Objective To investigate the relationship between fasting plasma glucose (FPG) and islet α-cell and β-cell function in patients with type 2 diabetes mellitus (T2DM).Methods Four hundred and thirty-seven patients with T2DM were divided into 3 groups according to the level of FPG:F1 group:FPG ≤ 6 mmol/L (73 cases),F2 group:6 mmol/L ＜ FPG ≤ 7 mmol/L (103 cases),and F3 group:FPG ＞ 7mmol/L (261 cases),and 30 cases of healthy people were selected as control group.Oral glucose tolerance test,insulin releasing test and glucagon releasing test were performed to observe the differences of glucagon,glucagon/ insulin,the ratio of 30 min insulin and blood glucose value after glucose load (△ I30/△ G30),and the area under curve of insulin (AUC1) among the 4 groups and the correlation analysis was performed between glucagon and other indicators.Results Glycosylated hemoglobin (HbA1c),plasma glucose 120 at min after glucose load in F1,F2 and F3 group were significantly higher than those in control group,and there were statistical differences (P ＜0.05).In F1,F2,F3 group,with the increase of the HbA1c,the course of disease and plasma glucose at 120 min after glucose load showed increasing trend.The triglyceride in F2 group and F3 group was significantly higher than that in F1 group and control group,and low density lipoprotein cholesterol in F3 group was significantly higher than that in F1 group,F2 group and control group,and there were statistical differences (P ＜ 0.05).The glucagon at 60,120 min after glucose load in F1 group,30,60,120 min after glucose load in F2 group,and 30,60,120,180 min after glucose load in F3 group was significantly higher than that in control group,and there were statistical differences (P ＜ 0.05).The glucagon at 60,120,180 min after glucose load in F2 group,at fasting and 30,60,120,180 rain after glucose load in F3 group was significantly higher than that in F1 group,and there were statistical differences (P ＜ 0.05).The glucagon at fasting and 30,60,120,180 min after glucose load in F3 group was significantly higher than that in F2 group,and there were statistical differences (P ＜ 0.05).The area under curve of glucagon in control group was 9.5 ±0.3,in F1 group was 9.7 ± 0.2,in F2 group was 9.9 ± 0.2,in F3 group was 10.2 ± 0.3,and there were statistical differences among the 4 groups (P ＜ 0.05).The glucagon/insulin at fasting and 30,60 min after glucose load in F1 groups,fasting and 30,60,120 min after glucose load in F2 group,fasting and 30,60,120 min after glucose load in F3 group was significantly higher than that in control group,and there were statistical differences (P＜ 0.05).The glucagon/insulin at fasting and 60,120 min after glucose load in F2 group,fasting and 30,60,120,180 min after glucose load in F3 group was significantly higher than that in F1 group,and there were statistical differences (P ＜ 0.05).The glucagon/insulin 30,60,120,180 min after glucose load in F3 group was significantly higher than that in F2 group,and there were statistical differences (P＜ 0.05).The homeostasis model of assessment for insulin resistance index (HOMA-IR) in F2 group and F3 group was significantly higher than that in control group and F1 group,in F3 group was significantly higher than that in F2 group,and there were statistical differences (P＜ 0.05).The insulin sensitivity index (ISI) in F2 group and F3 group was significantly lower than that in control group and F1 group,in F3 group was significantly lower than that in F2 group,and there were statistical differences (P ＜ 0.05).The homeostasis model of assessment for islet β-cell function index (HOMA-β) and △I30/△G30 in F1,F2,F3 group were significantly lower than those in control group,and there were statistical differences (P ＜ 0.05).The AUC1 in F2 group was significantly lower than that in control group,and AUC1 in F3 group was significantly lower than that in control group,F1 group and F2 group,there were statistical differences (P ＜0.05).The results of Pearson correlation analysis showed there was negative correlation between glucagon and △I30/△G30,HOMA-β,body mass index,ISI,AUC1 (r =-0.229,-0.153,-0.151,-0.146,-0.136,P＜0.01 or ＜0.05),and there was positive correlation between glucagon and FPG,area under curve of glucose (AUCG),HbA1c,course of disease and HOMA-IR (r =0.545,0.476,0.273,0.193,0.189,P ＜ 0.01).The results of multiplestepwise regression analysis showed there was positive correlation between glucagon and FPG,AUCG,HbA1c,course of disease (P ＜0.01 or ＜0.05),and there was negative correlation between glucagon and △I30/△ G30 (P ＜ 0.05).Conclusions Islet β-cell function is decreased with the increasing of FPG,while islet α-cell function is increased,especially in those with higher levels of FPG.Regulation of glucagon should be concerned to make the blood glucose target easier to reach,at the same time of protecting β-cell function.

Objective To understand the effects of "total quantity control" indexes on community health services and the residents' use of them so as to provide scientific basis for furthering reform in the medical insurance system.Methods A survey was made on the operation of the 3 community health centers of Jiangbin Xincun,Huashanwan and Hejianong in Jingkou District of Zhenjiang by means of direct inquiry and literature review.Results The average annual quantity of medical insurance plans allocated to the centers in the last 4 years involved 810 thousand yuan,the quantity actually fulfilled involved(953.5) thousand yuan,and the estimated annual quantity the centers were capable of fulfilling was valued at(1.45) million yuan,nearly 500 thousand yuan more than the quantity actually fulfilled. Conclusion Total quantity control on community health centers not only hinders the healthy development of community health services and the enthusiasm of the medical workers but also adversely affects the residents'use of health services and their health maintenance.

Objective To evaluate the myocardial protection of warm blood cardioplegic induction during cardiopulmonary bypass(CPB) Methods Twenty-eight adult patients undergoing valve replacement ,were devided randomly into two groups : in group test (group T,n=14) the warm (35℃-37℃) blood cardioplegia was infused to induce ECG straight line ,followed by the administration of the cold (6℃-8℃) blood cardioplegia , whereas in group control (group C ,n=14) the cold blood cardioplegia was applied simply The aterial blood samples were taken to measure the plasma concentration of cardiac troponin T (cTnT) with ELISA methods immediately after anesthesia induction,and immediately ,6 h, 24 h after the weaning from CPB The myocardial samples of right atrium were taken to observe the morphology with the transmission electron microscpe Results The rate of restoring spontaneous heart-beat in group T (93%) was significantly higher than that in group C (50%) One case in gruop T (7%) and three cases in group C (21%) required the interim pacemakers No case in group T (0%) and five cases (36%) in group C required the administration of dopamine perioperatively The durations of post-operative mechanical ventilative support and ICU-staying of group T were obviously shorter than those of group C The plasma level of cTnT in group T was obviously lower than that in group C immediately and 6 h after CPB Myocardial morphology in group T got much better outcome than that in group C did Conclusions Warm blood cardioplegic induction during CPB can provide better myocardial protection than cold blood cardioplegic induction

A fluorescence nanosensor based on an easily prepared fluorescent molecule, 1-oxo-1H-phenalene-2,3-dicarbonitrile (OPD), was developed for highly sensitive detection of glucose.Under the catalysis of horseradish peroxidase (HRP), 3,3′,5,5′-tetramethylbenzidine (TMB) was oxidized into oxidized TMB (oxTMB) by H2O2.And the fluorescence of OPD was quenched by the intense absorption of the formed oxTMB, thus realizing effective quantitative detection of H2O2.The linear range was 0.05-0.8 μmol/L and 1-10 μmol/L respectively, with limit of detection of 0.02 μmol/L.Besides, on the basis of transformation of glucose into H2O2 through the catalysis of glucose oxidase, this nanosensor could be further exploited for highly sensitive detection of glucose.The TMB-HRP-OPD sensor exhibited linear range of 0.1-3.0 μmol/L and 4.0-30 μmol/L respectively for detection of glucose, with limit of detection of 0.02 μmol/L.Furthermore, it was successfully applied to the determination of glucose in real human serum and the results were in good agreement with the clinical data.

In the light of requirements of medical equipment simulation system, the overall framework of joint control system of medical equipment integrated support in the theater is designed in this paper. Such modules are developed with Delphi as communication module, module for equipment basic information, module for equipment video information and module for medical faculty information. A joint control system suiting integrated support simulation sand table for medical equipment is complteted,which provides a multidimensional informational platform for integrated demonstration of medical equipment.

Objective To explore the role of PADI4 mRNA in the initiation and development of rheumatoid arthritis(RA)and its correlation with clinical features.Methods Fifty-three RA patients,27 OA patients and 30 healthy volunteers were included in the study.The real-time-fluorescence quantitative PCR method was used to measure the expression level of PADI4 mRNA.The level of Anti-CCP antibody and DAS 28 of the RA patients were measured at the same time.Results It was shown that the level of PADI4 mRNA from RA was significantly higher than that of the OA and control group(P

Ob jectiev Oxidized low-density lipoprotein ( ox-LDL) induces vascular endothelial cell injury , which is one of the factors initiating atherosclerosis .This study aimed to investigate the protective effect of Tongxinluo ( TXL ) on vascular endothelial cells with ox-LDL-induced injury . Methods Human umbilical vein endothelial cells ( HUVEC ) were cultured in vitro and divided into five groups:normal control, oxidative stress injury (OSI) model, and high, medium and low dose TXL.The HUVECs were incubated with ox-LDL at the concentration of 30 mg/L for 24 hours to induce oxidative stress injury and then treated with TXL at 50, 100 and 150 mg/L for 4 hours, followed by 24 hour incubation with 30 mg/L ox-LDL added to the culture medium .The viability of the cells was detected by MTS assay, the nitric oxide (NO) content, superoxide dismutase (SOD) activity and mitochondrial membrane poten-tial ( MMP) in the cell culture supernatant were measured with respective kits , and the expressions of iNOS , MMP9, and NF-κBp65 proteins were determined by Western blot . Results The HUVECs of the OSI model group showed a significant decrease in cell via-bility compared with the normal control , ([73 .89 ±0.67] vs [100.00 ±2.23]%, P<0.01) but a remarkably increase after treated with medium and high dose TXL ([92.15 ±0.76]%and [ 97.19 ±1.45]%, P<0.01).The MMP, NO content, and SOD activity were markedly reduced in the model group (P<0.01) but elevated in the low, medium, and high dose TXL groups (P<0 .01).The expressions of the iNOS, MMP9, and NF-κBp65proteins were significantly up -regulated in the model group (P<0.01) but down reg-ulated in the low, medium, and high dose TXL groups (P<0.05).C on clusion TXL has the effects of anti-oxidation and anti-in-flammation and can protect vascular endothelial cells against ox-LDL-induced injury .

Aged ; Diagnosis, Differential ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Lipoma ; pathology ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; S100 Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved.

Objective To explore the differential diagnostic value of color-Doppler technique in acute and chronic thrombosis of leg arteries. Methods The two-dimensional and color Doppler ultrasonographic characteristics were analyzed in acute thrombostic event in 80 leg arteries and chronic thrombostic events in 244 leg arteries. And some parameters (history, the vessel wall structures, hemodynamic of inlet and outlet at the lesion) were compared, too. Results There existed a significant difference in history, vessel wall structure and the establishment of collaterals between the acute and chronic groups. And there were also significant difference in maximum blood velocity proximal and distal to the lesion and proximal resistant index between two groups(P