Objective To obtain the most effective diagnosis method for diabetic muscle infarction by using the evidence based medicine.Methods In March 2006 we attempted to find the guideline,systematic review,random controlled trials,clinical controlled trials and case reports for the diagnosis of diabetic muscle infarction by searching Cochrane Library(Issue 4,2005),Embase(1974—2005),Medline(1966—2005)and CNKI database(1949—2005),then critically appraised the quality of available evidences.Results According to the present evidence,when the the patient was suspected to have diabetic muscle infarction,we should choose the sonography to exclude some common diseases at first;the CT examination of all the patients showed no obvious manifestations;the normal MRI examination of 67 patients showed obvious manifestations;the patients who did the muscle biopsy or needle biopsy did not develop any complications.Conclusion The diagnosis of diabetic muscle infarction should be based on the clinical presentations and MRI outcome,but when the diagnosis is uncertain,we should use the needle biopsy to confirm the diagnosis at an early time.

Child, Preschool ; Cysts ; Diagnostic Errors ; Humans ; Leiomyoma ; diagnosis ; Male ; Nose Neoplasms ; diagnosis ; Vestibular Diseases

Owing to the increasing morbidity and pulmonary infection,management of pulmonary function has become an important problem for COPD patients who undergo surgery.Surgical patient with respiratory disease such as COPD has declined lung function before operation,then increased the risk of post-operative pulmonary complications.Ipratropium bromide can significantly improve pulmonary function.Therefore,we hypothesis the treatment with nebulized ipratropium bromide will benefit the perioperative patients with COPD.A randomized,double-blind,placebo-controlled,parallel-group,multi-center trial (Ipratropium bromide in Peri-Operative COPD study,IPO-COPD study)has been conducted to evaluate the efficacy and safety of nebulized ipratropium bromide in Chinese perioperative patients with COPD under general anaesthesia.A total of 192 COPD patients who satisfied the eligibility criteria were randomly assigned(1∶1) to one of the two treatment groups(ipratropium bromide 500 μg or normal saline 4 ml) for 11 days.Measurements will include the change of the forced expiratory volume in 1 second(FEV1),the forced vital capacity(FVC),blood gas analyses and main post-operative pulmonary complications.

OBJECTIVE:To compare the quality of domperidone tablets produced by 3 different factories METHODS:The quality of different products was investigated according to the standards of Ministry of Public Health and manufacture factories,including dissolubility,uniformity of dosage units,related substances and seals of blister packaging RESULTS:In 3 batches of products manufactured by Y,W and L,the contents of domperidone were 98 23%～99 74%,96 92%～98 31% and 97 42%～98 72%,and content uniformity A+1 8S was 2 11～3 38,3 97～5 25 and 5 49～7 47 respectively,which were in keeping with the Chinese pharmacopoeia;impurity R061668 was not found,and contents of impurity R052211 were 0 004%～0 024%,0 029%～0 072% and 0 003%～0 056%;the total impurity substances were 0 030%～0 095%,0 102%～0 128% and 0 232%～0 489%;the dissolubity(45min) was 95 09%～95 77%,91 25%～96 43% and 95 48%～96 58% respectively In experimental condition,no leakage was found from blister package of Y and W products,however,the leak rate of L product reached more than 38% CONCLUSION:According to this survey,the quality of product Y is the best,W is better

Animals ; Fatigue ; prevention & control ; Female ; Gardenia ; chemistry ; Hypoxia ; prevention & control ; Male ; Mice ; Mice, Inbred Strains ; Plant Extracts ; pharmacology ; Thuja ; chemistry ; Ziziphus ; chemistry

OBJECTIVETo observe the effects of matrine on renal tubulointerstitial fibrosis in unilateral ureteral obstruction (UUO) rat model and to explore its mechanisms.

METHODSModel rats of UUO were established and randomly divided into 6 groups: the normal group, the sham group, the UUO model group, the fusinopril treated group (F group), the high dose and low dose matrine treated groups (HM and LM). The expressions of matrix metalloproteinase-3 ( MMP-3), tissue inhibitor of metalloproteinase-1 (TIMP-1), fibronectin (FN), connective tissue growth factor (CTGF) and alpha-smooth muscle actin (alpha-SMA) were determined semi-quantitatively by immunohistochemistry on the 14th day.

RESULTSThe expression of MMP-3 in the UUO model rats was significantly lowed on the 14th day, compared with that in rats not modeled in the normal and the sham groups (P < 0.05), but it was higher in the three treated groups than that in the UUO model group (P < 0.05); the expressions of TIMP-1, FN, CTGF and alpha-SMA were lower in the normal group and sham UUO group than those in all the UUO model groups, while they were lower obviously in the three treated groups than those in the UUO model group (P < 0.05); there was no significant difference in the above-mentioned indexes between HM group and F group (P < 0.05).

CONCLUSIONMatrine could decrease the expressions of TIMP-1, FN, CTGF and alpha-SMA in the tubulointerstitium, and partly restore the expression of MMP-3, so as to delay the progression of renal tubulointerstitial fibrosis.

Alkaloids ; pharmacology ; therapeutic use ; Animals ; Fibronectins ; biosynthesis ; genetics ; Fibrosis ; drug therapy ; etiology ; Kidney Tubules ; pathology ; Male ; Matrix Metalloproteinase 3 ; biosynthesis ; genetics ; Phytotherapy ; Quinolizines ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tissue Inhibitor of Metalloproteinase-1 ; biosynthesis ; genetics ; Ureteral Obstruction ; complications

OBJECTIVE:To evaluate the pharmacoeconomic characteristics of dapagliflozin combined with metformin in the treatment of type 2 diabetes mellitus systematically. METHODS:Retrieved from Health Technology Assessment(HTA),Cochrane Library,PubMed,Embase,CNKI,Wanfang and CBM during database establishment to Jul. 2017,published pharmacoeconomics literatures about dapagliflozin combined with metformin were collected,using"sodium-glucose-transporter-2 inhibitors""SGLT2 inhibitor""metformin""dapagliflozin""cost""benefit""utility""effectiveness""pharmacoeconomic""economic"as English retrieval words and"SGLT2 inhibitor""dage liejing""metformin""cost""benefit""utility""effectiveness"as Chinese retrieval words. Outcome indexes included incremental cost,incremental effect,cost-effectiveness ratio and incremental cost-effectiveness ratio(ICER).The results of the economic research in the included literatures were evaluated systematically. RESULTS:Totally of 4 literatures were included,and all of them were cost-effectiveness analysis. Dapagliflozin was more cost-effective than sulfonylurea because the ICER of dapagliflozin were €2 709/QALY,€10 494/QALY,€7 939/QALY,€5 433/QALY,€4 767/QALY and €6 094/QALY in the UK,Greece,Denmark,Finland,Norway and Sweden,respectively,which were all lower than willingness-to-pay threshold. Dapagliflozin was more cost-effective than DPP-4 inhibitor,and the ICER were €7 200/QALY and €15 120/QALY in the UK and Greece,respectively,which were all lower than willingness-to-pay threshold. CONCLUSIONS:Current economic research shows compared with sulfonylurea and DDP-4 inhibitor,dapagliflozin is a cost-effective treatment alternative for patients with T2DM whose metformin regimen does not provide sufficient glycemic control.

The value of snake venom polypeptides in clinical application has drawn extensive attention,and the development of snake polypeptides into new drugs with anti-tumor,anti-inflammatory,antithrombotic,analgesic or antihypertensive properties has become the recent research hotspot.With the rapid development of molecular biology and biotechnology,the mechanisms of snake venom polypeptides are also gradually clarified.Numerous studies have demonstrated that snake venom polypeptides exert their pharmacological effects by regulating ion channels,cell proliferation,apoptosis,intracellular signaling pathway,and expression of cytokine as well as binding to relevant active sites or receptors.

Objective To investigate clinical characteristics of relapsing polychondritis(RP)and to improve early recognition for it.Methods Clinical and laboratory data of 56 patients with RP were analyzed retrospectively.Results Ratio of number of male patients to female ones was 1.2.Age at onset was(46?11)years(ranging from 27 to 71)and average interval between onset and diagnosis was(21? 35)months,(8?6),(16?31)and(29?37)months for patients initial onset with auricle,respiratory tract and joints involved,respectively.Site involved included airway in 40 patients(71.4%),auricle in 32 (57.1%),joints in 32(57.1%),eyes in 27(48.2%),nasal chondritis in 25(44.6%)and inner ear in 13(23.2%).At initial stage of the course,17 patients were misdiagnosed as respiratory infection (30.4%),nine as perichondritis(16.1%),six as pulmonary tuberculosis(10.7%),five as rheumatoid arthritis(8.9%).Seven of 40 patients with airway involvement received metallic stents for their tracheobronchial stenosis.Four patients whose condition never improved after regular therapy all had respiratory involvement.Conclusions Patients of RP with initial onset at non-auricle,non-nasal sites tended to be misdiagnosed.Prevalence of airway involvement was not so low with a poor prognosis in patients of RP.

Objective To explore a new model of medical humanity education in new situation. Methods Extensive survey was carried out among medical students,and discussion and consultation were hold to faculty and education administers.A new teaching model was established. Results A curriculum system with 1 or 2 core courses supported by some elective courses and social practice is under the process of implementation and achieved preliminary success.Conclusion The medical humanity education should pay attention to the development of connotation instead of pursuing the extension of quantity blindly,which means that students' school work must be eased by focusing on self-study and self-education.Medical students'life path with high-minded personality training should be strengthened.