Insulin sensitivity index (SI).glucose effectiveness (SG) and insulin secretion function were assessed by modified minimal model method (MMM) with frequently sampled intravenous glucose tolerance (FSIGT) test in the controls, in patients with impaired glucose tolerance (IGT), and type II diabetes mellitus (NIDDM). There was significant correlation between modified MMM and standard MMM in evaluating SI and SG. The results indicated that SI and SG were significantly elevated in the control than in the IGT and NTDDM groups. SI diminished much more in IGT group than in NIDDM group (P

The influence of MRI on severity grading and activity staging in thyroid associated ophthalmopathy (TAO) was evaluated.The results showed that MRI had a higher detection rate in abnormal extraocular muscle than NOSPECS scores(χ~2 = 19.37,P = 0.000).MRI had higher sensitivity,specificity,and accuracy in detection of active TAO than clinical activity score (100% vs 95.7%,88.2% vs 35.3%,96.9% vs 79.7%,respectively).Therefore,MRI improves early detection of atypical grade 4 cases.Signal intensity elevation in adipose suppressed T2WI is helpful to define active stage.

Objective: Our aim was to observe the protective effect of propofol in clinical relevant concentration on the peroxidative injured erythrocyte. Methods: Intravenous blood samples taken from 20 healthy adults were prepared for red blood cell (RBC) suspensions and divided equally into 5 groups: groupⅠfor control, group Ⅱ with hydrogen peroxide (H2O2, 100 mmol/L) -induced injury, and group Ⅲ, Ⅳ, Ⅴ with the same injury as the group Ⅱ but being pretreated with 3 different concentrations of propofol (25, 50, 75 μmol/L), respectively. The concentrations of potassium and malondialdehyde (MDA) in RBC suspensions and hemolytic degree after incubation were measured. Results: After 60-minute incubation, the extracellular potassium concentrations (0.16, 0.14, 0.14 mmol/L), MDA concentrations (5.66, 5.57, 6.20 nmol/L), and hemolytic degree (76.89%, 59.84%, 64.22%) decreased significantly in the groups that were pretreated with propofol as compared with the group Ⅱ (0.26 mmol/L, 9.19 nmol/L, and 100%), but no difference has been seen within the groups pretreated with 3 different concentrations of propofol and between the propofol-treated groups and the group Ⅰ(0.10 mmol/L, 4.13 nmol/L, 52.73%). Conclusion: Propofol in clinical relevant concentrations may decrease MDA production, hemolytic degree, and potassium exflux from erythrocyte in response to in vitro oxidative challenge with hydrogen peroxide and enhance erythrocyte antioxidant capacity. The protective effect is not related with concentrations.

ObjectiveTo evaluate the clinical and imaging features and infarct pattern in patients with middle cerebral artery(MCA) stenosis and occlusion,to clarify its infarct pathogenesis. Methods35 MCA moderate and severe stenosis or occlusion patients diagnosed by TCD were studied;the clinical and imaging features and infarct pattern were retrospectively analyzed. Results( 1 ) Clinical features :The clinical manifestations of 35 patients was hemiplegia symptoms,in which 16 cases(45.7％ ) involved to the face,upper and lower limb,11 cases(31.4％ ) involved to the upper and lower limb,3 cases(8.6％ ) involved to the facial and upper limb,2 cases(5.7％ ) involved only to the facial,2 cases(5.7％ ) involved to the facial and upper limb,1 cases(2.9％ ) involved only to the upper limb. (2) MRA imaging characteristics and infarct pattern: 29 cases ( 82.9％ ) of patients with stenosis or occlusion showed moderate severe stenosis,6 cases( 17.1％ ) showed MCA occlusion. 30 cases( 85.7％ ) showed ischemic infarction,in which perforating artery infarction was the most common infarct pattern of middle cerebral artery stenosis or occlusive patients( 53.3％ ) ,followed by water-shed infarct ( 26. 7) ％, pial infarct was ielatively small (20. 0％ ). ConclusionThe hemiplegia was the most common clinical symptoms in patients with MCA stenosis and occlusion, and mainly involves to the face,upper and lower limb;The perforating artery infarction was the most common infarct pattern,and its infarct mechanism was an artery-to-artery embolism or hemodynamic abnormalities.

?AlM: To evaluate the long - term effects of laser peripheral iridectomy ( LPl ) and trabeculectomy in treating early chronic angle-closure glaucoma.
?METHODS: Ninety-eight patients (102 eyes) with early chronic primary angle-closure glaucoma were randomly divided into two groups. Group A of 50 patients (54 eyes) was treated with LPl and group B of 48 patients (48 eyes) with trabeculectomy. After 3 - 8y of follow - up observation, comparison would be made from the perspectives of postoperative eyesight, intraocular pressure, anterior chamber angle, visual field and cup/disc ratio ( C/D) .
?RESULTS:ln group A, 24 eyes with eyesight declining, 22 eyes with theintraocular pressure>21mmHg (1mmHg=0. 133kPa), 21 eyes with chamber angle synechia >180o, 21 eyes with visual field narrowed, 21 eyes with C/D ratio enlarged. The results of group B for the same items were 10, 5, 4, 4, 4 eyes respectively. The comparative difference was statistically significant (P<0. 05).
?CONCLUSlON:Good effects will be achieved for early-stage chronic angle - closure glaucoma with surgical method. Trabeculectomy is obviously better than LPl for the long-term effects.

Objective To analyze the prognostic factors and evaluate the effect of stereotactic radiosurgery for patients with multiple brain metastases. Methods Comparison was made in 53 such patients treated by stereotactic radiosurgery plus radiotherapy and 53 treated by radiotherapy alone. Patients were matched paired according to the following criteria: age, Karnofsky performance scale(KPS) before treatment, extent of systemic cancer and number of brain metastasis.Fourty patients had stereotactic radiosurgery, 13 patients stereotactic fractionated radiosurgery. In the stereotactic radiosurgery group, the patients were given a mean marginal dose of 20?Gy. Methods of stereotactic fractionated radiosurgery was 4 12?Gy per fraction, twice a week to a total dose of 15 30?Gy. Whole brain radiotherapy was given immediately after stereotactic radiosurgery. For patients treated by radiotherapy alone, the entire brain was treated by 30 40?Gy in 3 4 weeks. Results The median survival was 11.6 months in stereotactic radiosurgery plus radiotherapy and 6.7 months in radiotherapy alone. The one year survival rate and one year local control rate were 44.3%,17.1% and 50.9%,13.2%. Those with KPS increased after treatment gave 1 year survivals of 69.8% and 30.2%, respectively. The validity rates in CT or MRI three months after treatment were 82.0% and 55.0%.The difference in the two groups was found to be statistically significant (P

Traditional processes are mostly adopted in traditional Chinese medicine (TCM) preparation production and the quality of products is mostly controlled by terminal. Potential problems of the production in the process are unpredictable and is relied on experience in most cases. Therefore, it is hard to find the key points affecting the preparation process and quality control. A pattern of research and development of traditional Chinese medicine preparation process based on the idea of Quality by Design (QbD) was proposed after introducing the latest research achievement. Basic theories of micromeritics and rheology were used to characterize the physical property of TCM raw material. TCM preparation process was designed in a more scientific and rational way by studying the correlation among enhancing physical property of raw material, preparation process and product quality of preparation. So factors affecting the quality of TCM production would be found out and problems that might occur in the pilot process could be predicted. It would be a foundation for the R&D and production of TCM preparation as well as support for the "process control" of TCMIs gradually realized in the future.
Drug Compounding ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Humans ; Medicine, Chinese Traditional ; standards ; trends ; Quality Control ; Research ; standards ; trends ; Research Design ; standards ; Technology, Pharmaceutical ; instrumentation ; methods ; standards

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally.

Objective To evaluate the clinical efficacy and safety of Xuebijing injection in treatment of sepsis and multiple organ dysfunction syndrome ( MODS ). Methods A prospective multicenter clinical study was conducted. The patients with sepsis, severe sepsis, or MODS admitted to Department of Emergency and Critical Care Medicine of 70 hospitals across the country during 2006 to 2008 were enrolled. All of the patients received the basis treatment of conventional therapy, plus Xuebijing injection of 50-100 mL, 2-3 times a day for 5-7 days, and the dose might be increased in serious cases. The vital signs, 24-hour urine output, Glasgow coma score ( GCS ), white blood cell count ( WBC ), platelet count ( PLT ), Marshall score, gastrointestinal function score, syndrome of traditional Chinese medicine ( TCM ), blood lactate ( Lac ), blood glucose, serum creatinine ( SCr ), and total bilirubin ( TBil ) were observed before treatment, 1, 3, and 5 days after treatment, and at the end of the treatment. The results of above mentioned parameters after the treatment were compared with that before treatment in each patient. At the same time, the occurrence and the degree of adverse reactions were recorded to evaluate the safety of Xuebijing injection. Results A total of 2 574 patients were enrolled, and in 2 509 cases the treatment was completed in, with a drop of 65 cases. 704 cases were diagnosed to have sepsis, 768 with severe sepsis, and 1 037 with MODS. According to TCM, in 1 951 cases syndrome of stasis-toxin in the interior, and in 558 syndrome of excessive exuberance of heat-toxic in the interior were diagnosed. After the treatment of Xuebijing injection combined with conventional therapy, the temperature, heart rate, respiration rate, blood pressure, WBC, PLT, GCS, 24-hour urine output, blood glucose, Lac, SCr, TBil, Marshall score, gastrointestinal function score, as well as the symptoms, signs and TCM tongue condition and pulse condition, and TCM scores were significantly improved in all patients as well as the patients with sepsis, severe sepsis, or MODS ( P < 0.05 or P < 0.01 ). The effective rate of all patients and the patients with sepsis, severe sepsis, or MODS was 89.20%( 2 238/2 509 ), 92.76%( 653/704 ), 91.54%( 703/768 ), 85.05%( 882/1 037 ), respectively, and the 28-day survival rate was 93.90%( 2 356/2 509 ), 98.01%( 690/704 ), 96.35%( 740/768 ), 89.30%( 926/1 037 ), respectively. In 3 patients with MODS adverse events ( 0.12%) occurred, including 2 cases of stress ulcer and 1 case of Adams-Stokes syndrome. After clinical evaluation, the adverse events were found to be unrelated with the study medication, and Xuebijing injection was continued till the end of treatment. Conclusion Xuebijing injection combined with conventional therapy may effectively ameliorate systemic inflammatory response, protect organ function, alleviate the symptoms, improve organ functions, and elevate the clinical cure rate. Adverse events occur occasionally. Xuebijing injection is found to be safe.

BACKGROUND:Activation of Notch signaling plays a critical role in stem cel differentiation, and this effect seems to be cel-type dependent. Little is reported on the role of activation of Notch1 signaling in the differentiation of c-Kit+ bone marrow mesenchymal stem cels. OBJECTIVE:To analyze the influence of activation of Notch1 signaling on the differentiation of c-Kit+ bone marrow mesenchymal stem cels. METHODS:The Notch1 intracelular domain (N1-ICD) was obtained from the cDNA library by PCR and cloned intoBamHI/AgeI digested adenoviral GV314 plasmid to construct N1-ICD overexpressing shuttle plasmid, and the positive clones were verified by sequencing. N1-ICD shuttle plasmid and helper plasmids pBHGloxΔE1,3 Cre were used to co-transfect HEK293T cels to obtain N1-ICD overexpressing adenoviral particles (N1-ICD-Ad). The c-Kit+ subpopulation were isolated from bone marrow mesenchymal stem cels of the Sprague-Dawley rat femurviamagnetic activated cel sorting. After transfection of the c-Kit+ BMSCs with N1-ICD-Ad adenovirus, we assessed the activation of Notch1 signaling and differentiation in c-Kit+ bone marrow mesenchymal stem cels by quantitative RT-PCR and immunofluorescent staining. RESULTS AND CONCLUSION:N1-ICD coding sequence was successfuly generated from the cDNA library, and then was cloned into the linearized adenoviral vectors GV314. The resistant clones were verified by sequencing. With the assistance of packaging plasmids, recombinant N1-ICD-Ad adenovirus plasmids were successful packaged in HEK293T cels, and its title was 2×1012 PFU/L. c-Kit+ bone marrow mesenchymal stem cels with the purity of 91.6% were successfuly isolated from the bone marrow mesenchymal stem cels of the Sprague-Dawley rat femur. Compared with the blank and negative controls, N1-ICD-Ad infection in the c-Kit+ bone marrow mesenchymal stem cels led to substantial accumulation of N1-ICD in the cytoplasm and nuclei, significantly unregulated expressions of Hes1 (a downstream gene of Notch) and cardiomyocyte differentiation genes Nkx2.5 and cTnT, significantly increased the expression of von Wilebrand factor, an endothelial cel differentiation gene, and mildly increased the expression of smooth muscle22α, a smooth muscle cel differentiation gene. These experimental results indicate that the activation of Notch1 signaling contributes to multi-lineages differentiation of c-Kit+ bone marrow mesenchymal stem cels, and the construction of N1-ICD overexpressing adenoviral vector makes the foundation for further research on the role of Notch1 signaling in stem cel biology.