AIM To investigate antitumor effects of curcumin (Cur) combining with adriamycin (ADR) on human tumor cell lines in vitro and study the mechanisms. METHODS The antitumor effects of the drugs on tumor cell lines in vitro were determined with MTT method. The Jin's formula was used to analyze the effect of drug combination. Cellular ADR accumulation was measured by fluorescence spectraphotometry. RESULTS In simultaneous adiministration Cur 4 25～34 00 ?mol?L -1 combining with ADR produced a simple addition or potentiation effect. The cellular ADR accumulation was markedly increased in the presence of Cur in MDR cells, but decreased in sensitived cells. The experiment of membrane fluidity show that that Cur affects membrane fluidity neither on KB nor on KB v200 cell line. CONCLUSION Simultaneous adiministration of Cur combining with ADR produces synergistic effect. The mechanism is connected with increasing cellular ADR accumulationon on KB v200 cell line. While on KB cell line, it is related to synergistic pharmacological effect. But the action of Cur is not connected with the change of membrane fluidity on both cell lines.

Blood lipid level and its associations with insulin resistance were studied in patients with impaired glucose tolerance (IGT).Two hundred and twenty first degree relatives of type 2 diabetes mellitus were grouped into normal glucose tolerance (NGT) and IGT groups according to results of oral glucose tolerance test.Compared with the NGT group,the IGT patients had higher serum levels of total triglyceride (TG),total cholesterol (TC),low density lipoprotein-C (LDL-C) but a lower serum level of high density lipoprotein-C (HDL-C).Homeostasis model of assessment for insulin resistance index (HOMA-IR) and area under curve of insulin (AUCI) also increased.A positive relationship was found between TG and HOMA-IR (or AUCI),but a negative relationship existed between HDL-C and HOMA-IR.In conclusion,abnormal blood lipid metabolism is present in IGT patients and it has a close correlation with insulin resistance.

Objective To evaluate the inhibitory effect of statins on glucose-stimulated insulin secretion (GSIS) of pancreatic islet in rat and to explore its mechanisms. Methods According to the average volume, freshly isolated or 24-hour cultured pancreatic islets were randomly divided into control group( incubated with Kreb-Ringer bicarbonate buffer), the atorvastatin group( incubated with 100 μ mol/L atorvastatin), the fluvastatin group (incubated with 100 μ mol/L fluvastatin)and the pravastatin group (incubated with 100 μ mol/L pravastatin). Stimulated by 2. 8,5. 5,11.1,16. 7 mmol/L and 25.0 mmol/L glucose respectively, the effect of 100 μ mol/L statins on ATP content and GSIS was compared in the four groups. GSIS was performed by the 37℃ bath incubation method and ATP content was measured by chemiluminescence method. Results Incubated with 100 μ mol/L atorvastatin for 30 minutes, in the presence of 16. 7 mmol/L glucose, the ATP content [(9. 54 ± 1. 64) pmol/islet vs ( 12. 33 ± 1.89) pmol/islet] and GSIS (1.60 ± 0. 21 vs 2. 39 ± 0. 30) were significantly reduced in comparison with the control group (P＜0. 05). Cultured with 100 μmol/L fluvastatin for 24 hours, the ATP content [( 10. 24 ±2.01 )pmol/islet vs (12. 31 ±2. 16) pmol/islet] and GSIS (3. 12 ± 0. 32 vs 4. 17 ±0. 37 ) were all significantly decreased at the higher glucose concentration of 16. 7 mmol/L ( P ＜ 0. 05). Conclusion Atorvastatin and fluvastatin may inhibit GSIS by decreasing ATP content in pancreatic islet and the inhibitory effect is related to the strength of its lipophilicity.

The association of coagulation function with progressive proteinuria in type 2 diabetic patients was retrospectively analyzed.With increasing microalbuminuria,fibrinogen level was increased significantly.Fibrinogen was an independent risk factor of microalbuminuria. In patients as the early-stage diabetic nephropathy (DN)progressed to clinical-stage DN,the baseline level of fibrinogen was also increased [ ( 3.5 ± 0.9 vs 3.0 ± 0.6 ) g/L,P＜0.05 ].Fibrinogen may serve as a useful predictor of progressive proteinuria in type 2 diabetes.

According to the analysis of 9 237 hospitalized type 2 diabetic patients, the prevalence of diabetic retinopathy ( DR )was 32.9％ , with the prevalence of mild, moderate, and serious non-proliferative DR and proliferative DR being 10. 1％, 18. 3％, 3.2％, and 1.3％ respectively. The prevalence of diabetic macular edema ( DME ) was 3.56％ in type 2 diabetics and i 0. 8％ in patients with DR. Diabetes duration and proteinuria were the common risk factors of DR and DME.

Through retrospective analysis of the clinical and laboratory data of 1 466 inpatients with type 2 diabetes mellitus(T2DM),we investigated the prevalence of chronic kidney disease (CKD) and analyzed the risk factors.The prevalence of CKD in hospitalized patients with T2DM was 52.25％.In the patients with CKD,protein urine was present in 93.47％ of the cases,27.93％ of them had glomerular filtration rate(eGFR) ≤60 ml · min-1 · 1.73 m-2,damage of renal tubular function was present in 24.28％,and abnormal renal imaging in 14.88％.Logistic regression showed that age,body mass index(BMI),duration of diabetes,systolic blood pressure,serum uric acid,low density lipoprotein-cholesterol (LDL-C),and smoking were independently associated with patients of T2 DM and CKD.The prevalence of CKD was increased with aging,diabetic course,BMI,and LDL-C.CKD is a common chronic complication in patients with T2DM,especially in patients with prolonged course,advanced age,and obesity.Much attention should be paid to early detection of CKD in patients with diabetes.In addition to detecting urinary protein and eGFR,renal tubular function and morphological examination should also be included.

[Summary] To investigate the association between sleep disorder and ambulatory blood pressure rhythm in patients with type 2 diabetes. 418 patients with type 2 diabetes were divided into two groups according to Pittsburgh sleep quality index ( PSQI):patients without sleep disorder and patients with sleep disorder. Oral glucose tolerance test, insulin releasing test, and C-peptide releasing test were performed to investigate the differences in the β-cell function, the circadian rhythm of blood pressure, and blood pressure variation between the two groups after fasting and glucose-load. The correlation and regression analysis were performed between PSQI and other indicators. (1)The level of HbA1C , fasting plasma insulin, area under curve of insulin, fasting plasma C-peptide, area under curve of C-peptide, and homeostasis model assessment for insulin resistance ( HOMA-IR) were significantly higher in patients withsleepdisordercomparedtothoseinpatientswithoutsleepdisorder[(8.2±2.1)% vs(7.4±1.8)%,(13.42± 4.55vs11.86±4.52)mU/L,(8.51±0.54vs8.38±0.51)mU·L-1·min,(2.42±1.25vs1.79±0.73)ng/ml, (6.59±0.39vs6.49±0.43)μg·L-1·min,4.63±1.12vs3.86±0.97,allP<0.05]. Insulinsensitivityindex (ISI) was lower in patients with sleep disorder than that in patients without sleep disorder(-4. 26 ± 0. 78 vs-4. 05 ± 0.62,P<0.05). (2)Thelevelof24hmeansystolicanddiastolicbloodpressure,nocturalsystolicanddiastolicblood pressure, and systolic blood pressure during daytime and nighttime were significantly higher in patients with type 2 diabetes who were suffering from sleep disorder. The blood pressure variation was more marked in patients with sleep disorder. (3)Multiple stepwise regression analysis showed that PSQI score was positively related to area under curve of C-peptide, HOMA-IR, 24 h mean systolic blood pressure, and noctural systolic blood pressure (β=0. 242, 0. 293, 0. 352, 0. 413, all P<0. 05), and negatively related to ISI and decreasing ratio of noctural systolic blood pressure (β=-0. 124 and -0. 226, both P<0. 05). Sleep disorder may cause abnormal circadian rhythm of blood pressure through various mechanisms. Improving sleep disorder may help to ameliorate insulin resistance and restore normal circadian rhythm of blood pressure.

Objective To explore effect of family-centered discharge guidance on family care of premature infants in NICU.Methods A total of 174 premature infants with extremely low birth weight in NICU were studied and were randomly divided into study group and control group,with 87 cases per group.Control group received conventional discharge guidance while the study group received family-centered discharge planning.Height and weight changes of neonates at discharge,and at correct gestational age of 2,4,6 months were observed.Nursing knowledge and nursing skills,Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of puerperae were observed in two groups on admission and at discharge.Breastfeeding rate,re-hospitalization rate,morbidity and mortality within 6 months were compared.Results The body weight,body length and head circumference were not statistically significant of two groups at birth and at corrected gestational age of 40 weeks (P ＞ 0.05),and they were heavier,and larger than those of the control group at corrected gestational age of 2,4 and 6 months (P ＜ 0.05).Breastfeeding rate in the study group was higher,morbidity rate and readmission rate were lower than that of the control group (P ＜ 0.05),but there was no significant difference in mortality of two groups (P ＞ 0.05).At discharge of NICU,mothers of premature infants had no statistically significant difference in nursing knowledge and skills (P ＞ 0.05),but they commanded more after 2 monthsof discharge (P ＜ 0.05),and study group improved more significantly (P ＜ 0.05).At discharge of NICU,SAS and SDS scores of infants'mothers were not statistically significant (P ＞ 0.0 5),but it was significantly decreased at 2 months of discharge (P ＜ 0.0 5),and study group decreased more (P ＜ 0.0 5).Conclusion Family-centered discharge guidance can increase the physical development of children,reduce the morbidity rate,and improve the family's bad mood,so it is worthy of clinical promotion.

Objective To explore effect of family-centered discharge guidance on family care of premature infants in NICU.Methods A total of 174 premature infants with extremely low birth weight in NICU were studied and were randomly divided into study group and control group,with 87 cases per group.Control group received conventional discharge guidance while the study group received family-centered discharge planning.Height and weight changes of neonates at discharge,and at correct gestational age of 2,4,6 months were observed.Nursing knowledge and nursing skills,Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of puerperae were observed in two groups on admission and at discharge.Breastfeeding rate,re-hospitalization rate,morbidity and mortality within 6 months were compared.Results The body weight,body length and head circumference were not statistically significant of two groups at birth and at corrected gestational age of 40 weeks (P ＞ 0.05),and they were heavier,and larger than those of the control group at corrected gestational age of 2,4 and 6 months (P ＜ 0.05).Breastfeeding rate in the study group was higher,morbidity rate and readmission rate were lower than that of the control group (P ＜ 0.05),but there was no significant difference in mortality of two groups (P ＞ 0.05).At discharge of NICU,mothers of premature infants had no statistically significant difference in nursing knowledge and skills (P ＞ 0.05),but they commanded more after 2 monthsof discharge (P ＜ 0.05),and study group improved more significantly (P ＜ 0.05).At discharge of NICU,SAS and SDS scores of infants'mothers were not statistically significant (P ＞ 0.0 5),but it was significantly decreased at 2 months of discharge (P ＜ 0.0 5),and study group decreased more (P ＜ 0.0 5).Conclusion Family-centered discharge guidance can increase the physical development of children,reduce the morbidity rate,and improve the family's bad mood,so it is worthy of clinical promotion.

Objective To study the effects of family participation nursing model on the parents′master degree about nursing knowledge of premature infants, and promote the recovery of premature infants. Methods From June 2014 to May 2016, 46 premature infants admitted in the neonatal intensive care unit ( NICU) of our hospital were selected as research objects. According to the order of admission date, all premature infants were divided into the control group and the intervention group, with 23 cases in each group. Patients in the control group received routine nursing, while patients in the intervention group were given family participation nursing mode. After discharge, the nursing knowledge, nursing satisfaction and practice situation of parents of premature infants were surveyed, and the readmission rate of patients within 1 months after discharge were compared between two groups. Results The basic nursing knowledge and nursing skills of parents in the intervention group were higher than those of the control group (P<0.05); as for the satisfaction, the rate of intervention group was 98.83%, while the rate of control group was 93.67%, so the rate of intervention group was higher than that of the control group (χ2 =6. 732, P<0. 05 ); within six months after discharge, two premature infants in the control group were readmitted, and the readmission rate was 8.7%, while no premature infant was readmitted in the intervention group, and the readmission rate was 0 (χ2 =16. 463, P<0. 01 ) . Conclusions The family participation nursing mode has the advantages of high efficiency, simple operation, labor saving and time-saving, To a certain extent, it also solves the drawbacks of parent nursing for NICU premature infants, and plays an important role in promoting the rehabilitation of premature infants.