OBJECTIVE:To evaluate the curative efficacy of Chinese medicine vs. western medicine in the treatment of diabetes. METHODS:The randomized controlled trials(RCTs) comparing western medicine with traditional Chinese medicine alone or combination of Chinese medicine and western medicine in the treatment of diabetes were systematically evaluated. Meta-analysis of the cited trials was performed by evidence-based medicine method with Revman 4.2 software for statistical analysis. RESULTS:A total of 14 RCTs met our inclusion criteria. Meta-analysis showed that there was no significant difference between traditional Chinese medicine and western medicine in clinical efficacy in the treatment of diabetes; however,the diabetic patients treated with integrated Chinese medicine and western medicine showed much better efficacy than those treated with western medicine alone. CONCLUSION:Treatment of diabetes with traditional Chinese medicine plus western medicine has more advantages; however,this conclusion remains to be confirmed further by studies of high quality given the low quality in test methodology.

Acyl Coenzyme A Oxidase(ACO) is the rate-limiting enzyme of the ?-oxidation of dicarboxylic acid in Candida tropicalis . Using strains with low Acyl Coenzyme A Oxidase activity to produce dicarboxylic acid on an industrial scale will facilitates the improvement of the yield and purity of dicarboxylic acid. In this research, we improved the method of Allain, so as to determine the activity of Acyl Coenzyme A Oxidase from Candida tropicalis easily and correctly. This method can be used as quantity criterion in the screen of industrial strains of dicarboxylic acid production, and this work established the basic of character study of Acyl Coenzyme A Oxidase. We determined the activities of Acyl Coenzyme A Oxidase from a series of Candida tropicalis strains with different ability of dicarboxylic acid production, and found the obvious relationship of ACO activity and ability of acid production.

Objective To investigate the clinical value of MRI in the preoperative evaluation of breast cancer compared with mammography and ultrasonography. Methods A total of 35 patients with breast cancer were examined preoperatively with dynamic contrast enhanced MRI, mammography and ultrasonography. The findings were evaluated and compared with surgical biopsy. Results The detection rates of breast cancer with MRI, mammography and ultrasonography was 100%, 74.29% and 82.86%, respectively. MRI, mammographic and ultrasonographic measurement of tumor size had correlation coefficient to pathologic findings (r=0.94, 0.87, 0.70, respectively). The sensitivity, specificity, and accuracy of detection of intraductal spread of MRI, mammography and ultrasonography was 100%, 80.00% and 88.57% (P＜0.05), 66.67%, 95.00% and 82.86% (P＞0.05), 33.33%, 95.00% and 68.57% (P＞0.05), respectively. Conclusion MRI can detect breast cancer, especially intraductal spread more sensitively than mammography and ultrasonography.

AlM:To discuss the clinical effect and safety of the combined surgeries of phacoemulsification and goniosynechialysis for patients with primary angle -closure glaucoma ( PACG) .METHODS:Eighty-three eyes of 83 patients with PACG and cataract were ranomized into two groups. Group A:39 patients with 39 eyes of angle-closure <180.;Group B:44 patients with 44 eyes angle - closure ≥180.. The changes of visual acuity, anterior chamber depth ( ACD) , anterior chamber angle and lOP after operation were measured. The follow-up period was for 1a.RESULTS: The visual acuity was improved significantly in both group after operation. No significantly difference in ACD, anterior chamber angle after operation in two groups (P>0. 05). The lOP in group A was lower than that in group B 3mo after operation, there was statistical significance (P<0. 05).CONCLUSlON:Phacoemulsification and goniosynechialysis can deepen ACD significantly. This method make the anterior chamber angle open, can reduce lOP and improve the patients’ visual acuity, especially in patients with PACG. lt is a safe and effective approach to patients with PACG and cataract.

OBJECTIVE:To probe into the tendency and influencing factors of the drug expenses of the inpatients in our hospital.METHODS:The total drug expense,the antibiotic expense and its proportion in the total of the inpatients in our hospital were analyzed statistically in this retrospective study.RESULTS:During 2003～2007,the average daily total drug expense per inpatient was 371.77 yuan with average annual growth rate of 11.94%;the average daily antibiotics cost per inpatient was 110.35 yuan with average annual growth rate of 11.92%.Both the drug expense and antibiotic expense were correlated positively with the consumer price index (CPI).And the proportion of antibiotic expense in the total drug cost remained stable at about 29.68%.CONCLUSION:The average daily drug cost and antibiotic expenses per inpatient between 2003 and 2007 fluctuated yet with upward trend on the whole,and the proportion of antibiotic expense in the total drug cost remained stable.

Objective T_O analyze the electrophysiological features of shoulder-hand syndrome(SHS)fol- lowing stroke and investigate the relationships between peripheral nerve damage and the factors causing SHS.Meth- ods Fifty-eight stroke patients were divided into an SHS group(39 patients with shoulder-hand syndrome)and a model group(19 patients without shoulder-hand syndrome).Standard sensory and motor nerve conduction studies were performed with 58 of the patients,including sensory nerve conduction velocity(SCV),amplitude of the sensory nerve action potential(SNAP),distal motor latency(DMI)and the amplitude of the compound muscle action poten- tial(CMAP)of the median nerve.A needle electromyogram(EMG)test was performed on the abductor pollicis of the affected side with both groups.Results The needle EMG showed abnormal insertion potential,fibrillation po- tential and positive sharp waves in all 39 cases of the SHS group,which was significantly higher than in the model group.The amplitude of the sensory nerve action potential(7.77?4.34 mV)and the amplitude of the compound muscle action potential(10.13?3.15 mV)were significantly lower than those of the model group.Abnormal ampli- tude was more severe in sensory nerves than in motor nerves.Conclusion Peripheral nerve damage was found in the shoulder-hand syndrome patients,and this damage was mainly the dystrophy of axonal neuropathy.The damage severity was more in sensory nerves than in motor nerves.The study could offer an useful clue of prevention and treat- ment of shoulder-hand syndrome.

Aim To investigate the effects of co-administration of L-Arginine (L-Arg) and aspirin (ASA) on platelet aggregation in vitro and gastric damage in vivo. Methods Citrate anti-coagulation venous blood was obtained from rabbits. The blood was centrifuged at 1 100 r?min-1 for 10 min to obtain platelet-rich plasma (PRP). 500 ?l of PRP was poured into a cuvette, and then incubated with various concentrations of L-Arg and a small dose of ASA for 5 min. Platelet aggregation was assayed with Chrono-Log platelet aggregometer by changes in light transmission of platelet suspensions. After co-administration of L-Arg and ASA for 7days to rats, gastric damages were induced by water immersion restraint stress or reserpine. Results Co-administrateion of L-Arg and a small dose of ASA strengthened the inhibitory effects on platelet aggregation. Platelet aggregation rate was 6.6% using 3 mmol?L-1 of L-Arg and small dose of ASA. Platelet aggregation rate was 93.9% using the same concentration of L-Arg alone. 1 g?kg-1 of L-Arg and 0.1 g?kg-1ofASA co-administration for 7 days,significantly reduced gastric damage induced by water immersion restraint stress on Wistar rat. Similar results were observed on other animal experiments with gastric lesions induced by reserpine. The effects of L-Arg on prevention of gastric lesion were almost same as that of famotidine. Conclusion Co-administration of L-Arg and ASA can enhance the inhibitory effects on platelet aggregation and prevent gastric damage.

Objective To explore the value of diffusion weighted imaging(DWI) in the diagnosis of invasive ductal carcinoma not otherwise specified and find a suitable diagnostic cutoff ADC value.Methods The MRI findings of 69 patients (69 lesions) of invasive ductal carcinoma not otherwise specified and 67 patients benign tumors (69 lesions) confirmed by pathology were evaluated.ADC values of the carcinoma,benign tumors and their contralateral normal breast tissues were obtained.Independent-samples t test and ROC curves were used.Results The ADC values of carcinoma and contralateral normal breast tissues were (0.925 ± 0.268) × 10-3 mm2/s and (1.680 ± 0.446) × 10-3 mm2/s respectively,their difference had statistical significance (t =12.08,P ＜ 0.01) ; The ADC values of benign tumor and contralateral normal breast tissues were (1.350 ± 0.383) × 10-3 mm2/s and (1.690± 0.356) × 10-3 mm2/s respectively,the difference had statistical significance (t =6.64,P ＜ 0.01); The difference between carcinoma and benign tumors had statistical significance as well (t =7.56,P ＜ 0.01).The area under the ROC curve of carcinoma and contralateral normal breast tissues,benign tumors and contralateral normal breast tissues,carcinoma and benign tumors were 0.915,0.794,0.847 respectively.The diagnostic cutoff value for each were 1.185 × 10-3 mm2/s,1.505 × 10-3 mm2/s,1.015 × 10-3 mm2/s respectively;Corresponding sensitivity and specificity were 89.9％ and 85.5％,79.7％ and 63.5％,75.4％ and 87.0％respectively.Conclusions MR-DWI is valuable in the diagnosis of invasive ductal carcinoma not otherwise specified.The best ADC diagnostic cutoff value to differentiate invasive ductal carcinoma not otherwise specified from benign tumors is 1.015 × 10-3mm2/s.

Objective To retrospectively compare CT and MR features of hepatocellular adenoma with pathologic findings.Methods Twelve patients with histopathologically proved hepatocellular adenoma were classified on the basis of pathologic and genotype phenotype findings into four groups:steatotic type,cytological abnormality type,telangiectatic adenoma with inflammatory infiltrates type and atypical adenoma type.The CT and MR features of each type were reviewed retrospectively compared with the pathological results.Results In this retrospective study,12 patients were examined with CT (8 patients) and MR (8 patients).Among 12 patients,4 patients showed a steatotic type.One patient showed hypo-density on the non-enhanced CT and 3 patients demonstrated hypo-density on all phases of the post-contrast scans.Two lesions showed iso-intense signal on the in-phase T1 WI with signal dropout on the out-of-phase T1WI,and hypo-intense signal on the T2 WI with fat suppression sequences.One lesion demonstrated moderate hypointense signal on all phases of the post-contrast MRI scans.Two patients with the telangiectatic adenoma irflammatory infiltrates type were found.One patient showed hypo-density on the non-enhanced CT scans and hyper-density on all phases of the post-contrast CT scans.One patient demonstrated iso-intense signal and the other hypo-intense signal on the T1 WI,and both displayed moderate hyper-intense signal on the T2WI with fat suppression sequences and hyper-intense signal with gradual enhancement on all phases of post-contrast MR scans.There were 3 patients with a cytological abnormality type.One patient appeared hypodensity and 1 patient showed uniform iso-density on non-enhanced CT scans.All patients who had undergone contrast-enhanced CT scans were found to have hyper-density on the hepatic arterial-dominant phase and became slightly lower on the portal venous phase.On the delay phase the density reduced further.One mass showed iso-intense signal on the T1WI and hyper-intense signal on the T2WI with fat suppression sequences.There were 3 patients with an atypical adenoma type.One patient appeared uniform hypo-density on the nonenhanced CT and hyper-density on the hepatic arterial-dominant phase and became iso-dense on the portal venous phase.On the delay phase,it was slightly hyper-dense.Two out of the three lesions showed isointense and one hypo-intense signal on the in-phase T1 WI,and hypo-intense,hyper-intense,and iso-intense signal on the T2WI with fat suppression sequences,respectively.Two patients examined on all phases of post-contrast MRI scans.The result was similar to the CT findings.Conclusion The imaging features of hepatocellular adenoma are closely associated with pathological characteristics.