Objective To explore the clinical efficacy of captopril combined with nifedipine in the treatment of type 2 diabetes mellitus complicated with hypertension.Methods 100 patients with type 2 diabetes mellitus complicated with hypertension were divided into two groups by randomized single blind method.The two groups were given conventional hypoglycemic therapy,50 cases in the control group were treated with captopril,while 50 cases in observation group received captopril combined with nifedipine sustained -release tablets.The clinical therapeutic effect was compared between the two groups.Results The effective rate of the observation group was 94%,which of the control group was 80%,the difference was statistically significant (χ2 =9.65,P<0.05).After treatment,the diastolic blood pressure[(80.45 ±3.65)mmHg],systolic blood pressure[(128.67 ±5.66)mmHg],fasting blood glucose[(6.65 ±0.37)μmol/L],2h postprandial blood glucose[(9.76 ±1.22)μmol/L]of the observation group were significantly reduced than before treatment (t =8.06,8.18,8.00,7.94,all P <0.05),and diastolic blood pressure and systolic blood pressure were significantly different with the control group(t=8.66,7.90,all P<0.05). After treatment,the serum creatinine (97.44 ±6.32)μmol/L,urea nitrogen (4.20 ±0.30) mmol/L and 24h urinary albumin (17.99 ±4.10) mg/L of the observation group were significantly reduced compared with before treatment (t=7.67,8.27,8.32,all P<0.05),and the indicators had significant differences with the control group(t=7.23, 7.65,7.67,all P<0.05).Conclusion Captopril and nifedipine sustained-release tablets in the treatment of type 2 diabetic patients with hypertension can effectively reduce the blood pressure,improve renal function,and it has good clinical application and promotion value.

OBJECTIVE:To probe into the occurrence characteristics of the adverse drug reactions(ADR) in Lanzhou area and to intensify the reporting,monitoring and management of ADR.METHODS:A retrospective analysis was performed on 345 valid ADR cases.RESULTS:The ADR reports were mainly submitted by medical institutions,account for 88.70%.The clinicians and hospital pharmacists were the chief reporting personnel.16 drug categories totaled 143 varieties were involved in the ADR,leading the list were traditional Chinese medicine preparation that account for 48.70%and antibacterial drugs that account for 29.86%.CONCLUSION:The reporting and monitoring of ADR should be intensified so as to decrease the rate of missing report and incidence of ADR to a large extent.

Objective To explore the effects of high insulin and high glucose concentrations on glucose transport activity,the expression of insulin signaling peptides and glucose transporter 4(GLUT4) translocation in primary cultured rat adipocytes.Methods Isolated rat adipocytes were cultured for 24h at insulin(10 4?U/ml) and different concentration glucose(5,10,15 and 25mmol).Then the glucose uptake,cellular contents of insulin receptor substrate(IRS) 1/2,phosphatidylinositol 3-kinase 85 subunit(p85),protein kinase B(PKB) and GLUT4 were measured by Western blotting method.Results These adipocytes treated with insulin and different high concentration glucose had shown to impair glucose uptake in a dose-dependent manner,inhibited cellular IRS1 expression,impaired IRS2 protein expression independent on glucose concentration in the medium,it did not influence the contents of p85,PKB and GLUT4,but decreased GLUT4 translocation.Conclusions Chronic high insulin induced insulin resistance may be caused by the increasing glucose concentration surrounding the cells.The mechanism may be involved in affecting IRSs protein expression and GLUT4 translocation.

Background and purpose:CD4+CD25+ regulatory T (Treg) cells are an important naturally accruing subpopulation of regulatory T cells. They not only prevent the spontaneous emergence of autoimmune diseases and contribute to the establishment of dominant tolerance on allogeneic transplantation, but also play an essential role in the generation, development and immunotherapy of many different kinds of malignant tumors. We studied the expression of CD4+CD25+ regulatory T cells(Tregs) in colorectal cancer patients and its significance. Methods:The tissues of tumors and counterpart normal tissue of 30 colorectal cancer patients were collected, the proportion of CD4+CD25+ Tregs as the percentage of the total CD4+ T cells were analyzed using flow cytometry and immunohistochemistry.Results:Compared with counterpart normal tissue(5.5?1.3)%, the percentage of CD4+CD25+ Tregs in tumor tissues was significantly higher (24.1?4.8)%(t=5.155,P=0.002). The proportion of CD4+CD25+ Tregs in the patients with lymph nodes metastasis was (27.9?3.6)% which was significantly higher than that in patients without lymph nodes metastasis[(20.3?1.3)% (t=3.489,P=0.025)].Conclusions:The proportion of CD4+CD25+ Tregs in tumor tissues of colorectal cancer patients was significantly increased, and they may play an essential role in the development of colorectal cancer.

Objective To evaluate the diagnostic value of (1,3)-β-D-glucan assay (G test) in the plasma of premature infants with invasive fungal infection(IFI) and determinate the best diagnostic value of G test.Methods The premature infants who were at risk of IFI from NICU were enrolled in Shengjing Hospital of China Medical University from July 2010 to September 2011.The concentration of (1,3)-β-D-glucan were detected by GKT-5MSet microbial dynamic detection system,and the fungal and bacterial culture were performed in the same samples of blood.We used to perform statistic analysis for sensitivity,specificity,positive predictive value and negative predictive value at different cutoff values,and draw receiver operating characteristic curve for G test.Results Forty-four infants were eligible for the study,of 17 permature infants with IFI,and of 27 ones with non IFI,in whom bacterial culture was positive in 12 cases and culture was negative in 15 cases.The concentration of (1,3)-β-D-glucan in IFI group [5 ～ 3 117 pg/ml,median (Q75-25)190.60(501.44) pg/ml] was higher than that in non IFI group[5.0 ～434.3 pg/ml,median(Q75-25) 5.86(5.62) pg/ml],the difference was significant(Z =-3.77,P ＜ 0.01).15 pg/ml was the best cutoff value,and the area under curve was 0.839,95 ％ CI(0.697,0.980).Conclusion G test is useful in the diagnosis of IFI in premature infants with high sensitivity and specificity.G test can be used for the screening of high-risk patients with high risk of fungal infection ratio.

Objective To investigate the varaiation of the incidence of macrosomia and its influencing factors. Methods A population-based study of 25 944 pregnant women,who delivered in Peking University First Hospital in term birth,with singleton,between Jan. 1,2006 and Dec. 31,2013 and accepted the gestational diabetes mellitus(GDM)screening and diagnosis,was performed. The women are grouped according to the different clinical interventions at different period. Women delivered between Jan. 1, 2006 and Dec. 31,2006 was defined as Group 2006,and they were diagnosed with glucose metabolism disorder [gestational impaired glucose tolerance(GIGT)and GDM] and intervened only when meeting National diabetes data group(NDDG)criteria. Women delivered between Jan.1,2007 and Apr. 30,2011 were defined as Group post 2007,and NDDG criteria was also applied in this period. Women delivered between May. 1,2011 and Dec. 31,2013 were defined as Group post 2011,and Ministry of Health(MOH)of China was used for GDM diagnosis in this group. All pregnant women in Group post 2007 accepted the preliminary pregnancy nutrition advice and weight management. All participants met MOH criteria were diagnosed as glucose metabolism disorder in this study,in which women diagnosed and intervened in pregnancy were defined as Group diagnosis and those not being identified during pregnancy were defined as Group missed diagnosis. It was analyzed retrospectively for the incidence of macrosomia and the influencing factor. Results (1)The prevalence of macrosomia and cesarean section was decreased every year from Jan. 2006 to Dec. 2013. The incidence of macrosomia was 9.14%in 2006,reduced to 8.02%in 2007-2011 and 6.79%in 2011-2013. The incidence of cesarean section was 55.22%,reduced to 51.04%in 2007-2011 and 44.15%in 2011-2013. However,there was not remarkable change in the prevalence of small for gestational age(P>0.05).(2)Compared with Group 2006,the incidence of cesarean section was lower in Group post 2007 [51.04%(6 504/12 744)vs 55.22%(1 371/2 483)],and the difference is significantly(P<0.05). Meanwhile,the incidence of cesarean section(44.15%,4 732/10 717)and macrosomia(6.79%,728/10 717) in Group post 2011 was lower significantly than Group 2006 and Group post 2007(P<0.05).(3)The incidence of macrosomia was 7.41%(1 129/15 227)and 6.61%(1 006/15 227)respectively in Group diagnosis and Group missed diagnosis before May 2011,combined 14.02%(2 135/15 227)in total. It was increased significantly in the incidence of GDM 21.41%(2 294/10 717)after May 2011 compared with that before (P<0.05). The incidence of macrosomia was decreased significantly using MOH criteria in GDM women since 2011. It was the downtrend in the incidence of macrosomia since 2007 in non GDM women. However,there was no difference in SGA in different period.(4)In glucose metabolism disorder women, compared with Group 2006 and Group post 2007,the incidence of macrosomia and cesarean section was lower in Group post 2011,and the difference is significantly(P<0.05). However,there was no significant difference in the incidence of macrosomia and cesarean section between Group 2006 and Group post 2007, and there was no difference in SGA in the 3 groups(P>0.05). In non GDM women,the incidence of macrosomia and cesarean section was lower in Group post 2011 than Group 2006(P<0.05);meanwhile,it was the downtrend in the incidence of macrosomia in Group post 2007 compared to Group 2006,and the difference of the incidence of cesarean section was significant(P<0.05). Conclusion The prevalence of macrosomia and cesarean section might be reduced by application of suitable criteria for diagnosis of GDM and education on nutrition during pregnancy.

Objective To observe the analgesic effect and safety of dezocine used in the periextubation period in pediatric pa-tients undergoing cleft lip and palate repair surgery under general anesthesia .Methods 60 American Society of Anesthesiologists (ASA ) grade Ⅰ - Ⅱ pediatric patients undergoing elective cleft lip and palate repair surgery under under general anesthesia in the central anesthesia department from January 1 to August 1 ,2013 were selected and randomly divided into group D ,F and N ,20 cases in each group .All the cases were performed the endotracheal intubation general anesthesia .At 15 min before the end of operation , the group D was intravenously injected by dezocine 0 .10 mg/kg ,the group F by fentanyl 1 .00 μg/kg and the group N (control group) by the isodose normal saline .The mean arterial pressure(MAP) and heart rate(HR) in all groups were recorded before in-duction ,extubation and at 5 min after extubation respectively .The extubation time ,Riker sedation-agitation scores and face ,legs ,ac-tivity ,cry and consolability(FLACC) scores at 30 min after extubation ,occurrence rates of various complications within 30 min after extubation(breathing and circulation depression ,nausea and vomiting ,drowsiness ,headache and extrapyramidal reactions were ob-served and recorded .Results The three groups completed the operation successfully .There were no significantly differences in age , body weight ,operation time and sevoflurane inhalation concentration among the three groups (P>0 .05) .HR and MAP in extuba-tion and at 5 min after extubation in the group D were lower than those in the group N and F(P<0 .05) ,but HR and MAP in extu-bation and at 5 min after extubation had no statistically significant difference between the group D and F (P>0 .05) .There was no statistically significant difference in the extubation time among 3 groups(P>0 .05) .The Riker sedation-agitation scores and the FLACC scores at 30 min after extubation in the group D were significantly lower than those in the group N and F with statistically significant difference( P< 0 .01 ) .Adverse reaction such as respiratory inhibition ,nausea ,vomiting ,lethargy ,headache ,vertebral body reaction were not found in the 3 groups after 30 minutes .Conclusion Dezocine used in pediatric patients with cleft lip and pal-ate repair surgery is safe and effective .

The carotid plaque (CP) detachment can induce thrombosis, which may lead to cerebral vascular disease. In recent years,research of CP is mainly focused on qualitative and quantitative analysis of vulnerable plaque. Therefore, it is important to choose therapeutic method and opportunity according to the structure and stability of the plaque. This article reviews the progress in the diagnosis of plaque from the aspects of common ultrasound, contrast enhanced ultrasound, ultrasound real-time tissue elastography, intravascular unltrasound, digital subtraction angiography (DSA), comuted tomography angiography (CTA), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). Common and all kinds of new ultrasonic technology can be used to evaluate the vulnerability of CP from different aspects.

Objective:To evaluate clinical significance of change of serum thyroid hormone level in patients with ST elevation myocardial infarction (STEMI) and old myocardial infarction (OMI) .Methods :Clinical data of 52 STE‐MI patients (STEMI group) and 48 OMI patients (OMI group) hospitalized in our department of cardiology were retrospectively analyzed .Automatic chemiluminescent analyzer was used to quantitatively measure thyroid hormone levels in two groups .Results:Compared with OMI group ,there were significant reductions in serum levels of free triiodothyronine [FT3 ,(4.45 ± 1.09) pmol/L vs .(3.03 ± 0.14) pmol/L] ,free thyroxine [FT4 ,(18.53 ± 3.89) pmol/L vs .(11.83 ± 0.53) pmol/L] and thyrotropic‐stimulating hormone [TSH ,(1.85 ± 1.04)μIU/L vs .(0.26 ± 0.13)μIU/L] in STEMI group ,P<0.01 all .Conclusion:Thyroid hormone levels of STEMI patients are significant‐ly higher than those of OMI patients , serum thyroid hormone levels may reflect severity of coronary vessel lesions in patients with myocardial infarction.