Objective To evaluate two regimes of transient intensive insulin therapy in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Methods Sixty-eight newly diagnosed type 2 diabetic patients with fasting plasma glucose(FPG)≥10.0 mmol/L and glycated hemoglobin A1c (HbA1c)≥8.0％were randomized to either cantinuous subcutaneous insulin infusion(CSII)group or multiple daily injection(MDI)group.Glycemic control,daily dose of insulin,body mass index(BMI),the mean area under the insulin curve(AUC),β-cell function(HOMA-β)and insulin resistence(HOMA-IR) were compared before and after treatment.Results There were no significant differences between two groups in days reaching glycemic control and BMI.The maximal insulin dose for glycemic control in CSII group was(0.53±0.06)U·kg-1·d-1 and that in MDI group was(0.71±0.04)U·kg-1·d-1(t= 11.100,P＜0.01).After CSII and MDI treatment,HOMA-β and the mean AUC of insulin were significantly increased(P＜0.01),but there was no significant difference between two groups(P＞0.05).No significant changes in HOMA-IR were observed before and after treatment or between two groups.There were no severe hypoglycemic episodes in two groups and mild hypoglycemic episodes were 0.34％(13/3806)in CSII group and 1.09％(44/4045)in MDI group.Conclusions The excellent glycemic control can be reached by short.terra CSII and MDI treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.Lower insulin dose and less mild hypoglycemic episodes seem to be the advantage of CSII regime than MDI regime.β-cell function can be dramatically improved in both therapy regimes.

Primary intestinal lymphangiectasia is a rare disease, which is characterized by the obstruction of lymphatic return, dilated lymphatics and distorted structure of villi. Lymph fluid leaks into the small bowel lumen as a result of the obstruction of lymphatics and elevated pressure of lymphatics, and leads to malabsorption and loss of proteins. The causes and pathogenesis of PIL are not clear, hut the abnormal immunologic mechanism has got people's attention. Recently, the endoscopic technique has been improved, and the diagnosis rate of PIL has increased obviously. Antisecosis is the basic and effective treatment, especially for children.

Background Heideberg retina tomography Ⅱ(HRTⅡ) can offer the quantitative description of optic disc topography and optic nerve fiber layer thickness.The normal optic disc parameter by HRT Ⅱ from Chinese has been reported,but the comparisons between males and females or the left and right eyes are lack.ObjectiveThe goal of this study is to measure the optic disc topography of healthy people with HRT-Ⅱ.Methods Four hundreds eyes from 108 healthy male subjects and 92 healthy female subjects aged 10-72 years were measured with HRT Ⅱ in this study.The parameters of optic disc including disc area,cup area,rim area,cup/disc area ratio,rim/disc area ratio,cup volume,rim volume,cup depth,maximal cup depth,height variation,mean RNFL thickness,and RNFL cross-sectional area were analyzed and compared between the gender or left and right eyes.Oral informed consent was obtained from all of the subjects before this procedure.Results There were no significant differences in measuring parameters by HRTⅡ between female and male subjects (P＞0.05) or between right eye and left eye (P＞0.05).Conclusion The results can be used as a normal reference of optic disc parameters of HRT Ⅱ.

Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

Objective To study the sensitivity and specificity of oligoclonal bands (OCBs) and intrathecal IgG synthesis rate (IgG Syn) for diagnosis of multiple sclerosis (MS) and the correlation between qualitative and quantitative indices.Methods Albumin and IgG concentrations in the cerebrospinal fluid (CSF) and serum from 30 patients with MS, 40 with other nervous system inflammatory diseases (NID) and 22 with nervous system noninflammatory diseases (NNID) were determined by rate nephelometry method. OCBs in the CSF were detected using isoelectric focusing combined with silver staining, and IgG Syn was calculated. The sensitivity, specificity and positive result likelihood ratio (PRLR) were analyzed.Results There were no significant difference in the abnormal rate of OCBs and IgG Syn between MS group and NID group. When MS and NID groups were compared with NNID group, the difference was extremely significant (all P

Objective:To optimize the ultrasonic-assisted extraction technology of polysaccharide from Tremella by Box-Benhnken response surface methodology .Methods:The single-factor extraction tests and response surface analysis were employed to optimize the technology conditions , including ultrasonic power , ultrasonic time and liquid/solid ratio.Results:The experiment results indicated that the optimal extraction conditions were ultrasonic power of 360 W, ultrasonic time of 23 min and liquid/solid ratio of 45 ∶1 ( ml· g-1 ) . Under the conditions , 6 batches of polysaccharide from Tremella were extracted .The average extraction rate of Tremella polysaccharides was 20.4%±1.8%(n=6).Conclusion: The ultrasonic-assisted extraction process of Tremella polysaccharide using Box-Behnken response surface methodology is simple with good predictability .

Objective TO study the effect of trimetazidine on patients with unstable angina pectoris. Methods The pa-tients with unstable anglna pectoris with routine treatment were divided randomly into trimetazidine group(T) and nitro-glycerin group(N). They were given such treatment two weeks. Results There is decreased incidence of angina pectorisand less amount of nitroglycerin consumption in both groups. compared with before. There was no significant difference be-tween the two groups. Conclusion There are no signficantly. Trimetazidine has a definite effect in treating unstable angi-na pectoris,and it is similar to nitroglycerin in effects.

Objective To study the level of CD4+ CD25+ Foxp3+ regulatory T cells in peripheral blood of non-small-cell lung cancer patients.Methods The ratio of CD4+ CD25+ Foxp3+ T cells inperipheral blood of lung cancer group and control group were determined by flow cytometry.Its clinic significance was analyzed,Results The ratio of CD4+ CD25+ Foxp3+ Treg cells [the ratio of CD4+ CD25+ T and CD4+ CD25+ Foxp3+ T cells were (14.42 ± 1.22) ％ and (5.34 ± 0.45) ％] inperipheral blood was higher in the non-small-cell lung cancer group than in control group [the ratio of CD4+ CD25+T and CD4+ CD25+Foxp3+ T cells were (10.67 ±0.98)％ and (3.98 ±0.68)％] (t =2.431,2.273,all P ＜ 0.05).It was also higher in adenocarcinoma [CD4+ CD25+ T/CD4+ T to (15.05 ± 0.92) ％,CD4+ CD25+ Foxp3+ T/CD4+ T to (5.99 ± 0.38) ％] than squamous carcinoma [CD4+ CD25+ T/CD4+ T to (13.03 ± 1.64) ％,CD4+ CD25+ Foxp3+ T/CD4+ T to (3.91 ± 0.62) ％] (t =2.264,2.109,all P ＜ 0.05),and stage IV higher than stage m (t =2.165,2.058,all P ＜ 0.05).Conclusion The level of CD4+ CD25+ Foxp3+ Treg cells in peripheral blood of non-small cell lung cancer was significantly higher than that of healthy subjects,related with the pathological type and clinical stage.The CD4+ CD25+ Foxp3+ Treg cells may participate in the occurrence and development of non-small cell lung cancer.

Objective:To compare the effects of different anesthesia methods on stress hormones and hemodynamic changes in the patients with gynecological laparoscopic surgery. Methods:Retrospective analysis was carried out. Totally 145 patients with gynecolog-ical laparoscopic surgery were divided into two groups according to the anesthesia method, the control group with 72 cases was given routine remifentanyl propofol intravenous anesthesia, and the observation group with 73 cases was given routine propofol isoflurane com-posite anesthesia. Such hemodynamic indices as SBP, DBP and HR, and plasma NE, E, cort and AT II levels at different time points in the two groups were studied and compared, and adverse drug reactions were also observed in the two groups. Results:The BP and HR at T2 and T3 time point in the two groups were significantly lower than those at T0 time point (P<0. 05), and those in the obser-vation group were lower than those in the control group at the same time point(P<0. 05). The levels of NE, E, cort and ATⅡat T2 and T3 time point in the two groups were significantly higher than those at T0 time point (P<0. 05), while the increase in the observa-tion group was lower than that in the control group (P<0. 05). The incidence of adverse drug reactions (ADR), such as respiratory depression, hypertension, bradycardia and so on, and the total incidence of ADR in the observation group were both lower than those in the control group (P<0. 05). Conclusion:Compared with remifentanyl propofol intravenous anesthesia, propofol isoflurane composite anesthesia can keep the hemodynamic stability more effectively and reduce the stress reaction with fewer ADR and promising safety, which is worthy of wider application in clinics.

Objective: To study the anticancer and antioxidative effect of selenium and survival time in mice with tumor. Methods: According to body weight, the mice with S180 and ECS tumor(half in male and female) were randomly divided into group NS and group selenium. The inhibitory rate?survival time, serum and liver glutathion peroxidase(GSH-Px)?superoxide dismutase(SOD) and malondialdehyde(MDA) were studied. Results: The inhibitory rates on S180 and ECS in group Se were significantly higher than those of the NS group(P