flexion and head hypsokinesis test can give first diagnosis to patients with vertebral artery stenosis in clinic. Then examination of transcranial Doppler(TCD) and nuclear magnetic resonance angiography (MRA) can be given to increase accuracy of clinical diagnosis.OBJECTIVE: To appraise diagnostic value of vertebral artery stenosis by neck rolling-flexion test, TCD and MRA examination.DESIGN: Cases analysis based on patients.SETTING: Department of Neurology, Affiliated Hospital of Inner Mongolia Medical College.PARTICIPANTS: Totally 41 patients with diagnosis of vertigo were chosen in Clinic of Neurological Department in Affiliated Hospital of Inter Mongolia Medical College from February to April 2004. The cases with vertigo that were not caused by vertebral artery stenosis were excluded.METHODS: Totally 41 patients with vertigo whose symptoms were induced by neck rolling-flexion and head hypsokinesis test were given later examination of TCD and MRA to vertebral arteries and basilar artery.MAIN OUTCOME MEASURES: Three checking results of 41 patients.RESULTS: Totally 41 patients with vertigo whose symptoms were induced by neck rolling-flexion and head hypsokinesis test were chosen. Vertigo occurred after left-right neck rolling in 32 cases, which accounted for 78% in detectable rate, and vertigo occurred after neck flexion and head hypsokinesis in 25 cases, which accounted for 61% in detectable rate. Thirty cases were found dissymmetry of blood flow in vertebral arteries on two sides and diameter differences of vertebral arteries on two sides between 0.5-2.0 mm by examination of TCD, which accounted for 73% in detection rate. Thity-nine cases were found dissymmetry in inner diameter of vertebral arteries and the differences in diameter were between 0. 5-2.6 mm, which accounted for 95% in detection rate. The other two cases were detected vertebral artery stenosis.CONCLUSION: Neck rolling-flexion and head hypsokinesis test can induce vertigo symptom, which helps to give final diagnosis whether it is caused by vertebral artery stenosis. TCD examination has a corresponding higher accuracy in diagnosis of vertebral artery stenosis. MRA examination has the highest accuracy in diagnosis of vertebral artery stenosis.

BACKGROUND: Conventional opinions believe tissues of central nervous system(CNS) cannot regenerate after injury when they have been developed and maturated. However, recent researches have validated that neural stem cells exist in human and adult animal nervous system, and most of them are in static status in vivo. The therapeutic effects of neural stem cells in cerebral infarct have been a key point in the researches.OBJECTIVE: To observe the reactive process of endogenous neural stem cells after cerebral infarct to explore the effects of endogenous neural stem cell in CNS traumatic rehabilitation, which provides theoretical gist for the self-restoration after cerebral infarct.DESIGN: A randomized controlled trial by using experimental animals as subjects.SETTING: Department of Neurosurgery of Peking Union Hospital.MATERIALS: The study was conducted in the Laboratory of Neurosurgery Department of Peking Union Hospital from March to October in 2003. Totally 82 healthy male Wistar rats with a body mass between 250 g and 300 g were selected.METHODS: Cerebral infarct model was established in rats by thread-ligation method. Rats were divided into post-infarct 1 day, 3 days, 7 days, 14 days and 28 days groups with 14 rats each. Control group was sham-operation group( n= 12). The expressions of bromodeoxyuridine (BrdU) and Nestin in the brain of the rats were dynamically detected by immunohistochemical method.MAIN OUTCOME MEASURES: The changes of BrdU and Nestin positive cell numbers after cerebral infarct in rats.RESULTS: Only very few BrdU and Nestin positive cells had survived in hippocampal dentate gyrus and subventricular zone(SVZ) area in control group. BrdU positive cell significantly increased compared with control group in hippocampus and SVZ area after 1 day of cerebral infarct( P ＜ 0.05),which reached its peak on the 7th day( P ＜ 0.05), started to reduce after 14 days but still in the level significantly higher than normal( P ＜ 0.05), and closed to normal level after 28 days. And moreover, BrdU and Nestin positive cells were significantly more in infarct side than the opposite side ( P＜ 0.05), which migrated towards the opposite side through callus.CONCLUSION: Cerebral infarct can activate the proliferation in situ and migration of endogenous neural stem cell.