Objective:To evaluate the clinical efficacy and safety of repaglinide and gliclazide in the treatment of elderly type 2 di-abetes mellitus (T2DM). Methods:A total of 225 T2DM patients with the age over 60 were enrolled and randomly divided into repa-glinide group (n=112) and gliclazide group (n=113). The repaglinide group was given repaglinide 0. 5~2 mg, po, tid, while the gliclazide group was given gliclazide modified release tablets 30~120 mg, po, qd,both with the treatment course of 12 weeks. The level of FPG, 2h PG, HbAlC, TC and TG and the side effects were observed and the clinical efficacy was compared between the two groups. Results:The level of FPG, 2h PG, HbAlc and TC in the two groups showed significant decrease after the treatment (P<0. 01 or P<0. 05), and the level of 2h PG was decreased more significantly in the repaglinide group (P<0. 05). There were no significant differ-ences in the total effective rate (91. 8% vs 86. 2%), hypoglycemia incidence (4. 5% vs 8. 2%) and ADR incidence (6. 4% vs 10. 1%) in the two groups (P>0. 05). Conclusion:Both repaglinide and gliclazide show safe and reliable efficacy in the treatment of elderly T2DM.

Objective To investigate the effects of propofol on lipopolysaccharide (LPS)-induced brain injury in rats.Methods Fifty-four pathogen-free SD rats of both sexes, aged 6 weeks, weighing 200-250 g, were randomly divided into 3 groups: control group (group C, n = 6) ; LPS group (group L, n = 24) ; propofol group (group P, n = 24) . Brain injury was produced by injection of LPS 1 mg/kg via the left internal carotid artery in L and P groups. Propofol 100 mg/kg was injected intraperitonealry immediately after the LPS administration in group P, while the equal volume of normal saline was given instead of propofol in group L. The equal volume of normal saline was given instead of LPS and propofol in group C. Six rats in each group were sacrificed and the brain tissues were immediately removed at 24 h after intraperitoneal administration in group C, and at 6, 24, 48 and 72 h after intraperitoneal administration in L and P groups for determination of brain water content, high-mobility group box 1 ( HMGB1) expression and NF-κB activity, and microscopic examination. Results The brain water content and NF-kB activity were significantly increased, and HMGB1 expression was up-regulated in group L as compared to group C (P ＜ 0.05) . The brain water content, expression of HMGB1 and NF-kB activity were significantly lower in group P than in group L ( P ＜ 0.05) . The microscopic examination showed that brain injury was attenuated in group P compared with group L. The brain water content was positively correlated with the HMGB1 expression and NF- κB activity (r = 0.692 and 0.769 respectively, P ＜ 0.05). Conclusion Propofol can reduce the LPS- induced brain injury by reducing inflammatory response of the brain tissues.

Objective Discbuss the hypertension prevalence rate in the Wuhan male taxi drivers and the dangerous factor to provide the basis for its professional publie health work. Methods The Wuhan male taxi drivers were carried on the healthy physical examination who in the Hubei province medicine medical examination center during 2005-2007 and were carried on the epidemiology statistical analysis. Results The Wuhan male taxi drivers hypertension prevalence rate is 28.28%. That is higher than the common crowd. Hypertension leaves outside the heredity factor and be closely correlated with the age of harnesses, the body weight index, and so on. Conclusions The Wuhan male taxi drivers'hypertension prevalence rate is unoptimistic. We should take the synthesis preventing and controlling measure to reduce this crowd hypertension prevalence rate.

Objective To investigate the application effect of pelvic rocking with balloon bionic midwifery in head dystocia. Methods Prospective research method was selected, and 400 pregnant women with head dystocia were divided into 2 groups by random digits table method with 200 cases each. The observation group was given pelvic rocking with balloon bionic midwifery delivery, and the control group was given gauge and comfortable posture with manual rotation fetal head delivery. The labor stage and delivery outcome were observed in two groups. Results The rate of successfully correct the fetal position was 91.00%(182/200) in observation group and 65.00%(130/200) in control group,and there was significant difference between 2 groups, χ2=39.394,P<0.01. The cesarean section rate was 7.00%(14/200) in observation group and 27.00%(54/200) in control group,and there was significant difference between 2 groups, χ2=113.119,P<0.01. The first, second and total labor stage were (8.86 ±2.20), (0.72 ±0.52), (9.78 ±2.82) h in observation group and (12.60±2.10), (1.02±0.82), (13.83±3.01) h in control group, and there were significant differences between 2 groups, t=15.684,4.058,12.609, P<0.01. The incidence of episiotomy, perineal laceration of Ⅱ degree, fetal distress, neonatal asphyxia and postpartum hemorrhage were 17.20%(32/186), 6.45%(12/186), 1.00%(2/200), 0, (150.80 ±43.54) ml in observation group, and 42.47%(62/146), 41.48%(61/146), 9.00%(18/200), 3.00%(6/200), (254.60±83.50) ml, and there were significant differences between 2 groups, P <0.01 or 0.05. Conclusions Pelvic rocking with balloon bionic midwifery can effectively correct the fetal position, reduce head dystocia and cesarean section rate, shorten the first labor stage, the second labor stage, reduce the occurrence of complication of mother and infant.

Objective To investigate the status of the non-psychiatrist' s diagnostic and therapeutic ability of depression/anxiety disorders in 57 General Hospitals.Methods 1 152 non psychiatric clinicians in 57 general hospitals were surveyed.A custom-made questionnaire included the training of mental health-related knowledge which the general hospital physicians received and typical anxiety/depression case analysis.Results Among 1 521 non-psychiatric clinicians,596 (51.74％) clinicians participated the training of psychiatry,562 (48.78％) participated the training of medical psychology and 230(20.97％) clinicians participated the training of Healthy Psychology.In professional setting,59 (5.12％) clinicians participated the training of psychotherapy,255 (22.14％) clinicians had attended related academic symposiums.80(6.94％) clinicians believed that they understand the clinical display of anxiety/depression disorders,52 (4.51％) clinicians expressed the understanding of diagnostic criteria of anxiety/depression disorders and its treatments,while 44(3.82％) clinicians only possessed the knowledge of anxiety/depression disorder treatment.In the typical case analysis,it revealed that 794 (68.89％) clinicians made accurate diagnosis,458(57.68％)clinicians made a choice of medical treatment,764(96.22％) clinicians chose psychotherapy,29 (3.65％) clinicians applied physical therapy,while 438 (55.16％) clinicians combined drug therapy with one or more other therapeutic methods.Binary logistic regression analysis showed that the age(P=-0.093,Exp(B)=0.911)and work experience(P=-0.002,Exp(B) =1.080)significantly contribute to the diagnostic accuracy of non-psychiatrists.Conclusion The non-therapeutic psychiatric clinicians in general hospitals have certain basic knowledge of depression/anxiety disorders with lower level of diagnosis and treatment diagnosis and treatment.And there is bigger difference among different hospitals.

Objective To analyze optimal amount of drinking water,ways of drinking water,timelimit of drinking water on the effect of bowel preparation for intravenous pyelography (IVP) examination after oral administration of 50% magnesium sulfate 60 ml. Methods 200 patients who gave their consentfrom June 2009 to February 2010 drank 50% magnesium sulfate 60 ml for IVP check were divided into four groups. Group A: a large amount of graded oral administration of warm water 1200 ml within 1h; Group B: a small amount of oral administration of warm water 1200 ml within 1h;Group C: a large amount of graded oral administration of warm water 2000 ml within 1h; Group D: a medium amount of graded oral administration of warm water 1200 ml within 2 h. And then the bowel preparation effect of the four gro ups were analyzed. Results Through the comparison, group A was much better than the other groups on the aspects of cathartic satisfaction, the effective degree of reading films and flatulence. Conclusions To take a large amount of graded oral administration of warm water 1200 ml within 1h can improve cathartic satisfaction,the effective degree of reading films and flatulence.

The glutamate transporter EAAT 2 ( rodent nomencla-ture GLT-1:glutamate transporter 1), which is a predominantly astroglial glutamate transporter in the hippocampus and the pre-frontal cortex , is responsible for the majority of extracellular glu-tamate uptake .The glutamate transporter EAAT 2 can decrease the high levels of glutamate in the synaptic cleft , avoiding gluta-matergic excitotoxicity to damage the glial cells and neurons . Currently, the transporter EAAT2 has become a research hotspot of depression .This article aims to summarize roles of glutamate transporter EAAT2 in the occurrence and treatment of depres-sion.

Objective To investigate the characteristics of the event related potential(ERP) P300 and analyze brain network connections in patients with first-episode depressions.Methods P300 auditory oddball task were administrated on twenty-nine patients and twenty-five healthy controls.The P300 amplitude and latency of two groups were compared,and the brain network connectivity of the two groups were analyzed using Granger's Causality analysis.Results The P300 amplitude in depression group were significantly different from those in control group (C3 of the central regions(15.77±7.35) μV vs (20.90±7.82)μV;C4 of the central regions(16.98±7.21) μV vs (22.11±7.50) μV;P3 of the parietal regions(15.65±6.92) μV vs (19.49±5.73) μV;P4 of the parietal(16.35± 6.46) μV vs P4(19.72±5.18) μV;P=0.009,P=0.007,P=0.017,P=0.024 respectively).However,the P300 latency had no significant difference comparing to the controls(P＞0.05).The results also showed that patients had more connections in the brain network.Conclusion As an effective evaluation index,ERP P300 can play an important role in clinical diagnosis of depression.Patients suffering from depression have significant cognition function deficit.

Objective To investigate the effects of different duration of fluoxetine and escitalopram administration on depressive-like behavior and hippocampal BDNF expression in adult rats.Methods Ninety-six SD rats were randomly divided into twelve groups: (1)M 1 group: normal control for one week, (2)M2 group: CUMS +saline for one week, (3)M3 group: CUMS+fluoxetine for one week, (4) M4 group: CUMS+escitalopram for one week, (5) M5 group : normal control for two weeks, (6) M6 group : CUMS+ saline for two weeks, (7) M7 group : CUMS+fluoxetine for two weeks, (8)M8 group: CUMS+escitalopram for two weeks, (9)M9 group: normal control for three weeks,(10) M10 group: CUMS+saline for three weeks, (11)M11 group: CUMS+fluoxetine for three weeks, (12) M8 group: CUMS+escitalopram for three weeks.After CUMS procedures,rats in M2 group,M6 group and M10 group were injected with saline, M3 group, M7 group and M11 group were injected with fluoxetine, and rats in M4 group,M8 group,M12 group were injected with escitalopram.After one week of intervention,the openfield test and 1％ sucrose preference test were performed to evaluate depression-like behaviors in rats of M1 group, M2 group,M3 group and M4 group.After behavior test,rats were sacrificed and the hippocampi were isolated.The expression of BDNFmRNA was detected by using real-time quantitative PCR.After two weeks of intervention, rats in M5 group,M6 group, M7 group and M8 group underwent the same behavioral.After three weeks of intervention, rats in M9 group, M10 group, M11 group and M12 group underwent the same behavioral test.Results In the open-field test,total distance travelled in 10 minutes was significant difference among the following groups: M1 group ((3925.70±322.32) cm) vs M3 group ((1841.85±786.33) cm) ,M6 group ((1820.31±296.00) cm) vs M8 group ((4002.72± 1447.19) cm), M10 ((1961.66±919.16) cm) group vs M11 group ((3741.72± 1064.46)cm) ,M10 group ((1961.66±919.16) cm) vs M12 group ((4280.43±1187.05) cm).In the 1％ sucrose preference test,the difference of sucrose preference consumption was statistically significant (P＜0.05) among the following groups: M2 group ((56.23±7.49)％) vs M4 group ((70.55±4.96)％), M6 group ((60.22±8.81)％) vs M8 group ((75.08±4.15)％) ,M10 group ((60.26±7.20)％) vs M11 group ((73.88±7.73)％) ,M10 group ((60.26 ± ±7.20)％) vs M12 group ((73.52±7.58)％).The expression level of BDNF was significant difference among these groups: M2 group (0.66±0.14) vs M4 group (1.15±0.20) ,M10 group (0.90±0.15) vs M11 group (1.22± 0.09) ,M10 group (0.90±0.15) vs M12 group (1.48±0.20).Conclusion Both of fluoxetine and escitalopram can improve depression-like behaviors in rats and significantly increase the expression of the hippocampal BDNFmRNA.Compared with fluoxetine,escitalopram has a shorter onset time in the treatment of depression.It may be related with a rapid increase of the expression of BDNF mRNA.

Aim To investigate the effects of fluoxe-tine on the changes of of protein levels of GLT-1 in pre-frontal cortex in rat depression model, and to further explore the molecular mechanism of antidepressant ac-tion of fluoxetine. Methods Sixty male SD rats were randomly assigned into three groups: control group, chronic unpredictable stress ( CUS) group, and CUS+fluoxetine group. The rats of CUS group and CUS+flu-oxetine group were subjected to CUS for 2 sessions per day for 35 days. Then, the rats of the CUS+fluoxetine group were given fluoxetine for 28 days. Behavioral changes were assessed by the sucrose preference and open field tests. The GLT-1 protein levels in the pre-frontal cortex were detected by immunohistochemistry and Western blot analysis at the end of the fluoxetine treatment. Results ( 1 ) Compared with the control group,sucrose preference, total traveling distance, ve-locity and frequencies of rearing were reduced in the CUS group ( P < 0. 01 ) . These behavioral changes could be reversed after 28 day fluoxetine treatment. (2 ) Immunohistochemistry assay indicated weak im-munoreactivity for GLT-1 in the prefrontal cortex of CUS group ( versus the control rats: P <0. 01 ); the immunoreactivity for GLT-1 of the fluoxetine-treated rats was significantly up-regulated compared with the CUS group rats ( P<0. 01 ) . ( 3 ) Western blot analy-sis indicated significant reductions of GLT-1 in the pre-frontal cortex of CUS group ( versus the control rats:P<0. 01 ) , and chronic fluoxetine treatment reversed the CUS-induced decrease in GLT-1 levels ( P <0. 01 ) . Conclusions Chronic unpredictable stress ( CUS ) could down-regulate the GLT-1 protein levels in the prefrontal cortex, which is reversed by fluoxe-tine. These results further support the notion that en-hanced expression of the GLT-1 protein could be mo-lecular mechanism of fluoxetine antidepressant effect.