BACKGROUND:Many diabetic patients get microcirculation disturbance due to abnormal hemorheology In a long-term angiopathy,which finally induces severe complications.OBJECTTVE:TO observe the influence of Yishen decoction on hemorheology in patients with diabetes mellitus and diabetic nephropathy and compare with the healthy controls.DESIGN:Controlled observational experimentSETFING:First Clinical Medical College,Harbin Medical University.PARTICIPANTS:Seventy-six inpatients with diabetes mellitus were enrolled at Department of Integrated Traditional and Westem Medicine,First Clinical Medical College,Harbin Medical University from January 1998 to December 2000 as diabetes mellitus group.Sixty-five inpatients with diabetic nephropathy were selected at the same hospital from January 1994 to February 2001 as diabetic nephropathy group.130 healthy subjects,who did body examination,were selected at the same hospital in 1993 as control group,including 98 males and 32 females,with an average age of(42±12)years.All subjects in the three groups knew the program and agreed to participate in the experimont.METHODS:The patients received conventional treatment combined with Yishen decoction containing herba epimedii,herba leonuri,astragalus mongholicus,each 20 g,barbary wolfberry fruit,solomonseal rhizome,gold theragran,dioscorea root,rhubarb,each 15 g,cowherb seed 25 g,as well as sanguisuge 0.8 g(taken medicine after mixing with water).These Chinese herbs were decocted at a simmer(200 mL),taken in the morning and evening respectively for 4 weeks.2 mL venous blood was collected from fasting subjects in the case groups.Hemorheology was measured before and after treatment in the case groups,whereas in body examination in the control group MAIN OUTCOME MEASURES:Hemorheological indexes.RESULTS:A total of 76 subjects with diabetes mellitus,65 subjects with diabetic nephropathy and 130 healthy subjects were involved in the result analysis.①Whole blood viscosity,plasma viscosity and plasma fibrinogen levels were obviouslv higher in the subjects of the diabetes mellitus group compared with the control group before treatment(P＜0.05-0.01). These changes were more significant in subjects of the diabetic nephropathy group(P＜0.01).Hematocrit and erythrocyte sedimentation equation K value were obviously higher in the diabetic nephropathy group than the control group(P＜0.01)Whole blood viscosity level,hematocrit and erythrocyte sedimentation equation K value were markedly hiaher in the diabetic nephropathy group than the diabetes mellitus group before treatment(P＜0 05-0.01). ②Whole blood viscosity and plasma viscosity levels,hematocrit and erythrocyte sedimentation equation K value were remarkably decreased in the case groups and most recovered to normal(P＞0.05).CONCLUSION: Yishen decoction can ameliorate the hemorheology of diabetes mellitus and diabetic nephropathy patients.

OBJECTIVE:To approach the information of stem cell transplantation in treating myocardial infarction.DATA SOURCES: An online search of Medline database was undertaken to identify articles about stem cell transplantation in treating myocardial infarction published in English from January 1980 to December 2005 using the keywords of "stem cells, myocerdial infarction, cell transplantation".STUDY SELECTION: The literatures were checked primarily, and articles about the stem cell transplantation in treating myocardial infarction were selected, and the repetitive studies and reviews were excluded.DATA EXTRACTION: Totally 106 relevant articles were collected, finally 30 of them were involved and the other 76 were excluded.DATA SYNTHESIS: Myocardial infarction occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The transplantation of exogenous cells into damaged myocardium, a procedure known as cellular cardiomyoplasty (CCM), can be used to ameliorate the remodeling process by the regeneration of cardiomyocytes and replenishment of the vascular supply. Advances in stem cell therapy now provide wide cell sources for the treatment of cardiovascular disease by CCM such as skeletal myoblasts (satellite cells),embryonic stem cells (ESCs) and bone marrow-derived mesenchymal stem cells (MSCs). Although there are many problems to be resolved, recent in vitro and in vivo animal studies as well as clinical trials have suggested the promising potential of the transplantation of stem cells for the treatment of myocardial infarction.CONCLUSION:Stem cell transplantation acts as a more potential treatment measure for myocardial infarction. There are still some fundamental issues to be addressed for the clinical application in future.

OBJECTIVE: To investigate theresearch condition of mechanism of cardiomyocytes differentiation from embryonic stem (ES) cells and the application potency of ES cells at home and abroad.DATA SOURCES: We searched in Medline database from 1997 to 2005 with the key words of "embryonic stem cell,cardiomyocyte/cardiac myocyte,differentiation" in English.STUDY SELECTION: The retrieved data were selected primarily. Inclusive criterion: articles of differentiation into cardiomyocytes from ES cells.Exclusive criterion: the articles of repetitive research were excluded.DATA EXTRACTION: Totally more than 200 articles were researched,and 26 were included.DATA SYNTHESIS: Some articles of differentiation of ES cells into cardiomyocytes from the construction of primarily experimental methods of cardiomyocytes differentiation from ES cells to electrophysiologic study of ES cells-derived cardiomyocytes in monoplast level were collected. Furthermore, many investigators studied the expression of transcription factors that controlled cardio development in the differentiation of ES cells to cardiomyocytes from the angle of transcription factors. Cardiac transcription factors GATA4, MEF2C and NKx2.5 had been reported to control a cardiac gene program and thus to play a crucial role in transcriptional regulation during cardiogenesis. Meanwhile, calcineurin, MAPKs and other signaling pathways were also involved in the adjustment of cardiomyocyte differentiation. In addition, the purity of differentiated ES-derived cardiomyocyte cultures for myocardial infarction was a key issue.CONCLUSION: When ES cells are cultured within Ebs and in the absence of leukemia inhibitory factor (LIF), some of them can differentiate into cardiomyocytes. ES-derived cardiomyocytes express characteristic contractile proteins, such as MHC and myosin light chain (MLC)-2V. Transcription factors, including GATA4, MEF2C and NKx2.5, play a crucial role in the cardioblast differentiation and trigger the expression of specific genes such as α-actin, MHC and MLC2V. However, t he molecular mechanisms of cardiomyocyte differentiation from ES cells remain largely unexplored. The identification of factors that can promote cardiac differentiation is fundament in order to study cardiac differentiation.

Objective To comparatively investigate the effect of local cryotherapy pretreatment of tourniquet position on postoperative pain and short-term function recovery during total knee arthroplasty (TKA).Methods Thirty-one patients (38 knees) who received total knee arthroplasty for the first time from July 2012 to December 2012 were allocated to two groups according to the random number table:17 patients (22 knees) in experimental group received local cryotherapy pretreatment on the position of the tourniquet,while 14 patients (16 knees) in control group did not.Duration of tourniquet use in operation,postoperative swelling of limbs,visual analogue score (VAS) for tourniquet pain,postoperative function recovery,and perioperative complications were compared between the two groups.Results All patients were available to the follow-up.There were no significant differences between the two groups regarding the duration of tourniquet use,postoperative swelling of limbs,and perioperative complications.Lower VAS was observed in experimental group compared with control group at days 1 and 2 postoperatively.Time to meet the standard of short-term function recovery in experimental group was significantly shorter than that in control group[(5.3±1.5)daysvs(7.1±1.3)days,t=-3.77,P＜0.01].Conclusion During TKA,local cryotherapy pretreatment of the tourniquet position can improve local soft tissue' s tolerance to ischemia and anoxia,alleviate local inflammation and ischemia-reperfusion injury,ease tourniquet pain in early period after operation,accelerate short-term function recovery and improve patients' satisfaction.

Objective To observe the change and clinical significance of the heart type fatty acid binding protein (H-FABP) in ST Segment Elevation Myocardial Infarction (STEMI) after percutaneous coronary intervention (PCI).Methods Of 178 STEMI patients were recruited and were separated as ST segment drop group (137) and ST segment non-drop group (41).All the patients received H-FABP and cTnI tests,and re-tested H-FABP on 1 h,6 h,12 h and 24 h after the PCI,and re-tested cTnI on 12 h and 24 h after the PCI.Also,the ST segment drop amplitude (ΣSTR) was measured 2 h after the PCI.Results The demographics of both groups were similar.In both groups,the H-FABP on 6 h after PCI was significantly higher than the value measured prior to PCI.In the ST segment drop group,the H-FABP was reduced to normal value on 24 h after PCI,while it was not in the ST segment non-drop group.Conclusions The H-FABP elevation is associated with the severity of coronary lesions in ST segment elevation myocardial infarction,and the PCI may be involved in the H-FABP changes.ΣSTR≥50％ and normal HFABP may be used as index for judgment of myocardial injury and myocardial reperfusion.

The acurate diagnosis of invasive fungal infection(IFI)is the key point for the treatment and proginosis for IFI patients.Pathological diagnosis is still considered as the gold standard for the IFI diagnosis although difficult.The regular procedures for IFI diagnosis including culture and direct examintion are often low yeilding,the discrimination for contamination and infection is hard.Imaging manifestations are nonspecific but have important suggestive values.The detection for molds antigen content is useful,but its sensitivity and specifity need to be improved.The proper diagnosis for IFI relys on the combination of clinical characteristic,imaging manifestion and serial observation.

AIM:To observe and analyze visual quality changes of the patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection, including the change of the best corrected vision acuity ( BCVA ) , total high- order aberration ( tHOA ) , and the modulation transfer function ( MTF) .
METHODS:In this prospective observational study, 100 cases of patients ( 100 eyes ) with posterior cataract underwent Nd:YAG laser posterior capsular dissection ( posterior capsular diameter dissected was 5mm or higher). The mean age was 65. 52±7. 01 years old. The change of the BCVA was collected. The tHOA and MTF under the 3mm and 5mm pupil diameter were assessed by iTrace respectively before and after Nd:YAG laser posterior capsular dissection.
RESULTS:All the surgery went well without obvious intraoperative and postoperative complications happened. The preoperative BCVA was 0. 451 ± 0. 023 while the postoperative BCVA was 0. 763±0. 025. The difference of BCVA before and after Nd: YAG laser surgery was statistically significant (P<0. 01). At 3mm pupil diameter, the tHOA preoperative was 0. 551 ± 0. 031 while the postoperative tHOA was 0. 214± 0. 011, the differences were significance (P<0. 05). At 3mm pupil diameter while the spatial frequencies ( 5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd ) respectively, the MTF tHOA value postoperative (0. 644±0. 023, 0. 49±0. 011, 0. 311±0. 015, 0.202±0. 018, 0. 056±0. 027, 0. 041±0. 011) were significantly higher than that preoperative (0. 401±0. 021, 0. 261±0. 026, 0. 179±0. 012, 0. 108±0. 014, 0. 031±0. 016, 0. 022±0. 021), and the difference has statistical significance (P<0. 05). At 5mm pupil diameter, the tHOA preoperative was 0. 752±0.028 while the postoperative tHOA was 0. 361±0. 014, the differences were significance (P<0. 01). At 5mm pupil diameter while the spatial frequencies ( 5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd) respectively the MTF tHOA value postoperative (0. 426±0. 027, 0. 209±0. 018, 0. 172±0. 013, 0. 116±0. 015, 0. 049±0. 010, 0. 034±0. 014 ) were significantly higher than that preoperative (0. 234±0. 021, 0. 102±0. 019, 0. 088±0. 016, 0. 058±0. 022, 0. 021±0. 014, 0.016 ± 0. 011 ), and the difference had statistical significance (P<0. 05).
CONCLUSION: Patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection can help improve BCVA, reduce tHOA, increase MTF tHOA values, and significantly improve visual quality of patients.

Transcranial magnetic stimulation (TMS) is a non-invasive technique that can activate cortical motor areas and the corticospinal tract without causing the subject discomfort. Since TMS was introduced, numerous applications of this technique have been developed for the evaluation of neurologic diseases. They allow the evaluation of cortex excitability and motor conduction in the central nervous system and have been proved useful in monitoring motor abnormalities and the recovery of motor function. TMS also gives informations on the pathophysiology of the processes underlying the various clinical conditions and contribute to investigate the mechanisms of diseases. In addition, therapeutic use in depression, Parkinson's disease, epilepsy, spinal cord injury and stroke has raised great interest over the past decade. Theapplication of TMS has great potential both as an investigational and as a therapeutical tool in neurology and psychiatry. However, as an infant techniology, there should be further investigation and large randomized trials to be conducted.

ObjectiveTo investigate the clinical eflicacy of magnesium sulfate combined with nifedipine in treatment of pregnancy-induced hypertension.MethodsOne hundred and fifty pregnancyinduced hypertension patients were divided into two groups by random digits table with 75 cases each.The observation group was treated with magnesium sulfate combined with nifedipine.The control group was treated with magnesium sulfate.Then the blood pressure before and after treatment and the pregnancy outcome were observed.ResultsThe systolic blood pressure,diastolic blood pressure after treatment in observation group were lower than those in control group [ (133.2 ± 7.9) mm Hg (1 mm Hg =0.133 kPa) vs.(142.5 ± 8.0)mm Hg,(80.6 ± 6.1 ) mm Hg vs. (86.6 ± 6.1 )mm Hg],and there were significant differences between two groups (P ＜ 0.05).The spontaneous labor rate in observation group was higher than that in control group [ 65.3％ (49/75) vs.41.3％ (31/75 )],and there was significant difference between two groups (P ＜ 0.05 ).The incidence of placental abruption,hypoproteinemia,postpartum hemorrhage,fetal growth retardation,fetal distress,premature delivery,asphyxia neonatorum,perinatal mortality in observation group were lower than those in control group [ 1.3％(1/75) vs.12.0％(9/75),13.3％(10/75) vs.33.3％(25/75),8.0％(6/75)vs.16.0％(12/75),2.7％(2/75) vs.9.3％(7/75),2.7％(2/75) vs.10.7％(8/75),2.7％(2/75) vs.17.3％(13/75),1.3％ (1/75) vs.5.3％ (4/75),0 vs.5.3％ (4/75)],and there were significant differences between two groups(P ＜0.05). Conclusion Magnesium sulfate combined with nifedipine in treatment of pregnancy-induced hypertension can effectively reduce the adverse pregnancy outcome,and reduce the asphyxia neonatorum rate and caesarean section rate.

ObjectiveTo observe the clinical effect of methotrexate combined with mifepristone in the treatment of unruptured ectopic pregnancy.Methods96 cases of unruptured ectopic pregnancy patients were randomly classified into two groups,observation group with 48 cases was treated with methotrexate combined with mifepristone and control group with 48 cases was only treated with methotrexate.The treatment effect and adverse reaction between two groups were compared.ResultsThe time of blood β-HCG recovery to normal and hospitalization time in observation group were significantly shorter than those in control group( P ＜ 0.05 ),and mass diameter was significantly smaller than that in control group( P ＜ 0.05 ).The adverse reaction incidence in observation group was 10.4％ ( 5/48 )while 6.3％ (3/48) in control group.ConclusionMethotrexate combined with mifepristone in the treatment of unruptured ectopic pregnancy could enhance clinical effect,shorten treatment time,decrease adverse reaction,which could be applied in clinic.