BACKGROUND: Diabetic patients are often accompanied with the changes in lipid metabolism and hemorheology, which are the main factors to cause cardiopathy.OBJECTIVE: To observe the influence of the prescription for lowering glucose and lipid on the lipid metabolism and hemorheology in diabetic patients with accompanied hyperlipidemia.DESIGN: A randomized control observation.SETTING: Department of Traditional Chinese Medicine, the First Affiliated Hospital of Nanjing Medical University; the Staff Room of Epidemic Febrile Disease, Nanjing Medical University.PARTICIPANTS: Totally 103 diabetic patients with abnormality of lipid metabolism, who were selected from the Department of Traditional Chinese Medicine, the First Affiliated Hospital of Nanjing Medical University and the Hall of Traditional Chinese Medicine of Nanjing Medical University between May 1998 and June 2000, were randomly divided into the group treated with the prescription for lowering glucose (n=52) and xuezhikang control group (n=51).METHODS: In the treatment group, the patients were treated with the prescription for lowering glucose and lipid, which consisted of hawthorn fruit 10 g, safflower 10 g, peach seed 12 g, danpi 10 g, leech 3 g, danshen 15 g,American ginseng 2 g, fleece-flower root 15 g, king solomonseal rhizome 12 g, wolfberry fruit 12 g, astragalus root 20 g, one dose every day, and no other drugs for lowering lipids were used. In the control group, the patients were treated with xuezhikang,, 2 tablets for each time (03 g per tablet), 3 times a day. The blood samples of all the patients in both groups were drawn and examined before medication and 40 days after medication, the indexes of blood lipids and hemorheology were detected respectively, and the results before and after treatment were compared.MAIN OUTCOME MEASURES: The influence of the prescription for lowering glucose and lipid on the cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), high density lipoprotein cholesterol (LDL-C) and hemorheology of the patients were observed.RESULTS: A total of 103 patients were involved, all completed the analysis of blood lipid, and 75 cases completed the analysis of hemorheology,blood lipids: In the treatment group, the triglyceride, cholesterol, LDL-C and VLDL-C after treatment were all decreased as compaied with those before treatment, and HDL-C was higher than that before treatment. In the control group, only triglyceride, cholesterol, LDL-C after treatment were the whole blood high, middle and low-shear viscosities, haematocrit and platelet aggregation rate after treatment were decreased as compared with those before treatment. In the control group, only the platelet aggregation rate after treatment was decreased as compared with thate before treatment.CONCLUSION: The prescription for lowering glucose and lipid can ameliorate the indexes of lipid metabolism and hemorheology in diabetic patients with hyperlipidemia.

The lack of medical ethics education among young doctors substantially hinders the construction of a harmonious physician-patient relationship under the current condition. This paper addresses the disharmonies and ethical conflicts in current physician-patient relationship, and sheds light on major factors related to the causes of the lack of medical ethics education among young doctors. Furthermore, special considerations and coping strategies to eliminate this dilemma are also provided.

Three-dimensional syndrome differentiation is a new mode of syndrome differentiation of exopathic febrile diseases, which is based upon the six meridian syndrome differentiation initiated in Treatise on Cold Attack and defence-qi-nutrient-blood and triple-Jiao syndrome differentiation in the art of warm disease of traditional Chinese medicine. Syndromes appeared in the course of cold pathogenic diseases and warm diseases were differentiated through the survey of clinical cases and observation on syndrome features of exopathic febrile diseases, by applying means of analyzing, reasoning, concluding and deducting, from the stadium, location and nature of the disease. Three-dimensional syndrome differentiation theory explains and generalizes pathological mechanism and types of syndrome on acute exopathic febrile diseases roundly, has constructed theoretical frame and synthetical model of syndrome differentiation of exopathic febrile diseases. However, any new method of syndrome differentiation can not be leave nothing to be desired in the beginning, so it is proposed that we must develop epidemiologic investigation on syndromes of exopathic febrile diseases sequentially, make models of clinical commonly seen syndromes of exopathic febrile diseases and dispose fuzzy phenomenon of syndrome by applying mathematical method. By above measures, three-dimensional syndrome differentiation will be perfected gradually, therefore, it can provide scientific theoretical basis for the treatment of exopathic febrile diseases.

Objective To evaluate the application of tubular stomach gastroesophagostomy on the life quality after esophagectomy surgery.Methods From March 2011 to September 2011,66 cases of esophageal cancer patients were divided in two groups in randomized principles.Tirty-four cases in group of tubiform gastro surgery whose the stomach was cut into tubiform stomach in width of 4 cm.And 32 cases of conventional group and whose surgery method was adopted to maintain whole stomach but cut the cardia.And then,using statistical methods,life quality after esophagectomy (treatment related symptoms,general symptoms,daily life,social life,emotional activities) and the perioperative complications were evaluated in 3,6,12,24 months in comparison and analysis.Results Sixty-six surgeries of both group patients were successfully performed,tumor resection rate was 100％,and there was no intraoperative accident also no perioperative death.There was no statistical significance of perioperative complications of 2 groups (P ＞ 0.05).Life quality of tubiform gastro group had improved apparently more than conventional group at the 3rd,6th,12th and 24th month after surgery(78.68 ±2.23 vs 65.94± 4.13,83.79 ± 2.40 vs 66.84 ± 5.86,86.41 ± 1.94 vs 67.09 ± 4.43,89.02 ± 1.71 vs 68.88 ±3.53,P＜0.05).At each time point,there were statistically significant differences between tubiform gastro group and conventional group on treatment related symptoms,general symptoms,daily life,emotion activities (P ＜0.05).At the 3rd,6th month after surgery,tubiform gastro group and the conventional group had no statistically significant difference in the aspect of social life (P＞0.05).In the conventional group,the evaluation of quality of life at each time point after surgery and before a point in time in the same group showed no statistical significance (P＞0.05).Conclusion Tubiform gastro esophagectomy has a positive influence on life quality of patients of esophageal cancer after surgery prospectively.

Objective Thoracic cavity fistula following esophagus carcinoma resection is a serious complication with a high mortality.This study aims at a better therapy for thoracic cavity fistula following esophagus carcinoma resection by summarizing the ex-perience with the four-tube strategy ( jejunal fistula tube, stomach tube, chest drainage tube, and nasal fistula tube) in the treatment of the complication. Methods We retrospectively analyzed the clinical data about 62 cases of thoracic cavity fistula following esopha-gus carcinoma resection, 35 treated with the four-tube strategy ( treatment group) and the other 27 with the three-tube ( stomach tube, chest drainage tube, and nasal fistula tube) method ( control group) .We compared the hospital days, wound healing time, mortality, and incidence of anastomotic stenosis at 6 months after operation between the two groups of patients. Results Compared with the controls, the treatment group showed remarkable decreases in the hospital days (P<0.05), wound healing time (P<0.05), and mortality (P<0.05), but no statistically significant difference was observed in the incidence rate of anastomotic stenosis at 6 months after operation between the two groups of patients ( P >0.05 ) . Conclusion Compared with the three-tube method, the four-tube strategy has the advantages of shorter healing time and lower mortali-ty, and therefore is preferable for the treatment of thoracic cavity fis-tula following esophagus carcinoma resection.

AIM:To evaluate the effect of microRNA-155(miRNA-155) on the regulation of angiogenesis in diabetic rats with cerebral ischemic injury .METHODS: Adult male Sprague-Dawley rats were randomly divided into 5 groups:sham group, cerebral ischemia group , diabetic cerebral ischemia group , diabetic cerebral ischemia +miRNA-155 inhibitors group and diabetic cerebral ischemia +scramble group .Diabetes model was made by injection of streptozocin and permanent cerebral ischemic model was developed by suture-occluded method .The scores of neurological deficit and infarct volume were estimated at 24 h after cerebral ischemia .miRNA-155 level was detected by real-time polymerase chain reaction.The expression of platelet endothelial cell adhesion molecule-1 ( PECAM-1/CD31 ) and vascular endothelial growth factor ( VEGF) was detected by Western blotting .RESULTS:miRNA-155 inhibitor significantly reduced miRNA-155 levels in the ischemic cortex (P<0.05), improved the scores of neurological deficit , reduced infarction size and up-regulated the levels of CD31 and VEGF (P<0.05).CONCLUSION:miRNA-155 has a critical role in the regulation of angiogenesis in diabetic rats with cerebral ischemia .Down-regulation of miRNA-155 using miRNA-155 inhibitor attenuates brain infarct injury in diabetic rats .

BACKGROUND:Matrix metal oproteinase-13 is most active in the degradation of col agen type II in the extracel ular matrix of cartilage. Interleukin-1 (IL-1) is thought to be the inducer of matrix metal oproteinases, and participates in the degradation and degeneration of articular cartilage. OBJECTIVE:To study the influence of IL-1βon microRNA-27b (miR-27b) and matrix metal oproteinase-13 expression of chondrocytes in rats. METHODS:Chondrocytes isolated from seven male Wistar rats were cultured and divided into IL-1βstimulation group and control group. No stimulus was given in the control group;10μg/L of serum free medium was used to culture rat chondrocytes in the IL-1βstimulation group. Cel growth was observed at 0, 24, and 48 hours under an inverted microscope. miR-27b and matrix metal oproteinase-13 expression in the cultured chondrocytes were detected. RESULTS AND CONCLUSION:The relative expression of matrix metal oproteinase-13 in rat chondrocytes was gradual y increased when induced by IL-1βat 0, 24, and 48 hours (P<0.05). Expression of miR-27b and miR-31 in rat chondrocytes at 24 and 48 hours induced by IL-1βgradual y decreased (P<0.05);conversely, expression of MiR-26a, miR-26b, miR-23, and miR-204 gradual y increased (P<0.05). After 48 hours of IL-1βinduction, expression of miR-27b was the lowest in rat chondrocytes (P<0.05). These findings suggest that IL-1βinhibits miR-27b expression, strengthens the expression of matrix metal oproteinase-13, and damages chondrocytes, contributing to both the onset and progression of osteoarthritis.

Objective:To investigate the relationship between Creactive protein(CRP)/albumin ratio (CAR) and lymph node metastasis of gastric cancer. Methods:A total of 96 cases of gastric cancer were included in the study. The clinical pathological stage and lymph node detection in patients with gastric cancer were analyzed, with the preoperative CAR as the dependent variable. Results:1) The pa-tients with preoperative CAR>0.04 has higher transfer rate and metastasis than the patients with preoperative CAR≤0.04, and the dif-ference was significant (P<0.05). The lymph node stage of patients with preoperative CAR>0.04 was significantly higher than that of the patients with preoperative CAR≤0.04, and the difference was significant (P<0.05). 2) The mean CAR of patients with Borrmann typesⅠ,Ⅱ,Ⅲ, andⅣgradually increased;with the progression of the pathological stage of gastric cancer, the mean value of CAR in-creased. 3) During the operation, the total number of lymph node dissections was high and the mean value of CAR before the opera-tion was high. Conclusion:The correlation between preoperative CAR and lymph node metastasis in patients with gastric cancer may reflect the degree of lymph node metastasis to a certain extent.

This paper presents a nuclear radiation environment monitoring scheme based on the Internet of Things technology. The scheme primarily utilizes ZigBee wireless communication protocol, dedicated line network topology, and cloud-based processing techniques to achieve the entire process of acquisition, localization, transmission, tracking, monitoring, and management of X, γ, α, β, and neutron radiation data at nuclear radiation monitoring sites. Through initial application, the system demonstrates favorable characteristics such as good portability, strong scalability, secure information transmission, and deep data mining.

The rearrangement reaction of benzyl phenyl ethers (BPE) plays an important role in the organic chemistry and drug synthesis .This paper briefly reviewed the rearrangement reaction and its possible mechanism in various catalytic sys-tems ,such as trifluoroacetic acid ,phosphotungstic acid ,cyclodextrin ,molten tin and aluminium bromide .