Diabetic nephropathy ( DN) is one of the complications of diabetes, which is closely related to the pathogenesis of in-flammation. This article summarized the relevant literatures on the correlation between MCP-1 , TNF-α and DN, and the intervention of traditional Chinese medicine with DN. In kidney tissues, oxidative stress and NF-κB-dependent signal pathways induced the increase of monocyte chemoattractant protein-1 (MCP-1) expression, which could induce macrophage accumulation, proteinuria increase, renal fibrosis and renal clearance capacity decrease, and further leading to kidney damage. The clinical and experimental trails showed tumor necrosis factorαmRNA and protein levels in serum, urine and renal tissues were closely related with DN, which could be used as a bio marker to provide clinical guidance. As the therapeutic targets,MCP-1 and TNF-αcould give a novel insight into the clinical treatment of DN. Some traditional Chinese medicines or monomer could ameliorate DN by inhibiting MCP-1 and/or TNF-α. Thus, further verifi-cation or clinical application of those traditional Chinese medicines is worth trying.

Objective To evaluate the clinical efficacy and safety of modified anti -tuberculosis scheme in the treatment of tuberculous meningitis.Methods 60 cases with tuberculous meningitis were randomly divided into two groups.We enrolled 30 patients in each group.The traditional anti -tuberculosis group used traditional anti -tuberculosis scheme with isoniazid,rifampicin,pyrazinamide,streptomycin,and the modified anti -tuberculosis group was given isoniazid,rifampicin,pyrazinamide,levofloxacin,the treatment course of tuberculous meningitis was 12 months.The efficacy and safety through clinical manifestations and laboratory examinations,the dynamic changes of cerebrospinal fluid were evaluated by statistical methods.Results The total effective rate of the modified anti -tuberculosis group was significantly higher than the traditional anti -tuberculosis group(86.6% vs.63.3%,χ2 =4.36,P <0.05).The cerebrospinal fluid routine and biochemical index in the modified anti -tuberculosis group were obviously superior to the traditional anti -tuberculosis group after treatment(all P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups(26.6% vs.16.7%,χ2 =0.88,P >0.05).Conclusion Levofloxacin combined with other first -line anti -tuberculosis drugs,glucocorticoids,dehydration and other comprehensive measures improved brain function for the treatment of tuberculous meningitis is recommended.

Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

With the increment of the workload,high stability is required by hospital information system.When the amount of client exceeds the limit,we must reconstruct the Oracle server in order to meet the needs of workload increment.This article describes the principle of shared server and the reconstructed method from dedicated server to multithreaded server.

Objective:To investigate the therapeutic effect of tannins from pomegranate rind on passive Heymann nephritis ( PHN) in rats. Methods:Rabbits were with intradermal immunization for many times to obtain anti-Fx1A serum, and then PHN model in rats was established by tail intravenous injection of anti-Fx1A serum. The experimental rats were randomly divided into six groups, the nor-mal control group, model group, benazepril group, and tannins from pomegranate rind group respectively at high, medium and low dose. After the success of modeling, each rat was received intragastric administration for five weeks, and then the total of urine was collected once a week for the detection of 24-hour urine protein. At the end of treatment, serum was collected for the detection of serum albumin, blood urea nitrogen, creatinine, total cholesterol and triglyceride. The pathological changes of the renal tissue were observed using hematoxylin-eosin and Masson staining to observe the effect of tannins from pomegranate rind on PHN rats. Results:After the in-tragastric administration for five weeks, tannins from pomegranate rind could obviously reduce the level of 24-hour urine protein in PHN rats(P<0. 01), significantly reduce the levels of serum creatinine (P<0. 01), urea nitrogen (P<0. 01,P<0. 01,P<0. 05), total cholesterol (P<0. 01) and triglyceride (P<0. 01,P<0. 01,P<0. 05) in PHN rats, and increase the level of serum albumin (P<0. 01,P<0. 05,P>0. 05). HE and Masson staining results indicated that tannins from pomegranate rind could improve the pathologi-cal damage in PHN rats. Conclusion:Tannins from pomegranate rind has notable improvement for PHN in rats.

Objective; To explore mechanism of Zhongjiling tablet treats experimental autoimmune myasthenia gravis on rats. Methods:Normal mice, immunosuppressive mice and EAMG rats were used to investigate the mechanism. Results:Zhongjiling tablet enhanced T and B cells proliferation of normal mice and immunosuppressive mice induced by ConA or LPS, and increased the production of IL-2. T cell proliferation of EAMG rats was improvement stimulated by AChR and decline by ConA. Zhongjiling tablet inhibited the improvement by AChR and enhanced the decline by ConA, and reduced the expression of IFN-? and IL-4 mRNA. Zhongjiling tablet also induced the apoptosis of CD4 + T lymphocyte stimulated by AChR. Conclusion: Zhongjiling tablet increased immunity of normal mice, immunosuppressive mice and EAMG rats. But it suppressed specific T lymphocyte proliferation induced by AChR and reduced the expression of IFN-? and IL-4 mRNA. It was probably one of mechanisms Zhongjiling tablet induced the apoptosis AChR specific CD4+T lymphocyte.

Arsenic ; urine ; Chromatography, High Pressure Liquid ; methods ; Formamides ; analysis ; Humans ; Urinalysis ; methods

Objective To investigate the changes of intestinal blood flow and motility and their effects on intestinal mucosa barrier in rats with acute cerebral ischemia. Methods 64 male Wistar rats were assigned randomly into cerebral ischemia group (n=32) and control group (n=32).The two groups were divided into four subgroups according to timepoints of 6 h,12 h,24 h and 48 h after operation (8 rats for each subgroup).The intestinal mucosa blood flow,intestinal transmit index and endotoxin level in porlal vein were detected.The displacement ratio of E.coli was marked and counted with fluorescent microscope in tissue homogenate from organs. Results The intestinal blood flow in cerebral ischemia group at 6 h,12 h,24 h and 48 h after operation [(34.5±3.2)PU,(22.7±1.9)PU,(26.2±4.3) PU and (30.5± 4.1) PU] were significantly lower than control group[(46.8 ±5.4) PU,(50.1±3.6) PU,(45.4±4.1) PU and (48.7±7.3) PU] (t=2.650,2.875,2.639 and 2.507,all P＜0.05).The intestinal transmit index in cerebral ischemia group at 6 h,12 h,24 h and 48h after operation[(0.59±0.07),(0.48±0.06),(0.50±0.08)and (0.57±0.04)] were decreaesd as compared with control group [(0.73±0.04),(0.75=0.02),(0.74±0.06) and (0.76±0.03)] (t=2.409,2.758,2.649 and 2.807,all P＜0.05). The levels of endotoxin in cerebral ischemia group started to increase at 6 h and arrived to peak at 24 h,and the levels at four timepoints were (0.382 ± 0.014) Eu/ml, (0.466 ± 0.018) Eu/ml,(0.478 ± 0.029) Eu/ml and (0.412±0.036)Eu/ml,respectively,that were higher than those in control group[(0.102±0.007)Eu/ml,(0.114±0.021)Eu/ml,(0.112±0.018)Eu/ml and (0.108±0.011)Eu/ml] (all P＜0.05).The total E.coli detection rates in multiple organs in cerebral ischemia group (11.4％,18.8 ％,25.0％and 12.5％) were higher than in control group (2.1％,4.2％,2.1％ and 0.0％) at four rime points (all P＜0.05). The level of endotoxin was negatively related with the intestinal blood flow and intestinal transmit index( r =- 0.861 and - 0.796,both P＜ 0.05). Conclusions The higher intestinal mucosa blood flow and intestinal motility play important roles in the increase of intestinal mucosa permeability at early stage after acute cerebral ischemia.

Objective To explore the effective method of the prevention and cure of unstable bladder after transurethral resection of prostate(TURP).Methods Ninety patients with benign prostatic hyperplasia(BPH)undergoing TURP under epidural anesthesia were randomly divided into 3 groups(with 30 patients in each group):treatment group,control group I and control group II.Tolterodine combined with diciofenac sodium/lidecaine hydrechloride injection were used after operation in treatment group.Control group I was only given tolterodine,and control group II was only given diclofenac sodium/lidocaine hydrochloride injection.Observed the incidence times and continuous time of unstable bladder after operation in three groups.Results Three cases(10.0%)happened to unstable bladder in treatment group and they were I degree,14 cases(46.7%)happened to unstable bladder in control group I,8 cases were I degree,5 cases were II degree,1 case was III degree;16 cases(53.3%)happened to unstable bladder in control group II,8 cases were I degree,6 cases were II degree,1 case was III degree,1 case was IV degree.There was obvious significance either between treatment group and control group I(P = 0.003)or between treatment group and control group II(P = 0.001).Conclusion Tolterodine combined with diclofenac sodium/ lidocaine hydrochloride injection have obvious effect on preventing the incidence of unstable bladder after TURP,it is easy to perform and can be used widely.

BACKGROUND: In subjects with different inflammatory and autoimmune diseases, soluble vascular cell adhesion molecule-1 (sVCAM-1) in sera increases, and its change may become an important monitoring index of immunological function, but its change rule has been unclear in acute cerebral infarction.OBJECTIVE: To observe the change of sVCAM-1 in sera of subjects with cerebral infarction and its clinical significance, and compare between the subjects with cerebral hemorrhage and normal population.DESIGN: A case controlled analysis.SETTING: Second Department of Brain, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: A total of 132 inpatients were selected from Second Department of Brain, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between May 2002 and April 2004. Among them, 89 subjects with cerebral infarction were classified into large infarction group (n=25,＞ 10 cm3), medium infarction group (n=31,4-10 cm3) and small infarction group (n=33, ＜ 4 cm3) respectively according to the size of infarct focus. There were 43 subjects in cerebral hemorrhage group, and 30 healthy persons were as normal control group.METHODS: Blood samples were isolated from subjects with cerebral infarction at hour 24, days 3, 7 and 14 after onset of the disease, while the blood samples were extracted from subjects with cerebral hemorrhage at hour24 and day 14 after the onset of the disease. 4 mL venous blood was obtained from the three groups. The serum concentration of sVCAM-1 was determined with double antibody sandwich method (DASM) in all the examinees.MAIN OUTCOME MEASURES: ①Dynamic change of the serum concentration of sVCAM-1 in the course of acute cerebral infarction, and compared with the other two groups. ②Comparison of the serum concentration of sVCAM-1 in different size of infarct focus. ③Change of the serum concentration of sVCAM-1 in acute cerebral infarction subjects complicated with infection.RESULTS: A total of 162 subjects were involved in the result analysis. ①The serum concentration of sVCAM-1 at the 24th hour after cerebral infarction was significantly higher in subjects with cerebral infarction than in subjects with cerebral hemorrhage group and normal control group [(1 184.5±68.3) ,(693.9±41.7), (576.1±39.8) μg/L,P＜0.01].Serum sVCAM-1 in the cerebral infarction subjects increased from the 24th hour to the 7th day after infarction gradually, while from the 7th day to the 14th day decreased gradually. However, the serum sVCAM-1 in the cerebral infarction subjects at day 14 was still markedly higher than that in the cerebral hemorrhage group and the normal control group (P ＜ 0.01 ). ②The serum concentration of sVCAM-1 was significantly higher in the large cerebral infarction group as compared with medium and small cerebral infarction groups [(1 217.4±59.3) ,(1 132.6±51.9) ,(983.7±54.2) μg/L,P ＜ 0.01]. ③The serum concentration of sVCAM-1 was significantly higher at days 3, 7and 14 in cerebral infarction subjects complicated with infection than in subjects without infection (P ＜ 0.01 ).CONCLUSION: The sVCAM-1 participates pathological change process of cerebral infarction, which can be regarded as monitoring index of cerebral infarction change. To block its production and expression can provide a new approach for improving the prognosis of cerebral infarction.