So far, the major therapeutic drugs of diabetes are western medicine , but side effects of hypoglycemic western med-icine are large and not easy to take for a long time .In recent years , we found the side effects of some kind of hypoglycemic Chinese herbal medicine were small , much easier to be accepted by the patients .Thus, the clinical treatment of diabetes may have new meth-ods.According to the mechanisms of Traditional Chinese Medicine for protection of islet function , this review will discuss them from re-ducing oxidative stress , increasing the number of islet cells and promoting βcells to secrete, relieving insulin resistance , increasing in-sulin sensitivity and so on .All of these aspects reflect the unique role of Traditional Chinese Medicine in the treatment of diabetes and protection of islet function .

Objective:To discuss the clinical assessment value of comprehensive echocardiographic parameters in detecting the left ventricular diastolic function in patients with hypertension. Methods: 60 hypertensive patients (30 cases without left ventricular hypertrophy (non-LVH), 30 cases with left ventricular hypertrophy(LVH) were divided into hypertension group, and 60 healthy subjects were in control group. All of the subjects were underwent M type, color ultrasound and tissue Doppler imaging (TDI). And to compare their comprehensive echocardiographic parameters.Results: Compared with the healthy control group, the IVSd, LVPWd, LVMI, LAD and LVD of hypertension group were significantly enlargement; the s', e', E peak and LVEDP of hypertension group also significantly increased, while a' and A peak were significantly reduced; compared with non-LVH, e', E peak and LVEDP of LVH group were significantly increased, and a' and A peak were significantly reduced, and these differences were statistically significant (t=-4.39,t=-4.39,t=5.47,t=-8.02, t=6.20,t=18.95, t=16.12;P<0.01).Conclusion: The comprehensive echocardiographic parameters can evaluate the extent of damage for left ventricular diastolic function of patients with hypertension, and they can be as the assessment standard of left ventricular hypertrophy. In clinical practice, TDI can be used as a new means in the evaluation of ventricular diastolic function.

Drug-induced liver injury is commonly seen in ctinical practice and is usually caused by antipsychotic drags,antitubercnlar agents,paracetamol,and statins.Silybin,a substance with biological activity in silymarin extract,has antioxidant,anti-inflammatory,and anti-fibrosis effects.This article summarizes the research advances in silybin in the prevention and treatment of drug-induced liver injury.

Objective: To observe the toxic effects of cockle shell-derived calcium carbonate nanoparticles (CCNPs) on the SD rats, and to preliminarily explore the safe dose and biological effects of CCNPs. Methods: A total of 40 healthy male SD rats were randomly divided into control group, low, middle and high doses of CCNPs groups (given 0, 30, 60, and 120 mg middot; kg-1 CCNPs). The injection was consecutively given through the lateral tail vein once per day for 14 d. The body weights and daily feed intakes of the rats in various groups were measured. The haematology indexes, serum biochemical indexes, relative weights of organs and histopathology of main organs of the rats in various groups were detected. Results: In the 14-day repeated dose toxicity experiment, two rats died in high dose of CCNPs group, while no rats died in low and middle doses of CCNPs groups. The body weights and daily average intakes of the rats in different doses of CCNPs groups were slightly lower than those in control group, but the differences were not statistically significant (P>0. 05). There were no significant differences in the serum indexes of the rats between different doses of CCNPs groups and control group (P>0. 05). Compared with control group, the relative weights of lung of the rats in different doses of CCNPs groups were increased significant (P<0. 05); the relative weights of spleen of the rats in low and middle doses of CCNPs groups were increased significantly (P<0. 05); while the relative weight of spleen of the rats in high dose of CCNPs group had no significant difference (P>0. 05). The histopathological analysis results showed that the mild inflammatory infiltration was found in some organs of the rats in low dose of CCNPs group, while no obviously pathological changes were found. The obviously histopathological changes were observed in the main organs of the rats in middle and high doses of CCNPs groups, including inflammatory cell infiltration, slight disorder of hepatocytes arrangement, increased vacuoles in hepatocytes; thickening of alveolar interstitium and formation of granulomas in the lung tissue; swelling, rupture and even necrosis of cardiac muscle fibers; atrophy and fissures of glomerulus and so on. Conclusion: Intravenous administration of low dose of CCNPs couldn' t cause sever acute toxicity reaction.

Objective To assess the analytical performance of hs-cTnT and biological variations in healthy population as well as establish hs-cTnT reference intervals. Methods The serum samples from 100 acute myocardial infraction patients and 474 apparently healthy subjects were collected. The functional sensitivity,within- and between-run imprecision were determined. The hs-cTnT assay and con-cTnT assay were evaluated. The serum hs-cTnT levels were detected in apparently healthy subjects to establish reference intervals. Moreover,the long-term and short-term biological variations for hs-cTnT in healthy volunteers were assessed. Results The functional sensitivity of hs-cTnT was 0. 005 μg/L. The within- and between-run precision for lower level control(0. 014 μg/L) and higher level control(2. 500 μg/L) was 2. 97% vs 3. 64%and 0. 66% vs 1.01% ,respectively. The correlation between hs-cTnT assay and con-cTnT assay was good ( R2 =0. 972 ,P ＜0. 01 ). The 99th percentile in apparently healthy subjects was 0. 003 μg/L for women less than60 years, 0.008 μg/L for men less than 60 years, 0.015 μg/L for women above 60 years and 0. 021 μg/L for men above 60 years. The CVa, CVi, CVg and CVt of short-term biological variations in detecting hs-cTnT from 22 apparently healthy subjects were 3.8%, 4. 8%, 49.9% and 58.5%,respectively. The CVa,CVi ,CVg and CVt of long-term biological variations were 5. 3% ,6. 4% ,56. 6% and 68. 3% respectively. Conclusions The analytical performance of the hs-cTnT is better than con-cTnT assay,achieving acceptable level according to guideline. Our experimental result could provide the basis for the new high sensitivity cTnT assay in the diagnosis of acute myocardial infarction.

ObjectiveTo explore the influence of washable type subglottic attract on incidence of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation. Methods356 cases in need of mechanical ventilation from July 2009 to July 2010 in our hospital were chosen as the research object.They were randomly divided into the observation group and the control group with 178 cases in each group.The control group was treated with conventional endotracheal tube for mechanical ventilation.The observation group used washable type subglottic endotracheal tube to attract for mechanical ventilation.The VAP rate for the two groups occurred during mechanical ventilation in ventilator was compared.Migration of the dominant bacteria of the subglottic secretion was detected,underwent pathogenic examination and drug sensitivity test. ResultsThe VAP rate was significantly lower in the observation group than that of the control group.186 bacteria strains were detected from subglottic secretion,and 169 were detected from lower respiratory tract. ConclusionsWashable type subglottic attract for mechanical ventilation can reduce the risk of ventilator-associated pneumonia for patients with mechanical ventilation significantly,and it is worthy of clinical application.

Background and purpose: Arginase-1 (Arg-1) is an enzyme involved in the urea cycle. Research has shown that changed expression of Arg-1 plays an important role in the cellular metabolism and growth. The purpose of this research was to investigate the expression of Arg-1 in hepatocellular carcinoma (HCC) and to analyze its correlation with clinicopathological features. Methods: The expression of Arg-1 protein and mRNA in 31 samples of HCC, paracancerous liver tissues and 12 samples of normal liver was detected by Western blot and reverse transcription-polymerase chain reaction (RT-PCR). The expression profiles of Arg-1 at protein level in 158 samples of HCC and paracancerous liver tissues were detected with high-throughput tissue microarray technique and immunohistochemistry. The relationships between Arg-1 expression and clinicopathological features were also analyzed. Results:The expression of Arg-1 mRNA and protein was signiifcantly decreased in HCC compared with the paracancerous liver tissues and normal liver tissues (F=57.83, 160.89; all P<0.01). The expression of Arg-1 in HCC was related to differentiation degree (F=10.41, 30.03; all P<0.01). And with tumor differentiation decreased, the expression level down-regulated. Immunohistochemistry revealed that Arg-1 protein was mainly located in the cytoplasm and nuclear. The expression rates of Arg-1 were 88%, 98.7%and 100%in HCC, paracancerous tissues and normal liver tissues, respectively. Statistical analysis revealed that Arg-1 protein staining rate was signiifcantly lower in tumor tissues than that in paracancerous tissues (χ2=14.7416, P<0.01) and normal liver tissues (χ2=4.1415, P<0.05). The Arg-1 expression was correlated with differentiation degree of HCC, vascular invasion and recurrence after operation (χ2=22.8459, 10.2639, 10.6368 respectively;all P<0.05), but not correlated with age, gender, the hepatitis B virus, the level of serum AFP, liver cirrhosis, diameter of tumor and tumor number. Conclusion:The expression level of Arg-1 is much lower in HCC than that in the paracancerous liver and normal liver. Moreover, Arg-1 expression level is closely related to tumor differentiation degree, metastasis and relapse. These data demonstrate that Arg-1 may play a negative role in the development of HCC.

Objective To explore the value of arginase-1(Arg-1) and glypican-3 (GPC-3) combined examination in the differential diagnosis of hepatocellular carcinoma (HCC),metastatic carcinoma (MC) of liver and intrahepatic cholangiocarcinoma (ICC).Methods From January 2005 to December 2011,a total of 54 patients with HCC were selected,including 10 cases with high differentiation,25 cases with moderate differentiation and 19 cases with poor differentiation.At the same time,25 patients with MC of liver and 20 patients with ICC were selected.A total of 31 normal liver specimens were set as control.The expressions of Arg 1 and GPC-3 in the above tissues were detected by immunohistochemistry method.The sensitivity and specificity of the examination in the diagnosis of HCC were analyzed.Chi-square test was performed for count data analysis.Results The positive expression rate of Arg-1 in HCC,MC of liver,ICC and normal liver tissues was 87.0％ (47/54),4.0％ (1/25),5.0％ (1/20) and 100.0％ (31/31),respectively.The Arg 1 positive expression rate in HCC tissues was higher than that in other tumor tissues of non-HCC,and the difference was statistically significant (x2 =66.98,P＜0.05).The positive expression rate of GPC-3 in HCC,MC of liver,ICC and normal liver tissues was 70.4％ (38/54),12.0％ (3/25),5.0％ (1/20) and 0 (0/31),respectively.The GPC-3 positive expression rate in HCC tissues was higher than that in other tumor tissues of non-HCC and the difference was statistically significant (x2=37.98,P＜0.05).The sensitivity and specificity of Arg-1 or GPC-3 positive in HCC diagnosis was 92.6％ (50/54) and 86.7％ (39/45).The sensitivity and specificity of both Arg 1 and GPC-3 positive in HCCdiagnosis was 64.8％ (35/54) and 100.0％ (45/45).Conclusion Arginase-1 and glypican-3 combined examination has an important value in HCC diagnosis and differential diagnosis.

Objective To search for differentially expressed proteins in normal ovaries,benign,borderline and malignant ovarian tumor protein. Methods The protein from ovarial carcinoma tissue and benign ovary was drawn, and analyzed with SELDI-TOF MS. Results There are some high expression proteins in ovarian cancer tissues: M/Z 15 112.15, 15 296.79, 7560.78, 16 049.39, 7682.06, 7932.30,15 851.32, 4619.68 and 8052.10. Borderline ovarian tumor protein peak were between benign and malignant:M/Z 15 112.15, 15 851.32, 7560.78, 7682.06 and 7932.30. Conclusion There were some differentially expressed proteins in different ovarian tissue. They might lay the molecular basis for the clinical diagnosis and therapy of ovarian cancer.

Objective To investigate the possible mechanism of natural killer cells(NK cells)in immune dysfunction in sepsis by monitoring the phenotype and function of periphery NK cells in patients with sepsis. Methods A retrospective study was conducted. The patients with systemic inflammatory response syndrome(SIRS,n=59)or sepsis(n=65)admitted to Department of Critical Care Medicine of Anhui Provincial Hospital from August 2011 to August 2013 were enrolled. Blood samples were collected within 48 hours after intensive care unit(ICU)admission,the phenotype and function of periphery NK cells were determined by flow cytometry. Twenty-eight healthy people served as controls. Results The proportion and number of peripheral blood CD3-CD56+NK cells in SIRS and sepsis groups were normal,and no statistical difference was found when compared with those of the healthy control group〔cell proportion:0.102±0.019,0.102±0.108 vs. 0.106±0.018,F=0.018,P=0.982;cell number(×106/L):182.46±65.98, 172.97±63.51 vs. 179.25±60.44,F=0.349,P=0.706〕. It was shown by NK cell degranulation detection that there was no significant difference in the expression of CD107 and interferon-γ(IFN-γ)secretion〔CD107:0.135±0.050,0.140±0.058,0.128±0.070,F=0.583,P=0.560;IFN-γ(kU/L):14.36±4.74,12.49±4.21, 13.45±5.04,F=1.616,P=0.202〕among healthy control group,SIRS group,and sepsis group. It was shown by antibody dependent cytotoxic effect(ADCC)test that there was no difference in the expression of CD107 among healthy control group,SIRS group,and sepsis group(0.574±0.166,0.643±0.165,0.581±0.157,F=0.808,P=0.448). When compared with healthy controls,the secretion of IFN-γwas increased in SIRS patients(kU/L:40.5±13.2 vs. 28.4±9.6,P=0.001),while reduced in sepsis patients(kU/L:19.8±6.7 vs. 28.4±9.6,P<0.01). Compared with SIRS group,only NK cell surface inhibitory receptors CD158e(KIR 3DL1)expression in sepsis group was significantly increased(0.203±0.057 vs. 0.079±0.021,t=15.762,P<0.001),and there were no significant differences in the other phenotype between the two groups. Compared with SIRS group,the IFN-γproduction of the sepsis group was significantly lowered(kU/L:0.280±0.040 vs. 0.310±0.038,t=3.390,P=0.009),and the level of IL-12 was also significantly decreased(ng/L:0.15±0.03 vs. 0.30±0.08,t=32.832,P<0.001). Conclusion It was showed by NK cell phenotype and function assay that the function of NK cells in patients with sepsis was impaired and led to a poor production of IFN-γ. The IFN-γmediated immune dysfunction may be a main reason for the disorder of NK cell function,which laid the foundation of the clinical immune intervention practice to improve to NK cell function.