OBJECTIVE: To evaluate whether T-type CCBs are equivalent with or superior to ACEIs/ARBs on renal outcomes in hupertensive patients with chronic kidney disease. METHODS: Cochrane Library, Pubmed, EMbase and CNKI were searched for relevant randomized controlled trials (RCTs) from inception to May 2012. The meta-analysis was performed by Revman 5.1 software. RESULTS: Five RCTs (563 subjects) were included in the present study. T-type CCBs performed a pooled improvement in creatinine clearance and glomerular filtration rate similar to ACEIs/ARBs but were inferior to ACEIs/ARBs on reducing proteinuria excretion (three RCTs, 389 subjects, WMD 0.26 g·d-1, 95% CI 0.10 to 0.43), although T-type CCBs and ACEIs/ARBs showed stable anti-hypertensive effect. CONCLUSION: Our findings suggest that despite T-type CCBs do offer salutary effects on kidney outcomes and hypertension can be applied to treat hypertensive patients with chronic kidney disease, ACEIs /ARBs might be better choice for pressure control in this target population especially when proteinuria is the main issue of renal dysfunction.

Objective To investigate clinicopathological features of abdominal wall endometriosis(AWE).Methods A retrospective study was conducted on 151 consecutive AWE patients undergoing treatment in Affiliated Obstetrics and Gynecology Hospital,Fudan University from January 2003 to December 2010.The period of following up was at range of 16 to 97 months.Results(1)The incidence of AWE was 1.96％(166/8469).All 151 AWE cases followed up had previous cesarean sections.The period between the previous cesarean section(CS)and the onset of symptoms of AWE was 24 months(3-192 months).However,the latency was not associated with the age at CS,incision site,gestational week at CS,duration of lactation,postpartum menstruation recovery,the choice of contraceptives and size of AWE(P ＞ 0.05).The duration of disease,defined to be the time interval between the onset of symptoms and surgery,was 26 months(2-168 months),which was negatively correlated with the latent period(r =-0.267,P ＜ 0.05)and was positively with size of AWE(patients with large-scar endometrioma with diameter of lesions ≥ 3 cm had longer disease duration than those with small-scar endometriomas ＜ 3 cm,r =0.326,P ＜ 0.05).(2)The rate of pre-operational ultrasonography detection was 97.4％(147/151).The lesion size detected by pre-operative ultrasonography was significantly smaller than that measured intraoperatively by palpation (20 mm versus 35 mm,P ＜ 0.05).Moreover,only 26.5％(40/151)of AWE patients were found to have deep infiltration by pre-operative ultrasonography.(3)All patients were managed by surgical treatment to completely excise lesions on the abdominal wall.Of all 34 patients(22.5％,34/151)took medicine preoperatively while 57 patients(37.7％,57/151)taking medicine post-operatively.The rate of recurrence was 3.1％(3/96)of cases with lesions ≥3 cm,which was significantly lower than 17.8％(8/45)in cases with lesion ＜ 3 cm(P ＜ 0.05).(4)After surgery,the symptoms were found to be relieved in 93.4％(141/ 151)of patients.The recurrence rate was 7.8％(11/141)while the average recurrent time was(20 ± 16)months.Conclusion Surgery is the main management on AWE.The risk factors associated with recurrence were size of lesion and postoperative medication.

OBJECTIVE: To explore clinical efficacy of dorsal plate assisted fixation of dorsal lunate fossa fracture block of distal radius. METHODS: From January 2019 to January 2022, 30 patients were treated with dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius, including 13 males and 17 females, aged from 42 to 68 years old with an average of (48.7±5.6) years old;According to Doi fracture classification, 24 patients were type 3 blocks and 6 patients were type 4 blocks. The degree of palmar angle of anterior and posterior distal radius was fixed by dorsal steel plate during operation. Fracture healing and functional recovery of wrist were observed after operation. Functional evaluation was performed by Gartland and Werley scoring system at 12 months after operation. RESULTS: All patients were followed up from 12 to 13 months with an average of (11.3±0.9) months. All fractures healed for 4 to 5 months with an average of(4.7±0.8) months. Median palpal inclination of anterior and posterior distal radius fixed by dorsal plate was 5.30°(4.85°, 6.03°), 12.45°(11.98°, 13.43°) respectively, and had statistical difference( P<0.01). Gartland and Werley scores was (1.1±0.4) at 12 months afteropertaion, and 27 patients got excellent result and 3 good. CONCLUSION Dorsal plate assisted fixation of dorsal lunate fossa fractures is beneficial to reduction and stabilization of displaced dorsal fractures and restoration of palmar inclination.
Female ; Male ; Humans ; Adult ; Middle Aged ; Aged ; Radius/surgery* ; Lunate Bone/surgery* ; Upper Extremity ; Wrist Joint ; Wrist ; Fractures, Bone

ObjectiveTo investigate the association between catechol-O-methyl transferase (COMT)gene polymorphism and Gilles de la Tourette' s syndrome(GTS).MethodsUsing Amplification Refractory Mutation System(ARMS) PCR genotyping assay method,a polymorphism (val158met) of COMT gene was genotyped in 112 of all GTS patients ( total GTS group) including 54 GTS-alone patients group,48 GTS + ADHD patients group among of them and 71 healthy controls.The correlation between positive association of polymorphism (val158met)of COMT gene in GTS and the age of onset in patients with GTS was also analyzed.ResultsCompared with healthy controls group,genotype of val158met did not differ in total GTS patients group or alone-GTS patients group (χ2 =0.56,P=0.756;χ2 =1.05,P=0.600 respectively).There was also no significant difference (P＞0.05)in allele distribution of val158met in total GTS patients group or alone-GTS patients group compared with controls group respectively (χ2 =0.18,P=0.669;χ2 =0.29,P=0.593 respectively).However,genotype distribution of val158met was significantly different between GTS + ADHD patients group and controls group( χ2 =6.35,P =0.041 ).The frequency of the val allele of this locus was significantly higher in GTS + ADHD patients group than those in controls group ( χ2 =5.49,P =0.019 ).The mean age of onset (6.80 ± 1.54 ) in 36 children within GTS + ADHD patients group with the val/val geantype of COMT gene val158met polymorphism was significantly earlier than the mean age of onset (8.04 ± 1.54)in 12 children in val/val genotype (P =0.016 ).ConclusionPolymorphism (val158met) of COMT gene may be associated with GTS children with comorbid ADHD,which may play an important role to make the age of onset in children with GTS become earlier.

OBJECTIVE:To investigate the effects of different elutions of Hyssopus cuspidatus on smooth muscle contraction of isolated tracheal in Guinea pigs. METHODS:Isolated tracheal rings were prepared and soaked in Krebs-Henseleit,using acetyl-choline(ACh,1×10-7 g/mL)or histamine(His,1×10-6 g/mL)to induce contraction of tracheal rings,then the effects of H. cuspi-datus water elution and 30%,50%,60%,70%,95%ethanol elutions with mass concentrations of 0.08,0.16,0.32,0.64,1.28, 2.56 mg/mL on contraction of tracheal rings were respectively investigated. Contraction curves were recorded and antispasmodic rates were calculated. Tests were treated with saline as blank control and aminophylline (0.08 mg/mL) as positive control. RE-SULTS:Compared with blank control,0.16-2.56 mg/mL 30%,50% ethanol elution,0.32-2.56 mg/mL 60% ethanol elution and 0.64-2.56 mg/mL 70%,95% ethanol elution can obviously inhibit ACh-induced contraction of tracheal rings,antispasmodic rates were obviously increased(P<0.05 or P<0.01);0.32-2.56 mg/mL water elution and 30%,50% ethanol elution,0.16-2.56 mg/mL 60%,70% ethanol elution and 1.28-2.56 mg/mL 95% ethanol elution can obviously inhibit His-induced contraction of tracheal rings,antispasmodic rates were obviously increased (P<0.05 or P<0.01). The effects of 2.56 mg/mL 60% ethanol elution ap-proach to aminophylline. CONCLUSIONS:Different elutions of H. cuspidatus has certain antagonistic effect on the ACh-induced or His-induced smooth muscle contraction of isolated tracheal in Guinea pigs;60% ethanol elution shows the strongest effect, which has similar effects with aminophylline at high mass concentration.

ABSTRACT AIM To investigate the effect of ch-itosan on protein kinase C (PKC) activitives and diacyl glycerol(DAG)concentration in murine peritoneal macrophages. METHODS A new ion-pair reversed-phase high liquid chromatography and ra-dioimmunoassay were used to determinate the activity of PKC and the concentration of DAG respectively. RESULTS ( 1) Chitosan induced activation and translocation of PKC in murine peritoneal macrophages. The peak time was 25 min and the activity of PKC came back the basic level at 1. 5 h. (2)Chitosan increased the production of DAG in murine peritoneal macrophages. The peak time was 30 s and the concentration of DAG came back the basic level at 3 min. CONCLUSION The im-munopoteniating effect of chitosan may be associated with the channel of DAG /PKC.

OBJECTIVE To compare the difference of testing cleaning effectiveness in the operation instrument between the eye measurement and hemoglobin enzyme test.METHODS Five batches of instrument after cleaning were tested by two methods.RESULTS By eye inspection,all tested samples were qualified.However there were only 76 percent of samples qualified according to enzyme test.CONCLUSIONS Compared with eye inspection,enzyme test is a more sensitive method.Enzyme test can better assess the cleaning effectiveness than others.

In this article,the oral medicine laboratory teaching of non-oral medicine international students was analyzed and summarized. Teaching plan should be made in accordance with the aptitude of students and goal of training. We used many teaching methods such as multimedia teaching,demonstration with teeth in vitro,etc and acquired good teaching effects. It gives us many experiences for the future teaching.

Objective To observe the effect of inhaled glucocorticoids combined with theophylline in smoking patients with bronchial asthma.Methods Seventy-three patients with bronchial asthma were enrolled in this study and they were divided into observation group (34 cases,smoker) and control group(39 cases,no-smoker).They all accepted inhalation of budesonide 200 μ g/suck,bis in die,plus aminophylline tablet (0.1 g,ter in die,per os) for 3 months.After treatment for 3 months,the basal control rate was compared between two groups.The levels of asthma control test (ACT) score,peak expiratory flow (PEF),the first second forced expiratory volume accounted for the percentage of prediction (FEV1％pred),eosinophil leukocyte (EOS) count and immunoglobulin E(IgE) in two groups before and after treatment for 3 months were compared too.Results After treatment for 3 months,the basal control rate in observation group was 88.24％ (30/34),in control group was 92.31％(36/39),and there was no significant difference(P＞ 0.05).After treatment for 3 months,the levels of ACT score,PEF and FEV1％pred in two groups were increased and the levels of EOS count and IgE were decreased than those before treatment,and there were significant difference (P ＜0.05).After treatment for 3 months,the levels of ACT score,PEF,FEV1％ pred,EOS count and IgE in observation group were (22.43 ± 2.64) scores,(292.52 ± 98.64) L/min,(74.87 ± 4.83)％,(270 ± 180) × 106/L,(68.25 ± 13.89) U/L,in control group were(22.81 ± 2.27) scores,(300.34 ± 100.45) L/min,(75.26 ± 5.04)％,(210 ± 170) × 106/L,(65.47 ± 11.28) U/L,and there were no significant differences (P ＞ 0.05).Conclusions Low dose inhaled glucocorticoids combined with theophylline in treatment smoking and non-smoking asthmatics patients are equal.It can improve asthma symptoms and lung function,improve hormone sensitive and reduce airway inflammation.

AIM:To investigate the effect of insulin and gliclazide therapies on the liver fat accumulation in type 2 diabetic rats .METHODS:A high-fat diet plus low-dose streptozotocin was implemented to establish a type 2 dia-betic rat model, and the rats were randomly divided into diabetes mellitus (DM) group, diabetic rats treated with insulin ( INS) group, diabetic rats treated with gliclazide per os ( PO) group, and normal control ( NC) group.The diabetic rats in INS group and PO group were given insulin and gliclazide for 3 weeks, respectively.The changes of the liver fatty were evaluated with oil red O staining .Fasting plasma adiponectin concentration was measured by ELISA .The expression of adi-ponectin receptor 1 ( AdipoR1 ) was detected by real-time PCR.The protein levels of AMP-activated protein kinase (AMPK), phosphorylated AMPK on threonine 172 ( Thr172p-AMPK), sterol regulatory element-binding protein 1c (SREBP-1c), phosphorylated SREBP-1c on serine 372 (Ser372p-SREBP-1c), acetyl-CoA carboxylase (ACC), phospho-rylated ACC on serine79 (Ser79p-ACC) and immunoglobulin-binding protein (BiP) in the liver homogenate were deter-mined by Western blotting .RESULTS:Compared with the normal rats , in DM group, the presence of cytoplasmic lipid deposits was confirmed by oil red O staining .In INS group, these changes were significantly lower than those in DM group . Similar results were obtained in PO group .Insulin therapy significantly increased the plasma concentration of diponectin and liver tissue levels of AdipoR1 compared with DM group.At the same time, these 2 indicators returned to normal levels after gliclazide therapy .Thr172p-AMPK/AMPK, Ser372p-SREBP-1c/SREBP-1c and Ser79p-ACC/ACC expression ratios were significantly reduced in DM group compared with control values .The expression of BiP was increased on the contrary . After insulin therapy, Thr172p-AMPK/AMPK and Ser372p-SREBP-1c/SREBP-1c were significantly increased, and Ser79p-ACC/ACC and BiP returned to the normal levels .After gliclazide treatment, Thr172p-AMPK/AMPK and Ser372p-SREBP-1c/SREBP-1c returned to the normal levels , the expression ratio of Ser79p-ACC/ACC had no significant improve-ment compared with DM group , and the expression of BiP significantly declined .CONCLUSION: Both the insulin and gliclazide therapies reduce the lipid deposition in the liver of rats with type 2 diabetes by activating AMPK , but the extent and mechanism are not the same.In insulin therapy, AMPK restrains the expression of SREBP-1c directly, increases the phosphorylation of SREBP-1c, and affects SREBP-1c by inhibiting the endoplasmic reticulum stress .Gliclazide treatment, which has no effect on the lipid oxidation , reduces lipid deposition in the liver only through the phosphorylation of SREBP-1c and the suppression of the endoplasmic reticulum stress .