Objective To investigate the association of insulin dose with clinical factors of type 2 diabetes. Methods We reviewed the data of 214 type 2 diabetic patients who received insulin regimens.We compared the insulin dose and period at the targeted blood glucose levels among 6 groups according to different type of oral hypoglycemic agents. Results There existed statistically significant correlations of the glucose-targeted insulin dose with course,FPG,BMI,combination therapy with oral hypoglycemic agent(P<0.1,test level P=0.1).Merely metformin failure group took less insulin than the group admitted due to combination therapy failure (P=0.016, 0.53(0.35～0.62)U/kg and 0.63(0.51～0.75)U/kg respectively).The longest targeted period existed in the later. Relationship between the targeted bedtime insulin NPH dose and FPG level can be demonstrated by equation Y=0.255X+7.8. Conclusions The targeted insulin dose is influenced by synthetic factors. Patients admitted due to combination oral hypoglycemic drug failure have the maximal targeted insulin dose and the longest titration period. The final bedtime insulinNPH dose can be predicted by FPG level.

Objective To investigate the diagnosis and differential diagnosis of primary hepatic malignant fibrous histiocytoma (MFH) by ultrasound. Methods A retrospective analysis of clinical data and ultrasonic findings was performed on 16 patients with pathologically proven hepatic MFH from July 2005 to August 2012 in Eastern Hepatobilary Surgery Hospital of the Second Military Medical University. Results Of the 16 patients, all the tumors were single, which including 9 tumors located in the right lobe, 6 tumors located in the left lobe, and 1 tumor located in caudate lobe of the liver. The tumor sizes were larger than 10.0 cm in 3 cases, between 5.0 cm and 10.0 cm in 10 cases, and less than 5.0 cm in 3 cases. Tumor internal echo was heterogeneous, including 1 case with honeycomb pattern and 2 cases with mosaic sign. Most tumors were unclearly-deifned (11 cases) without obvious halo. The pathologic results identiifed 15 cases of primary hepatic MFH and 1 case of primary intrahepatic bile duct malignant ifbrous histiocytoma. Conclusions It is dififcult to make correct clinical diagnosis of hepatic MFH. A comprehensive analysis of ultrasound ifndings and clinical information is needed to obtain an accurat diagnosis of malignant liver tumors.

Objective　To study the value of B type ultrasonography guiding percutaneous radiofrequency ablation (PRFA) for hepatic cancer (HC). Methods　70 patients with primary or metastatic hepatic malignancies were treated by PRFA under ultrasound guidance through LeVeen multipolar array needle electrode and RF 2000. All patients were followed up by turnor marker, B type sounography and MRI monthly. Results　PRFA were performed in 53 patients with hepatocellular carcinoma (HCC) and 17 cases with metastatic liver cancer. Liver function classfication was 53 cases in Child class A, 15 in class B and 2 in class C. In 21 patients with non-operated small HCC (≤5 cm), 12 of 17 patients with AFP positive were decreased to normal (70.6%) and decreased markedly in 4 (23.5%), and MRI showed the treated tumors were completely necrosis in 16 patients (76.2%). The 3, 6 month survival rates were 90.5%, 100% respectively in small HC groups, and 66.7% to 72.7% and 27.6% to 72.7% in large HC groups.Conclusions　PRFA as a local thermal therapy is becoming a kind of new palliative treatment for hepatic malignancies, which not only is safe, minimally invasive, and effective for small ones; but also can be used with combination of TACE for larger ones.

OBJECTIVETo explore the possible pain mechanism of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

METHODSThe models of CP/CPPS were established in male Wistar rats by the autoimmune method. The paw withdrawal threshold (PWT) was detected using Von Frey filament. The expressions of the substance P and c-fos in the prostate and spinal L5-S2 segments were determined by immunohistochemistry followed by analysis of their correlation with CP/CPPS.

RESULTSCompared with the control rats, the CP/CPPS models showed significantly decreased PWT (P < 0.05), remarkable prostatic inflammation, enlarged scope of lesions, and obvious interstitial lymphocytic infiltration (P < 0.05). Both the expressions of substance P and c-fos were markedly elevated in the prostate and spinal dorsal horn (L5-S2) of the rat models (P < 0.05), but the expression of substance P in the prostate exhibited no correlation with that in the spinal cord (r = 0.099, P = 0.338), nor did that of c-fos (r = 0.027, P = 0.454).

CONCLUSIONThe upregulated expressions of substance P and c-fos in the spinal cord L5-S2 sections may be associated with the pain mechanism of CP/CPPS.

Animals ; Chronic Disease ; Immunohistochemistry ; Male ; Pelvic Pain ; etiology ; metabolism ; Prostate ; metabolism ; Prostatitis ; complications ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Wistar ; Spinal Cord ; metabolism ; Substance P ; metabolism ; Syndrome ; Up-Regulation

OBJECTIVE: To study the risk factors for severe acute pancreatitis (SAP) complicated by pancreatic encephalopathy (PE). METHODS: Clinical data from 255 patients with SAP from January 2005 to December 2006 were reviewed. Thirty-one SAP patients had PE, and 224 SAP patients did not. Clinical characteristics of SAP patients in both PE group and non-PE group were analyzed. RESULTS: Ranson scale and the incidence rates of acute respiratory distress syndrome (ARDS), renal failure, hypoproteinemia, hypocalcemia and hyperglycosemia in PE group were higher than those in non-PE group (P<0.05). There were no significant differences in acute physiology and chronic health evaluation II and CT severity index scales, the activities of amylase and lipase, the incidence rate of liver function failure, the infection rate and the operability between the PE group and the non-PE group (P>0.05). Multivariate logistic regression analysis showed that ARDS and hyperglycosemia were high risk factors. Cure rate in PE group was higher than that in non-PE group. CONCLUSION: Nosogenesis of PE is the result of multiple factors. ARDS and hyperglycosemia may be the high risk factors for PE.

Objective To assess the left ventricular (LV) systolic synchrony in patients with myocardial infarction using real-time three dimensional echocardiography(RT-3DE) and speckle tracking imaging(STI). Methods Twenty-five healthy subjects and thirty patients with myocardial infarction underwent two-dimensional echocardiography and RT-3DE examination. The systolic synchrony parameters derived from RT-3DE were the dispersion of time and the maximum difference of time to minimum regional volume for 16 LV segments (Tmsv-16-SD and Tmsv-16-Dif). When the Tmsv-16-SD was above the percent 99 of the control group distribution in patients with myocardial infarction were considered statistically different from those in the control group and were accordingly classified as LV systolic asynchrony. The time from the onset of QRS complexes to systole peak strain from the radial vectors was recorded using STI. The standard deviation and the maximal temporal difference of the radial (TRS-SD and TRS-Dif) of 18 segments were calculated as indicator of LV systolic synchrony. LV systolic asynchrony was defined as an interval≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (TAS-POST). Results All the systolic synchrony parameters derived from RT-3DE and STI were significantly larger in the myocardial infarction group than those of the control group (all P＜0.01 ).For Tmsv-16-SD and Tmsv-16-Dif,a moderate correlation with TRS-SD and TRS-Dif( r = 0.675 and 0.620,all P＜0.01) was found. No significant difference and general consistency were found between the systolic asynchrony parameters by RT-3DE and STI ( P = 0.125, Kappa = 0.60). Conclusions RT-3DE and STI provide effective tools to assess the LV systolic synchrony. There is no obvious correlation between these methods, thus it is essential of using different methods and parameters to evaluate the LV systolic synchrony.

OBJECTIVETo study the possible mechanisms of chronic nonbacterial prostatitis (CNP) pain.

METHODSCNP models were established in male Wistar rats by the autoimmune method. Then the paw withdrawal threshold (PWT) was detected using the Von Frey filament, prostate pathological examination was conducted, the expressions of substance P (SP) and transient receptor potential vanilloid 1 (TRPV1) in the prostate tissue and L5-S2 spinal segments were determined by immunohistochemistry and their correlations were analyzed.

RESULTSCompared with the control group, the CNP model rats showed markedly decreased PWT (P < 0.05) and obvious inflammation in the prostate tissue, with significant differences in the scope of lesion and interstitial lymphocyte infiltration (P < 0.05). The expressions of SP and TRPV1 in the prostate and spinal cord dorsal horn L5-S2 were remarkably upregulated in the models as compared with the control rats (P < 0.05). However, the expression of SP in the prostate was not correlated with that in the spinal cord (r = 0.099, P = 0.338), nor was that of TRPV1 (r = 0.000, P = 0.5).

CONCLUSIONSP and TRPV1 were involved in the formation and persistence of pain in CNP rats through their upregulated expressions in the L5-S2 spinal segments.

Animals ; Lumbosacral Region ; Male ; Neuralgia ; metabolism ; physiopathology ; Pain ; metabolism ; physiopathology ; Prostate ; metabolism ; Prostatitis ; metabolism ; physiopathology ; Rats ; Rats, Wistar ; Spinal Cord ; metabolism ; Substance P ; metabolism ; TRPV Cation Channels ; metabolism

Objective To screen 18 endophytes from Pseudolarix kaempferi Gord for molluscicidal effect and identify them by morphology. Methods Molluscicidal tests were performed according to the immersion test suggested by WHO and the strain screened was identified by the slide culture. Results The mortality rates of snails immersed by JJ18 broth salified (pH=7) were 26.7%, 76.7% and 100.0% for 24,48 h and 72 h, respectively, and 53.3% and 86.7% in 5% and 10% concentrations of JJ18 broth, respectively. The active components were extracellular moiety of the broth which had no acute toxicity to fish, and JJ18 strain belonged to Aspergillus. Conclusion Extracellular moiety of endophyte JJ18 from Pseudolarix kaempferi Gord is a new resource of molluscicide.

Spontaneous intracerebral hemorrhage (ICH) refers to primary non-traumatic parenchymal hemorrhage.Its mortality and disability are extremely high.A simple and easy clinical grading scale for ICH can not only evaluate the prognosis of patients,but also has an important guiding significance for clinical treatment and clinical research.This article reviews the contents of major intracerebral hemorrhage scales,external validation,advantages and disadvantages,and explains its scope of application and clinical application.

Objective To determine the neuroprotective effect of clonidine on primary cultured cortical neurons in rats exposed to oxygen-glucose deprivation ( OGD) injury. Methods Cortical neurons cultured for 8 days were randomly assigned to the three groups: normal control group, model control group, and clonidine pretreatment group. OGD injury model was established by chemical hypoxia and glucose deprivation in incubation liquid for 4 h. Clonidine (1. 0, 3. 0, 10 μmol·L-1 ) was added 24 h before OGD injury. Neuronal injury was evaluated by MTT staining and the release of lactate dehydrogenase ( LDH) . Results Under the microscope, primary cultured cortical neurons in normal control group presented great density, round size, smooth edge, and high diopter,The suvival rate of neurons and the percentage of LDH releasing were (100. 00±32. 12)% and (100. 00 ± 37. 51 )%, respectively. After exposure to OGD injury, cortical neurons showed karyopyknosis, incomplete cell membranes, low diopters and a significant reduction in optical density of MTT staining. In addition, the suvival rate of neurons and the percentage of LDH releasing were (53. 61±7. 62)% and (166. 07±9. 65)% separately compared with normal control group. In the group with pretreatment of different concentrations of clonidine (1. 0, 3. 0, 10μmol·L-1), morphological changes induced by OGD injury were significantly reversed and optical density of MTT staining was dose-dependently raised. The percentages of survival neurons much higher than that of model control group were [(67. 53±10. 54)%, (71. 50±9. 79)% and (87. 48±5. 29)%, separately] and the obvious reductions of LDH releasing were [(136. 45±25. 72)%, (130. 92±24. 94)%and (121. 63±32. 68)%, respectively]. Conclusion Clonidine can exert neuroprotection against OGD-induced injury in primary cultured cortical neurons in rats.