Matrix metalloproteases(MMPs)and tissue inhibitors of matrix metalloproteases(TIMPs) have a co-regulation of changes of the extraeellular matrix(ECM).MMPs can control the proteases which are related to the process of tumor development.Moreover,MMPs,produced by host cells including inflammatory ceUs,endothelial cells,pericytes and fibroblasts have a positive or negative correlation with tumor formation.

Objective To evaluate two regimes of transient intensive insulin therapy in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Methods Sixty-eight newly diagnosed type 2 diabetic patients with fasting plasma glucose(FPG)≥10.0 mmol/L and glycated hemoglobin A1c (HbA1c)≥8.0％were randomized to either cantinuous subcutaneous insulin infusion(CSII)group or multiple daily injection(MDI)group.Glycemic control,daily dose of insulin,body mass index(BMI),the mean area under the insulin curve(AUC),β-cell function(HOMA-β)and insulin resistence(HOMA-IR) were compared before and after treatment.Results There were no significant differences between two groups in days reaching glycemic control and BMI.The maximal insulin dose for glycemic control in CSII group was(0.53±0.06)U·kg-1·d-1 and that in MDI group was(0.71±0.04)U·kg-1·d-1(t= 11.100,P＜0.01).After CSII and MDI treatment,HOMA-β and the mean AUC of insulin were significantly increased(P＜0.01),but there was no significant difference between two groups(P＞0.05).No significant changes in HOMA-IR were observed before and after treatment or between two groups.There were no severe hypoglycemic episodes in two groups and mild hypoglycemic episodes were 0.34％(13/3806)in CSII group and 1.09％(44/4045)in MDI group.Conclusions The excellent glycemic control can be reached by short.terra CSII and MDI treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Lower insulin dose and less mild hypoglycemic episodes seem to be the advantage of CSII regime than MDI regime.β-cell function can be dramatically improved in both therapy regimes.

The pathogenesis of migraine is not fully understood as yet. Recently, with the development of ultrasonography, some stud-ies indicated that the prevalence of right-to-left shunt (RLS) seemed to be higher in migraine, especially in migraine with aura. The progress in the relationship between migraine and RLS was reviewed.

Objective To investigate the nalaxone treating first acute right heart failure.Methods52 patients with FARHF were divided into the naloxone group(30cases)and control group(20cases)at random.Patients in control group were given general comprehensively treating.Patients in naloxone group were given naloxone as well as comprehensively treating,were given intravenously 0.8 mg of first dose,if it was necessary,repeated 0.8 mg of dose,and continuously dropped for 1.2 mg was added into liquid 500 mL.After treatment of 24 hours,were compared the changes of HR、SBP、SV and heart function.ResultsIn the naloxone group,the total effective rates were 84.4%,the mortality rates were 6.6%;in control group.The total effective rates were 60%,the mortality rates were 18.3%.The difference of the effective rate of the naloxone group be treatment was statistically significant(P

Acupuncture treatment of insomnia has been reported for many years,but its validity remains controversial up to now.In the present review,the authors took "Acupuncture","Insomnia" as the key words to do a literature search from databases in both Chinese and English via computer retrieval system and also conducted a hand-made retrieval from journals of Chinese medicine as Chinese Acu-moxibustion,and collections of theses of the related academic conferences.Then,they made a systemic evaluation on the original articles from methodology,diagnosis,criteria for the enlisted and excluded patients,intervention methods of acupuncture and control groups,standards for assessing the curative efficacy,follow-up visit,etc.Of the retrieved 80 clinical articles,20 are RCT(randomized controlled trails) composed of 1907 cases,including 4 high-quality trails and 16 lower-quality trails.Regarding the assessment of the therapeutic effect,measuring scales are often adopted in overseas studies,while in domestic researches,self-drawn standards are frequently used.In conclusion,there have had no high-quality clinical trails about acupuncture treatment of primary insomnia in China at the present,and the related evaluating methods could not definitely confirm the efficacy of acupuncture in relieving insomnia.Therefore,a strict and scientific clinical trail scheme being in line with evidence-based medicine is urgently needed in the coming studies on acupuncture treatment of primary insomnia.

The incidence of severe acute pancreatitis in children is lower.But it has abrupt onset and atypical symptoms.The fatality rate is relatively high.This paper will review the progress on the diagnosis and treatment of severe acute pancreatitis.

Objective To observe the effect of high glucose on the expression of activating transcription factor 4 (ATF4) in cultured retinal Müller glia cells.Methods The retinal tissue of Sprague Dawley (SD) rats was collected,and Müller cells were isolated and cultured.The glial fibrillary acidic protein (GFAP) and glutamine synthetase (GS) of Müller cells were identified by streptavidin-biotinperoxidase complex.Cultured rat Müller cells were divided into control group (5.5 mmol/L glucose),group A (20 mmol/L glucose),group B (30 mmol/L glucose) and group C (40 mmol/L glucose).ATF4 protein expressions in Müller cells of four groups were measured by Western blot four days after cultured.Results GFAP and GS expressed in more than 95％ of Müller cells.Over 95％ of Müller cells of group A,B and C were positive for GFAP and GS.Western blots indicated that ATF4 protein in group A,B and C increased obviously compared with the control group (q=0.293,0.754,0.484; P＜0.05).Conclusion High glucose can increase the expression of ATF4 protein and cause endoplasmic reticulum stress in retinal Müller glia cells in vitro.

Objective]To discuss and analyze Professor Cheng Jing's clinical experience for treating decline in ovarian reserve(DOR). [Method]Through learning from the tutor in the outpatient service and case studies ,we analyzed and summarized Pro. Cheng's recognition on the etiology and pathogenesis of DOR,together with his dialectical way of thinking, combined therapy of Chinese and western medicine ,and empirical prescriptions. [Result] Pro. Cheng believes that this disease lies in the kidneys as wel as in the thoroughfare and conception meridian ,the pathogenesis is kidney deficiency and the imbalance of the thoroughfare and conception meridian,or combined with the stagnation of liver qi,spleen deficiency,and blood stasis and phlegm fire (heat); the therapy is mainly nourishing and warming kidneys as wel as conditioning the thoroughfare and conception meridian ,combined with Chinese medicine's periodical therapy,such as adjusting the circulation of qi and blood in livers,spleens,hearts and other organs. [Conclusions] Pro. Cheng's combined therapy of Chinese and western medicine for curing DOR ,of which his empirical prescriptions the Bushenyichongkangshuaitang is the main part,is of remarkable curative effect and significant clinical value.

Objective To give a systematic reviews on effect of taking blood gas via cephalic artery for infants.Methods Meta-analysis were used to analyze literatures about taking blood gas via cephalic artery for infants.Results 11 studies were included.The rate of successful puncture was 87.5％～98.0％ in the intervention group and 55.3％ ～94.6％ in the control group.The rate of successful puncture via cephalic artery were higher.Conclusions Effect of taking blood gas via cephalic artery for infant was better than that via other artery.Successful rate was high,while the incidence rate of local side effects was low.

Objective To identify the patient satisfaction on follow-up service from the community health service (CHS) or West China hospital (WCH) and to compare the patient satisfaction on follow-up service from CHS and WCH.Methods A cross-sectional survey was used in this study to identify the patient satisfaction on day surgery.The questionnaires were self-made through literature review.Purposive sampling was used in collecting the data.Results Totally 758 qualified questionnaires were collected.The proportions of qualified questionnaires were 96.3％.Respectively,79.3％ of patients were completely satisfied with follow-up service from WCH,19.3％ of patients were partly satisfied,and 1.4％ of patients were completely dissatisfied.66.7％ of patients were completely satisfied with follow-up service from CHS,33.3％ of patients were partly satisfied with follow-up service from CHS,and no objects were completely dissatisfied.Conclusions Patient satisfaction on follow-up services from WCH was higher than CHS.It is essential to enhance follow-up services from CHS.